572 100 60584 https://digital.lib.buffalo.edu/files/original/b9346049fc802407de3096818844a090.JPG b4f24b39888f8bd9e65005ac207a52a6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3177 Title A name given to the resource Display ad for German child-oriented "Jump City" Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource The poster advertises trampolines and illustrates other child-oriented activities at a special club. Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Berlin (Germany) Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Language A language of the resource de Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f5235bb7394053f4c5fa139348036d30.JPG 7c72f0b29add802f9c7a8ef8840970c4 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3178 Title A name given to the resource Ads for knight's festival near Berlin Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource Drawing on romanticism for the Middle Ages, these posters advertise a 'knight's festival,' to be held at a Berlin-area estate. Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Berlin (Germany) Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Language A language of the resource de Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/2611f2fc6428ad3df8aac326eed5237b.JPG 4234dfd94e45ee5b48771df963f80d6e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3179 Title A name given to the resource Old or new Town Hall? Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource Wittenberg has both maintained its former town hall and built a new one, as the sign indicates. Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Wittenberg (Germany : Landkreis) Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Language A language of the resource de Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/fdd34257908c3aff6d99585bc9870174.JPG 08e99f16b5ade3ad82f6b7397f905206 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3180 Title A name given to the resource Stylized theater sign, Magdeburg, Germany Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource Designed in the style of Hundertwasser, this sign directs patrons to the "Green Citadel" Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Magdeburg (Germany) Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Language A language of the resource de Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/2c97a65e1b239d47eb456388fad4555b.JPG 405b1175636c866b7f2d5131df4620e7 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3181 Title A name given to the resource English-language poster touting Berlin as city of the future Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource Future office and commercial sites can be found in Berlin, the German text indicates. Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Berlin (Germany) Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Language A language of the resource en Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/13308bd09afd46241f9cbba009bd3737.JPG 939593059fb933fc971721eb34c4ec08 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Still Image A static visual representation. Examples of still images are: paintings, drawings, graphic designs, plans and maps. Recommended best practice is to assign the type "text" to images of textual materials. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Identifier An unambiguous reference to the resource within a given context psc001_psc3182 Title A name given to the resource Ladies' room graphic sign Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Description An account of the resource Prepared in the spirit of Hundertwasser, this sign conveys its message quickly and clearly. Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant German Wittenberg Creator An entity primarily responsible for making the resource Welch, Claude Emerson Type The nature or genre of the resource Image Format The file format, physical medium, or dimensions of the resource image/jpeg Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Publisher An entity responsible for making the resource available State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/6bb5cab1456249f371735e36c185cb40.JPG 6eca6b9be1bdcf738c6516777b99fa57 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Welch-Ludwig Collection Description An account of the resource The images in this collection come from 35 mm. Kodachrome slides or .jpg pictures taken by Claude Welch, SUNY Distinguished Professor in the Department of Political Science. He started his teaching career in 1964, directly after completing his doctoral work at Oxford. The images reflect a wide span of his interests and continents, with particular strength in sub-Saharan Africa, Western Europe, India and China. The addition of metadata to this collection is an ongoing project. Identifier An unambiguous reference to the resource within a given context PC001 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Beer shampoo poster Description An account of the resource Residents of the Czech Republic consume more beer per capita than any other country in the world. Beer finds its way into other consumer products as well. Creator An entity primarily responsible for making the resource Welch, Claude Emerson Publisher An entity responsible for making the resource available State University of New York at Buffalo Date A point or period of time associated with an event in the lifecycle of the resource 2018-04 Format The file format, physical medium, or dimensions of the resource image/jpeg Language A language of the resource en Type The nature or genre of the resource Image Identifier An unambiguous reference to the resource within a given context psc001_psc3167 Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant Czech Prague (Czech Republic) Is Part Of A related resource in which the described resource is physically or logically included. Welch-Ludwig Collection PSC001 Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/77748a01ec55afafcc2f48fa6ec5306b.pdf ad6ae51514747afafbd5808acf1aac8b PDF Text Text Volume 21, Number 5 I and Biomedical Scientist Study lryDr. Lau,renceBone demonstratesneed for aggressivesurgeryin trauma cases Lace Winter 1988 �Dear Alumni, Alumnae and Friends: STAFF EXECUTIVEEDITOR UNIVERSITY PUBLICATIONS Robert T. Marlett BUFFALOPHYSICIAN EDITOR Connie Oswald Stofko ART DIRECTOR Alan J. Kegler PHOTOGRAPHY DouglasLevere EdNowak Ian Redinbaugh Simon Tong ADVISORYBOARD Dr. John Naughton, Chairman Dr. Harold Brody Mr. Kevin Craig Ms. Karen Oryja Ms. Nancy Olieco Dr. James Kanski Ms. Marion Marionowski Dr. Daniel Morelli Dr. Charles Paganelli Mr. James Phillips Mr. John Pulli Dr. Robert Scheig Mr. Mike Shaw Mr. Steve Shivinsky Mr. Raul Velasquez Dr. Mary Voorfiess Dr. John Wright Dr. MaggieWright Dr. Franklin Zeplowit:z Dr. Joseph Zizzi,Jr. TEACHINGHOSPITALS BuffaloGeneral Children's Erie County MedicalCenter Mercy Millard Fillmore RoswellPark Memorial Institute Sisters of Charity Veterans Administration Medical Center Producedlry ihe Divisionof University Relatumsin associationwith ihe School of Medicine,State Universityof New Yorkat Buffalo. THE BUFFALO PHYSICIAN (USPS 551-860) Late Winter 1988, Volume 21, Number 5. Publishedfive times annually: Late Winter, Spring, Summer, Fall and Early Winter - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk postage paid at Buffalo, New York. Send address changes to THE BUFFALOPHYSICIAN, 146 C.F.S. Addition, 3435 Main Street, Buffalo, New York 14214. Cover Photo: Dr. Lawren ce Bone,photographedb:,Rob McElroy. T he medical school has embarked on its second Institutional Self-Study in preparation for the accreditation visit by the Liaison Committee on Medical Education (LCME) Survey Team scheduled for November of this year. The first self-study was condurn:d in 1980. We have set an ambitious time-table in that all committee work is scheduled tO be completed during the first six months of 1988 so that a final document can be edited and collated for submission to the LCME by September. Just as was done in 1980, a large steering committee has been assembled with representation of University administration, hospital board members and administrators, department chairmen, faculty and students, alumni, practicing physicians and members of my staff. In contrast tO 1980 , the established commim:es of the Faculty Council are serving as the working committee for the various areas to be reviewed. External representatives have been added to the membership of each committee to ensure that as much communication and cross-fertilization as possible can be and is facilitated. When the task is completed this summer, we will have an appreciation of the progress made since 1980, the current status of the medical education enterprise in Buffalo, and an agenda of tasks to be accomplished bt::tween now and 1995. These outcomes will be summarized in a future issue of the Physician. As I had indicated in an earlier letter, the timing for this study is fortuitous since it comes during the 25th anniversary year of the merger ofUB with SUNY. The process should be helpful to the life and vigor of the institution and in preparing us for a successful accreditation visit next fall. Sincerely, John Na ughton , M.D. Vice Presidentfor Clmrcal Affairs Dean, School of Medrcine Medical Alumni President's Message I t gives me a great deal of pleasure to announce that the recipient of the Stockton Kimball Memorial Award for 1988 will be Dr. Robert Gale of the University of California at Los Angeles - UCLA. Dr. Gale is a 1970 graduate of the University at Buffalo School of Medicine and has distinguished himself in the field of bone marrow transplantation. His prominent role in leading the American effort in aiding the Soviet Union after the world's worst nuclear disaster is, I am sure, well known to all of you. His involvement in this endeavor as well as his consu lt ant role in other nuclear accident incidents continues. His timely and info rm ative lecture at the luncheon will be a highlight of an outstanding program at "Spring Clinical Day and Reunion Weekend" - May 7, 1988. The morning scientific program will be devoted to Controversies and Treatment of AIDS, Breast Cancer, and Coronary Arte r y Disease with national and local experts . Mark your calenda rs now so that we can welcome as many of you as possible from around the count ry and the Western New York area to this program and to your five-yea r reunions. Your A lu mni Association continues co play a prominent role in Medical School affairs, with you r President being a member of the Executive Committee of t he School and a member of the Steering Committee and Executive Committee of the "Liaison Committee for Medical Education" - LCME which is self-evaluating the School prio r to the acc reditation survey in the fall of 1988. If you have not become an Active or Life Member of the Medical Alumni Association, please do so now, so that you can help us continue and expand all the activities I mentioned in the last Newsletter. - Sincerely, Franklin Zeplowit~, M.D. '58 �BUFFAlD Volume 21, Number 5 PtIX§l~~ Late Wint er 1988 2 Lead Poisoning. Screening children for lead poisoning should be a routine part of medical care, Public Health Official urges. 7 Black Monday. One man lost his shirt in the market crash and shot his stockbroker; others shrugged it off. Why the difference? 8 Premenstrual Syndome. Dr. Uriel Halbreich, head of a new Life~ Cycle Center, finds the term premenstrual changes or PMC more accurate. 11 Leeches. What do leeches and microsurgery have in common? Plenty if you ask Dr. Kulwant Bhangoo. 14 Lawrence Bone M.D. Thousands of lives lost following auto accidents and other causes of severe trauma co uld be saved, this orthopaedic surgeon has found, if a new surgical approach is adopted. Departments Page8 Page 14 17 Research. Unique Roswell case report was the key to a breakthrough genetic study published recently by British scientists. 21 Medical School News. The Buffalo General Hospital, a major UB teaching hospital, is establishing the State's second heart transplant center. 30 Classnotes . Two Med School graduates are the co~founders of the Comprehensive Headache Center at The Germantown Hospital and Medical Center in Philadelphia. News of the classes. 35 Hospital News. The Batavia Veterans Administration Center becomes UB's ninth affiliated hospital. 36 Deaths. Medical �POISONING Samephysicianssay it isn't a problemin theirareas becausethey haven'tseena casein 20 years. But many childrenshowno overtsymptoms,healthofficialwarns BY CONNIE OSW ALO STOFKO S creening children for lead poisoning should be a routine part of medical care, recommends Jane S. Lin-Fu, M.D., whose research was instrumental in the federal legislation that banned lead from household paint. Some physicians say that lead poisoning isn't a problem in their area because they haven't seen a case in 20 years. But many children with lead poisoning show no overt symptoms, Lin-Fu cautioned. Even when there are overt symptoms, they're so vague that they're often misdiagnosed, she noted. It's nearly impossible to detect lead poisoning without a blood test. It's also a myth that lead poisoning affects only inner-city children, she added. It's a ''Yuppie" problem, too, especially for those who move into older homes and do the renovat ion themselves. in-Fu is acting chief of the genetics services branch of the Health Resources and Services Administration. That's pa rt of the U.S. Public Health Services. She recently gave a lecture sponsored by the Research Center for Child ren and Youth, one of UB's eight organized research centers. In the United States, Lin-Fu estimates, tens of thousands of children are affected by this condition, which can lead to retardation and even death. While it can affect adults, children are more prone to lead poisoning for many reasons, including the fact that child ren have greate r L Late Winter '8 8 intestinal absorption and retention and their organs are more immature. Routine screening is important because there's convincing evidence that undue lead absorpt ion in early life may be associated with neuropsychological deficiencies and behavioral disorders, leading to learning disabilities. This happens before there are any overt symptoms, Lin-Fu said. And even when it gets to the point of overt symptoms, there's no guarantee that lead poisoning will be detected without a blood test, she noted. The symptoms are vague: irritability, refusal to play, apathy, poor appetite, occas ional vom iting, sleep disturbances, stomach aches, and constipation. Lin-F u , who has three children of her own, noted that these symptoms are common to "no rm al" children. "You have to be very astute to pick it up as lead poisoning," she said. "You can't rely on signs and symptoms to diagnose it." Those are the relatively early symptoms, she said. If nothing is done, the child can experience developmental delays and regressions . A child may stop making sentences or stop jumping. The child may have protracted vomiting, ataxia, or convulsions, or even die. Even when the condition gets to the convulsions stage, lead poisoning can be misdiagnosed. A two-year-old with lead poisoning was operated on twice because it was thought she had a brain tumor, Lin-Fu said. The test for lead poisoning, eryth r ocyte protoporphyrin (E P), is cheap, she said, and has the added advantage of picking up iron deficiencies.Just a small amount of blood from a finger prick is needed. The equipment, a hematofluorometer, costs about $4,000 and is cheap enough to be purchased by a clinic, she pointed out. Because it gives an instantaneous d igital readout, follow-up tests can be performed while the child is still in the office. There's no loss of follow-up. But how much lead is too much lead? The answer has been changing in the last two decades, Lin-Fu noted. Unlike calcium, zinc, or iron, which the body needs in certain amounts, the body doesn't need any lead at all. But researchers forgot that fact when they tried to define "normal" lead levels, she said. "They started studying the 'normal' population, not realizing that the 'no rmal' population was contaminated." In 1970, the accepted level of lead in the blood was a whopping 60 micrograms . Lin -Fu fought a tough battle to get it lowered to 40 micrograms. Today, even 40 is considered much too high, she noted . Various agencies in the past few years have recommended 25, 20, or even 10.S. Lin-Fu said she doesn't know whether the accepted limit should be dropped to zero . She noted that people in the Himalayas were tested and even they had 3 micrograms of lead. There is disagreement ove r when treatment should begin , she noted. The treatment is painful. It Buffalo Physician and Biomedical Scientist �can also be dangerous because it removes vital zinc and forces some of the lead to the brain. Even if the physician decides not to treat the condition, it's important to look for lead in the environment, Lin-Fu said. 3 A major culprit is lead paint on walls. Th e ban on lead in household paint didn't go into effect until 1978, she noted. Lead abatement must be done carefully. If done improperly, scraping the paint off the walls can actually do more harm because it creates fine particles which can be more easily absorbed, she explained. Once the particles get into the rugs and curtains, a regular vacuum cleaner won't pick them up. During lead abatement, it's important to get everyone out of the house, remove all belongings that can be moved, cover everything that remains, and clean up carefully. Disposal of the lead is a problem, too. She noted that when people remove lead from their houses, they just put it in plastic bags and take it to a dump. But it doesn't change into some other substance when burned; the problem is just recycled. ead paint isn't the only source of lead poisoning, Lin-Fu said. "We pay a price" for living in this modern world, she said. "Lead is in the air you breathe, the food you eat, and the water you drink." The elevated lead levels of most children aren't caused by eating paint chips, as was once thought, Lin-Fu pointed out. Small children put their hands in their mouths a lot and ingest the lead from household dust and soil they pick up while playing. Another source of lead is water that sits overnight in pipes soldered with lead. "New houses, including the one I moved into two years ago, have copper pipes with lead solde r ," she noted. People are advised to run their water each morning to get rid of the stagnant water. L Buffalo Physician and Biomedical Scientist Late Winter '88 �4 Othe r sources of lead include industrial emissions, burning at city dumps, storage batteries, ammunition, improperly glazed dinnerware, burning old wood that's covered with lead paint, arts and crafts supplies, colo red ink for newspaper, smoking, some alcohol, and cosmetics such as Grecian Formula. Some folk remedies contain lead as well. "Health care providers must remem- ber this is a land of immigrants," Lin-Fu said, and that people bring these remedies with them. A couple of sources of lead are on the decrease. Leaded gasoline has been banned for newer cars. In the four yea rs since the ban, blood lead levels have decreased 30 per cent. Lin-Fu is convinced the ban should get the credit. "Nothing else could explain such a dramatic drop," she explained. Lead solder for food cans is also on the wane. In 1979, 90 per cent contained lead solder. In 1986, only 28 per cent did. Lead poisoning is still a problem, even though we've known since early in this century that it's preventable, Lin-Fu pointed out. "Here we are 70 years later still talking about lead poisoning," she remarked. • Two UB units working on lead study T wo UB units are working together to compare lead levels in the umbilical cords of newborns to medical and socio-economic data, with an eye to how that information may be related to developmental disabilities. The two units are the interdisciplinary Research Center for Children and Youth and the Division of Developmental and Behavioral Neurosciences of the Department of Neu ro logy in UB's School of Medicine and Biomedical Sciences. During pregnancy, lead is mobilized just as calcium is and may go to the fetus, explained David Shucard, Ph.D., professor of neurology and pediatrics and director o f the Divisio n of Developmental and Behavioral Neurosciences. No one knows what levels oflead are toxic, Shucard noted . The other researchers o n th e project include: • Janet Shuca rd, instructor in neurology at UB • Matthew Lanighan, Ph .D., clinical instructo r in medical technology at UB and assistant director of public health for the Erie County Public Health Laboratory • Robert J . Patterson, M.D., clinica l associate professor ofGYN-OB at UB and clinical chief in the depa rtme nt of GYN-0B at Child ren's Hospital • Robe rt Gu thr ie, Ph.D., M.D., professor emeritus in pediatrics and neurobiology In February, the researchers expected to finish collecting abou t 1,200 blood samples from births at Children's Hospital. The blood is taken routinely Late Winter '88 for other tests, Shucard noted. The researchers also collected medical and socioeconomic data from the mothers' and babies' charts . The informa t ion included the baby's gestational age, b irt h weight, Apgar scores, sex, and order of birth in the family. Information on the mother included hemoglobin level ( there may be a relationship between lead and anemia, Shucard explained), any complications during pregnancy, age, education, and where she lives. Where the women live may show if certa in local areas have higher lead levels than others, he noted. Unlike toddlers, the mothers aren't eating paint chips. The researchers have been looking for fund ing to pay salaries of a gr aduate student and clerical help to analyze the data. State money is available for screening, Shucard noted, but this project doesn't co unt as screening because there are no existing guidelines o n what levels oflead are considered high for u mbilical blood. T here have been very few stud ies in this count r y on the lead levels in umb ilical cord blood, Shucard said . Work is generally done with toddlers, not newborns. A large scale study is planned with federa l support. It will include more of the preventive and socia l aspects of lead poisoning, which are of major interest to Anthony M. Graziano, Ph.D., and Murray Levine, J.D . , Ph .D., the co-directors of the Research Ce nter for Child ren and Youth. • Buffalo Physician and Biomedical Scientist �Yes,I want to help PSRpreventnuclear war. D Pleasesend me more information. D I would like to host a PSRspeakerin my home/c ommunitygroup. D I want to makea tax deductiblecontribution of $____ to further PSR'swork. Name_ ____________ _______ ____ Street Address____________________ City,State, Zip ________ _ _ _ _ __ _ _ _ ~ hone____ PSR.1601ConnecticutAvenue, NW., Suite 800, Washington.D.C. 20009 _ �:I . :!' 1 l ', 5 t 5 ,.. - ,j .. 3 ;:- <,. (. ~. :.: . "! 7 i 9 , 8 8 t, , I_,";> •" • 9 0 7 7 I I • d s s ... ~ ~ S ;;- () l (, 0 9~ G . , 1 1 1i l 1 - . z 1., .... . ... l I - n ' <; ,, :, J - .) ~ ~ ,. ,. ., •... ;:. 1 ~ 2 '/ ,, :,. , . 'i .. i: : 6 0 ' .., .. 1 : "1 • -: 7 ·, I 1 I 7 -• I 7 t• _.. :"-.; s , a 1' ? ti s-s e a a ., -. .. • -l -~ i 9 { I .. £ 9 9 ~ J ~ t. S d , 9 ·-· "' "' :. C. <, r 0 ~ 11.G.(. 0 ·o' :. ( ~ ..... , (. J 7 ~ .... i..; 1t· 1 · • ".I 9 '• -1 1 J O " l 0 1 .,.s4.s4. 'L6 I 5 5 I\ ' '- - , _ , 6,6 J.., "-.' ' _-7· .,. ,.:''H•~,aa •C'9 •• • " ,rq•_t !f9 O ) �1 BIACKMONDAY Someinvestorsshrugged;otherspanicked.Why? BY CONNIE OSW ALO STOFKO 0 ne man lost his shirt on "Black Monday" and shot his stockbroker. Other investors lost just as much -or even more - in October's stock market crash and simply shrugged it off. Why ar e there such different reactions to the same event? It has a lot to do with both the individual's history and the significance of the loss, explained George Molnar, M.D., associate professor and vice chairman in the Department of Psychiatry at UB. Molnar has an interest in stress-related disorders. As a psychiatrist with the U.S. Army Reserve, he looks at the concept of stress and stress reaction to extreme situations. The stock market crash was a stressful situation and could be experienced by some individuals in the same way they would experience other extreme situations, such as a car accident, combat, or the loss of a parent, Molnar explained. These situations have different meanings for different people at different stages in life. T he significance of the loss to the individual is an important factor in how the person will react, Molnar said. Where the loss of $2,000 may break one investor, even a $1 million loss may be dismissed by another as just a "paper loss." The person's reaction also depends on his vulnerability, social supports, the intensity of stress, and how he deals with anger. Alcohol and other drugs can disinhib it behavior, such as violence, that's normally inhibited, Molnar said. One case of violence was the incident in Miami where a man incurred heavy losses and killed his stockbroker. But, according to newspaper accounts, the man apparently had a complicated life history, Molnar pointed ou _t. He was in the government's protected witness program. He may have been an unbalanced individual, prone to impulsive actions, particularly precipitated by events such as his sudden loss in the market. "So in addition to looking at the immediate stress, he was probably predisposed to acting this way," he pointed out. "It didn't come out of the blue." Buffalo Ph ysic ian and Biomdica l Scientist Indiffer enc e and homicidal anger are the two extremes, Molnar said. Many reactions fall in th e middle and can occur long after the crash or other traumatic event. Anxiety disorders, depressive disorders, or adjustment disorders are other means of response and reaction to such events. In some extrem e cases, ther e can be a brief reactive psychosis, Molnar said. Psychosomatic conditions such as hypertension, peptic ulcers, migraine headaches, and irritable bowel may also come into play. Some people just become irritable, angry, or depress ed and begin to self-medicate with alcohol. These feelings can add to ongoing marital conflicts. Stress over the course of the stock market doesn't affect just investors. People who work in the market, such as brokers and secretaries, feel it, too, Molnar pointed out. They find their jobs are more precarious, and their workdays are filled with pressure and angry clients. Often their self-esteem rides with their success in the stock market. "S everal individual s no doubt committ ed suicide, from what I read," Molnar said. Even people who don't have money in the market can feel anxious and alarmed when hearing news reports about the economic situation. S tress-related conditions are eminently treatable, Molnar said. If there are no previous complicating disorders, brief psychotherapy and medication should be sufficient. Treatment will diminish the severity of or remove symptoms and keep the condition from getting chronic. There shouldn't be excessive use of medication, Molnar pointed out; usually a single agent should be used. Molnar noted that most people haven't become ill from the stock market crash. "The great majority of individuals went about the normal business of their lives,'' he said. ''They weren't pleased with the loss of money, even if it was only a paper loss, but they took it in stride. They accepted it as part of doing business." • La tt: \Vintcr '88 �8 PREMENSTRUAL CHANGESARETHE FOCUSOFA NEW LIFE--CYCLE CENTER BY CLARE O'SHEA 0 n two different Friday nights, Jane goes to parties. On Friday night numbe r one,Jane and her boyfriend have three or four drinks and feel equally tipsy. The nex t Friday night, they go to another party and drink the same amount of alcohol. Jane 's boyfriend is no more tipsy than he was last week. But Jane is more impulsive, her concen tration is a little off, her memory's not as sharp as usual. This week, Jane is tipsier. She's also expecting her period. Such an effect of alcohol on women in the premenstrual phase is just one of many possible characteristics of the condition known as premenstrual syndrome, or PMS. Uriel Halbreich, psychiatry professor and director ofbiobehavioral research at UB, rejects the popular PMS label, however, in favor of PMC, or premenstrual changes. PMC is the more accurate term, Halbr eich believes, for a couple of reasons. The term syndrome implies more than one symptom; it is possible, though, to have just one change premenstrually. In addition , research has shown that positive as well as negative changes can be associated with the premenstrual phase . Lare Winter '88 T he study of premenstrual changes as a phenomena is relatively new. "There has been a tendency in the past for the problems associated with PMS to be minimized or simply dismissed by some physicians," Halbreich said. "Often the patient's complaints were not taken seriously or it was implied that he r symptoms were 'all in her head.' 11 PMC research has not been without controversy, either. For example, the theory that women usually are more sensitive to alcohol premenstrually than at other phases of the cycle, and in comparison to their male counterparts, can be a touchy one, ripe for accusations of male chauvinism, Halbriech pointed out. And, indeed, he said, certain preconceptions or biases, perhaps gender-related, may influence such research. A definition of the phenomena of premenstrual changes is still being worked out. According to Halbreich, symptom or symptoms are considered as PMC if: They reoccur cyclically, du ring the premenstrual phase ( that is, the late luteal phase, one to seven days prior to menstrual bleeding); they are significantly changed in severity compared to other times in the cycle; they subside shortly after the onset of menstrual bleeding. Without eve r having heard of PMS, many women recognize changes in the way they feel or behave just befo re the beginning of their periods. Some women are depressed, or go through rapid mood swings; others lack control, are aggressive or compulsive; still others might have an increase in sexual drive, in appetite or in sleep. Halbreich has found that some women consciously alter their behavior during this time - they drink less, for example, or try not to take complicated, high-performance tests. It's difficult to say , he added, just how many women have premenstrual changes. Although the symptoms are quite consistent in one woman, they can vary widely between women. Some women have symptoms for only one day; others for 14 days , the entire luteal phase. "If one defines PMC as including any noticeable changes, some people say up to 80 per cent of women are affected," Halbreich said. "If you count only women who seek treatment and in whom the premenstrual disorder is confirmed , it wou ld be somewhere between two to eight per cent of the normal women's population . 11 The premenstrual changes are conside red a disorder if there is an impaired function , socially or occupat ionally, Halbreich explained. "It also depends on how you do your research - on what group you study, for example," he continued. "We surveyed nursing students and over 90 pe r cent ( reported PMC). Among women executives or highly successful professionals, not even one ( of 23) reported premenstrual changes .'' H albreich has been studying PMC for more than 10 years. Before coming to UB in 1985, he was on the faculty of Albert Einstein College of Medicine in New York City. He was previously a faculty member at the medical schools of Columbia Univers ity and Buffalo Physician and Biomedi cal Scie ntist �lllUSTRATlON : GLYNISS'M:ENV �10 Hebrew University in Israel. Biological aspects of PMC were the focus ofHalbreich's initial studies of the condition. He soon realized, however, that certain methodological issues needed to be addressed first. For example, the groups of women under study were not homogeneous; they did not necessarily reflect the diversity of types of premenstrual changes. A reliable procedure for the clinical and research assessments of premenstrual phenomena did not exist. The Premenstrual Assessment Form, subsequently developed by Halbreich and his assoc iates , uses 95 different items to measure changes in mood, behavior, and physical condition during the premenstrual period. Rather than following the common practice of viewing PMC as a single entity, the form reflects the wide variability of PMC. "While there are more than 200 symptoms associated with PMS, the major ones are depression, anxiety, and diversified discomforts states, 11 Halbrei ch said. responsive to external stimuli. If taken to a party, they can be cheered up. Symptoms of atypical depression are quite similar to those of premenstrual depression. A women with premenstrual depression can also be cheered up at a party, for example. But there are differences, Halbreich pointed out. Premenstrual changes can last just one or two days. A woman would have to be depressed for at least two weeks, however, before she could be diagnosed as having a major depressive disorder. In addition, unlike atypical depression, premenstrual depression by definition is exclusive to one phase of the menstrual cycle, and the depression is usually not as severe. That leaves premenstrual depression out of the category of major depressive disorders. Interestingly, research has suggested that those women who have dysphoric PMC are more likely to develop more depressive disorders in the future than those who do not have dysphoric PMC, Halbreich said. A I s one of the most common of premenstrual changes, depression has undergone especial scrutiny. It has been suggested, by Halbreich and others, that there may be an association between dysphoric PMC ( characterized by abnormal moods, especially depression) and more severe depressive disorders, and that PMC can be studied as a model for such disorders. Among the several types of depressive disorders are atypical depression and endogenous depression, or melancholia, Halbreich said. Melancholia is associated with a variety of biological symptoms including decreased sleep, weight loss, severe depression, guilt feelings, and suicidal ideations. People with melancholia are miserable; if taken to a party, Halbr eich offered as example, they will not be cheered up. Atypical depression, although possible in both men and women, is more prevalent among women, he noted. There's an increase in appetite and sleep and a decrease in energy. People with this form of depressive order are very Late Winter '88 n recent months, his work has taken a multidisciplinary and practical approach in the form of a research and service clinic which evaluates and treats women suffering from negative PMC. The Life-Cycle Center at Millard Fillmore Hospitals, directed by Halbreich, is staffed by two physicians, two gynecologic nurse practitioners, a psychiatric nurse clinician, and a clinical social worker. "We very thoroughly evaluate each patient - though you can't really call them patients because we are dealing with normal women who have symptoms only a short time during their menstrual cycles, 11 Halbreich explained. "We are giving treatment which is aimed mostly at the elimination of the fluctuations of the gonadal hormones." It takes about six weeks to fully evaluate each patient at the Life-Cycle Center. Treatment primarily takes the form of medication - patients are given tablets that influence the production of estrogen and progesterone, usually eliminating ovulation. Hormonal patterns are examined through blood studies. Group therapy and nutritional consultation will be offered in the future. "We schedule patients for two visits, at specific times of the menstrual cycle - once during the phase when they are not expecting the symptoms and once during the luteal phase when they're supposedly having the symptoms," Halbr eich said . "Between the first visit and the second, the patient monitors her symptoms daily so that we can see if these symptoms are exclusive to the premenstrual phase and if there is a change in fluctuations. "We know that for about 70 per cent of the women, the treatment is effective," he added. "We don't yet know why it is not effective for the other 30 per cent, however, or why one drug is effective and another isn't." Studies will be conducted at the center to evaluate the efficacy of new treatments and test medications currently used for other conditions but which may relieve PMC symptoms. Last November, a few weeks after the center opened, patients were coming in at a rate of about one per day, Halbreich said. The center's capacity is two new patients per day. If the PMC studies Halbreich and his associates carried out at Albert Einstein College and Columb ia University are any indication, the Life-Cycle Center should have no trouble finding patients. "Many times family physicians or gynecologists just don't have time ( for PMC patients), but there is quite a lot of demand," Halbreich said. "In New York City, we ( evaluated and treated) close to 800 women over the years. We had more potential participants than we could handle." Women should seek treatment for negative PMC , according to Halbreich, when "the severity is such that there is an impairment of social or individual functioning to a degree that is clearly significant to the women and/or those around her." The Life-Cycle Center is located at Millard Fillmore Hospital, 3 Gates Circle, Buffalo. Appointments can be made by calling 887-4444. • Buffa lo Physician and Biomedical Scientist �LEECHES 11 Theirusewas an important aid in a successful microsurgical reattachmentof a severedear Dr. Bhangoo examines successfullyreattachedear. BY LISA JOSEPHSON W hat do leeches and microsurgery have in common? Plenty, if you ask Dr. Kulwant Bhangoo, Mercy Hospital's ch ief of plastic surgery and clinical assistant professor of plastic surgery at UB. Dr. Bhangoo is the first surgeon in the Buffalo and Western New York area to use leeches as an adjunct in a successful microsurgical reattachme nt of a severed ear. During the early hours of June 2, 1987, a SO-year-old white male patient, Frank lin Dye, was rushed into the emergency room of Mercy Hospita l with Buffalo Physician and Biomedical Scientist severe facial lacerations, including amputation of his right ear. During emergency surgery, Dr. Bhangoo used microsurgical techniques to reattach the ear. Unde r the magnification of the operating microscope, he found a transected artery in the ear and its corresponding stump on the scalp of the patient . The diameter of the small artery was less than 5 millimeters. Using the extremely delicate technique of microsurgery, the two cut ends of the artery were anastomosed using sutures that are barely visible to the naked eye. With the repair of the arte ry , it was possible to get blood flow- ing into the ear. However, Dr. Bhangoo notes, in order to have a successful microvascular reimplantation of an amputated part, it is als0 necessary to anastomose veins in addition to the arteries; this allows the blood brought into the part by the reconstructed arteries to d rain back out into the body's circulatory mainstream. Conventionally it has been extremely difficult to find and anastomose veins in reimplantation of the ear because the veins in that structure are extremely small; in th is particular case, they were cru shed and irreparable. Late Winter '88 �12 l i,, 0 i .____ ___ 0 Dr. Bhangoo(le/!) with patient Franklin Dye. Soon after the surgery, the ear had blood flowing into it, bearing testimony to the successful arterial anastomosis. Howeve r , a few hours later, the ear started to turn blue and became engorged with blood, indicating that there was inadequate outflow of venous blood from the ear. Dr. Bhangoo knew that there was no other surgica l technique that could salvage the ear from succumbing to venous strangulation. He left the hospital k nowing that the only way to save the ear would be to somehow gently rid the reattached part Lace Winter '88 of the stagnant veno u s blood until natural healing of the veins could take place. That takes about five to seven days in a circumstance such as this case. In the past, in simila r situations, surgeons had made small incisions in the reattached parts in hopes of causing sustai ned oozing that would allow for decompression. Howeve r , Dr . Bhangoo said, such small incisions soon clot, even when an ticoagulants are applied topically or given int r avenous ly. Large cuts wou ld mak e the re att ached pa rt suscep tible to in fection . As Dr. Bhangoo walked from th e hospital to his nearby office, it suddenly occur red to him that here was an ideal sit u ation to use medicinal leeches to salvage the failing reattached ear. Medicinal leeches had been u sed very effectively in the past for draini ng blood from patie nts. The leeches attach th emselves wit h microscopic bites infl icted by a row of teeth in their circular jaws which mak es a triradiate incisio n into the sk in. This wound in the sk in remains ope n because of its clever des ign. T he leech, Dr . Bhangoo notes, secretes Buffalo Physician and Biomedical Scientist �in its saliva, three pharmacologically potent substances. A local anesthetic similar to novocaine makes the bite painless, a fact not relevant in amputated parts that are insensitive co pain because of severed nerves. The second su bscance is a potent vasodilator which opens up the blood vessels and enhances the local blood flow. The third and most important substance is a locally acting long lasting anticoagulant which prevents the blood at the bite marks from clotting and allows for small amounts to ooze continually from these sites for between 24-48 hours. This prolonged oozing facilitates removal of stagnant blood in situations such as in Mr. Dye's reattached ear. After making several phone calls, Dr. Bhangoo found that medici nal leeches could be obtained from a company in Westbury, New York, called Leeches, USA, which is a subsidiary of Accurate Su rgical and Scientific Instruments, a co rporation dealing with instruments and supplies for microsurgical procedures. Dr . Bhangoo presented the option of using leeches to Mr. Dye . Faced with the possibility of losing the reattached ear, the patient readily agreed. In fact, Dr . Bhangoo recalled, Mr. Dye was surp risingly nonchalant and very receptive to the idea. "It won't be the first time," he said about the leeches. "I pulled one off my leg as a child after play ing in a pond many years ago." Over the ensuing five days, three leeches were applied to the ear daily. The response was quite dramatic- "nothing short of amazing," D r . Bhangoo no tes. "The dark, plum colored ear would become less swollen and pink in short order with each application." The leech attaches itself co feed and stays on for a period of from 15-45 minutes . Mr. Dye remarked that diffe rent leeches fed at differe nt speeds. "Some engorged themselves with blood and d ropped off within 15 minutes, while othe rs fed more leisurely and took u p to one hour ." Dr . Bhangoo is not sure what causes the animals to stop feeding. It is Buffalo Physician and Biomedical Scientist conceivable, he said, that the increases in the animal's weight may be a facto r, or possibly there may be a built-in mechanism telling it when to quit. With one feeding, the animals are able to susta in themselves for from six co 12 monchs. In order to prevent infection and cross contamination, these leeches, which cost about $6 apiece, are used only once and then discarded. npe.ople think these thingsmust bite you likea king crab,but theyjust go on like a suctioncupand then it is all over. Youdon't even know they are there. The hardestpart is lyingstill so as not to disturbthem.'' Mr . Dye remarked that "people t hink these things must bite you like a king crab, but they just go on like a suction cup and then it is all over. You don't even know they are there. The ha rdest part is lying still so as not to disturb them." Mr. Dye's ear has healed completely and is one of only a very few successful ear reimplants in the world literature, D r. Bhangoo notes. T here are fewer than six documented cases of successful microvascular ear reimplants, he says. T he leeches used are not the ordinary pond variety animals. The supplying fir m obtains them from a leech farm in Wales, United Kingdom. This species ofleeches is called "Hirudo-medicinals;" they are farmed at Biopharm in Swansea, Wales, and then shipped to the U n ited States via air freight . They are maintained in sterile, cool, damp containers for shipment. The organization in Wales, Dr. Bhangoo says, is at the center of the resurgence of medicinal leeches. Currently, apart from their use in salvaging failing reimplants in situations similar to that of Mr. Dye's or as adjuncts in microvascular reattachment of ears, noses, lips, avulsed scalps, digits, and limbs, they are finding wider use in o t her surgical procedures. These include correction of venous engorgement in transposed microvascular free flaps, or pedicle flaps. Leeches over the years have also been used quite effective ly in decreasing swelling following trauma, such as in treating black eyes and hematomas. The idea of us ing leeches medicinally stemmed from the anc ient belief that disease was caused by an excess of corrupt blood. The principle used today is similarly aimed at removing stagnant and unwanted blood from parts of the body . The earliest written reference to the medieval use of leeches was by a Greek in the second century B.C. However, medicinal leeching originated much earlier in India . The French also used leeches. They applied up to SOat a time to "blood patients" and found accidentally that leeches helped pulmonary edema, cardiac failure, and hypertension. Ho wever, pat ients who did not have these ailments were often made wo rse. This was particularly so in conditions such as obesity. Use of the leeches often caused anem ia and blood loss and sometimes lead to death. By the early twentieth century the practice of using them for bleeding had almost died out. Dr. Bhangoo anticipates a widespread readoption of the technique as an adjunct in microvascular reimplantation and also in plastic and reconst ru ctive surgery. But he cautioned that it has to be used judiciously and discrimi nately. When asked whether he will use the technique again, he said, "If the situations are righ t and if the patient is willing, then we will do it again." • Late Wimer '88 13 �14 CE ♦ BY BRUCE S. KERSHNER T housands of lives lost following auto accidents and ocher causes of severe trauma could be saved if a new surgical approach is adopted . This is the finding of a just completed research study by UB orthopaedic surgeon Lawrence Bone, M .D. His study demonstrates that aggressive immediate surgery for multiple long bone fractures significantly reduces irreversible respiratory failure and markedly reduces morbidity rates. In addition, he has found that hospital costs could be halved by the rarely used surgical approach. Nationwide, the primary approach is to surgically stab ilize long bone fractures , such as occur in an auto accident, several days later. Dr. Bone's findings provide convincing evidence that this traditional surgical approach is a major factor in increa sed morbidiry and prolonged hospitalization for the multiply-injured patient with fractures. "Surgeons can no longer ignore the implications of delaying fracture stabil ization," Dr. Bone states. The study provides the "smoking gun" against continued use of the traditional surgical approach, Dr. Bone maintains, "because it is the first published prospective random ized study on the subject, and the results are statistically significant ." While several previous retrospective studies reached the same conclusions, retr ospect ive studies lack a control, unlike prospective studies . "Because the retrospective reviews of patients were uncontrolled studies, their findings made little headway in con- Late Winter '88 Dr. Lawrence Bone (left) with Dr. Steven Lasser. vincing most of the American medical community," he commented. This skepticism has prevented the adopt ion of the new surgical approach to trauma, and probably less than a dozen hospitals around the nation currently use the new approach. "Our findings were that 12 of 28 trauma patients that had traditional delayed surgery developed respiratory failure. However, only one of 30 such patients with prompt surgery developed respiratory failure. That one patient (who was struck by a train) was so injured that we expect he would have died of his multiple, severe injuries anyway," noted the assistant professor of Buffalo Physician and Biomedical Scientist �15 orthopaedic surgery. r. Bone emphasized that it is an economic breakthrough, not just a medical breakthrough . While medical advances often tend co increase hospital coses, chis advance would result in reduced coses if adopted. "le is nearly twice as expensive co delay someone's operation by 48 hours ," he explains . "Thi s is not just because of an additiona l ten days ofhospicalizacion but also because oflonger treatment in the Intensive Care Unit. "Based on our study, it will cost half as much co treat multiple D Buffalo Physician and Biomedical Scientist trauma patients with early fracture stabilization." Bone's interest in the subject was sparked by che work of Dr. John Border, who is acknowledged as one of the fathers of modern trauma surgery. Dr. Bone was trained in trauma medicine under Dr. Border who is a UB professor of surgery based at Erie County Medical Center. Border helped pioneer the new creacmenc methods that enable dramat ic improvement in che survival of patients with severe mult iple trauma. Dr. Border developed the "Total System Approach" co trauma pat ients. It involves six basic techniques, including aggressive Late Winter '88 �16 immediate bone surgery {the one Or. Bone focused on), as well as aggressive cardiopulmonary treatment, massive protein nutritional support, and continuous ventilation of the patient, among others. Where adopted, Border's approach has reduced the mortality rate for severe multiple trauma from 30 per cent to 3 per cent or less. "Dr. Border's studies have focused on a broader range of trauma medicine concerns while mine focused only on orthopaedic surgery," Dr. Bone -----.--remarked. Dr. Border's research, while it demonstrated the importance of aggressive bone surgery, relied on retrospective studies only. This is one of several reasons why this approach is still rarely used. It is also the reason that Dr. Bone decided to undertake this study in 1984. "! saw a need for a study that would definitively establish the role of early fixation in the trauma patient. Because the approach was viewed with skepticism by the medical community, I saw chat this kind of study could change this skepticism," he related. While chief orthopaedic resident at Parkland Hospital, University of Texas-Dallas (1984 to 1986), he became project director for the study. It was funded by a $64,000 grant from the Orthopaedic Research and Education Foundation. Dr. Kenneth Johnson, University of Texas associate professor of orthopaedic surgery, served as co-investigator. Dr. Bone's prospective randomized study compared 125 trauma patients who had femur fractures. They were separated into two groups, one which had early stabilization of bone fractures and one which had de layed stabilization. These two groups were in turn divided by level of injury, whether moderate or severe. In the group with moderate inju r y levels, those with delayed su rgery showed 2.6 times greater levels of abnormal arterial blood gases than those with immediate surgery. Pulmonary emboli occurred in 3.3 per cent of the delayed group, but none in the immediate group had this difficulty. For the group with severe injuries, differences were much more dramatic. Ventilation support and admission to the ICU were required for mo re than twice as many in the delayed surgery group as in the immediate surgery group; amount of time spent in the ICU was almost three times greater in the Late Winter '88 delayed group; major pulmonary failure was 13 times greater ( 42.9 per cent vs. 3.3 per cent) for the delayed vs. the immediate surgery group. The reason pulmonary failure occurs from the multiple bone fractures has to do with the reaction of the body following severe trauma. It appears, Or. Bone states, "that fat from the fracture site, from the liver and from adipose tissue form emboli and other vascular cellular elements that lodge in the lung, ---, mechanically occluding or constricting smaller capillaries." This results in an irreversible reduction in oxygen for the lung. Dr. Bone has presented his findings at the American Academy of Orthopaedic Surgeons meeting in San Francisco, at the American Orthopaedics Association in Washington, D.C., and at the World Surgical Conference in Australia this fall. "I have received a very, very positive reaction from fellow surgeons so far," he says. He expects to pub-lish his results in a primary orthopaedic journal. Or. Bone returned to Buffalo in 1986 after he was invited to join UB's faculty. But his connections to the area are not just career-related. He is a Buffalo native, his family lives in Western New York, and both he and his father are UB medical alumni. Besides receiving his M.O. and completing his surgical residency at UB, Or. Bone has participated in fellowships in Switzerland, Germany, and Texas. He is both director of the Musculoskeletal Trauma Service at Erie County Medical Center and acting chief of the Division of Orthopaedics at Buffalo Veterans Hospital. He has other staff positions at Buffalo General and Children's hospitals . Dr. Bone is unusual because he is one of only several physicians nationw ide who is board certified in both orthopaedic surgery and general surgery. This year, Dr. Bone was honored with the American Orthopaedic Association Traveling Fellowship. He is the author of 15 publications. He hopes his findings will spark interest in the new approach to trauma so that the advances will become standard techniques. Regarding his uniquely fitting last name, the bone surgeon remarks, "I get a little bit of ribbing from my fellow physicians once in a while. On the other hand, none of my patients ever forgets my name." • Buffalo Physician and Biomedical Scientist �17 ROSWELL REPORT WASKEY TOGENETIC BREAKTHROUGH BY COLLEEN M. KARUZA A unique case report of a Roswell Park patient was the key to a breakthrough genetic study published recently by British scientists. Sir Walter Bod mer, of the Imperial Cancer Research Fund, in London, and his colleagues have provided compelling evidence demonstrating that the genetic defect responsible for familial adenomatous polyposis - a premalignant condition leading primarily to colorectal cancer - resides in the long arm of chromosome 5. Their study was published in the August 13 issue of Nature, a well-known British journal. In an article published on the same date in the New York Times, Sir Walter acknowledged that his group's research was triggered by a 1986 published case report from Roswell Park involving a mentally retarded patient with colorectal cancer, extensive adenomatous polyposis and several unusual chromosomal anomalies. This brief report, which appeared in the American Journal of Medical Genetics,was written by Lemuel Herrera, M.D., FACS, director of the Familial Adenomatous Polyposis Registry of Western New York, and several members of Roswell Park's Genetics & Endocrinology Department. Or. Herrera is an assistant professor of surgery at UB. Familial adenomatous polyposis is an autosomal dominant, premalignant condition. If one parent carries the gene for this condition, 50 per cent of the offspring will inherit the gene. "If an offspring develops colon polyps," said Or. Herrera, "there is a 99 per cent chance that he or she will develop cancer by age 35." Moreover, only those affected may transmit the genetic defect to their children. Because familial polyposis is premalignant primarily for colorectal cancer, it is, according to Dr. Herrea, "the classic prototype for studying the genetic back- Buffalo Physician and Biomedical Scientist ground of the number two cancer killer in both the U.S. and Great Britain." Of the 140,000 new cases diagnosed in the United States in l 987, it is estimated that 25 per cent to 40 per cent may be linked to a genetic defect. The human genome has been calculated to have l 00,000 genes distributed in 23 pairs of chromosomes. Chromosomes can be compared to sentences that contain an individual's genetic blueprint, while the genes are the words. The chemical bases that make up these genes are the letters that spell out an individual's inheritance. In the report, Dr. Herrera, who is also a clinician in Roswell Park's Surgical Oncology Department, evaluated a mentally retarded male patient who had undergone a proctocolectomy for a colon carpeted with adenomatous polyps. The resected specimen contained two well-differentiated colorectal cancers. Four years later, the patient developed a large mass which occupied the entire abdominal cavity and was ultimately responsible for his death. An autopsy revealed an enormous desmoid tumor and other congenital anomalies, including a horseshoe kidney, a liver consisting only of the right lobe, absence of the gallbladder, rounded configuration of the heart, and deformed feet. Subsequent cytogenetic studies showed that the patient's mother had normal chromosomes, while the father had an enlarged satellite area on chromosome 22. A similar assessment of the patient revealed that a portion of chromosome 5 was missing; and that the same enlarged satellite area appeared on chromosome 22. Although the family had no known history of colorcctal cancer or adenomatous polyposis, Dr. Herrea and his colleagues believed that the combination of colonic adenomatous polyps, cancer and the desmoid tumor represented a mutant of familial polyposis often labelled as Gardner's syndrome. G ardner's syndrome is characterized by several abnormal growths caused by a single dominant gene, with the colon being the central tumor site. Familial polyposis has been claimed to involve just colon cancer, and not the other anomalies associated with Gardner's syndrome. Recently, there has been evidence to suggest that Gardner's syndrome is the full-blown phenotypic manifestation of the familial polyposis gene. Only five cases of abnormalities on chromosome 5 had been reported previously in the literature, with Roswell Park being the first and only research institute to describe a constitutional chromosome anomaly in a patient with Gardner's syndrome and colorectal cancer. Despite several decades of intensive research, this was the first time that a cytogenetic finding led to the discovery of a recessive genetic effect in one of the most common types of cancer. "At that point, however," said Or. Herrera, "more cases needed to be studied to establish the possible significance of this cyrogeneric abnormality in familial polyposis." Prompted by the Roswell Park report, the British research team studied several families with adenomatous polyposis syndrome from the St. Mark's Hospital Registry in London. For those individuals who later developed colorectal cancer, variants in the generic material were disclosed by ONA recombinant techniques. This indicated a gene deletion on chromosome 5. The British team not only corroborated rhe results of Dr. Herrera's research that indicated that the defect was in bands 2 l and 22 of the long arm of chromosome S, but they also established an Lare Winter '88 �18 assoc1at1on for the gene deletion in both inherited and sporadic forms of colon cance r. With these findings, Sir Walter contends chat teams currently working on this project should be able co sequence the chemical bases of the gene within the next few years. If the promise of the new studies is borne out, periodic blood tests will be available to detect the defective gene in individuals at greatest risk for colorectal cance r; and knowing the gene sequence may lead to more effective treatments. As Dr. Herrera explains, "This research will provide the basis for presymptomatic or prenatal diagnosis of familial polyposis as well as the early detection of a significant percentage of colorectal cancers chat are often associated with the presence of adenomatous polyps in the general population.11 Dr. Herrera's collaborators on the report were Surabhi Kakati, Ph.D.; L. Gibas, Gen Pietrzak, and Avery A, Sandberg, M.D. • Epidemiologist finds link between SIDS & retarded fetal growth N ew evidence linking Sudden Infant Death Syndrome (SIDS) with retarded growth of the fetus during pregnancy has been reported by a UB epidemiologist. According to the study conducted by Germaine Buck, Ph.D., babies who die of SIDS typically, at birth, weigh less than five pounds and five ounces, measure less than 20 inches long, and are delivered earlier than 3 7 weeks gestation. Buck's findings were presented lastJune at the meeting of the Society for Epidemiologic Research in Amherst, Mass. The study, conducted by Buck as a doctorial candidate in UB's Department of Social and Preventive Medicine, also won the Society's prestigious Abraham Lilienfeld Award for best student research. She is currently a clinical assistant professor in the department. SIDS, which swiftly and without warning kills, usually within the first six months after birth, has no known cause. Late Winter '88 SIDS babies are typically normal, healthy infants who are found dead, usually in their cribs. This killer of infants gives no signs, no symptoms, and it strikes rich and poor alike. "Diagnosis of SIDS at autopsy is always a diagnosis of exclusion; it remains as the likeliest cause of death when all other diseases and disorders have been excluded," says Buck. The UB researcher says reduction in birth weight and birth length, called proportional growth retardation, which the SIDS infants share, may be related to insults which occur to the fetus early in the pregnancy. These insults include the mother's consumption of alcohol; consumption of drugs - illegal, prescription, or over-the-counter; inadequate nutrition, and exposure to chemicals or other substances in the environment which can affect fetal growth. These may be particularly criticaI in the earliest weeks and months of pregnancy, Buck believes. "We know, for instance, the fetus achieves about 75 per cent of its birth length by the end of the second trimester of pregnancy," she points out. Therefore, it may be during this time that insults which would slow the growth involving length could occur. I n general, risk of SIDS decreases with increase in infant size. SIDS, which was formally recognized during the early 1960s, occurs in two to three live births pe r thousand in the population of developed nations around the world, a rate which remains unc hanged after two decades. It is extremely difficult, says Buck, to estimate the figures for SIDS in developing nations because infant s there are likely to die within the first year oflife from a variety of diseases and problems connected with nutrition and environment. Buck's study examined birth weight, birth length, head circumference and length of time in uterofor all babies born in New York State in 1974, excluding New Dr. Gennaine Buck York City. She then examined identical factors for infant deaths in New York State for 1974 and 1975. A total of 148autopsyconfirmed cases of SIDS, 114 infant deaths from all other causes including trauma, and 355 living infants who had reached their first birthday were compared in the study. "Even when I examined factors such as education levels and occupations of the parents of the babies in the three groups, none of these data suggested that socioeconomic , educational or health status of the parents affected the SIDS risk," Buck points out. The only factors, she says, which the SIDS babies had in common were birth weight of less than five pounds, five ounces, birth length ofless than 20 inch es and a gestation period of less than 37 weeks. "This is not to say that all babies which fit this pattern will die of SIDS," she emphasizes, "it only suggests that these factors which are the result of delayed development which occurs in pregnancy put them at higher risk than average." Buffalo Physician and Biomedical Scientist \ J �19 Roswell skin cancer study enters second year of tests R oswell Park is entering its second year in a nationwide research study designed to test the vitamin A derivative, isotretinoin, as a prophy lactic against basal cell carcinoma. This five-year study was made possible through a $500,000 research grant from the National Cancer Institute (NCI) . ~ Basal cell carcinoma, a disorderly growth of cells near the skin's surface, is the most common - and most commonly cured - human ~ malignancy. Although cure is virtua lly guaran6 teed with early detection and treatment, persons who have had basal cell carcinomas in the ... past are likely to see new skin lesions developing in the future. The first tumor may appear on the face; the next one on the neck. Cur rently, ased on the results of her study, Buck there is no way to prevent new basal cell carsays it wou ld appear that the earlier cinomas from forming. the mothe r-to-be r eceives prenatal counThe NCI has been investigating drugs that seling and examination, the better for the would arrest or disrupt this regeneration. In a infant. pilot study conducted by the NCI, a synthetic derivative of vitamin A called isotrecinoin "Many women may believe that it's not effectively slowed the development of new skin important to check in with the doctor o r cancers in a small group of patients treated for clinic until they 'show' weight gain. Othbasal cell carcinomas. ers may not believe they are pregnant in Basedon this preliminary evidence, the NCI the first two months, especially if they launched an intensive five-year clinical study of have a history of irregula r menstrual pe r ilow-dose isocrecinoin as a prophylactic against ods," Buc k points out . And some physibasal cell carcinoma . Eight study sires around cians have suggested women not schedule the U.S., including Roswell Park, were sethei r first prenatal visit u ntil after they 've lected to conduct the cooperative clinical trimissed two periods. als. Currently, more than 800 patients nationwide are enrolled in the study. ''The study suggests, howeve r , t h at the At the Roswell Park study site, Dr. Howard earlier the mother-to-be gets adequate nuL. Stoll, director of the Dermatology Section trition, abstains from alcohol and tobacco and clinical associate professor of dermatology, and other chemicals including illegal is the principal investigator; and Ors. B. Dale drugs as well as medications, the less lik ely Wilson and Corne lie Jones, clinical assistant she may be to r un the risk of the baby dying professor of dermatology, are co-investigators; later from SIDS," Buck surmises . Barbara Slusarski, R. N., M.S., is the study Buck's study was conducted with grant coordinator. monies from the National SIDS FoundaThe Roswell Park study began in the spring tion and assistance from the New York of 1986,with 68 skin cancer patients volunteerSt ate Health Depa r tment . • ing as subjects. "The patient s have been ran-Mary Beth Spina domly assigned to one of two groups," said Mrs. i i --------- ~----------- B \ j Buffalo Physician and Biomedical Scientist i Slusarski. "One receives a placebo; the other group, the isotretinoin." The study is "doubleblinded," which means that neither the patient nor the physician knows which agent is being administered. Each patient is required to take two fivemilligram capsules each day and make regular visits co the Roswell Park Dermatology Clin ic. After three years, study researchers will compare che groups to see if the isocretinoin group had fewer basal cell carcinomas . Although they will stop taking the capsules after the third year, patients will still return to the clinic for routine follow-up visits every six months for II patients have been intwo more years. ''.A. formed that should we find proof chat the isotretinoin is effective, the 'blind code' will be broken, and the drug will be prescribed for all study participants," explained Mrs. Slusarski. Conversely, if the drug proves harmful at an y time, the study will be abruptly discontinued. And how safe is isotretinoin? "Physicians have successfully treated more than 1,000 acne pat ients with isotretinoin at doses three to ten times higher than the 10 milligram daily dose in our study," said Mrs. Slusarski. ''.l\swith any medication, side-effects can occur; however, we feel that, because of the low dosage, any side-effects that do occur are very unlikely to be dangerous." Some of the possible side-effects are chapped lips, mild nosebleeds, and tired or irritated eyes. This may occur because isotrecinoin has a drying effect. Unlike vitamin A, isocrecinoin appears to have no deleterious effects on the liver or kidney. "However, if eithe r organ malfunctions, the body may be unable to break down che compound," said Mrs. Slusarski. "We routinely test patients' blood to ensure that these viral organs work normally." Ac che end of the trial, patients will be notified of any significant results, but chat isn't the only benefit they'll derive for their participation . During the five years of the study, patients receive free dermatological care, including check-ups and treatment. • Late Winter '88 �20 Dental researchersJoseph Margarone (left) and Charles Liebow demonstratehow laserwill be used for surgery. LASERUSEDTOTREATSOFT TISSUELESIONS IN MOUTH BY MARY BETH SPINA P ioneering research in the UB School of Dental Medicine shows that soft tissue lesions in the mouth can be successfully biopsied or removed on an outpatient basis with a pulsing carbon dioxide laser beam. Although the laser "light knife" has been used to treat a var iety of medical problems, its use in the oral cavity has been largely limited to experimental surgery under general anesthetic. Charles Liebow, D.M.D., Ph.D., told the Society of Optical and Quantum Electronics in Lake Tahoe, Nevada, in December that a UB team has successfully used the laser to treat some 15 patients. Four had fibrotic outgrowths or "callouses"; four ochers had hemangiomas; two were diagnosed with the potentially precancerous lesion leukoplakia; and five had papillary hyperplasia. The pulsing rather than continuous laser beam has dis t inct advantages in the oral cavity, said Lie bow, an associate professor of oral Late Winter '88 surgery here. The continuous beam can produce inflammation in healthy tissue adjacent to the lesion being removed . "Patients who underwent treatment with the pulsing laser experienced no post operative bleeding and little, if any, discomfort compared to what would be expected using traditional surgical procedures," he emphasized. Since the laser energy source, which literally boils and vaporizes tissue, can deliver a pulsing beam in l / 100,000th of a second in an area as small as one-tenth of a millimeter, small amounts of tissue can be lased. "Microscopic capabilities combined with the laser gives the oral surgeon a great deal of control in a precise manner that may not always be possible with traditional surgery methods," Liebow adds. Deep lesions can be lased in layers; intact biopsy samples can be removed by using the laser to cut around and under tissue in a pie-shaped wedge. "While the carbon dioxide laser has proved itself successful as a surgeon's tool in the oral cavity, I don't anticipate every oral surgeon will use it," he predicted. He believes cases which can benefit most from the laser will be referred to tertiary dental centers where clinicians specially tr ained in its use will perform the procedure. Laser treatment does not appear applicable for oral surgery involving bone no r may it be recommended fo r certain other procedures in the mouth, Liebow said. The UB team has, however, used the carbon dioxide laser to treat one case of periodontal disease with good results. Liebow said that the researchers in the Department of Oral Surgery are involved in other ongoing research which may expand applications of laser technology. Others involved in the study include Robert E. Braun, D.D.S., Joseph Natiella, D.D.S.,Joseph Margarone, D.D.S. and Laurie Hartman, D.D.S ., all faculty in the UB School of Dental Medicine. • Buffalo Physician and Biomedical Scientist �21 e Buffalo General Hospital, a major eaching hospital of the State University of New York at Buffalo, is establishing the State's second heart transplant center. Among institutions which also submitted proposals for the heart transplant center were Mt. Sinai Hospital and Montefiore Medical Center in New York City and Strong Memorial Hospital in Rochester. The State's only established center is at ColumbiaPresbyterian Medical Center in New York. The new heart transplant center at Buffalo General will be directed by Robert M. Mentzer Jr., M .D ., head of the Division of Cardiothoracic Surgery at the UB School of Medicine and Biomedical Sciences and chief of Buffalo General's Department of Surgery. The center will be heavily oriented toward research aspects of cardiovascular surgery, including follow-up studies of transplant patients and the development of bioengineering devices such as artificial hearts and support systems for surgery, Mentzer said. "The Cardiac Transplant Center is an important step forward in the development of Buffalo as a national center of excellence for health care," UB President Steven B. Sample commented. "The establishmen t of the center is the result of cooperation among the University's eight teaching hospitals, including Roswell Park Memorial Institute , the strong support of the community, and our faculty's experience in heart transplantation at the Buffalo Veterans Administration Medical Center, where 12 heart transplants have already been performed." "The Cardiac Transplant Center will enhance the Medical School's academic program in cardiovascular surgery," said John Naughton, M.D., vice president for clinical affairs and dean of UB's School of Medicine and Biomedical Sciences. He also emphasized the cooperative effort among the University's eight teach ing hospitals and the involvement of the Western New York Health Sciences Consortium in developing and supporting Buffalo's program in heart transplantation. Fourteen heart transplants are projected during the first year of operation with an average of 25 each year after that, Mentzer said. The Organ Procurement Agency of Buffalo Physician and Biomedical Scientist STATE'S 2ND HEART TRANSPLANT CENTER ESTABLISHED HERE BY LINDA GRACE-KOBA$ THEBUFFALO ENl:RAL HOSPITAL .," -~n. ... BUFFALO GENERAL HOSPITAL I z i5 ~ i Q :.,__ _ ________________ __J ~ President Sam/1le at podium d111·ingheart trans/1lan1 /Jrcss conference. Western New York will handle organ location and procurement. Mentzer noted that no additional hospital construction or equipment is required before the program's start-up and that two operating rooms, intensive care units, and a newly created stepdown unit on the 13th floor in a new medical tower building will easily accommodate the cardiac transplant procedures. Mentzer, with Joginder Bhayana, M.D., will co-direct a cardiac transplant team con- sisting of University at Buffalo facu lty surgeons from Buffalo Children's Hospira!, Buffalo Veterans Administration Medical Center and Buffalo General. In addition to Mentzer and Bhayana, team members include Jacob Bergsland, M.D., Thomas Lajos, M.D., A. Norman Lewin, M.D., Gary Lofland, M.D., Syed T. Raza, M.D., and Theodore Spooner, M.D. Since 1984, this team has performed a total of 14 cardiac transplants in Buffalo. Late Winter '88 �22 Also involved in the heart transplant program are Francis J. Klocke, M.D., SUNYBuffalo professor of psysiology and medicine, who this year serves as president of the American College of Cardiology, and Lewis M. Flint, M .D., chairman of the U niversity' s Department of Surgery. All persons involved in the Buffalo Cardiac Transplant Center emphasize the cooperative effort that resulted in its approval by the State. Other principals in the program's development include William V. Kinnard Jr., M.D., president and chief executive officer of Buffalo General Hospital; John E. Friedlander, Buffalo General's executive vice president, and Andrew J. Rudnick, president of the Greater Buffalo Development Foundation, Inc. Mentzer said the comprehensive nature of Buffalo's program in cardiovascular surgery could not be achieved by a single institution. Officials at Buffalo's renowned cancer research institute, Roswell Park Memorial Institute, have supported efforts to establish transplantation programs for heart and bone marrow transplants, he said. Pediatric cardiovascular surgery and research studies have been under way at Buffalo Children's Hospital, while researchers at the Buffalo VA medical center have developed a highly regarded program in heart transplants and cardiovascular surgery . He also cited Klocke's reputation as a leader in the study of coronary blood flow in humans who has performed important studies in that discipline. Klocke will initiate new coronary blood flow studies in transplant patients, Mentzer said, particularly in the area of atherosclerosis. Other research studies to be performed within the new center will be a systematic investigation of coronary blood flow in transplant patients. Leon Farhi, M.D., chairman of the University's Department of Physiology, is a leader in respiratory physiology who will participate actively in clinical studies investigating changes in blood circulation after a patient undergoes a heart transplant. "Most heart transplant cente rs are not prepared to study changes in the body after transplants in as comprehensive a manner as we are able to because we have the involvement of so many University departments and teaching hospitals," Mentzer said. "In extensive follow-up studies, we will be looking at Late Winter '88 Governor Cuomo visits heart 1:rnnsplan1 cenwr following announ cement of its cstablishmcnL ways to help patients after their heart transplants through Buffalo General's Cardiovascular Life Sciences Program." Another unique aspect of the Buffalo Cardiac Transplant Center is the University's commitment to biotechnology, Mentzer noted. "We are also going to investigate support systems to maintain patients and the furthe r development of cardiovascular technology," he said. "We are prepared to look at the experimental development of artificial hearts over the next several years. We have associations w~th bioengineering experts at the University and with its Health-care Instruments and Devices Institute. "Most other cardiac transplant programs in the country do not have as well rounded a research base to expand their programs as we do in Buffalo. Our goal is to establish ourselves as a transplantation center as good as any in the country." Mentzer was recruited by the University at Buffalo to head its Cardiac Transplant Program from the University of Virginia, where he established a reputation as one of the leading young researchers in cardiovascular surgery in the country, University officials said. His awards include a National Institutes of Health Research Career Development Award and two Public Health Service Awards. • Buffalo Physician and Biomedical Scientist �23 Consortium wi ll focu s on marrow tran splan ts B one marrow transplants are the initial focus of the new consortium formed by three medical institutions: UB School of Medicine and Biomedical Sciences, Roswell Park Memorial Institute, and the University of Rochester Medical Center and School of Medicine and Dentistry. The purpose of the consortium is to share resources in transplantation medicine in the areas of patient care, research, and medical education. The consortium is also exploring the possibility of sharing resources outside trans- Buffalo Physician and Biomedical Scientist plant medicine. "This cooperative agreement is a good indicator of further inter-institutional cooperation in the two communities of Buffalo and Rochester," said John Naughton, M.D., UB's vice president for clinical affairs and dean of the medical school. "Sharing of our expertise in bone marrow transplantation is a sign of more things to come." "The consortium is unique in that it br ings together in a single program the resources of a nationally designated Comprehensive Cancer Center and two university teaching hospitals recognized for thei r excellence, for the benefits of patients throughout Upstate, Central and Western New York." said Thomas B. Tomasi, M.D., Ph.D., director of Roswell Park Memorial Institute (RPMI). "Each institution will bring unique strengths to the program." "We're looking at an era where cooperative use of resources will be crucial if expensive and complex medical technology is to serve the public efficiently," said Paul F. Griner, M.D., director of the Medical Center at the University of Rochester. The cooperative agreement will establish interactions among researchers on a formal basis, Tomasi said. "The three institutions will work toward sharing common interests," Naughton said, adding that the agreement will include cooperation and exchange in research and education. At first, the interchange will involve faculty visiting neighboring institutions to work on joint research, according to Naughton. Later, the exchange could involve the exchange of senior residents and special fellows from the two medical schools. It is proposed in the consortium agreement that a joint program for bone marrow transplantation be established at Roswell Park Memorial Institute and Strong Memorial Hospital of the University of Rochester Medical Center, enabling physicians to perform allogeneic (donated) bone marrow transplants for patients suffering from leukemia, aplastic anemia and related diseases. The bone marrow transplantation program at RPM! and Strong Memorial will serve patients in Western New York as well as the Finger Lakes and Central New York. Tomasi said RPMI currently offers autologous bone marrow transplants in its clinic. (Autologous transplants involve drawing marrow fluid from the patient, treating the fluid, then returning the marrow to the patient.} This procedure is less complicated than allogeneic transplants, which require special facilities. "Research is needed in the bone marrow transplant area, including gene thereapy," Tomasi said, adding that gene therapy, now an experimental procedure, entails inserting genetic material into the cells to replace missing genes. Tomasi's research team is also studying the reasons why organs are rejected when transplanted to a patient. This research may result in improved methods of transplanting organs, such as the heart or liver. • Late Winter '88 �24 JOHNNAUGHTON : DEAN& VICEPRESIDENT BY CONNIE OSW ALO STOFKO I t's not easy to tell where one of John Naughton's jobs stops and the other starts. Naughton is vice president for clinical affairs. He's also dean of the School of Medicine and Biomedical Sciences. When he's wearing his vice presidential hat, he reports to President Steven Sample. In his role of dean, he reports to Provost William Greiner. "Often I report to both together because you can't separate the roles out," Naughton noted. As dean of the medical school, he takes care of the school's academic needs. As vice president, his job is to work with the local hospital system. Clinical education is different in Buffalo than it is in other places because UB uses a system of affiliated hospitals instead of a single teaching hospital as is the case with most others. "To make the system work in Buffalo, we need the cooperation of the hospitals and the school," Naughton said. "To develop the system was the job of the vice president for clinical affairs. To keep it going is the dean's job." Since about 1983, his duties as vice president have remained stable, he indicated. "My job is to be the University's representative and officer to the teaching hospitals in Buffalo," Naughton said. It's his job to represent not only the medical school, but the other schools and departments that have programs in the local hospitals. However, Naughton isn't placed Late Winter '88 over the other deans. "l have oversight in relation to affiliation needs, but not over programs," he explained. The affiliation agreements with hospitals are now cent ralized in rhe Office of the Vice President for Clinical Affairs. Originally, they were in the office of Edward W. Doty, vice president for finance and management. Any department that sends students to work in a hospital must have an affiliation agreement, Naughton said. Each school pretty much works out the relationships with the hospitals itself. Units with affiliation agreements include the School of Dental Medicine, School of Nursing, School of Health Related Professions, Department of Communica tive Disorders and Diseases, Psychology Department, and School of Social Work. A s vice president, Naughton also oversees lease agreements with the hospitals. UB pays hospitals for space it uses at their facilities. He is also responsible for the clinical practice plans for both the medical school and dental school. Another of his vice presidential duties calls for Naughton to oversee programmatic issues concerned with clinical practice. For instance, he has been working on the attempt to get a heart transplant center in Buffalo. That is, in large part, a patient care issue, but it requires a strong academic presence, he pointed out. But even this example is one of the areas that overlaps with his role as dean, he pointed out. Coordinating the residency programs is another example of the mixture of his roles, he said. Residents are paid by the hospital, so they're agents of the hospital. But they're there for an education, which falls into his role as dean, he explained. The residency program is operated by the Unive rsity faculty who are chairmen of the clinical departments. Invariably, they're also chiefs of the same clinical areas at the hospitals. Naughton's position as vice president differs from the other vice presidencies in one big way - it's a staff position rather than a line position, he explained. That means that although he reports to President Sample as the other vice presidents do, he has no control over resources when wearing his vice presidential hat. • Editor's Note: The Reporter, ihe campus' weekly newspaper, has been running a series of articles on the University's organizational srructure, explaining how each vice presidential area is set up and how it functions. This article on chevice president for clinical affairs attempts to delineate the differences and complementary relationships between John Naughwn's two administrative roles as both vice president for clinical affairs and dean of medicine and biomedical sciences. Buffalo Physician and Biomedical Scientist �25 PHOTODOUG LEVERE �26 It'searthshaking,but rwt anotherPlague,Mohnsays BY MARY BETH SPINA U B immunologist James F. Mohn, M.D., describes the AIDS crisis as "the most earthshaking infection of this century," but cautions against comparing it with The Plague - The Black Death which killed about one-fourth of Europe around the 14th century. Speaking at a seminar organized by the Depa rtm ent of Microbiology on AIDS and other venereal diseases, Mohn noted that unlike The Plague, which in its pneumonic form spread rapidly through casual contact, the AIDS virus is transmitted only in blood and semen and by intimate sexual contact. Transmission appears to be primarily by means of unprotected intercourse with an infected partner, contaminated needles shared by IV drug abusers, transplancental exchange during pregnancy from an infected woman to her fetus, and - much less frequently t0day - transfusion of blood products. Very rare instances have been reported where health workers, in no other high risk group for AIDS, accidentally received the virus from an infected patient through a needle prick, or through infected blood entering an open sore or scratch. Mohn noted that while there's no cure for the virus - HIV 1,2,3 - great strides have been made since the syndrome was first recognized a half-dozen years ago. Not only has the virus been identified, but screening tests sensitive to and specific for HIV antibodies have been developed to minimize its spread through the human blood supply. In addition, there are continuing efforts to educate health workers as well as the general public about methods they should Late Winter '88 employ to prevent the spread of AIDS. "All we have going for us now is prevention through essentially personal hygiene methods," said Mohn, director ofUB's Ernest Witebsky Center for Immunology. He also serves as chairman of the New York State Council on Human Blood and Transfusion Services which Gov. Mario Cuomo charged to be responsible for insuring safety of the blood supply. Mohn said that although there is some promise for AZT, the drug currently approved for treatment of AIDS patients, it has t0xic side effects. The best hope, he believes, is for an effective vaccine to be developed. The lethal effects of the retrovirus HIV can be blamed on the type of cells it recognizes and attacks as well as on the fact that it can remain latent or inactive but alive for an undetermined number of years in the human body, said Thomas Flanagan, Ph.D., a virologist and chairman of the Department of Microbiology. While other viruses have a particular attraction for certain types of human cells, HIV is especially deadly because it recognizes and infects primarily T4 helper cells and, to a lesser extent, certain types of cells in brain tissue. Because the virus attacks, infiltrates, and renders impotent these important T helper cells, the AIDS patient falls victim to a number of organisms found normally in the body and normally held in check by cellular immunity. Among these are the parasite Pneumocystis carinii. S ince the humoral immune system is compromised to a lesser degree than the cellular Buffalo Physicianand BiomedicalScientist ��28 one, it is more unusual for AIDS patients to die from exposure to infectious agents for which they have developed antibodies in the past. Flanagan noted that, compared to other viruses, HIV appears relatively "inefficient" in its transmission. Hepatitis B, for instance, which may also be spread by infected blood, is considerably more efficient in producing active disease than · HIV. This difference, Flanagan hypothesized, may lie in the amount of the virus which may be transmitted per occurrence. Especially of concern are babies born to HlV positive mothers. "Fifty per cent of these infants are born HIV positive with a certain number going on to develop active cases of AIDS," Flanagan said. But among those born HIV negative to positive mothers, it cannot be determined how many will undergo seroconversion or how many years could elapse before this might occur. T imothy Murphy, M.D., a faculty member in the Department of Medicine, told the audience that physicians can estimate the individual AIDS patient's expected survival rate from time of diagnosis to death based upon the syndrome's initial manifestations. "Patients who first present with Kaposi's sarcoma will live about 125 weeks after diagnosis, compared to 35 weeks for those initially presenting with Pneumocysciscarinii pneumonia and 18 weeks for those first affected by other opportunistic infections or disease," Murphy said. In addition to opportunistic infections, some patients develop certain types of brain tumors typically found only in AIDS patients. Murphy's case presentations showed the abstract term "fatal" takes on a more tragic picture: most patients with AIDS will die within three years of diagnosis. Although laboratory screening tests for HIV antibodies can assist the physician in confirming a suspected diagnosis of AIDS, they are more important as a means of screening the human blood supply, according to Roger Cunningham, Ph.D., associate Late Winter '88 professor of microbiology. Screening at blood banks features an initial ELISA (Enzyme Linked Immunosassay). A test sensitive for HIV antibodies, ELISA is repeated twice if the first result is positive. "False positives can result from antibodies in the blood which are not anti-HIV, reacting with material from the cell culture used in growing the virus for use in the test," said Cunningham. If the prospective donor has two positive ELISA results, the blood is tested using the electrophoretic Western Blot, which while as sensitive as ELISA, is more specific. "If the donor is repeatedly ELISA positive or positive on the Western Blot, he or she is barred from blood donations but still may not develop an active infection from HIV," he added. There is no guarantee that those who are HIV negative on these tests are not incubating the virus and might not convert to positive at a later time. But, Cunningham noted, "all that can be done is being done" to protect the human blood supply. "The time required from exposure to the virus co a positive test result is something we still don't know," he explained. Asked later about a recent finding by Johns Hopkins researchers that suggests that some patients who are seropositive for HIV later may convert to a negative test result, Cunningham said this discovery may indicate HIV "acts just like other viruses" in certain aspects of its behavior. "What these researchers have found is what we might suspect could happen," he added. I n addition to scientific questions about HlV and the AIDS syndrome, there are legal and ethical considerations which confront the physician and society, said Cheryl Nohejl, M.D., a UB pediatrician. Among these, she said, are allocation of available resources, maintenance of confidentiality, privacy for the patient, and duty co warn third parties. Some of these issues, notably allocation of resources, figure prominently in controversies involving other types of disease states, Nohejl pointed out. In addition to AIDS, Janek Patel, M.D., and Joseph Mylotte, M.D., discussed other sexually transmitted diseases, notably herpes and gonorrhea. Use of oral contraceptives, the IUD, and changes in sexual behavior since World War n have led to incr~ases in certain venereal diseases such as gonorrhea, genital warts, and genital herpes, they noted. Patel told the audience that the drug, acyclovir (Zovirax), has proved useful as a treatment for patients who suffer from initial outbreaks and recurrences of genital herpes caused by either Type l or Type II herpes simplex virus. The drug, he cautioned, should be given for no more than six months at a time in chronic cases. Daniel Amsterdam, Ph.D., a faculty member in the Department of Medicine and the Department of Microbiology who is based at the Erie County Laboratory, discussed laboracory diagnostic methods for various sexually transmitted diseases. Also included in the seminar, which was offered as part of the coursework for Microbiology 600 and 51 I, were Joseph Kite Jr., Ph.D., and Boris Albini, M.D., Department of Microbiology. • $200 ,000 bequest will provi de scholarship s M re than $200,000 will go toward cholarships for VB medical stuents under the terms of a trust fund established by a Medical School alumnus. The University at Buffalo Foundation Inc. recently received $205,229 from the estate of Vivian Sampson of Chicago, the widow ofW alter Sampson, a nephew of the late UB alumnus Walters. Barnes, M.D. Barnes had established a trust fund for his nephew. The terms of the trust stipulated that the principal would reve rt to the Medical School upon the Sampsons' death if their marriage produced no children. The UB Foundation has used the money co establish an endowed account, the income of which will be used for the scholarships. Buffalo Physician and Biomedical Scientist �29 Barnes, an 1892 graduate of UB, left the University $211,000 upon his death in 1958 at age 89. That money was used to upgrade facilities in Sherman Hall, and a plaque commemorating Barnes was unveiled in Sherman in 1962. A native of England, Barnes came to the United States with his parents in 1877. He had been affiliated with Mercy Hospital in Chicago for mor e than 65 years, and had served as a professor at the Northwestern University Medical School. • ADDEO PROT!,;CTI O!I OF' FAE E. RAO!Ct,L AH •. ERS OJHt •.RECOVER - l"BALI .Y lSCHE :-\IC RAT m : ;,P.T MTSP student wins national scholarship D avid J. Altman, a Medical Scientist Training Program (MSTP) student at UB, was one of thr ee M. O./Ph. D. students nationally awarded a Medical Scientist Scholarship worth $14,000 per year and renewable up to five years. Mr. Altman, an alumnus of Harvard University, received a letter of commendation for academic excellence for the 1984-85 year. In addition to his fine scholarship, he has also been involved in student affairs and in the orientation program for enter ing students. MSTP students are different from other medical students in that they can work coward a M. D./Ph. D. simultaneously, completing both in six co seven years. This program, started in 1982, was designed to narrow the gap of knowledge and understanding that often separates highly specia lized scientists from practicing physicians. • Psychiatry unit changes its name T he School of Medicine and Biomedical Sciences is not the only medical unit at UB that has undergone a name change. The Department of Psychiatry has been renamed the Department of Psychiatry and Behavioral Sciences. The ratio nale for this is that the department Buffalo Physicianand BiomedicalScientist :,: I i----1 ___ ~ ._l ~ I Q ;&Ii i..._ ______ __ ___ _____. Peter Bloom was one of the exhibi tors in UB's seventh annual Medical Student Research Forum held in Decembe r . is the principal unit in the Medical School responsible for teaching and research in the behavioral sciences. Three required courses in behavioral sciences during the preclinical years are offered, and psychiatry is taught in the clinica l years. The faculty consists of both psychiatrists and psychologists with some individuals, especially the psychologists, primarily responsible for teaching courses in the behavioral sciences. Fur thermore, research interest of faculty include such areas as behavioral aspects of health and illness, neuroendocrine effects on behavior, and prevention of mental retardation and mental illness. Dr. Marvin Herz, chairman of the renamed department, points out that 23 other medical school psychiatry departments have already adopted the new names. These include Stanford, George Washington, Johns Hopkins, SUNY Stony Brook, and Univers ity of Texas. • Minority students win Regents awards T wo UB minority medical students have received Regents Health Care Scholarships in Medicine. The two students are Lisa King and John W Smith. The Regents scholarship program is aimed at reducing the critical shortage of physicians in certain areas of New YorkState. It also aims to expand medical educational opportunities for underrepresented minority students and economically disadvantaged students. Scholarship holders receive up to $10,000 a year during their four years of approved study. After completion of their professional studies, they are required to practice in underserved areas of New York State. The UB students represent two of the 40 medical students selected Statewide. • Late Winter '88 ~ �30 HEADACHES ARE THEIRSPECIALTIES The information in chis scorywas compiled by Clare O'Shea from interviews wich Elliott Schulman and Greg Tramuca, brochure information and articles on the Comprehensive Headache Center, and nor.es by Bonnie Schulman and by Bruce Kershner. W hile at UB in the mid-60's, a couple of undergraduates met playing pinochle in the old Norton Hall. Twenty-five years later, they're meeting regularly again. But this time, it's to talk about headaches. Elliott A. Schulman, a neurologist, and G regory J. Tramuta, a psychiatrist, are cofounde rs of the Comprehensive Headache Cente r at The Germantown Hospital and Medical Center in Philadelphia. The center diagnoses and treats patients suffering from one of mankind's most common ailments. The shift from a pinochle team to a headache team was not exactly planned. Schulman and Tramuta were buddies all the way t hrough medical school unt il their graduat ion in 1974. But then Schulman moved to Pittsburgh, Tramu t a moved to Philadelphia, and eight years went by without any contact between them . Then came the day Tramuta was making h is rounds at Philadelph ia's Germantown Hosp ital. It just happened to be the same day and the same hospital in which Schu lman was making rounds, covering for another doctor. "It was totally serendipitous," said Tram uta, now chief of psychiatry at Germantown and a clinical assistant professor at Temp le University Medical School. " Here was someone out of my past - I had not heard from Elliott in years. I was very surprised." ln the years since he had last seen Schulman, T r amuta had completed postgraduate training and a residency at the Albe rt Ein- Lare Winter '88 stein Medical Center. He had held various positions including assistant professor of psychiat ry at the Medical College of Pennsylvania, psychiatric consultant at Germantown and at Wissahic kon Hospital, and psychiatrist at the Fox Chase Cance r Center, where he worked with terminally ill patients and their families. It was at Fox Chase, where he served as chairman of the pain management committee, that Tramuta became interes ted in chronic pain. He began discussing wit h Ge rmantown's chief of neurology, Stephen D. Silberstein, the idea of developing a center where patients with chronic pain could receive multidisciplinary treatment. Schulman arrived in Philadelphia by way of Pittsburgh and Washington, D .C. Afte r an internship at Montefiore Hospital, an affiliate of the University of Pittsburgh, Schulman served as a resident at Georgetown Univeristy School of Medicine and a fellow at the National Institutes of Health. He was subsequently appointed staff neurologist at Temple University Hospital and assistant professor at Temple Univers ity School of Medicine. Currently, Schulman is an attending neurologist at Germantown and is in private practice with Silberstein. T he pain cente r idea surfaced again when Schulman and Tramu t a began p r ivate practices. Because of the overlap between neurology and psychiatry, the two friends were t reating some of the same pat ients, shuffling them back and forth between their offices, then discussing them by mail. Rather than tryi ng to provide service for the whole spectrum of chronic pain problems, however, Tramuta and Schulman decided to establish a multidisciplina ry cente r focusi ng on a manageable segment of pain sufferers. In 1982, the two medical school friends . Buffalo Physicianand BiomedicalScientist �31 along with Silbe rstein and two psychologists, Ronald Kaiser and Joseph Primavera Ill, founded the Comprehensive Headache Center. The center, which meets once a week at Germantown, now includes a social worker and three nurse practitioners. "We knew that we could handle the head and facial pain populations within our disciplines," Tramuta explained. "We think we do a lot better than the primary sole practitioner can for patients with chronic pain problems." "This is a comprehensive approach," Schulman added. "Now that we are working side by side, we can address the problems as they come. We don't have to communicate by mail." The center is able to treat patients more effectively and efficiently because of the accumulated experience and expertise of the staff. In addition, opportunities for specialized research are made easier in such a setting. There are about 15 such centers in the United States. Of these, the Comprehensive Headache Center is one of only three with an inpatient unit, according to Schulman. It remains the only center of its kind in the tri-state area of Pennsylvania, New Jersey, and Delaware. The medical team cannot promise miracle cures, but they can in many cases help reduce the frequency and intensity of their patients' headaches, the two US-educated physicians agree. "ln the past, headache sufferers were never taken seriously," Schulman said. "It was the classic case of'take two aspirins and call me in the morning.' We now know there are treatment plans that really work." W hen the headache sufferer first contacts the center for help, he or she is given an extensive questionnaire to complete and bring to the initial appointment. The patient is given a complete medical exam and is seen by a psychologist or psychiatrist. A psychological profile of the patient is created using the information provided on the headache history along with psychological tests . That profile is given to a staff neurologist. A t reatment p rogr am tailored to the Buffalo Physician and Biomedical Scientist individual headache patient is then designed by the medical team. Treatment will vary, but it may include a change in diet, medication, behavior modification, biofeedback, and psychological and physical therapies. Some of the newer medicines used by the headache center include calcium channel blockers, various antidepressants, beta-blockers and DHE ( dihydroergotamine), an ergot preparation. The center has been involved in testing a nonsteroidal anti-inflammatory agent, and a new selective beta-blocker, Schulman said, and has experimented with low doses of anaprox, a motrin-relative . Those patients in need of inpatient evaluation are taken off all unnecessary medications and, in some cases, given a prophylactic medicine during a five- or six-day hospital stay. Classes are given on headache types, drug therapy, and the social ramifications of headaches. A social worker meets with the patient and family several times during the hospital stay. M any headache patients have suffered every day for years without finding relief from pain. "lt would not be unusual for us to treat a person who has suffered with headaches for over 25 years, often on a daily basis," Schulman noted. "These patients commonly ingest l Oto 12 aspirin or Tylenol daily, along with an assortment of narcotics and ergot preparations." "Because we're really a referral center, we tend to see people with more severe problems," Tramuta added. "These are people with severe headaches, people who daily are taking large amounts of analgesics, tranquilizers, sleeping pills, or specific migraine medications. They're a wide mix of personalities; some are depressed or neurotic, others are not.'' The physical pain frequently affects other aspects of the patient's life. "Severe depression is a common manifestation," Schulman pointed out. "Patients miss school or work, have problems with their families, don't go out.'' ' 'T hey are socially isolated because of their Late Winter '88 �32 headaches," T ramuta added. "Chronic headache pain wears people down. They feel depressed in response to the pain, and frustrated because they can't get rid of it and don't understand why they get it. The pain and the depression can feed on themselves it's a vicious cycle." J ust as there is no one patient that is typical, there is no such thing as a typical headache, Schulman and T ramuta point out. There are many misconceptions about the cause of headache pain. Some people blame their sinus problems. Although sinuses can ache, the headache in the area of the sinuses described by most people is rarely caused by congested or inflamed sinuses. It is more often the pain of a tension or migraine headache. Neither are headaches usually a sign of high blood pressure, allergies, dental problems, or eye problems, according to Schulman. Some sufferers of severe or chronic headaches fear the possibility of a brain tumor. Actually, fewer than 10 per cent of chronic recurring headaches have such a serious underlying cause as brain tumor, blood clot, infection, or hemorrhage, he said. It is now believed that many headaches may result from a biochemical imbalance in the brain, according to Schulman. This involves the compound serotonin which may lead to inflammation of the blood vessels and irritation of the nerves, resulting in a headache. The imbalance can be triggered or aggravated by many agents, including head injury, emotional or physical stress, hormonal changes, drugs, sleep disturbances, noise, bright lights, weather changes, odors ( including certain perfumes), menstruation, lack of adequate exercise, alcohol (especially red wine), large amounts of caffeine, and certain foods such as bananas, nuts, aged cheeses, chocolate, smoked or pickled meats, pickled herring or chicken livers. "Not every headache problem is headacheinduced," Tramuta pointed out. "People should take a close look at their environments.'' The most common Lare-Wimer '88 types of headaches treated at the center are migraine, tension, cluster, and rebound. Migraine and tension are the two major types of benign chronic recurring headaches. Since symptoms of each can overlap, however, it has been suggested that migraine and tension are not two distinct headache types but rather exist at opposite ends of the same spectrum. A bout 20 per cent of the population suffer from chronic, recurring headaches, Schulman said, although almost everyone suffers a headache at some time in his or her life. "More women than men get headaches," he added. "And while more women get migraines, more men get cluster headaches." The tension headache is typically a dull, constant ache which usually affects the whole head. Sufferers often describe the pain as a tight band around the head, often accompanied by a tightness in the neck, dizziness or nausea. Aspirin or acetaminophen often quickly relieves the pain, although it may last for hours or even days. The common migraine pain is usually throbbing, periodic, and one-sided, although it can be bilateral. Often there is a family history of this type of headache, which also can last for hours or days. Nausea or vomiting, sensitivity to light and loud noises, abdominal pain, anxiety, and fever are possible symptoms. The classic migraine may bring the same symptoms, plus it may be signaled by flashing bright lights before the eyes lasting as long as 20 minutes. In rare cases, weakness or numbness in parts of the body or blackout in a part of the visual field accompanies the migraine. Interestingly, a headache need not be part of the symptoms of a migraine. If taken early enough, aspirin or acetaminophen or other prescription drugs can sometimes relieve migraine pain. Drug therapy may be necessary, however, if the migraine is chronic. The cluster headache occurs in bunches from one to five times a day over a period of days or weeks, followed by a remission of six months to a year or longer. Attacks last from 15 to 90 minutes, and recur at approximately the same time every day, often interrupting Buffalo Physician and Biomedical Scientist �33 the person's sleep. The pain always affects one side of the head, is located around the eye, and is described as a severe, boring sensation, like a hot poker is being pushed into the eye. Nasal stuffiness and eye tearing on the same side as the pain are usual symptoms. There are no warning signs associated with the cluster headache, although alcohol frequently brings on che attacks. Cluster headaches are not inherited. The analgesic rebound is a newly described form of headache. The first thing many people do when a headache hits is to reach for the aspirin bottle, or maybe a strong cup of coffee. And they keep reaching, perhaps taking more than 14 tablets a week or more than 100 a month. It has been shown that such abuse of analgesics can perpetuate and worsen the headache pain. And when the medication is withdrawn, the result is a rebound headache which increases in intensity and lasts from four days to one or two weeks. Finally, there is the headache which com- Stress seen as primary cause of children's headaches S tress brought on by social or family pressure is the cause of the vast majority of all headaches experienced by child ren and adolescents. "Headaches are very common throughout all pediatric age groups," said Michael E. Cohen, M.D., speaking at the Annual Meeting of the American Academy of Pediatrics (AAP) in November. Dr. Cohen added, though, that toddlers and children between the ages of 5 and 15 years have the greatest incidence of headaches. Peer pressure, school phobia and family problems such as d ivorce are some of the env ironmental facto rs that can cause stressrel ated headaches in children, Dr. Cohen said. Tension headaches also may develop, he said, as a result of difficulties with sibli ngs or when children have problems achieving their parents' expectations. Buffalo Physician and Biomedical Scientist manly occurs as part of the post-traumatic syndrome chat follows a head injury. Such a headache can have one or several of the symptoms of either migraine or tension headaches. M ore than 300 headache sufferers have been treated at the Comprehensive Headache Center since it opened its doors. The success rate has been about 80 per cent, Schu lm an said, due in large part to drug therapy and the addressing of psychological issues. "We have treated patients as far away as Florida and the Midwest," Schulman said. ''Our youngest patient was 12; the oldest was 80." "We'll get people who sometimes have had headaches for years, who feel wretched, miserable, hopeless," T ramuta said. "They've been told they have to live with this pa in which has disrupted thei r who le lives. It's very gratifying to see people walk out the door feeling a new optimism about life." • Dr. Cohen, professor of neurology and pediatrics at UB, and director of child! neurology, Children's Hospital of Buffalo, explained that stress-related headaches are non-migrainous and can occur frequently or infrequently. He estimated that about 40 per cent of all children have expe rienced such headaches by age seven and about 70 per cent of all children experience th em by adolescence. Medication may help reduce some of the symptoms of a non-migrainous headache; however, Dr. Cohen said that counseling with a pediatrician, child neurologist, or child psychiatrist may be a better alternative. "Counseling of the parents can also be quite helpful," he added. Dr. Cohen estimated that the minority of childhood headaches are caused by physiological problems, such as chronic infections, brain tumors, or blood vessel abnorma liti es. He also noted that sinus problems, visual difficulties and sensitivity to chemicals in certa in foods are often suspected but seldom proven as causes of chronic headaches. • Dr. John \V. Cudmore John W. Cudmore (M'62 ), a physician with Health Care Plan's (HCP) group practice, was recently promoted to Brigadier General, Army National Guard. He is a clinical associate professor of surgery at UB. Cudmore, who received his first commission in the National Guard in 1963, is in charge of 6,500 troops throughout New York Sta te. "What is unusual about my assignment," Cudmore said, " is that a medical officer has been given command of general service troops." During his years of military service, Cudmore has given many more hours than the standard two weeks per year and one weekend per month required for reserve service personnel. He has been called in to assist with floods and blizzards and the prison uprising at Attica Sate Penitentiary and to command Military Medical Support to the 1980 Winter Olympic Games in Lake Placid. "l wouldn't do this ifl didn't really enjoy it," the general said. In his new command, Cudmore will oversee the training of New York State's National Guard and will be responsible for the level of readiness sustained among his troops. The National Guard maintains a force that is prepared to respond to any state or federal emergency that should arise. Cudmore, who has been a full-time member of Health Care Plan's physician staff for five years, is a genera l surgeon and a staff member of Buffalo General Hospital. • Late Winter '88 �34 William S. Edgecomb '47 1940's William S. Edgecomb (M' 47 ) • has been appointed a life fellow of the American Psychiatric Association in honor of his long-time contribution to the medical and general community. Dr. Edgecomb has a private practice in Orchard Park, N. Y., and is currently an assistant clinical professor in the UB Psychiatry Department and president of the medical staff ac Bry-Lin Hospitals. 1950's Patri cia A. Meyer (M'50) • writes, "I would like t0 cell you of my good fortune. I entered the February comest of the Monthly Prescribing Reference and was the winner of a trip to London on che Concorde. Along with the trip, there is a gift of $1,500 for other expenses." 1960's Loui s Trachtman ( M'65 ) • has been elected president of Eta Chapter (Tu lane University) of the Delta Omega Society, a national public health honorary Late Winter '88 soc iety . Dr. T rachtman is comedical director of the State Office of Preventive and Public Health Services and a clinical instructor at Louisiana State University School of Medicine. He is also continuing as assistant adjunct professor ac Tulan e University School of Public Health and Tropical Medicine and has a pare-time pediatric practice. Dr. Trachtman has published numerous articles in che]ournal of the Louisiana Seate Medical Society. Raymond A. Martin (M '68 ) • writing from Houston, Texas, tells us that he is president of the Texas Neurological Society for 1987-1988. He is an instructor in neurology at the University of Texas . 1970's Ar thu r M. Seigel (M'7 0) • assistant clinical professor of neurology and pediatrics at Yale University School of Medicine, writes that in 1987 he published "The Neurological Examination" in PhysicalDiagnosis.Dr. Seigel is a member of the Board of Directors, New Haven Individual Practice Association. Richard J. Goldberg (M'74) • was appointed chief of psychiatry at Rhode Island Hospital and Women's and Infant's Hospital in Providence. Dr. Goldberg is an associate professor in the Department of Psychiatry and Human Behavior at Brown University. Richard S. Elman (M'78) • has been named medical director of the emergency department at Sisters of Charity Hospital. Dr. Elman, who assumed years of practice in general internal medicine at Harvard Community Health Plan, Dr. RockwelI is now a firsc-yearfellow in endocrinology at Beth Israel Hospital, Boston, Mass. Dr. Jederlinic is an assistant professor of medicine: critical care, pulmonary and occupational medicine, at the University of Massachusetts-Worcester. Richard S. Elman '78 his duties on September 1, is the only board certified emergency medicine physician in the Buffalo area. A magna cum laude graduate of Case Western Reserve University, Dr. Elman, after receiving his UB med ical degree, completed an internship in family practice at University of Arizona Affiliated Hospitals. Prior to joining the Sisters staff he was director of emergency services at Lockport Memorial Hospital. Paul Summ ergrad (M'78) • writes, "I have been appointed director of che inpatient psychiatric service at Massachusetts General Hospital. where I completed my psychiatric residency in 1985. I also completed a residency in internal medicine at Boston City Hospital in 1981. I am board certified in internal medicine and psychiatry." 1980's Peter Jederlin ic (M' 79) and his wife Jessica Rockwell (M'82) • inform us that they have two children: Nicole Sarah and Alex Michael. After completing cwo Robert A. Herman (M' 83) • recently completed his residency in psychiatry ac NYU School of Medicine and opened his private office for the practice of psychiatry at 35 West 90th Street, Suite lA, New York, N. Y. 10024. He has been accepted as a candidate at the Columbia University Center for Psychoanalytic Training and Research. Dr. Herman is a clinical instructor at NYU and is assistant clinical psychiatrist ac Bellevue Hospital. Patricia Flanagan (M'83) and Mark Schwager, (M'83) • of Cumberland, R.I., joyously announce their new arrival, Zachary Alexander, born July 8, 1987. Herbert B. Newton (M'84) • informs us chat he has been accepted for a fellowship in neurooncology at Memorial Sloan-Kettering Cancer Center in New YorkCity. He is planning to publish a paper on che effects of cisplatin in che treatment of malignant brain tumors. Blackford Middleton (M' 8 5) • writes, "Mose exciting news is of marriage co Ursula G. King in September. After chat I am happy co report that I marched for my first choice fellowship position which will be at Stanford Unive rsity as a fellow in General Medicine and Medical Informatics!" Buffalo Physician and Biomedical Scientist �35 The Batavia VAMC Batavia VAMC joins UB affiliate group A s if eight affiliated teaching hospitals weren't enough, the UB Medical School has added one more : the Batavia Veterans Administration Medical Center (V AMC). The addition extends UB's educational mission not only to Batavia, 30 miles east ofBuffalo, but into Rochester as well. This is because Batavia V AMC has an outpatient clinic in Rochester. Batavia V AMC is UB's first teaching hospital outside Erie County. "We are pleased at the opportunity to extend our work with the Veterans Administration to facilitate development of education and research in geriatrics and rehabilitation," Vice President and DeanJ ohn Naughton comments. "We see Batavia VAMC as accelerating the school's ability to strengthen its role as a national leader in geriatrics and rehabilitation." Specifically, the new affiliation provides an alternative environment for training students, residents, and fellows in geriat rics and rehabilitation medicine. It will also stimulate resea rch activity in these disciplines as well as in long-term care and home care. For the hospital, it will provide a more focused mission in these areas. It will also help Buffalo Physician and Biomedical Scientist the care of veterans by bringing the University in contact with the hosptial, and enabling the staff to be enriched. All hospital appointments in the future will become UB appointments. Batavia V AMC previously had an educational linkage with the University of Rocheste r. That affiliation was dropped after a review indicated chat the hospital's interests complemented UB's strengths. The reporting relationship of veterans hospitals in Batavia and Buffalo will remain independent. Neither one will have a subordinate role regarding UB and both will sit on the same dean's committees. • State proposal would limit residents' hours A proposal before State Health Commissioner David Axel r od would limit resident physicians throughout the State to working no more than 80 hours a week. The report from the Ad Hoc Adviso ry Commit tee on Emergency Services, chaired by Dr . Bertrand M. Bell, also recommends that non-emergency room residents be scheduled to work for no more than 24 hou rs in a row. They must be off for one 24-hour period a week. An ear lier proposal had recommended that residents work no more than 16 hours in a row. Residents in emergency rooms would be limited to working 12 hours in a row, which is already standard practice, said John Naugh ton, dean of the UB School of Medicine and Biomedica l Sciences and vice president for clinical affiars. An individual who has worked the maximum number of hours as a resident won't be allowed to work additional hours as a physician in another hospital. The proposal also requires that hospitals provide more ancillary care to make up for the decreased workload of house officers . Hospitals must have sufficient IV services, phlebotomy services, and messenger/transporter services to meet the new demands, the committee's report says. All of the recommendations are based on the understanding chat the Department of Health will provide the necessary funds to implement the recommendations; according to the report. • U.S. Army contract at Roswell Park T he United States Army and Roswell Park Memorial Institute have entered into a th ree-year, $488,379 contra ct co develop and test more effective, less toxic interferon inducers to prevent and treat viral diseases. The contract was announced by Dr. David Axelrod, New York State commissione r of health, and Dr. Thomas B. Tomasi, director of Roswell Park. Interferon is a natural protein that cells produce when attacked by a virus in order to "interfere" with the reproduction ~f the virus in the body. Interferon inducers are synthetic mate• rials chat are injected into the patient to scimu• lace che body to produce its own interferon. Dr. Judith A. O'Malley, director of biological resources, and Dr. Jake Bello, principal cancer research scientist in che Roswell Biophysics Department, are the co-principal investigators on the contract. • Late Winter '88 �36 Dr. Ko rn el Lud wig Terplan • 93, former chairman of the pathology department at the University of Buffalo School of Medicine, died Nov. 21 ar his new home in Sonoma, Calif. He taught two generations of medical students and was renowned for his studies of children's brain development. Dr. Terplan, a native of what then was the Austro-Hungarian Empire, had lived in Buffalo from 1930 to last June and had continued his brain research and part-time teaching until last year. A tall man described as formal and private, but noble, by one of his former students, Dr. Terplan was said to have been an inspiring teacher as well as a renowned medical researcher. His description, released in 1932, of body changes during insulin shock is said to have been the first report of its kind. His pediatric brain collection, called one of the world's best, was transferred last year to the UB School of Medicine, where it is used in reaching medical students. He lectured widely on pathology ro medical groups. Born in Aranyosmaror, Hungary, Dr. Terplan was raised in Schessburg, a German Lutheran enclave in the Transylvania part of Hungary. He studied medicine in Budapest and Prague and served during World War l as a medical officer in the Austro-Hungarian Army. He graduated in 1919 from the German University of Prague and did research there until 1930 when he was asked co come to the UB School of Medicine and Buffalo General Hospital. He began here as a research professor in pathology and in 1934 was appointed the department chairman. He is credited with developing UB's modern pathology department. After he retired from UB in 1960 and was appointed professor emeritus, Dr. Terplan continued his research under grants from the National Institutes of Health. He maintained an office in Children's Hospital until shortly before he moved to California. He belonged to the Buffalo Athletic Club, where he regularly swam until about a year ago. Survivors include his wife, lnge; three Late Winter '88 sons, Dr. Martin of Sausalito, Calif., Dr. Peter of Los Angeles and Dr. Fritz of San Francisco, and three grandchildren. (Reprinted from the BUFFALONEWS) Frank Chambers (M'40) of Plant City, Florida, died July 13, 1987. Dr. Chambers had a family practice in Plant City for 36 years. He was a member of the American Family Practitioners and a Federal Aviation Authority medical examiner. He was a veteran of WW II, having served in the Navy as a pilot. He is survived by his wife Elizabeth Bateman Chambers; two daughters, Mrs. Pamela McGinnes and Mrs. Sherrie Mueller, and a son, Dr. Step• hen F. Chambers, all of Plant City. Milton A. Palmer (M'27) of Lancaster, New York, died March 30, 1987. Dr. Palmer was a life member, incorporator, and charter member of the board of directors of the Bufflao EyeBank and Research Society. He was chairman of its executive committee for 10 years, president for 21 years, and was president emeritus . Dr. Palmer was a life member of the Eye-Bank Association of America, and in 1983 he received the Rudy Spitzer Memorial Award for Sight Preservation and Dedicated Participation in the Buffalo Eye-Bank and Research Society. He is survived by his wife, Doris Wheeler Palmer, and a son, William W. • Walter Stafford, Jr. (M'44), a UB physician who once also served as a special assistant to the acting president ofUB, died August 12, 1987, at age 67. He held several faculty titles, includ ing clinical associate professor of neurology, clinical associate in anatomy, and a former title with the Pathology Department. He was a neurologist on staff at BuffaloGeneral Hospital for more than 30 years. Dr. Stafford served with the U.S. Navy in the Philippines during World War II. An accomplished pilot, he once conducted research at Cornell into the effects of high speed flight on the human body. • Dr. John Charles Robin, 38, a second-year student at the UB School of Medicine, died September 2, 1987. A lifelong Buffalo resident, Robin had suffered leukemia for about two months. He held a degree in psychology, a master's degree in natural sciences and a doctorate in pathology, all from UB. Robin was a member of the Erie County Historic Preservation Board, the Allentown Association and the University Club. Survivors include his parents and four brothers. • Norman S. Ellerstei n (M'71), known for his work on the detection and prevention of child abuse, died August 25, 1987 in Amherst after a long illness. He held various positions at Children's Hospital and was an assistant professor of pediatrics at UB's Medical School. Born in Akron, Ohio, Dr. Ellerstein was raised in Buffalo. He earned his undergraduate and medical degrees at UB. Dr. Ellerscein was a full-time staff member and held several administrative positions at Children's Hospital. He was director of the Child Abuse and Neglect Program, run jointly by UB and the hospital, and was director of the hospita l's Child Protection Clinic and of the pediatric house staff program. A fellow of che American Academy of Pediatrics, Dr. Ellerstein wrote many articles and books on pediatric medicine and child abuse and neglect. He was an editorial consultant to many professional and medical journals. Surviving are his wife, a son, and his mother. • A lfre d Mi tchell (M'38) • died on June 20, 1987, in Elmira, New York . Or. Mitchell practiced internal medicine in Elmira, from 1940 co 1987. He was a Diplomat of the Board of Internal Medicine. Elme r G r ob e n (M'4 1) • died Septembe r 5, 1987, after an extended illness. He practiced medicine in Columbus Junction from 194 7 co 1970 when he moved to Iowa City where he practiced until 1983. Or. Groben was an associate professor in family practice at the University of Lowa College of Medicine. He is survived by his wife Martha and two sons and cwo daughters. Robert Wa rd ( M'47) • died on November 25, 1987, in Miami, Florida. Buffalo Physicianand Biomedical Scientist �SPRING CLINICAL DAY AND REUNION WEEKEND May 7, 1988 Buffalo Marri ott 8: 15 , Morning Scientific Session 12:30: CONTROVERS IES AND TREATMENT OF AIDS, BREAST CANCER AND CORONARY ARTERY DISEASE 1 :00: Stockton Kimball Memorial Luncheon and Lecture Honored Leaurer ROBERT P. GALE, M.D. '70 Associate Professor of Medicine, UCLA Medical School Dr. Roberr Gale --~--------------------------------------------------------------NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFFALO. N.Y. POSTAGEWILL BE PAIDBY ADDRESSEE 146 C.F.S. Addit ion State University of New York at Buffalo Buffalo, New York 14214-9980 I,,,II,I111,, I,I,,,II,I,,II,I,,I,I,,I,,I,II11111 I,II �BUFFAlD Non-Profit Org. U.S. Postage PAID Buffalo, N .Y. 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For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b9e7d5bc38e6182e6a53b6b4a90ded40.pdf 176af84cc28a3d0cd5088c01ed804b1f PDF Text Text Vol 22, No ~ �Dear Alumniand Friends: STAPF EXfC l '11\ f EC'ffi)R Lil's!\ ER'iITT Pl 3llt ATI->!'>IS R.:bcrt T \hr 6l fh\1.0 PIH~!( Al'<EDr,DR 1d Cor: c l)s" u d /1 =cdia.l ~ tr:mr m· hdd l l.ide,; :i shortl'ned \l'rs :Jn of m\ rem 1•k$to •he rctMlt tees Tro of Board nd n, 1s1r,m• .idm11, ft, t, h, the med1, I •o uixl.i•c i;ned Jc•, rrtre h1< p11,1IT Ho l,rneml Buffalo rh "' 1 1hc !,_.,spit I, 11\ 1hc 1he1r L 111,mLeiu.Jc Lbou1 de\dopml'nts ln~11tutc, "a< ried1c I chool, and JI 1hc Ro wet: P.ir:.. Memon I Thl. hosp11al (l.-sslul s1, .,..i1te \\a OUnt ~•1.1el. well atlendcJ ,md h', C'ndJct .ich , Ii> b c.onpr.itul •l-d fn IJkm .. \ luJblc t me 1,1.. , sul'S m ,111mlorm..illH' •l' nn lOlllcrnm~ rr ,1Jor c,)ntt.wporar\t.-du , >n .md h 'th <,ire. n ,J .-sJrc nd As vou "111 glt'ln from m\- rem.irks. m,1Jor d1..ingt to "• I Nnr llX,11ly, tc\\1dc anJ n.mon.illy "h1 h w1I rH· I med the lxrneen tt.d cx1 ,c h 1hat ps h ch,m :, the rcfauon fhcsc ,hangcs cdu, 110n'-""llll'llll ty anJ ~h, p 111t•ntcJrt· sy•ttm 1hat h.ivc 111tcr.1C11ons \\ill oltcn be tro·1bk-wm • .i1 that 1hc um'iuc 1 dNUPll.-d as 'llOrc .ind r x1stt·d m th, husp t I em ronn, nt "1 1 be mt-d m ,lm riore mt.-d1, I studc111 .md re d nt cdu.a".;>n 1spcdor of tht l.ilrrtnt hul:itor', md ...om'll m ty l'!l\ .ronm,llls, ,mJ mu h tc Urtl-S ot "ork {'C'l'IOrlT',J h\ res1dc111s ~ urned h.., altcrn ht.11th manpowu. ,mpc:nJ ng ,h,mges m thc mmner Ill wh1lh Di,-.;p1te th~ .te'l' w1'I med .ii edu,.1•1on 1sconJul.tcd, thn teach ng hosp1rn: sy '- ·re pJUcnt ,md fl.h, • r<." uon. c<lu.. f ull be. maJur 1n:!fU"TIC'l'o .1 tc,Jlh•ngl.m,1y for the .,, Je'll' lly ,mcntl.-d I, ulty ,rd thr rctrt ll ,>ricnlt'd pFl t1 mg phy,K,JII commun11y Hopctulh. ot us for dc11I ;cr\N 10 reinforce th t cont.er• JnJ tu pr,p,1rc .ill "1th m the mr wuh the rl·,1l11eswh1t.h we ,ire .md "rll he f,1,t·d J. he ye r T h 1< 1c C)frh B11/fle, Pin l<W ~mil,:, ART Dliu.C'TPR AJ,c J K,glcr ADVISORY BOARD [)r )o, I l',; IL n, • tl1<11m: Or H • ,Id Broov ' ( " lf .., :::>r.; .'" 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WRITI:RS \!ark Marc'i.,lla hn "'•ugh· I: •sabcth % fhc J "ue 'll'uctchr ILLUSTRATORS CiiTg B, hop &m F•.:gm'J P l l(mlG R1\ Plll:RS Tong 'i.m Bo "- on Jm· 1 rrat n John n 8 Na u ghto n , M.D. Prc,.Jert/0"'Clrm<.i!IAIJa,r, v•.._.._ u & ...... l. - TE.ACHINGIIOSPITALS ANI> LIAISONS of M, I, me u· 1 Bron: t,c..11'x .,,.e, D.m '><.ho<f l t , A Dear FellowAlumni: "M llarc.lFllh, ore llo-p1·al, Clan•, 1: Day, Bo..ird, A'umm thl' H~CJ. 6, MJy 1,dJ to wh,,h pie , j 10 1 mount. th it the pn:y,rJm h • hu:n cl 11,r1hc pe 1ker, w111 Jay A J, ,11n-; 11 h -<lfJl •1h of l<X1 11' :l nauon 11 "•~ ri,1h• .i'T'r J, i.. •~urmon 1r th '4! •I•• ou• ~ pc 1h,111' ret.r,1011 ,la 1he1r nJ . ,rn p·ogr th1 tt•nd lo ., cvl"-•·rrrd dfort l hh hm l't of Th Alur m· Bo rJ I. t<•t pn t I th nu:·bo ,rd r llHrl·ntl. 01,1m 'J hed Ml-d ,JA ,urr r,u 'A"JrJ. , • p col th1 p 1hlll. I th )r, C. .urJ (-C~ mp n ·n r, , :t< f0r tin ., po t,1rl' "l;. 1d (ard nJ • t nom1nt tkttm,; • 1 <rlter. th n n I' I..)ffi'\lumm the.· ro for -t.l'd 1, \'Ol r n0m1n,ltlon p 1 )· r '-<' ti ,J th1 t th r,nuur. I hi-e I 1. I\',""" Lr.. .r, ti, l11<1or','of ,r 'llt-n':-t yang p thl· l,rg~ I c.·nrol'n,t1,t ••I J~. \'\' on the bo rJ Pixnn. 1,41, l' 1 \ 'I A11•n" I \1cJ ~h lur. 1d wot, J 1cn•lxr r ir • rrori , 10i.:. for" ,rd t '< >flti"'l'H: ! JP"''"' • r~ I,, '1\ ,nc In• ti, It l fl• \1c ·nhcr ' p •n .i• '"l'J"'I; 1 tr t po , t>·••~.pll' <' rc~po,,I f v ~.1bl, •o ,.1 rr, , re 11011 1 the ~.rr, 1<rro\\ Ill's ntJrc r to our Spnll Bl•) \ r C l Pl > " l , C , • A, Ju [' \/T [ j 16 ( f "''.,.. ' . 'l , II h11'1,r, \1 .:... /~//1./~k Paul If. Wicrzbicnicc, M. D. Pre .Jer.1 . I! I l �Vo l. 22, No. 5 Features The best is yet to come. Donald S. Faber, Ph.D ., received the prestigious Javits Neuroscience Investigator Award for his work that has helped change the way we think about the nervous system . I lucky13. For alumnus Larry Schreiber and his wife, Carol, ten adopted children plus three children by birth add up to one big happy family. Cholesterol.Can you trust laboratory measurements of cholesterol levels?An October conference looked at that and other question s pertaining to cholesterol. I Passivevaccine.Edwin D. Kilbourne, M .D., one of the world's leading experts on influenza, is working on an influenza vaccine that actually allows a virus to invade the body . He described his research in the fall Harrington Lecture . Airwaves.Three students find that jobs as radio disc jockeys ease the tension of medical school. ~ Handpicked . The students entering UB's medical school are talented and diverse. Departments HospitalNews.The board of managers at the Erie County Medical Center has more power over the day-to-day operations of the hospital, thanks to a new law that was effective Jan. l. Classnotesand alumninews. A new annual award will honor a Distinguished Medica l Alumnus/a . Cover P hoto: Bob Walion ��3 It's More Than Electrical Wiring Faber gets ]avits Award for researchon nervous system i f ver the last 14 years, Donald S. Faber, Ph.D. has he lped change the way we think about the nervous system . In recogn ition of that fruitful work, and in anticipation of more to come, the UB professor of physiology has been given the prestigious Javits Neuroscience Investigator Award by the National Institute of Ne u rologica l and Communicative Disorders and Stroke . The award, named for the late Sen . Jacob K. Javits of New York, is given to investigators who have a distinguished record of substantia l contrib utions in neurologica l or comm u nicative sciences and who can be expected to be highly productive over the next seven years. The award grants Faber an extra two years of funding for his new NIH grant, bringing it to a total of $1.2 million over seven years. Since the 1970s, Faber and the members of his laboratory have collaborated closely with a group of researchers, led by Henri Korn, M.0., Ph.D., at the Pasteur Institute in France . "The award is the result of our collaborative efforts;' Faber said . This grant, as well as h is previous work, focuses on synaptic interactions in the central nervous system. Faber and his colleagues work with the Mauthner cell in the brain of a goldfish, BUFFALOPHYSIC IAN AND BIOMEDICALSCIENTIST which he finds to be a better experimenta l mode l than mammals or invertebrates. "Ic's a very beautiful system for a number of reasons," Faber said . "The cell is identif ied-you can give it a name . That's not common in other systems. "There are just two of these Mauthner cells, one on each side of the brain . And the cells are large." The job of the Mauthner cell is to trigger the fish's escape mechanism-when you tap the aquarium, the fish swims away. Different kinds of sensory input trigger the cell and trigger it reliably. How does this trigger work? Using microelectrodes, the researchers recorded the Maut hn er cell's responses to inputs from sensory cells and from inhibito ry interneurons (the cells that "talk" to the Mauthner cell). These inhibitory cells are part of the network that controls when an escape occurs. Injecting dyes into the inhibitory intemeu ron, the researchers were able to look at the structu res of the synapses using the light microscope and electron microscope . "By combining physiology and structure, and statistical ana lysis of responses of the Mauthne r cell to inhibitory intemeurons, we have developed a mode l at the microscopic level for synaptic transmission in the central nervous LATE WINTER 1988-89 �4 Does one synapse influence another? "We're excited about the question of cross talk because it opens up a number of possiblr ua)S of thinking about hou the nervous s, stem i0orks." 1 LATE WINTER 1988-89 system; Faber said. "This mode l is common not just to fish, but to most neural connections!' ne aspect of the model is related co the fact that the endings of nerve cells release chemical transmitters in a "probabi listic" way, Faber said . 'There's a degree of uncertainty in the way the connections work ." We often think of the nervous system as a wiring diagram . If you flick a switch, a light bulb goes on. But Faber pictures it this way: You've got 10 light bulbs . When you flick the switch, sometimes all 10 bu lbs light up. Another time just four light up, or none come on at all. Though the stimulus is the same, the message that the cells receive is different each time. This probabilist ic feature also provides the basis, in some systems, for forms of "plasticity" where, with experience, synaptic connections become reinforced . For example, if you stimu late a nerve cell repeatedly, there's a greater chance that subsequen tly all 10 bu lbs will switch on . Faber likes to use the term "plasticity" co describe this phenomenon, preferring that word over "learning" or "memory~ That, in capsule form, is what Faber has been working on for 14 years. About four years ago, Faber and his colleagues began to think about the u nity of a synapse-not on ly how the chemical trigger is released, but how the Mauthne r cell responds . They've developed computer models of how that works, tak ing into account the diffusion of the chemical transmitter in the synaptic cleft (the very small space between the inh ibitory interneuron and the Mauthner cell) and how the Mauthner cell responds to that transmitter . T his mode l prompted the researchers to become interested in new questions, including : Are the adjacent synapses isolated from each othe r or does one synapse influence another? The re are indeed mechanisms for cross talk between adjacent synapses, Faber and Korn wrote in a November 1988 article in the Proceedingsof the National Academy of Science.This work becomes the focus of the Javits Award, Faber explained. "We're excited about the question of cross talk because it opens up a numbe r of possible ways of thinking about how the nervous system works:• he said . The genera l notion about a synapse is chat a chemical neurot ransmitter is released, diffuses over the synapt ic cleft, binds to specific receptors on the other side, and is quickly deactivated when Pac-Man-like proteins gobble it up or carry it away. But Faber has found that instead of being active ly carted away, the chemical transm itter slowly diffuses away. While the chemical lingers, its effect can be compounded . For instance, if two adja- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �5 Faber thinks a chemical transmitter can change an adjacent receptor site. "If iue're right, we have a tremendous mechanism for modulation of synapses that use even different transmz.tters.'' cent inhibitory incemeurons transmit glycine, the effect is greater than the two individua l effects added up. "The fun thing we want to do in the next few years is expand chat concept;' Faber said. Suppose two adjacent nerve endings, called A and B, release different chemica l transmitters onto one cell. In the old way of thinking, chose nerve endings are isolated from each ocher. Chemical A affects receptor site A and Chemica l B affects receptor site B. Then the chemica ls are quickly deactivated. But Faber thinks it's possible that chemical A may affect not only receptor site A, but diffuse over to receptor site B and change it as well. "If we're right, we have a tremendous mechanism for modulation of synapses that use even different transmitters;' he said . This adds a level of sophisitication to our thinking that's left out of the "wiring diagram" view of the nervous system. He noted that a lot of experimenta l models for plasticity in the nervous system on ly work when groups of cells are active, not when a sing le cell is active . Faber's postulation "is one type of mechanism that explains chat, we hope . We'll try to find our:• aber received his S.B. in electrical engineering from the Massachusetts Institute of Technology and his Ph .D. in physiology from UB in 1968. For cwo BUFFALO PHYSICIAN AND BIO MEDICAL SCIENTIST years he worked ac UB as a postdoctora l research fellow supported by an NIH grant . He left UB to become a visiting research associate at the Max Planck Institute for Brain Research in West Germany, chen moved on to a similar position ac the Universice de Paris. From 1972 to 1974 he was an assistant professor of physio logy at the University of Cincinnati. Faber moved back co Buffalo co cake a position as a research scientist with the Research Institute on Alcoho lism. In 1975 he joined che faculty at UB and in 1978 became director of the Division of Neurobiology, a pose he held until 1986. A prolific writer, Faber has published 82 papers and one book. In addition, he holds numerous positions with faculty committees. Awards are nothing new to Faber. He was an exchange scholar with the Capital Institute of Medicine in Beijing in 1986, a fellow of the Neuroscience Institute in New York City in 1984, a fellow of the Claude Bernard Association in Paris in 1972, and a Grass Foundation fellow at the Marine Bio logical Laboratory in Woods Hole, Mass. in 1969. About the Javics Award, Faber says modestly, "It's a nice feeling to be recognized . le says my colleagues like what we've been doing:' • LATE WINTER 1988-89 �0 Il.§ 6 LATEWINTER1988-<W 0 ceil.Ir BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �7 Larry and Carol Schreiber, the jay of adoption has evolved into a lifetime pursuit. They have adopted 10 children- nine in seven years - in addition to their three children by birth. In the rural town of San Cristobal, New Mexico, population 200, the Schreibers and their 13 children comprise 5.5 per cent of the total population. Their experiences have been so good, they have formed a non-profit organizationcalledChild-RiteIncorporated to help place other children with special needs. The couple's interest in adoption began in Buffalo in 1971 while Larry Schreiber, a UB medical schoolalumnus (M'72), was on his senior pediatric rotation at Buffalo Children's Hospital and Carol was there as a recreationaltherapist. It was there that they met Lawrence, a 17-year-oldhemophiliac. or BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST LATE WINTER 1988-89 �8 awrence "was having various medical, financial, and family problems at the time and cou ldn't return home to his family in New York City. He needed a temporary place to stay while he was being treated in Buffalo;' Schreiber explains. "Carol and 1,having worked extensively with him during his treatment ar the hospital, were concerned for him. So, we offered him our place to stay:' After 10 months he was able co return successfully to his own family. Now 29, Lawrence resides in Buffalo with his wife and three children. Sho rtl y following Schreiber's graduation from medical school, the coup le moved to New Mexico where Schreiber began his summer internship at the University of New Mexico-affiliated hospital in Albuquerque. Working primarily in the pediatric ward, Schreiber met a four-year-old boy named Matthew who had lived in five foster homes after being abandoned by his mother when he was only a year old . Since Matthew had no home or family waiting for him, the Sch reibers yearned to give him a loving and permanent home, something he had never yet experienced in his young life. ln response co Matthew's needs and cheir unwavering emotions, the Schreibers adopted Matthew in December 1972. He was their first child. Only one month later, Sch reiber helped Carol deliver Jordan, the first of three children born to the couple. Lucas, their second son, was born in July of 1974, and their daughter, Gabrielle, was born in November 1978. le was not until 1980 chat the Schreibers considered adoption again. Schreiber was working as a volunteer for the International Red Cross Committee on the Thai-Cambodian border when he met Michael in a refugee camp. Michael was an II-year-old Cambodian orphan who was subjected to horror of watching his family of four die at the hands of the Khmer Rouge. He had been surviving on his own in the war-torn country for several years. Schreiber was moved by Michael's circumstances during his three-month stay in the refugee camp. Having inadequate medical facilities to treat a cleft palace from which Michael was suffering, LATE WINTER 1988-89 Schreiber wrote to his wife suggesting Michael's adoption and treatment in the U.S. Caro l agreed and the Sch reibers applied for Michael's adoption immediately through the United Nations, but there was extensive polit ical and bureaucratic red tape. "The political climate in that region of the world was very unstable ar rhe rime; Schreiber recalls, "so Carol and I were extremely worried that Michae l wasn't going to be released from rhe country ." ;\1tcha l arni eel at L A. International Airport not knoi i g an'\ En lish, Just tearing a tag around hii; neck that identifze his famzh and destination Wzthin u eek,, bab'\/ Yo Ri chaperoned tu o from Korea, arrned zn the U.S. Feeling frustrated and helpless, the couple sought advice and emotional support from Friends of Children of Various Nations, an adoption agency based in Denver. Here they became interested in a nine-month-old girl from Korea named Yo Ri. The Schre ibers were first introduced co Yo Ri through "exchange books" that contain a phorograph and an extensive case history of each child . The Korean infant was also suffering from a cleft palate . However, un like Michael's situation, Korea was politically stable enough co have her released for che Schreibers' adoption. While they were awaiting Yo Ri's arrival, much co the relief of the worrystr icken Schreibers, Michael was finally released from Cambodia . He arr ived in June 1981 at L.A. International Airport, not knowing any English, just wearing a cag around his neck chat identified his family and destination in New Mexico. Within two weeks of Michael's homecoming, baby Yo Ri, chaperoned from Korea, also arrived in the U.S. "June 1981 was a very excit ing month for us with the addition of both Yo Ri and Michael within such a short time;' recalls Schreiber. "After such elation, Carol and I had very few reservations about adoption." In 1983 che Schreibers again adopted two children at one time. Eight-year-old Kevin and his IO-year-old sister, Mary, came to the Schreibers from southern New Mexico . The two black children had only each olher as family after experiencing child-neglect and then several temporary homes through the foster-care system . They were a welcomed addition co the growing Schreiber clan . Next, in 1986 came Gina - all the way from Calcutta, Indi a. Gina, on ly eight years o ld and suffering from polio, was abandoned because her mother cou ldn't care for Gina's special needs while caring for Gina 's six sisters. The Schreibers were informed of Gina's situation through an Albuquerque adoption agency called Rainbow House. Since joining the Schreibers, Gina has had back and leg surgery and is able to walk with the help of braces. When Schreiber flew co Calcutta co escort Gina back to New Mexico, he met Gina's good friend Champa . Champa was co be adopted by a family in another region of New Mexico. In November 1987, Rainbow House called che Schreibers to tell chem chat Champa's adoption didn't work out with her prospective family and chat she was going to return to India. Once again the Schreibers opened their hearts and their home and took Champa in. All of their children are now thriving. Matthew, 20, from New Mexico, is currently a sophomore at Eastern New Mexico University. Michael, from Cambodia, is 19 and attends Pitzer College in California. Jordan, 15, attends Taos County High School. Champa, from In- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �9 Hen•'s tht whole clan Larn <1nd Mattheu art st<1nclmg m bad,. ln the m1clcllerow, from left ar~ Mary, C hamf>a· Michael; Re) na1clo bemJ:'hl'lcl 1,..,( arol; I 1cas; Jordan and Ket m. Th girls m front ar Yo Rr, Lorena, Gabriell huJ:'grngC 1ela and Gma dia, is now 14. After studying English and the equivalent of eight years of school in merely three years, she attends junior high with Lucas, 14, and Mary, IS, one of the black siblings. Mary's natural brother, Kevin, 13, attends Taos Middle School with Gabrielle, 10, and Gina, 10, from India. And Yo Ri from Korea, 7, attends Taos Elementary. chreiber acknowledges that all has nor been smooth sailing with such a large and diverse family. Problems often arise when another child is added to the family, especially when a newly adopted child is the same age as a child already there. "It is sometimes a difficult adjustment for a child who has already been through BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST four or five foster homes; Schreiber added. "It takes a little bit of time for a child to figure out how he fits into the new environment. But that's only natural. All the kids have fit in just beautifully. "We have family meetings all of the time, so that grievances and growing pains are aired before they become too large to handle. We keep the lines of communication open. When we are considering another adoption we discuss it among rhe whole family. If anyone is uncomfortable with an addition at a certain time, then we decide against it. When we do decide to adopt a child, it is a family decision." The latest additions to the Schreiber brood came in the beginning of 1988 with little hesitation from the family. They are Lorena, 4; Ciela, 3, and Reynaldo, 2 - three Hispanic siblings from southern New Mexico. They are now the youngest of the Schreiber children . "Carol and I had never really planned to adopt ten children, but the addition of each individual child, with his or her own diversity of unique personal and cultural backgrounds, has helped all of us grow immeasurably closer and stronger as a family. The tribulations seem minimal by comparison. We have found adoption to be the most splendid thing in our lives; Schreiber emphasized. The Schreibers say they are now at "capacity; but their enthusiasm for adoption hasn't waned . They've steered their efforts coward Child-Rite Incorporated, a non-profit organization they formed in LATE WINTER 1988-89 �---: 10 �h hut II un J hi orgar z ati Ri n th t I he co plt t mp li m~ pro oft often n 1986 to help place "special needs chi ldren" in permanent residences. "Special needs children" is a term given by the government for children in state institutions or foster care who are older (9 years and up), are in sibling groups, have minority backgrounds, or have exceptional physica l, mental, and emotional needs. Most special needs children are placed in state custody or foster care as a result of child abuse, neglect, or abandonment. ... II of the Schreibers' adopted children were considered "special needs children" by the state . The couple emphasizes that their family is living proof of the overwhelming joy chat these often-neg lected children can add to a family. They point out chat the wait to adopt a special needs infant is usually less than a year, which is much shorter than the usual three-year wait for healthy white infants . Also, it is not only possible, but common, for loving single parents to adopt a special needs child. To families who decide to adopt special needs children, the state may pay a stipend depending on the family's income and the specific needs of the child, Schreiber pointed out, but laws vary BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST l from state to state . There are also other subsidies such as food stamps and Medicare, which may include both medical and psychiatric treatment for the adopted children . Child-Rite has placement and referral services that are national in scope. It will refer prospective parents to other agencies and organizations which may better fulfill the parents' needs. Schreiber stressed that Child-Rite does not charge for consultation or referral. Its funding depends so lely upon private taxdeductible donations. Child-Rite works closely with Bob DeBolt and Aid for Adoption of Special Kids (AASK). DeBolt established AASK in 1976 to place special needs children in permanent residences after his family reached adoptive capacity at 20 children. Other Child-Rite board members include Carol Schreiber, who is completing her M.A . in social work at the University of New Mexico, prominent regiona l artist Veley Vigil, and author John Nichols, who wrote The MilagroBeanfield Wars, which Robert Redford recently brought to the screen. For more information concerning adoptions or donations, write to the Schreibers at Child-Rite Inc., P.O.Box 42, San Cristobal, New Mexico 87564, or call (505) 776-8158. • LATEWINTER 1988-89 �12 TRUSTWOR 7• Cholesterol tests yield dubious results hen I was in medical school, I thought if I sent a sample to the lab, I could rely on the values," said Philip L. Green land , MD. "I don't think we feel that's entirely true any more, especially in relation to cholesterol testing." Greenland, an associate professor of medicine and preventive medicine and director of preventive cardiology at the University of Rochester, spoke at UB in Octobe r during a conference on "Elevated Cholesterol: A Public Health Crisis?" sponsored by the UB medical school. The medical literature points out that laboratory measurements for cholesterol around the country aren't very good, Green land said. He noted that 240 mg/di of cholesterol is considered the cut off for high risk. But if a blood sample that has a value of 240 is sent to a lab it might come back with a result ranging anywhere from 226 ro 254. "In other words, you might see a patient today whose true value is 240 and it comes back 254,"he said. "You might see him tomorrow and you measure it again and it comes back 226, and nothing's happened to the patient; it's simply the laboratory variability!' Using the instruments and chemicals they have today, the laboratory people don't think they can get more precise than that, he added. In a 1986study, blood samples were sent to 5,000 labs in the United States. While the true value of the specimens was 262,95 per cent of the lab results ranged from 210to 3IO. That's when peop le started getting excited and the Wall Street Journal ran an article about it on the front page, Green land noted. The problem is with reference materials supplied by the manufacturer that laboratories use to calibrate their resting systems. The best reference material would be blood, but that's coo expensive co use. Manufacturers are trying to come up with better references and have improved their products in LATE WINTER 1988-89 the last several years, Greenland noted . That resulted in some inadequate tests being pulled off the market. Another problem with cholesterol testing is that several methods are used, but the results aren't comparable. One method might give a result of 225 while another yields a value of 240. "Laboratory directors are aware of this problem now and by and large are correcting for it," he said. G reenland indicated that labs shou ld use a system that's comparable with one used by the Centers for Disease Control. While the CDC standardizes systems, it doesn't have enough resources to standardize labs, except for labs conducting NIH-sponsored research. "To my knowledge, between Rochester and C leveland, there is no CDC-standardized laboratory," Greenland said. "Thank goodness we're in New York because the State Health Department is developing a reference lab so that laboratories in the State can send samples to Albany and assure themselves that they are giving answers traceable back to the CDC. "ls that happening now? No. The best thing you can do is ask your lab director if he's using a system traceable back to the CDC." Also ask the lab director for data on the precision and accuracy of his lab, Greenland suggested. While there are a lot of problems with cholesterol testing, testing for components of cholesterol is even worse, Greenland said . There are several components to cholesterol. One, called low density lipoprotein or LDL, is connected with a higher risk of heart disease. But another, high density lipoprocein or HDL, protects people from heart disease. While it might be beneficial to know rhe levels of various components, today's tests don't tell you much, Greenland said. Cho lesterol testing "has problems, but it's getting better," he said. He predicted char we'llsee more specific tests in the future. The cholesterol levels of most of the people in BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST .... �... -.. ' •• , • • •• Bad Food s: • • ••••••• •• •••• cream ► sour cream ► ice cream ► cheeses ► butter ► eggs ► red meat ► sausages ► organ meats ► palm and coconut oil ► �14 "lf somebody enjoys drinking, I might allow him two drinks a night . But I wouldn't recommend it as therapy for a ceecocaler." There's a whole list of drugs chat can lower cholesterol, bur all have drawbacks, Kohn said. Each drug has its own sec of possible side effects. For instance, Nicotinic Acid can cause flushing, gastritis, nausea and malaise. You'll feel lousy for a week, Kohn promised, then these side efects generally disappear . Nicotinic Acid can also cause abnormal results on tests of liver function. The cost can be another drawback. Prescriptions may run $100 a month. And after a while, a single drug may be no longer effective and the doctor may tum to a combination of drugs . "But when you consider what this costs, the patient may be taking $200 or $300 worth of drugs," Kohn noted . "lf the pat ient also happens co have hypertension or something else, he has $200 more of that medication. The patient must be very rich, indeed. "When you're dealing with real patients, you've got to be aware of the costs of all these medications you're ordering or you won't have a very big practice very long." Kohn says he hopes that new cholesterol drugs will spark enough competition among drug companies to bring the price down. "If patients are concerned about the price of drugs, the only alternative we can offer is diet, and they will have to modify their behavior and stick to that diet the rest of their lives," he noted . But this diet is nor well accepted by Americans, he added. His point was illustrated by a 27-yearold woman in the audience. Her mother had had oods to watch out for, Kohn said, include dairy a stroke, she explained, and she was concerned foods, eggs, palm and coconut oil, red meats, about her own cholesterol levels. Ac what point organ meats, and anythingin a sausage casing. Good would Kohn prescribe medication, she asked, adfoods include poultry, fish, cereals, legumes, com ding chat she's not going to give up pizza and oil margarine, sunflower oil, and low-cholesterol chicken wings for the rest of her life. products like Egg Beaters . "That's one of your choices," Kohn said. "You Pasta is good, but be careful of the sauce, he know the risks, and you've got to be willing to acwarned . Fish oils are fine if you use chem instead cept them ." of saturated fats in your diet. If you supplementyour When co prescribe d rugs is a very individualdiet with these oils, he emphasized, it's only going ized thing, Kohn said, and strongly recommended to make you fat. a rigid diet for the woman. He pointed out that Shellfish have some cholesterol, but they also if she planned to get pregnant, she should avoid have a lot of unsaturated fat . So they're fine, but medication since we don't know the effects on rhe watch the drawn butter, he added . developing fetus. Kohn suggested chat two drinks a day can Physicians tend to overlook the contributions elevate rhe levels of HDL, the beneficial cholesterol. co-professionals such as nutritionists can play in Bue more than two d rinks a day can pose ocher getting somebody to alter his or her diet, Kohn problems. remarked in answer to a question . "I don't know if (it helps reduce the risk of heart Yeagle also pointed out that there is a whole disease) because it increases HDL or because it's a family of risk faccors for heart disease, including socially accepted tranquilizer that makes you feel family history, age, sex, smoking, and exercise. better;' Kohn said. Cholesterol levels can't be considered in isolation. • the moderate to high-risk range can be modified by diet, said Philip L. Yeagle, Ph.D ., associate professor of biochemistry at UB who has done research in the basic role of cholesterol in cell membranes . "Five years ago I wouldn't have believed it," he added . At the high range, more than strict diet is needed. A one per cent decrease in serum cholesterol leads to a two per cent decrease in risk, Yeagle added. "Youcan have a very interesting diet and reduce your cholesterol," said Robert M . Kohn, M.D., clinical professor of medicine at UB and medical director oflndependent Health. "However, in order to reduce your cholesterol and keep it down, you have co stick co the diet . If you go off the diet even two days a week, you're not going to have a significant reduction in your cholesterol." Heart-smart refreshments were served during the break at rhe conference . There was plenty of dip and lots of celery sticks, bur not a chicken wing in sight. Instead, participants were treated to fresh fruits and vegetables with low-fat dips, soda pop, and tangy "Red Satin Punch" made from apple and cranberry juice . LATE WINTER 1988-89 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �I ::: .. r . ~:H4,,.I . /ii!!~ ....,,;:-~· ~.. ~,·:: .• !/~.IJJ;f!. I I' 'I I , Jj1,, j:1:: /. [.:: ,·"' :.: I ....-:, ':°/ l ff::::': ; I • I''/!::: !' I I ., ·1, :·:.:; , .. :: ~ .rlJ(v·. .aL.•• I . • . '.:. : : I • • • -.r- .. •, ' : . j . ~ •i : ·:,, ·; ,' ..... . . .,. ..; •I:• ' ,,, ' . • • • 't .. ' • : : t . . . •1 ' ' ' ' ' , '1 I \ . \ I• .' • I ' C t t . I • I \ • \ 11, , • .f f '\.:,:1,•·, • I I I 'r.','•. . ' ,I I I C ' .' 't I' , j : ' I ; PI . I; I Good . . . . . . . . .Food ... . . . . s: . poultry ► f ish ► cereals ► legumes ► pasta ► corn oil margarine ► sunflower oil ► Egg Beaters �. ..: -', .."..··1.. ...-•-::\•..·..... . ...·. :~~ -· . . .•. .. . -~ _:(FP: ·:i}_:/ ::,-. ~·-. . -' - .- ·.. ..·:,,.. .-:t~ ~ ..\ -: . ...-'.' • . . ...-- .···.·:t'':'; . · .. .- . ·' . ~~ . . • . .:•..:,....!-.: • ., ~ . • ·• . .~ . , . ..,.~·. ~· • r;. • - ;::·•~):: ·: . .. ~ I • ~ ,--; •, I :, _.:: ::·., :T:~•/\.~ ; •• . ..... _ �17 Vaccine Lets Virus Invade-On Purpose By CONNIE OSWALD he soldiers stand ready ar battle stations, prepared to annihilate rhe enemy. Their duty is to make sure none of the attackers get into the fortress alive. That's how conventional vaccines work. Made from a weakened or nonvirulent form of the virus, the vaccine stimulates antibodies-the soldiers that fight off infection. But Edwin D. Kilbourne, M.D., one of the world's leading experts on influenza, is working on an influenza vaccine that would actually allow the attacking virus to invade the body. Kilbourne, a distinguished scientist both in microbiology and preventive medicine, offered a glimpse into his work during the medical school's Harrington Lecture in October. One of the founding chairmen of the Mount Sinai School of Medicine, he's a distinguished professor there and is a member of the National Academy of Sciences. Kilbourne's vaccine uses a single, purfied protein of the virus, a technique that other researchers arc crying as well. But what's really different about Kilbourne's vaccine has co do with the antibodies chat are produced . Instead of standing with guns poised to fend off any invaders, these antibod ies allow the attack ing virus into the body. But once the attacking virus gets inside, the antibodies prevent it from duplicating a great deal. By keeping the quantity of virus low, disease is prevented, yet new antibod ies are induced by the viral attack. The vaccine would allow the enemy within the gates, then suppress the enemy's activities, explained Kilbourne . A study by UB's Pearay L. Ogra, M.D. showed chat such an infection-permissive approach could work, Kilbourne said. Ogra is professor of microbiology and pediatri cs at UB and chief of the Division of Infectious Diseases at Children's Hospital. In Ogra's study, Buffalo schoolchi ldren were given a vaccine similar to the one Kilbourne is working on. "Disease was prevented, though not as well as with a conventiona l vaccine: Kilbourne said. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST S1DFKO "But it showed the approach is feasible. That's the lesson I took away~ The use of a single purified protein, in this case neuraminidase, is a technique rhat wasn't available when Ogra's study was done about IO years ago. It's something char may help overcome some of the drawbacks of rhe earlier vaccine, Kilbourne noted. All of Kilbourne's work with the single purfied protein has been done in mice. The next step is to begin studies in humans. It may be two, or more realistically, three years before a vaccine is on the market, he emphasized . "We've had encouraging preliminary results, but it's not for tomorrow's use in man; he cautioned . Influenza is a highly significant disease, Kilbourne explained, because it paves the way for pneumonia which can prove fatal. Even when it's not fatal, influenza causes fever, aches and pains, and lands people in bed. "Ir cou ld tic up a whole community; he said. "Ir has a high attack rate-it can be devastating econom ically.• The influenza virus produces widespread pandemics of disease in cycles, every 10 to 30 years. Episodes occur when the antigens change so much that they confront the whole global population as new viruses. 'So we all become children again in front of these new viruses,• he said. "We have essentially no past experience with the antigens ~ One advantage to Kilbournc's vaccine is chat since the protein used changes less frequently, we may be able to go for a longer period without having ro change rhe vaccine. Kilbourne is hopeful that his approach will provide a better vaccine for young children. With the present vaccine, child ren under two years old have about a 25 per cent change of developing untoward reactions; that is, developing flu symproms from the shoe. If you give them only a single purified protein, there's less chance of having a reaction. "That's a long way from being proved, but we think that giving one protein is better than giving seven-which is what you have with an intact virus; he said. • LATE WINTER 1988-89 �18 Students on , These three found f their love of mus By MARK M, hey close themselves inside a foampadded room on a regular basis co escape the pressures of their hectic schedu les. No, they're not asylum inmates, bur some may call them neurotic when it comes co thei r passion for music. David Blaustein, Tony Capocelli, and Rohic "Rob" Bakshi are medical students at UB and all have pursued their musical interests as disc jockeys on the FM airwaves. Bakshi, a third-year student, is working at KYUU-FM in San Francisco. He's caking a leave of absence from UB in order co participate in neural research at the LATE WINTER 1988-89 University of California at San Francisco. Capocelli and Blaustein, both fourthyear med students, currently co-host ThursdayNight Jazz on UB's radio station, WBFO, 88.8 FM. Although their styles and musical formats at the stations differ, all of the aspiring M.D.s agree that the air time provides them much-needed relief from the tedium and discipline of their rigorous med school studies. Capocelliand Blaustein Tony Capocelli and David Blaustein, both self-professed "jazz junkies," have been voicing their musical addiction across the airwaves at WBFO for the past thr ee and a half years. "I love jazz and I love neural regeneration research," the 24-year-old Capocelli professed . "If I had to choose an ideal goal right now, it would be to head a groundbreaking team of neural regeneration researchers and have a jazz band on the side. "Even if I never end up running a research lab, I know I'll always be playing jazz." Capocelli and his partner in jazz, Blaustein, met three and a half years ago through their mutual love for jazz. "I had just begun med schoo l and was blowing off a little frustration by jam ming on my alto (saxophone)," explained Blaustein. "I was in the student lounge at about 10 o'clock at night, so the place was pretty empty . Tony, who I didn't know at the time, was corning back from the library and heard me playing . So he brought his acoustic guitar down from his room and started jamming with me. We had a really good session ." Shortly after that, Blaustein and Capoce lli each began their l-to-6-a.m. "graveyard shifts" on WBFO-Blaustein on Satu rdays and Capocelli on Sundays . Although the positions were volunteer, BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST l J �19 the Airwaves P way to harmonize 1sic and medicine MARABELLA l J the early morning shifts gave the young jazz enthusiasts an opportunity to develop their formats, styles, and selections . The collection of jazz albums in the extensive WBFO library tops 20,000 records, so it took them both some time to distinguish their own repertoire of music for their shows. "They (management) don't give us any specific record lists. As long as we stay within the spectrum of jazz-which is pretty broad-we can pretty much play anyone we want to," said Capocelli. During the year and a half that both endured the graveyard shift, Blaustein and Capoce lli started their own jazz/blues band called Code Bluenamed for their mutual interest in both music and medicine. Code Blue is an "allclear" signal given in one hospital after a Code Red, which is the emergency or cardiac arrest signal. It also represents.the band's own brand of cool blues music which alleviates the "Code Red" pressures of med school. The six members of Code Blue include Capocelli on electric guitar; Blaustein on the alto saxophone; classmates Dave Vogel on electric violin, Esther Ponce on synthesizer, and Tom Grimaldi on bass, and Tom's younger brother Chris on the drums . Whi le the two-year-old band has BUFFALOPHYSIC IAN AND BIOMEDICAL SCIENTIST made no local appearances yet, Capocelli and Blaustein are hoping to play sometime on open jazz night at some of the Buffalo jazz clubs. Capocelli has been playing the guitar and working as a disc jockey since his days as a junior at Windsor Plainsboro High School in Princeton Junction, New Jersey. The high school station had a rock format, so Capocelli didn't develop an interest in jazz until he worked two years at WRUR-a jazz station at the University of Rochester . After completing his undergraduate degree in neurobiology there, Capocelli came to UB to specialize in neurosurgery as well as to pursue his interest in neuralregeneration research. Since WBFO is Blaustein's first experience in radio, it took rhe ZS-year-old native Long Islander a little while before he felt comfortab le behind the microphone . "It (the graveyard shift) was a learning experience," Blaustein admits. "Sometimes I thought that I was the only one listening. On the nights that no one called during my show, it was sometimes cough to stay awake even after drinking a six-pack of caffeine-saturated LATE WINTER 1988-89 �20 Mountain Dew. But after a while both of us established a fairly faithfu l latenight following. We would get the same peop le calling the stat ion at the same time week after week.n Although it was time-consuming, the station helped him tremendously in coping with med schoo l. "The first couple of years of med school were the hardest for me because of the constant studying and lab work . I don't think that I was exactly ready for the work because after I graduated from Emory University (in Atlanta), I traveled around the Un ited States for a year with my buddy . We were proverb ial 'freespirits' -picking up odd jobs here and there as we needed money. So when I started med school, 1 wasn't used to the schedule or the pressure '.' laustein's primary interests in the field of medicine include rehabil itation medic ine and functiona l orthopaedics . Because he majored in psychology and minored in English as an unde rgraduate, he developed a strong interest in the humanities . "I'm more concerned with the human aspect of medicine-like how a patient is going to function in society after a traumatic operation. My job will be to help patients after neurosurgeons, like Tony, get through cutting them up," he quipped . While Blaustein and Capocelli may one day professionally comp lement each other, they are current ly combining their talents on their own jazz show on Thursday nights from 9 p.m. to I a.m. and have done so for the past two years. They have also added a jazz/ fusion hour from midn ight to 1 a.m. Tuning into WBFO on Thursday evenings, one might hear Pac Metheny, Jon Scofield, Chic Corea, or The Yellow Jackets. "Even though some of the old-time LATE WINTER 1988-89 'jazz-purist' listeners take exception to the newer jazz/fusion, overall our listeners have exceptionally increased since ou r days on the graveyard:' Capocelli estimated . Blaustein and Capocelli are currently the on ly student disc jockeys on the air at WBFO. "Sometimes I thought I was the only one listening. But after a while both of us established a fairly faithful late~night following. We would get the same people calling week after week.'' Bakshi While Rohit "Rob" Bakshi began both his medical career and radio career in Western New York, his recent endeavors have taken him across the country to the West Coast . After completing his second year of med school at UB in May, he took a one-year leave of absence in order co pursue neu ral research with Alan Faden, M .D., at the University of California at San Francisco. However, Bakshi has also cont inued performing as a DJ at KYUU-FM, a "top-40" station in San Francisco . Although Bakshi is no stranger to top-40 commercial radio, he was forced to start from the bottom on the "graveyardshift" at the west coast station . Nevertheless, the Bay Area currently has the fourth largest popu lation area for radio in the country, so Bakshi's show is listened to by thousands of people even at the wee hours of the morning . Bakshi developed his interest in radio when he was a senior at Cornell University. There he entered a disc jockey competition for new ta lent for WVBR, the Cornell -owned-and-operated top-40 commercial radio station. Bakshi entered the competition with a field of 75 ocher hopefuls. "1 d idn't really think that I had a chance because I had never worked in radio before. But I worked pretty hard on my demo-tapes whenever I cou ld'.' "Demo-tapes" are demonstration tapes used in the music industry to screen prospective DJs for a job. Bakshi was one of the first of three chosen for the air. Shortly after, he acquired his FCC / FM license and began his nine-month stint at WVBR. After he received his bachelor's degree in biology, Bakshi started medical school at UB and made his local radio debut on the now-defunct top-40 station, WNYSFM 104. He worked the weekend "graveyard shift" for four months until the station was sold {it's now Classic Hits 104.1). Soon after, Bakshi appeared briefly again; this time playing top-40 on the weekend graveyards on the popular WPHD-FM 103.3. Then in the summer of 1987 Bakshi was hired at WKSE (KISS 98.5 FM) for its radio prime-time weekend daytime BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Medical School 21 Rohit "Rob" Bakshi shows. "It was a big break to get the numberone sloe on the number-one local top-40 station;' Bakshi recalled. "l guess they must have really liked my demo-tapes:' During his one-year seine at KISS 98.5, the radio station became Buffalds highest raced top-40 radio station (for 18- to 34-year-old listenership). Moreover, during the 1987 winter rating period, Bakshi's Saturday show from 3 to 8 p.m. was rated number one in Western New York. Bakshi, alias "Rob Miller" on the air, had to follow strict formatting, but still BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST introduced several creative features on his show that made it distinct in Western New York. He created call-in comedy spots for such characters as "Pee Wee Herman" (played by Greg Sambuchi) and "The Jammin' Grandma" (played by Bakshi's girlfriend Lorraine Baeum ler). One phone call in particular brings back pleasant memories for Bakshi . "On Mother's Day I called my mother and put her on the air live. le was pretty funny be,cause she didn't realize that she was on clhe air and said some pretty embar rassin1g things ." As hiis mother, Deebika Bakshi remembers, Rohic wasn't even going to apply for the job because he was sure he wouldn't get it . She encouraged him to app ly and "the number-one DJ had to thank his mother on the air." Rohit's parents have been a prime influence in his life. The 23-year-old was raised in the Buffalo area where his father, Suraj Bakshi, M.D., a specialist in nuclear medicine, works at Roswell Park Memorial Institute . Although Bakshi spends weekends working as a professional top-40 disc jockey, his medical studies have not suffered. This past summer he secured fellowship grants from the prestigious Alpha Omega Alpha Medical Honor Society and from the Ame rican Heart Association in support of his work with neuro logist A lan Faden, founder and directo r of the Center for Neural Injury at the University of California at San Francisco . Bakshi is one of the few pregrad investigators working on Faden's research team . More specifically, Bakshi's research encompasses central nervous system injury and neural-regeneration, focusing primarily upon the endogenous excitotoxins, opioids, and their receptors. Faden's research has been instrumental in the development of naloxone, which has recently been approved by the FDA for testing on acute spinal cord-injured patients. "I really love working as a DJ, but my main objective is to become a doctor. I don't think I will continue working at a radio station when I return to Buffalo in September because my third and fourth years of medical school are critica l years in my medica l education . But after I'm through with my medical training and have established myself in academ ic medicine, I would really like to gee involved with radio again," Bakshi emphasized. • LATEWINTER 1988-89 �\ 22 Handpicked Ne w student s are talent ed and diver se By CONNIE OSWALD STOFKO espire the gloom and doom predictions about the shrinking nation-wide pool of applicants to medical schools, UB had no prob lem finding talented people to fill its 1988-89 first-year class. In fact, it sent out only 301 offers of admission to fill its 135 spaces, noted Thomas J.Guttuso, M.D., assistant dean and director of medical student admissions for UB's School of Medicine and Biomedical Sciences. This is the lowest number of offers UB has sent out since 1974, and UB has the lowest turnover rate of the 12 medical schools in New York State, Guttuso added. While UB accepted only 2.2 students for every one who actually enrolled, some fine medica l schools have had to accept five students to enroll one, he said. "Our school is more popular; Gutruso said . "Our reputation is improving and there's less turnover ." He explained that medical schools across the country send out acceptance letters in different months. Students may accept at one school, then withdraw that acceptance when they hear from their first-choice institution . "Obviously, we're becoming number one for more people if they stay with us," he noted. According to John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB, this popularity can be LATEWINTER1988-89 attributed to the school's improved facilities, stronger faculty, the diversity of the program, and economics-the low tuition and low cost of living in Buffalo. The warm atmosphere of the school is another factor, said Guttuso. He noted that many applicants are offered free overnight lodging with students when they come to town to interview. Students eat lunch with the applicants, and performances by the Dermarones, the student singing group, break the ice. "Faculty are very warm and supportive of students, and students are that way with applicants; Guttuso said. "It's the general atmosphere in the school." "It's an environment rhar stresses achievement and excellence, bur not a frenzied environment of competition," added Naughton. Students play a strong role in the life of che school. There's even a new group chat organizes parents into a support group for the school, he noted. "The number of applications is down, but the quality is nor down-not here," said Guttuso. "In spite of all the negative news about medicine, there are still plenty of people applying" to UB's medica l school. Negative publicity about medicine has eroded the profession's patina of glamor. What was once seen as a lucrative and prestigious profession is now viewed as one filled with long hours and huge malpractice insurance payments . People seriously weigh their decision to become a physician, Guttuso noted, and those who finally do choose medicine are usually very dedicated . "I th ink we'll have excellent physicians from these classes we have now; he said . The numbers bear him out. The class's average underg raduate GPA (grade point average) is 3.43. The mean MCAT is 55.92, above the national average of 54. Three of the new students have Ph.D.s and 15 have master's degrees. "In genera l, we've been getting very good classes;• said Naughton . "T he feeling is that the current classes are really outstanding ." The students come from a wide range of academic and social backgrounds . About 80 per cent majored in the sciences, with about 46 per cent majoring in biology, 10 per cent in chemistry, and 7 per cent in biochemistry. There are a total of 27 majors outside the sciences. About 13 per cent of students majored in the humanities and social sciences and 5 per cent majored in health-related fields. Falling into none of these categories are one student who majored in German literature, psychology, and biological sciences; another who majored in fashion design, and a third who majored in life sciences. The adm issions committee tr ies very hard ro make sure no group is discriminated against, noted Naughton. "This is a very representative class, made up of d iverse people of diverse BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �23 backgrounds;' he said . "The proof of rhe puddin g is in the class,• Gurruso added . The class contains a record-setting proportion of females-48 per cent. There are 10 black students, four Puerto Ricans, and one Chicano. The oldest member of rhe class is 40 years old, and 25 students are 26 or older. There is one handicapped student . The largest number of students-70comes from the 8th Judicial District (the area surround ing Buffalo). Another 37 come from downstate, 17 from the extended Western New York Area, 6 from upstate, and 5 from out of stare . Because UB is a State school, it must favor applicants from New York State, and some preference is given to students from Western New York. Bur in order to show that rhe school is responsive ro its alumni, children of out-of-state alumni are now cons idered as local residents. BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST They, of course, must have compet itive credentials. "The number of children of alumni from our of state who matriculate is low; Naughton said, "bur we want them to know we welcome their applications ." • Focusedon a goal usic has always been special to D,eborah Shuste r of New York C ity. She received her bache lor's and master's degrees in music, then played viola professionally for five years. Yet she always felt a pull from the field of medidne. "My dad's a doctor," Shuster explained . "I've always loved science and I've always been fascinated by medicine . "As a child, I was encouraged to play music- I got a chance my parents didn't have. So I pursued music. It seemed the thing co, do at the rime." Shuster, now 29, performed with the Spokane Symphony Orchestra in Washington, played with professional orchestras in Italy and South America, and free-lanced in New York City with her own quartet as well as with small orchestras, ballet companies, and opera companies. "But it wasn't intellectually stimulating eno ugh;' she said . "I needed to use the other part of my brain." Shuste r attended a special program at Columb ia University for two years to pick up the science courses she needed, free-lancing on viola in her spare time. When it came time to choose a medical schoo l, she chose UB for several reasons, including the affordable price and its location . Her husband, a guitarist, teaches in Syracuse, so she wanted to stay upstate . Being a cad older than most of the other students is an advantage as she emLATE WINTER 1988-89 �;\, J l I' I 24 barks on her medical career, Shuster says. "I've seen a loc, dealc with people a lot, and that'll make my job easier; she noted . "I'm more focused and I know what I wane." • During his Early Assurance interview , he noted chat some people feel pressure co become a physician because they have a relative who's a physician. But Adams told the interviewer, "My father's not a doctor . My mother's not a doctor . The reason I'm here is because I wane co be here ." His inte rviewer cold Adams that, with his record, he could probab ly go to any medica l school he wanted . But Adams decided o n UB beca use it's inexpensive and he can get a good education here . He noted that since the facilities have just been refurbished, he's among the first to use the new labs. And he likes the staff. "It's a grind, bur I really enjoy medica l schoo l; he said . "It's like one big family. A lot of peop le have different interests, but we're all in the same boat, trying to become doctors." • Creative and dedicated fo.ld Servingothers odd Adams, 22, of Grand Island chose medicine as a career because "I couldn't picture myself doing anything else. I couldn't just sit behind a desk. I wane co work with peop le and help people:' Adams entered medical school through the Early Assurance Program, which allows qualified students to apply early. A biochemistry major at UB, he had a 4.0 average and had taken part in research . He also volunteered in the emergency room at Millard Fillmore Suburban Hospital, belonged to academic organizations, and enjoyed skiing, golfing, and playing basketba ll. LATE WINTER 1988-89 felt a real need to help peop le, as cliched as that sounds," said Hisla Bates, a first-year medical student at UB. A successful fashion designer, she abandoned that lucrative career to pursue her childhood dream of becoming a doctor. Born in the West Indies, Bates lived in Guyana unti l she was six, then moved with her family co the New York City area . In junior high school and high school, her arc teachers cold her she was very talented . "I got so much enco u ragement in arc, I decided to cry ic; she said. "It seemed a very exciting career, I was using my talent, and I felc confident. In science, I didn't get that kind of encouragement, though I was a very good student:' Bates attended the Parson School of Design in Manhattan , majoring in fashion design . After graduation, she worked her way up co become head designer for Herman Geist and did a licensee line for Stanley Blacker. "I traveled extensively thro ughout Europe and th e Orient; ' Bates said . "I started to make lots of money, but it still wasn't satisfying." After three years as a fashion designer, she spent four years as an undergraduate at Hunter College in the City University of New York to pick up her required science courses . She also d id research in the Marine Biological Laboratory in Woods Ho le and at Rockefe lle r University . "I'm glad I did it chis way; said Bates, 29. She's seen much of the world and has developed the confidence chat comes with success. Ac che same time, it was hard to give up a $40,000 a year job where she managed several assistants . But it shows one thing . "I really wane co do this," she said . • f·hsla Bates BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �\[ ",l ( I 25 GROUPSTRENGTHENS FAMILYTIESTO SCHOOL he notion is very simple;' said Peter Ostrow, M.D., Ph.D., associate dean for curricular and academic affairs. "Even though your son or daughter has become an adult and graduated from college, their need for su ppor t from their parents doesn't stop . It may even be greater because medical school is such a stressfu l time." Ostrow, along with a group of inspired parents, spearheaded the establishment of the UB Medical Student Parents Council chis past fall. The organization was form ed in o rder to strengthen ties between the medical school and parents . "(The council) is simi lar to the PTA in grammar school, only it's on a higher level;' explained Ost row. "Most families want to be more involved with what's going on in their son's, daughter's, or spouse's medical education above and beyond Family Day, which takes place on ly once a year." The deve lopment of the council was spurred by the huge success of Family Day, an event initiated in 1981by John Naug ht on, dean of the Schoo l of Medicine and Biomedical Sciences. The day allows families to interact with the medical school's faculty and other students, and stim ulates interest in the school and its activities. Families of freshmen and sophomores v1s1t classrooms and meet facu lty who can answe r quest ions about courses and teachin g methods, while families of juni ors and seniors visit US -affiliated hospitals where those students conduct practical rotations. Naughton introduced the idea of a parents cou ncil as early as 1981,but it wasn't until 1986,when attendance at Family Day surpassed 500, chat the BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST medical school decided the time was ripe to develop such an organization . When Ostrow presented the idea last summer to parents of UB medica l students, he met wirh overwhelming ly positive response. Gail Pitterman, one of the founding parents and a member of the council, spoke about the new organization at the opening presentation for first- and second-year students ar the most recent Family Day. "The primary goal of the Medical Student Parents Council is to give moral and financia l support to students and the ir schoo l;' noted Pitterman. Pitterman said the council is looking for volunteers in various cities co ace as hose families for UB students who need a place co stay when interviewing for residency programs. Local hose families are also needed to accommodate students interviewing for entrance into the UB medical school and to provide hospitality during holidays for chose unable to return home. The council is also inviting parents to work with student organizations and the UB Foundatio n to plan social, educational , or fund-raising events, and to gee involved with publicity for the school. Cu rrently, the council is helping to raise funds co support the medical school's Computer-Assisted Int eractive Video Teaching Aids. Since the counci l's inception, membership has grown from 14 parents to about 50, most from New York State . Some parents who find it d ifficult to attend meetings at UB are consider ing organizing a New York City chapter as well. "We encourage parents and any othe r family members to get involved, make suggestions, or offer their services if they're interested;' Ostrow remarked . "There was a very similar program at the University of Houston where I previously taught that proved to be very successful and popula r with the school and the families of the students . "What's unique about a Medica l Student Parents Council is that it provides people with more info rmed support and activity that isn't always after the pocketbook . "We wane our students' families co know that they haven't lost a ch ild but have gained a med school;' Ostrow said . Th ose who are interested in the council can call (716) 831-2802for more infor• macion. -By Mark Marabella LATE WINTER !988-89 �26 ~ The Other Classroom Buffala hospitals maintain a key role in medical education By JOHN NAUGHTON, !though numbered among the oldest of America's medical schools, UB is one of the few which has maintained the status of a "community-based" medical school for such a long time. Medical historians note that of the northeastern medical schools that survived the 1910 Flexner Report, LATEWINTER 1988-89 M .D. two, namely UB and Albany Medical College, chose to distinguish themselves primarily as centers of clinical training in which our network of teaching hospitals was and is a key element . The merger of the private UB with the public SUNY system did not treat the medical schoo l kindly during the early years of trans ition . It threatened the bonds between the old UB and its already existent faculty and hospital system . The university medical center that was proposed for the Main Street Campus or the future Amherst Campus probably never had any real chance for success. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �27 We are still, and will continue to be for the foreseeable future, a communitybased medical school working with a group of affiliated ho spitals . The major differences between now and 1962 are that we have forged through the partnership with the SUNY system a much larger, stronger, and more secu re funding base which has enabled the University and its hospital community co raise their sights and to become compet itive with major medical centers throughout the Stace and the nation . The cha llenge that the hospitals and medica l schoo l share is ro develop the interrelationships necessary to use the investment of the citizens of New York Scace and to make it benefit each of us as individuals, institutions, and communities . I chink we are on char course, and, hopefully, when chis century closes, each of us can look back on the efforts put forth with a sense of satisfaction and accomplishment. The hospitals' principal co ncern in medical education relates co the role of residents in the hospital system and the future of loca l graduate medical education . There are three things we should keep in mind: First, reform of graduate medica l education is upon us. Second, the public policy priorities for graduate medical education at the federal and Scace level are ar variance with much of what occurs in the nation's 127 medical schools . Third, funding mechanisms for support of graduate medica l education will change . Given the above assumptions, we shouldn't dwell so lely on the quality of the graduate medical education programs in Buffalo. We know char the q ualit y is good and it will continue to improve. In stead, we should dwell on any incongruities char exist between institutiona l and recommended pub lic policy, BUFFAW PHYSICIAN AND BIOMEDICAL SCIENTIST "We are still, and will continue to be for the foreseeablefuture, a community~based medical school working with a group of affiliated hospitals." and how these issues might be addressed and resolved. simplified statement of contemporary public policy is char we shou ld prepare more generalists, fewer specialists, and more physicians from minority and underrepresented populations. In reviewing the Buffalo scene, it is apparent chat we are not much different than the other medical schools in the United Stares . It appears that almost half of ou r residents arc in so-called prima ry care programs, i.e., internal medicine, pediatrics, and family medicine . Bue of the 120 residency positions funded for internal medicine and pediatrics, the number used co train genera lises is about the same as che number assigned co fellowships. Since fellows usually come from an existing residency base, we aren't in accord with existing Scace guidelines or developing federal guide lines. To deal with chis situation, it is clear that the faculty and the governance structure of the Graduate MedicalDental Education Consortium will have co develop strategies for change . Th ese strategies might include: • A more formal emphasis on the value of being a generalise and a proper reward system for primary-care faculty . • Transfer of funding for fellows from the reimbursement system co ocher resources. • Increased emphasis on recrumng fellows whose commitment is broader than char of achieving specialized skills for che practice of medicine . • Transfer or reallocation of a large portion of a resident's education from the highly technologically oriented tertiary care center to ambulatory care and community activ ity. You can see why the school has spent a certain amount of its energy over the past few years in reordering its community and hospita l relationships to ensure a new and needed variety of educational opportunities . For in stance, fami ly medicine has been very successf ul in incorporating a suburban and rural network designed to complement its urban base located at the Deaconess Center. Pediatrics complements its tertiary base with o utr each activities ac the Erie County Medical Center and Buffalo Mercy Hospital. Medical students and residents in nonsurgical and non-hospital-based specialties will need educational opportunities in environments othe r than hospitals, and both full-time and voluntary faculty will be needed co facilitate and implement the changes . Two oche r areas of concern are the distribution of future physicians and the extension of ou r affirmati ve action program to resident recruitment and training . The former is being addressed by LATE WINTER JQSS-89 �\I cl t 28 diversification among the primary care departments, especially in areas such as family medicine and geriatrics. The school now has educationa l relationships in these two areas tied directly to the major reaching hospital system . The combination of these organizations has permitted the development of a balanced program designed to ensure opportunities in urban, suburban, small community, and rural environments . As part of the LCME self-study (see Early Winter 1988 edition of Buffalo Physicianand Biomedical Scientist), the clinical chairmen reviewed their performances in recruiting residents from minority and underrepresented backgrounds. Ir was evident chat the medical schoo l's commitment was not adequately incorporated into its graduate medical education mission. The chairs affirmed a commitment to give a priority to chis important public policy issue. They will have to consciously prevent the current matching system from interfering with this priority . le is premature to address the issue of funding graduate medical education, except to state chat New York Stace's new Council on Graduate Medical Education has proposed that all graduate medical education funds provided through the reimbursement funds be placed into a centralized governance under control of consortia. There is a need to deve lop new training programs as well as to modify the manner in which some programs are operated. The Graduate Medical-Dental Education Consortium of Buffalo has recommended the development of programs in emergency medicine, radiation oncology, and plastic surgery over the next three to five years. Soon we will cons ider developing another program in preventive medicine. It is obv ious that even without the LATEWINTER1988-89 future constraints imposed by the Bell Commission, major changes in the conduct of graduate medical education, especially in the primary care specialries, will be forthcoming. More emphasis will be directed toward educational prepararion, less coward service, and more diversity of educational experiences will be required. • ADSMAYSWAY VIEWS OF BIRTHCONTROL elevision and radio commercials advocating birth control may help reduce the high race of pregnancies and abortions in New York State, according co a UB study. The study by the Health Services Research Program of the UB School of Medicine and Biomedical Sciences found that after exposure to a limited media campaign, women were more aware of birth control methods and the risk of pregnancy without birth control, and less likely to believe chat birth contro l spoils the spontaneity of sex and chat it gives men a false impression of the woman's availability. The media campaign, which ran in Buffalo and New York City in the summer and fall of 1987, used paid commercials, not public service announcements, said Harry A. Sultz, head of the Health Services Research Program and professor of social and preventive medicine. Researchers also interviewed women in a contro l city, Syracuse. The "media messages" were developed by a New York City advertising agency as part of a five-year plan by a coalition of family planning agencies and clin ics to reduce the high rates of unintended pregnancy and abortion in New York State, Sultz said. The New York State Family Planning Media Consortium has 23 members from across the state. The Buffalo-area members arc UB, Planned Parenthood of Buffalo and Erie County, Deaconess Center, and Planned Parenthood of Niagara County. The four messages in the campaign's (Ml 5IC THROIJGHOL 11 SONG· Lon.[!er than there't c been fishes m the ocean, l11gher than uny bird 0111;er t'll r flen, thun BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST �29 30-scconcl radio and television spots, underscored with music by singer Dan rogclberg, were: • Birth control: from saving no co takmg rhc Pill, you're coo smart not co use it. • Four out of five young women who don't u,e birth control get pregnant before chev want co. • Boch young men and young women in a caring relationship arc concerned about having children at che right tame. (Young, obviously carmg, couples arc featured in the celcv1s1onspots). • Call 0ocal telephone number) or look under "Binh Control" in the yellow pages. "The intcrt.'Stmg thing is, nowhere, in either Buffalo or New York, wa, there a negative reaction," Sulc: noted. "They didn't get any letters, they didn't get any complamcs. In face, the ads in New York City had the New York Cn~ Health Department's Health Lmc telephone number on them, and there was an immediate Jump in the number of calls to the Health Linc asking for information." The spot wa, aired during prime time on two network-affiliated television ,rations m Buffalo and on rwo Spanish-language television scackms in New York, Sulcz said . Howt.·ver,the maior telC\'l'IOn,rations in Nt.'\\ York said che ,pot was coo controvcrnal and wouldn't nJn the ad. The same mformauon then was placed on 12-foot placards on 500 New York City buses, on carcards on all sub\\ay Imes in the city, and on six radio srat1on,. Once the evaluation of the media campaign wa, completed, the family plannmg consortium placed the television ad m prime t1me m all nine maJor media markets around the Mate, Sult: ,ay,. WWOR-TV, one of New York City's independent television stattons, then approved the ad and aired tt m prime time, he n,oced. The scud, offer, proof that birth control is ,1 way of life for the maJ0rtt\ of young women, Sultz sm<l.Overall, two-rh1rds of sex• ually active women reported they always uSt.--d birth control. A little more than 16 per cent ne\er used birth control, while 16 per cent said they sometimes used contraception. These fig,urcshelp researchers pinpoint rhe population at risk for unintended prcgnan- Bt..FFALO PHYSICIANA:-.;OIIIOMWICALSCIENTIST cy and abortions: those women who never use birch contro l or arc haphazard about its U!'C, about a third of the sample, Sult: says.• - B) S11e\\½,etcher CALIFORNIA DEAN IN APRILWill DISCUSS CAREEDEVEL R OPMENT Lyn Behrens, M.D ., dean of the S(hool of Medicine at Loma Linda e University, will give presentations on professional development as che first Harrmgton Visiting Profe,'\Or at UB. The program will run from April 25-28. Bchrcm is becoming recognized nationally as an expert on profc,,1onal development. One of only three female deans o( medical schools 111 the country, she 1, active in AAMC, especially m programs on advancing the car~-ersof \\Omen. Topics for the introductory program include advancement in ncn<lemia, policies of academic institutions, and professional growth. There will be a short program on UB's servKt.'Sfor rt.-,,earchers. A whole day will focus on research planning, including the characteristics of producttve researchers, the nuh and bolts of research design, and the Loma Lmda faculty model. A management workshop will al,o be held for a small number of people. The program will include the Annual Faculty Research Day, whe re faculty will display posters summarmng their research. Behrens will be available co addrc<< small groups of faculty . The Harrington V1s1tingProfessorship is an expansion of the spnng Harrington Lecture. The new format allow, the v1s1tmg scholar m spend more time at UB developing a topic. The school will continue co sponsor its fall Harrmgcon Lecture. For more information, call Glenda Donoghue, APFME director of Continuing Medical Educat ion and Professional Development, at 831-3714. • LATE WINThR 19!18-89 �30 WE BID FAREWELL TO LOISLEWIS ired in September 1959 when UB was still a private institution, Lois Lewis has worked in the dean's office at the medical school through four University presidents, five med school deans, and explosive student riots. She has also watched the progress of the Amherst Campus from its meager beginnings as a swampy flood plain. "I've seen a lot of changes in UB and the med school during my 28 years working here," Lewis recalled, "and even though I'm happy co be retired, I'm going co miss the University and the med school very much." In late September, John Naughton, dean of UB's School of Medicine and Biomedical Sciences , held a buffet reception in the new lobby of the med school to honor Lewis, who had served as his senior staff administrative director since Naughton joined UB 13½ years ago. More than 100of Lewis' friends and colleagues came to the reception where Naughton presented Lewis with a captain's chair inscribed with the UB seal for her 28 years of contributions and dedication to UB. "She is missed already and will be difficult to replace," Naughton remarked. "She cook pride in everything she did. She paid attention co every detail and always wore a smile. We all wish her the best in her retirement because she deserves ic.• "If Lois Lewis couldn't find something char was requested, then it wasn't findable," Peter Ostrow, associate dean of the med school, said. "She was dedicated and personally involved in the life of the school. She was always a pleasure co deal with and made me feel at home when I first came to UB in 1984.• However, working at UB has nor always meant good rimes and parties. Lewis remembers vividly when student riots erupted on the Main Street Campus in 1969-70 and police occupied the troubled University at che request of Martin Meyerson, president of the University at the rime. "We were evacuated from our offices several times because of smoke bombs and the general threat of violence," Lewis recalled. "The students were protesting (federa l) LATEWINTER19SS-69 government contracts with UB. At the time there was hyperbaric research (the study of rhe physiological effects of high pressure) going on in Capen (now Farber) which was contracted with rhe Navy. They were protesting right in front of our building, so we could see them demonstrating from our windows. It was difficult to enter or leave the building without being harassed by all the people from rhe 'sicins: Ac one point our staff was locked into the office for our own protection. It was a scary time." evercheless, che campus soon became less explosive as talk of a new campus in Amherst spurred the imagination s and expectations of everyone involved with UB. "Originally the med school was planning ro be relocated into Hochstetter Hall on rhe Amherst Campus, but they decided lacer that Main Street was the best location because of its close proximity to the hospitals in Buffalo," Lewis recollected. "It didn't really bother me, though, because I like the Main Street Campus better anyway. It seems more endearing and the city location gives it some character . The Amherst Campus is coo cold and isolating, bur I guess I'm partial," Lewis commenced . "When I first came to UB in 1959, the med school was part of a small private college and graduated a total of only 60 students. Now the med school is a State school with one of the largest budgets for research in the University. The size of the graduating classes have more than doubled while the faculty has tripled." Lewis, a 30-year member of the Professional Secretaries Association, enjoyed the work she did for the University. Working as the BUFFALOPHYSI CIAN AND O!OMEDICALSCIENTIST �31 manager of the dean's office always kept her busy, she says. "There was never a dull moment at the University. There was always something happening-a lot of action," Lewis remembered. "The dean's office was always a busy place, especially since Or. Naughton arrived in 1975. He is one doctor who doesn't play golf on Wednesdays. He doesn't even rake a lunch break." Lewis plans to spend her retirement traveling and visiting her friends. Although she will miss the day-co-day pace of the medical school, when asked what she would miss most about the University, she stated simply, "All of the people." • -By Mark Marabella SCHOOL EXPANDS EARLY ASSURANCE he UB School of Medicine and Biomedical Sciences has expanded its Early Assurance Program to qualified undergraduates at any college, and now offers Early Assurance in the M.0./Ph.O. program. Previously, the program was open only to undergraduates at UB and Canisius College who wished to pursue an M.0. here. Students who are accepted into the Early Assurance Program know in their junio r year of college chat there'll be a spot waiting for them in the medical schoo l, explained Thomas J.Guttuso, assistant dean and director of admissions for the UB medical school. The purpose of the program is co attract highly intelligent students and allow them to pursue a broader range of classes in their last two undergraduate years, Guttuso explained. Students often feel chat they must rake certain science courses that will look good on medical school applications, leaving little time to explore the humanities, he said. In addition, many juniors reduce their courseloads to study for the MCAT, further limiting the variety of courses they take. Since they don't have to rake the MCAT and the pressure of getting admitted to medical school is off, Early Admission BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST students can broaden their backgrounds beyond science, making chem well-rounded individuals. Students need about a 3.5 average in science and non-science subjects and must have completed half of the courses required by the UB Medical School before they can apply, Gurruso said. They must be residents of New York Stace. After they're accepted, students enroll in a clinical preceptorship to see how medicine should be practiced. For local students, preceptorships are arranged at UB. For those living outside of the Buffalo area, arrangements are made with a UB alumnus. Students in the M.0./Ph.O. program are expected to have conducted research before applying to the program. After acceptance, they are encouraged to continue their research at their own college or at UB. Other medical schoo ls in New York State have established early assurance programs and are considering expanding them. • THIERTO SPEAK AT SPRINGCLINICAL DAY r. Samuel 0. Thier, M.0., president of the Institute of Medicine, National Academy of Sciences, will be the Stockton Kimball lecturer at the annual Spring Clinical Day and Reunion Weekend. Thier will speak during the scientific session on Saturday, May 6. The theme for the session is "Nutrition in the '90 s." The weekend will begin with an evening reception for the reunion classes on Friday, May 5. For more information, call the medical alumni office at (716) 831-2778. • MERRILEE$ DONATES ANTIQUEMICROSCOPE n antique microscope valued at $6,500 was donated to the Health Sciences Library's History of Medicine Collection by William H. Merr ilees, M.0., C.M., associate professor of obstetrics and gynecology at UB. A gift from his father, William Merrilees, Ph.D., upon Merrilees's acceptance into medical school in 1936, the Powell and Lcaland No. I microscope was hand-built in England in 1884. It marked the summ it of microscope design and manufacture in England for over 50 years. This microscope was renowned in its time for its innovatively designed stage, which could be rotated 360 degrees, and its steadying stand, which singly required at least 600 man-hours of production. It also introduced the unique ability to be converted to a binocular device by simply unscrewing its monocular eyepiece and replacing it with a binocular eyepiece. Merrilees has also donated 21 titles of medical monographs from the turn of the century. • LATE WINTER 1988-89 �\ VOTERS GIVEMORE POWER TOECMC'S BOARD OFMANAGERS The board now can deal with issues in a timely and businesslike fashion, with less political influence, says the chairman. he board of managers of the Erie County Medica l Center has more power over the day-to-day operations of the hospital, thanks to a new law that was effective Jan . I. The legislation allows the board to deal with issues in a timely and businesslike fashion . "We felt it was very critical because in the eyes of the New York State Health Department, we had the responsibility, but not the authority co ace; said Kevin I. Sullivan, chairman of ECMC's board of managers. The law, passed by referendum in November, "allows us to be more responsive, reduces delays in acting, and reduces political influence over the day-to-day actions of the hospital," he said. Sullivan noted that the county legislature retaii:is certain powers. The board of managers must report to the legislature before programs or services are curtailed. The county still bargains with unions, and the county decides how large a subsidy it will give the medical center. In 1988, the county supplied $5.9 million LATE WINTER 1988-89 K 11 l ~11ll1 m d,c 1rma11 of E( MC\ board of mcma LTS BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �33 of ECMC's $117 million annual budget. For 1989, the county subsidy is $6.9 million . The county subsidy, along with some Scace money, goes toward care of the indigent. Mose of the ocher money in ECMC's budget is received through fees for service, including third-party payments, Sullivan said. The move co governance by a board of managers was prompted by a fiscal crisis in the early 1980s. The county's subsidy co che medical center zoomed up co $24 million in 1984. In 1985, the hospita l superintendent resigned and the firm of Ernst and Whinney was hired to provide interim management. Lacer that year, the board of managers was created co govern the hospital. A cask force sec up by the county identified five long-rerm objectives: Keep ECMC open. Reduce operating costs and financial losses. Continue co serve the community with special attention co the indigent. Operate the facility in a businesslike and cost-effective manner . Continue a leadership role in medical education. Also, in 1985, che county reduced its subsidy co $7.7 million. In 1986, the Vitalnet Group, an independent management firm, was retained to manage the hospital. The goals of its two-year contract were to improve the hospital's operation, ease its drain on county taxpayers, and separate it from political influence. The county further reduced ECMC's subsidy to $6.6 million . In 1987, the medical center repaid co the county $10 million for loans it received during its fiscal crisis. Lase year, the Vicalnet Group decided co let its management contract expire and the referendum was held. Now the board of directors, through a chief executive officer and financial officer, is empowered to operate the hospital on a day-to-day basis. The law also provides two new board members, one appointed by the majority of the legislature and che ocher by the minority. That brings the board to 13 members, all BUFFALOPHYSICIA N AND BIOMEDICALSCIENTIST of whom are voluntary and receive no fee, Sullivan noted. • DEACONESS STARTS GERIATRIC CLINIC he Deaconess Center of Buffalo General Hospital has begun a series of geriatric clinics to help families with assessing and coordinating care of the elderly. During the weekly sessions, the clinic staff primarily provides consultation to caregivers, though some primary care services will also be provided, said June Chang, M.D., director of the clinic. Chang is also an assistant professor of medicine at UB. The clinic directs families co appropriate services and helps with concerns that arise when the patient is under the care of several specialists or takes mu ltiple medications. • NURSING FACILITY NAMESLEVITT acqueline Levitt, M.D., was recently ap• pointed medical director for rhe Sisters of Charity Hospital Skilled Nursing Facility. A geriatrician, she is on the faculty of the Geriatric Division of the Department of Medicine at UB. Levitt is also associate director of the Division of Geriatrics/Gerontology at Buffalo Veterans Administration Medical Center, medical direccor of the Odd Fellow and Rebekah Nursing Home in Lockport, and associate medical director of both the Amherst Presbyterian Nursing Home and the Rosa Coplon Nursing Home. A graduate of the University of Chicago, Levitt received her medical degree from the University of Illinois and completed a residency in internal medicine at UB. She is a diplomace of the American Board of Internal Medicine and the American Academy of Family Practice. In addition co professional memberships in the American College of Physicians, American Geriatrics Society, Maimonides Medica l Society and the Network on Aging, she is on the advisory boards of the Alzheimer's Disease Association and the Carer's Association. • NEWMEDICAL STAFF ELECTED AT MFH orman E. Hornung, M.D., EA.CS ., clinical assistant professor of urology at UB, has been elected president of the medical staff at Millard Fillmore Hospitals. Hornung is a practicing surgeon in rhe Department of Urology at the hospitals and has been a member of the hospitals' medical staff for the past 20 years. He received the American Medical Association's Physician's Recognition Award for the past seven years. Ocher elected medical staff officers include Robert Barone, M.D., clinical assistant professor in surgery, the new president-e lect, a member of MFHs' Department of Genera l Surgery; Andras Vari, M.D., clinical assistant professor in medicine, secretary, medical codirector of the Western New York Sleep Disorder Center, and Thomas Cumbo, M.D., clinical assistant professor in medicine, treasurer, chief of Infectious Diseases with the hospitals' Department of Internal Medicine. • CORRECTION " lease note chat in the Buffalo Physician and BiomedicalScientist, Vol. 22, No. 3, page 7, the edifice you identify as the 'Forbidden City' is in fact 'The Hall of Prayer for Good Harvest' in Tiancan Park, commonly known as the Temple of Heaven Park! This important site is sou ch of the Forbidden City but linked co it ceremonially since the ancient emperors of China paraded in majestic style from the imperial palace co the Temple of Heaven at the time of the winter solstice to invoke the gods!" - Marshall A. Lichtman, M.D. LATE WINTER 1938-89 �34 Vic tor Panaro (M'52) • was elected councilor of the American College of Radiology and member of the Board of Directors of the New York State Radiological Society. Harold K. Palanker (M'40) • of Albuquerque, N .M., was invited by the chief of surgery of the University of New Mexico to be a founding member of the Albuquerque Surgical Society. John D. White (M'40) • was honored for over IO years of meritorious service as a consultant to the Florida Health Professional Services, Inc. Abraham S. Lenzner (M'41) • who has a private practice in psychiatry in Norwich, Vt., was appointed a fellow of che Academy of Psychosomatic Medicine and is now an attending at Mc. Ascurney Hospital and Health Center. Gilbert B. Tybring (M'45) • informs us chat he had coronary bypass surgery in 1988. Dr. Tybring, who is retired, is editor of che newsletter of the Wisconsin Psychiatric Association, Wisconsin Psychiatrist. Reinhold Ullrich (M'53) • is president of the 10,000-member Los Angeles County Medical Association for a one-year term. Dr. Ullrich has a private practice in obstetrics and gynecology in Torrance, Calif. Joseph P. Armenia (M'62) retired from active practice as a specialist in Internal Medicine with the Kaiser-Permanente Medical Care Program in Harbor City, Calif. During my 33 years with Kaiser, 1 served as chief of the Department of Medicine, medical director of the Harbor City Medical Center, and for the last 11years in clinical practice as a general internist." Edward Sha nbrom (M'Sl) • who was among the first to recognize the potential of detergent treatment co inactivate viruses in blood produces, has Geo rge H. Mix (M'47) • in- assigned his patents co the New York Blood Center . Dr. Shanforms us he is retired and living in Summerland Keys, Fla.; "Life brom, senior consultant in che Lindsley E Kimball Research Inin che Keys is great." stitute of the blood center, will Philip C. Dennen (M'49) • of participate in pilot studies co be conducted jointly at Alpha Middlebury, Conn., is che author of the textbook Dennen's Forceps Therapeutics and the blood co improve so lDeliveries,Third Edirion, published center venc/decergcnt technology. in lace 1988by EA. Davis ComResearch has resulted in a new pany. The forward co the book procedure which uses a special was written by Kenneth organic solvent cogecher with Niswander (M'48). detergent to inactivate viruses that can contaminate blood produces. The success of che method was demonstrated in a clinical Jay B. Belsky (M'S 1) • writes study of the blood center's antihemophilic factor concentrate. from San Pedro, Calif., "I have LATE\\~NTER 1988-89 Milton Alter (M'SS) • of Philadelphia, writes, "In September 1987,I stepped down as chairman of neurology at Tem• ple Univers ity Hospital (after 11 years - 1975-1987)." William J. Sullivan (M'SS) • of Los Angeles, Calif., is a diplomate of the American Board of Psychiatry and Neurology. He is certified in psychoanalysis and is now specializing in forensic psychiat ry. Philip A. Brunell (M'57) • is president of the Society for Pediatric Infant Disease and editor-in-chief of PediatricInfant Disease News. Dr. Brunell is associate director for academic affairs and chief of pediatric infant disease at Cedars-Sinai Medical Center, Los Angeles. Edwin R. Lamm (M'60) • is president-elect of th e medical staff of Lakeland Regional Medical Center, Lakeland, Fla. Kenneth Be ll (M'61) • has been appointed associate medical director for Kaiser Permanente in Orange County, Calif. As chief of staff for the medical center located in Anaheim, he is responsible for selecting physicians, setting medical policy, planning new programs, and administering budgets. Dr. Bell is an associate clinical professor of obstetr ics and gynecology at the Unive rsity of California (Irvine) School of Medicine. Joseph P. Armenia (M'62) • received the 1988Citizen of the Year Award from the Western New York Chapter of the American Diabetes Association on May 25. Armenia is a clinical associate professor of medicine at UB and chief of the Division of Endocrinology at Mercy Hospital. During the past 20 years, he has been instrumental in the organization an d development of the local chapter of the diabetes group. He served as its president for many years and is currently chai rm an of the board. Jr. K e nn et h H. Eckhert, (M'68) • has been appointed chairman of Sisters Hospital Department of Surgery. Eckhert is medica l d irector of che hospital's Breast Care Center and is ch ief of surgery at St. Francis Hospital. Maxine Hayes (M'73) • of Bellevue, Wash., has been named director of the Bureau of ParentChild Health Services wich che Department of Social and Health Services. Dr. Hayes is serving an executive session four-year term with the John E Kennedy School of Government's (H arvard University) Center for Health and Human ResourcesPolicy.She has also been selected as che Har- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �35 D ouglas Pl eskow (M'8 2) • writes chat he and his wife Ran• di Ples kow (M'82 ) completed a vard School of Medicine's Fae Golden Kass Lecturer for 1989. Israel J. Ja co bo wit z (M '73) • of Brooklyn, N.Y., has been appointed director of the Cardiovascular and Thoracic Division of the Maimonides Medical Center. GI fellowship last year. "Randi and I have a two-year-old daughter named Sara. Randi is an assistant professor of pediatrics at Tufts Medical School and I am an instructor of medicine at Harvard Medical School." Larry R. John so n (Ph .D. '73) • is project coordinator of rhe Oregon Health Sciences University Lung Health Study in Portland. He is partly responsible for spirometry quality control at 10 study sites and consults on Chinese and Japanese spiromerry longitudinal studies. Steve n J. Morri s (M'73) • received a J.D. degree from Georgia Stare College of Law in 1988 and is a member of the Georgia Bar. Dr. Morris has a private practice of gastroenterology in Atlanta and is a clinical associate at Emory University. He is president of rhe Georgia Gastroenterologic Society. Dr. Morris is married and has four children. Michael Rowland (M'75) • of Pinehurst, N .C., is general surgeon of the Pinehurst Surgical Clinic and vice president of the Norrh Carolina chapter of the American College of Surgeons and chairman of the Cancer Committee of Moore Regional Hospital. Bess Mill e r (M'77 ) • a medical epidemiologist, division of tuberculosis control at rhe Centers for Disease Control, writes, "The job is great-and if that doesn't keep me busy, my husband and I have two little boys: David, 4 years, and Matthew, 11/2 years-who do keep us busy!" Paul A. Gree nb erg (M'84 ) • Mi chael Row land (M '7 5) writes, "After doing rwo years of surgery and three years of medicine, I'm on my way to do a medical oncology fellowship at MD Anderson Tumor Institute in Houston." Tumor Institute. He helped found the Head and Neck Surgical Society, the James Ewing Society (now Society of Surgical Oncology) and the Radium Society and was president of each. James D . Tyner (M'29) • died on April 29, 1988in Newark, N.Y. He was a past president of che Wayne County Medical Society and a founding member of the American Academy of Family Practice . Ric hard Taylo r (M'30) • a others, Leah and H:adass. Ir's because I became a certified mohel." B o n n ie Ri c hard so n (M '85) • announces that she is scarring a private practice in family medicine in Hudson Valley, N.Y. Dr. Richardson's daughter, Emily Fjaellen Thompson was born in August 198i. M a rk S. B ore r (M'80) • is staff child psychiacrisc and director of the Dover Day Ho:spical for Troubled Youth, Dover, Del. David Stein (M'87) • is a resident in medicine at the Massachusens Medical Center in Worcester, Mass . general practitioner in Blasdell for 51 years, died Oct. 24 following a long illness. He was 82. Born and raised in Hamburg, Taylor served as the town's health officer from 1935co 1975.He also served as the physician for the Blasdell and Frontier Central schoo ls, for the Blasdell Fire Company, and for the Eric County Fair and Exposition. He was active in many UB fund drives. Taylor is survived by his wife, three sons, 12grandchildren, and a great-grandchild. Anth ony S. U ng er (M'8 0) • a Bruce R. Saran (M'88) • mar- Charles F. Banas (M'37) • chief clinical instructor a't George Washington University Medical Center, recently published "Total Ankle Arthopla sty" in Operaci1:e Orchopaedicsedited by M. Chapman, M.D. ried Robin I. Kauffman in Occober 1988.Dr. Saran is a resident at the Medical Center of Delaware, Dover, Del. of scaff at Mercy Hospital from 1966to 1986,died September 13, 1988. He was 75. Born and raised in Buffalo, Banas joined Mercy Hospital in 1938 as a family practitioner. From 1942 to 1946 he served in the Army Air Force-Air Transport Command, Medical Corps . In 1952 he instituted the Allergy Clinic at Mercy Hospital and served as its director for 30 years. He also helped co-organize the General Practice Section and served as its first president. Banas served as the first chief of the Genera l Practice Department from 1956 until his appointment as chief of scaff in 1966. Wes ley S. Bl ank 1(M'80) • writes, "Nan and 1 ha,d another baby girl, Rebecca, to join our rwo Joe l Fiedler (M'81) "' is clinical assistant professor of pediatrics at Sc. Christopher's Children's Hospital in Philadelphia, Pa., and an allergy consultant for rhe North Jersey Medical Group. Mark M. Chun g (M '82) • writes, "I am a practicing pulmonologist in Ora nge County, Calif., and a member of the pr'ofessional staff of UCLA." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST W illi am S. Mac Co mb (M'2 7) • died at his home in Walnut Creek, Calif., Sept. JI, 1988. He is survived by his wife, Janet, three sons and a daughter. Dr. MacComb lived in Houston from 1952 to 1974. He developed and was chief of rhe Head and Neck Service and was professor of surgery at the University of Texas, M.D. Anderson Hospita l and LATE ll.1r<TIR IQ~ �AlHmm 36 CALLFORNOMINATIONS our president and Board of Governors has, over the past several years, received many requests for Alumni/ae to establish a Distinguished Medical Alumnu s/a Award. Therefore, your president and board arc seeking nominations for this award to be presented annually beginning this year. The award will be presented to a graduate who has distinguished himself/herself nationally or internationally in the eyes of his/ her peers and has made an outstanding contribution to medicine, the arts, or humanity during his/her career. The selecltion will be made during the summer and the award will be presented in the fall at a special award dinner. Please forward the name of your nominee as soon as possible on the attached card. A June 30 deadline has been established for the receipt of all nominations. Your cooperation is absolutely viral if this is to be a true alumnus /a award. our way of showing ou r appreciation to the members for their past suppo rt of the school. Preparation is under way for the 1989 meeting of the society. The James Platt White Society is named for one of the founders of the medical school who was in private practice in Buffalo from 1835-1875. A founder of the American Gynecological Society and one of the founders of several Buffalo hospitals, he made important contributions to the practice and teaching of obstetrics. • GUTTUSO GIFT CREATES TWOAWARDS wo new annua l student awards have been created, thanks to a fund established by Thomas J. Guttuso (M'60), director of admissions for the UB Medical School. One award will go to a senior medical student who has contributed most significantly to research in ophthalmology or who has demonstrated significant concern for patient care while in ophthalmology service. The oth er award will go to a resident who has contributed most significantly to ophtha lmology overall. Guttuso has a private practice in Lockport. He is a member of the James Platt White Society (the school's highest gift recognition group) and the President's Associates (the University's highest gift recognition group).• JAMES PLATT WHITE SOCIETY TOURS NEWFACILITIES DURINGANNUALMEETING he third annual meeting of the James Platt White Society, a group of major annual contributors to the medical school, rook place on Friday, Oct. 21, in the Lippschutz Room of the school. In addition to a tour of the new medical school facilities, the members and their spouses and guests were treated to an excellent afternoon program. The topics ranged from cardiology in Buffalo to bioengineering in anatomy to biotechnology and the human side of AIDS. The topics were excellently presented by facu Icy, not on Iy from the School of Medicine and Biomedical Sciences, but from nursing and physiotherapy. The capstone for the day's meeting was a cocktail reception and dinner in the Center for Tomorrow on the Amherst Campus. All members of the society received an engraved Jeffersonian pewter cup. The cup is LATEWINTER 1988-89 DIRECTORIES SLATED FORMAY DELIVERY he UB Schoo l of Medicine and Biomedical Sciences Directory is coming soon! This comprehensive new volume is a compilation of the most current data on more than 4,655 medical school alumni/ae. Now chat the editing, proofreading, and printing are almost finished, the distribution of this impressive edition will scare. All alumni/ae who reserved a copy shou ld receive it around May 5. If you have a question on your order or wish to place an order, contact the cuscomer service department of Bernard C. Harris Publishing Co., Inc., 3 Barker Ave., White Plains, N.Y. 10601. The phone number is (914) 428-8921. • HERE'S ONEMORE hen we ran one photo of each reunion year in our Autumn 1988edition, we thought we had all of the bases covered. Bue there were two graduating classes in 1943 and we inadvertently left out the spring graduates. Here they are, with our apo logies: Front row: Harold P. Graser, Gertrude S. Swarthout, Kenneth W. Bone, and William H . Georgi. Back row: Duncan K. Macleod, Richard S. Fletcher, Richard J. Buckley, Charles C.B. Richards, Alfred S. Evans, and Joseph H. Melant. BUFFAW PHYSICIAN AND BIOMEDICAL SCIENTIST �,, �MEDICALHISTORICAL ~1~, KIMBALLTOwER, SERIALS DEPT, MAIN ST., CA"1PUS c-/ BUFFALO NY 14214 ff1Jfrl � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Late Winter 1988-1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-1989-Late Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v22n05-1988-89-LateWinter Table Of Contents A list of subunits of the resource. The best is yet to come Lucky 13. Cholesterol. Passive vaccine Airwaves. Handpicked. Hospital News Classnotes and alumni news Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/e75df90ccdda2d8d51acc53ae4a881d8.pdf 4d453869241aa240ad70c4d0932ac018 PDF Text Text Vol. 23, No. I Spnng 1989 and Biomedical Scientist ~ Procedurecan save lives­ but donor organs are needed �STAFF EX[ Cl 'TIVE E[)ffilR UN vl'RSITY PL RLIC'ATK'NS Rehcr1 T M irlcr 6t'rFALO ffi'r<;IC IA1\ l'[)ffi)R C ( l'OIC ()s, 1ld S10110 ART o: {fC'Tl 'R A, in I Kcgl.r Dear Alumniand Friends: 0 n Feb. l, President Stc\en B. Sample announced that the L'nhersity at Buffalo had h,ecn ,m1t<.-dto jom thc_prest1g1?us Assoc.1at1onof AmL'T!<.an Gmversmc-s (AAUl. Tlus orgaruzallon, founded in JQOO , has 5o members, .1 rcprt-s<.:nt,ltlonof tw0 per cent or less of all American umvcr,mes . Sigmfkant in this v~-ar'sadmissions 11asthe fact char rno p:1bhc inst1tut1ons, both from the East, rather than one publ1<.and one private in,titution, each w<:reasked to JOlll. The Uruversity at Buf• falo 1s rhe first public institution from either ~ew York St.tte or New England Jdmirred w th<: organi:arion. The other invitee is Rutgers University. The other member institutions from Ne11 York StJte <1reColumbia, Cornell, ~ew York University, Syracuse, and the Umvers1ty of Rochester. Our acceptance into this important organi:ation signifies the growth and academK maturity that has resulted in the short period of 25 years smcc the merger of UB with the SUNY system. Tod av, Buffalo's l.Jnivcrsity rep resents a comprehensive unit committed to excellence in research and teaching, and to servicing a broad public mission. Special recognition and congratulations are due President Sample, who set this achievement as a major goal from the beginning of his presidency seven years ago. There is little doubt that all of us who current'.y associare oursdves with this academic eN<-rprise and those who J0tn and follow us will benefit enormously in the years ahead. \X'e owe the fTes1dem ,:md Sl.JNY a great debt of gratitude. I hope ) ou are as pleased as we are. ADVISORY BOARD Dr John :--=au~hton,rli.:,rman Dr. H .old Brody ?\ts. N1n1.y GI C\.O Dr. James Knrua, Dr t harl~ P O ,ncll· \.tr. G~•>:"',' Zinc: Dr Antoinette Pctcr-s Dr. l harlc Pru, • Dr. l ,1>i., Rob·.,-;on r>r. rhor RiY.-tnt•11 Dr. S.k•d, Sures [)r b1..rron ')in.ge--man Dr :01erhcn '>1 ulJinc Dr ?\:cl.on rorrc Mr. EJ,.. ird \'<,.,:kc nr f'.:.._ I \\ 1cr; 1 lcr 'l""[)r Jerernc:-Yates WRITERS M \IJ,-,bdi UK l Ar(I _ !'a~t: ILi USTRATORS L1 H~ncy ), re Mir k~ P ul '-•p,ko" k l\.t1kc: ~- ,Iosc1 , c , D ,-, l ,kroc:.·msk, l'HOTOl:RAPHERS ~-L 1-"' \l.•k ' rn:~~LJ Jo hn Na ughton, M.D. \'ice Prc"de'll for Climcal AJfa,rs Dean, School of \ Lhme and Bwmed".al Sciences &,\-, \'( ''"' H.ACHl:S:G HOSPITALS AND LIAIS01'S o· • \ \ ..tcranir. AJn, \'c._:'P.uft 1 .,.r••no: '-crrc Buff..!o Gcn\.r,. 1n1 V \h •• AJrr r · 11 ,nrc 'ohn I ill \kd, ,t , ( b,IJ,,,-, Ho II • l\.an:n Fr. ( um1 \1 l, ,I l n· r, \f'- 0 \1 0 'tl .._,,. nn"'~u ' \1rn Dear FellowAlumni/Alumnae: l➔l h:nn .> \ Ho rt 1 • '- hui.. k, r.u:<(: M,llord F 'lmon- .!, pu ,I, !) l'l J,'rlfl I r ... \1i me. 1al : ' K. " 'i r H< r . I),. nn tit . . .. I-ct \~ -< .artlr- Rt!~ j n .. r'!, ~I JUlo<~~ ~l~ n.; fli' >l Ff \:....l PHY-,ICIAN A \l[) BIL' \lEl11l \~ ,( IEl',,rt,r ,L ,f"i "t> r ,,, '5( \I \dune. ~ ,,1 'luo •er I fu,.,1 1-\ h\c: t mL ~•· · u~ 11\· "'ip..m~ "-lu1 11Y.r, \ ·u1 r--, f. r v \X.mtcr, 1nJ ii..u W t • 1-- th 'i<hoc•I.,. \.kJ1o n, mJ Bmri.l-Ju.. ,1 Sl1cm.1. . ~t.: • l .1 ,er ·\ c•f i\ic.\ Yn·k lt B -,11 l•f\C. \1am '"itrcc·, Buffa!~ 1', , for. I,!•; flu-J , ulk pl . [ p11' f bL.""1 l, ~ "- Yul Send JJrc c mg, '" n:E BL Fl'\.ll PH) -,I( I\ \l AN[' AIL)Mfl:',C \L 'ip ~u_~•:~: IE1';T'>f, 16 ( F 5. AdJ,· " '-t t Buff lo 1', " Y,·l I t .s hard ro heltl'\L rh.H my year as pn ..,tdLnt Jf thl' Alumm Assocaoon 1s .1lrcady ~oming tC',1n end The Sprin~ Cl ,mc.ill Dav k'Stl\ ttK>s,induding the educ anona, sesstC'ns,ind •he gal,1 e\ent for the reunion c.'as,e,, ,!Tl'Sl't for the \\cekend of Mav 6. 1h,s \e,lf the :-.1edtlJI Alumm Assnc.,ation will stirt a nc\\ award for , medic.ii ,tudent or students \\'1th the highest .ic.ademK achkvemcnt in their first and se<.ond \cars. It has heLn noted b\ our board th.it studc:tts rc:c.e1vcs,hul,ir,lups upon <:ntmnce to ,choul, but altu rh.,t the: highest 1-h1e\l'rs .tren't honored before the third year. It is our attempt to recognm: those students. As mentioned in prtvious \Hl'!ngs, the Distinguished Ahmnu,1A:umna A\1,:,.rd, sponsored 1:-ythe A:umm Assouatt('!'l, will he presc:mcd rh1s fall Ad nner honormg th·s person will be held Ill c.Onjun,tton \I 1th our Pa,t Pre,id<.'nts' Dmner. \Xt will h·ep vou po<ted .1, to rhe winner, .Jnd \1·eexrend an opt:n mva.,tion to ill! .,!urns to attend the dmner. In .:losm!l, note thJt 111 the <.<'!"11111!!y~.1r.the Medical Alumn· \I uh the flepartmenrs of Surgerv Assoc1anon will c.o-ho,,trc.-ccpt1011s .,n..l Ant:<tht:si,1 ,,t their 11.it1unalmeetmgs. \Vt: 1m ,te alumm in the .trca, 0( the nauon.il meetings to .JttcnJ. 1 •l t IZl4 cJ?d/V ~~ Paul H . \\'icr:bicn ic c, M.D. �Vol. 23, No. I SPRING 1989 Features 0 Theelusive miracle.Heart transplantation El A hot new field. Thermography, which maps the can be a lifesaving miracle, but the shortage of donor organs keeps this miracle out of the reach of many. various skin temperatures on the body, has great potential in the diagnosis of circulatory and neurological disorders, say UB researchers. ffl Earthquake. UB physicians offer medical assistance to victims of Armenia's December quake. Page 2 lffl BoneGrower.Munro Strong, M.D., associate professor of orthopaedics, pioneered the use in North America of a revolutionary apparatus for people with limb deformities and severe fractures . Page 25 Departments '1'1 Research. Testing "clot busters," cutting costs in trauma cases, and exercises for arthritis of the knees are subjects of UB researchers. ffi1 MedicalSchoolNews. You could call them the unsung heros of the school. They're the voluntary faculty who receive no pay but provide a vital service to the school. Page 21 Page 12 ml HospitalNews. iDJ People.The focus is on Thomas R . Beam, Jr., M.D., who's looking at ways to speed up the FDA's drugapproval process, and Peter Ostrow, M.D., Buffalo's only physician/TV reporter . Spotlight . The watercolor work of cardiologist Ivan L. Bunnell, M.D., Class of 1943, is featured in our premiere of this department. In each issue, we'll take a look at the artistic work of one of our alumni, students, or faculty . Classnotes. Cover lllurtnrtion: Mike Wolruchinow ��3 FORMANY, HEART TRANSPLANTATION REMAINS A DREAM By CONNIE OSWA LD S1DFKO harles Hilton knew he was going to die soon. Though they didn't tell him, his doctorsthought he'd die that night. He couldn't eat, couldn'tbreathe,couldn'twalk. His anginacausedconstantpain. His only hope was to get a heart transplant."I had nothing to lose,"Charles said. "Anything would have been an improvement- even death." Charles was one of the lucky ones. He got a heart in time. That's the life-saving miracle of heart transplants. Bue ochers aren't so lucky. Across the country, 20 co 25 per cent of heart transplant candidates die while waiting for a donor organ, according co Robert M. Mentzer, M.D., director of UB's Heart Transplant Program and a professor of surgery. "It's a very serious prob lem," agreed J. N. Bhayana, M.D., co-director of the program . "We're losing patients ." In Buffalo, heart transplants have been performed since 1984, first at the Veterans Administration Medical Center and now at Buffalo General Hospita l as well. In chat time, 23 transplants were performed. Five people died while waiting for a heart, and, as of February, there were more than iO more patients waiting. Another 15 are being evaluated as possible recipients . SPRING 1989 The UB program has excellent facilities, a top-notch staff, and plenty of willing patients . There's only one shortcoming : the number of available donor hearts. One reason for the shortage is that as heart transplantation lost its experimental status, more and more new centers opened . In 1984, there were only 32 centers in the United States. Now there are 135 and counting . That's causing keener competition for the organs. Another major problem is that people just don't understand about heart transplants . "People don't even realize organs can be transplanted, or they don't know which organs can, or they never thought about donating organs; said Elizabeth A. McNamara, M.S.N., R.N., che transplant coordinator for the Organ Procurement Agency of Western New York. "Then they're faced with the sudden, tragic loss of a loved BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �4 obert M. Mentzer, M.D., director of UB's Heart Trans, plant Program: "We have to try to think in terms of not wasting organs." one, and when they' re asked if they want to donate his organs, they may say 'nd because they're not ready to deal with it." McNamara pointed out that the best organ donors, especially for hearts, tend to be young, healthy people who suddenly suffer brain death. It's the guy whose motorcycle spun out of control. Or the one who fell during a fist fight and hie his head on the sidewalk. Or the child who walked out between two parked cars. "That's the rub~ she said. "These aren't predictable deaths. The family has just lose a loved one they may have been speaking to a few hours earlier." And the idea of brain death is difficult for families. "It's rough for the family to accept chat their beloved one has died," said Bhayana, associate professor of surgery at UB. "But if they wait too long, the heart may stop or there might be an infection of the lungs. Then the person is no longer a candidate for donation ." "Even within medicine and nursing, you'd be amazed at the number of people who are nor comfortable with the term 'brain deach:" added McNamara . "They chink, 'Well, maybe the person's not reallydead .'" Exacerbating the problem is the fact chat there's no Scace-wide criteria. Instead, the Stace has empowered each hospital co decide how many flat EEGs and ocher evaluations constitute brain death . Because chis is such a trying moment, hospital staff members are often reluctant to approach che family about SPRING 1989 possibly donating organs . "Some of the professional staff take it on themselves not to ask the family, chinking the family won't be able to handle the emotional strain," McNamara said. "Bue chat's nor fair to chem-we need to give chem rhe opportunity to say 'yes' or 'no? "In the IS years I've been in nursing, it's the hardest thing I've ever done. But there's also a redeeming aspect. le helps them go through the grieving process. And it helps chem build a kind of memorial co their loved one to know chat he or she has given three or four people a second chance at life (if several organs are recovered). "I just spoke with a mom whose daughter died in a car accident. She calls every so often to talk . The daughter was an only child and chis was the parents' first Christmas without her . They got through it because they thought of the people who could go on living. They were very happy they gave consent." Boch the Scace and federal governments have now passed laws chat mandate chat families of suitable organ donors muse be given the opportunity co donate, McNamara noted . Every hospital has designated a key person who will be the one co approach the family when brain death is imminent . While a person is still well, he can sign a donor card pledging his organs at his death, or sign che special space on the back of the New York State driver's license. These are considered legally binding . BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST �5 N. Bhayana, M.D. , codirectorof UB's Heart Transplant Program: • "It's a very seriousprob­ lem. We're losing patients." But the most important thing he shou ld do is let his family know his wishes, said McNamara, because the agency won't accept an organ without the family's consent . "Ir's great to carry the donor card around with you, but if your family doesn't know anything about your decision, it's worthless," she said. Because of the high level of emotion that may be involved, the agency won't accept the donor if there is overwhelming family disparity . "We don't want to cause a permanent emotional rift in the family," she explained . In addition, the bad feelings it would generate would work against the agency. "If you turn off one member of one family, and that person tells the story to 50 or 100 people, it turns all of them off; McNamara said. If there is no known next of kin, the agency won't accept the donor . Some people are reluctant to give consent because they hold misconceptions . The agency tries to overcome this problem by assuring the family that donating organs won't cost them any money, that it won't mutilate the person, that they can still have an open casket funeral, and that major religious denominations allow organ donation . Still another reason for the shortage of donor hearts is the small geographic area from which they can be drawn . The average maximum ischemia time is four to five hours; that is, the donor heart can be without blood flow for only four BUFFALO PHYSICIAN AND BIO~EDICAL SCIENTIST to five hours from the time it is removed until it is transplanted . That limits the distance the transplant team can travel to recover a heart . Another factor that may aggravate-or alleviate-the shortage of donor hearts is a new distribution system that started in January . Those involved agree that it's still too early to tell how it will affect Buffalo's program . Under the new system, if a heart is available in Buffalo, the Organ Procurement Agency of Western New York contacts the University transplant program . If there is a suitable recipient at Buffalo General or the VA, the organ stays in the area. (fhe donor heart must be compatible in a number of ways, including size and blood group.) If the Buffalo program can't use the heart, the local procurement agency contacts the United Network for Organ Sharing (UNOS), a national network . That group runs a computer match to find a recipient within a 500-mile radius of Buffalo. Out of all of the suitab le candidates, the person who has been waiting the longest gets the organ . But what happens if a donor heart is available in Rochester or Syracuse or Albany, cities which don't have their own transplant programs? Under the old system, a candidate first would be sought within New York State, so Buffalo would have a good chance of getting the organ . Under the new system, however, the organ goes to the candidate within a 500-mile radius who has been waiting the longest . Ir's feared by some that out-of-State centers will get srrui-o 1989 �Say 6 lizabeth A. McN a~ mara, M.S.N., R.N.: Hospital staffs often ......... are reluctant to ap~ proachfamiliesabout donating organs. many of the hearts that, under the old system, would have been sent to Buffalo. People are also concerned chat these centers won't reciprocate and send hearts ro Buffalo because these ocher centers are larger and able to use every heart that becomes available in their local areas. "Because the system is changing-we hope it's changing for the better-we're not sure how these changes are going to affect our programs;' said Mentzer. "But we all share the same goal, which is to gee as many donor organs to as many patients as possible, no matter where they live. "We're always talking about the patient, but equally important is protecting the donor supply. We have to cry to think in terms of not wasting organs, and placing the donor organ in an environment that has the best chance of being successful, because there is such a demand." Still anothe r factor contributing to the shortage may be the sheer newness of everything surrounding heart transplants. Western New York has had a system for procuring hearts since only 1983, Bhayana pointed our . Before chat, each hospital acted on its own. And since the University program is so new, it doesn't yet have rhe community awareness and support that other, more established programs have, Mentzer added. Predicting the future of organ procurement is difficult . New problems may crop up. For instance, the spread of AIDS may cut into the supply of donor organs in the future, Bhayana and Mentzer speculate. SPRING 1989 For now, a number of solutions to the shortage are being examined. Researchers are looking for ways to increase rhe length of time rhe donor heart can be without blood flow, as has been done with livers. Livers once had to be transplanted within eight hours, but now a perfusion solution has expanded that time frame to 24 hours, allowing chem to be distributed all over the country, McNamara said. Also, the maximum allowable age for heart donors has increased, Mentzer pointed out. It's now 40 years old for males and 45 years old for females. Organs from older people aren't accepted because it raises the chance of implanting a heart with coronary artery disease. The key solution to the shortage, Mentzer, McNamara, and Bhayana agree, is education of both medical staff and lay people. Ir's important to educate the smaller, rural communities around Buffalo, said Bhayana, such as Jamestown, Olean, and Warsaw. "Thar's where we're going to have our donors;' he predicted. "We're trying to get a foothold into the community, especially into the minority community, through the clergy who deal with death and dying every day;' McNamara said. Many minority people have strong religious beliefs, she noted, and if their minister stands up in the pulpit and endorses organ donation, the efforts will trickle down . The organ procurement agency also conduces free BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �7 harles Hilton pends on a suitcasefull of medication, but he and hisfamily see his transplantas "a gift of life and God's miracle." workshops and seminars, and will make presentations to clubs and "anyone who's willing to listen," she said. "We're always in need of additional media attention." "I want to emphasize chat the media has to help us educate peop le," Bhayana added. "If someone is brain dead, his family owes it ro society at large to use his organs ro save somebody else. Thar's what will he lp us." Mentzer pointed out that it's important to get across the idea that organ donations have the potential to save a life. "As long as we can continue to emphasize how important organ donation is, and what the benefit is, we can separate the tragedy of the death from the goodness of the gift," he said. "It's a gift of life and it's God's miracle,"says Martha Hilton, Charles' wife. "There are miracles." Sept. 2, 1986 was Charles' 54th birthday. And it was a birthday in the true sense of the word because that was the day he receiveda new heart at the VA and a new chance for life. Charles' heart camefrom a 17--year-old killed in an all-terrain vehicle accident. "That was the one sad part-that someone had to die to let my husband live," Martha said. The desperatelyill patients waiting for transplantspray for hearts, Charles said; not hoping that someonewill die, but hoping that if someonedoesdie, the heartcomesin time to save their lives. It's difficult for them to wait day after day wonderingif they'll BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST survive long enough to receivea heart. One fellow Charles knew waited three years without getting a heart. A couple of his friends have been waiting six months. Charles had an unusually short wait-only a week. It's been about three years since his transplant at the VA, and Charles,a retiredapartmentsuperintendent,sayshe feelsgreat. He walks a couple of miles a day in the winter and 10 miles a day in the summer. A new endeavoralso keeps him busy. Knowing how difficult it was for his family to commute almost three hours from his daughter'shome in Naples, N.Y., to the VA,Charles hasambitious plans to open a housein Buffalowherefamiliesof out-of-townheart transplantpatientscan stay at no cost. He speaks to veteransgroups lookingfor donations,which can be sent to him at 18 Mark Circle, Naples, N.Y., 14512. Gratefulfor the secondchancehe got, Charlesalsodoespublic speaking on behalf of the Organ ProcurementAgency of Western New York. Through the agency, the Hiltons sent a letter to the family of the teenagedonor, thanking them for chisextraordinary gift. "Everytime my husbandhasa birthday, their son hasa birthday, too," Martha said. • Editor's ::-..'ote: For more infonnac1onon che Organ Procurement Agenof Wbtcm ::-..'ca)ork, Inc., call I-800-227--1771. For more information on ihe UB!Bujfa/o General Heart TransplantCenter, call 1-800-2-12 00-15. C\' SPRING 1989 �8 SPRING 1qgq BUFFALOPHYSICIANAND BI0~1EDICALSCIENTIST �THERMOGRAPHY: A HOf NEW FIELD By CONNIE OSWALD STOFKO he patient's image appearson the computer screenas blotchesof garish reds, blues, and greens,lookinglike a wild paint-by-numbers . The facial features are indistinct, but that doesn't matter. This picture is more like a map than a portrait. The picture was created using a technique called thermography,which maps the various skin temperatures on the surface of the body. This data on distribution of skin temperatures has great potential in the diagnosisof circulatory and neurologicaldisorders,say UB researchers. And they're ready to take the lead in the new and growing field of thermography. "Currently, we are the most active center for thermographyresearchin the country and are expanding rapidly," said Michael Anbar, M.D., chairmanof the Departmentof BiophysicalSciences at UB. "We've got cameras matched by nobody. We've got software matched by nobody-because we developed it. "We want to make Buffalo the national center for thermographyresearch." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SPRING 1989 9 �T hermography is a relatively simple technique. "It's ve r y much like taking a 10 photographic image-the re's a camera , it looks at you, it takes your picture. You can even smile if you want to," Anbar quipped. The camera is a rectangular , black metal box about two feet long. A spinning mirror located in a recess of the box picks up the light reflected from the surface of the subject . The light is reflected to another mir ror inside the box, and then to a third. Finally, the lighr is reflected inside the box onto a detector rhar's sensitive to infrared light. (Everyone emits infrared light. Broadly, it can be said that the intensity of the infrared light depends on the temperature of the subject.) The detector changes its resistance depending on the temperature char falls upon it. If a photo detector were used in place of this infrared detector, you'd get a photographic image, Anbar noted . Using the thermographic camera, vivid color images that show the distribution of skin temperatures are produced on a computer screen, displayed in colors ranging from hot red to cold blue. Since skin temperature is a function of the pe rfusion (or blood flow) under the skin, hot and cold spots can indicate problems wirh blood vesselssuch as clogging of the arte ries, thrombosis, or an inadequate blood supp ly to the feet of diabetics. "Whenever you have a perfusion problem, thermography is ideal because it's non-contact, non-invasive to the extreme, it doesn't hurt, you can repeat it as many rimes as you like, and you can quant icace the resulrs; said Anbar . "I feel we haven't scratched the surface of its potential:' Changes in skin tempe rature and blood flow can indicate more than circu latory problems. Since blood vessels can constrict or dilate depending on signals from nerves, we can learn about the behavior of nerves by watching the behavior of blood vessels, Anbar explained. Thermography cou ld be used to flag a pinched nerve or a disorder of the sympathetic nervous system . Thermography can also be used to SPRING 1959 "visualize" pain. That's because when a nerve sends a signal to the brain that registers as pain, it's often associated with a change in blood flow. If the affected area of the body shows a change in temperature, it might indicate that the patient feels pain . However, even if nothing unusual shows up on the thermographic image, the perception of pain can't be ruled out. While this technique can be very helpful in rehabilitation medicine, it also can be abused, Anbar pointed out . Lawyers like to use it when they suspect that a litigant is faking an injury in order to collect money after an accident. "T he r mography has fa llen into disrepute because it has been used so much by the legal profession as a kind of lie detector for pain," Anbar noted. While thermography is now used most- ly in non-surgical procedures, it has great potential for use during surgery, Anbar believes. le could be used in all surgical procedures where perfusion is critical, such as during organ transplants . "Here's a non-contact technique char tells you whether perfusion is uniform, and it could be performed du ring surgery," Anbar said. T he University researchers are investigating ways that thermography can be used to assess irritation to the cornea and to try to prevent the rejection of corneal transplants . Thermography could also be used to check on the healing of skin grafts. The researchers are developing new computer hardware and software for thermography, as well developing better diagnostic tests. 0 EGREES CENTIGRADE 32.4 32.0 31..7 .. 31..4 .. 31..0 30 • I ''ffjl •' 7 .4 ·1 :~ . ~..... 30 ~~, ii. BUFFALO PHYSICIAN �They want to take the subjectivity out of thermography. Instead of simply looking at a thermographic image and making judgments about "hot" and "cold" spots on the body, the researchers want to be able to assign number values to the data . "We're focusing on quantitation of rhermographic information;' Anbar noted . "Ar the moment, we're the only ones in the count ry doing this." The researchers also are crying to develop "normative data; chat is, data from healchy people to provide a baseline for comparison co different pathologies. They hope to use rhermography as a model for diagnostic imaging in general. T he data they're developing may be applicable to any diagnostic imaging problem, from X-rays to ultrasound. "An image is an image, no matter how it's generated," Anbar noted. The UB team is an interdisciplinary group char includes : • Robert A. Spangle r, M.D., Ph.D., associate professor of biophysical sciences at UB • John Loonsk, M.O., instructor in biophysical sciences at UB • James Montoro, biomedical engineer in biophysical sciences at UB who is developing quantitative techniques • Kyu-Ha Lee, M.D., associate professor of rehabilitation medicine and director of the residency program in physical medicine and rehabilitation at UB as well as chief of rehabilitation medicine at the Veterans Administration Medical Center • Linda A. Hershey , M.D., Ph.D., associate professor of neu rology at UB and chief of neurology services at the VA • Steven M . Steinberg, M.D., assistant professor of surgery at UB and chief of the surgical service at the VA • William H . Coles, M.D., M.S., professor and chairman of ophthalmo logy at UB and clinical director of ophtha lmology at the Erie County Medical Cen ter. A relatively new field, computerized rhermography has existed for only about IO years. Buffalo's first rhermography camera arrived at the Veterans Administration Medical Center less than three years ago. Buffalo now has three such cameras-two at the Veterans Administration Medical Center and one in the Department of Biophysical Sciences at UB . By 1992, Anbar hopes to have seven or eight in the area. The Department of Biophysical Sciences decided to put a great deal of effort into thermography because it's a problem researchers here can attack with relatively inexpensive equipment, Anbar said. For example, an MRI (magnetic resonance imaging) machine costs about $2 million to buy and $1 million to run. Thermography equipment costs about $100,000. T hese gra:,•-sca le th e rm og raphi c im ages show th e hand s of a pa ti ent s uff e rin g f ro m a neur olog ica l di so rder. T he han d at left is co ld er . than th e on e a t ·; right. A NO BIOMEDICA L SCIENTIST "We cannot easily become leaders in areas which require larger investmentsand we should be leaders; Anbar said. "With chermograp hy, it's not a 'me-tod situation . Thermography is one of those areas where we have an advantage over anywhere else in the coun tr y." Hardly a bargain-basement techniq ue, thermography can do things that other techniques can't . Thermography looks at the functions of the body, while othe r techniques, such as X-rays and MRI, look at the structure of organs or tissues. The rmography assesses the surface of the body, while the ochers look inside the body . All of the tech niques operate differently and the information each provides comp lement one other. "Thermography is not a substitute and it's not a competitor to these ocher techn iques ; Anbar emphasized. "They're very different. "Thermography can identify physiological phenomena that can't be identified by other means . T here's no simpler, more direct way to measure" some of the functioning of the nervous system. • SPRIN G I9S9 11 ��FromDestruction to Recovery B y M A The Armenian R K MARABELLA rom their devastated homeland in the moun- earthquakein tainous region of Armenia, 10 young earth- December devastated quake victims arrived at snowy Buffalo cities and International killed 50,000 Airport in February for treat- people. But for ment at Children's Hospital of Buffalo and survivorslike MartinMekret- Millard Fillmore Hospital-two major chian, left, life goes on-with help from hosp itals affiliated with UB's Schoo l of Medicine and Biomedical Sciences. some UB physicians. Children's treating youngsters, seven H ospital is Armenian more than any other American hospital. The children range in age from 5 to 14. UB physicians affiliated with the Hand Center of Western New York at Millard Fillmore are treating a 17-year-old and two Armenians in their early 20s. BUFFAW PHYSICIANAND BIOMEDICALSCIENTIST SPRI!'< G 1989 13 �14 Munro Strong, M.D., associate professor in orthopaedics at UB and orthopaedic surgeon at Children's Hospital, was one of a team of 10 American medical personnel who traveled co Armenia for the difficult cask of choosing which patients were co be airlifted to the U.S. for continuing medical treatment. During his nine-day stay in Armenia, he and physicians from Syracuse, Boscon, Philadelphia, and Chicago, in cooperat ion with Armenian officials, selected a coral of 37 patients for treatment in 10 American hospitals . The Armenians were chosen for medical treatment in the U.S. if their injuries were liferhrearening, infected, or healed improperly, according to Strong . Many will receive prostheses and rehabilitation during their stay. "Ideally, you would like co help all of the children and bring them all back co the U.S.," acknowledged St rong . "Unfortunately, we can only directly assist relative ly few of these kids, but these kids we help will gee excellent medical care here." An est imated 3,000 to 4,000 Armenian chi ldren are suffering from serious injuries including broken spinal cords, crushed pelvises and limbs, and infected SPRING 1989 fractures . The earthquake, which hit two and a half weeks before Christmas, claimed the lives of more than 50,000 men, women, and children . Those who have survived or sustained injuries have lose others in the catastrophe . "The children who made th is trip are extremely frightened; Strong emphasized . 'They have been through a great deal. Most of chem in face have lost one or both of their parents. Many of their parents were never even found. Many who came co the U.S. were accompanied by an older sibling, an aunt, o r a grandparent as their guardian ." Buffalo became involved in treating the Armenians through Robert Gillespie, M.D ., acting chair of orthopaedics at UB and chief of orthopaedi cs at Children's . On Christmas Eve he received a phone call from officials of Project HOPE, an independent, nonprofit, international, health education foundation lilit Ermand- based in the U.S. Both G illespie and Strong had worked with Projian, S, left, ject HOPE as orthopaedic consultants to the Pediatric Institute of Krakow, Poland for the past two years. The radiates suninstitute is the largest hospital for children in the world shine. Below: and is affiliated with Project HOPE's continuing education of Polish and Soviet medical personnel. ArevikToroProject HOPE had been contacted by cop White House officials following Soviet Premier Mikhail Gorsian, 13, and bachev's request for aid from the U.S. SonjyPangoian, Strong emphasized char the airlift and treatment of the Armenian child ren is merely an initial gesture 17, are mesfrom Project HOPE, which negotiated a more enduring relief initiative with the Soviets and their Ministry merizedby of Health. The long-term project includes plans co Americansoap develop a rehabilitation facility in Yerevan (the capital of Armenia located 3 7 miles from rhe site of the operas. catastrophe) in cooperation with Armenian authorities . Initially, the facility will provide services co earthquake victims requiring continuing treatment for their injuries. Children fitted with prosthetic devices in the United States will need co have them mod ified as they grow. The project will include training technicians co operate the Yerevan facility and establishing an or- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �chopaedic and plastic surgery exchange program with American hospitals and universities. "There is no ability co make prosthetics or rehabilitate people with upper-extremity loss in Armenia," noted Strong. "All of the children who had injuries of upper or lower limbs were left unsplinted, so chat the patients we found who had upper extremity nerve injuries had their joints contracted in one (contorted) position or another." There is a great dea l lacking in the medical expertise of the Soviet Bloc as well as the Eastern nations in general, Strong said. He reported that he did not see one spline of any kind the entire time he was in Armenia . "Many concepts considered basic to medical care are not known or regarded there-such as the need for splines or removal of infected bone without the need for amputation," Strong pointed out . Nevertheless, he emphasized chat the Armenians, given the available facilities, did a "remarkable and massive job caking care of the hundreds of thousands of injuries chat literally came into Yerevan within the first several days." It's hard to envision the devastation of the quake . In Leninakan, a town with approximately 200,000 inhabitants, officials blew up unsafe buildings every day at 4 p.m. and dragged the rubble outside of town,. In Spicak, a town of 30,000 chat was very close to the epicenter of the quake, 50 per cent of the buildiings were destroyed and the other ha lf were unsafe . T hose who survived had to be evacuated . "In a small village of about 2,000," Strong sob1~rly recalled, "the entire place was leveled. Not a single structure was left standing. There was simply a pile of rubble for about two miles along the highway . ''Any medical system, no matter where it might be located, would be overwhelmed by such an event. The people there worked night and day in order co save BUFFALO PHYSICIAN AND BIO MEDICAL SCIENTIST few were as 15 lucky as Artem Horontyunian, below, who traveled to Buffalowith his mother.The girls at right check out Polaroidsof themselves. lives." Strong urges people, particularly in ArmenianAmerica n communities, to continue opening their hearts and responding to the needs of the Armenians. Buffalo's Ronald McDonald House, which affordab ly houses our-of-town families of patients who have traveled co Buffalo for medical treacmenc, has graciously opened its doors co the parents and guardians of the Armenian victims. Moreover, all of the hospital services, equipment, and the medical attention given by the Americans have been donated without charge to the victims or their government . "le is a tribute to the quality of medical care available in Buffalo,"noted John P. Naughton, UB vice president for clinical affairs and dean of the medical school, "chat UB physicians working at two of our major affiliated hospitals will treat the largest number of children-IO-airlifted from Armenia . "It is also a tribute co Buffalo's reputation as The City of Good Neighbors' chat it will play host to the families and guardians of these young patients?' UB President Steven B. Sample commented that, "shortly after the Dec. 7 catastrophe, the University at Buffalo was able to lend engineering and technical expertise to the people of Armenia through our National Center for Earthquake Engineering Research. We are pleased to be able to continue this international commitment through our participation in Project HOPE's humanitarian program?' • SPRING 1989 �16 BO GRO R This one device can lengthen or straighten a limb. It can grow strong, healthy bone in the gap left by the removal of infectedbone. And it can do it better and faster than other treatments, says the UB orthopaedist who pioneered its use in North America. By MARK MARABELLA lthough its appearance may resemble a gruesome medieval torture device, nothing could be further from the truth . Called the Monticelli-Spinelli External Fixation System, this apparatus of stainless steel wires, nuts, and rods is a revolutionary system which has given new hope to patients with limb deformities and severe fractures. "The European company that manufactures this device didn't realize the importance of what they had: asserted Munro Strong, M .D., an associate professor of orthopaedics at UB. "I had a difficult time convincing them to increase its production and distribution for use in the States. "This one device can be used to correctangular deformity and limb length, abnormal growth, and rotationa l adjustment." A • SPRING 1989 Ant hony H int o n It has been used for patients who need to lengthen one leg that is shorter than the orher, to straighten a leg that is crooked due to abnormal growth, or to grow healthy bone in the gap left by the removal of an infected bone segment . Ocher devices aren't able ro perform so many diverse functions, Strong noted. Furthermore, they require more extensive surgery and often require rhe use of plates or grafting, which result in weak BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �17 and britcle bones that are more susceptible to fractures. The Monticelli-Spinelli device requires a shorter treatment period than other devices, with only a brief stay in the hospital when the device is initially attached. The device is monitored and cleaned by the patient daily, requiring only intermittent examinations by the attending physician. Furthermore, the device allows the patient to put weight BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST on the limb with only limited restri,ctions. "The most impressive feature of this devic,e is its ability to develop new strong and healthy bone, with few postoperative complications; emphasized Stronig, who is also an orthopaedic surgeon at Children's Hospital of Buffalo. Once Strong convinced the manufacturers of the device's importance, he and Robetrt Gillespie, M.D., acting chair of orthopaedics at UB and ch ief of orthopaedics at Children's, were the first surgeons in North America to implement the device in October 1987. Children's Hospital was chosen as one of four initial North American sites to be study centers for the instrument, manufactured by Jaquet Orthopaedic, S.A., in Geneva, Switzerland, a subsidiary of the Howmedica Company. Just two years later, there are 43 centers SPRING 1989 �18 across the U.S. and Canada, and more than 200 patients have benefited from the system-IS alone have been treated at Children's Hospital. For Anthony Hinton it meant that not only could he avoid the amputation of his bad ly ipfected leg, but he can also look forward to a full recovery. "This device is one of the greatest inventions I know," declared an enthusiastic Hinton . "I didn't think this thing was going to work, but now I'm happy to see that it really has ." Hinton suffered a bad ly broken tibia (the thicker of the two bones in his lower leg) when the tractor trailer he was driving flipped over and pinned him inside the cab. A lthough his leg was set and placed in a cast, he developed an infection within the fracture of his bone several weeks later. This meant that Hinton had to undergo surgery to remove the portion of infected bone . In the recent past, this type of operation meant that the patient might lose the full use of the limb or would have to have it amputated . But that's not the case with the Monticelli-Spinelli device. The stainless steel device is composed of two or three concent ric rings which encircle the limb, stabilized by three vertical rods which look like long bolts. Wires, attached to the rings, hold the severed bone in place and provide che necessary traction tension . Nuts are attached to the rods. As the patient tightens the nuts, the device, and in turn the leg, is stretched . Strong used the device in a technique called proxima l corticotomy in Hinton's case. Once the infected portion in Hinton's lower tibia was removed, a cut was made in the proximal metaphysis (the growth plate in the tibia closest to the knee). Within this incision, a hematoma (a blood-filled swelling) formed, which in time changed to fibrous tissue, and then SPRINC 1989 Hinton had lost about 1112centimeters (.6 inches) due to bone absorption in addition to the 4 centimeters (1.6 inches) of infected bone removed by Strong. So Hinton had his leg lengthened almost 6 centimeters (almost 2.4 inches) co compensate for the bone he lost. Hinton was required to tighten the nuts only a quarter millimeter (about .01 inches) four times a day for six months . This he lped to stretch the healing bone tissue gradually. To prevent infection, which is common in such cases, each day Hinton had to carefully clean the wires which pierce the skin . "I didn't think this thing was goingto work, but now I'm happy to see that it reallyhas,"said Anthony Hinton. "The pain was minor compared to the benefitsI received.Even thoughI couldn'twork, I could still get aroundand put T he device is most often used on younger patients because of their ability to heal and regenerate new bone faster. However, Hinton, at 28, is the oldest patient in North America to have used the device thus far. "The doctor cold me that I was the oldest patient, but that didn't bother me; recalled Hinton . "The pain was minor compared to the benefit s I received from this thing . The only pain involved was when I had to tighten (the nut s) or if I bumped it by mistake. The cold weather during the winter wasn't too pleasant either, but I got used to it. "Even though I couldn't work, I could still get around and put weight on it," Hinton added. "My mother made me a special pair of pants to wear for the winter, and I slept with pillows under my leg." Although Hinton stopped tightening the nuts after six months, he continued co wear the device for two and a half more months to give the new bone, muscles, and tissues in his leg a chance to strengthen. Now that the wires are removed, he will wear a cast for about six to eight months, according to Strong. "There was some inconvenience, buc • now my leg is fixed," said Hinton. weight on it. There . . was some inconvenience, but now my leg is fixed.'' into solid bone. As the incision in the metaphysis gradually began to regenerate new bone, Hinton tightened the nuts . That increased the length of the growing upper tibia and moved it toward the lower portion of the tibia. Eventually, the gap caused by the removal of the infected bone became narrower . Finally, the upper and lower port ions of tibia met, fused together, and became solid . BUFFA LO PHYSICI A N A ND BIOM EDICAL SCIENTIST 1 �Alumni & Et•ents 19 AWMNISETAWARD FORTOPSTUDENTS he Medical Alumni Association Academic Achievement Award has been established ro honor the third-year student or students who have achieved the highest academic standing during their first two years of medical school. The Medical Alumni Association began the award because it was felt that while many awards and scholarships are offered to students when they enter medical school, based on their undergraduate records, nothing is done to recognize the top scholars before their third year of medical school. The achievement award will be presented for the first time during the school's annual awards ceremony for students in August . • T REHAB MEDICINE sm SYMPOSIUM he Department of Rehabilitation Medicine at UB is sponsoring a symposium on "Functional Assessment in Rehabilitation Medicine" to be held July 8-9 at the Marriott Hotel in Amherst . The conference will discuss measurement of the disability of patients in rehabilitation programs and how this scaling is developed and used, said Carl V. Granger, M.D., professor of rehabilitation medicine at UB and head of rehabilitation medicine at Buffalo General Hospital. Ocher topics will include the implications of medical ethics, the implications of financing, and the implications of research. The symposium is geared to physicians, nurses, therapists, social workers, psychologists, and administrators involved with chronic health care services or medical rehabilitation health care services. The cost of the symposium is $195. For more information, write to Granger at the Department of Rehabilitation Medicine, Buffalo General Hospital, 100 High St., Buffalo, N.Y~14203. • T 'l ticipated in the famous Framingham Study. Lasting almost 30 years, it is the longest continvovs swdyof c;:an;liovascular disease. Much of what we know about strokes has come from this study. Speakers from UB are Linda Hershey, M.D., Ph.D., associate professor of neurology, and William Kinkel, M.D., professor of neurology. Organizers of the symposium arc Glen E. Gresham, M.D., professor and chairman of rehabilitation medicine at UB; Carl V. Granger, M.D., professor of rehabilitation medicine at UB, and John V. Basmajian, M.0., professor emeritus of medicine and anatomy at McMaster University in Hamilton, Ontario. The conference is funded through a grant from the National Institute on Disability and Rehabilitation Research, part of the U.S. · Department of Education. Ir's a feather in the cap of the University to be chosen to host this international symposium, said Gresham, who noted that UB's research in chis field is strong. • REMEMBERING YESTERYEAR emember what it was like when you were at UB-the classes, the parties, the friends? The Alumni Association wants to capture a bit of chat feeling through a collection of memorabilia to be housed in a locked display case in the LippschuczConference Room in the medical school. The association is looking for alumni to lend or donate items for display. Items might include pictures, small medical equipment, programs, pennants, buttons, or other souvenirs that remind you of your academic and extracurricular activities. Send items to Dr. John Richert, Alumni Affairs Office, 146Cary-Farber-Sherman Addition, State University of New York at Buffalo, 3435 Main Street, Buffalo, N.Y. 14214.• R CALLFORNOMINATIONS our president and Board of Go vernors has, over the past several years, received many requests for Alumni / ae to establish a Distinguished Medical Alumnus / a Award. Therefore, your president and board are seeking nomination s for thi s award to be presented annually beginning thi s year. The award will be presenced to a graduate who has distinguished himself/ her self nationally or internationally in the eyes of his/ her peers and has made an outstanding contribution to medicine, the arts, or humanity during his/ her career. The selection will be made during the summer and the award will be presented in the fall at a special award dinner. Please forward the name of your nominee as soon as possible on rhe atta ched card. A June 30 deadline has been established for the receipt of all nomination s. Your cooperation is absolutely viral if this is co be a true alumnus / a award. Y WORLD EXPERTS TOMEET ATUB TODISCUSS STROKE any of the world's experts in stroke outcome research will gather in UB's Center for Tomorrow July 10-12for an international symposium on "Methodologic Issues in Stroke Outcome Research~ Attendance at the symposium is by invitation only. The proceedings will be published by the American Heart Association as a supplement to Stroke: A Journal of CerebralCircularion. The speakers will come from the United States, Canada, Australia, Japan, Israel, and Great Britain. They will include two who par- M SPRING 1989 BUFFAID PHYSIC IAN AND BIO MEDICAL SC IENTIST - ---- -------- ��I Research 21 Testing 'Clot Busters' Simple blood test may do the trick ' By ARTHUR PAGE simple blood ccscmay provide an alcernacive co immediate coronary arceriography when it comes co determining whether medications have successfully dissolved blood clots in coronary arteries following a heart attack, according to researchers at UB. The researchers showed chat the test, which measures proteins released into the bloodstream by cells in damaged heart muscle, was 88 per cent accurate. While the test was already available commercially, the researchers were the first co use it for this purpose. It's essential co determine whether rhe blocked arteries have re-opened in order co plan a patient's treacmenc. That determination now relies on coronary arteriography, an expensive and invasive procedure nor available in all hospitals nor at certain times even in chose with cardiac cathecerizacion laboratories. Unlike coronary arteriography, the commercially-available blood test is inexpensive, noninvasive, and relatively risk free. Results of the research, conducted in con• junction with scientists at Emory University, were reported in che December issue of Circulation, the scientific publication of the American Heart Association. Avery K. Ellis, M.D., Ph .D., UB assistant professor of medicine, was principal investigator for the study, funded by the Veterans Administration and American Heart Association. Ellis is chief of cardiology at Buffalo Veterans Administration Medical Center. His UB co-investigato rs were Francis J. Klocke, M.D., who is the Albert and Elizabeth Rekatc Professor of Medicine as well as chief of cardiology at UB and che Erie A . BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Unlike coronary arteriography, the in a cardiac cachecerization lab. He noted, however, chat "most of the patients chat have infarcts are in hospitals where cathecerizacion labs are not available. Even if they are in a hospital with a cachecerizacion laboratory, you could not logistically make immediate cathecerizacion routine wichouc greatly expanding the facilities and personnel." On the other hand, che blood cescused by the UB and Emory researchers can be used in all hospitals. The researchers are the first co focus on measuring myoglobin, an oxygen-carrying protein essential to the heart's normal functioning, co gauge che success of thrombolycic therapy, according to Ellis. They focused on the myoglobin level in blood samples taken from 42 patients at the time they received a thrombolytic drug and at regular intervals thereafter. The subjects also underwent cardiac cathete rizacion co assess the success of chrombolycic therapy. There was a rapid rise in blood myoglobin levels in patients in whom the drugs resulted in reperfusion. In contrast, che levels rose slowly in those in whom the attempt co open the artery was unsuccessful. The researchers found that a co mparison of myoglobin levels in a blood sample taken ac che time medication was given and one taken two hours lacer corre lated with the resulcs of reperfusion attempts, as confirmed by coronary arreriography, 88 per cent of the time. "The need co develop a non-invasive marker of reperfusion is important in view of the large number of patients in whom intravenous thrombolysis is now likely to be used and in whom subsequent triage becomes an important issue; they said. • commercially~available blood test is inexpensive, noninvasive,and relativelyrisk free. County Medical Center, and A.R. Zaki Masud, M.D., clinical assistant professor of medicine. n the shore time since their approval by che U.S. Food and Drug Administration, thrombolycic drugs have been hailed as a major development in efforts to reduce deaths from heart attack. Experts project that an estimated 150,000 Americans a year who experience a type of heart arrack known as an acute transmural myocardial infarction are candidates for thrombolytic therapy. When successful, it results in reperfusion, oc reopening of che blocked corona ry artery, potentially reducing heart-muscle damage and saving lives. To be effective, the medications must be administered within four to six hours of onset of chest pain. Klocke said corona ry arteriography has been che 'gold standard" for assessing whether a thrombolytic drug has worked on a patient. Coronary arceriography muse be performed I SPRING 1989 ��Research 23 Early Surgery Cuts Cost, Hospital Stay in Trauma Cases By ARTHUR PAGE arly operative stabilization of thigh-_bone fractures in trauma panents drasncally cuts the length and cost of their hospicalizacion, according to a study coor• dinated by a UB researcher. In the most seriously injured patients, the study showed chat even a short delay of only 24 hours increased che average length of hospital stay by nine days and the cost of hospitalization by more than $13,000. Lawrence B. Bone, M.D., assistant professor of orthopaedic and general surgery, said the study is rhe first prospective examination of the benefits of early versus delayed fracture stabilization. The results, scheduled to be reported in the Journal of Bone and Joint Surgery, have been presented before the American Academy of Orthopaedic Surgery and American Orthopaedic Association. Bone was principal investigator for rhe study, which involved patients at Parkland Memorial Hospital in Dallas, where he did his residency in orthopaedics in conjunction with the University of Texas Southwestern Medical Center at Dallas. He is now direc• tor of the musculoskelecal rrauma service in the Department of Orthopaedics at the Erie County Medical Center. The study compared che medical course of parients whose rhigh-bone fractures were stabilized operatively within the first 24 hours after injury with that of patients whose fractured femurs were placed in traction and not stabilized for more than 48 hours. Bone noted that in hospitals without a trauma service the delay in stabilizing fractures in trauma patients may stretch into days. He said the results confirm both che experience of major trauma centers where frac- E BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST cures in multiply-injured patients are stabilized as soon as possible and studies based on review of patient records from trauma centers. B one said che study shows chat immediate stabilization of fractures, whether they be of che femur, pelvis, or other bones, should be a focus of medical efforts to treat trauma patients. "The patients are in the best shape they are going to be in when they first arrive; he added. "There is very little reason nor to stabilize rhe fracture when rhey first come in, regardless of their ocher injuries, and that includes head injuries. "]f a hospital doesn't have the facilities or capabilities co do this, the patient should be transferred to a trauma center chat does chis routinely because it not only saves lives, but is cost effective. By reducing the incidence of complications, we were able to reduce hospitalization costs by nearly half in our study." The study was designed co evaluate the impact of early versus late stabilization of leg fractures on the incidence and severity of pulmonary complications and the occurrence of adult respiratory distress syndrome (ARDS) in patients. A pattern of progressive respiratory failure, the syndrome has a 50 per cent mortality rate, according to Bone. The 177 patients in the study were random• ly assigned co early and delayed stabilization groups, which were subdivided into two groups: the less severely injured and chose with multiple injuries. All emergent and urgent surgical procedures were performed on each patient according co his specific injuries. Only the fracture of the femur was random• ized to early or delayed treatment. Early stabilization had a positive impact among chose with multiple injurie s, with the syndrome developing in only I of 45 patients whose fractures were stabilized early, com• pared co 5 of 37 of chose in chelate stabilization group. ARDS did not develop in any of rhe less-severely injured patients. Bone said significant pulmonary complications developed in 14 of the 37 patients with multiple trauma and delayed fracture stabilization. On the ocher hand, only one of the 45 patients with multiple injuries and early fracture stabilization developed any significant pulmonary complications. Among the most seriously injured patients, chose in the early stabilization group had average hospital stays of 17.5 days at a coca! cost of $19,492, compared to an average of 26.6 days ac $32,915 for those whose fractures were stabilized after 48 hours. In chose who were less severely injured, the average time of hospitalization was 7.3 days for the early stabilization group and 10.2 days for chose whose fracture was stabilized after 48 hours. The cost of hospitalization averaged $5,235 for the early group and $6,929 for the late group. None of the less severely injured patients needed co be placed on a respirator or in an intensive care unit. Among chose with multiple injuries, 18 of 42 stabilized early and 24 of 37 stabilized late required intubation and admission co an intensive care unit. The early group spent an average of 2.4 days on a ventilator and 2. 7 days in the ICU, while in the lace group there was an average 6.9 days on a ventilator and 7.6 days in an [CU. • SPRING 1989 �:!!'''' ' ~ f ~ ~ ~ '! ''' i1, I I: t 11 ~ -' ~ ,i ;~ ~ -. .. .•~ - ~ ~-- . • _,'!. ., :·,, ~ ~ -·--) ~ - -~ ··~ .. .,,~ �Research 25 Exercises Promise Relief From Arthritis in Knees By ARTHUR PAGE new exercise program chat has promise to improve the mobility of millions of Americans with arthritis of the knees is being evaluated by researchers at UB. In earlier studies, the researchers showed chat Progressive Quantitative Exercise (PQE) increased the strength of some patients' leg muscles fivefold, dramatically improved functioning of their knees and their mobility, and decreased pain. Subjects were able to walk better, stand longer, and get out of a chair more easily. One man, an avid fisherman who previously had to pay someone to carry his day's catch up a river bank, now boasts of being able co scale the slope while carrying his fish. The UB researchers, led by co-principal investigators David R. Pendergast, Ed.D., and Glen E. Gresham, M.D., will study the effects of PQE on leg muscles under a $501,597grant from the National Institute on Disability and Rehabilitation Research of the U.S. Depart• ment of Education. Gresham, UB professor and chair of rehabilitation medicine, is also director of rehabilitation medicine at the Erie County Medical Center, where the study will be conducted . Gresham noted that while arthritis of the knees may occur at any age, it affects an estimated one-third of the elderly. When it is severe-with resultant pain, stiffness, decreased range of motion and muscle weakness-it limits the ability to use stairs, get up from a chair, stand comfortably and, eventually, to walk. The UB researchers A BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST The study showed that subjects were able to tvalk better, stand longer,and get out of a chair more easily. The exercisesincreased strength, dramatically improved mobility and functioning of the knees, and decreasedpain. believe chat's due in large part co accompanying weakness of the quadriceps muscle that controls extension of the knee. The goal of PQE is to strengthen the quadriceps muscle by gradually and precisely increasing the amount of work it is required to perform over a three-month period. le involves isometric exercise, focusing on contracting leg muscles without moving the knee, and isotonic exercise, which includes extension of the knee. While their preliminary studies showed PQE cased the symptoms and limitations, che researchers do not believe it affects progression of the arthritis. Subjects' progress will be monitored based on pioneering work in quantitating muscle strength conducted by Pendergast, UB professor of physiology, and Nadine M. Fisher, Ed.M., UB clinical instructor of rehabilitation medicine, who is project director. They showed that not only is there a norm for leg-muscle function at a given age, but that function and strength of the quadriceps muscle decreases dramatically past age 55. Gresham noted chat while the work focuses on arthritis of che knees, che researchers are interested in "improving the rehabilitation of people with a wide variety of musculoskeletal impairments, particularly those affecting the frail elderly." Ocher UB faculty members involved in the study are Judy Cameron-Ruh, RPT, M.S., adjunct instru cto r of physical therapy and exercise science who is physical therapy supervisor at ECMC; Evan Calkins, M.D., professor of medicine and head of the UB Division of Geriatrics/Gerontology; Beverly Bishop, Ph.D., professor of physiology; Carl V. Granger, M.D., professor of rehabilitation medicine, and Theodore Papademecriou, M.D., clinical professor of orthopaedics. • SPRll',:G 1989 �,\ led1calSchool 26 VOWNTARY FACULTY: THESCHOOL'S UNSUNG HEROS ou could call them the unsung heroes of the medical school. Though they receive no pay, voluntary faculry generously give their time and expertise to the medical school. "Voluntary physicians collectively and as individuals receive far too little credit and recognition for their contributions to medical education and to the advances in medical care,"said John Naughron, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB. Voluntary faculty members serve on school committees, teach courses, represent the school in national and Stace societies, and play an important role at affiliated hospitals . "This information serves ro confirm that there is a role for the voluntary physician, and chat the school has not excluded that role," Naughron said. "There's a need for coexistence and involvement of a strong fulltime and voluntary staff in the years ro come While UB still doesn't do enough co recognize its voluntary faculty members, it is ahead of other medical schools, the dean noted. The long-standing Siegel Teaching Award and the annual reception for voluntary faculty are a couple of examples. A new award, the Robert S. Berkson, M.0. Memorial Award in the Art of Medicine, will be given for che second time in May. The award goes to a voluntary faculty member who exhibits skill in patient care and teaching and who combines the features of scholarship and compassion that elevate medicine in its best sense from a science to an arc. The award is named for Berkson, who was a respected solo practitioner of internal medicine and served on the voluntary faculty from 1949 until his death in 1966. "His devotion ro patients was his greatest attribute," said Philip Weis, M.D., clinical professor of surgery and a member of the UB Council. Weis met Berkson when they were undergraduates ar UB. They continued Y SPRING 198'1 through the UB medical school rogether, graduating in 1941. "He was an excellent student and was interested in people," Wels recalls. "The outstanding thing about Dr. Berkson in his practice was that he was extremely, extremely devoted co his patients. He gave all the time they required. His humanitarianism is unsurpassed to this day. He would spend time with the patient beyond the normal role, and would discuss things again and again with the family in a repetitive way that most physicians would nor tolerate. "He was an ardent reader and always kept up with che newer modalities in medicine . "Dr. Berkson liked to reach, and his students liked and respected him because of his concern and his abilities ." Berkson served as a captain in the Army Medical Corps during World War U. After his discharge, he underwent four years of training in internal medicine, then began private practice. He was on staff at Buffalo General Hospital, Sisters Hospital, Millard Fillmore Hospital, the Veterans Administration Medical Center and the former E. J. Meyer Hospital. He was a fellow of che Ame rican Board of Internal Medicine, a diplomate of the National Board of Medical Examiners, and belonged co local and national medical societies. He loved his community and was active in several Jewish groups. A family man and very devoted father, Berkson encouraged his cwo children, Weis noted. His son, Richard, is now a physician. Berkson was a voluntary physician on the staff of David K. Miller, M.0. "I admired him and he did a good job," Miller said. Years ago, all faculty members were voluntary, he remembers . In 1937, Miller became the first full-time faculty member in the medical school. At that time there were a great number of "service patients" who didn't have a private physician. Times have changed and the number of full-rime faculty continues to grow, buc Miller hopes chat we won't see an end co voluntary faculty. "I think certain people have a great deal to offer in teaching residents and interns, as well Robert S. Berkson, center front, abot ie, enjoys the 1956 reunion with his colleagues from the class of 1941. Also pictured at left, he is the namesake of an atvard for voluntary faculty. as medical students," Miller said. His personal convictions are reflected in his actions. Miller left UB in 1974, but is now a voluntary faculty member with the University of California. BUFFAIO PHYSICIAN AND BIOMEDICAL SCIENTIST �>.!edical School 27 T he first person co receive the Berkson Award was James F.Phillips, M.D., clinical professor of medicine. A specialist in internal medicine with a subspecialty in gastroencerology, Phillips teaches students, interns, and residents at Buffalo General Hospital and in his office. Every year he takes a month-long teaching service. He works with an assistant resident, a couple of interns, and a few students for about one and a half hours a day, five days a week. Sometimes a fourth-year student will spend a month with Phillips, working at his elbow from 7 a.m. to 9 p.m. as he makes hospital rounds and sees patients in the office. Every year Phillips takes on a seven-week preceptorship, meeting with students for one and a half hours, three times a week, to discuss patients. Once or twice a year, he cakes a monthlong service in gastroencerology, supervising the training of a fellow. Phillips meets with the fellow for an hour a few times a week. Every day he meets with the residents and interns who arc assigned to his patients in Buffalo General Hospital. Occasional! y Phillips will lecture. All of this is time consuming work for which Phillips receives no pay. Yee he does it gladly. "I enjoy teaching," he said. !e's a great way co keep up on the latest developments in medicine, he noted. "I learn from my students and they learn from me," Phillips said . As modern medicine races ahead, it's difficult co keep up with every new advance. A student may have access co new information in a field outside of gastroencerology that is helpful to Phillips. Teaching also stimulates a physician co keep on his toes-he doesn't wane to appear uninformed to his students . There's also a certain amount of prestige that comes from teaching, Phillips said. "Physicians respect someone who teaches in the medical school," he said. "Everyone wants to be respected among his peers, no matter what the business. "It's self-gratifying, I enjoy it, so I do it." But he also feels an obligation to teach. As outlined in the Hippocratic Oath and elsewhere, all physicians have the responsibility co take care of the sick, to conduce research, and to teach, he said. The role of the voluntary faculty member will always be here, Phillips predicted. "More and more medicine is being practiced outside the hospical; he explained. "Insurance people wane it chat way, the government wanes it that way, and magical modern medicine allows it. People who work only in hospitals can get a skewed viewpoint. They see only the patients who are critically, terribly ill." But the real world of medicine isn't filled SPRING 1%9 BUFFAW PHYSIC IAN AND BIOMEDICAL SCIENTIST - ---- --- -- �Medical School & Hospital News 28 with intensive care units, he asserts. Instead, it's marked by sore throats and belly aches and diarrhea. The voluntary faculty present rhe world "as it really is,"Phillips said. "The full-rime faculry don't have rhar privilege." A challenge facing medical education roday is how to allow students to spend more time in "the real world" of medicine-offices and clinics, he noted. In his reaching, Phillips tries to inform students about a disease and to convey rhe things he's learned through experience. But he also tries to be a role model and impart the qualities of compassion, kindness, gentleness, and friendliness. Disease doesn't exist on its own; it's affecting a human being and that person's family, he pointed our. "The best way to teach people how to be a good human being is by being a good human being; he noted. When Phillips accepted the Berkson Award, he did so in rhe names of all the great teachers who went before him, especially William Lipp, Elmer Milch, and Clayton Green. "I learned everything from chem," he said. "My name is on it, but rhe award is for all those great people who taught me my trade and taught me rhe love of teaching." • SURFACE SCIENCE IS TOPICOF CENTER acuity from the UB School of Medicine and Biomedical Sciences will participate in a new Biological Surface Science Center established at UB. The research at the center will focus on the interaction of biological materials with another material at the molecular level. For instance, a dental implant should stay securely in rhc jaw. However, a company making chewing gum docs not wane gum that sticks to rhe reech. Surface science can determine why dental implants stick to gums, as well as why chewing gum will nor stick to reech. The co-directors of the center are Robert E. Baier, Ph.D., a research professor of biophysical sciences at UB and director of rhe F SPRING 1989 Health-care Instruments and Devices lnsrirure (HlDl), and Joseph A. Gardella Jr., Ph.D., an associate professor of chemistry. The National Science Foundation (NSF) gave UB a $25,000 planning grant to start rhe center. The center will be funded with annual grants of $75,000 from the NSF and about $200,000 from HIDI, a New York Scare Center for Advanced Technology. Faculty from rhe School of Dental Medicine, the Faculty of Natural Sciences and Mathematics, and the Faculty of Engineering and Applied Sciences, are also involved in the center. • STUDENTS HONOR ENTIRE DEPARTMENT he UB dental class of 1992 has presented an award co rhe gross anatomy faculty and staff in the School of Medicine and Biological Sciences for their outstanding service and dedication. "This is che first time chat an entire class has collectively recognized the efforts of an entire depamnent," said Harold Brody, M.D., Ph.D., chairman of the Department of Anatomy. "I chink chis award exemplifies the sense of cohesiveness that exists between the students (both medical and dental) and the staff within UB's medical school." • T CAPLIFTED FOR NON-RESIDENTS he UB medical school has rescinded its cap on the number of out-of-Stare applicants that can be admitted. However, the medical school will continue to give preference to New York Stare residents. Ir was decided that the cap of 4 per cent of the class, that is, five our-of-State students, was too restrictive. The declining pool of applicants ro medical schools may make it necessary for UB to accept more out-of-State students, bur the cap discouraged them from applying, it was argued. • T SISTERS EXPANDS HEAD,NECKPROGRAM S isters Hospital, in conjunction with the UB School of Medicine and Biomedical Sciences, is developing a "commitment to excellence"in otolaryngology and head and neck surgery. The project is spearheaded by John M. Lore Jr., M.D., chairman of the Department of Otolaryngology and Head and Neck Surgery at Sisters as well as professor and chairman of the Department of Orolaryngology at UB. Sisters has 12 years of experience in treating cancer patients in a special unit. In addition, UB's Department of Otolaryngology has a fellowship in Advanced Head and Neck Oncologic Surgery, which is centered at Sisters and the Veterans Administration Medical Center. Established in 1979, the fellowship is one of the first five to be developed and is one of only 16such programs in the United Scares and Canada. Plans for the center include: • Expanding facilities, equipment, and programs. • Expanding research and establishing a program to develop new biomedical instruments. • Improving medical education for professionals as well as improving educational pro• grams for the public. • Contributing ro and utilizing the National Cancer lnstirure's database on patient treatment and outcomes. • Funding the new position of Chaired Professor of Otolaryngology / Head and Neck Surgery and filling it with a nationally recognized head and neck oncologic surgeon. • Developing an endowment to fund a scientist conducting basic research. • Developing a head and neck tumor registry. • Evaluating treatments, including surgery, radiotherapy, chemotherapy, and irnrnunocherapy. The University's Department of Otolaryngology will continue to work closely with che other UB affiliates, including Roswell Park Memorial Institute, Buffalo'sdesignated corn- BUFFALO PHYSIC IAN AND BIOMEDICA L SC IENll sr �Hospiwl ;-,7c.:H'S 29 BGHNURSING HOME ADDING 80 BEDS uffalo General Hospital is adding 80 skilled nursing beds to one of its nursing facilities and has announced an affiliation with another nursing home. Buffalo General's Deaconess Skilled Nursing Facility is adding a 21-bed pediatric unit, a 21-bed unit dedicated to head trauma patients, and 38 conventional skilled nursing beds. The $7 million project includes renovation and modernization of the current 162-bed facility and is expected to be completed in mid-1990. The Downtown Nursing Home, an 80-bed skilled nursing facility on Buffalo'slower West Side, has affiliated with the General Care Corp., parent company of the Buffalo General Hospital. Both nursing facilities provide services primarily co disadvantaged persons in Western New York. The affiliation is expected to reduce costs for both facilities. • B CATHETERIZATION LAB STARTED ATMERCY Jo hn M. Lore Jr., M .D. prehensive cancer center. Both Sisters and Roswell are members of the Western New York Health Sciences Consortium. • NEWRULES TOCUT RESIDENTS' HOURS c looks like the recommendations of the Bell Commission Report are becoming reality. New Seate regulations that limit the number of hours residents are allowed co work are slated to go into effect July I. Under the new rules: • Residents may work no more than 80 hours a week when averaged over four weeks, and no more than 24 hours in a row. • On-duty assignments must be separated by at least eight hours of non-working time and residents muse get 24 consecutive hours off each week. I BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST • Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. Buffalo hospitals are still gearing up to meet these requirements. Regulations for emergency rooms went into effect in October. They include: • Limiting assignments for residents and attending physicians to 12 consecutive hours. • Requiring that residents be supervised 24 hours a day. This requirement can be met by a resident in his last year of training if the attending physician is within a reasonable distance of the hospital, explained James P. Nolan, chairman and professor of medicine. The Graduate Medical-Deneal Education Consortium is also developing a formal system to credential residents. This would replace the informal system of documentation of skills chat exists now. • ercy Hospital is now equipped with a Cardiac Cachcterization Laboratory, the first of its type to be constructed distinct from a cardiac surgical center in Western New York. The lab has been fully operational since early October. "Diagnosis and early treatment are critical factors in preventing cardiovascular disease from seriously afflicting chose at risk," stated Anthony Bonner, M.D., chief, Division of Cardiology, Department of Medicine. "A cardiac catheterization procedure is one of the best diagnostic cools available co pinpoint the disease state in those at risk, as well as a tool to develop the proper regimen of treatment." While the laboratory cost approximately $594,000, this expense will be offset by eliminating transportation costs and the time spent waiting to transport patients to another laboratory, noted Mary Ann Gottstine, assis• cant administrator. M SPRING 19$9 �People 30 SPEEDING UP THEFDA T homas R. Beam, Jr., M.D., associate professor of medicine and microbiology at UB, has been named director of a new project that will explore ways to speed up che U.S. Food and Drug Adminisrracion's drugapproval process. The two-year projecr also will develop recommendations for improving the federal agency's monicoring of drugs already on the market for early warnings of serious adverse reactions in patients. The project will be conducted under a $280,550 contract between the FDA and the Infectious Diseases Society of America (IDSA). While the project will focus specifically on antibiotics, ics recommendations are likely to be applied co drug groups across the board, said Beam, an expert in infectious diseases. He is also associate chief of scaff for education and former chief of infectious disease at Buffalo Veterans Administration Medical Center . He praised the IDSA for initiating the project and the FDA for welcoming the cooperative effort between the professional society and federal agency. "To their credit, they recognize that the system is flawed," Beam added . He said problems have been highlighted in recent years by complaints that che FDA drug-approval process unnecessarily delays the approval of new drugs, some of which already are available in othe r countries. Critics of the process calling for reforms have ranged from AIDS activists co officials at the National Cancer Institute. Despite the lengthy process designed to assure the safety and efficacy of new drugs, Beam noted chat some medications approved by the FDA still have been implicated in serious adverse reactions and patient deaths. "The regulatory process chat now takes 10 co 12 years no longer guarantees safety; according co Beam. "At issue is whether the compounding of regulations benefits anyone; he added . "Ir delays the entry of good drugs into the marketplace, creates tremendous costs for the SPRING IQSQ Thoma s R. Beam , Jr., M.D. pharmaceutical industry, is costly to the FDA and means the Ame rican public does nor get access r,o drugs as quickly as people in Europe, Japan and che rest of che world." The classic example cited to defend the FDA's ,conse rvative approach on drug approval iis that of thalidomide, which caused major birth defects in the children of pregnant women who used it in the late 1950sand early 1960s. The drug was not approved for clinical use in the U.S. when che birch defects appeared in children born in West Germany and Great Britain, where it was already available. Whil,e the layers of regulations built into che reviiew process since then have stretched out the drug-approval protocol in the name of safety, Beam noced char "the recent history of drug development has not been one of sue- cessful protection of the American public." He cited the examp le of benaxoporfen (Oraflex), an anti-inflammatory drug for the treatment of arthritis that won the FDA's scamp of approval, yet later was associated with serious complications and the deaths of several patients. Also of recent vintage, he added, were the cases of ticrynafen (Selacryn), a diuretic shown to be associated with irreversible liver damage and patient deaths after it was approved for marketing, and moxalaccam (Moxam), an antibiotic that caused severe interna l bleeding in some patients . While the FDA subsequently ordered benaxoprofen and ticrynafen pulled from the market, moxalactam is still available, although "the physician community has essentially stopped prescribing the drug BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �People 31 because its toxicity outweighs its benefits; according to Beam. He said the examples underscore the need for a "scheme of monitoring that relatively quickly identifies serious side effects and brings them to the attention of the FDA so that physicians can ultimately limit their use of a drug or it is pulled from che marker, if necessary." Beam, who will work ac the federal agency in Rockville, Md., until midsummer, was selected from more than 30 members of the 1,600-member IDSA who applied to head the project. He will collaborate with FDA officials, representatives of che Pharmaceutical Manufacturers Association, national leaders in academic medicine, and approximately 50 members of the IDSA who will serve on pro• • jeer subcommittees. - By Arthur Page HEAIRSALLTHENEWS THATKEEPS YOUFIT s the lights go up on the WIVB news set, Peter Ostrow, M.0., Ph.D., straightens his notes and peers con• fidently into the red-lighted camera which will broadcast his health / medical report to thousands of Western New York viewers. "I used to be nervous at first; admitted Ostrow, associate dean and professor of pathology at UB's School of Medicine and Biomedical Sciences. "But, a year of experience, and doing up to six hours of research for my two-minute segment gives me confide nce chat my report will be accurate and informative." Ostrow was chose n for the three-year position with WIVB over seven other hopefulssome who previously had broadcasting ex• perience. However, with his expertise in the field of medicine, his 14 years of experience in medical education, and his commi tment to UB and the surrounding area, the native Buffalonian had some definite advantages over the others. "I cold the producers at the station chat my idea was to showcase the cutting-edge medical A Peter Ostrow, M.D., left, confers with Jacq11ie \Valker on the news set. research and health care that is going on at the University and area hospitals, which is among the nation's most advanced; explained Ostrow. "And they loved che idea." John Naughton, dean of the School of Medicine and Biomedical Sciences, views Ostrow's position as "an honor to the medical school" which helps to create a positive relationship between the University and the community. W hen Ostrow landed a seat next to anchors Bob Koop and Jacquie Walker, he became, and still is, Buffalo's only physician• reporter. His segments appear live on \'(,'JVB's news broadcast ac II p.m. on Tuesdays and Thursdays and are rebroadcast on Wednesdays and Fridays ac noon. Ostrow's topics have ranged from antibiotics and influenza, co smoking and cancer, to medical history. One of the biggest viewer reponses co an Ostrow report concerned a new drug called ciprofloxacin which helps heal hand and foot infections in diabetics. The clinical research which proved this drug's effectiveness was conducted by Tom Beam, M.D., associate professor of medicine and microbiolog y, and Jerome Schentag, Pharm.D., professor of pharmaceutics, noted Ostrow. This is an im- porcant development because diabetics otherwise have a difficult time fighting peripheral circu latory infections. WIVB and Ostrow received phone calls from Rochester, Pennsylvania, and Canada. However, Ostrow noted char not all viewer response has been enthusiastic. "Once when my topic was syphilis; he recalled, "I had mentioned in my report char Christopher Columbus and his crew brought the disease to the New World. The next day the station received a phone call from an irate viewer who happened to be the man who was almost single-handed ly responsible for having Columbus Day declared a national holiday. He threatened to call the FCC and bring charges against the station, but nothing more came of it. "I feel that if something is true, then it's worth saying; emphasized Ostrow. "The peo• pie at the station aren't only concerned with ratings but with quality and integrity as well." A lth ough Ostrow enjoys working as a television reporter and has learned a great deal from the experience, his primary interests remain in neuropathology and in medical education. Ostrow received nine awards in reaching excellence from his students at the University of Texas at Houston where he was SPRING 19$9 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST -- -- - -~- -- ---------- �Peot>le 32 the director of neuropathology before returning to UB as an administrator in 1984. Ost row began his academic career as an undergraduate at UB in 1962. "Unlike other health / medical reporters, I am responsible for my own material because medicine is my field of authority. My reputation as a doctor and an educator depends upon the accuracy of what I say; Ostrow pointed out. "I have to prepare a lesson plan just as if I were in the classroom. I research the topic and conduct interviews with other medical experts. I don't just report the story-I explain it. "Television is a powerful medium and I see chis job as a great opporrunity co educate and inform the general public about recent advances in medicine." Ostrow's uncompromising pursuit of accurate and informative topics has meant sacrificing many early evenings at home and saying goodnight to his three children . He was also asked to shave his beard and mustache, which he had worn for 18 years, because the producers thought it was a "sinister" and "less than trustworthy" image for a doctor to have. His children, however, thought just the opposite. "My children, the oldest of whom was 15 at the time, had never seen me without a beard: Ostrow remembered vividly. "My youngest child, Rachel, threatened to run away from home if I shaved my beard off. So I let her shave it. I held a basin under my chin and the 10-year-old first trimmed it with scissors and finished it off with an electric razor. "Now that my family ha s gotten used to me without a beard, they like it better." Although Ostrow has appeared on television for over a year, he hasn't gotten used to basking in the limelight. He still gees embar• rassed when he is recognized at the supermarket or at a souveni r booth at Rich Stadium . "I just can't get used to being recognized by strangers; Ostrow admitted . "However, their comments are usually very complimenta ry, which is reassuring. le lets me know that people out there are listening to what l have to say." • - By Mark Marabella SPRING 198'1 of psychiatry at the Erie County Medical ~nre~ • Francis J. Klo c ke, M.D. , the Albert and Elizabeth Rekate Professor of Medicine, has been appointed to the National Heart, Lung, and Blood Advisory Council of the Nationa l Institutes of Health. He is also the chief of cardiology at UB and the Erie County Medical Center. • John M. Lor e Jr ., M.D. , professor and chairman of the Department of Otolaryngology at UB, has completed his third edition of An Atlas of Head and Neck Surgery.Originally published in 1962 and up• dated in 1973,the text is considered to be one of the most complete works relating to techniques in surgery of che head and neck. Lore is also chairman of the Department of Otolaryngology and Head and Neck Surgery at Sisters Hospital • Gerald Sufrin , M.D. , professor and chairman of the Department of U rology, has been appointed to the lntersociety Council for Research of the Kidney and Urinary Tract.• Mark Flanz enbaum , a third-year medical student ac UB, cook first place in che medical school's eighth annual Student Research Forum. He won for his presentation on his basic research on oncogenes. Second place went to Janice Errick , a third-year student. In a three-way tie for third place were Kevin Osterhoudt , a second-year student; Gar y C ro ghan , a third-year student, and John Klemper e r, a third-year student . • Marvin I. Herz, M.D. , professor and chair of the Department of Psychiatry at UB, has been elected president of the Western New York Psychoanalytic Society. He is director Rohit Bak shi , a second-year student at UB's School of Medicine and Biomedical Sciences, received the Saul R. Korey Essay Award in Experimental Neurology, sponsored by the American Academy of Neurology. An abstract of his essay, "N-Mechyl-D-Aspartate antagonist Dexrrorphan limits dinorphin induced paralysis in racs; will be published in the AAN annual abstract issue of the jour• nal Neurology. 1'vo UB medical students have been elected to positions with the American Medical Student Association . Th omas R. Piazza has been named chapter president and Richard S. Musialowski is recruitment coordinator.• Mary Ann e Rokitka , Ph.D. assistant professor of physiology at UB, has been elected vice president of the Undersea and Hyper• baric Medical Society. • SPOTLIGHT SHINES ON ARTWORK earring with chis issue, the Buffalo Physicianand BiomedicalScientistwill regularly feature the artistic work of one of the UB medical school's alumni, students, or faculty. The work could be in painting, photography, sculpture, poetry, fiction, or ocher media. If you'd like co be featured, send us a photo of your artwork, or even a photocopy, so we can see if it will reproduce in black and white. Feel free to send shoes of several pieces. lf we decide co use your work, we'll make arrangements to rake a good, clear photo . If you submit literary work, please send a photocopy. We'd hate co see artwork lose or damaged, so don't send us the original artwork . Please include your address and phone number, and tell us if you're a student, alumnus, alumna, or faculty member. Address submissions to Connie Oswald Stofko, 136Crofts Hall, University at Buffalo, Buffalo,N.Y. 14260. • S BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �"I have been doingwacercolors for more chan25 years. ... Many paincingshavebeeninspiredby nacureobservedduring20 )-etlTS of joggingaround Williamsville. Paincingis a good way w sharpenyour eye, co see more beaucyaround." Ivan L. Bunn e ll, M.D . (M'43), Ca rdiologist, Director of the Buffalo General Hospita l Angiology Laboratory from 1960-1982 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SPRING 1989 �Clmsnotes 34 1960s Edwin R. Lamm (M'60) • of Lakeland, Fla., is president of the medical staff of the Lakeland Regional Medical Center and also secretary-treasurer of the Independent Physicians Association of Lakeland . G eo rg e B. Kuit e (M'Z 7) • has been disabled since 1970. His address is: lntervalc Rd., Box 1457, North Conway, N.H. 03860. 1930s Or van W. H ess (M '3 I ) • is clinical professor (emeritus) of the Yale University School of Medicine . H arr y Bergman (M'3 4) • received a gold medal in March from Phi Lambda Kappa Medical Fraternity for his contribution to the advancement of medicine and the medical sciences, and particularly for his work in the field of urology. The Bergman's Sign, along with a short biography of Bergman, was included in the 27th edition of Dorland'sMedical Diccionary.The author of several books, Bergman is clinical professor of urology at rhe University of Miami Medical School and New York Medical College. Harry Bergma11 '34 founded and it is in chis spirit char the recipient of the award is honored . 1940s Burton L. O lmsted (M'41) • writes, "Enjoying retirement after 37 years in the practice of plastic and reconsrruccive surgery in Portland and South Portland, Maine?' 1950s John Ambru sko (M '3 7) • is the namesake of the new $3 million public health building in Manatee County, Fla. Ambrusko is retiring after 11 years as medical executive director of the county's health department. In addition, Ambrusko found time for occasional stints as the physician on cruise ships. James E. Youker (M'S4) • will receive the Distinguished Service Award from the Medical College of Wisconsin at the May commencement. Youker is professor and chairman of rhe Department of Radiology and is currently serving as chairman of rhe Residency Review Committee for Radiology. Maxwell Rosenblatt (M'38) • The Maxwell Rosenblatt Commemorative Award has been established by the Public Health Foundation of Los Angeles Coun• ty. It was through Rosenblatt's vision and persistence that the Public Health Foundation was Robert A. Bren ne r (M'59) • gave up private practice to take a full-time position at the Veterans Administration Medical Center in Syracuse. SPRING 1%'1 Tarik E lib ol (M '62 ) • assistant professor of medicine ar rhe UB Schoo l of Medicine, has been elected chief of medicine at DeG raff Memorial Hospital. Virgin ia V. We ldon (M'62 ) • has been named vice president of scientific affairs for the Monsanto Company . She will advise the company on public policy issues in science and medicine . Weldon is also deputy vice chancellor for medical affairs at the Washington University School of Medicine in St. Louis. Marvin Z. Kur ia n {M'64) • has been elected to Who's Who in America and is a lifetime member of Fellows' Leadership Society of the American College of Surgeons. Kurian is a clinical instructo r of surgery at UB. David E. Pittman {M'64) • has been invited to serve on the editorial board of t he Journalof Angiology.Dr. Pittman is associate director of the Cardiovascu lar Laboratory at Allegheny General Hosp ital and a clinical assistant professional of medicine at the University of Pinsburgh School of Medicine . Calv in Ma rantz (M'65) • writes from Santa Ana, Calif., where he is a pathologist / dermatopathologist, that he is now serving as co-director of Laboratory Coastal Communities Hosp ital. Virgin ia V. Weldon '62 Daniel S. Sc hubert (M'65) • of Shake r Heights, Ohio, is currently the edito r of rhe lncernacional Journalof Ps)'chiatryin Medicine. August J. D'Alessandro {M'65) • of Newtown, Conn ., is supervis ing psychiatrist at the Fairfield Hills Hospital and consultant psychiat rist to the Co nnecticut Department of Mental Retardation and Region #4 PGM Review Committee member. Jared C. Ba rlow {M'66) • is president of the New York State Soc iety of Anest hesiologists for the 1989 ter m. Barlow is medical di rector and chairman of anesthesia at Millard Fillmore Surgery Cente r, and associate professor of anesthesiology at UB. John R. Fisk {M'69) • was elected president of t he Association of Child ren's Prosthetic and Onho t ic Clinics - a U.S. and Canadian organization of clinic personnel. D r. Fisk is ch ief of the Child Amputee Clinic at the Chicago Shrinc rs Hosp ital. BU FFALO PHYSIC IA N AND BIO MEDI CAL SCIENTIST �C/assnotc, 35 presented four papers at the 7th Medical Command Radiology Conference, both in Heidelberg, Germany. 1970s Jan M. Novak (M'70) • has been elected president of th e medical-dental staff of the Erie County Medical Center where he is director of the gastroenterology division. Mark Glassman (M'78) • was promoted to associate professor in the Division of Pediat ri c Gastroentero logy at the New York Medical Center. Roy M. Oswaks (M'71) • of Virginia Beach, Va., was recertified in general surgery by the American Board of Surgery. Larr y Zemel (M'73) • married Jesse Stoner in June, 1987. They have a son, Michael, born in April, 1988. Zemel is director of pediatric rheumatology at Newington Children's Hospital, Newington, Conn . Howard R. Goldstein (M'74) • joined the Urological Professional Association in Cherry Hill, N .)., where he lives with his wife, Judy, and three child ren, Lee, Lauren and Daniel. Mic h ael L. Stei n fe ld (M'75) • is clinical assistant professor of cardio logy at the University of Pittsburgh and president of the medical staff at Forbes Health System. Jane K. Dorval (M'76) • was recently appointed medical director of Moss Rehabilitation Ho spital, a 144-bed freestanding, not-for-profit hospital with an affiliation with Temple University's PMR Residency Program. Dr. Dorval is a boa rd -certified physiarrist. Nora 8. W ilcox (M'76) • writes, "I have decided to make a career of the Navy and have been selected for promotion to the rank of comma nd er. Also this summer l was appo int ed head of the Jared C. Barlow '66 Department of Aviation Medicine and senior flight surgeon at the Naval Air Station, \'Vhidbey lsland, \Y/ash." Cliphane W. McCleod (M'77) • reports char he is the only obstetrician in Hin esville, Ga., where he has a solo practice. His wife, Joan, is his office manager and nurse. The McCleods have five children : Cliphane II, 13; Lucien, IO; twins Travis and Nice!, 7, and Natacha, 4. Richard R. Curran (M'78) • an internist with Buffalo Internal Medicine Associates, P.C., has been appointed rhe new medical director for the Alden Medical Center . Angelo M. DelBalso (M'78) • and an alumnus of the Deneal School (72) writes chat in 1988he presented a continuing education cou rse sponsored by the School of Deneal Medicine in lxcapa, Mexico. He also presented continuing education lectures to the 89th Medical Detachment and BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Mark E. Brenner (M'79) • writes, "Recently completed hand and microsurgery fellowship in Louisville, Ky., and am relocating to Pinehurst, N .C. to establish a practice in hand/orthopaedics/ microsurgery ." Joseph Caprioli (M'79) • of Hamden, Conn., was recently promoted to associate professor of ophthalmology and visual science at Yale University School of Medicine . David M. Kenton (M'79) • writes, "presently practicing cardiology in Deerfield Beach, Fla.,-would like to hear from Mark Brenner and Alan Schimmel." His add ress is: 5580 G Coach House Circle, Boca Raton. William J.Lawrence (M'79) • is vice president of Associated Healthcare in Buffalo. 1980s Jain Avanindra (M'80) • is an assistant professor of medicine and cardiology at the University of North Carolina at Chapel Hill. He and his wife, Diane, have a two-year-old son, Brian. Jan A. Koenig (M'81) • writes, "Completed a fellowship in joint replacement surgery of hip and Jan M. Novak '70 knee. Now in private orthopaedic surgery practice in Long Island, N .Y. Expecting first child (a boy) March 1989." Brett C. Shu lman (M'81) • recently married Amy Libenson, an attorney, of \Y/ilkes-Barre,Pa. Shulman has a solo practice in dermatology and dermatologic surgery in Rochester, N.Y. Arlene Rose Curry (M'82) • of \Y/oodside, N .Y., writes, "\Y/illbe married coJohn Patrick Hynes on May 28, 1989. Unfortunately, my father, Howard Curry, will not be with us - he died March 7, 1988." Richard L Collins (M'83) • writes, "I recently accepted the position of medical director at the Northwest Buffalo Community Health Center . I rook this position in October, 1988. This is a federally funded multi-specialty health center." Mary M. Lee (M'83) • is a research fellow at Massachusetts General Hospital, Boston . Adolph Soto (M'83) • is currencly working as a psychiatric attending at Lincoln Hospital in the Bronx on a special bilingual/ SPRING 1989 �Classnotes 36 bicultural inpatient unit . Soto was married on May 29, 1988. Raymond Graber (M'84) • writes, "l recently married che former Mary Kowalczyk of Amhe rst, Ohio . We hope to start on our 10 kids soon." Graber is director of anesthesia at che Veterans Administration Medical Center, Cleveland, Ohio. M ichele Kaufman Koleszar (M'84) • joined a women's medical group in Bridgeport, Conn., in the practice of obstet rics and gynecology. She marr ied Miklos P. Koleszar in May 1988. David J. Forster (M '85) and Carol A. Hammer (M '85) • were married in Buffalo in July. Dr. Hammer is practicing pediatrics in the Washington, D.C. area and Dr. Forster is associate chief resident in the Department of Ophthalmo logy at Georgetown University Hospital. He will be going co USC / Estelle Doheny Eye Center in Los Angeles in July for a fellowship in uveitis and ocu lar immunology. Lesley Burton-lwinski (M'85) • Finished a residency in June 1988 and is now a clinical instructor in che Department of Family Medicine at the Medical College of Georg ia. Jon M. Wardner (M '85) • who is a resident in P.M.&R. at the University of Michigan writes, "Blackford Middleton (M'85) and his wife Ursula King visited on June 28 en rouce co Palo Alco from Hartford . Enjoyed their company and an evening of gourmet beer casting. To Jim Esse r (M'85 ), we say 'ouzo' ." SPRING 1989 Chr istopher S. Walsh (M'85 ) • presented "Control of Neck Disease in Carcinoma of Waldeyer's Ring" at the October 1988 meering of the American Society ofTherapeuric Radiology and Oncology. Walsh is chief resident in the Department of Radiation Medicine at Massachusercs General Hospital. M. Miles Braun (M'86) • has joined the Internacional Activities Office of AIDS Program in Atlanta, Ga . N icholas D 'Avanzo (M'86 ) • will be completing his pediatric residency in 1989 and plans co open a private pediatric practice in Connecticut. Donnica L. Moore (M'86) • writes "I am well on my way coward recovery from my spinal fusion surgery, enjoying married life, and love my switch from ob/ gyn co family practice." Jos e ph A. Pierro (M '86) • is the first author wich Ors. Berens and Crawford of che Clinical Manual of Radiology,which was released in March. Ros ylyn R. Romanowski (M'86) • has scarced a fellowship in hemacology/ oncology at New England Deaconess Hospital. Evan D emestiha s (M'87 ) • is assistant medical director for Sandoz Pharmaceuticals in Hanover, N.J. He is responsible for products in the neuro-endocrine-metabolic cherapeu tic area including Parlodel (bromocripcine), Sandostatin (occreocide), and Tavist (clemanstine). moor Psychiatric Center, Queens Village. He began his career with the Scace Department of Mcneal Hygiene in 1935 ac Harlem Valley Psychiatric Center, Wingdale. During World War II, Haigh t served in the Army Medical Corps for nearly five years, seeing action in the Pacific. He rose to the rank of lieutenant colonel. He retired from the Army Reserve in 1967 with the rank of colonel. M ichele Kauf man Kole.1:.C1r'84 Brian D. Gal e (M'87 ) • has started his residency in nuclear medicine at Albert Einstein Hospital, Bronx, New York. R h onald 0. Hyndman (M '8 7) • informs us that he is still single. Jill E. K oe hl e r (M '87 ) • announces her marriage co Edilberco A. Mo reno, M.D. of Puerto Rico on April 10, 1988. Dr. Kochler is a pediatric resident at the Hurley Medical Center in Flint, Mich. Thomas P. Smith Jr. (M '87) • announces the birth of a son, Thomas Patrick 111,born on Dec. 25, 1988. Smith has a daughter, Megan Elizabeth, age 3. Deaths J. Roth ery Haight (M'3 4) • retired director of Gowanda Psychiatric Center, died Dec. 9. H e was 81. In New York Seate service for 42 years, Haight was director of the St. Lawrence Psychiatric Center, Ogdensburg; assistant director of the Kings Park and Utica psychiatric centers, and supervising psychiatrist of Creed- John D. Persse (M'42 ) • chief of surgery at Mercy Hospital from 1951 through 1971, died in Sarasota, Ra. He had joined Mercy's staff in 1948 and retired in 1981. Buffalo-born George Hatem, 78, the doctor credited with eradicating veneral disease, opium addiction, prostitution, smallpox, trachoma and filiarisis in China, died October 2 in Beijing. He had hoped co eliminate leprosy in that nation by the year 2000. He was known in China as Ma Hai-ceh, a name chat means "virtue from overseas." Harem received an honorary degree from UB in September 1987 and spoke ar the medical school's Spring Clinical Day in Ju• ly 1986. He is survived by his wife, two children, a sister, and two grandchildren. Former director of Child ren's Hospital Mo ir P. Tanner died August JI, 1988. He was 88. He held the position of director for 30 years - longer than any ocher administrator of his era. When he retired in 1967, a 10-story addition co the hospital was named for Tanner, who was known as "Mr. Chi ldren's Hospital." He also was very active in community and religious organizations . He is survived by a son, Duncan C., five grandchildren, and four great-grandchildren . • BUFFAID PHYSIC IAN AND BIO MEDICAL SC IENTIST ��Buffalo Physician & Biomedical Scientist State University of New York at Buffalo 3435 Ma in Street Buffalo. New York 14214 Address Correction Requested :S:on-Profi,Oll:U.S. Po,tage PAID Buffalo, '-.Y Perma :So. l 11 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n01-1989-Spring Table Of Contents A list of subunits of the resource. The elusive miracle A hot new field Earthquake. Bone Grower Research. Medical School News Hospital News People. Spotlight. Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/3a41cae185ffc27558085f42c817f643.pdf e41be51c1198e075933af57621de8e9b PDF Text Text �STAFF DearAlumniand Friendsof the school: EXECLTnVE EDITOR Ul's'IVERSITY PUBLICATIONS Rob,,,, 0 T Marlen Bl!FfALO PHYSICIA!\ EDITOR Conni• C.1-v.-ald Stoflo AITTDIRECTOR Alan stlllln from che fine l"Jirorsh1p of Bob McGranahan to the leadership provideJ first hy Bruce Kershner and no\\' Connie Os,vald Stofko, every auempt has been made for its contents to n:fleccmore fully the life of 1he total m<-.:lica!Khoo] in Buffalo as ·xs·mplificdthrough its multiple constituencies, i.c::.,students, fa,;u!• ty, alumni, parents, and affiliated huspitak The compo,ition of the Advisory Boardwas stn:ngthenc,.I and its functions increased. The n:wurces of the University's publications and public relations staff h,ivc added significantly once-missing support and participation. I am plea5e.,Jthat these efforb have borne 1heir fruit. The publication ll'as n."Cognizedfor its excellence when awardt.-da gold m<-dalin thi, year\ rnmpetition sponoored by the Council for Ad· vancemem and Support of Education (CASE), This organization 1• compo5Cd of representatives from the major colleges and universities located throughou t the United States and Canada, and represems profel<sionalsin the areas of publications, alumni rda· tiom, puhlic n:lation~, and fund rai~ing. Of the 82 publications ,·ith whkh the Buffalo Plry~icianand Biomedical Sc1cn1is1was evaluated, there wen: three go!J medals, three silver medals, and chree hmn:e ml-dais awan.k,J. Alan Kegler, the art direnor; Mrs. Stofko, anJ all of those in• vnlved with this publication ~hould he justifhbly prouJ of this r, >gnit1vn. Thl"y have ,,mrked harJ to bring tn our s(.mstituen • cies a timl·ly, informati\'e puh!ication designed to reflect :111aspects of this medical and hiomedirn! edu.:;1tional enterprise. I hope ~·ou arc as pleased as I am about their success. I look forv,ard to their rnmimR.J innovation~ and contributions in the years ;1head. J. Mo(l,r ADV ISORY BOARD f>r.John Naughton. C~ ,.,...,~ D, Harold Brody l.!.. ~&r><:Y C Dr. J..,,,.,,!-:an,. Dr. ]Okf'h L. Kun1 1),-, CharlN l'aRandli M,. P:aul O P:ner,on Dr. An1rn1m~ l't,1,:n Dt Chorln Ptu<1 Dr. L.nhn- Rol,n,..,n Dr. Thon1;10 Jl.,ocnthal Dr. Sal... la Su,...h Dr. Burton S1¥frn•n Dr. S.,ph.n Spaulding Dr. Ndson Tom Mr. EJ,.·arJ \t', :k Dr. Jero Ya,~ WR ITl::RS ),.hrk Marahdla A<thur P~ Da 1d M. S, ,-Jtrma ILLUSTRAroRS Thomas Roonty Jooq,h Thd P HOTOGRA P HERS M•rk Lrw, la , RalinN di - ,..on To" B,,h \J:'abon TE.ACHING H OSP ITALS AN O LIA ISONS !L,.,,·,a \',,,.,_,,,. ,1 I. /'. f'1--~~-' AJmini1tratim McJ1-.,:, ..,,,,., Ruffalo G,,,~r:,I H,,.pu.-.l, .\t,kc Sn.n.., Buffalo V.-,,,,,.ns AJmm1>1rat1on Modk•I C.enu,r, Joh~l'wH Ch,lJ,en·, H,,,;pit.,I. i,.:_. D,,..,.,.,,._,,.,k, Eue Coun,y \\«h, al C4'n1e \l~,;,,,, ""'""""""'' M=v Ho,p,ul, Clu,d Trlr Dm:m,~ m,.. ~ • 1wD11, "' _,..,,a,..,... .... d Elion, N,,. \D"- S< IJ -,;i ___:, R""' r. :1,.,,...:,,11oo1'l(.\t.C.::>< S,.,- l.1n11rntt;,>I PKn, &./fa o. TIIE BUFFALOPHYSIC!A:,./AMl flll). MEDICAL SCJESTIST tLN'S ". -&::• ··-·· ·"" 191:P, \\,h,mc .: l, :-.:umi-... f'yt, .,hed f,.·e t!meo ,rnn«allv, Sprn,K, Summer, ,\.,,u,nn, l:arlv Wn>t,"T, 11,J La,e ll'1n1er . l'T1he S.hool ol McJi<m<"and ~ .....:!,calSc1en<e,, Su!< lln1<·<1'"1,1< of y N..,. Yotk a< Buffalo, Hl> Main Srr,:c1, Buffalo.:,i,.., York 14214.Third cb~• bulk ""''"F~,J •t Buffa!c,,Nrw Yo,. S.-r,~ aJJ,.,.. changes 10 TIIE BUfFAlO i'HYSICIA1' A1'O 1110.\IEDIC.-\L ::;.c:iE:-.:nsr. 146c.F.s.AJJ"""'· HJ" Mmr, Sm,.,. Buffalo, Ncw York H214. Smmdy, --.. Jo hn N aught on , M .D . \· r~si.Jmt j<H C/m,",! Affair, Dean, Schoolof ~lt-dicineand BiomedicalSciences M,llard F,lln1or,: lfo,pna\, R,..,,,,,~ll P:.rk Mm"'t»l ln,t,tule, J, . Si,,c,; H°'p,t.11, D"""" M,-C.nlr, vcr th_ccou_rse~f the past several year~.the Buffalo Ph;11ician and 81om,:d1cal SciffliLJt has ,;hanged <.:ons,Jerab]y.In its mm• Dear FellowAlumni/Alumnae: I \\'ou!d like to wckome th, · rec, m gradu.1te to th, )\.ledical Alumni A"5Ck.1ati,in.'fou an: . .i' ,,__: m· . :-s >IoJr group l'J also like m extcnJ a warm and ~lnlere invita110n to 1he new m,·mhers nf the Uni\'<c'TsityRe~1Jency Program t,, bccom, a= - :.uc· memh.--, Re:.idcm.smay join even if ihc"Yarc n,1t graJuatrs of the L,11ven11v Jt Buffak S,·hoc: of !l.ledi im and Bio1"1ed1c:il 5' icnce We ,ire your <1rganizationand our sole purpose is 10 wrve you ,nd our medical ochool. 'i\'c- art."very im=reJ in anything VOJ wam to hring to our attemion for aJvice, help, or ~urpon. Be 5Url.Jthat any n,mmunication will be prompdv :onsiderl-d and am,nJeJ to within the bt·s1 ,,four ,1hilities. On annther note, l'-e arc gratified hy thc ,·mhusiast1, l\.">,pon~ to the rail for n,,minet'S for 1he Di~tinguishcd Alumnus Award, This emirwm graduat<c'll'il! be announced anJ ho11oredin the fall. I .· 0- ~ ----;, J o se ph L. Kunz , M .D . �BUFFAlD Ptoc§L~~ Vol. 23, No. 2 Summer 1989 Features II Boonorbane?Nobody wants residents to overwork, but will new State regulations that limit residents' hours help or harm medical education? The debate rages on in Buffalo. II SpringClinicalDay.One speaker urged physicians to take a hand in shaping health care policy, while another said that grapefruit pectin may lower cholesterol. The theme of the alumni-sponsored event was "Nutrition in the '90s." Page32: Polio's Aftermath Departments Page 18: Nutrition fl MedicalSchool News. Lectures and conferences covered topics ranging from microbial pathogenesis to the question of whether we have enough doctors in this country . And UB's Match Day was better than ever. I.DJHospitalNews.Treating the fetus as a patient is the focus of the new Buffalo Institute of Fetal Therapy at Children's Hospital. Over at the Erie County Medical Center, they're struggling with post-polio syndrome . Page 2 7: Match Day IJ People.Leon Farhi, chairman of physiology, has been named a distinguished professor by the State University of New York. He was honored for his years of work in human lung gas exchange and the human circulatory system. Page25: Milk & Sleep IJl Research.Routine ultrasound screening of infants could pick up "silent" urinary problems, say UB researchers. ImClassnotes.Find out what your former classmates are doing nowadays. Cover Photo: &b Walion Page 26: Luc Montagnier �2 Boon or Bane? Debate ragesover new regulationsfor residents BY CO~"\IE OS\\ ',\LD STOFKO ependingon whom you talk to, new regulations on residents' hours and supervision are improvingor destroyinggraduate medical educationin the State. They're saving or jeopardizingpatients' lives.There will or won't be enough money and staff to implement the changes. One chairmansaid the potentialfor harm in his residencyis so great, he'd rathershut down his pro­ gram than beforcedto limit hisresidentsto working only 80 hours a week. Another chairmansayshis specialty is already in compliance. PIIOTOS BY BOB \\'J\L I O ' �3 .· ·11 1 1·2' ·10 3. ·9 .8 l l ~ s. 4• 6:01 a.m. Monaa1 Holx-n OriSC'OII.ll:ft. chief surgical residen1. s1ans his 37-hour day ai Buffalo General 1 1osp i1al. ,\ day 111 the lif e of a resident. as chro ni cled in 111 ese p ll otos. would change under nc-w Staw wgulations. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SUMMER 1989 �ne student chose an out-ofState residency because he says rhe regulations will damage education, while another stayed in New York because he says the regulations are humanizing medicine. The changes limit residents to working no more than an average of 80 hours a week, with 24 consecutive hours off each week. They also mandate increased supervision of residents. Other changes in the code mandate more formal credentialing of residents' skills and limit residents in emergency rooms to 12-hour shifts. (See box for derails). The 1984 death in a New York City teaching hospital of Libby Zion, 18,the daughter of a well known journalistlawyer, led ro a grand jury investigation. Though rhere were no indictments in the case, the grand jury made several recommendations concerning emergency room staffing, the supervision of residents, and residents' working hours. Then the New YorkState Department of Health appointed an Ad Hoc Advisory Committee on Emergency Services, chaired by Bertrand M. Bell, M.D., a 1955 graduate of UB's medical school. The committee recommended derailed policies on which the new regulations are based. The starring dace for the regulations on residents' hours and supervision was ro have been July 1, but that was uncertain at press time because the Hospital Association of New York Scace filed litigation in State and federal courts to have the regulations deferred. The hospital association proposed that if the regulations are deferred, hospitals and medical schools should develop policies to meet the intent of the regulations. . There's vociferous disagreement on Just about every part of the regulations, but one thing char everybody agrees upon is that the intent is good. The purpose of the changes is ro improve patient care by making su~c t~at residents don't work when they re improperly supervised or sleep-deprived. The changes also try to regain a balance between education and service residents are employed by hospitals, but they're there to learn. 0 4 SUMMER 1%9 A second point of agreement is that the regulations present a number of hurdles. It means a rethinking of the educational system. "We'renot saying it's going to be a piece of cake; conceded a spokesman for the State Department of Health. W cent are we interfering with the educational process and how do we plan co compenate?" In surgery, the regulations are interfering to a great extent and there's no way around it, shore of shuning down the residency program, according to Lewis M. Flint, M.D., professor and chairman of surgery ac UB. If the surgery program is forced to obey the letter of the law, it will damage surgical education so much that it would be better to stop training surgical residents. "I'm quire sincere about ir; he said. Ocher specialties have been able to meet the regulations by reducing the number of patients they see, Flint said. But each surgical resident must perform a minimum of 600 surgeries with in 55 months of training co meet national standards, and UB e..xpectsresidents to perform 800 surgeries. Flint complai ned that the figure of 80 hours a week was chosen almost at random. He doesn't see how residents can work less than 96 hours a week. The program trains residents co act like surgeons, he explained. A surgeon cares for the patient before, during, and after an operation. "Ifa resident operates on a patient, the resident is given as much responsibility for care of the patient as he's capable of shou ldering; Flint said . That includes staying with a patient whds having tro~ble, no matter how many hours the resident has already worked. "If we asked a resident to leave at the end of his shift, he would say 'no; no matter what the health department said; Flint asserted. "They like taking care of their patients and they rake their obligations co patient care very serious ly." hile several other states are examining these conce rns, New York is the first to impose new regulations. Many people question whether these regulations, as written, are the best way to meet these lofty intentions. "Are we improving services co patients? Arc we improving education?" asked Michael F. Noe, clinical associate professor of social and preventive medicine. "There arc a lot of suppositions here that haven't been tested. I'm not sure we have rhc answers co chose questions . "If you decrease the number of hours of experience in the clinical arena by re• quiring residents to work an a~e:3ge_of 80 hours a week, arc you depriving individuals of a certain number of decision-making experiences that are crucial? Will you have to increase the length of training? That question is unanswered; stated Noe, who is also chai rman of the coordinating board and the administrative commince of che Graduate Medical-Dental Education Consortium as well as vice president of he problem could be solved by adding professional affairs at Buffalo General a year co the residency program. Hospital. "There are 100 good reasons for "The fact of the matter is, patient care lengthening the training program, but is a critically important clement in that's nor one of them; Flint said. "A betgraduate education. By decreasing the ter alternative would be to close the pronumber of experiences, you're abgram." breviating the educational process. He criticized the health department for "I'm certain ly not advocating that peomaking wholesale changes in the educaple work in a sleep-deprived state, or that tional system without any evidence chat we should put people through an exrhe changes will work. perience chat is physically or Referring to the death of Libby Zion, psychologically harmful. Bue to what exFlint said, "The incident that precipitated t BLIFFALO PHYSICIA!s AND BIOMEDICAL SCIENTIST �1v ~ c-1I',-- 5 '- this hysteria - and that's what it is, hysteria - happened on an internal medicine teach ing service. "It can't happen on a university surgical teaching service. A jun ior resident is not left alone to make a life-and-death decision ." Junio r residents are supervised by senior residents, who have usually been out of medical school for six years that's longer than some residency programs in other specialties. A major operation is almost never performed without the attending physician in the building, Flint added. There's no data stating chat residents are making poo r judgements because of sleep deprivation, he said . The only data t hat exists says that surgeons get grumpy after being up for 36 hours . Flint expects that the new regulations will be modified . "If they're not, then we're going to have a lot of trouble in surgery; he said . At the othe r end of the spectrum is family medicine, wh ich is already in comp liance with all aspects of the regulations. The maximum workweek for family BUFFALO PHYSIClAN AND BIOMEDICAL SCIENTIST 6:30 a.m . Mo n day Oppos ite page. s urgica l reside rns discuss cases befo re rou nds. 6:44 a.m. Monday Above. Drisco ll sees pa licni s ,n irnc nsive care. 7: 17 a .m. Monday 1.. ef 1. studc rns and rcside rns go 10 a m ee1ing. 10.2 1 a.m. Mo nday Bonom lef1. Drisco ll prepa res fo r surgery. medicine residents is 75 hours, noted Thomas C. Rosentha l, M.D., director of the family medicine residency at UB and clinical associate professor . For years family medicine has used a system of supervision that meets the new requirements. "The faculty is active in patient practice," said Rosenthal, who is also director of the Office of Rural Health. "We utilize, but don't rely, on residents for care." Family medicine is an outpatient specialty, Rosenthal noted . Forty per cent SUMMER 19S9 �6 ·, V 2. ·10 ·9 .8 ~ l ~ 3· 4. 5. ' I.! o:; p 111 \/0111 I, 11 ,\IXM'. l>n."',~I Ix·11onns d ....1gmrncl ( ol<'( IOlll) umlcr 1lw w,111t1ful n 1· or ..,urg,·on lt~ph ( ,HU,Hld J .io p 111 \/011d,1\ OPIX)",llt' p.ag(' I1111",lllllg Ill<' -.,urger) .i 20 pm \/()ll(/d .\ Bdow IJn',!·oll hrt'cll-..., tor lunch w11h S11·,1· S( .ahd. a -.urgw.il r, ·..,1clt·111. 111<'11 ",f wncl..,IIW t'\t'llllls;l Ill lllt'('lings , 111<1I 'Xillllll1111A ;,;.r,l\ 'S . • of residents' time is spent in outpatient care. Ocher specialties fall somewhere between surgery and family medicine. For instance, overall, residents in gynecology and obstetrics work 80 hours a week, but "overall" is the key word, noted Myroslaw M. Hreshchyshyn, M.D., professor and chairman of gynecology and obstetrics at UB. At Children's, which is UB's main and busy - obstetrical site, a resident works in labor and delivery the entire time he is on call. At ECMC, che resi- llLFFAIO PHY~IUAN AND BIOMEDICAL SCIENTIST �dent works in gynecology and may have to attend patients in the emergency room or occasionally perform emerge ncy surgery at night . Otherwise, he can sleep. During a rotation at Children's, a resident may average 90 or 100 hou rs a week, but at ECMC, average only 65 or 70, Hreshchyshyn said. The regulations force the program to distribute work more equally, but Hreshchyshyn doesn't anticipate a problem. He sees more difficulty with the supervision requi rement. The program has BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST been working toward providing better supervision for residents already, but che law makes it inflexible and costly, he said. Five years ago, full-rime faculty members started caking turns spending one or two nights a week at Child ren's Hospital co supervise residents - free of charge. "I sold them on the idea because it was good practice, it was good for the patient, and it was good for the resident," Hreshchyshyn said. Little by little he was introducing the idea to each hospital. About a year and a half ago, full-rime and volunteer faculty members at Buffalo General Hospital started spending nights at the hospital. Bur because it was prompted in part by a shortage of residents, the faculty members asked co be paid, Hreshchyshyn noted. Since the supervision at UB's hospitals is being mandated, rather chan performed by faculty of their own volition they too will want to be paid: Hreshchyshyn predicted . Ultimately, his department will find ways to adjust within constraints of the law, he added . Flexibleor inflexible? t he inflexibility of the regulations is the big drawback, agreed Gerald Logue, M.D., chief of staff at the Buffalo Veterans Administ ration Medica l Ce nter. He is professor of medicine and head of the Division of Hemato logy in the Department of Medicine at UB. "The point needed to be made that the re should be a ba lance between education and service , but the point is being made with a nuclear weapon," Logue said. "There are ocher ways co make sure residents are awake and alert chat still allow you educational opportunities . "If these regulations were less driven by hours, it would be better . The hou r thing limits your flexibility." Because che regulations are so rigid, the continuity of care is disrupted, Logue said. Residents can be on call any night of the week, buc outpatient clinics are scheduled only on certain days. If a resident works at night, he has to miss the clinic the next day. Yeea very important need in medical education is co have residents see more ambulatory patients . And residents teach medical students. If the residents aren't around , the education of the students will suffer, Logue said. Because of the invasiveness and intrusiveness of governmental regulations, New York State is the worst place in che country co practice medicine, Logue complai ned . "The regulatory climate is going co drive good people out of New York Stace; he said. Vicki Zeldin, a spokespe rson for the health department, countered chat che regulations are indeed flexible. The rules say chat residents shouldn't work more than an average of 80 hours a week, she pointed out . Some weeks they can work more. "We're not going to be there scopwacch in hand," Zeldin said. "The bottom line is, if someone is coo tired co serve patients adequately, chat patient's life is in jeopardy ." She said chat the position of David Axelrod, M.D., the Scace commissioner of health, is chat "if these regulations didn't go into effect, patients would die. They're very important to the quality of care. "Personally," Zeldin said, "if 1 had the choice between being treated by the same doctor who had been up for hours SUMMER 1989 7 �8 n r 8.20 /l Ill. Monda_, . Driscoll. top lctt. explains 10 a patien t the de tmc1emen1 he'll perform w11I) caruana 8 :32 p m Monday Top ngh1. DriS<"0II helps transport l.>illient 10 surgery 9 pill . .\1011( /cl_\' Lower left. surgery conunues un11I 10:so p.m. .\lidnig/11 At lower right. DriS<"oll discusses a case wilh 01her residents . so I could have continuity of care, or getting a fresh doctor, I'd choose a fresh doctor." Residents rend to resent patients near the end of an exhausting 36-hour-day, she added, and these regulations are necessary to remove some of chat resentment. "Frankly, these are new regulations," SUMMER 1989 Zeldin said. "If we find that physicians all over the State are saying that they can't spend enough rime with patients, we would listen." Nobody is ever comfortable with changing from the familiar way of doing things, she pointed out, and that may account for some of the concerns people are expressing. Residents themselves view the regulations as benign, said James Woytash, D.D.S., M.D., chairman of the House Scaff Committee of the Graduate Medical-Dental Education Consortium. The new regulations "provide the best of both worlds. "They give residents time to spend with patients, and they give them time to keep up with the medical literature and have time for a personal life,"said Woycash, a fourth-year resident in pathology at the Erie County Medical Center. "It looks very promising." Residents in some specialties, especially surgery, are worried about seeing their cases through to completion, he said. They're also concerned that if there's nor enough money to hire all of the needed ancillary staff, patient care will suffer. While residents weren't demanding the changes, no one has left UB because of them. "The doomsday prophets were saying it was going to drive people away from New York State in all areas of medicine," said Woytash. But looking at the latest Match Day results, "the great exodus out of New York Seate hasn't occurred:' For UB medical students, the percentages of people choosing to stay in New York State are about the same as in previous years. From 1985 to 1988, between 56 per cent and 66 per cent of the class stayed in New York. This year, 62 per cent stayed . Anecdotal information from fourthyear medical students at UB, however, indicates mixed feelings about the regulations. John Osborn feels that the regulations will damage the training program in New York, so he accepted a pediatric residency at the University of BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Washington in Seaccle. Classmate Doug Sillarc, on che ocher hand, says che regulations are "making medicine more human ." He chose a residency in internal medicine ac Millard Fillmore Hospital in Buffalo. Ocher students were confident that, no matter what specialty they chose, the regulations will have no effect on them. "l doubt it's going to affect surgeons; said Joseph Ciac ci, who accepted a surgery residency at Mt . Sinai in New York City . "It wasn't designed around surgery residents. The system for surgery is okay as it is. I really think I'll be working just as hard as residents did in the past." Some students who chose out-of-Scace residencies noted char those states are looking at similar regulations, but they aren't expected co be as drastic as New York's. 9 B:50 a. 111. Tlicsdm• Mi er ge 11 111ga • r ha n,e 10 slccp tro m abo u1 1-30 a rn 10 6a m .. 1tw n ro ndu,li ng rou nds and see ing pa 11 e111 s. Drisc:oll rt' \'l t' W S 1cx 1s 111p rcpara 11 on fo r vascu lar surgny Is it practical? e ven if you agree that we shouldimplement these new regulations, many people ask, "can we implement them?" The two biggest concerns are whether there will be enough money and staff. "We believe that the changes to the code carry a very important message; said Thomas J. Faith, assistant administrator ac the Erie County Medica l Center. "They establish a daily menu for che quality of care. I believe that with all my heart . "But being able to do it is another matter." But when push comes to shove, ECMC won't cut back on services, he emphasized. The hospital administrators interviewed agreed that, somehow, they will comp ly with the changes. Bue it won't be easy. "Down the line it might be bette r, but the transition will be wicked; noted Marcia A. Brierly, administrative director in the Department of Medical Education at Millard Fillmore Hospital. The health department says that funding for the changes is available, though the hospitals wonder . Private hospitals, and even the Erie County Medical Center, get most of their funding through third-party payers BUFFA ID PHYSICIA N A ND BIO MEDICAL SCIENTIST ,. Illa..: SUMMER 1989 ��(such as private insurance companies or the Stace's Medicaid program). The State regulates the rates that hospitals can charge third-parry payers. In July, the rates are being increased and the hospitals in the State will receive an extra $270 million to cover the coses of the changes, said Zeldin of the health department. Since an outside consultant had estimated the changes would cost between $200 million and $300 million, chat amount is in the ball park, she noted. Bue since the regulations are so new and haven't been implemented yet, "there's a concern as to whether anyone knows what the financial impact will be," countered Brierly of Millard Fillmore. "It's difficult co know whether chis will cover everything." Finan cially, the Batavia and Buffalo Veterans Administration Medical Centers operate a bit differently from the ocher teaching hospitals. Their funding comes from the federal Veterans Administration, noted Logue. So far, the VA hasn't promised any new money for its hospitals in New York State co meet the code changes, but Logue predicted chat the federal agency may allocate extra funds as other states adopt similar regulations. In the meantime, the Buffalo VA Medical Center will spread its resources more thinly. "It'll be macaroni and cheese instead of steak," said Logue. Cutting back on che number of hours a resident can work is creating a manpower shortage, hospital representatives agree. "The bottom line is there'll be less work done by residents, so there has co be some other way co take care of patients," said Logue. Hospitals are adding more staff, with nurse practitioners and physician's assistants most in demand. Bue since the regulations have created a new demand, they've become hard co recruit, noted Logue. t he health department's position is that it may be difficult, but it's doable. "Our belief is that, except for isolated incidents, hospitals will be able co find BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST II I the staff; said Zeldin. "They should be able co find the ancillary staff and use attendiings without having to hire a lot of extra people. We're not saying it's going to be a piece of cake." The health department isn't going to be counting heads on Day One of these regulations; it just expects a good-faith effort from the hospitals, she said . Hospitals are also looking at adding more registered nurses, phlebotomists, IV teams, and transport people. Logue said that the cost for additional staff at the Buffalo VA Medical Center is approaching half a million dollars. Bue he conceded that it's hard to sort out which changes are being made simply co meet these new regulations. 1p m . -niesda.1 ,\ l>O\' C , Drisco ll :,a w m o re paueni s ,-md 100 k a s h o n brea k l.>e fore \ 'lt' Win g X-rays Wllh Jo hn HIC-Olld. , ·.i:,cu la r s urg eo n opp os i1e pa ge. Orisco ll sc nil , s up lor a \'C'in by pass ~rail SUMMER 1969 �12 "We probably would have had to add an IV team anyway," Logue pointed out. "There was too much service and not eno ugh education going on. If these regulations hadn't come a long, something else would have forced us co do this." To meet the staffing crunch, hospitals would like co hire more residents. Bur the number of residents a hospital may hire is limited by the accrediting bodies, explained M. Luther Musselman, M.O., director of medical education for Millard Fillmore Hospital and clinica l associate professor of medicine. Besides, it would be expensive and difficult to find enough qualified residents to fill some slots. One hospital chat is adding more residents chis summe r is Sisters Hospital. Five new residents from osteopathic schools will start in a program that was begun independently of the health code changes, said A. Charles Massaro, M.O., vice president for medical affairs at Sisters and clinica l assistant professor in medicine and family medicine at UB. Fortunately, the timing is convenient. Sisters also plans to spread hours a bit more evenly between junior and senior residents. Normally, as a resident advances, he spends less and less time on call, Massaro explained. "But (senior residents) are going to have to, much to their chagrin, work more on call; he said. "It was a nice little perk they had, but we can't do it any more. I don't blame them for not liking . " It. While hiring ancillary staff is the hospitals' main strategy, it's only a stopgap measure because "it only helps solve the problem with hours; it doesn't solve the supervision prob lem; said Brierly of Millard Fillmore. In the past, attending physicians or the patient's doctor were on call and could be reached by phone if a resident had questions at night. The supervising physicians had to be able to get to the hospital within 20 or 30 minutes. Now, supervising physicians in seven acute care areas - internal medicine, family practice, surgery, anesthesiology, obstetrics, psychiatry, and pediatrics must be at the hospital 24 hours a day. A resident who has completed four years, or is in his last year, of his residenSUMMER 1989 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �13 cy may supervise ocher residents. To solve chis problem, hospitals have several choices: • Require fellows in subspeciaky training to work at night. • Use senior residents to supervise ocher residents. • Hire attending physicians and pay them per hour to stay in the hospital at night. • Require full-time faculty to periodically spend a night in the hospital. Each of these solutions has its drawbacks. Fellows in subspecialty training won't be attracted to the idea of overnight shifts and it may interfere with their education, said Noe. The problem with hiring senior residents is that there are few of them and, like all residents, they're limited to working no more than 80 hours a week. When it comes to hiring attending physicians, money and availability are the two big drawbacks. BUFFAID PHYSICIAN AND BIOMEDICALSCIENTIST "Physicians are just not out there to hire," said Faith of ECMC. And even if you can find them, you have to be able to pay chem competitive wages. 1:50 p.m mesdm Top ld1 . Hicoua · and Driscoll make rinal prepara11ons 10 1he pa11cnrs leg before ;,urger~ 2 pm nwscfm Bollom 1cr1. suriery Noe estimates chat it would cost at least $350,000 to $400,000 a year to provide 24-hour coverage in one specialty in a single hospital. And what happens to the attending physician who takes care of his practice all day, supervises at the hospital all night, and sees his private patients again the next day? asked Brierly of Millard Fillmore. Another twist to this dilemma is that making night shift work lucrative in order to make it appealing to physicians could work too well. Some doctors may decide to work only nights, she said. Musselman added that with so many of these night positions opening, we may run into a shortage of physicians in the nexc few years . "We'recreating a monster in a different area," Mu sselman predicted. lxgins. 3.10 p.m nwsc/c11· they · prepare 111evein 10 1\!)0ve. l)(> gral1ecf a nocher option is to require UB faculty members to stay overnight in the hospital. "Historically, the residency training experience was chis opportunity to have as intense and as emergent training in patient care as possible," explained John Naughton, UB's vice president for clinical affairs and dean of the medical school. "Residents providing coverage in hospitals around the clock goes back to the cum of the century. The supervising physician can usually go home at night, permitting the resident co fill the gap." Bue that is changing and will be extremely difficult for physicians living in large SUMMER 1<189 �I urban areas such as New York City. Each medical director, with each director of service, is working out what faculty 14 doctors have to be at the hospital overnight, the dean said. The department faculty are involved in the decision. Bue the definition of who may be a supervisor poses a problem, Noe pointed our. Supervisors in certain areas must be board-certified or board-admissible physicians. Bur there are fully qualified physicians who may have chosen co skip the adding char the question may end up being settled in court . If the attending is held responsible for any mistake a resident makes, attendings may view the supervision of residents as a high-risk enterprise they'd rather avoid, predicted Faith of ECMC. Eventually, there might not be enough attendings to supervise residents and the number of people in graduate education could decline. Noe also questioned whether teaching hospitals are being asked to meet a higher standa rd than community hospitals char aren't required to have a full array of specialists on site. "Presumably, the management of patient care at those hospitals can be provided by somebody who can be called from home," he said. ''.A.rewe defining a different, higher level of patient care in teaching hospitals than in other community hospitals?" Otherregulations a certification test and, because a certain time period has elapsed, are no longer eligible to become board certified. "So does a program director have to make a distinction between his faculty?" Noe asked. "It's causing some uncertainty among program directors." Conversely, he pointed out, a physician who is board certified and, by definition, is qualified to supervise residents, may be a subspecialist who finds it difficult to supervise a broad array of problems. Still another problem with on-site supervision of residents is the question of liability of the supervising physician. Can one attending physician be available to perhaps 5 to 10 residents, each of whom is responsible for IOto 20 patients? "Can the attending physician carry that responsibility and meet the intent of the standard? It's uncertain; Noe said, norher portion of the code called for more formal credentialing of residents' skills and for limitations on residents' hours in the emergency room . Generally, those have been easier to meet. For UB, it was a challenge to invent a system that could be shared by its nine different reaching hospitals. A task force of the Graduate MedicalDental Education Consortium, headed by James M. Hassett, Jr., M.D., associate professor of surgery, set up the system. He is also assistant professor of biophysics and anesthesiology . Before the changes, when a supervising physician deemed a resident had shown he was able to perform a procedure satisfactorily, the supervisor gave the resident permission to perform the procedure on his own . The documentation wasn't structured and there wasn't communication between the hospitals. Now the faculty in each specialty have defined uniform criteria char residents must meet before they're allowed co do a procedure on their own. A computer is used to record the number and types of procedures residents do under supervision. Looking at a resident' s record, the chairman decides whether to grant privileges to the resident. When residents move between hospitals, their records move with them. While chis is probably rhe easiest and cheapest of all of the code changes, administrators at Millard Fillmore Hospital noted chat the start-up costs alone at their hospital ran $45,000 . Still another change in the code, in place since October, requires that residents and attending physicians in emergency rooms be scheduled for no more than 12 consecutive hours. The atrendings in rhe emergency room can't be the same ones cover ing the rest of the hospital. Again, cost and manpower are the issues. Faith of ECMC estimates that it will cost about $1 million a year just for physician coverage at his hospital. Rural hospitals probably have the toughest time recruiting physicians, bm city hospitals are scrambling, too. "We're recruiting nationally to staff our emergency rooms and we're just making it," said Musselman of Millard Fillmore, though his hospital was one of several Buffalo hospitals chat had mer the regulations before they went into effect. Noe pointed out that the medical school is planning to establish a residency training program in emergency medicine for 30 residents . "As the program develops it will go a long way to relieve the manpower problems, particularly upstate," he said. Also easing the problem is the fact that people in internal and family medicine are showing more interest in emergency medicine. "I don't think there's any doubt that (the changes to the code) are burdensome," said Naughton. "It's seen as adversaria l rather than as a positive thing. "Bur for us as a medical school, the changes create an awareness that we need to do a better job of supervising our srudents and residents and of credentia ling them. It makes good pedagogical sense. "Sometimes we don't solve a problem without a crisis. In the short haul, it may be tough. But in the long haul, we • should be able to do it." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �SUMMARY HOURS Effecnw:JwlyI, /989 • Residents may be scheduled for no more than 80 hours a week, when averaged over four weeks. • They may be scheduled for no more than 24 hours in a row. • On-duty assignments must be separated by at least eight hours of non-working time. • Residents must get 24 consecutive hours off each week. • Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. • In certain departments that don't have a high volume of acutely ill patients and where the resident is able to get enough rest, there JS more flexibility in scheduling. (Ex eluded from this clause are anesthesiology, family practice, medical, surgical, obstetrica l, or pediatric services.) ... •,i t',· /10 :9 ·.8 lil. 2· 3: -, 4.- .7 .? _s•. s p.m . Tuesday Opposite page. finishing surgery 6:50 p.m . Tuesday TOp. Driscoll confers with or . M. carlin and Dave 1tarshman. a surgical resident. 6:57 p.m . Tuesday center. Driscoll examines a patient. 7:05 p .m . Tuesday Driscoll and photograph er BOb Walion end their workday . ON-SmSUPERVISION Eff«aw:1111, 1 989 • A sufficientnumber of supervising physicians must be present tn the hospital 24 hours a day m the acute care specialties of anesthesiology, family practice, mediane, obstetrics, pediatrics, psychiatr¥ and surgery. • Supervising physicians mustbe. board certified or board adm1ss1ble, or have completed a minimum oJ four years of postgraduate tramingi • The supervising physician may be a resident in his final year ofpost graduate training if the padeJj physician can get to the hosp within 20 to 30 minutes of beliDRP called. CREDENTIALING E/f«tiwJan.1 1989 • The medical staff must written documentation o care privileges granted to EMERGENCY ROOM Eff«tiw • Residents and attending ph cians can be scheduled for no mote than 12 consecutive hours. SUMMER 1989 15 �I 16 Samuel 0 . Thi e r �Spring Clinical Day 17 Doctorsurged to shape national policies l 1 l BY CONNlE OSWALD SlDFKO = ~ f physicians don't take a hand in shaping this :::: country's health care ::: policy, they're shirking their responsibilities, according co Samuel _.._-_ ~ 0. Thier, M.D., president of the Institute of Medicine of the Nationa l Academy of Sciences . Physicians should be key players in deciding today's tough health care issues, but "the silence from the medical community is deafening," said Thier, who gave the annua l Stockton Kimball Memorial Lecture at chis year's Spring Clinical Day on May 6. The United States leads rhe world, but we're at a point of instability, said Thier, who is also visiting professor of medicine ac che Johns Hopkins University School of Medicine and clinical professor of medicine ac the George Washington University School of Medicine. It's rime to choose whether we will evolve and remain leaders, or give up chat leadership to some ocher group . Ideas for evolution are desperately needed and they have to bubble up from the medical community. "I don't see a sense chat we're engaging the issue," Thie r said. "What will replace chis? We have the responsibility co chink about what we want next." The policy makers in Washington view the medical community "as apologisesfor the status quo" rather than an active - BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Physiciansshould be key players in deciding today'stough health careissues,but "the silencefrom the medicalcommunity is deafening,'' said Samuel 0 . Thier, M.D. of the National Academy of Sciences. force for change, Thier noted. One of the issues facing physicians today is access co care. There are 35 to 40 million people in this country with no hea lth insurance at least pare of the year. One to two million are turned away from care, and the rest don't seek care as often. When Thier was a resident at Massachusetts General, physicians who wanted hospital privileges had to contribute time to care for the indigent . Now, some physicians feel that if they're not reimbursed for care, they don't have to provide it. "I believe chat's an abrogation of our social contract," Thier said. Some social problems, such as teenage pregnancy, the indigent, and aging, aren't dealt with adequately because physicians cry co force the issues into a medical model, T hier said. Picture the elderly person who lives in poor housing: he or she becomes depressed, doesn't eat much, and gees pneumonia . The physician successfully treats the pneumonia and sends the person back to the same house. Rather than just treat the pneumonia, we need co keep people functional, Thier pointed out. He noted that in Japan, they tail off the money they spend for medical care for the elderly and spend it instead on housing and fo.od. In this country, we need to create some kind of a plan chat uses preventive strategies and somehow moves from a medical model to a social model, he indicated . We made a mistake 50 or 60 years ago when we separated schools of medicine from schools of public health. "If we simply watch the scene evolve, we won't have met our professional responsibilities," he concluded. • SUMMER 1989 �Spring Clinical Day 18 PECTIN It thickens jelly, but can it thin arteries? �Spring Clinical Day 19 WR:R:T TJE N JBY CON ][JE ((})§W A JLD §TO>FKO utrition in the '90s" was the theme of the 52nd annual Spring Clinical Day, held May 6. The event, which also ) included the class reunions, was sponsored by the UB ) Medical Alumni Association. The topics of the scientific sessions were nutritional of cholesterol; epidemiology of nutrition management and cancer; recent advances in characterizing and managing obesity; new fuels for the gut, and normal nutritional requirements. CHOLESTEROL I II chink we can lower plasma cholesterol and LDL (which is connec ted to an increased risk of heart disease) with _ , .,..v.,a grapefruit pectin and no change in diet," said James J. Cerda, M.D., professor and associate chairman of the Department of 1 , ,I"' 0 • Medicine at the University of Florida at(: ~ Gainesville . According to studies performed by Cerda and his colleagues, grapefruit pectin appears to lower cholesterol. (Pectin , is a water-soluble fiber that binds adjacent cell walls in plants . It's used by homemakers in preparing jellies and jams .) will actually reduce atherosclerosis once In experiments with pigs, Cerda found it forms. That's an important question that even when fed a high-fat diet, the because most of us already have atheropigs' cholesterol decreased when they sclerosis, Cerda reminded his audience. were also fed pectin . The pectin also apThe researchers also conducted a peared to prevent atherosclerosis, the double-blind trial of people with high plaque buildup that results in narrowing cholestero l who couldn't or wouldn't of the arteries. change their lifestyles. He noted that it The next question the researchers wasn't hard to find subjects. would like to look at is whether pectin r. ) ) ][JLJLU§TRAT][O) BUFFALOPHYSIC IAN AND BIO MEDICAL SCIENTIST BY The researchers found that pectin was ,statistically significant in reducing ·cholesterol. One-third of the subjects had at least a 10 per cent decrease in cho lesterol while taking pectin. Cerda emphasized chat he's not suggesting that people rely only on pectin to lower their cholesterol. They should also eat a good diet and get exercise. Since it's important for physicians to advise patients about diet, medical schools shou ld prepare them by teaching nutrition as part of the curriculum, Cerda added, and physicians should also rely on dieticians more than they do. CANCER W hen it comes to reducing the risk of cancer, fiber - but not just any fiber - may be beneficial, according to Saxon Graham, Ph.D., professor and chairman of Social and Preventive Medicine at UB. Vegetable fiber, but not fiber from grains, is helpful in reducing the risk of Jr({))§JEJP>H THIEJL SUMMER 1989 �Spring Clinical Day I zo rectal cancer, according to a study by Jo Freudenheim, assistant professor in Social and Preventive Medicine at UB. Graham pointed out that that's not the fiber the National Cancer Institute cold us to eat. Vitamin A may reduce the incidence of cancer of the mouth, larynx, esophagus, bladder, lung, and cervix, he said. As well as searching for foods char prevent cancer, researchers are also on the lookout for ones chat cause cancer. There's epidemiological evidence eying the amount of far in one's diet co both colorecral and breast cancer, Graham said, but he cautioned that it's a leap in logic to say fats cause chose cancers. He also observed chat closely associated with fats are obesity and the coral calories ingested. These interrelated factors could be connected co cancer of the colon and rectum. And since physical exercise can reduce obesity, exercise may also be associated with decreased risk. Ir is also possible chat exercise by itself may reduce the risk of colon and breast cancer. While the ocher recent, well-publicized recommendations of the National Research Council seem well-founded, there's little epidemiological evidence to support its advice co decrease the protein SUMMER 1989 in our diets or to increase grains or calcium, Graham said. The first strategyin dealing with obesity should be prevention. Physiciansshould recognizethe family at risk - whereone or both parents are obese. OBESITY T he first strategy in dea ling with obesity should be prevention, said Lyn J. Howard, B.M., B.Ch., ER.C.P., head of the Division of Clinical Nutrition at Albany Medical College. Physicians should recognize the family at risk - where one or both parents are obese, said Howard, who is also a professor of medicine and associate professor of pediatrics. Children shouldn't cross over their growth curves, even if the children are at the correct weight for their height. Also at risk of obesity are people with a low resting metabolic rare. Those at risk should hold down their calorie intake, particularly during periods of rapid growth, such as during the fetus' last eight weeks of gestation, early infancy, adolescence, and during pregnancy for women, she recommended. Physicians must advise patients about the fat in their diets. The percentage of fat in the diet, rather than coca! calorie intake, is a big contributor co obesity, Howard explained. Because the sympathetic nervous system regulates the mechanisms that tell the body chat it has had enough co eat or chat it needs to burn up calories, anything that turns on the sympathetic nervous system is beneficial. The best thing is exercise. "Diec is not the first thing, but exercise is," she emphasized . "Exercise has to be a forever commitment." Another thing that cums on the sym- BUFFALOPHYSICIAN ANO BIOMEDICAL SCIENTIST �Sprmg Clinical Da:,· 21 pathetic nervous system is the carbohydrate content in the dier, so people should use carbohydrates as their chief calorie source. For people who have become obese ro a point where it's affecting lifo expectan· cy and health, strong consideration has robe given ro the possibility of performing surgery, Howard noted. 1'\·o pro· cedurcs, gastric bypass and vertical banded gasrroplasty, restrict food intake and ro some extent impair food digestion. They have a 60 ro 70 per cent success rare. However, gastric balloons haven't proved safe or effective, she pointed our. Howard mentioned rhar some new drugs to aid weight loss may be available in the next decade. They will be aimed at increasing rhe mobili:arion of far, mimicking satiety, and delaying gastric emptying. FORTHEGUT FUELS I n certain conditions where the intestines aren't working properly, it may help ro feed the intestines certain fuels that their mucosa use best, said John L. Rombeau, M.O., director of the Nucri• tional Support Service at Philadelphia Bl.:FFAW PHYSICIAN AND BIOMEDICAL SCIENTIST Medical Administration Veterans Center. Patients with intestinal malfunctions are often placed on a regimen of "bowel rest" and fed in a way (such as intravenously) that attempts to bypass the intestines. Bue bowel rest has side effects, noted Rombeau, who is also associate professor of surgery at the University of Pennsylvania School of Medicine. The gut begins to arrophv and the muscous lin• ing of the intestines begins ro function poorly. Studies show that in selected conditions, it may be preferable to feed the intestines certain fuels char the mucosa use best. For example, glucamine, a non-essen• nal amino acid, is seen as the preferred fuel for the enterocytes, the cells that line the small intestine, he explained. Shorr-chain fatty acids are rhe preferred fuels for the colon, with soluble fiber, such as pectin, as a precursor. When part of the intestine is removed, the addition of pectin to a liquid diet improved adaptability of the remaining portion of the intestine, Rombeau explained. Pectin also decreased diarrhea. The shore-chain fatty acids improved the strength of the colon. EMENTS L NORMAREQUIR I t's difficult to establish nutritional requirements, noted Jorge E. Albina, M.O., associate director of the Nutritional Support Service of Rhode Island Hospital. Minimum requirements arc defined as the minimum intake that will maintain adequate function and health, explained Albina, who is also assistant professor of surgery at Brown University. But adequate for what, he asked. ls the goal to reduce dietary diseases such as scurvy? To maintain good health? To reduce the risk of other diseases such as cancer? For hundreds of years, we've been try• ing to figure out what kinds of foods and how much food people require. The first recorded nutritional allowance was written in 1753 when British sailors were told to drink an ounce of lemon juice a day to prevent scurvy. Recommendations have changed over the years, and today different dietary boards disagree on minimum nutritional requirements. "If we try to answer the same question: 'How much food does man require?; I chink we still don't know, but we're learn• ing pretty fast," Albina concluded. SUMMER 1%~ �Medical School 22 Health Manpower Will we have enough doctors? How many is enough? BY CONNIE OSWALD smFKO W ill we have enough do ctors in the future ? That's a hard question to answer since no one has yet decided how many doctors we need, according ro George E Sheldon, M.D., professor and chairman of the Department of Surgery at the University of North Carolina at Chapel Hill. And the kind of doctors we'll need in rhe future changes with every scientific breakthrough. Sheldon discussed "Health Manpower the Future Challenge" March 23 ac the indu ction ceremony of the UB chapter of Alpha Omega Alpha, the national medical honor society. He is a regent of the American College of Surgeons and chairman-elect of the American Board of Surgery. "Nobody has ever decided how many doctors we need,"said Sheldon, a trauma surgeon. "There's no question we've got more than we did 25 years ago, but we didn't have enough then." There was a time when medical schools were turning out large numbers of doctors. Back at the turn of che century, standards were so low chat anybody who could pay the tuition could enter medical school. Then, the Flexncr Report, which urged reform in medical education, was published in 1910.Standards were raised, closing down some schools and causing a shortage of do ctors. Between 1920 and 1950, there were less than 120 physicians for every 100,000 Ameri cans, Sheldon said. SUMMER 1989 "Nobody has ever decided how many doctorswe need," said Sheldon, a trauma surgeon. "There's no question we 've got more than we did 25 yearsago, but we didn't have enough then." Now there arc 200 physicians per 100,000 Americans, but that's only a few more than we had at the turn of the century, he pointed out. If we assume tha t we have enough doctors today, we're pretty good at predicting the numbers we need. But we don't fare as well in predicting what specialties will be in demand. Sheldon described a 1978 study by the Graduate Medical Education National Advisory Committee, which was an extensive and expensive project that projected the kinds of doctors we'll need by 1990. The study was right on target in predicting the number of physicians we'd have - about half a million, he noted . "But it was off by a mile on all the specialties," Sheldon said, because medicine is changing so rapidly. Back in 1978, no one predicted the importance that organ transplantation would have today because cyclosporine, the drug that greatly improved the success of transplanta• tion, wasn't around yet, he said. And no one had heard of AIDS. AIDS is becoming a problem today, but we have to keep it in perspective, he cautioned. More people die on the nation's highways each year than have died from AIDS since it was identified . in the futu re, She ldon noted, the aging populatio n in this country will create new demands for certain types of physicians. And BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �Medical School 23 there may be a greater demand for sports physicians. He also outlined ocher trends: ■ Before the 1970s, health care was a "corcage industry." Doctors ope raced fee-for-service solo practices. This was coupled with voluntary hospitals. Now, the trend is toward group practices, Sheldon explained, and hospitals have become very fragile economic entities. During Texas' recent oil problems, hospitals closed because they are very dependent on che overall economy of an area. ■ Most doctors work 60 to 70 hours per week, though females tend to work fewer hours, he said. The number of women is increasing, which could mean that the total number of hours worked by physicians will decrease. BUFFALOPHYSICIANAND BIO~IEDICALSCIENTIST "Bur I think that women have kept the quality of heal ch care up; Sheldon said. "As the number of applicants (to medical schools) dipped down, if we didn't have the interest of rhe women, quality would have gone down." ■ The retirement age of physicians, driven by high malpractice insurance rates, has dipped below 60 years old. ■ Medical school enrollment has plateaued . No new schools are being built. An important aspect of the medical manpower question is how much society is willing to spend for health care. The U.S. now spends 12 per cent of its gross national product on health care, while Brirain spends only six per cent, Sheldon noted. But he pointed out that 86 per cent of what Britain spends comes from the government while less than half of what rhe U.S. spends comes from the government. And in Britain, patients wait 28 months ro get a hip replacement or 26 monchs to have a hernia fixed, he added. "These are choices we make in sociery; Sheldon said. "Health care is not going to get less expensive as technology increases. \Y/e have co decide how we'll spend our money." Quoting Rashi Fein, Ph.D., a Harvard economist, Sheldon said, "If we become comfortable with a culture char tells us that health care is analogous to selling shoes, and that the level of health spending and major allocation decisions are to be determined by marker forces, rather than by a political or social consensus, we will be comfortable with rationing." • SUMMER 1989 �Medical School 24 Timothy Murphy, M.D. of diseases caused by microbes (such as BUFFALO IS EMERGING bacteria, viruses, and protozoa), provides vital AS LEADER IN STUDYOF research that contributes to vaccine development and to the control and understanding MICROBIAL PATHOGENESIS of diseases. B uffalo is emerging as a major center in the study of microbial pachogenesis, researchers here report. That prominence is highlighted by a national conference held here in March that was sponsored by the UB Microbial Pathogenesis Graduate Group. "We attracted many heavyweights in the field ro the first Buffalo Conference on Microbial Pathogenesis; said Timothy Murphy, M.D., associate professor of medicine and microbiology and direcror of the graduate group. "This attests to the nationa l respect chat Buffalo has in the field, as well as to the need to collaborate our efforts." Microbial pathogenesis, which is che study SUMMER 1989 Barbara H. lglewski, Ph.D., and Stanley Falkow, Ph.D., national leaders in the field were among rhe six speakers at the March event. lglewski is professor and chairman of the Department of Microbiology and Immunology at the University of Rochester and president of the 15,000-member American Society of Microbiology. She has contributed groundbreaking research in using molecular techniques for studying bacteria. Falkow is professor of microbio logy, immunology, and medicine at Stanford University School of Medicine. He is known for his pioneering work in the field using genetic techniques in order to understand how a microbe adheres to and invades a cell. "Basically, there is a lot of pathogenesis research going on in Buffalo and all over the country," says Mu rphy. UB's new graduare group, as well as the con• ference, offers opportunities for researchers scattered among several departments at UB to organize and communicate with their colleagues. The UB Microbial Pathogenesis Graduate Group includes 25 graduate students and 33 faculty members from the Departments of Medicine and Pediatrics (Divisions of Infectious Diseases), Microbiology, Biochemistry, Oral Biology, and Surgery. "Tom Flanagan (Ph.D., chairman of che Department of Microbiology) was instrumental in recognizing the need for such a group; explained Murphy. "le was formed in order to foster the exchange of ideas and technology among faculty members in different departments who have interest and expertise in the study of molecular biological aspects of infectious diseases." While many of the researchers in the various departments study different types of organisms such as bacteria, viruses, protozoa, and other parasites, they ask similar fundamental questions ('What are the factors in microbes chat enable them co cause diseases?') and use many of the same techn iques regarding pathogenesis. Interaction among departments has facilitated the development of a vaccine for the disease called Haemophilusinfluenzae a bacterial disease, unrelated to the flu, which preys mainly on preschool ch ild ren and causes bacterial meningitis, pneumonia, and ocher serious conditions. "This development is a potentially significant one," explained Bud Nelson, a postdoctoral research associate in microbiology and biochemistry. "Previous vaccines were ineffective in children under two years because their immune systems did nor recognize the vaccine and produce the necessary antibodies. Currently there is a pha rmaceutical firm interested in resting the vaccine." T hrough this interaction among departments, Michael Apicella, M.D., professor BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Medical School 25 of medicine and microbiology, steered Nelson to David Rekosh, Ph.D., associate professor of microbiology and biochemistry. Under Rekosh's direction, Nelson learned a gene sequencing and cloning technique used in Rekosh's lab in order to characterize the specific protein for the new vaccine. "It took about eight months to learn the technique; said Nelson, "but once I had, l rook what I had learned back ro the infectious disease labs at the Erie County Medical Center and continued the studies ." The technique of genetic engineering is a powerful molecular biologica l tool that has revolutionized the study of infectious diseases in the past decade. Since the faculry using these techniques are located throughout different departments, the graduate group allows collaboration for research projects. This collaboration, together with the conference, are examples of the type of interaction needed wirhin the field, both at the University and nationally, Murphy said. • - By Mark Marabella A GLASS OFMILKMAYHELP S leep disorders in che elderly are usually complications of other problems and are too complex ro be whisked away with prescription drugs, said Troy L. Thompson U, M.D., professor and chairman of the Department of Psychiatry at Jefferson Medical College. Thompson made his remarks during the second annual conference on "Current Issues in Geriatric Psychiatry," co-sponsored by the Division of Geriatric Psychiatry, Department of Psychiatry, and rhe Western New York Geriatric Education Center at UB. His was one of five talks presented at the April conference in the Ramada Renaissance Hotel in Cheektowaga . "Conservative estimates indicate chat about 5 million elderly patients in this country have a severe sleep disorder," Thompson said . "For unknown reasons, the death rare among people who 'often' use sleeping pills is 1.5 times higher than that among marched subjects who have never used sleep- BUFFAlD PHYSICIANAND BIOMEDICALSCIENTIST ing pills." Thompson maintains char sleep disorders, such as the common insomnia, are too complex co be whisked away by the hasty prescription of sedative-hypnotics or benzodiazepines. He emphasized rhar, especially in older individuals, insomnia is usually secondary in nature and arises as an aspect or complication of psychiatric, medical, environmental or pharmacological events. "Many sleep disorders, such as insomnia, are merely a secondary symptom of a complexity of factors; explained Thompson . "A patient's complaint of a sleeping problem should trigger a comprehensive review which includes that patient's medical history, family background, and current lifestyle." Many times, remedies for sleeping difficulties need not come from the medicine cabinet or a doctor, Thompson pointed out. An adequate dose of L-Tryptophan, an essential amino acid which is sometimes recommended as a hypnotic, can be obtained by drinking a glass of milk. However, if a sedative-hypnotic medication is chronically needed to maintain adequate sleep, the physician should regularly reevaluate the initial diagnosis, reconsidering such possibilities as depression, anx iety or one of a dozen ocher primary sleep disorders, Thompson cautioned. "Judicious use of sedative-hypnotics in the elderly requires an understanding of drug metabolism in the aged, as well as knowledge of the differential diagnosis of distu rbed sleep; he said, adding that "the clinician should be familiar with the changes in sleep patterns and sleep architecture that are seen in the healthy elderly person." • - By Mark Marabella SUMMER 1989 �Medical School 26 -- Luc Montagnier, M.D. SUMMER 1989 FOCUS ON BASIC AIDSRESEARCH, SAYSMONTAGNIER "we should put our research efforts first in basic research; said Luc Montagnier, M.D., the noted French AIDS researcher, "because we still don't know many things about the virus and how it causes disease. It's very difficult to design new treatments and also to design a vaccine" without this knowledge. Montagnier, a professor at the Pasteur Institute in Paris who identified the HIV virus associated with AIDS, spoke April 12 at the 19th Annual Ernest Wicebsky Memoria l l..e<:cure in Bueler Auditorium. The lecture is sponsored by the Ernest Witebsky Center for Immunology and the Department of Microbiology. According to Montagnier, AIDS is not caused, but only triggered, by HIV (the human immunodeficiency virus). He contends that the virus causes autoimmunity, in which the body becomes immune to itself. The virus hides from the immune system by mimicking che configuration of a human cellular structure so that the immune system can't discriminate between itself and the virus. HIV alone, in sufficient amounts, is enough to induce the disease in susceptible humans, Montagnier says. However, when the virus dose is low, and thi s is probably the case in sexual contact, then some co-factors may play a role. It's important to understand the basic workings of the virus, but "at the same time, of course, we have to deal with the disease in patients and we should try anything that works, even in an empirical way; Montagnier said, referring to treatments that seem to work but haven't yet undergone thorough study. "If something works, we should cry it." In all parts of the world the treatments are the same, he said, and the best we've got is an antiviral drug called AZT (azidothymidine). While it may be beneficial to a patient for months or even years, it's not a cure. Many other compounds are under Phase BUFFALOPHYSICIAN AND BIO MEDICAL SCIENTIST �Medical School 27 I trials, Moncagnier added. The Ernest Wicebsky Memorial Awards for proficiency in microbiology were given co Alison Koehler, a medical student; Kevin G. Cleary, a dental student, and Sam Jayanch Samuel, a graduate student. • BETTER THANEVER l ooking like a contestant on The Priceis Right, Paul Lecat, amid applause and cheers from his friends, ran down the steps of Butler Auditorium to the podium. He received an envelope, tore it open, and jubilancly yelled out che good news - "Akron, yeah!" Lecac had just found out he got the residency he wanted in medicine and pediatrics at Children's Hospital of Akron in Ohio. The occasion was March Day, che annual event where lase-year medical students find out where they'll spend their residencies. About 65 per cent of che medical students got the best news they could have hoped for - chey got their first choice of residency. And a whopping 87 per cent got one of their cop three choices. Students aimed high and were placed in some of che more competitive residency pro• grams, such as Yale, Cornell, Columbia Presbyterian, Strong Memorial, and Johns Hopkins. "le was a very impressive match overall~said Dennis Nadler, M.D., assistant dean of student affairs in the medical school. "It's going • to be very difficulc to cop." Scott Bookner congratulates Joan Murray. Peter Ostrow, associate dean, prepares for a second champagne shower . ./ Doug Sillart and David Bloom BUFFALOPHYSICIAN AND BIOMEDIC AL SCIENTIST Charlene Vita le and Kristina Hart share their happy news. SUMMER 1989 �Medical School 28 NOBEL PRIZE-WINNER EXPLAINS WORK G erald M . Edelman, M.0 ., Ph.D., D.Sc., winner of the 1972 Nobel Prize in Medicine and Physiology,delivered the annua l Edward Fogan Lecture in Neurology on March 16 in the Albright- Knox Arc Gallery . The lecture was sponsored by UB's Department of Neurology. Edelman discussed "Cell Adhesion Molecules in Morphogenesis and Neural Development." In recent years, Edelman has worked in neuroscience. He is the proponent of a theory explaining development and organization of the human brain, which is outlined in his book Neural Darwinism: The Theory of NeuronalGroup Selec1ion. Before that, he worked in immunology. Edelman received his Nobel Prize for his discoveries of the molecu lar configurations of the immunoglobulin molecule. This work led Edelman to consider questions of how ou r immune system develops specificity in recognizing objects chat are foreign to the body. This ana logy has been adapted co che nervous system. Cell adhesion molecules, first described by Edelman in 1977, are markers on the surface of cells chat provide a framework by which the billions of cells in the nervous system are able co relate co one another. These molecules provide the structure by which the nervous system differentiates itself from an immatu re mass at birth, incapable of sensing its environment, to che more mature nervous system able to respond to the intricacies of its environment. Edelman suggests chat cell adhesion molecules provide the matrix by which cells relate co one another, thereby creating specific neurona l differentiation . By chis means, he suggests a mechanis m by which selective parts of the nervous system develop specificity for vision, pain, temperature, memory or fine motor coordination, etc. Related to chis work is Edelman's theory of neu rona l Darwinism. Just as adaptation co the environment is the foundation of Dar- SUMMER 1989 Gerald M. Ede lman, M.D., Ph.D. , D.Sc. win's theory of evolution of species, Edelman's theory proposes that brain development is based upon competition for survival among neural cells and response co stimuli in the environment. Those that are used survive while unused ones do not . Cell adhesion molecules provide che structure that allows cells chat are to be programmed for a specific function to relate to one another. Those areas that do not develop affinities for one another do not survive. This theory of how cells relate to one anothe r and how they differentiate is so important that some people speculate chat Edelman may be in line for a second Nobel Prize. Edelman is the Vincent Astor Professor at the Rockefeller University and director of the Rockefeller University Neurosciences Institute. He is also scientific chairman of the university's neurosciences research program. • - 8)' Michael £. Cohen, M.D. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Medical School 29 Tai-Hwang M. Fan, a fourth-year student, represented UB at the eighth annual Medical Student Research Atvards Program sponsored b-v the Associated Medi cal Schools of New York. The May event was held in Buffalo for the first time. Judith Tamburlin, cl inical instructor, right, explains her work on an anatom::, atlas for the blind to Stephanie lovino, a graduat e student. The di spla::, was part of the medical sc hool's first Faculty Research Day held April 25. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SL:MMER1989 �Hospital News 30 Decked out in a frill:>•hairband and sucking on her pacifier, Carley Mallon is cuddled by her parents, Peter and Diane. Treating the Fetus as a Patient S cace-of-the-arc diagnostic and treatment methods have introduced a new concept in medicine - treating che fetus as a patient. That's the focus of the new Buffalo Institute of Fetal Therapy, formed by che Perinatal Center of Children's Hospital of Buffalo and the UB medical school. The program is the first of its type in New York Scace. "The traditional field of fecal and maternal medicine knows how co treat the mother and normal pregnancies, and how co treat an abnormal pregnancy when it affects the mother; explained Philip L. Glick, M.D., co-director BUFFALOPHYSICIANAND BIOMEDICALSCIE1''11ST of the program, "but it doesn't know how co treat the fetus:' In the recent past, a physician might be able to predict chat a fetus would be born with an ailment, but there was little he could do about it. Now he can cake some action, explained Glick, who is also an assistant professor of surgery at UB and a pediatric surgeon at Children's. Sometimes physicians can treat a fetus surgically or medically while it is still in the womb. A more common action is co plan rhe rime, place, and mode of delivery, and have experts ready when the baby is born. The ocher co-directors of the program are Luther K. Robinson, M.0., director of clinical generics at Children's and UB assistant pro• fessor of pediatrics, and Amel S. Lele, M.D., director of the Women's Clinic at Children's and UB clinical associate professor of gynecology/obstetrics. Glick said a wide range of fecal abnormalities can be identified using ultrasound and rests that sample amniotic fluid, maternal blood, and fetal cells and tissue. Among che problems chat can be detected chis way are urinary tract obstruction, thoracic masses, congenital diaphragmatic SUMMER 1989 �Hospital News 31 hernia, abdominal wall defects, and spina bifida. Some are best corrected after a full-term delivery, others may require a cesarean delivery, and still others may require induced prererm delivery for early correction outside of the uterus. Some may require medical therapy before birth and some may require in-utero surgery. The Buffalo program, Glick explained, rakes a multidisciplinary team approach to the unborn patient. The program has assembled a team of experts consisting of perinacologists, neonatologists, radiologists, cardiologists, anesthesiologists, geneticists, ethicists, clergy, and pediatric surgeons with various subspecialries. Rather than usurp the role of the community physician, the team members act as consultants, Glick said. The results can be very gratifying. I II fit wasn't for you people at Children's Hospital, we wouldn't have our baby today," said Peter Mallon, gazing at his fourmonth-old daughter Carley. Peter and his wife, Diane, 35, were thrilled co find out she was finally pregnant. Their joy turned to shock when doctors discovered through an ukrasound test that the baby girl Diane was carrying had a congenital diaphragmatic hernia. In this condition, the diaphragm (the muscle chat separates rhe chest from the abdomen) hasn't developed properly. Carley's abdominal organs were in the chesc. Her intestines compressed her lungs, resulting in small and abnormal lungs. Although many babies with chis condition also have other abnormalities, a cest called amniocentesis and a thorough feral ulcrasound confirmed that Carley had no ocher birth defects. The doctors discussed the options with the Mallons and they chose surfactant replacement and surgery after birth. When the pregnancy was full term, labor was induced and the baby was delivered vaginally. Surfactant, che soapy coating that prevents the lungs from collapsing in between breaths SUMMER 1989 Philip L. Glick, M.D. and makes the lungs more pliable, was placed in the baby's lungs before she rook her first breath. Surfactant replacement is an accepted therapy for premature babies, Glick explained, but it's a new approach for babies with diaphragmatic hernias. Babies with that condition have lungs that appear similar ro rhe small and sriff lungs of premature infants. It apparently worked. Now the physicians will go back to rhe laboratory and examine whether rhe surfactant really did help Carley and whether they can recommend it for other children. After Carley was treated with the surfactant, she was rushed off ro surgery where all of her abdominal organs were removed from her chest and placed back in her abdominal cavity. Her diaphragm was repaired with a piece of plastic. That indicates how risky her condition was, Glick noted. When plastic is needed co repair the diaphragm, the mortality rate is almost 100 per cent. After six weeks, the baby was discharged from che hospital and sent home without respiracory or feeding difficulcies. "She's coming along real good - she's real alert," Diane said. "She's lifting herself from che crib and crying ro roll over a little bit." "As far as we can tell, she's absolutely normal," Glick confirmed, and Carley's future looks bright. "She will be an absolutely normal five-year-oldon the playground with normal lung capacity." He stressed that it took team work. Work- ing on Carley's case were Diane's obstetrician, ultrasonographers and technicians in radiology, perinatologists and neonatologiscs, geneticists, pediatric surgeons, a developmental pediatrician, house staff, operating room and intensive care nurses, and the hospital chaplain. The Buffalo Institute of Feral Therapy is modeled on a handful of similar programs across che country, including the pioneering effort of Michael R. Harrison, M.D., ac the University of California at San Francisco, where Glick did his general residency in surgery and a fellowship in fetal surgery. The Buffalo program was founded in conjunction wich the deparrments of pediatrics, gynecology/ obstetrics, radiology and surgery at UB and Children's. Its work, Glick noted, is facilitated by che fact that Children's Hospital of Buffalo is che only free-standing children's hospital in the continental U.S. with an in-house maternity division. J.E. "Ted" Sribbards, Ph.D., president of Children's, noced that pediatricians used to wait as long as five years co carry our some corrective procedures that are now carried our in the first few days of life. Glick's work pulls back chat riming even further. John P.Naughton, M.D., UB vice president for clinical affairs and dean of the medical school, said rhe new program "represents an important clinical addition to the Perinatal Center chat has existed at Children's Hospital for the past three years. "It will provide added and needed services for unborn children with feral abnormalities and will stimulate research designed to prevent such abnormalities from occurring and co treat those chat are not preventable." "The future of fetal therapy is inspiring; according co Glick. "As our understanding of the fetal immune system progresses, the possibility of in-utero transplantation of stem cells and whole organs looms as a distinct reality. If che secrets of fecal wound healing can be unraveled, the scarless healing of the fetus may usher in a new era for plastic surgeons. ln-utero fetal nutrition may lessen the mortality and mor• bidity of intrauterine growth retardation. "The list just goes on and on." • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Hospital Neivs 32 Struggling with Polio's Aftermath BY MARK MARABELLA H en ry Bauld, 78, was struck with polio as an infant in 1912. Although he successfully thwarted this potentially crippling disease, in his 50s he began to experience extreme fatigue and pains in his shoulders. He couldn't walk any distances without becoming exhausted. When he consulted his physician about what was happening to him, his doctor chalked it up to "oldage." It wasn't until last year, when he first consulted the Erie County Medical Center's PostPolio Center of Western New York, chat Bauld learned he wasn't alone in his affliction . Bauld signed up for an appointment with Frederick McAdam, M.O., director of the center and clinical instructor in UB's Department of Rehabilitation Medicine. Following Bauld's initial examination and evaluation, McAdam and the center's specialists prescribed individualized daily exercises and vitamin supplements. Bauld soon discovered that he had renewed energy that he hadn't felt in 25 years. Sudden ly, his formerly diagnosed "old-age" was seemingly in remission. People who had polio as youths are now suffering in their lacer years from chronic muscle and joint pain, fatigue, weakness, and breaching difficulties. They are being diagnosed as having "phantom pain" or symptoms of "old-age," according to McAdam. Because the number of post-polio patients with these symptoms has steadily increased, physicians have begun co realize chat polio may indeed have effects that linger well after a patient's initial onset and rehabilitation. Over the past decade, more physicians and researchers have turned their attention to this syndrome. McAdam began the ECMC clinic in Oc- SUMMER1989 suffering from post-polio syndrome or poliomyelitis. McAdam stresses that the main objective of the clinic is co help a patient mentally and physically cope with this synd rome; there is no miracle cure . The clinic emphasizes the teaching of energy conservation and establishing functional limits for patients. With correct diagnosis and treatment, there is improved quality of life. "Many patients who come to the clinic are wiped out just from getting out of the car and walking into our office,"McAdam noted. "So what we try to do is help them to function more efficiencly in everyday life." P Frederick McAdam, M.D. tober 1987 with two Department of Rehabilitation compatriots, Carl Granger, M.0., professor, and Byron Hamilton, M.O., Ph.D., clinical associate professor. The clinic is now a division of the Neuromuscular Diseases Clinic and Laboratories of UB. At first, the clinic was held one afternoon a month with two to three patients at the most. However, starting in July, it will take place biweekly (then weekly some time thereafter) so that it can better meet the growing need for special post-polio medical care. "The response to the center has been overwhelming," McAdam noted . Since its establishment, the Post-Polio Clinic of Western New York has remained the on ly facility in the area which provides both clinical care and valuable research for people rescribed treatments vary with each patient . While in Bauld's case a vitamin deficiency was recognized, vitamin supplements aren't a common aid. Anaerobic and stretching exercises also vary with a patient's co nditi on and needs. The specialises at the clinic may even recommend orth otic devices - canes, braces, and walkers - to help conserve the energy of the patient . There is already a lengthy waiting list for treatment at the center. It is difficult co handle the high demand because the initial evaluation and treatment is so time consuming and labor intensive . A physiatrisc, neurologist, clinical nurse specialist, physical therapist, occupational therapist, and social worker may all work together on a single case. Once a patient contacts the Pose-Polio Center, a questionnaire is sent asking for the patient's symptoms and medical history. Then McAdam meets with each patient to assess his or her problem using var ious tests, including X-rays, CT scans (computerized tomography), videoflu roscopy (barium swallowing and monitoring), and ocher lab BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �33 Henry Bauld work. Following this, McAdam and his staff establish a specified program for each patient. Most of the time, these programs are designed co endure for the duration of the patient's life. Overall, McAdam is pleased with the clinic's effectiveness and patient satisfaction. "We'remaking a difference in most people's lives, and chat's what's important," McAdam emphasized . McAdam also pointed out chat while one function of the clinic is to help sufferers cope with this debilitating condition, the other function is to gather and evaluate valuable evidence concerning the syndrome . At this time, there is very little known about post- BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST polio an ,d there is no specified cure for the syndrome. The March of Dimes estimates from polio records ,chat there are somewhere in the neighborhood of 500 post-polio sufferers in the West,ern New York area alone. However, McAdam believes there are probably twice chat number because many with this affliction still think it's just aches and pains from old age. This is why educating che pub lic is another important function of the clinic. Donald O'Conner, president of the Polio Survivor Support Group of Western New York, maiintains a symbiotic relationship with McAdams and the Post-Polio Center at ECMC. O'Connor's group helps educate and inform potential patients - as it did with Bauld - of the center's availability. In cum, McAdam recommends that patients join the support group. The condition of most patients affected by post-polio syndrome usually isn't life threatening, says McAdam. However, those patients who had previously been afflicted with Bulbar Polio - polio which affects the diaphragm, incercostal muscles (voluntary muscles between the ribs), or the muscles involved in swallowing - can be affected more seriously by post-polio syndrome. They may experience respiratory disorders and difficulty with breathing which can indeed be life threatening . • SUMMER 1989 �People 34 LEONFARHIJOINS RANKS OFTHEELITE L eon Farhi, chairman of physiology, has been named a distinguished professor by the State University of New York for his years of work in human lung gas exchange and the human circularory system. The prefix of distinguished professor is considered to be the highest academic title in the SUNY system and is held by only about 50 professors. Farhi joins the ranks of poet and literary critic Leslie Fiedler, Gerhard Levy of pharmaceutics, Felix Milgrom of microbiology, Hermann Rahn of physiology, and Eli Ruckenstein of engineering, among others, as UB faculty who are distinguished professors. The honor "recognizes his tremendous contributions to both the scientific world and the University," noted John Naughton, vice president for clinical affairs and dean of UB's medical school. "We feel honored that he was so recognized and it indicates that the efforts he has made and chat the school has made have been recognized." Farhi joined the medical school more than 30 years ago. "I was offered a job here in '58 and have been here ever since; he said with a content smile. "I have always been interested in the heart and the lungs and also in the effect of gravity on the heart and lungs." Sitting in his office, Farhi swiveled in his chair and pointed out the window on his back wall. "See that?" he asked, as he pointed to a cylinder on a circular track, surrounded by a moat of calm water which in turn was circumscribed by a running track. "That's a human centrifuge. We are the only University in the free world ro have one." Farhi explained chat cest subjects sit inside the capsule as it revolves. Centripetal acceleration from the revolution mimics high gravity situations, up to the equivalent of seven times the earth's gravitational field. What Farhi is currently working coward is a June 1990 shuttle launch. He will be studying blood flow in the astronauts before, during, and after their flight. Sound cumber• some? Needles and blood samples sticking out SUMMER 1989 Leon Farhi, M.D. everywhere? Not quite. "We have developed a technique chat allows us to measure the amount of blood the heart pumps out without putting any needles into the subject," he said. Farhi's technique requires the subject co breathe into a bag. "We have developed a sec of mathematical formulas that allow us to use the rate at which CO 2 accumulates in the bag to calculate the amount of blood that brings it there," Farhi said. "If I know how much CO 2 reaches the lungs every minute, I can calculate the amount of blood going through the lungs ." The amount of blood going through the lungs, he said, is the same as the amount that the heart is pumping out. The experiment itself, Farhi ex'])lained,consists of looking at the heart's output under different amounts of stress while the astronauts are in space and comparing that ro their cardiac output on earth both before the flight and after it. "The heart is an organ which is supposed ro regulate itself. In order ro find whether it is acting adequately or not, we look at subjects at different levels of exercise and determine whether cardiac output is appropriate for that level," Farhi said. "We look at the cardiac output as a function of the power output of the subject." The subjects work out on an exercise bicycle hooked up to a power generator. On earth, each subject is tested ro determine maximum power output. In space, they will be tested at 30, 60, and 90 per cent of maximum, he explained. "Out technique looks at an astronaut before flight as a baseline, then follows up on him or her every day in flight, and provides special emphasis after the return to earch; he said. T he problem that Farhi is looking into is known as cardiovascular deconditioning. What it involves is the heart's adjustment to zero gravity and its subsequent readjustment to earth's gravitation. Problems resulting from cardiovascular deconditioning affect the astronauts after they return ro earth. They have to do with the body's ability co return blood ro the heart from its tissues, especially the legs. "Man has developed a mechanism which allows us ro make blood come back against gravity," Farhi said. In space, he explained, there is no gravity and so the body's methods of pulling blood back up from the legs in to the heart are "unlearned." "It's like riding the tiger," Farhi explained. "As long as you keep riding, you're all right." But "if the astronauts stand up without chose mechanisms once they are back on earth, the blood accumulates in the lower part of their bodies. If it's down there, then the heart doesn't pump it back and the brain doesn't get the right amount of blood." BU FFALO PHYSICIAN AND BIO MEDICAL SCIENTIST �People& Research 35 Farhi said chat chis can lead to fainting in asrronaucs after chey return to earch. "That rums out to be a rather important problem for NASA because it amounts to a loss of che inborn ability to cope with the effects of gravity." Five astronauts, three payload specialises, and two mission specialises have been training for this flight since 1984, when they visited UB to gee a chance to use Farhi's equipment. Two of che payload specialists and both mission specialists will fly on the summer 1990 flight while che ocher payload specialise will fly at some time in the future. The experiment was supposed co be conducted on a summer 1986 shuttle flight but was postponed, due to che disaster which befell the Challenger, on which UB alumnus Gregory Jarvis was flying. Along with preparing for the NASA flight, Farhi is conducting other lines of inquiry. "We've been involved recently with the problem of rediscriburion of blood in che lung; he explained. "If you have an area of the lungs char is not breaching properly, che body shunts blood away from rhose pares to the healthier parts of the lung."This happens in emphysema and pneumonia, among ocher diseases, Farhi said. The equipment in Farhi's facility was paid for by che Department of Defense almost 20 years ago. Besides the centrifuge, which is used for studying the effects of gravity and pressure on man, there is a swimming tank chat is used co investigate man's reaction co temperature. Near the centrifuge and swimming tank, there is a diving tank which is being used by Claes Lundgren, also of physiology, co study the consequences of pressure on man. "ln the late '60s; Farhi said, "the Depart· ment of Defense decided it would be a good idea if there were a few centers across the country char could be mobilized in case of a national emergency. Thar was Project Themis. "Our project was environmental physiology. We proposed to study how various environ menta I factors, such as gravity, temperature, pressure, oxygen levels, etc., affect man and his performance." He said che only Defense Department in- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST volvement was to help scare the program. The agency provided the start-up coses for the facility so chat in case of national emergency, the Defense Department would be able to turn co Farhi's group for specialized research. lnicially, he had a grant with the Air Force. Currently, he is being supported by the National Heart and Lung Institute. Farhi said he has never done classified research. Farhi's well-traveled career has carried him far from his native Cairo, Egypt. He attended college and medical school in Beirut, Lebanon. He was a postdoctoral fellow at the Trudeau Sanacorium, in Trudeau, N.Y.. 1952-53; che University of Rochester department of physiology, 1953-54, and the Johns Hopkins University, 1954-55. Farhi was also an instructor at the Hebrew Universicy-Hadassah Medical Center in Jerusalem immediately before arriving in Buffalo. In 1983, Farhi was named the Western New York Heart Association "Man of the Year" and in 1978 received the medical school's Stockcon Kimball Award for teaching, research, and service. Chairman of physiology since 1982, he was recently appointed co his third term. • - By David M. Snyderman DETEOING 'SILENT' AILMENTS IN INFANTS R outine ultrasound screening of infants could lead co earlier diagnosis and treatment of significant, yet "silent; urinary tract problems in more than 47,000 infants born annually in the U.S., according co researchers at UB. The projection is based on the investigators' identification by ultrasound of significant kidney problems in six of a group of 437 apparently healthy infants participating in a study reported in Pediatrics. The UB researchers said chat if ocher studies show similar results, the medical profession should consider recommending chat che use of ultrasound co check infants for urinary trace problems become a routine pediatric screening procedure. The cost of the rest, which can be done in less than IO minutes, is about $35. The researchers, led by Jacob M. Steinhart, M.D., UB clinical associate professor of pediatrics, turned co ultrasound to dececc a group of problems chat account for the highest incidence of human birch defects. An estimated IOper cent of all humans are born with some form of genitourinary problem. Despite chac prevalence, the researchers said that in private practice they continued co encounter "significant numbers of children in whom renal disease had escaped diagnosis until an acute illness, perhaps unrelated, prompted investigation of the urinary trace." They added, "\Viedecided co undertake chis study to determine whether it would be feasible and cost effective to screen apparently healthy infants with ultrasound in an effort to diagnose renal abnormalities that might be helped by early treatment." The researchers concluded chat "there are a significant number of infants harboring silent urinary trace abnormalities chat can be dececced by ultrasound at a relatively low cost." Referring co the six infants in whom significant problems were identified, chey added: "le seems likely rhac che monetary cost as well as the morbidity would have been greater had these infants' problems not been diagnosed until they had become infected and/or progressed to varying degrees of renal insufficiency." Referring co the incidence of significant problems of l in 73 in their study, they said "one could extrapolate chat, of the approximately 3.5 million babies born in che Uniced Scates each year, more than 47,000 would have significant urinary tract pathologic conditions." Also participating in che study were Jerald P.Kuhn, M.D., UB professor of radiology and associate professor of pediatrics; Bernard Eisenberg, M.D., clinical associate professor of pediatrics; and three clinical assistant professors of pediatrics: Russell L. Vaughan, M.D., Albert J. Maggioli, M.D., and Thomas F. Cozza, M.D. Kuhn also is head of che Radiology Department at Children's Hospital of Buffalo. • - By Arthur Page SUMMER 19S9 �Classnoces 36 for his efforts on behalf of the care of physically deformed children by organizing voluntary surgical reams willing ro rravel into rural Mexican communities . 1930s Richard C . Batt (M'36) • a retired radiologist, writes, "The past three years of my retirement have been successful as a volunteer in helping to rehabilitate selected brain-damaged patients through computer usage." Bernard St e ll (M '36) • a retired psychiatrist, keep s active by teaching photo amateurs at a community college and by creating phoro slides char bring him honors. "I won an honorable mention ribbon in an internationa l stereo exhibition for my stereogram, 'Thar's My Tongue: Ir is a high-speed sequence (three figures) of a hummingbird in flight with its tongue sticking our. In rhe PSA International Traveling Exhibition, I was awarded a second place ribbon for my srereogram, 'Red Lipped Clown' a 3x magnification of a water droplet with an image of a clown . A water droplet acts like a lens; it projects an image of a clown that is about 12 inches behind the water droplet." Dr. Stell also won, for the second year in a row, first place in the December 1988 contest for the Sun Cities home decorating contest. 1940s Richard J. Buckley, Sr. (M'43) • has recently been elected president of rhe New Voice Club of the Niagara Frontier, a support group for laryngectomees . A lfred S. Evans (M'43) • was elected vice president (president• elect) of the American College of Epidemiology . His busy schedu le includes a paper at a Scientific Conference on Epidemiology in SUMMER IQ89 Ernest A. Fatta (M'63) • of Woodland, Calif., is president of the California Affiliate of rhe American Heart Association for 1988-1989. Richard C. Batt '36 Beijing, China, in April; being a visiting professor ar rhe University of Valencia School of Public Health in Valencia, Spain in June and teaching the Graduate Summer Program in Epidemiology at rhe University of Michigan in July. "In August I will fish." Dr. Evans is the John Rodman Paul Professor of Epidemiology, Emeritus at Yale University. The third edition of Viral fn/eccions of Humans:Epidemiology and Control, (A.S. Evans, Ed.) was published in March by Plenum Press, New York, N.Y. Clifford W. Gates (M'48) • former ch ief of radiology services and chief of outpatient services at the Long Beach Naval Hospital, is retired and living in Fountain Valley, Calif. 1960s Jack C. Fisher (M'62) • has been selected by the San Diego County Medical Society as Physician/Cit izen of the Yca·r. The society cited Dr. Fisher's contributions roward establishing a higher regard for the medical school by community physicians, and also Jeffrey Kahler (M'66) • was recently elected to serve a oneyear term as president of the medical sraff ar Sr. Joseph Hospital, Cheekrowaga, N.Y. Dr. Kahler is rhe director of the hospital's orthopaedic surgery section. 1970s Denni s E. Stemp ien (M'73) • was appointed associate company medical direcror of clinical medicine at the General Electric Company in Fairfield, Conn. Melvin Pohl (M'76) • of St . Louis Park, Minn., is medical director of rhe Pride Institute and co-chairman of AMSAODD' s Third National Forum on AIDS and Chemical Dependency. Barlow S. Lynch (M'77) • has a private urology practice in Washington, D.C.,and is an assistant professor in the Deparrmenr of Urology at George Washington University, Georgetown University, and Howard University. Ira L . Sa lom (M'77 ) • writes, "I am enrolled in rhe J.L. Kellogg Foundation Sponsored Advanced Management Program for Clinicians at the NYU Graduate School of Public Administration." Pete r E. Shields (M'79) • is a fellow of the American Academy of Orthopaedic Surgeons. 1980s Thomas J. Lane (M'81) • writes from Bristol, Conn., that his research interest is in chronic fatigue syndrome. Dr. Lane is an assistant professor of medicine at the Universiry of Connecricut Health Center. Richard L. Co llin s (M'83) • has been named medical director at the Northwest Buffalo Community Hea lth Center, a federally funded medical center for the medically underserved . Kenneth Ja y Ru th (M'83) • writes, "I am in solo pracrice in internal medicine in a San Diego beach community. My practice is growing rapid ly and I'd be most interested in having a fellow UB grad as an associate. Please call (619) 226-4524." His address is 5825 Caminito Del Estio, La Jolla, Calif., 92037. Brian Gale (M'87) • writes, "I am a nuclear medicine resident at the Albert Einstein College of Medicine and will begin a radiology residency at New York Medical College in July 1990. I will marry lawyer Marla Kirsh in Augusr '89." Tina Marie Gardne r (M'87) • writes from Fairfield, Maine, "We moved from New York City to Maine; we love the fresh air and free parking. This program is much berrer too?' Dr . Gardner is a resident physician in the MaineDarr mou rh Family Practice Residency Program at the Kennebec Valley Medica l Center. BUFFALOPHYSICIANAND BIOMEDICAL SCIENTIST ��CAMPUSMAIL 998 MR. CHUNG•KAI HUANG HEALTHSCIENCE LIBRARY ABBOTTHALL CA...,PUSMAIL � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. 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Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/aa8f7d2b89af658c8b73ddbb1e980eae.pdf 37ff1706a44303ab813d74a0693eed5a PDF Text Text Vol. ~J. So. l Autumn 1989 �STAFF EXECUTIVE EDITOR LJJ\:l\'ERSITY Pt..:BLIC"ATIONS Robert T Marlen BUFFALOPHYSICIAN EDITOR Conme Os"ald Stofko ART DIRECTDR Al J. 1-:e er ADVISORY BOARD Dr. John :\aught• · . mnan Dr Harold llroJ,, !\Is. :--;ancy Gh..-co Dr. James Kanska Dr )o<cph L. 1-:un: Dr Charles Pagane1!1 !1,1r.Paul D. Pat«scn Dr Antoinette Pecers Dr. Charles Pru<1 Dr. Lu, her Robon;,:,n Dr. Thomas Rosenthal Dr. Saleda Surcsh Or. Burtl>rl Smgc-rman Dr. Stephen Spaulding Dr Ndsc,n Torre \1r Edward \Ven:ke Dr J1n ,rr Y,r, WRITERS M ,rk \1.ir ,~ [; [)· J !1,1.';urllcrman ILLUSTRATOR L H. PHOTOGRAPHERS ~ancr J. Paroso DearAlumniandSupporters of the UBmedicalschool: T he 1933-39 academic year was a stellar one for the school's faculty \'i,'c were honored that the SUNY Board of Trustee, and the chancellor singled ouc three faculty memhcrs for special recognition. Dr. Leon Farh1, professor and chairman of phys1ology, was awarded the title of Oiscmgu1shed Professor. This is pcrhap, the most ~igrnficant award char can be given to a SUNY facultv member since its bestowmenc indicates significant achievement in all phases of academic life and extraordinary evaluatiom by peers world-wide. Dr. Murray Ettinger, profc,sor of h1ochemistry, wa, awarded a Discmgutshed Teaching Professorship. :\1urray, an accomplished academician in all re,pe..:ts, has always excelled as a dedicated teacher of medical, dental, and graduate students. His LOmm1rmcnc to teaching is well known and he is fully deserving of thb spcual rccogmrion. The third farnlty mcmher, Dr. Charle, Severin, assoLiatc profc,,or of anatomical science,, was awarded the ChanLellor\ \fedal for excellence in reaching. Chuck Severin has provided superb leadership smce coming to Buffalo, and together with Dr. Farh1 and Dr. Ettinger, is alway, regarded a, among the ,crongest of the fine cadre of teachers and cducators we have in the medkal school. I am sure chat ca..:hof you Join me m congratulating cl1L-se three fo.:ulcymemhcrs 111their indindual and colk'Cnve accomplishments, and in rendering our thanks for their efforts on the schtx)l's hchalt. Simon Tong Bob\\ 1,n___, Li TEACHING HOSPITALS A'SD LIAISO!'.S Bauv.a \r.:•.:r.i.:~ Adm:. -·r . \ 1ed,cnl Center Buffalo General Hosp1tal, M,l, \hau John Naughton, M.D. Vice Pro~sulenr 1nr Clmical Affain Dean, S.hool of .\lediunr and Riomedical \cienc·cs Buffalo Veterans AJmm1strauon !\1cJ,cal Center, John Po,ll, ( h!Jrt·n's Hospotal, Karrn Dr,Ju \u oenk Enc Count-,: \1cd1Cal( t1.c1.:•". \!anon \forwnousb !\lerq Hos~,11al,Ch,.,k Tele«o \l,llard hllmorc Hc,spn ,!, Debo-rahFenn Roswell Park !\1cmoroal lnsraute, Jud,Ru., S1,1ers Hosp11al,D,-nnrs McC.mll) Pmdw:,db-, rh, Dn mon of l,noi-mm Rela "'"" ,n =ocu,uon u, ch ch.-S..hoolf .\l,,du. nc urul Bo•medocal'i.:1ence,.Stace l nn t'NI) of :\,u )O'fk at B1<jjolo. THE! Bl FFALO PHYSICIA:S: A'\D 810~IEDICAL SCIE:S:T!Sr (U:,PS 5>l•ll601 Summer !OS<), \\,lume '\uml--er 2 P bli-.hc.:dfi\'c umt.~ i.1IJt1ual1v: Spring, ~ummcr, Autumn. Earlv \'C.'tnt(!'r, :id L.::ttl• \Xm«r h 1he School oi !l,l,d,une and B1omc.~1cal X1cnces, State l mvcrstty vf ~""' Y.1rkat Buffalo. IH> !\hon S1ree1, Buffalo, ~c"' fork 14214.Third das 1"ulk rosu~e paid at B"ffalo, :--.;ev. York. Send address changes 10 THE BlA'fAIJ..) PHYSICIA'\ A:--.;D BI0!\1EDICAL SCIE:--.;TJ$T,140 CFS. AJJ,1,on, HJ5 !\bm Sir«c Buffalo. New )c,.k 14214 n. Dear FellowAlumni/Alumnae: T he first D1stingu1,hcd Alum nu., ha, hcen chosen hv che Ad Hoc Commim:c for l9SQ, The m1ard will be presented co Dr. Gt•orge \\'. Thorn, cerrnmly a worthy cho1Ce of one whose ,ntcrnanonal reputation ha, brought muLh h,mor to our medical ,,hool. \X'carc msmuting a program for alumni mtcnicws of pm,pcctlve candidates for medical school admission in distant cities, designed for students who find it difficult to come to Buffalo for their 1nterv1e11.\\'ould you be interested in bcmg of ,ervice in vour cit\, 1fsuch a situation arises? f.:indly contact Dr. John Richert at the Alumnt Offi.:e. \\'c would be most grateful for your help. Please mark Apnl 28, 1990 nn your calendar for next vcar\ Spring Clinical Dav and Alumni Reunion \X'i:ckend. Weare planning a great smnulacmg program. :\-1orc about chis later. Through your support, we ha,·e reached an all-ume mcmbcr• ship high ,,f 1,474 ducs-paying mcmhcrs, mcluding 53 Life \kmbcr ,uhscrihers. It is an honor to serve you as president for the 1939-1990term. Please contact us with any problems or suggestions you may have. ~ ~ 0' - Sia.~,,,, Joseph L. Kunz, M.D. President �BUFFAID \ ol. 21, ~ o. 3 PW-§!~l6N l Autumn 19t!9 Features II ~ ~r/4 The history of trauma care, Page 18 IJ Notjustbecauseit's there.Growing up in the shadow of the Alb orz Mountains in Tehran, Fero Sadeghian, M.0., developed an early interest in mountain climbing that lasted throughout his adult years. He climb s not "just because it's there;' but because of the challenge. "It becomes us against the mountain." His mo st recent challenge: the remote and trea cherous east face of Mt. Everest . Likerubbingsnowon frost bite. A popular treatment for "acute mountain sickness" may actually make matters worse, according to John Krasney, professor of physiology at UB. We'renot hurtinganimals.The scientific community must come together and convey this message to the public: we're not hurting animals, we're saving human lives, medical researchers are told at a campus conference. Mountain medicine, Page 10 Departments MedicalSchool News. From rags to stitches: John Border gives a history of trauma care in the 1989 Stockton Kimball Lecture. School graduates its 143rd class. Pull out all the stops in treating patients, a noted pediatri c surgeon advises. 143rd commencement, Page 20 ■ Specialsection. Meet the Class of 1993 - a directory of this year's incoming class begins after page 24. Thi s year's reunion classes generously pledgFDedAlumni. a total of $102,220. All IOclasses sat for portraits that are featured on pages 26-29. Mountain cl1mbmg, Page 2 �2 Fero Sadeghian to mountain the beauty By MARK is drawn climbing by & challenge MARABELLA up in the shadow of the Alborz Mountains in Tehran, Fero Sadeghian, M.D., 53, developed an early interest in mountain climbing that lasted throughout his adult years. Sadeghian, a clinical assistant professor of surgery at UB, has climbed the Alborz Mountains in Iran, Mont Blanc in France, Kilimanjaroin Africa, Growing AUTUMN IQ89 ~.- the Andes in South America, and even a small peak on the southwest face of the legendary Mount Everest - the highest mountain in the world. Unnamed peak In Himalaya chain. However, Sadeghian's highest and BUFFALO PHYSICIAl-: Al-:D BIOMEDICAL SCIEl-:TIST �most exciting climb u·as in Ma)·, 1988, when he revmted Eierest and climbed its remote and treacherouseast face. There, completelyby chance,he met up with another smaller expedition that BUl+Al.O PHYSICIAN AND lllOMl·DICAI. 5'( ll:1'TIST u·as one of only tu:oexpeditions in his, tor)' to reach Everest'ssummit by way of the eastface. Sadeghian'smedicalex, pcrtise played a key role in the safe return of these historic climbers. Photos: Fero Sade&hlan ,\l l l \11" 1•1~<1 �(From top to bottom) Potala, The once the home of the Dalai lama; climbers three the drove days before transferrin g equipment to yaks ; frostbitten foot of a member of the Americ a n / British expedition a a . a • wile Sadeghian himself did nor set out to attain Everest's summit of 29,028 feet, he trekked ro the h ighest altitude in his climbing career-22,000 feet . Th e callesr peaks Sadeghian had previously visited ranged from 15,000 to 19,500 feet. (The Hima layas are so high chat peaks be low 24,000 feet don't even gee named there .) "To attempt the peak of Everest, a climber must devote a great deal of time co its pur:-uit . It may even be the culmination of a lifetime of preparation;· Sadeghian asserted . "I wish I cou ld make an actcmpt, but I'm a surgeon by profession and find it difficult co make time for ~uch a \'Cnture. Bl FFALO PHY:c-lCIA:S: A'D Bl0~1EDICAL SCIE:S:TIST �5 "Bue still, I've always found mountain climbing co be an exhi larating way co recharge one's batterv from the day-to-day monotony that everyone muse endure;' he observed. "The attraction is not merely because 'It is there'. The mountain attracts a certain breed of people those who seek natural beauty chat is both isolating and challenging. There is a unifying camaraderie among mountain climbers that transcends race, religion, and politics . le becomes us against the mountain ." Certainly, Everest - called Chomolungma hy the locals, meaning "Goddess Mocher of the Earth" BL"FFAL.0PHYSICIA:-.:A:--:O BI0:'-1EDICAL SCIE:-;TJST - represents what Sadeghian seeks in his mountain pilgrimages. Everest separates Nepal from Tihet and has three faces: north, cast, and southwest. The southwest face can be seen from Nepal and is the conventional way of climbing Everest . This face was the first path co the summit con4ucred by the New Zcalander Sir Edmund Hillary, with the Tibetan Sherpa, Tenzing Norgay, in 1953. In 1975, Sadeghian climbed co Everest's southwc!:>t base camp with a small group t h at inc.lude<l two other individuals from UB's medical school - David Greene, M .D., professor emeritus Members of Sadeghi a n's group with members of the American /Brit­ ish expedition. Sadeghlan is third from right. no ace• �of medicine, and Winfield Butsch, M.D., clinical professor emeritus of surgery. Sadeghian always dreamed of one day revisiting Everest. "On my previous climb of Everest my group went through Nepal (where the southwest face base camp is located). But this route has become coo commercialized, busy, and Lrowded," he recalled. The north and case faces are approachable only through Tibet and attempts along chese routes have been scarce. "The cast face base camp in Tibet is more remote and less traveled and I always wanted to sec Tibet," Sadeghian said. "fur many decades the ease face was closed because of poor political conditions in Tibet due to its relations with the Chinese; now with what has recentlv happened in China it is unlikely anyone will be climbing there for some time to come:' The east face provides a significant challenge because it takes days of trekking over high passes to reach its isolated base camp. Sadeghian's month-long trip co Tibet, highlighted by his three-week ascent on Everest's case face, was the culmination of many months of preparation. Sadeghian first contacted the Mountain Travel organi:arion m Albany, Calif., eight months before rhe trip to express his interest in dimbing Everest. The organization then assembled a group of nine climbers who expressed the same interest, secured the necessary mountain climbing permits from the Chinese government, and provided the group with the supplies needed to trek in the Himalayas. All expenses were paid by the climbers. Six months before the climb, Sadcghian started a rigorous workout schedule running six miles, four times a week, with aerobic exercises in between, to im:rease his !'-trengrh and stamina for the challenge of Everest. Sadeghian was appointed the phy~ician for the group and was responsible for carrving antibiotics, sutures, bandages, pain medicine (morphine and Demerol), intravenous and ~urg1calequipment, and a supply of oxygen. He was 101ned by his friend, Nas Efrckhar, M.D., an orthopaedk surgeon at Columbia University. The group of nine was forrunate because it is rare to have two doctors on such a small expedition. 6 Sadeghian and Eftekhar fle\\ into Beijing, China, where they mer the other people with whom they would spend the next four weeb. The appointed leader of the climb was Bruce Klepinger, a full-ume mountaineer. Other members of the group included SI-year-old Jeffrey Davis from Canada; 47-year-old Steven Ncgler, a retired U.S. Air Force officer from Urah; 57-year-old Peter Anson from Minneapolis; 32-year-old Minnie Chin from California, and John and Carol Goodman, AUTUMI\ IY84 married and in their early 20s, from Texas. From Beijing, the climbers spent several days driving over narrow dirt roads along steep valleys and climbing up 17,000-foot passes before they reached Shigacse, the Tibetan town located closest to the east face of Everest. There they transferred their equipment from their truck and three jeeps onto the backs of 17 yaks. Each yak was loaded with approximately 150 to 200 pounds of equipment. The equipment included five double tents, three larger rents, gas-burning stoves and lanterns, and plenty of canned food. Here they were joined by five Sherpas who were in charge of the yaks. Sherpas are Himalayan residents who, due to their climbing experience, are hired to carry supplies and assist rhe climbers on their trek. The group was also joined by several Chinese who were hired co cook, guide, and maintain an established base camp. The mix of the English, Chinese, and Tibetan languages proved cumbersome. The translator for rhe Tibetans was Mr. Chin, a well-respected mountaineer who had been a member of a Chinese expedition to Everest and had lose part of his nose and right hand to frostbite. Another man, named Mr. Jin, translated for the English-speaking climbers. To communicate with the Tibetan yak drivers, the climbers spoke m English co Mr. Jin, who spoke Chinese to Mr. Chin, who spoke Tibetan to the yak drivers. The group traveled by yak for nine days and set up a base camp. Then, carrying 35-pound day packs, they set out to ascend Kangshung Glacier. Climbing along lateral moraines, where an immense glacier had deposited large amounts of rock and debris from its gradual movement down the moumian, Sadeghian and the others could see and hear the thunderous avalanches of the east face. The cast face of Everest is accessible only through the Kama Valley, near Shigatse, which is ,urrounded by mountain passes averaging 18,000 feet. The terrain varies significantly. At lower almudes, it's lush green dotted with wild roses, rail poinsettia bushes, and turquoise lakes. However, the terrain near the passes is cold. barren, and snow covered. When they had climbed to approximately 20,000 feet, the group split up. Five of the climbers, who chose to rest their weary lungs and muscles, visited a base camp char was established for the group that reached the cop. Sadeghian and three others continued climbing until they reached a rocky spur at 22,000 feet. Herc Sadeghian's small group rested for some rime and gazed at the impressive Everest, raking rare photos from che ease face. BCFFALO PHYSICIAK Al\D BIOMEDICAL SCIE:-.:TIST �7 l \ " "These mountain climbing trips always bring tremendous pleasure for me," Sadeghian reflected with a smile. "Not only is the natural scenery and landscape unparalleled, but the variety of people one meets is always so diverse. "During the day we share the dangers, frustrations, and unpredictabilities of the climb," he continued, "and at night around the fire we discuss the day's events and plan the next day's goals. This is the best part of the trip because it brings everyone together like a family." Meanwhile, the other half of Sadeghian's group at the American/British base camp discovered several climbers who were in desperately feeble condition. "What happened was that these climbers got stuck near the top without oxygen, food, or tents," explained Sadeghian. "They were unable to return to their base camp at first because the weather and their weakened reflexes prevented a speedy descent~ Returning from the small peak, Sadeghian's group joined the other climbers at the American/British base camp. It was here that Sadeghian first met the American/British group that managed co put one man on the top without rhe use of oxygen. Only 15 individuals have ever managed to go to the top without oxygen and none before had accomBUFFAI.D PHYSICIAN AND BIOMEDICAL SCIENTIST (From top to bottom) Sadeghian and companions received warm welcomes from natives; Sadeghlan in front of Rongbuk monastery near the north face of Everest; Camp Frost on the way to Everest. a es a s a AUTUMN l'l!\9 �8 (Top) Framed against the Himalayan peaks, the 1,000 •room Potala r ises 1,000 feet above the valley and can be se e n for miles; (bottom ) Sadeghi an watches drivers dinner . yak cook plished ic from che treacherous Getting to the Everest summit face had been accomplished only \\'as done by an American group \'arJ in 1983. east face. by way of the east once before. That led by Andy Har- In chc 1988 attempt, the man who reached the top, Stc\'C Venables of Britain, made headlines across Europe as the first European to reach rhe summit from the cast face. And he accomplished his feat on the 35th anniversary of Hillary's ascent. But the attempt was not without its coses. All of the climbers suffered frostbite to a \'arving degree. One of them, Ed Webster, described his group's traumatic events in a Januarv 1989 Sportsllluscraied arricle. \X'cbster was malnourished, extremely dehydrated, dcmorali:cd, and consramly in tears. He was abo suffering from severe frostbite with black toes and fingers . Another climber, Robert Anderson, was also suffering from frostbite on his fingers and toes, but co a lesser degree. Venables, who reached the top, suffered severe frostbice on his toes and nose. For several hours, Sadcghian and Eftekhar cared the best they could for the climbers' injuries, us- ing medications and bandages chat Sadeghian was rnrrying on his back. "\X'hac they really needed more than anything else;• explained Sadeghian, "were some words of reassuran<.e and some idea as to what to expect as far as prognosis was concerned. At the time, I choughc chac they mighc lose portions of their fingers, toes, and nose, buc I tried co remain as positive as I possibly could." Both Webscer and Venables had to be carried down the rest of the mountain by cheir Sherpas on improvised litters. \X1hen they returned to the BLFFAI.() PHYSICIA;\ A:S:D 810.\tEDICAL SCIE:--:TIST �(Top to bottom) Tibetans friendly are and maintain serene a nature ; 9 two Sherpa children whom the climbers encountered in the T ibetan / Everest region; John Goodman (foreground) Sadeghian the foothills and In of the Himalayas. ed very little, if any, medical treatment. Only a few of the climbers suffered from cerebral edema and required some oxygen, which is no rmal." Sadeghian and his group returned safely down the mountain, hiking over to the north face upon their descent. From the north face the group traveled to Nepal, abandoning their yaks for some wheels before eventually flying back ro the States . One precious souvenir that Sadeghian brought back from h is trek on Everest was a note, written by Miriam Zieman, the medica l advisor from the American/British camp. It was sent to Sadeghian's camp via a Chinese runner and gave thanks for the surgeon's treatment . "May 20t h- 8:00 p.m. - Everest base ca mp " "Endless thanks for your support and encouragement today . It was quite an unbelievable vision to see your companions this morning after three months of isolated company, but to find out that two surgeons were on thei r way down (from a peak just above our base camp) was very reassuring for both the climbers and myself. "It was very gene rous of you to help and advise me. T he past few days were exasperating and it was a great relief for me to have you here . Needless to say, the climbers enjoyed your care and expertise and felt better after your consulta tion." United States, Webster had ro have all the fingertips on his left hand amputated, as well as three on his right hand and pares of three roes on his left foot. Venables lost three and a half toes on his left foot . "Fortunately," noted Sadeghian, "my group need- BUFFALO PHYSICIA1' AND BIOMEDICAL SCIENTIST "One thing I enjoy about being a physician," Sadcghian commenced, "is that, regardless of politics or language barriers, doctors are always well received by people . Closed doors always are opened for physicians." • ALJfUMN 1989 ��LIKE RUBBING SNOW FRO! i I BITE ~ ~ ON By CONNIE OSWALD S1DFKO ike rubbing snow on frostbite, a popular treatment for "acute mountain sickness" may actually make matters worse, according to John Krasney, Ph.D., professor of physiology at UB. Acute mouncain sickness affects lowlanders who travel to high altitudes where the air is thinner. "The symptoms are terrible," said Krasney, who suffered from the condition when he attended a conference in Snowmass, Col., which is 11,000feet above sea level. Acute mountain sickness is marked by a severe headache, along with nausea, irritability, lethargy, severe fatigue, and trouble eating and sleeping. In the past few years, mountaineers have been teaching climbers to treat the condition by breathing into a paper bag . But that makes matters worse and could actually prove lethal, Krasney contends . His findings are important as more and more people ski and hike at high altitudes. Bur, Krasney emphasized, his research also has implications for peop le with heart and lung diseases that inhibit oxygen intake. The idea of breathing into a paper bag has been promoted by neurologist Marcus Raichle of Washington University in St. Louis. Both Raichle and Krasney agree that the trigger for acute mountain sickness is a decrease in the oxygen supply to the b rain. Raichle contends that breathing into a paper bag increases the person's intake of carbon dioxide, which dilates (widens) the blood vessels in the brain. That allows more blood flow, and therefore, more oxygen, to reach the brain. But this dilation of blood vessels is the problem, not a solution, Krasney explained in a paper presented earlier this year during a symposium sponsored by the International Society for Mountain Medicine in Lake Louise, Alberta . ILLU Bl.:FFALO PHYSICIAN AND BIOMEDICAL SCIENTIST S TRATION S: LI SA H A N EY II �THE MESSAGE FOR PERSONS PLANNING This dilation of blood vessels in the brain ele,·ates pressure in the capillaries (the tiny blood 12 vessels that connect larger blood vessels to tissues). That causes a mild form of high altitude cerebral edema - the brain tissues fill with fluid. "Our data says there's already roo much vasodilation" caused by rhe low oxygen level at high altitude, Krasney explained. "If you increase carbon dioxide, you make the situation worse. "Normally, when you go to a high altitude, you hyperventilate. You bring in more oxygen and exhale more carbon dioxide. Thar's a normal response. And we think that has something to do with the eventual resolution of mountain sickness - we think it's the decline of carbon dioxide'.' Krasney says he's upset that Raichlc didn't publish his data in scientific journals before his theory was presented in lay magazines such as Discover. "I think it's a good example of something that could be very dangerous getting into the popular literature." Krasncy said. While acute mountain sickness is a condition that has plagued man for centuries (Marco Polo described traveling over the "Big Headache Mountains" in China), we haven't made much progress in treating it. Theoretically, administering oxygen should help, but it doesn't help immediately, Krasney noted. One option is to simply let the condition run its course. Without treatment, most people recover from acute mountain sickness in a few days or weeks as they become acclimati:cd to the high altitude. However, the condition can develop into a lethal form of high altitude cerebral edema or high altitude pulmonary edema. Then the only thing that can be done is to get the patient to a lower altitude. One treatment that mountaineers arc trying now is the Gamow Bag, named after Igor Gamow of the University of Colorado. The patient's entire body from head co toe is placed in the portable fabric bag, making him resemble a mummy. Then the bag is inflated using a foot pump. Thar increases the pressure in the bag, which increases the oxygen saturation. In many cases, the oxygen saturation is increased enough to begin resolving the edema, Krasney said. It's easier to prevent acute mountain sickness than to treat it. The symptoms are brought on by the failure of people to acclimatize themselves properly to high altitudes, Krasney explained. Once a person reache~ 10,000 feet, he should take a full day to ascend another 3,000 feet. AL'Tl,MN ICl8Q GO TO TO HIGH ALTITUOES IS THAT THEY SHOULOTAKE CARE TO ACCLIMATIZE PROPERLY ANO GO SLOWLY. UP (By comparison, skiing areas in Western New York arc only about 900 feet above sea level.) The minimum altitude to get acute mountain sickness is 8,000 feet - that's the height of Mexico City. The condition can be lethal at 9,000 feet, Krasney noted. Some people with underlying lung problems could probably experience symptoms in Denver, which is only a mile high. He also pointed our that the cabin in a jet aircraft isn't pressuri:ed to sea level, only to the equivalent of 7,000 or 8,000 feet. So passengers arc mildly hypoxic, that is, their tissues aren't getting enough oxygen. "So if you get a headache flying from Buffalo to California, there might be more reasons for 1t than the wine you drank;' Krasney said. "Thar's another aspect - acute mountain sickness or hypoxia can really intensify the effects of alcohol. If skiers make the bar the first stop, they can be quite violencly ill." Exercise can also exacerbate the condition, Krasney and his colleagues believe, because circulation is severely altered at high altitudes. As blood pressure goes up, it may produce an undesirable increa~e in brain blood flow, which causes a marked elevation of pressure in capillaries. Thar can cause a rupture in the blood-brain barrier. "The message for persons contemplating going to high altitudes is char they should rake care to acclimatize properly and go up slowly; Krasney said. "If they can't, they should certainly take ir easy for the first few days at altitude." Certain drugs to prevent acute mountain sickness can be taken before traveling to a high altitude. The standard drug is acctazoleamide, which is distributed under the brand name Oiamox, Krasney explained. Ir works well if taken four to five days before going ro a high altitude, and helps to a variable extent after symproms have developed. "No one has any idea how Oiamox works; he added. Another drug, a steroid called dexamethosone, can also be effective when used prophylaccically. The problem with dexamethosone is chat if you lose your pills or stop raking chem, the symptoms of acute mountain sickness can be amplified in a nasty way. How these drugs work and what ocher therapies could he useful are other areas the UB researchers wane to investigate. "Clearly, anything we develop here is going to have tremendous benefits for people with lung disease who suffer from oxygen lack at sea level; Krasney said. BL,FFALD PHYSICIAJ\. A1'D BIOMEDICAL SCIE:-..TJST .. �TMIS KINOOF RESEARCH FALLS UNCER A BRANCH OF MEDICINE .. CALLEO 'MOUNTAIN MEOICINEt THAT ONLY FIVE YEARS CLO. his kind of research falls under a branch of medicine called "mountain medicine" chat's only about five years old, Krasney said. It looks ac physiological problems caused by high altitude. Krasney performed his research with Douglas Curran-Everett, who was a Ph.D. student at UB and is now at the University of Colorado, and Jun Iwamoto, M.D., Ph.D., a Japanese neonatologisc who is working at UB on a Buswell Fellowship. Iwamoto is from the University of Occupational and Environmental Health in Kitakyushu, which has become one of UB's sister institutions. The reseachers conducted a fairly simple experiment. Sheep were placed in a low-oxygen chamber for four days, which produces the effects of being at high altitude - comparable to about 15,000feet. The real stress of being at high altitudes is the lack of oxygen, not the low pressure, Krasney believes, so using a cumbersome low-pressure chamber with air locks isn't necessary. This experiment lasted much longer than those conducted by ocher researchers which subjected animals or people to low oxygen levels for only an hour or two. The longer time span enabled the UB researchers to better follow che course of the sickness, which generally cakes a few hours co develop, Krasney noted. In the experiment, the researchers used radiolabeled microsphercs - tiny plastic beads only IS microns in diameter. These beads were injected into the left ventricle of the sheep's heart where they mixed with the blood and were d1stributec.l throughout the body in proportion to [i BvFFALO PHYSICIAN AND BIOMEDICAL SCIEl'-'TlST IS ABOUT the blood flow. This is a very high-resolution indicator of the blood flow co a region, in this case, the brain. "In fact, radiolabeled microsphem, have become the 'gold standard' for the measurement of cerebral blood flow,"Krasney explained. "This is the method against which everybody judges the more indirect clinical methods." After four days, the sheep brain was removed and studied. The researchers found signs of cerebral edema. "It appears that edema 1smore prominent in the white matter, but we don't know why; Krasney added. Now that they've studied high altitude cerebral edema, the investigators plan to look at the related problem of high altitude pulmonary edema, where the lung tissue fills with water. The UB researchers also plan to continue collaborations with researcher,. in other parts of the country. They've worked with a group of Army per· sonnel at Triplcr Medical Center in Hawaii who have a lab at 14,000feet on Mauna Kea, an extinct volcano that offers the only snow skiing in Hawaii. The Army is interested in acute mountain sickness because when two armies are fighting at high altitudes, the one that gets acute mountain sickness is the one that loses, Krasney pointed out. Much of the clinical data we have today came from the 1967 Indian-Chinese War. The sickness devastated the Chinese Army during battles in Tiber. Krasney also has startcJ a collaboration with Peter Hackett, M.D., of Anchorage. An emergency critical care physician and a mountain climber, Hackett was one of the two physicians who attained the summit of Mount Everest in 1981with the American Medical Research Expedition. Hackett has established a laboratory at 14,000 feet on the west buttress of Mount McKinley or Denali, which they prefer to call it. "It's probably one of the more hostile environments on che planer;• Krasney noted. Crevasses suddenly open up and people disappear. Hackett and his colleagues have sec up an emergency aid station during the climbing season. Climbing has become so popular, probably 1,000 climbers a year try to get to the summit. A great number will get quite ill and have to be treated or evacuated. They've been able to try some innovative therapies - the climbers are not only ill, but they make very useful research subjects, Krasney pointed out. Control stuJics done at sea level in Buffalo will AUTUMN l'l!N 13 �be coupled with high-altitude studies on Denali, 1-l which has a very well equipped laboratory. This winter, Krasney will cake a course in ice climbing and winter mountaineering in order co go up on the mountain himself. "My interest is co work with the human patients who are suffering from acute mountain sickness and high altitude cerebral edema. I wane to gee some further insights co cake back co the laboratory and attempt to work out the more fundamental issues in experimental animals," Krasney said. "Ir's a nice example of how we can go back and forth from the experimental animal laboratory to the field situation where people arc actually suffering." • Environmental Research Unites The Several Disciplines in Physiology //'An interest in abnormal environments unites the different disciplines in the Department of Physiology," said Leon Farhi, M.D., distinguished professor and chairman of physiology. "Environmental research has always been the core of the department." The researchers wane to know how biological systems reacr co extremes in gravity, temperature, air pressure, and gas density. This research is applied to a wide range of interests, including circulatory and lung disease in newborns, space travel, and deep sea diving. The work goes back co World War II and the respiratory studies of Hermann Rahn, distinguished professor of physiology who is known as one of the fathers of aerospace medicine. He and his colleagues clamped themselves into low-pressure chambers to conduce experiments that had direct application to fighter pilots. "Almost the entire subject of respiratory physiology came out of chose very early studies," noted John Krasney, Ph.D., professor of physiology at UB. "So, in a way, we're still studying things that Dr. Rahn began investigating 40 years ago." In the 1960s, UB was selecred as the site for a federal center of excellence in special environments. The government decided to set up a number of these centers in varied fields such as biology, linguistics, and mathematics. Ir grew out of a desire co enhance the country's research potential in case of an emergency, said Farhi. The government had learned a lesson during AUTUM:--:198Q World War 11,he explained. When the military had co land troops in North Africa, it was discovered that nobody knew how the desert affects humans, nor did anyone know where to find the experts who could study the problem. The centers of excellence were set up with no specific mission - they would simply be available if needed. Teamwork was co be a key element of the centers and UB had already assembled experts in altitude and gravity, temperature regulation, diving, and other fields. With the center "we got a nice pot of money for equipment," Farhi added. "It paid for the big BLiFFALOPHYSICIA:>:A:>:DBIOMEDICALSCIE:>:TIST �ments ar UB came in 1985 when rhe University established an interdisciplinary research center. The Center for Research in Special Environments serves as a resource for researchers in academia and industry who need equipment, technical support, and access ro scientists in environmental physiology and human engineering, explained Claes Lundgren, M.D., Ph.D., professor of physiology and director of the center. "Imagine how difficult it would be if a researcher needed to conduct an experiment with a highgravity load and didn't have rhe equipment," said Lundgren. Nor many agencies are willing ro give a grant for a $5 million centrifuge or a $2.5 million pressure chamber, he noted. And who would have the rime co plan and build rhe equipment, then hire and train personnel? "We're here and available; Lundgren said. The maker of a diagnostic device for eye disease is one company that took advantage of the center's services. It had to test the device to ensure it would function at high altitudes, such as in Denver. The center is working on several projects for the aerospace industry, Lundgren said. It's looking at ways to protect crews against high-gravity loads, such as when a plane makes a sharp turn. Another project looks at the body's reaction to explosive decompression, which could occur when a cargo door blows off. Still another project with local industry involves a mathematical model for a pressure regulator valve that has applications for pilots. Other experiments examine ways to prevent .....decompression sickness, better known as "the bends;" how to swim using a minimum of energy, and how to build a better breathing apparatus for §it use underwater or in hostile gaseous environments. To aid this research, UB's equipment has been improved, Lundgren noted. The deans of the schools of medicine and engineering gave a $250,000 grant for a technical upgrading of the saturation diving system that allows people to live in the pressure chamber for extended periods. Through a grant from the medical school, the pool was clad with stainless steel to reduce upkeep. An upgrading of the human centrifuge from a capability of 7G to 9G or more is expected to be completed this fall. "There have been a lot of improvements to the equipment, reflecting the commitment of the University to this unique facility; Lundgren noted.• I j pressure chamber, the human centrifuge, the swimming tank, and lots of lab equipment." The equipment is housed in the Hermann Rahn Laboratory on UB's South Campus. Once the government provided the equipment, the researchers were on their own to support their research. They've gotten grants from NASA, the Air Force, the Navy, and the National lnstitures of Health. (No classified research may be done at UB.) As well as lab work, field expeditions have been conducted underwater in Korea and Australia, as well as high on mountaintops in the Alps. Another boost to the study of special environ- BL'FFALO PHYSICIAN Als:D BIOMEDICAL SCIENTIST CLAES LUNDGREN DIRECTOR THE FOR IS CF CENTER RESEARCH IN SPECIAL ENVIRON­ MENTS. -B, Connie Oswald Scofko AUTUMN 1989 15 �' l6 ~Y lonni~ ~~wal~ ~rntko he scientific community must band together and convey this message to the public: we're not hurting animals, we're saving human lives. That was one of the points brought out during a day-long $UNY-wide conference on animal rights held at UB in June. The conference was attended by public relations staff, researchers, veterinarians, and administrators from several SUNY campuses and Buffalo hospitals. John Deats, director of public relations at New York University, told the group that when one researcher at NYU was targeted in protest by an animal rights group, the whole university got involved with the matter. At NYU, "we developed a consensus among the faculty: no researcher can stand alone," he said. Deats also emphasized that universities must open their labs - not to animal rights activists, but to representatives of the public, that is, to the media. That suggestion was echoed by Charles (Bud) Middleton, director of the Division of Lab Animal Resources at Stony Brook. It's important to show that the animals are perceiving no pain and that there is a compelling reason for the ~ research, he explained. "But you can't give a partial tour," he warned. "It has to be all or none." The problem with opening all of the labs is that a number of investigators have received death threats, Middleton noted. They fear for their safety and the safety of their families, as well as for the animals and University property. At Cornell, one researcher was the target of months of protests, said Fred Quimby, director of the Center for Research Animals at Cornell. One day she received a phone call ac l a.m. in which an unidentified caller told her char if she didn't drop her research with cats, he would kill her children and kill her. The next morning she dropped her work. Cornell wants to make sure that doesn't happen to one of its researchers again, Quimby said. It has developed a "proactive" faculty committee to stress che point that animal research has greatly benefited both human and animal health. The panel involves representatives from research, teaching, wildlife conservation, and agriculture. "I think this lies at the crux of what we all have to do," he said. "The time of looking at che issues as they relate to our use of animals, with a narrow focus on • AUTUMN 1989 BL'FFALOPHYSICIA:-S A),.;DBIOMEDICALSCIE:-.:TIST �- ~ Q z 0 ::E vi 17 § .i Charles (Bud) Middleton, director of the Division of Lab Animal Resources at Stony Brook, says that it's important to show that the animals are perceiving no pain and that there is a compelling reason for the research. education or research is over. "Standing alone is the way that we're going to be split up and the way that eventually we'll lose this battle. I, for one, feel that we all have the same vested interest and we're all going to approach this in a solidified manner." SUNY is bringing its researchers and administrators together through a new committee on animal research. The purpose of the committee is to share i,deas among campuses on how to protect' the welfare of animals and how to conform to rapidly changing State and federal regulations. One mission of the committee will be to tell the researchers' side of the story - how animal research helps human BUFFALOPHYSICIAN AND BIOMEDIC AL SCIE:S:TI ST welfare. "We're all interested in animal welfare, but that's different than animal rights; explained SUNY Provost Joseph C. Burke. "Animal rights, if carried to an extreme, would make it difficult or impossible to conduct research on animals. Neither our society nor our University can accept that." • AUTCMN JQS9 �Medical Scudencs 18 From Rags to Stitches John Border gives a history of trauma care By DAVID M. SNYDERMAN .000-year-old . mummy was discovered vith an open fracture (where both km and bone are broken). John ~ Border, M.D., pointed out that there were no signs of healing and rhm rhe broken femur was the cause of death. "This is an ancient problem; explained Border, an expert in trauma care. "The results of trauma care were absolutely dreadful. The mortality rate for any significant injury (penetrating wounds of abdomen or chest, or open fracture of the femur) was 50 to 80 per cent. Those who did survhe were permanently disabled. "This began to change for open fractures !are in World War I but did not change for other injuries until the mid '4(}.; and early '50,. "Since rhen the results of care have progressively improved as our knowledge of rhe basic sciences of physiology, biochemistry, and cell biology has improved." Border is a professor of surgery and orthopaedics and a research professor of biophysics at UB. As the recipient of la,t year's Stockton Kimball Award, he delivered the 1989 Stockton Kimball Lecture ac rhe annual faculty meeting this spring. He acquainted his audience with ~ome of the historical developments in trauma care. Border knows of these improvements firsthand because he has played a large role in developing them. The methods that Border has pioneered have decreased mortalitv rate, length of hospital stays, and the amount of permanent disability in patients treated in this manner. Referred ro as •one of the fathers of modern trauma surgery," Border is an advocate of aggressive treatment of trauma patients, which includes performing surgery immediately. AUTl.'M1': 198<1 "Ir is quite clear that our old belief that rhe average of 1,819 days; Border said. In addipatient was too sick to he operated on the tion, "70-100per cent had some degree of pernight of the inJury was wrong; Border noted. manent disability and 20 per cent of these "Such patients get sicker with the passage of were so disabled they never worked again." Today, a simple femur fracture usually rime. They do not get better. They need comcauses three to six months of lose \\'Ork and plete surgical care the night of the injury to help them get rapidly better." no significant permanent disability. Border, who is the director of the trauma "This is a dramatic reduction m time even service at Enc Countv Medical Center from rhe '60s and '70s; according ro Border. (ECMC), reccntlv received the Roswell Park owever, as damaging as \\'Ounds were to Medal from rhe Buffalo Surgical Society and soldiers, there was a \\'Orse enemy stalkwas honored by ECMC for his contributions mg the fighters on the field of battle. co trauma care. "The major problem, in all armies, was nor Border drew the material for hi, lecture death from wounds," Border explained. "The from his new book titled Blum :--111/tiplemaJor problem was dcarh from disease. For Trauma: Comprehensite Paihoph,·s1olog;; and every soldier in rhe American Civil War who Care.Ir is a guide ro the understanding and died of wounds, cwo died of disease. These treatment of blunt multiple trauma cases, for were communicable diseases of childhood, rhe instance, auto accidents. diseases of filth, and problems such as H Border said that for hundreds of years up through part of World War I, open fractures were treated by amputation. In fact, the army field hospitals "were usually marked by huge piles of amputated limbs and dead bodies." As a result, he said, rhc hospitals "were usually quite easy to find." The amputations \\'ere performed in under three mmuces and required up ro six strong men to restrain the patient. The military surgt.'OnDominique-Jean Larrey "at the Barrie of Borodino did 200 amputations m 24 hours," Border noted. \Vhen patients managed co keep borh their li\'es and limbs, "they lost years our of work" and , for the most part, "were permanenrlv and severe!y disabled; he said. "According to Lorenz Bohler (a modern surgeon who "'as an expert m the treatment of fractures), prior to World War I a simple femur fracture kept you out of work an malaria." In fact, it was nor until World War I that disease and wounds had similar mortality rates and not until World War II that wounds passed disease as a cause of death. "These ad\'ances depended on vaccination, ~anitation, and antibiorics," he said. Border remarked that poor sanitary practices of the day horh in and our of the hospital helped co aggra\'ate the disease situation. Sanitation was, m fact, one of the primary problems of medical care until rh1s century, Border said. Wounds were washed \\'ith pieces of non-sterile doth rinsed in a communal "pus bucker." "These rags came from an international rag marker, or were discarded linens; Border explained. "They were later found co be a major carrier of bacterial disease from place to place." BL'FFAI.OPHYSICIA:>.A:S:DBIO~IEDICALSCIE:S:TIST �Medical Students 19 Conditions in the operanng room were little better, Border said, giving the example of a Viennese surgeon from the last century. "This is Theodor Billroth operating in Vienna," Border said, explaining a particular shde. "Notice no hats, no gowns, no gloves. The huge audience is breaching on the wound." Many of the improvements in sanicac1on can be traced co Florence Nightingale's reform of hospitals during the last half of che 19th century. The care during the Crimean War was so bad and so well publicized that the Briti,h government hired a group of young women to go with Nightingale - these were the fir,c paid nurses. The mortality rate at the hospital where Nightingale worked during the war dropped from -l2 per cent before she arrived to 2 per cent while she was there. She later repeated thb performance at a second hospital. As a result, Border said, Nightingale is credited as the founder of nursing as a profession. One of her decisions, although seeminglv simple, was extremely important. "An absolutely valuable change here," Border said, "was doing the laundry with hoc water. It was not until much later that ic was proved that laundry with cold water did not change the bacterial content at all, whereas laundry with hot water did." Another invaluable change that Nightingale made ro patient care was an insistence on accurate patient records and statistical summanes of the patient care. "One has to give her credit for creating modern scientifk medicine," Border concluded. "Pnor to Florence Nightingale there were no hospital records." 0 ne of the next great advances in surgery and patient care, Border said, was the use of anesthesia. Anesthesia entered the scene in 1846. "Bue no doctors could make a living ac it, so there were very few doctors who gave anesthesia, and the tradition was chat the surgeon called on whatever docror walked down the hall; Border said. "No measurements were made of vital signs or blood loss and no intravenous fluids were given during surgery. try of both toxins and bacteria? This is an enormous change in viewpoint. Granted, the basic hiology involvL-dapplies co most ~ritically ill patients and not just to the trauma patient." The care of trauma patients, Border said, has improved "primarily because of a large amount of basic science research, which allows us co understand metabolism, cardiopulmonary physiology, the whole thing that goes wrong with the trauma patient." Florence Nightingale: she improt·ed hospital sanitation. "There was no real professional anesthesia until World War II. At chat time, the armb trained and designated anesthetists. "There was another very important change at chis time and chat is that the anesthetiM should nor only be an echcrizer buc a rcsuscicacionisc; he noted. "This required an enormous development in biochemistry and physiology to know whar to do. "John D. Stewart, a former professor and chairman at the department of surgery, made the major contribution co chis advance." The latest and probably greate<\Cadvance in trauma care i, the realization that we were looking at the problem of infection complccely wrong, Border said. To fight infection, stronger and more numerous antibiotics were used. Bue because che critical illness and infections came from toxins and bacteria in the gut, annbiotics actually encouraged infection by destroying beneficial bacteria which kept detrimental bacteria in check. This allowed the detrimen• cal bacteria to multiply and enter the rest of the body. "The annbiotics we administered to treat infection undoubtedly caused infection; explained Border. "The correct way of looking at chis problem is undoubtedly, how do we support growth of the good bacteria in the gut and how do we support the gut mucosa as a barrier to en• BI.JFl'Al.O PHYSICIAN AJ\:D BIOMEDICAL 5CIENTIST Despite public belief to the contrary, Border said, the total cost of health care has accually gone down because modern medical care has been able to get people on their feet and hack to work sooner. This has more than offset increased hospital and doLtor bills. "You have to understand chat, of rhc total cost of accidental injuries today, only some place between 13 and 15 per cent goe,, for doctor and hospital bills; he said. "Eighty-five per cent of the cost is in temporary and permanent disability and death. "Of this, the dominant portion is temporary or permanent disability. This is where the real cost is." He explained that the net effect of all changes in modern care has been to shift coses from the disability/death category inro the hospital care dassiftcation. "The per diem cost has gone up even more rapidly because of the reduction in the length of hospital stay," Border ~aid. "This trend began in the '40s because it resulted in better care. John D. Stewart also contributed to thb advance. "Unfortunately," he continued, "our political leaders look only at hospital costs and do not look at rhe effect of the changes in care (reflected in hospital coses) on the length of temporary disability, the numbers of cases, and degree of permanent disablity or the mortality rate both in and out of the hospital. "The essence of all changes in modern care that have occurred has been to reduce outof-hospital costs by increasing hospital coses~ A, a result, he concluded, the total cost of health care, when both hospital and ouc-ofhospical costs are caken into account, has "dramatically" decreased "in total coses for many dbease problems, including trauma."• AUTUMN 191!9 �Medical Students 20 \ J THEHEADBONEIS CONNECTED TO. . . F or the 143rd time, the University at Buffalo School of Medicine and Biomedical Sciences has injected new physicians into the practice of medicine. On May 21, during a ceremony held in Alumni Arena on the University's North (Amherst) Campus, 140doctor of medicine degrees were conferred, along with 26 Ph.D.s, and six master's degrees. As proud parents and families looked on, the new doctors strolled down the aisle to receive their hoods and diplomas in a ceremony that featured vocal music hv the 0ermatones, an a cappella group of medical students. John Naughton, vice president for clinical affairs and dean of the medical school, commended the graduate, for the concern they showed for a classmate, John Robin, who contracted cancer during the sophomore year and died in September of 1987. The medical students memorialized Robin in their yearbook, the Iris. Robin's untimely death, Naughton said, "was a tragedy that we all felt," and the medical students' compassion toward their classmate "shows that you are ready to become physicians." The class speaker, Paul Lccat, looked back on the four years the new physitians had spent together. "As I look around the room, I can only think of one four-lccter word that I picked up in New Orleans to describe all of you, and chat is 'fine;" Lccat said. The 1989 yearbook, che Iris, was dedicated co the art of medicine. Loriann Fraas and Diane C1cacel10,co-editors, presented a copy of the yearbook to Lilh Sentz, history of medicine librarian. C ommencement speaker Harry L. Metcalf, M.D., former president of the AmerJCan Academy of Family Physicians and associate clinical professor of family medicine, warned students who were leaving Buffalo that "in about two months you will have acute withdrawal symptoms for chicken wings and Bocce pizza." On a more serious note, he left the class with three things to remember. "First and foremost, you owe a very large deht of gratitude to your parents and family,"Metcalf said. "J\.:evcrforget char many years of struggle, support, and sacrifice went into allowing you to realize your dream." He also urged graduate, to support their medical school and to live up to their responsihilities to help their communities. "\'('hen you arc setrled into your career, give something back to the community in which you serve," he urged. "Participate in your specialty organizanons, the PTA, your church or ,ynagogue, or whatever charitable way you <:hoose. But please, don't he Just a taker~ He concluded with a short anatomy lesson. "There's one more thing you can learn about the body that only a non-doctor would cell vou; Metcalf said. "I hope you'll always remember this: The head bone is connected to the heart bone and don't let them come apart." • BlJFFALD PHYSICIAN AND BIOMEDICAL SCIE:S:TJST �Medical Students \ J BlJFFALO PHYSICIA~ AND BIOMEDICAL SCIENTIST AUTUMN 1989 �Medical Students 22 Pull Out All the Stops Go as Far as Possiblein Treating Patients, Advises Noted Pediatric Neurosurgeon By DAVID M. SNYDERMAN P ediatric surgeons who work with brain damaged and potentially brain damaged children face difficult ethical problems, Benjamin Carson, M.D., told a group of medical students recently. "The whole issue becomes one of how much time do you put into the care of individuals like chat?" he asked, advising the future doctors chat they should, wherever possible, "pull out all the scops" in the treatment of their patients. Ca rson, the director of pediatric neurosurgery at Johns Hopkins Medical School, made the comments at UB May 5 in the first annual Progress in Medicine Lecture sponsored by che Student National Medical Associanon. Carson is known for his separation of a pair of Siamese twins. He illustrated some of the ethical questions confronting physicians by detailing case histories. "I remember a case of a young girl - four years old - who had Ix-en hit by an ice cream truck and suffered a very severe head injury," he said. The girl was brought in over the weekend and Carson did nor sec her until Monday morning. He was told chat "the only function she had at chat point was pupillary reacrivicy." However, when he examined her, her pupils were fixed and dilated, implying severe head trauma . He decided to operate. "T-vo weeks later, she was awake, talking, and responding co commands," Carson said AL,TIJMl\ I98Q Benjamin Carson, M.D., gave the first Progress in Medicine Lecture . with a smile. After two more weeks, "she walked home and was neurologically normal." Many people, he noted, would have argued early on char surgery was a waste of resources, chat the girl's case was hopeless , and chat it would be best to just let her die. "If we had done that, we would have lost someone who was subsequemly normal," he said. In another, similar case, a young boy was seriously injured and the mother wished to pull him off che respirator. Carson talked the woman imo allowing him to treat the boy. "We wem ahead with it, and he subsquently walked; the neurosurgeon said. Although the boy did have some neurological impairments, Carson said, che mother was oveqoyed to have her son alive. Then there was the case of a man injured m a car accident . The patient was in control of his mental faculties despite being depen- dent upon a respirator. "He made a request to us bv sign language chat we disconnect the respirator and allow him to die; Carson said. Boch his family and clergyman accempted to calk him out of it, "but no one could convince him otherwise. After several days we removed che respiracor." Thar brings up the question of what should be done for children in similar circumstances who do not have che experience and know ledge co make similar requests. "How can you make such a dc.-cision(rcmoving a respirator) for someone who hasn't experienced life?"Carson questioned. "That's one of the biggest ethical problems." Carson gave another case history concerning a girl who had been seen by several cop specialists around the country . When he saw her at Johns Hopkins, he felt surgery was in order. However, a well-known neurologist disagreed and attempted co get the hospital to intercede to keep the girl out of surgery. But the neurologist "then made a big mistake; Carson said. "He went to Rome for a conference, and I realized this would be a good time co do it." Carson said the girl has made excellent progress, thanks to the surgery. F inally, Carson told of his experience in the separation of a set of Siamese twins. Traditionally, such twins were either left together or one was sacnficed so the other could live. BUFFALO PHYSICIAN A1'D BIOMEDICAL SCIENTIST �Medical Students 23 However, m the case of the seven-monthold twins brought to him, "the mother didn't want to choose which one would survive and which one would be sacrificed." So Carson embarked on a procedure to separate the twins in such a way that both would be able to live. "We thought the chances were no greater than 50-50," he recalled. After a grueling surgical marathon, in which a total of 70 people were involved, the twins were separated. During their recovery, "they suffered just about every complication known to man but they subsequently began making a significant amount of progress, and eventually went home." The enti re action of separating and caring for the twins cost about $2 million, Carson said, of which the hospital paid half. But no hospital can afford that kind of expenditure on a regular basis. "The way you solve that problem,' he noted, "is you share the wealth. You don't require one institution to perform all of these procedures." • Academi1cLadder; she told her audience that it's important to set goals. Academic promotions - the rungs of the acaderni,c ladder - arc just benchmarks of our succ,ess, not goals m themselves, Behrens emphasized. We must always remember the larger goals - helping asthmatic children or finding a cure for cancer. While setting goals, you can dream big dreams, but the dreams have to be focused through the small end of the telescope of reality, Behnms said. You must also realize that your goals can change. As a teen, Behrens wanted to help with health care in Third World countries, but didn't plan to be a dean. She diid become a dean and her plan to practice in the Third World was deferred, though not abandoned. As a dean, she facilitate:sThird \Xlorldprograms through her school. Still, the pediatrician plans to someday practice medicine in the Third World. Using your personal time carefully is as important as using your professional time carefully, Behrens added. "It took me a number of years to realize that other people can cook and clean, but I'm the only one who can listen to my husband and put psychological Band-Aids on my hurting children," Behrens said. She also discovered that when juggling many roles, it's easy to forget to set aside time for one important person. "] had left out one person - me," Behrens said. "I was giving so much, there was nothing left for me." She learned that she had to attend to her own emotional and spimual wellbeing before she could focus on her goals. There's no room for coasting, Behrens added. "You must develop as a professional and a person for the rest of your life,"she urged. • B:, Connie Osu:ald Stofko CLIMBINGTHE ACADEMICLADDER A t one point m her career, she felt as if she was living in a pressure cooker. She was on 20 cornrnirree:sand trying to juggle her roles as clinician, researcher, teacher, administrator, spouse, and parent. With so many deadlines, it was hard to get through the day, said 8. Lyn Behrens, M.B., B.S. She eventually learned that prioritizing one's goals makes it easier to say "no." Drawing from her own experiences, Behrens, the dean of the School of Medicine at Lorna Linda University and one of only three female deans of medical schools in chis country, took parr in a four-day program on academic achievement. This spring's OW. Harrington Visiting Professor, Behrens is gaining a nauonal reputa• tion for her presentations on faculty development. As part of a session on "Climbing th c B. Lyn Behrens, BUFFALO PHYSICIAN A:-.:D B10:l.1ED!CAL SCIE:-.:TJST one of only three female med school deans in the U.S. AUn..:M:-.: 1'189 �,. Medical Students 24 OUTSTANDING FACULTY HONORED AT ANNUAL MEETING T he 1989 Annual Faculty Meeting witnessed the presentation of many awards for teachmg excellence, research, and service to the school and communitv. This year's Stockton Kimball Award for excellence in academic achievement was given to Saxon Graham, Ph.D., who will deliver next year's Stockton Kimball Lecture. Graham, an epidemiologbt, is a preeminent member and chair of the Department of Social and Preventive ML'Clicine.His work has been primarily m linking diet to various diseases and suggesting dietary modifications ro help prevent the onset of these maladies. His best known qud1es involve colon and breast cancers . Graham has linked dietary fats ro a high risk of cancer of the colon, lung, and stomach. Equally important, he has reported a potential protective effect of carotene in combatting cancers of the mouth, lung, esophagus, and stomach. Graham has also suggested that women who arc m high-risk categories for breast cancer limit their alcoho l mtake. This year's Stockton Kimball Lecture was delivered by John Border, who 1sprofessor of surgery and orthopaedics and a research professor of biophysics at UB, as well as director of the trauma service at Eric County ML-dical Center (see accompall)mg amcle). The Dean's Award was given to No rman Solkoff, Ph.D., a probsor in the Department of Psychiatry, for his service tO both the medical school and the University as a whole, and outstanding research. Special recognition went to Murray Ettinger, professor of biochemistry, and Charles Severin, associate professor of anatomical sciences. Ettinger was recently named a Distinguished Teachmg Professor by the SUNY Board of Trustees and Severin received the Chancellor's Medal for Excellence m Teaching. The second annual Robert S. Berkson AUTUM:-..'19R'I I Saxon Graham Memorial Award in the Art of Medicmc was given to Robert Reisman, clinical professor of medicine and pediatrics. The purpose of this award is to recognize excellence in patient care and teaching by a volunteer faculty member. The Louis A. and Ruth Siegel Teaching awards, which recognize teaching excellence, were presented in four categones: ■ Steven Gutman, M.D., assistant professor of pathology, received the Pre-Clinical Award . Letters of commendation were given to Edward Car r, M.D ., professor of pharmacology and therapeutics; Perry Hogan, Ph.D ., professor of physiology; Alan Lcssc, M.D., assistant professor of pharmacology and therapeutics as well as medicine; Charles Severin, Ph.D., associate professor of anatomical sciences, and John Wright, M.D., chair and professor of pathology. ■ Ralph Doerr, M.D., assistant professor of surgery, received the Clinical Award. Letters of commendation went to Paul Davis, M.D., professor of medicine; Margaret Paroski, M.D., assistant professor of neurology and physiology; Luther Robinson, M.D., assis- tant professor of pediatrics, and lnsook Shin, M.D., clinical assistant professor of neurology. ■ Joel Paull, M.D., clinical assistant professor of surgery, won the Volunteer Award. A letter of commendation was awarded to John Treanor, M.D., clinical assistant pro• fessor of psychiatry. ■ Edward Co leman, M.D., clinical as:;istant insrructor of surgery, was given the House Staff and Special Award . Letters of commendation were given to Donna Desmone, M.D., clinical assistant instructor of medicine, and Deborah White, M.D., clinical assistant instructor of medicine. Also at the meeting, Nancy H. Nielsen, M.0., Ph.D., the new president of the Medical Society of the County of Eric, introduced Charlene Cortese, New York State Medical Society Auxiliary, American Medical Association-Education and Research Foundation (AMA-ERF) chairperson, and Phyllis Caputi, president of the Medical Society of the County of Erie Auxiliary. They presented checks totaling $8,004 to the medical school.• - 8,· Dal•idM. Sm·derman BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST .. ��Medical Students Suraj Arthur Acharva, French LitcralllreB .A , Lniwrnr) of Califonua S.C I am mr,·rc,1edm ,ntL~uumnalmedicine, ch,1mb..>r mu,i,, and arr Kawh Ali:adch, BwloJ<., B.A.. Ctmiell Unn-ernty. Bnrr! Eli:abcth Ann Allen, Trina Bernadette B1ochcmi,1n B S , Allen, BwloJ?Y B.A., Unit a,rr, at Buffalo. I \' assar Colle[!.eI like l(J(Jk foru·ard w sf>,mdmg hiking, mm ies, and caung <'hce.,ecake cnwtht.-r four ,·ears m . .\led sch,-,1fu, m /i.ruwn Buffalo. :--:ancv A. AllenRichard, Bi.. :hemistry B.S , Sl';'\JYat Sum, Brook I h,ll'e 11great st1f>f>or111 c Jamily and Jewel Damita Alleyne, Bwchcmmry, Hof,1ra. I like w ,mg, I lo,e w tratel. I chose lJB becauseof the re.,earch. I'm gladw Ii. m Buffalo. hmm,. Matthe,- Evan Alt.,,, Chcmisrr, B A., \eu YorkL'nn-ernry I cho,e l'B bern111eof rhewe,11 Rmh:·rs. Elvs,a Anne Blissenbach, Bwk,J<., B \ , Fairfidd L nn ,'TS1fy.,\h jat<>me pasume" figure ,karmf!.. Gre~ory A. Andre",, Got<"Tltmenr A. B, Michael Jo,eph Aronica, Bwlos::,B.A., Harmrd L'nm:rsuy. I cho,e L'B med sch(J(JI h.!causc! of Its ow,tand1111! rcpuumon Uml'L'T'ilt)· of Rochl!stc:r. Mike "a t,prcal med srudcnru-hoha1cs l1brarr.:.1 and Ime, w parry Renier Jo,eph Brcntjcn,, / fowry B A., Darnison Jon Michael Bruce, Bwlogy BS. Chemmry B.S , L'nin>rm:,at Buffalo and ,'\Jia[!.ara Una·er,11y.Hello B11ffal11! Colle[!.,'.1 um born ,n Ams1erd,1m,The Nethc'Tland.,. and like \(lllmf!., Behnam A,~harian, B10.:hcm111nB <;_, L'n11m1t)·at Buffalo I look foru·ard w med schml and cnio:,,/i.mf!.a1 L'B Andre" Jacob Bam,r, Bu><:h,·mNry B A., Thoma, Gerard Burke, Mc<·hamcal EnRtneeringB S., Notre Dame Ir's fun to come homefor schoolm rhe,c Crai~ H. Burrow,, B.,,r,,!?Y B.S . Ho11ghton Collt>gc.I enim the an of pantomime curmu_, ume.o;. Carolvn L. Be""1te, Bioloi:yB.A , Camsrm Collef!.e.I <1lsc, Unnc'TSII)of Roche,ier. lune degreesm la1t•, Lookmgfonmrd to music, d..'!lusrry,and medicalsch,.,I. Enj<>y elecm.:alengmeenng. playm,irhe1·1olmand cycling. Heather R. Campbell, Bioloi:yB.S, Cornell L'n11ernr,.I like being uurdoon and bakmgnut necessonl~ · m the ~me ume. �Medical Students Rodnn Cap,ro, P,:«·ho/og,B A , Xcu r,,rk Um1s'T"':· Becominga ph,.\lcklll has />.:ena lifelong ambmun. Ann" Mari" Comi, B,o/og, B.A . f/oly Cm". I reallyrhmk the.,t!qut.1.,rlmt,an.• ab,urd so I'll JIN keep :mu folksgun\lng Li,a Ann Cardamone, 810l01?:B A . Lrmh·nil'\ vfRo,·hesct:r I am tloconh a sc:,:unJ. gencrarum 1>h,"c1<1n /,ur aho a u·c,i:htl,frcr. Andre" C. Cor,dlo, Chcm1Srry13.A.. C,m1dl L'1mernr, I ,d\11hatc J,·,grccs111ltm· and m1Nc. I mincedw round offm~-c.•Jucawm I,:.gomg co mcd1,,1I "h,.,I. T ridJ L. Ei~~n..,tctn, John Alt,xander D:ik, ,\1cchamcalEng111ccr111Jl 81mndK<1lEn.~anccrmg 13.S.. L'n11crnr,lH Buffalo. I cnJm pki,ml! ra,:q1«1ball anJ bmdmg. B.S E Duk,· l 1m a<1r,. I l,ke w f), />kmc,- I'm a ,ucdcnr 1,1101. \!aria T er1!,a Cartai:cna, B,olog, ll S. L'mwrsit) at Buffalo. 11,,w dorhc, Richard Mark Chcmdli, Bwlog, B.A, Comdl Unn•c.>f\!l'.''· h\ nnr JU\( ll pro/1.!s,1,m. 1t', cm Elaine Hee-Young Ch,.,on, lliolo.~",md ~,..-1e1,B -\,. C,,rndl l '1111 <"T\11\ 11,ke ,kuni: and 101111\. William F. Chlo,ta, Biulo.~"B S Ca.,.: \\.'t'.Slt."ntRc:,c..'n 1..: l Hll'~T\ll),' I ~1110: ,k11ni:.,,ulmi:, remm, ,md<1rt.I'm l,x,kmg fi,rn ,ird ro m,·d,ch,x,I \1ichacl La" rencc DuBartcll, Bwlogy 13.A , l 'nn,'T\lt, at /l11ffa/u.A/1,:r _gr,id11a11011 I 1m111Jl,k.: 10 praruct.' /1..uml) m,:Jii.-mc.·. Karen M. Dui:uid, (1t.lt·i:1UUTt.." \'ane"a L. Crother,, Win,ton G. Oou1,:la,, Cherm,rn and llw,:hcnmrn 13~-, l',y,hology ll .A , l 'nn.:rnl\ of Ro,hc,r,'T I U.dtU to ht!-u doctor,o /'II h,:,,bk w (rttm~,: healthfare m necd.:d. Ru/,..-rr,\\'.'csle,an (•oil..:~.:.Fmu ~\'t.'<ir, /rom nou I hope w/,..-<1 ph,"cr,m. Julene Op1al,.,neE,an,, ,\ f ,rr.,/>wl,J!i:'.' /l S. Cumdl L'mwrnr, I ,ho,c L B hl?f,111,c I urn,IJlike w twrk j,,r ih,· \\'.'orlJ I kalrh Gil Michael Farka,h, Hu._hemhtn B-~., L nn cT\11\ dl llujji,lo I ( >r.s,:c1rn,aw,111 m Kl'n)·a n.·r~·~.,cm:Jahuut ,mendingm.:di.al,,hwl <II LB. ,,nnc:dtl\· c.'HJO)' ,1 Jnt."nH, oj ,pc,rb md,«Jml!1cmm, ,kun)(. andu:orklll,1!out I ,m1 Paul Jo,eph Fa,orito, P"chohwlol!", H,mulwn Coll,:g,· I um ,:a~erlo hcgmmed ,, h,.,1 and I hk.:m pl," ,..,,w,h \ kd1,11ITe(hn,,/o~" 13S l '1111,·Nryof \ l1,h1ga11. I ,un <1 <'<Yllfi.:d Sign kmi:11,1~,: m1t:rt>r1.'rc.·r. I Cdn r U.'(UI 10 ,wn ! Ilana L. Fcincrman, B,,..-h,·m"'" 13.S l"nn.:rnr, ,u B11/f<1lo. I thmk 13ujf<1lo " " ~.,..:,u pla..·c<111</Im 11/,ul111/,,_, bt,,kJi,rfour mor,: )'t?(JT\, �Medical Students \1ich,,cl '-cott D,1\IJ K. he,, Bio!oi:y B.S . L'nu ernry ar Buffalo. I'm an early assurance mukm. I'm from N ia1;araFailsand enJO)golf Orn·ego I chose Buffalo ~cau..\l'of ns gtc!at weather. Gloria \1. Gladk,m,ki, Bwlol(Y B A., L'nii·,.,._m::,,ai Buffalo. I trnrkcd in a hmp,caiJoreight :,cars as a medicalsecretllr. and nou am dum)(ini:role,. '-.indr., \I. Gutierre:, Timoth, Danah, H·,ln, Chemmr. BS., Honora \f. Heffner, En1;!i,hB.A , Colgac.t St. Lawrence Lnu·,.,._my.I'm ured.• l,'mtt'l'SII). / «ill he a ihirdgmaarwn Fl·r ~U..,llO, 810ch1;.~mrscry,' B.S.. SL,\ Y ac Biochenmcr:,B.A.. Neu York Un1tcrnry I pia, the drnm sec. I I,ke compwer \Clenc~, and l u,li bea firn gcnt'l'amm phys1cu111 ph::,,s,c1an and I like w piay ciannet. Charle, R. Gr.w, Health SciencesB S .. Beu, B. Grc~oirc, Speechand Drama, K1thl~cn T. Grimm, Canis,us,/Y}'mm!k. I lJnncNI) at Buffalo. I am final/:,a firn,ycar med suukm SL \IY at Gt>neseo./ ha,, a ma.,1ds m library haw a B S. m med wch and aL,oa BS;-.. Jame, \I. hernia, B11smess;<v1an,1J?emcnr B.S, Cornell L'nn-asuy Fr,mhali mJ11nesfurcedme to be the paucm. Nou I i:ct to ,~«! tht>accwnjrom Ute! Wallace E. John,on, Philosophyand Theatre B A. , Yale. I look foruard to leamin.~ ~cicnce,tu.•ochildrt!n. and like w readand sail Robm \i. """• Psycho!oi:yB A , Varonouch. Phowwaphy and owd,.,r s[><ms ahaw B11ffab,. mht.,."ck. Li,a F. Kci,her, BwlogyB.A., Camsn,s College.I, a capuon ri.?all~ · nrce~.\ll~·! Kt·vin J. Kelleher, B,olol(YB A , Camsn1s College. Ba.,kechali, wlle,hall, and rcnm, arc my font' (hueI rau!y use chat,wrd) Jonathan Robert Kemp, Brrx:hem1,cr:, B.A , Neu· Yark Linu ,.,.m, / u·i,h m)' brmht'l'George u·a., here. PEACE. Cath\ Kim, Biology B.S , \1/T Llfe" temporaryso fin~if to the fullesc· u•,,rkhard and piay cwn lu1rdcr: Eli:abeth H. Kim, Bro!ol(Y B A . Camm" Co/le1;eI u-ar11to be /urch~r young! Ricardo Alfon:o Knight, Ph"iail Thera{)yB.S .. Uniwrncy at Buffalo. I ihmk bemg a docc,,rrs the ea,u:.~t u·a-\ to achie,eall charI can be �Medical Students T cd J. Kolia,, Bwloi," BS. , L nn .:mi,· of \fa:hr.i:,m I en}o) pla:m.i:ha,keiroll. .,occcr, anJ the pram,. Paul \t. Ko:1,m,ki, Bwlolt' B .A . C,mrsrus Collei:e I u·an1 w reach hikingrn 1hel'hrlippmes. Brian J. Krah.ik, Elecmcal En.i,ne<.'1111 .~ BS., Comdl L·nriern1, I like playmi: the /nano ari,l .101.n-r, neuh.:rof wh,.-h I' II h,a e wne for Da, id J. Lee, Biolo.i::,/ .'-.·curoKrcnccB.A .. Oh..-r/111 College I'm on Kcuni: Wai Lee, Kc\\•Juni: Lee, Brochemr,1ryB.S , SL',\') <11Hinghamwn l\ycholo.l!)B.A., Comdl Uniwr,11,. I dm«J11111.: u hen I ,ki on /me />kl'lll/? ,o,.-er. lrke ,um1ming lx1-'ke1h,II,1runnmi:. f><11d.:r Julie A. Madcj,ki, Bwchcm1<1r.· B. S . l ·nrt.·Nt) at Buffalo Can' 1 u·au w i:ei S1<1rted on rhrs1,.:11· ewurng (><rrr of m, lrfe Karen \1. Maier, l're;\ieJ B \. . ,\' orre D<1me I Ion! l\·ntrc Durn<? {tH!lNII Jerald Chri,tophcr Timoth, J,1,· L,R,"a, Kuhn, Enl!/i,h B.A , Biolo.l!)B.A .. flamrlwn Collei:e I am l 'mt ..·r,H~' of Rocht',ll'T an attd .\liilor, ,u1dcnJo-:,. · I hale cmds.,<1<.'latl.''srn the heaimful mnny u·eaiherrn Bu//<1/0. appliedscrence111 hro..-he11m1r,, Charle, Hoonjani: Lieu, Chem1>1r.B .A Comd/ Unncrsu, .\fohular Bro/ol:'AB , Tammy J. Linsner, Chcm,,m B.A., Princeton L·1111c·rsr1). I U.'ant w Sl'rtt.' (;od ch a Harru-rckCollq,:e I am lookmi:f"nmrd IO med ph,srcran.' ,chMI Bruce B. \farshall, Bu<me,.1.\fona.11,,,nent, Comd/ Um,crnr,. I Ed"ard F. .\lath, Biololt' B A., Branders \\'.'hLnclo~!.'i orn·ntauon .. i!nd! Jame, Kcillh Mantc.>ne, Gina M. Marrero, Bu><:hernr.\lry BS, ;\11crnhrol".I!) BS, C,mid/ L'nncrnl\ I am /,.,km~ fonmrJ w " ,cry SL;-,:y,11Bmi:hamron I u'll.SIn mg r.a/iprlyrm ,1 beachrn Ca~rfomta,then mmn and ,uul mademe come here. Tr.in !-Idem· Lathrop Chcmr.m, B.A ~l i':Y m Brn1:h<11mon r~uardin,J.? t' xpc:rrence at LB Christina Lc,lie Lin, hate hem a ieach~rf,rr four JCars I like m(),t ,f><,m Un11crn1,· I rhme w be a ph~srcwnh.:came I enJ") pressureand tcn~ion �Medical Students Fiona A. McConnell, Kc,·in Christopher B1ol111;V B A . \\:'11!1,11111Md-,,{ahon, (,oternCollege.I likehangmg ment B.A , f-larrnrd out I hop.:to mdke flm<' L"nlt'c..'n:lly /"d like to hate u praftice in duringmed ,ch,,ol to do sport.'i.makt.·mu~,l, anJ Cha11ta11<1ua Count, 1omcda,. lune fun . frrnfe~_,ion of medirmt.' becau,c I lm·e 1mrk111i: Daniel J.Mollin, BA . P"<"hoh,,,loRY ?\'eu· Yurk L"nrtern!) . I dcoded w i:o ro med on />a.1r ,chwl h<1,ed u uh p.:ople. exf>t!TICUO! Lorncllc B. Mill,, Bwlol!)B S . ,--:cl< fork l 'n,urnr, I cho,e the Claudia F ranee, Michalek,, Nurnni: B.S , D'Yrnml/e I hate a dt.'grt!r 1n nt4rsmg. Michael John Naughtor,, Philosophy B.A.. \',:'il/1am1College I rnn ,p.:ll,\;1ct,.<ehc Andre" Charle, Michel, Bio,:hcm"try B.S . .\f11/m11lk L'mn.>rstt~·1tnJ'" Jly fi.,hmg.and crm,country skiing. I look fonrnrd to s(h<H,I . Tuni: V. Nguyen, Biuengmuring BS , L'C (II B,.,-keh I trill he a third,i:cner<1t1on ph,sic1an. Rogena Leonila Miller, Bwlol!JB.A , Talladega I chme med <ehmlhecau.seI'm mt,.,.e,ted111the medical profernon and helpml( mhcr,. Jennifer Ann Nordby, BiologyB.A . Corne// L"m1,,,.1uy . M>·greatgrandfathergraduated from UB medicalm David A. Milling, .s.' B Unn,.,..m, at Buffalo. I PhdTTMC;i haw a B.S m pharman I c?nJo) racquethalland rcnms. Katherine Anne O'Donnell, Bu..:hem11try B.S . SL'NYat Bmgh.1mwn.I hate <111 ,\1 S m pharmacoloio. 1901! Sanjay R., Ogra, Biolol(;iB. ~ • Cornd1 l'mtcrnt:,. From r,,day. 1am a doctor (,umd><,d) ') . wld me rh,,r ycsterciay Mia Pappagallo, Bwlol()B.A P,ycholol:;i B.A., Lnnernry of Rochc,u:r .\1y p,mport phoro" heucr than mi,!' Jeffrey Richard Parnell, Bwlo);VB S , L'nncr.ll!y Ill Buffalo There" no heltercaret'l' ch.anmed,cme! Vikram N. Patd, Bmchcml\lr\ B S.. SUNY at Swny BrcxJk.I choseLB became I l,ke huffalne.1. �Medical Students Frand, R. Patterson, Bwloif.<BS \1/T I like pla)mg ,porr, and arn,·mcs . ocheroWlUH>r 1':a"er Ra,ack, Neurobwloif.<• Archaeoloifi·.L'nncr,u:, of M1Chiga11 . I decu.ledw p,o w med ,chwl m Bufjal,, b.?rnu,eI Inc Kri,tcn Loui,c Paulus, B,olog, B.S , Come!/ L·mwn1r, I hope clwcu e all b.?wme chet:,·peof ph,,icum char u·e m,ncliL', u"<rnltl. like wgr,w . playmg tennis, dancmg, and oh so much more. Jame, D. Pile, B,o!,,in B.S., L'nrt,·rnc, m ~tichad D. Rabicc, :\1ach13S I /ohm Buf[<lit, . Uymnd\UC:\ , College So m1Khfor children, mtd med ,,h11<>I math and mu,1c - on w are 111,fllratim1al tnl'dtclllt.' '\'ita K. Ram, Chcmicc1IF.ngmccrmg 8 S . t ·1111crnc, 111 Buffalo I like pl,rnnl( t.:nni_,, cookmf!, l'atm~. and l>cmgk:, Arlene I:. R,carJo, :\larcu, Med Te< ·h BS . Sl ,-.;y at Alba1n \\'.'hm I grad,uueI 1nm1 w hate ,m officerm rn:,:,a<·hrm 1heCaril>ne<1n . Romanow!<.ki, Richard llwloi:kal E!a.sr,of Bchmror B .A , Leon Ronco, \lmhcmau.:, B A , 'iLSY at Bmgh<1111wn. I likeco tn.nd lo furt:11,!tl Umtcr.,m ,,f Pcnm,ltanra I'm i:l,~Iw l>cba,:k m Buffalo. mtd mn h,km)( Joruard to ,uu.l,mg m L'B med. countries . I l'nJo)· plaw11(1cnn1, und Eric Joseph Paul Davi ,d Seeman, Schneider, Biology B.A., We.deyan Um,oermy.I enjoy the outdoorsand athleucs. Psychologyand Zoology B S .. Du~• Um,oersity. l l,ke to pla:y golf, cennis, and j(O ,ai/i,ng. Jeffrey A. Senall, B10/og:,• B A , Cams1u.s hi:r!! Richard Scott Safeer, NucnuonalScience B.S . , Camell Unwersicy I relax by Laura J. Pierce, Bioloin B A , l ·111, ernry ac Buffalo. I CllJo' runruin.~and pl,1ymgtenm, . "'"chill College.H,, how are ya, mce to ,ee ya! I enjoy sportsand lookforu:ard to an easy four years. Ju.stlikeei,eryonesays 11 u:,Ube, yeah. righr. Paul Brian Ro,cnthal, Ernnoml(\ BA .. r \l'' ac Bmghamwn lott.' ro rr£ztd.tkmct.' , ,mJ plm ,fx,m . Mark Anthon, Runfola, Prr/•mfr,"'"'"1/Ecrmr,m10B.A., .,otrr Dame . Im h,kmg fonrnrd w lunch. �Medical Students Jdfrn J. <,.,ymour, General S111d1e, B.S.. Cornell L'mwrnry I enJO)tl'eiihr l,frmi, skimg, and music Peter U-Fu Shen, Chemi.,rry B.A.. t.:m,ernry of Chicago. I JOI(for fun Chri,rma Ann Smith, BiologyB.A .. Comdl UmH'TSU). I cho.<e UB becau.,eI low mmhml' Michael K. Soeder, BiologyB.A . lin11ern1yat Buffalo.A pic111re 1sunrrh a thousand,wrck and rho,eBuffalo beachc.,. Andre\\ L. Sherman, BmmessMana;:ement, Cornell l ·111wr1it,. Alu<1yslookmgfor a good game of balland decent road trips. Samiri, So,trc, Laun Amencan L11erawreB10loi::,B.A.. Neu• YorkU1mermy I hope w do some mlunceer unrk m .\iex1co. !1-fan,our \'. Sh1rbachch, Biochemist') BS. CSU-Las Angele.,. I read now ls. Chri,tophcr D. 5prtrn I, Biochemistry B.S, L'm«'TSII) at Buffalo. I am concerned for our enuronmcnt. !min C. Srcinbcriz, Biolo,:;;B.S . SL'NYac Bmghamwn. I cho.<e t.:B becauseof the lackof sun. Ali-sa \iaric Shulman, Farmand F11ncnonB.A., L'mwrsuy a1 Buffalo. I am an ani<1 of che human bod:,and would like w 111e1heseialent< m medicine. '\; 1chola, A. Stathopoulo,, Bio,:hemiscryB.S . t.:nn ,.,.<It:,of Rochester. /' m frnm Rochesterand l,ick checreauwy w fill rh" 1~mow Ed"ard R. Stcphcn,on, Bwlogy B.A .. Fordham lfmwrsicy. l mjoy all rypesof spam and hope w parucipateac l.JB. Gail H. Smallen, BiologyB.A.. Brandeis L'm,ersicy. I plan w go w Honduras. l enjoy playing/Jureand piano. Donna \laric Sia\\ a,:, Bioloir.,B.S. Chemmry s B A. ' )1'0CIISC L'mt·erm,. I don'r always l,ke 1h1s!! 1;,k Patrkia Sticca, Bwlol(Y B.A. Psy·choloit> B A., lJmwrncy· of Rochester. l u·illbe the firn person m my family w auend medical school. �Medical Students \{i(had F. S"<·cnc), Anthmpolo,r.,,Ca,e \l;!e,tem Re.,.:ne L:nnersu\ . .\1d1.:n1e ,hould ~· m1cnll.ltlfJJU1I. Roh•rt \\ . Tahara, P,),hulo,r.,fl.A .. l 'n11,>r"I)m B11Jjalo "' ot onl) am I a c.:rti{it:'d ,cub<,,her, hm I al.", make m) 01m ~,.,. L,,okm!,!fomt1rdto a Kristine L. Tl·nchru,o, ,\.'euTl,,. .1ocii:nl't:', l nit't..'ntt)· of R,x:h.:,t,:r.l lik.: to pl,_,~ tennis but most of all ,:o 01<1 u·uh friend, anJ Ii.a e fim \ idr, C. T ,,11,·n, Life Science, B.S , L 111,ernl\ at Bu!Jalu. I l,k,·ch..-Bill, and hope the1 do JtN a, udl or 1->c?ucr thi, 1..-ar Jo-<·rh S. \',1lcnti, C,,urtcna, Bml,,,r.,/l',~chol"J.::i B.A . Can""" Coll~gc Biolo.i::;B.S L urn Colkge of \\racu,e I hof>c! to combmt! m)· gncH(thwuc rc:~c:arch ba,kgrmmd uuh m) ,p.nt (. ra1i:\\'.111, rhc f><Nrnu ~-l'an u:urkinRm a mol.:rnlar /,wlo/.!)l,_,h mt!d1calt.'ducauun n.-tn1rdin.l? cart..'l."T in rraumd sur.(!t:>n·. JuJ, ,\. \\'c,,,l,m,ki, \ kJicin,,/ C:h.:mMn ll S. L 1111,:rnl\ m 1311/Ja/,,. I'm ,,amng w Thoma, Charle, Wh,·atlc,, BioL,~ /l A. , Cornell L'nnc:nu~ I \.'njo)· Chri,tophcr R. \\'lute, Ch,·mmr) ~li,had B.A . Add1,h, Stmt:, Brmk I um Ann \\',,.xi, 1310/0,r., B.A , C,m""'' Colle/,!<'I cnJo:, trmdmg th.:C<l\) ,t11/l / l,k..B11fft1/o u in.i:,. 1mrk, and u.:t1th.-r b.:gm a r,:1n1rdmg nir,:,:r runmnJ!and am m m1.·Jrcmt' mh.'TC:1ilL'tf m ~diatrrC\ from SL .\'Y ,u Sr""' Brmk. fh,,ma, J. YJnwdla, P"choloi,')B.A , L 111wrnl\ <lt Buffalo I 1,k..ha,k.:1/,,.1/1. l lun,: a Che,.:u..-.I J,J not 11mk th" ,wnm..-rand I h.1te the 1'rd,, nd.:. Atif Zaf.1r, /l1olol:) BA . .\lath BA , L nnenu,· tit ll1<Jfalo. I'm " /11l,;t I .:nio:,/1/e l na, ail,1bl,· tor l'hot<>s: Paul,, A Bcnn,·u, D,n,d ,\1 Fl\ha l,,:ojfr,·) (;. Hoh1k.1)u,cph .\1 1'um1hk1,,mJ liu: Ta\lor. Jona1han I. \\'cin,tcin. Bu,lol!) 13..-\.,Cornell Un11ernt) So much for mightbe a fl,~ht ,urgeon at ,\'AS.-\ t ·111,crnt\ (,ra,/ de.i:rcc E. \\ ilJ, BwloJ.::i B.S SL.\Y ,u Kdh h,kmg J,,ru,1rdw u and tt'~t'c.m..·h I'm cht,llcngmg careerm excncd medKmc. ,chool. .,,-.,,.t med 1t?n ��,, • Medical Swdent.s 25 by che UB Medical Alumni Association. They also received a "welcome to Buffalo package" \\'Ith maps and hints on things co do, provided by the Medical Society of the County of Eric. The orientation also gi\'es the hospitals the ability co sign the residents on co 1hc payroll and perform pre-employment physicals . Approximately half of the residents are graduates of the UB medical school. • SCHOOL HONORS VOLUNTEER FACULTY A reception thanking the volunteer faculty of the medical school for the many hours thev have devoted to the school was held May 12 in the sculpture court of the Albright-Knox Art Gallery. "The volunteer faculty make an extremely important contribution ro the School of Medicine and Biomedical SuencC!-; said John Naughcon, dean of the school and vice president for clinical affairs. "Historically, they've served as role models to students and enriLhed the eJucarional experience in ways chat otherwise would not he possible." • ) I ,. 0. P. JONESDIES; WASDISTINGUISHED PROFESSOR OFANATOMY ORIENTATION EASES RESIDENTS' TRANSITION E sw- asing rhe transition from medica.l dent to resident is a prohlem heing tackleJ by the UB medical school through irs second annual resident orientation. Two separate one-week sessions were hclJ st;ircing June 19. Ahout I50 students parnnparcd. One of the maJor goals of the orientation ts to lcr the rc,idents "gee to know one another," according to Glenda Donoghue, M.D., director of continuing medical education anJ professional development ar UB. The orientatton consisted of lecrure copies caLh day with informarion char the residncts will find u;cful throughout rhc1r rnrecrs, Donoghue said. lndudl-<l were presentauons on organ procurement, rhc new credentialing process, the prevention of malpralti,e, knowing rhe patients' rights, cost conrninment, and advanced cardiac life supporr. Also presented was a program ro teach residents how to reaLh. The first half-day co\'cred the skill, of hedside teaching and the second dealt w1rh the skills of evaluating. A luncheon for the residents was sponsored Jones received his Ph.D. from rhe Univer• ,ity ofMinne,ota m 1935 and his M.D. degree from UB in 1956. He Joined the medical school faculty in 1937 as an assistant professor. In 1943, he was named an associate professor. Lacer that vear, he was promoted co professor and chairman of the Anatomy Department, a position he held until 1971. He was assistant dean of the medical school from 1946 to 1954. Jone, wm,al,o a v1s1t111g professor at several institutions, including Baylor University and National University in Mexico. In 1%4, he was a distinguishL-d IClturer at Tulane University School of Medicine. A member of 15 profc,,,ional societies, Jones was program secretary of the American Association of Anarom1sts from 1954 to 1966. He served on the advisory councils of both che American Society of Hematology (1962-67) and the Continental Associatton of Funeral and Memorial Societies (1954-1971). He ,,·a, accive in the International Society of Hematology, ,.:rving as its vice president from 1958 ro 1962. He was a director of the , ational Society of Medical Research from 1956 to 1961, and president of the Society of Experimental Biology and Medicine, Western New York Section, from 1951-52. Jonl'!<was assoctatc L-ditorof The A11awm1cal R..:cord (1955-1968),and served on the ediconal hoards of Blood (1946-1955), and Folta Haemawlo~1ca of Lcip:1g, Germany (1937-1949). The 1954 edition of Meden1ia11, the joint yearbook of the medirnl and dental schools, was dedicated co him. His other honors include the 1964 Dean's Award from rhe U111versity,and rhe l9il Silver Medal from the medical school. He was a member of Alpha Omega Alpha, the national medical honor society. He was the husband oft he late Dr. Cathryn M. Jones. He is survived by three daughters, Helen Jones of Maynard, Mass., Carolyn Gurney of Asheville, N.C., and Ann Davidson of West Yarmouth, Mass.; a son, Oliver, of Columbus, Ohio; two sisters, Ann An near of Abs(.'(On, N.J., and Evelyn rord of Pleasantville, N.J., and IO grandchildren. Concributions may be made to a fund to he established in his name ar the University. • Dr. Oliver P.Jones (M'56), di,ringuished professor emeritus in the medical school and a leading figure in hematology, dieJ June 18 in his home in Buffalo. He was 83. A native of West Chester, Pa., Jones caught gross :macomy in the medical school from l93i until 19il, when he was named distinguished profC!-sorof anaromy. His scientifil accomplishments were many and worldrcnowned, and his work was said to contain rhe hcst descriptions of hone marrow changes. He was a pioneer in the use of the clcuron microscope in morphological studies of blood. "Not only were his contributions in teaching and research of critirnl importance~ said Harold Brody, chairman of the Deparcml'.nt of Anatomical Sciences, "but the roles rhat he played m helping to Jevclop the organizations and professional journals in hematology were primary from an mtcrnanonal point of view. "Above all, the loyalty and concern for his students were maior facets of his c:haracter and arc rcmemhered by graduates of the Schoob of Med1Cine and Demiscry, as well as hy graduate students during his years of tenure~ During his later year, as chairman and ,tnLC 191I, Jones de\·◊ted himself co examining the early h1scorv of the medical school in addition co the scory of its founders. These ummbution, ,,ere published in national journals as well a, m che Buffalo Phwcian. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST AUTUMJ\! 1989 �Alumni 26 MED SCHOOL REUNIONCLASSES PLEDGE $102,220 TO UNIVERSITY Reminiscingabout theirUB dayswas a greatpastimefor alumni duringthe SpringClinicalDay/ ReunionWeekend, heldtheweekendof May 6. The alumni not only rememberedwhat UB gave 1934 .. . . .. ....... . ... . .. . . . From left, seated:John V. Andmon, Maria N. Samo, Charles E. May, to them, they also took the time to and Max B. Weiner.Standing:JosephR. Saab, EarleG. Ridall, Nicholas Linderman, John M. Constantine, and Harry Bergman. give somethingback to the University. This year'sreunionclassesgenerously pledgeda total of $102,220. Class of Class of Class of Class of Class of Class of Class of Class of Class of Class of AlJTUMN 1989 1939 .......... $18,400 1944 . .... . .... $ 6,725 1949 . ... ...... $ 7,125 1954 .......... $ 8,000 1959 .......... $15,450 1964 .......... $16,255 1969 .......... $ 9,500 1939 ... . .. . .. . ....... . . .. . . left, seated:CarlosC. Alden, William Dugan, Elizabeth Olmsted, 1974 .... . ..... $10,500 From Ruth C. Burton, Marvin Siegel, George C. Brady, and Henry V. Middle row: Kenneth Goldstein, John J. Squadrito,John H. 1979 . . . . . . . . . . $ 8,220 Morelewicz. Remington,John H. Geekier,Lloyd A. Clarke, RoyE. Seibel, and Frank T. Riforgiato.Back row: Alfred H. Dobrak, Frederic Hertzmark, James 1984 .......... $ 2,045 ). Creighton,and A. V. Posto/off. BUFFALD PHYSICIAN AND BIOMEDICAL SCIENTIST • �I Alumni Reunion 27 1944 ...................... . 1954 ...................... . Fromlefc,seated:L.~diafutmcain,Mrs. Strong,IdaSchaer,S)lda Ginsberg, Charloue Fros[ Ph.llis \'(/i/kinson,Jean Boardman,~fo. Sulli,an, Mrs. Momani, Santd M~riaCassara,Jean Bamecc,HelenHudson, Mrs. Gage, and Ka:,,Weygandc.Standing: Mary Lou Bondi, Raymond G. Bondi, Willard H. Boardman,Newland W. Fountain, Anchony M. Aquilina, Clinton H. Strong,Andreu A Gage, Sidney M. Schaer,Fmnk T Frost, Carrol].Shater, RobertG. Wilkinson,JamesR. Su/Iii-an,FrankH. Long, Samuel Cassara,Howard R. Bamecc,Ra)mond A Hudson, Helmw A. Mueller,PaulWeygandt,JamesF.Mohn, /ruin A Ginsberg,Mrs. Mohn, and Casimir F. Piecraszek. From lefc,seaced:John A. KutT)bala,l\'orberc]. Kuberka, EugeneC. Hyz), Sylda G. Lislot·s,Allen L. Less1,1,mg, :S•.1icholas C. Carosella,and CharlesH. Manno. Secondro1t·:Walter A. Olszett·ski,Jacob Lemann, PaulL. Weinmann,Edtmrd F.Wenz/a//,HarryT Olil'er, RobertD. fuley, and Donald]. Murray.Third row:£mesc H. Meese, William R. Kinkel, Eugene L. Belcrami,James £. Youker, Richard F. Mayer, \'(/il/iam]. Hou-ard,Lows C. Cloucier,and RobercH. Miller. Fo1mhroil': ByronA. Genner,£du·ard A. Rayhill, John L. ConbO),Donald M. \X'ilson,and HerbercH. Benson. 1949 . . . . . . . . . . . . . . . . . . . . ... 1959 ... From lefc,seaced:FredShalu-it,, Julia M. Cullen, and Joseph£. Griffin. Standing:Edtmrd W. Rosner,J.B.Ausc,John Sharp,PaulT Buerger,Max A. Schneider,Carmelo S. Armenia, Laurence M. Carden, and James A. Werick. From lefc, seaced:RobercJ. Brennen, Daniel C. Kozera, George R. Baeumler,Sandra\'(lilcse,DorocltyC. Rasinski,Mary Ann Bishara,Joseph F. Monce, £/con M. Rock, and Dadd E. Den,el. Scanding:JosephA. Ferfoi,Julius\I. Rasinski,John]. McMahon,ScerlingM. Doubrata,Logan A. Griffin, Alf M. Tannenberg,Morron H. Heafic,, Jason H. Scetens, James R. Do::-le,Thomas D. Doeblin, and Selbert A. Chemila. BLFFAI.O rHYSICIA:S- A:-.:D BIO~IEDICAL SCIE:--:TIST . . .. . . . . . . . . . . . . . . . . �Alumni Reunion 28 1964 ......... 1974 ...................... . . From lefc, seated: Bela F. Ballo, Gerald B. Goldstein, Lillian V. Ney, ElizabechG. Serrage,William Fleming,Da11idZiegler,and JosephA. DiPoala.Secondrow: Paul Sussman, Stephen P. Katz, Jeffrey S. Carr, Michael Feinstein,Michael A. Judd, RichardWolin,John F. Reilly,Anthony Ferrari,and Charles Ladoulis. Third row: lroing Scerman, ). FrederickPainton,ScephenScheiber,Da11idA. Leff, Marl.'inZ. Kurian, and James C. Tibbem. Fromlefc,firscrow:ElaineMarie Bukowski, Suzanne A11ery,Gordon L. Avery,JudyOufiero,and LawrenceA. Oufiero.Secondrow: Alan G. Bur• scein, Sharon Burscein,and Stephen A. Yerkovich.Third row: Sandy Piecraszek,James C. Piecraszek,Roseanne Berger-Morelli,Daniel J. Morelli,James L. Budny, Pam Budny, Conrad F. Wolfrum, BradleyT. Truax,ElizabethTruax,RichardJ. Buckley,Judy Buckley,Bruce F.Middendorf, Mimi Middendorf, Paul H. Wierzbieniec,Ellen Wierzbieniec, James A. Smith, and Beverly Smith. 1969 ...................... 1984 ...................... . Fromleft, seated:Madeline). White, Moira ). Burke, Evelyn Roisman, Marion Wind, DorocheaA. Downey,and PennyA. Gardner.Secondrow: Hanley M. Horwicz,Gerald D. Scinziano,Louis He111ZY, IsraelKogan, Roberc). Gibson, James L. Ca11alieri,Michael N. Pisick, Han:ey I. Weinberg,TimochyV Siepel,and BernardC. Muscaro.Third row: Thomas S. Scanlon, James J. Whice, William K. Major, David S. Schreiber, Timothy F. Harringcon,Douglas L. Robercs,and Carl ). DePaula. AUTUMN 1989 . Fromleft, seated:HeleneSurowiec,CherylMiller,ElaineSchaafGergelis, Maria Billinson,Maritza Alvarado, Amy SchuecklerRosceing,Jennifer Curletta, Lynn Picano,RoseDeAnwnis, and )ill Pfa/zer.Scanding:Roberc W Lasek, Man: ). Koblick, Herbert B. Newwn, RichardE. Gergelis, Mark Billinson,Andrew M. Knoll, Ke11inP.Rosteing,JosephD. Curletta, John ). Picano,John F. Noe, and Dal •id F. Pfalzer. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni Reunion 29 JUSTWHATIs THEUB FOUNDATION? H 1979.......... .. .......... . From left, seared:Tunde Kashimawo,BarbaraE. Klein, Letitia R. Clark, IvonneS. Cellino, Andrea C. Bracikowski,Norma Creighton,Kathleen Buran,Jody Spooner,Ellen Balon,Donna Irene,LindaA. Cardone,Gale A. Barg,Christine A. Marino, Connie Shields, Marilyn Armenia, and Kay Baron.Secondrow: Robin H. Adair, Ann Canty, Michael Schneider, Susan Lehrer,BarbaraEames,FrederickA. Eames,Katlty Hall, Theodore R. Hall, Walter A. Balon, Peter Condro, Bruce J. Naughton, Thomas L. Mahoney, Thomas McKeever, Mary PacSchreck,Robert L. Baron, Cindy Kaiser, and MargaretNaughton. Third row: Jason Dunn, John M. Canty, Myra N. Rubyci, Michael Cellino, RichardT Irene,James P. Bracikowski,JosephE. Buran, Ted H. Spooner,Donald ]. Armenia, JamesJ. Creighcon, Peter E. Shields,John Naughcon,Jim Cardone,Roger E. Kaiser,and John W. Crofts.Fourthrow: GeorgeBoyar,MichaelCamp, bell, TajudeenA. Kashimawo, Andrew T Costarino,James R. Miller, LIO)·dM. Lehrer,and Frank T Schreck. ave you ever wondered why your gift to the School of Medicine and Biomedical Sciences is acknowledged by the University at Buffalo Foundation? Simply because the University at Buffalo Foundation is the chief administrator of all gifts to the Univer• sity. As a non-profit organization, the UB Foundation seeks, manages, and invests private gift support on behalf of the University. The Foundation was established in 1962 when the private UB join• ed the Scace system to ensure that gifts for the University would re• main at UB and not be dispersed throughout the State. Since its founding, the Foundation has generated more than $140 million in private support. 1988 revenues totaled almost $23 million, of which more than $7 million was earmarked for the School of Medicine and Biomedica l Sciences. Donors can designate thei r gifts to the medical school, a depart· ment, a specific research project, a schola rship or even a new com· purer. No matter what the final designation, the gift is made through the University at Buffalo Foundation. Just as donors make many d ifferent kinds of gifts, the University shows its appreciation in many ways. Individuals who contribute $1,000 or more annually to the medical ~chool receive membership in the James Platt White Society. In add i• tion, for persons who make a commitment of $10,000 or more payable at the rate of $1,000 annually, recognition is given through the Presi• dent's Associates program of the University. For more information about the James Platt White Society or gifts to the School of Medicine and Biomedical Sciences, contact rhe Qf. fice of the Dean (831-2775) or Mary Greene at the UB Foundation (636-3315). • A NUMBER OFPEOPLE MADEMEMORIAL GIFTS: MEDICAL ALUMNI ASSOCIATION ELECTS KUNZPRESIDENT Clas s of ' 39 Gift Fund: • Dr. WillardH. Bernhoft- in memo1)of his brother,Frederick,a member of the Class of '39, who passed away in his lasr year of medical school. • Anna L. Bleich- in memory of her husband, La Moyne. • James Marinello - in memory of his brother, Carlo. • Connie Plummer Miller - in memory of her sisrer, Lois. • Dr. Ann Rudmgerand David Rudinger- in memory of che1rmother, Ellen. • Berry Storms - in memory of her husband, Rober!. • Harriet E. Wesp - in memo') of her husband, Et·erert. Class of '44 Gift Fund: • Dororh) Kennedy- in memory of her husband, Sidney. Class of '49 Gift Fund: • Victoria Van Coevering- in memory of her husband, Russell. Class of '64 Gift Fund: • Dr.and Mrs. David C. Ziegler- in mem07) of Dr. Ziegler'sclassmare and friend, Dr. Sheldon Roth/leisch. oseph L. Kunz (M'56) has bee n named to a one-year term as presi• dent of the UB Medical Alumni Association. A lso elected were Bertram A. Porrin (M '53), vice president, and Nedra J. Harrison (M'77), treasurer. A clinical assistant professor of medicine at UB, Kunz is a specialist in internal medicine with subspecialties in gastroentero logy and endoscopy. Kunz is an attending physician at Buffalo General Hospital and a staff physician at the Oute r East Side Clinic sponsored by the Erie County Health Department. He formerly was a consulting gastroemerologist at St. Francis Hospital. Portin, a colon and rectal surgeon, is a clinical professor of surgery and chairman of the division of colon and recta l surgery in UB's Department of Surgery . Harrison, a general surgeon, is a clinical instruc tor of surgery at the University at Buffalo. • BUFFAI.O PHYSICIAN AND BIOMEDICAL SCIENTIST J AUTUMN 1989 �Alttmni 30 175 ATTEND1STREUNIONRECEPTION he first annual reception to honor the members of the reunion classes at the Spring Clinical Day/ Re'union Weekendwas held May 5 in the Center for Tomorrowon UB's North Campus. More than 175 alums attended the reception sponsored by the UB Medical Alumni Association. The gala event providedan opportunity for all of the returning classes to mingle and it set a warm and friendly atmospherefor the rest of the weekend's activities. We hope that next year's returning classeswill plan to attend our second annual reception on Friday evening, April 27, 1990. (1-r) Mrs. Raymond Bond, Raymond Bond '44, Helmut Mueller '44, Mrs. Paul Weygandt, Paul Weygandt '44. The 50,year reunion class. (1,r) Sandra Wiltse Logan Gr iffin '59. Leininger '59, Daniel Kozera '59, The 25,year reunion class. BL"FFALO PHYSICIA:S: A:-;D BI0~1EDICAL SCIE1'TIST ��Buffalo Physician & Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 N,n l <; PAIi) flu Pu Address Correction Requested 998 MR. CHUNG-KAIHUANG HEALTHSCIENCE LIBRARY ABBOTTHALL CAMPUSMAIL �•Profit Org. i/"""g,, f.10, NY. mit No. lll � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n03-1989-Autumn Table Of Contents A list of subunits of the resource. Not just because it's there Like rubbing snow on frost bite We're not hurting animals Medical School News Special section Alumni. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n03 Extent The size or duration of the resource. 45 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/29271f84e7bc25fb0e525fabe21b5ced.pdf a287a68baa3b329da1143dd9ccdf4527 PDF Text Text E.rly Wmrer1989 \bl 23, :-<o.i ---• - ····- . ..:::--; .. ; : :: : : \t\fi ~: ; '. ff ·; =-;-!_: ~:~::·~-:- I I I ......... _____ _ ••• ;•. I t • ' ~--u&; :e;;;' ~=f~~:::-; ~-~=~ --------- 1Ile Class of '45 and Its Tn,e Humorists ·.·:·r ' �STAPF OIREC1Ult Of PlJIUCAT1oNS N-yli,bin ..-w l'H'tSICIAN mm:,o "-°"'"""""' ARTDIRECIOll Alan).~ ADVl80RY BOARD Dr J,,hn N...... , 0.- .,.. ........ r,....... Ma. NMKy 01i«o , T he August II, 1989 issue of Tone nuipunc publilhcJ an lmpoftllntanicle de.ling with the cumnr and posa1blefuture 1tMU1 of dx medicalpro(aaion. Not 111rprilinawerethe n111ny a>nc:emcdand nepave pen:ep, bOnL Thfflt ol the moet distftaina: poina arr the public's pcrcq,- tion that physicians no °' """" ''""' Dr,Ku.Ir., 11,o.... kmaclisten r to patients. CONiflcntlv run la, and laU<o ecplam what they arr Dr. J-ph l. K11ru Dr a..ta Pap,,.lli Mr l'auJ.D"-""" Or. O..lo.PN "-Dr. ,,,,'-" Or. U11ha Ran..,.. Dr a.-nduil n-n. .... .... ... 0........ .., .... .... _., "'-"' ..... _ o. 0. -.... °""" warreu -M~~ .......... W...ll'r.,tor.M.Jl :=.":i~ ILLUll'Mmll8 dometo patients. Of all the mucs. these an: the chanca:riat1cs which rhc rnemben ol the prolnaion md1vidually and collectively can corffCt at l1nlcpmonal and cconomtc COit. A:non ally, I find rl\em so intrirwcally fundammtal to the 1ntqrr1ty of a physici an, reprdlca of ipeciaky identification. that I would think thar wouktwant ro dimnwe fflCICconcmu, 81 ei:pedlnowly as posaihlwe c. The b.inh major con«m rdated ro the percepaon of over· cluraing ior ICl"VICa. Fortunately, our 10e1tty supports the con• that-phyadam ahowd be adequately compmsated for rhcir tltttlsand talentLHowever, It II becomina:1nctta111alv col'K:ffllN with the lnc:artsuitv whichelCIIU betwem the kwb of compe:n· NIIDD ftC:doled anclthe pc.abed wtthdrwal of physiciana from czpt dealina'WMhpahmtt Ir -.. of modest co ltmlfN means. obviousrhM:medical,chook, their ttaduna: hoepitab. and the pro(euton at larsc must deal with the1e four llSUCS in a ditect, t'ordlriaht, consuuctive mannn if dw pasunllhC p,ctuttofered In Jmv 1& to be ff'VC!'Sed. • at l.J8"amedical school contin~ to commH ounclves preparlna phystc1ans wellpounded 1n the fundamentals of Klflldftcmedicalpracoce and dedicated to the neelB ol all pat"ac nu. '° ~ (}i-_~~~: ftM:HINGAND John Naup,.,.,, M.D. Va PmidaacforOmamlA//mn 0-,Sdloola(....,.,,,,..., -- ... ~pilll• ..W- .... ~ Nwbk.Sftlll THE BUPl'ALO PHYSICIANAND BIOMEDICAL ......... IICIEHl1ST. c.,, ................ .. eo.liallv, �BUFFAlD \ol. P tJX-?i l~~ n. ~"-4 Earl1 Winter 191N Features fl Top teachers,Page23 II PETScanner . Buffalo is getting state-of-the-art imaging equipment that shows not how the body looks, but how it works. A joint project of the UB medical school and the VA Medical Center, the $12 million center for Positron Emission Tomography should be fully operational by the end of 1991. Meet the chairmen.UB has created a new Department of Emergency Medicine and has placed one of the field's pioneers at its helm. Meet him and five other new chairmen who have visions of new ways to bring UB to the forefront in research and teaching. m Thoughtson a nasty day. William R. Taylor, Class of '45, reflects on three classmates who understood the importance of humor in their profession and their lives. IEJPhoto directory. Here's an introduction students in the basic sciences. to the Departments I] fl Antique treasures,Page30 fl I] Neu· image, Page2 Ill Alumni au:ard, Page26 Cowerlllurnotion:JosephTh,d People. Keep your teaching fresh, even offbeat. That's the advice of award-winning professors Murray Ettinger and Charles Severin. Research.A product called INFASURF significantly reduces respiratory problems in premature infants, according to a national study coordinated by UB researcher Edmund A. Egan lll. Alumni.George W. Thorn, Class of '29, a pioneer in endocrinology, organ transplantation, and kidney dialysis in the United States, received the first Distinguished Alumnus Award from UB. MedicalSchoolNews.Two antique chandeliers have been restored to their original luster thanks to a donation from Robert L. Brown, Class of '44. The pair now graces UB's Health Sciences Library. Classnotes. �2 PlEI s <e<r1lIl1lIl1l<eJr With plans to build $12 millioncenter, Buffalo is poised at a new frontier uffalo is approaching a new frontier in diagnostic medicine with plans to build one of the most ad; vanced Positron Emission Tomography (PET) imaging centers in the world. PET imaging, the latest in com; puter scanning techniques, has the unique ability to visualize and quantify complex physiological pro; cesses occurring in the human body. It has potential for important advances in the understanding and treatment of major ailments, in; eluding heart disease, stroke, cancer, epilepsy, and Alzheimer's disease. EARLYWINTER 1989 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �3 Joseph A. Preiio, M.D., Jayakumari M. Gona, M.D., and Robert E. Ackerhalt, Ph.D. A joint project of the UB School of Medicine and Biomedical Sciences and the Buffalo VA Medical Center, the $12 million center will serve the entire community, including non-veterans. Funding of $3.4 million for the project has been awarded by the federal Department of Veterans Affairs. UB has committed $1.6 million. The balance will be provided by state grants and private support. The James H. Cummings Foundation already has committed $1 million - the largest grant in the charitable, nonprofit BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST PET centers m the nation bave tbe capabilities proposed for tbe Buffalo site. corporation's 26-year history - to the project. The center will be the first PET imaging center in the SUNY system and the only one of four in New York State that's located upstate. There are some two dozen PET imaging centers in the U.S.,but only a handful have clinical and research capabilities on the scale being proposed for Buffalo, noted John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB. Naughton said the PET imaging center EARLYWINTER 1989 �4 "will be significant not only co this region, but co the entire northeastern United States. This project will put the UB medical school at the very edge of a new frontier of diagnostic medicine." "We will be offering an imaging technology not available in most big teaching centers in the United States; added Joseph A. Prezio, M.O., chair of the UB Department of Nuclear Medicine who will serve as the cenrer's director. "It will also add significantly to the services we offer our patients:• The center will have two major components: a PET scanner facility located at the Buffalo VA Medical Center and a cyclotron facility housed in Parker Hall on the adjacent UB South Campus. The cyclotron facility will produce radionuclides, low-level radioactive materials, to be used by the PET scanner. Underground pneumatic rubes connecting the hospital and Parker Hall will transport the radionuclides. The cyclotron is a specially designed electromagnetic device that will permit researchers to accelerate charged particles or ionized atoms to very high velocities. The particles collide with targets composed of various elements, compounds, or gases, producing the low-level radioactive materials. Most radionuclides produced by the cyclotron will totally decay to a stable element within a few hours to a few days, Prezio noted. The hospital-based PET scanner is expected to be operational by September 1990 and the UB-based cyclotron by the end of 1991, Prezio said. It's anticipated that other local hospitals and private medical practices will decide to buy scanners and use radiopharmaceuticals produced by the UB cyclotron. Millard Fillmore Hospital has indicated that it will open a diagnostic imaging center with a PET scanner, and Buffalo General and other area hospitals have also expressed interest in getting PET scanners. The chief of the PET scanner facility at Veterans will be Jayakumari M. Gona, M.O., chief of nuclear medicine at Veterans and UB clinical assistant professor of nuclear medicine. The director of the EARLY WINTER 198Q cyclotron facility will be Robert E. Ackerhalr, Ph.D., vice chairman of the UB Department of Nuclear Medicine and research associate professor of nuclear medicine. The project has received enthusiastic support from the Western New York Health Sciences Consortium. (That consortium is composed of area hospitals, the UB medical school, and the Greater Buffalo Development Foundation.) In a 15-month child uncontroHeJ ( top anJ normal. old with seizures, center) appear Howevc-r, on the PET image (bottom), the- dark area epileptic event 1s page occurring. is a view of the PET e<Juipment, A PET scan will cost about $1,500, which is comparable to the cost associated with a study using CT scanning or magnetic resonance imaging. lt is less than many invasive studies used to evaluate cardiac, neurologic, and oncological problems, bur without the increased risk of morbidity or mortality associated with them. It's anticipated that soon third-party carriers will provide reimbursement for a PET scan. PET scanning is the newest computer imaging technique to arrive in Western New York. The first CT scanner in all of New York State arrived at the Dent Neurologic Institute at Millard Fillmore Hospital in 1973. It was the fifth in North America. The Dent also got Western New York's first working magnetic resonance imaging scanner in December 1982. For the first two years, it was used only for research. UB President Steven B. Sample noted that Buffalo's PET center "is part of the effort of the University and its affiliated teaching hospitals co establish 'centers of excellence' in healrh care and enhance the regional and national reputation of the high-quality health care delivery system in Western New York. Its establishment also is in keeping with our goal of moving the University into the ranks of the top 10 public research universities in the country." Richard S. Droske, director of the VA Medical Center, said the cooperative effort that led to designation of the new center is another example of how the VA Medical Center and the University work together co benefit the community. "The PET Imaging Center; he predicted, "will lead co quantum leaps in our clinicalcare and research abilities in such fields as cardiology, neurology, and oncology." • BUFFALO PHYSICIAN AND BIOMEDICAL SCLENTIST �To get a better idea of what Positron Emission Tomograpy (PET) imaging is, it's helpful co compare it to the more familiar X-ray computed tomography (CT) scanning. Boch are noninvasive and provide glimpses into the human body. There is a significant difference, however, noted Joseph A. Prezio, M.D., chair of the UB Department of Nuclear Medicine who will serve as the director of Buffalo's new PET imaging center. While CT scanning shows anatomic structures in the body, PET scanning visualizes and quantifies information about physiological and chemical pro­ cesses occurring in body organs. Put another way, CT scanning reveals how organs look, while PET scanning tells how well they function. Because it detects disease-triggered chemical changes in the body that are precursors to anatomic changes and physical symptoms, PET scanning already has shown its value in early detection and treatment of disease. In coronary artery disease, for exam­ ple, PET scanning can help physicians tell the difference between viable and dead heart muscle. PET scanning has potential for major advances in the understanding and treatments of ailments such as stroke, cancer, epilepsy, and Alzheimer's disease, noted Prezio. It also will allow physicians co evaluate the effectiveness of chemotherapy programs in cancer treat­ ment within one day, rather than several months. Pharmaceutical companies will use PET to accurately determine effective drug dosages. Prezio noted that PET scanning has also been used co successfully pinpoint the sire of electrical outbursts in rhe brains of epileptics chat set off seizures, BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST and to advance medical understanding of brain tumors. Another difference between PET and CT scanning is the manner in which the images are produced. In CT scanning, low-level X-rays are produced by the scanner unit and pass through the part of the body being studied. A computer generates a three­ dimensional image based on readings that result from the X-rays. With PET scanning, trace amounts of radioactive biological compounds called radiopharmaceuticals are introduced into the patient's body. These radiophar­ maceuticals emit positrons, a positively charged electron. A computer generates three-dimensional images based on the pattern of X-rays emitted by the positrons. Radionuclides, the low-level radioac­ cive materials contained in the radiopharmacuecicals, will be produced in the cyclotron facility at UB. • EARLYWINTER 1989 �6 N ew names,new faces,new directions. Six new chairmen are among the 19 to lead departments in UB's Schoolof Medicineand BiomedicalSciences. Just created is a Department of EmergencyMedicine, which will be headed by G. Richard Braen, M.D. The other new chairmen areStephanieH. Pincus,M.D., dermatology;L. Nelson Hopkins, M .D., neurosurgery; Robert Gillespie, M.D., Ch.B., orthopaedics;F.BruderStapleton, M.D., pediatrics,and Ron­ ald P. Rubin, Ph.D., pharmacology and therapeutics. They have outlinedplans to bring to their departmentsnationaland internationalreputations for excellence. Severalchairmenhave also been reappointed: • JosephA. Prezio,M.D., De- partment of Nuclear Medicine • Myroslaw Hreshchyshyn, M.D., Department of Gynecology and Obstetrics • George Alker Jr., M.D ., Department of Radiology • James P. Nolan, M.D., Department of Medicine • Leon E. Farhi, M.D., Department of Physiology • Saxon L. Graham, Ph.D., Department of Social and Preventive Medicine • Harold Brody, M.D., Ph.D., Anatomy • William H. Coles, M.D., Ophthalmology • Glen E. Gresham, M.D., Rehabilitation Medicine • David Holden,M.D., Family Medicine • John I. Lauria, M.D., Anesthesiology • John R. Wright, M.D., Pathology • John M. Lore Jr., M.D., Otolaryngology PHOTOS : EARLYWINTER 1989 BOBWALION BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �EMERGENCY MEDICINE G. Richard Braen, M.D., has been named chairman of the new Department of Emergency Medicine at UB. He is also head of the Department of Emergency Medicine at Buffalo General Hospital. "Dr. Braen is one of the new breed of emergency medicine specialists," said John Naughton, dean of the medical school and vice president for clinical affairs at UB. "He's been in the discipline since its inception. He's regarded as an academic leader for the discipline and is helping to set the foundation of what the discipline is." Braen is residency-trained and board-certified in emergency medicine. He ran the residency program at the University of Kentucky for several years. He came to UB from his post as assistant professor at Harvard Medical School. The autho r of spiral-bound manuals for medical students and residents, his popular Clinician's Pocket Referenceis in its sixth edition. Braen is working on the third edition of EmergencyMedicine: Conceptsand Clinical Practice. Bl.ifFALD PHYSICIAN A:S:D BIOMEDICAL SCIENTIST G. RichardBraen, M.D., a pioneer in the field of emergency medicine,is chairmanof the medical school'snewest department. Along with a UB medical student, he's working on another spiral-bound emergency medicine manual. 7 He also wrote Managementof the Physicallyand Emotionally Abused: Early Assessment, Interventionand Counseling. Getting a brand-new department off the ground takes quite a bit of work. "Our major goal is education, initially," said Braen. "We'll get into research as time goes by." The department will be very communityoriented, Braen said. It will work with pre-hospital personnel such as ambulance staff and emergency medical technicians. Within the school, the new department will work with medical students at various levels. le will expand the offerings for emergency medicine rotations and offer services to existing cou rses that want to include emergency medicine topics. The three-year residency program will train IO emergency medicine residents a year. Emergency medicine is one of the most competitive residencies, he added. UB's program will be based at two main hospitals, Buffalo General and Erie County Medical Center, with Millard Fillmore and Children's hospitals supplementing the program. Most emergency medicine residency programs use more than one hospital, Braen noted. He hopes to have the residency program in place by July 1991. "The big job in starting a residency program is getting the board-certified emergency medical physicians," Braen said. "In the greater Buffalo area, I can count all of them on two hands, maybe one hand." Nation-wide, there are on ly about 7,0CXJ certified emergency medicine physicians available to fill 30,000 available positions, he noted. Since most of the training programs are in the midwest and west they can't keep up with the need in the east. ' Because UB's training program is located in the east and is at a university, "we1Ibe very competitive and in very high demand, and we'll get very good, qualified residents in the program; Braen predicted. The residents in tum can teach the students. "The key is the people," he said . Ten years down the road, Braen hopes the department will have a fully credentialed residency program that will be supplying residency graduates to area hospitals, that there's an appropriate interest in emergency medicine from medical students, and that there's a well-established research component in areas such as shock and trauma. • (Fordetails on the new department, see page 8.) EARLY WINTER 1989 �8 DERMATOLOGY Stephanie H. Pincus, M.D., has been named professor and chair of the Department of Dermatology ac UB. Pincus also serves as head of the Department of Dermatology at Buffalo General Hospital. Board-certified in both internal medicine and dermatology, she specializes in care of skin problems chat are unique to women. Her research is in a type of cell called an eosinophil, which participates in allergic and parasitic disease. It's found in large numbers in skin disease. Pincus, who is highly regarded nationally as a teacher, comes to UB from a post as associate professor of dermatology and medicine and vice chair of the Dermatology Department at Tufts University School of Medicine, Boston . She was also associate dermatologist-in-chief and director of the phototherapy unit at New England Medical Center, Boston. Re-establishing the national image of the dermatology department is one of Pincus's major goals. Dermatology has a tradition of being strong in Buffalo, she said. In view of the many changes chat have raken place in dermatology in America in the lase few years, it was time for re-evaluation of the residency program. One change was to integrate che department SKILLED PHYSICIANS NEEDED AT 'FRONTLINES'OFMEDICINE ''You never know what's coming in," said G. Richard Braen, M.D. That's the challenge of emergency medicine - it's the front lines in the fight against the trauma of major injury. And because the emergency room is the first stop for many kinds of cases, emergency medicine physicians need skills that cut across many disciplines - surgery, obstetrics, pediatrics, psychiatry, and community relations. Braen, a pioneer tn this relatively new specialty area, has been named chair of UB's newly created Department of Emergency Medicine. "l've been practicing since 1976, and I don't know of a day tha t's gone by when I didn't see something I'd never seen before; said Braen. "l like the variety." Braen remembers the time he was working an evening shift in Lexington, Kentucky. A call came in over the radio to expect five people burned in a car accident. le turned out that all five were deaf and mute. Because their hands were burned, communication was a challenge - they couldn't speak, couldn't write, couldn't use sign language. "We had to do the best we could; Braen said. Ac one time, the emergency room was a kind of Siberia where the hospital's least qualified physicians were sent, or the ER was staffed by interns. "Then it was realized that this was where the most qualified people were needed," Braen noted. Emergency medicine is an important new field, said John Naughton, dean of the medical school and vice president for clinical affairs at UB, because as the technology of caring for patients becomes more sophisticated, people who used to die from major injuries can now be saved. An important part of emergency medicine is the integration with the rest of the pre-hospital system, such as ambulance staff and emergency medical technicians, Braen explained. "We want to make sure the initial care is high so when EARLY WINTER 1989 they come to us they are salvageable;' he said. Many emergency room cases are not true emergencies, Braen noted. Emergency medicine physicians also cake care of minor medical problems at odd hours when the patient's regular doctor might not be in his office. Making sure char patients are properlyreferred so they get needed care, but avoid elaborate services that aren't necessary, is part of the job of the emergency medicine physician, Naughton noted. "There's a lot of emphasis nationally on improving emergency room care - where a lot of mistakes used to be made," he added. It was just a little over 10 years ago that emergency medicine was recognized as a specialty by the American Board of Medical Specialties. UB is one of the few medical schools with a department in this field. "I could probably hold a meeting of all of the chairmen of the academic departments of emergency medicine right in my office; Braen noted, glancing around the room. "There are only about seven or eight, so this is a relatively uncommon position to hold." UB decided to create a freestandtng department rather than a division within surgery because emergency medicine is a more defined specialty than it once was, explained Naughton. It also cuts across many disciplines. A freestanding academic department will be a big attraction to residents, Braen predicted. And, since this is an area where many mistakes can be made, having a freestanding department puts fewer people in the chain of command and makes residents more directly accountable, Naughton noted. The freestanding department was recommended by a special committee appointed by the dean. The hospital directors unanimously supported the plan, and it was in turn approved by the Faculty Council of the medical school, the provost, and the president. • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �more closely with other hospital departments. Dermatology's administrative and clinical offices were mo\'ed right tnto Buffalo General Hospital. The department also will emphasize more basic resean.:h to educate residents in the pachophys1ology of dermatological diseasl' and its relation to other basic science. "The res1dencs have, in large part, responded very positively, and there's very good esprit de corps; she noted. The next goal is thl· recruitment of more dermatology faculty memhcrs for the Erie County Medical Center and Buffalo General Hospital. ~1orc physician, are needed becau,e new regulations mandate that every patient who is seen by a resident must also be seen by an attending physician. Research is also an important part of the department. "Ulcimatelv, we want to develop a very strong re"Can..h program to further the development of the specialty," Pincus said. She also envisions that dermawlogy will plav an important role in an increasingly busy outpatient practice in the hmpitals. Another aim of the department is to strengthen the faculcv clinical pranicc plan, which provides private care on a fee-for-service basis. "I want to provide good care and use the fiscal rewards for departStephanieff. mental development," she said. Pincus, \Vhen asked about her accomplishment,, Pincus points to photos of her children, ages 17, 13, M.D.,has and I. integratedthe "I'd like to convev to women medical ,cudents Dermatology that it's not easy, but possible, to have a personal and professional life," Pincus said. Department In her quest for an administrative position, Pinmoreclosely cus was happy to find a city where both she and her husband, Allan Oseroff, M.O., Ph.D., who is withother also an academic dermatologl',t, could work. Oseroff is chief of dermatology research at Roswell hospital Park Cancer lnsntute. Roswell'ss1mulrnneous affiliadepartments. tion with, yet independence from, UB allows the couple to work wgecher,with(?ut one spouse working for the ocher. A graduate of Reed College in Portland, Ore., Pincus received her medical degree cum laudc from Harvard Medi cal School in 1968. Pincus served her internship at Boston City Hospital and her residency in medicine at the Umversity of \X'ashingron Affiliated Hospitals, Seattle. She served as senior fellow in dermatology at the University of \X'ashington and resean..h folio\\ BlJFFALO PHYSICIA~ A,'\;0 BIOMEDICAL SCIE?--.'TIST 9 in dermatology at Harvard Medical Sl hool. From 1987-88,she was a visiting scientist at Biogen Research Corp. m Cambridge, Mass. She is a fellow of the American Academy of Dermatology and a member of the Souetv of Investigative Dermatology. · Pincus 1sthe author or co-author of more than 60 articles and abstracts and nine book chapters. • NEUROSURGERY L. ~el,on Hopkms, M.D., has heen named chair• man of the Department of Neurosurgery at UB. He is also Lhairman of the departments of neurosurgery at Buffalo General Hospital, Millard Fillmore Hospital, Children's Hm,pital, and the Eric County Medical Center. A local product, born and raised in Buffalo, Hopkins comes to the chairmanship directly from private practice. His natural interest in arndemic neurosurgery led him co publish a book, several hook c.hapters, and more than 40 ahstracts and papers. He has lectured widely and sponsored national seminars in Buffalo on the management of aneurysms. EARLY 'IX'J!\TER l9bQ �Because of his energetic work as a teacher and IO clinician, several people suggested that he consider lhe chairmanship at UB even though he was a clinical associate professor, not a full-time academician. Re-establishing the reputation of the residency program, which was on probation, was his major goal when he started in January 1989. "A year ago, all but one resident failed the boards, and he was borderline; Hopkins said. "Now, all the residents have passed, and they did well. "In one year, we've turned around the teaching program, and that's largely because of Jim Budny (vice chairman of the department) ." In order to concentrate resources and avoid duplication of services, Hopkins aims co develop subspecialry centers of excellence at different University hospitals. Neurovascular surgery and neurosurgery of the spine would be located at Millard Fillmore Hospital; neuro-oncology, Buffalo General Hospital and Roswell Park Cancer Institute; trauma, Erie County Medical Center, and pediatric neurosurgery, Children's Hospital. Millard Fillmore Hospital is building a lab for spine research, as well as a multidiscip linary back institute for care of patients with back problems in conjunction with the medical school's Department of Rehabilitation Medicine. An exciting area that's being developed at Millard Fillmore is endovascu lar neurosurgery, Hopkins said, which can sometimes eliminate the need for open surgery or make surgery much safer. For example, a tiny catheter could be inserted at the groin and moved through the artery up to the head. Then doctors can inject fluid through the catheter into a tumor or vascular abnormality to take away its blood supply. This procedure could cut the hospital stay from 10 days co just a day or two in some cases. The department also is concentrating on neurologic diseases of the spine and has recruited two outstanding young surgeons who are experts in treatment of patients with spine disorders. "Back pain is the most common cause of disability in the U.S. besides the common cold; Hopkins noted. The department is also trying to develop a program for care of brain tumor~ with Buffalo General Hospital and Roswell Park Cancer Institute. Hopkins received his bache lor's degree from Rutgers University and graduated cum Laudefrom Albany Medical College in 1969. He served his internship in surgery at Case Western Reserve, then served as a resident in EARLYWINTER 1989 L. NelsonHopkins , M.D., aims to develop subspecialty centers of excellence at various University hospitals. neurology and neurosurgery at UB. He is certified bv the American Board of Neurological Surgery. Active with the Congress of Neurological Surgeons, he is general chairman for this year's annual meeting and last year was scientific program chairman. Hopkins is the chairman of a computer subcommittee of a joint committee on education for the two national neurosurgical organizations. He also chaired a subcommittee on drugs and devices for the two organizations. He's a member of the executive committee of the Congress of Neurologica l Su rgeons and has served as a member of the editorial staff of Neurosurgery,rhe group's journal. • ORTHOPAEDICS Robert Gillespie, M.0., Ch.B., who had been acting chairman of the Department of Orthopaedics at UB, has been appointed chairman . A member of the faculty of the UB medica l school since 1985, Gillespie is a professor of orthopaedics . He is also director of orthopaedics ac Children's Hospital of Buffalo. BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Establishing a coordinated research program and an organized sports medicine component are two of Gillespie's goals for the department. "I want ro establish a vigorous research base," he explained. Central laborarory facilities for all aspects of orthopaedic research will be located in renovated space in Farber Hall, the old dental school building, probably by June 1990. He also plans to establish a clinical research office with computer linkages throughout affiliated hospitals. Gillespie is working to recruit an established leader in orthopaedic research. Recruiting is also under way for a new scate-ofthe-art sports medicine center . The center, for patient care and research, will be established in conjunction with the Family Medicine Department, che Division of Athletics, and other departments at UB. le will provide overall health care for UB's varsity and intramural sports reams, students who want to gee fie and stay fie, and other residents of Western New York. One of the strengths of the Department of Orthopaedics is its strong teaching program that offers excellent, well-rounded training for residents, especially in spine and hand surgery, trauma, and pediatrics. The residents have a very high success rate on the orthopaedic board exams, Gillespie said. "And we are optimistic that we can move our training program - which is already well respected - to a level where it is regarded as one of the major orthopaedic programs in the country," he said. "Part of that process is to enla rge our research fellowship program co facilitate our research capability and to be able to build a stronger and more complete research experience into the residency training program itself. "We hope to build and strengthen our contacts with other departments th roughout the University, especially Engineering, Physiology, and Health Related Professions." Before coming to Buffalo, Gillespie was an assistant professor in the Department of Surgery, University of Toronto and an orthopaedic surgeon at Toronto's Hospital for Sick Children. He also was a consulting orthopaedic surgeon and clinic chief of the amputee service at Ontario Crippled Children's Center in Toronto and on the staff of the Department of Orthopaedic Surgery, Orthopaedic and Arthritic Hospital, Toronto. Gillespie is an orthopaedic consultant to the Pediatric Institute of Krakow, Poland, which operates under the auspices of Project HOPE . BUFFAl.O PHYSICIAN AND BIOMEDICAL SCIENTIST RobertGillespie, M.D., Ch.B.,plans to establish Since 1970, he has been active in the research into the problem of children with spinal deformities 11 and congenital limb deformities. The author of multip le publications and book chapters on these topics, he has also been an invited guest speaker in many major centers around the world . He received bachelor of medicine and surgery degrees from Sc. Andrew's University, Sc. Andrew's, Scotland, in 1959. He was named a fellow of the Royal College of Surgeons of Edinburgh in 1965and a fellow of the Royal College of Surgeons of Canada in 1969. Gillespie has served for the past four years on che board of directors of the Scoliosis Research Society of North America. • a coordinated research programand an organized sports medicine componentin orthopaedics. PEDIATRICS F. Bruder Stapleton, M.D., has been appointed chair of the Department of Pediatrics and the A. Conger Goodyear Professor of Pediatrics at UB. He also serves as pediatrician-in-chief and chair of the Department of Pediatrics at Children's Hospital of Buffalo. A nationally recognized pediatric nephrologist, EARLY WINTER 1989 �12 i Stapleton previously was professor of pediatrics and chief of pediatric ncphrology at the University of Tennessee Center for the Health Sciences in Memphis. The first step toward developing a nationally recognized academic department is to strengthen its already fine faculty by recruiting talented scientists who can also provide the state-of-the-art clinical skills in pediatrics, Stapleton said. The lack of a research building to show candidates is an impediment to recruiting, he noted. UB's planned research building will help, and there arc plans for Children's Hospital co gee additional research space in the next five years. Another recruitment hurdle is the limited number of people going into academic pediatrics. But UB's Department of Pediatrics has several points in its favor, Stapleton pointed out. It's affiliated with Children's Hospital of Buffalo, a strong pediatric hospital with a unique feature: it's the only children's hospital in the continental United States with a high-risk delivery service and a strong neonatology program. Children's Hospital enjoys a great deal of community support and there's a very close relationship between the hospital and the University. The EARLY WINTER 1989 F. BruderStapleton, M.D., is recruiting talented scientists to strengthen the fine faculty in the Department of Pediatrics. hospital is clearly oriented to support the move to national recognition for academics, Stapleton added. Because UB has a system of affiliated hospitals rather than a single medical center, faculty in pediatrics can draw upon the other hospitals, such as che Roswell Park Cancer Institute. The drawback, though, is that Children's Hospital is geographically separate from the core of scientific activity at UB. Because researchers have to travel between sites, "it takes tremendous commitment to meet patients' needs and conduct research; he noted. Stapleton received his medical degree in 1972 from the University of Kansas Medical Center in Kansas City, where he also served as chief pediatric resident and a fellow in pediatric nephrology. Before joining the University of Tennessee, he was on the faculty in pediatrics at the University of California at San Diego and the University of Kansas Medical Center in Kansas City. He also served as co-associate director of the Clinical Research Center at the University of Tennessee and medical director of its Pediatric Unit and as direccor of research for the department of pediatrics at LcBonheur Children's Medical Center in Memphis. Author or co-author of 88 scientific papers, Stapleton has done extensive research in urinary and kidney problems in children. He participated last year in the development of a consensus doscument prepared under the auspices of the National Institutes of Health chat focused on a long-rage plan to combat kidney and urological disorders. A fellow of the American Academy of Pediatrics, Stapleton is certified in pediatric nephrology. He was recently elected a member of the American Pediatric Society in recognition of his accomplishments in pediatric research. Stapleton also was elected co the executive council of the American Society of Pediatric Nephrology. He is a member of the executive council of the Internacional Pediatric Nephrology Association and the national executive board of the American Board of Pediatric Nephrology. • PHARMACOLOGY Ronald P. Rubin, Ph.D., has been appointed professor and chair of the Department of Pharmacology and Therapeutics. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �___ -_-_ ___ --~- ---- - ---~ Rubin previously was professor of pharmacology at the Medical College of Virginia, where he had been a member of the faculty since 1974. Before chat he was on the faculty of Downstate Medical Center and Hunter College. After receiving his undergraduate degree in biochemistry from Harvard College, Rubin attended dental school at Harvard University, then switched gears and obtained his master's degree in teaching from Harvard. He taught high school science for a year before he decided co go into pharmacology. In 1963, he received his doctorate in pharmacology from the Albert Einstein College of Medicine. Rubin's goal is to build a department of national and international repute. He emphasizes chat he is seeking quality, not quantity. "Quality begets qualicy; he noted. "People build reputations individually. We're not dealing with a numbers game. When I retire, I want to be remembered for having built a good department; nor a large department. He's crying to recruit a "critical mass" of faculty with world-class reputations. In the next four or five years, he wants to see the faculty invited to national and international meetings. "If you have a good department, several faculty members should go on co be chairmen of their own departments; Rubin added. "We've identified a couple who could be in the next few years." One of che strengths of the department is its good young research faculty. Rubin has recruited a colleague from che Medical College of Virginia, Suzanne Laychock, Ph.D., and he's looking for two additional people. John Naughton, dean of the medical school and vice president for clinical affairs at UB, has been very supportive and understands the need to bring in outside people, Rubin said. Having chis critical mass of fine faculty members will in turn attract fine pre- and pose-doctoral trainees, Rubin added. It's important co have an active graduate program with approximately one student per faculty member. You need that blend of pre-doctoral trainees, post-doctoral trainees, and faculty for an optimal intellectual environment, he said. To strengthen che department's teaching program even more, Rubin plans co interact more close1y with the Department of Biochemical Pharmacology in UB's School of Pharmacy. Research is an important part of the department, and Rubin expects the faculty to be productive. However, he stresses that grants are only a BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST - 13 RonaldP. Rubin, Ph.D., emphasizes that he is seeking quality,not quantity,for the Departmentof Pharmacology and Therapeutics. means to an end. He'd be satisfied with a productive faculty member who had one grant. And if a faculty member had two grants and wanted a third Rubin would want to make sure the faculty membc; could handle it. "My goals are productivity. My goals arc quality, not quantity," Rubin stressed. "I think this department as a group feels that. "I'm not against grants; I'm against making grantgetting the goal of your work." Rubin studies secretory mechanisms, also called signal transduction. He focuses on calcium as a mediator of secretion. The author or co-author of more than 80 scientific articles, 19 book chapters, 2 monographs, and numerous abstracts, he also serves as field editor for cellular pharmacology with the Journalof Phar­ macologyand Experimental Therapeutics. He won the faculty member of the year award for excellence in research from the Medical College of Virginia. A member of the American Pharmacology Society and the Endocrine Society, Rubin was on the Public Information Committee of the Federation of the American Society of Experimental Biology. • EARLY WINTER 1989 �14 Bv WILLIAM R. TAYlDR, ~1.D. n the second day of January, the weather in California was so cold and nasty chat it reminded me of Buffalo. I began watching two large gray squirrels playing tn a naked oak tree. They were running at top speed, alternating the lead, up and down branches, then jumping many feet co another tree. All this was 50 feet above the ground, on wet footing and in the rain. Their obvious joy and pure fun broke me out of my slowly developing depression, and changed my thinking to happy thoughts from 45 years earlier. A great day in the history of medicine was Jan. 2, 1944. On that d:w penicillin was released for u,e on the general population and memhers of the Class of 1945 were assigned their first live patients. We were designated a, "junior clinical clerks" and called "Doctor" bv thl· knowing nur,es. That day was also cold and wet in Buffalo. We were herded mto a large room where we met Abe Aaron, full professor of medicine, in charge of converting us "masters of ac.adem1c theory" into "dinicians" - Ill ahout one hour. The most memorable subject covered bv Dr. Aaron chat day wa, the role of humor in the pracm:e of mediune. He proposed char etery disease inflicts a secondary effect on the psyche of the patient and that chis ranges from simple worrv to depre~sion. It is also similar among their kinfolk, if not worse. He assured us that the presence of the physician could etther lift or further depress the mood of the sick room and we Jl/uslralions EARLY WINTER IQ~q must never forget chis potential. He used the word "humor." This must never be of a flippant type, hut a "discreet and appropriate" type; when the doctor leaves the room, ewryone involved with the disease should foci better. This is espt.•dallytrue in those cases where ,pccific therapy \\ ill not cure the primary disease. Abe Aaron then proiected ro our future and promised us that a good sense of humor would be necessary if we were to survive 111 the potennally depressing career environment of disease. Meditating on the above leads me to update three inadequate t)bituarv notices. While our Class of '45 mav not he the most outstanding in every category, we certainly had the greatest collection of True Humori.,ts. It is a sad reality that our three greatest humorists have re,encly died. The ohicuary notices 111 chis UB alumni journal missed their real greatness when they factually reported: Mamn Downe',', Jr. ane,thesiolog1st; Joseph Rutecki-surgeon and anatomist; George Fuggm-urologist. I would like to introduce you to these three outstanding members of my c.lassand offer a few thoughts concerning their true greacnes:s.Furthermore, should they (Xlssess that elusive nbility co read this from their position in the Great Beyond, I would like them to know how much I admired themthen and now. I met Joe Rutecki fir~t because we both went to R1vcrs1deHigh Sthool, where I was a vear ahead of Joe. Accordingly, I did not t'/ JoseplJiie/ BUFFALO PHYSICIAN ASD BIOMEDICAL SCIENTIST �. ----------+~-:j ____________ ::::::-1:➔ ••••-••-~.f•• '' ••••••••••• II 11 I ;.,....... : I t I I , I I I , I I .... - . - :: t - - • - ••••.::: I I I - --- ---------- .. I I I I I I I I I I I I ,-............ - _.,. ~ •' I I I 0 I .. ---_-_-:___ --_- ----•• I ,,' .:L ... I ' ,-----==-- II I I"• I . -------- ----- --- :,I I 1 I ••••• �16 know Joe very well, after all, he was only che laseof a long line of Ruceckis. Joe was known co be unusually smart, bur nor as flamboyant as his older brother. We all knew him as a nice kid. We didn't know che term "humble; but he was that coo. I next met Joe in anatomy lab on the morning of July 5, 1942, the day our class started med school. I was with him every day for the next three years. I had the only car going from Riverside to med school and I drove Joe to and from every day. There was a constant attitude of humor that grew more inescapable as time went on. This was every day in the car, in the classes, and in our frequent bull sessions which were often about a very real WW II, which was not always going well for us. Joe had a specific type of humor we all noticed: he never extracted humor ac the expense of any other person. We identified Joe's humor as "benign humor." I think of the humor of Red Skelton as "benign humor" and that of Don Rickles as "malignant humor." I cannot separate Joe's humor from his sharp and quick mind, which may explain why he made med school after only three years at Canisius College. Joe very rapidly changed from "just another Rutecki." Since he was "Ru" and I was "Ta"in the alphabet, we spent both years of our clinical clerkship not only at the same hospitals, but in the same small groups. It was in the clinical setting chat we saw him use the type of humor char Abe Aaron called "discreet and appropriate." He was often with a patient in the desperate throes of a terminal illness, but I could not help noticing how his innate humor spilled over co make the patient somehow feel better. This was not a phony act just because Aaron had cold us to inject a dose of humor; this was the real Joe who had chis quality from rhe cradle on. Another word we muse use is "sincerity; which he had in full measure. Among his colleagues, Joe was noted for coining nicknames and propagating, if not originating, "rumors." When the med school was between deans, he wanted to start a rumor campaign to get our most eligible classmate appointed. Norm Chassin was not elected, bur he EARLYWINTER IQ8Q ,~..-...._. . .,_,,,_,,~._~......,._,.~, '! rn Jle I courl jesler ' ' anJ a Jarn root! i sluJenl, j 300 pounJs-pfus , I, I i 'e was II . I I' ' J ' of Jumor anJ fun,· i I, I I:, I' ' i: . 'i ii nol an ounce meanness '- ..... • ,n of /, • tm. I' i I I . i' I I' , ~~ ........ ~...... ,- ,~ ·•- •1 - ,,-!: was a dandy. When I lase saw Joe Rutecki it was at our 1985 class reunion. Several of us were in a conversation when Joe joined the group. A classmate said: "Here comes Joe ... now we will all scare laughing." I don't remember che derails of the conversation, but the laugh titre went sky high. As his special "benign" humor went to work on his beloved classmates, he was personally carcinomatosis, bur concealed the grim fact. He was a great guy for me co have known. C hronologically, the next one I met was George Fuggin. This was in September, 1938 when we both scarred pre-med on campus. We met more literally when we both went out for frosh foot• ball. On the first day he played defensive nose tackle and I played offensive center. We bashed each ocher all afternoon. My mother ended my career when she refused to sign the parental consent to play. I don't know if George's mother scuttled him in a like manner, but I was sure he would not make the team. He was 300 pounds-plus of humor and fun; not an ounce of meanness in him. Through countless encounters, four years on cam- pus and then three more in med school, George Fuggitt was always the "court jester" and a dam good student, coo. In med school he was in all my preclinical classes, but he was "Fu" in contrast to my "Ta" so we were on opposite sides of most rooms. George met Gene Morehouse in med school and their chemistry hit it off. They had a running pseudo-feud chat injected humor into every situation. Since George was over six feet call and always on the upper side of 300 pounds, he was dramatically bigger than Gene, who played the straight man. This pair we called our "Laurel and Hardy." Their humor was not necessarily classic benign, but it was also never malignant. At the 1980 reunion party, George was the master of ceremonies. His spontaneous and continuous humor further underlined the rumor (possibly started by Rutecki?) chat George was the only doctor who had his patient laughing during a prostate massage. It is good that George chose urology, where humor is so appropriate. I last saw George at the 1985 reunion. He couldn't be the MC because the ravages of his rumor diminished his ability - but not his beautiful smile. His humor fit well in his huge countenance. The last of our trio was Marty Downey. He sat two stools co my right in histology lab and we met for the first rime on the afternoon of July 5, 1942. At that time l evaluated him as a quiet, incelleccual type. ln those days he started no conversations, but always joined in with comments on all subjects. His comments were always very appropriate and usually raised the level of conversation. He was more a Catholic philosopher than a humorist. As the freshman year progressed, he became more relaxed and the humor began co show. It was especially effective because of his original reputation as an intellectual. Marty Downey and George Fuggitt contrasted in many ways: George was at all times a gross extrovert; George was the biggest man in the class and Marty was probably the smallest; George was not a football payer and Marry was. But both were equal in the quality of their humor. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �,.. . .·J • : ~ · .-- .... .~ ... ,,,,,,.... ..- ••:•. • ~•• 0 •• : ... A ., --~...... .. _ ,.,,....,.- .~ • . """' ·-. ··. ~.- : } . : ..~ ~;·.:. ....,...io!!_j~;;\. ··- \-.-~ -·· .. :l ..___:' ..' ' ·.~l ·:·:. . ' ...:--- ----:-::. ~ ·,'··............ ' . ...._.... . ~ ,. ..;,,,,.. .:·....:,:,,: __,,,,,,,,,,, . ,( { .. ·::__ ... . By October, 1942, we had spent three full months with the freshmen dentists. While we spent every afternoon in labs, they were having a series of picnics with endless beer and spectacular couch football games. The lace afternoon lab schedule was aggravating enough, but their arrogance abouc their games was building our resentment to hatred. We finally arranged a showdown game. On the team were several former college star players, but chose Dents were pros. They beat us 35 to 7. Marcy Downey was our entire offensive threat and they identified him immediately. He was so fast and shifty that he was the only one co gain ground all day. The Denes would frequently cackle Marty because they were afraid a mere touch might miss this dancer. Each time Marty would bounce up in testimony to his great physical conditioning, and each time he would make a snide remark about the rough game, but in a manner chat both sides had co laugh. By the end of the game he was both our M.V.P. and top humorist. We arrival. They were not disappointed at the plight of this terribly proper bronchoscopist. We were convulsed ar rhe retelling. ln my medication on the theme, l am somewhat disappointed that Marry Downey chose anesthesiology for his life's work. It is regrettable chat so many of his patients were sleeping rhrough his humor . Bue, to remember the second admonition of Abe Aaron, the physician needs a good sense of humor to survive a career in chis potentially depressing environment of ours. all had to use humo r co accept chat terrible beating, but Marcy was the best. The last time I saw or heard Marty Downey was on the occasion of our 35th reunion. In a small group setting, Marry reviewed a case which he had not been forewarned about. The first inkling that it was co be a sex change operation was when the surgeon in charge made his initial bold incision, actually excision, to change a boy into a girl. This surprised the anesthesiologist, who was attempting to sec up a very proper chart. He gave a resume of the surgery and the comments in the O.R. by all of the various members of the O.R. ream. Marty convulsed chis audience, which led him into a discussion of the gastrocolic reflex of Herman Boser. It seems chat at 9 a.m. his urge to respond to the reflex would have to be answered. Ac 8:45 a.m., Marty set up a phony occupant in each of the two toilet booths in the doctors' lounge at Buffalo General Hospital. He then locked the doors and climbed out over the partition. Then the boys all sat back and awaited the urgent BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST <T here is one more unique circumstance that involved all three: ASTP. ln July, 1943 the military took over all the approved medical schools with a program called "Army Specialized Training Program." Our three heroes were all soldiers, first as privates and later promoted to Pfc.The olive drab uniforms were wool, which can get hot and itchy. Mass formation each 0800 our in High Street was awful as witnessed by us Navy men wacchin~ them from the comfort of inside. Worst of all was the military protocol, which demanded that these privates behave as subordinates to the corporals, sergeants, and most especially the major, who constituted the staff. All the above stimulated the funny bone of our class instead of breaking their spirit. There were many other classmates who were humorists in this regimented lifestyle,but none greater than our Big Three. These were three great men who have left a hole in the remnants of the Class of '45. The level of humor will be lower. If we allow these three men to die and fill an obscure niche in a stack of obituaries, the cause of humor in medicine will be offended. [ hope there is some professor of medicine at UB who repeats the message of Abe Aaron, and impresses the budding doctors chat humor should be a big part of their careers in medicine. I am quire sure each class will have potential Ruteckis, Fuggitts, and Downeys, and they should be officially encouraged in this beautiful line of therapeutics. Can you now see why l love these three men? • J EARLYWINTER 1989 J7 �Graduate Students he scientist values research by the size of its contribu, tion to that huge, logically articulated structure of '' ideas which is already, though not yet half built, the most glorious accomplishment of mankind?' - Sir Peter Brian Medawar (who won a Nobel Prize for his work in immunology). The grandest of goals is shared by the graduate students who are entering the University at Buffalo School of Medicine and Biomedica l Sciences. As it did in the last issue for the medical students, the Buffalo Physicianand Biomedical Scientist now presents a photo directory of the new graduate students. Their biographies inc lude undergraduate major and degree, unde rgraduate institu, tion, and current department. �Graduate )tudents 19 Susan Lynn Dagenais, Peter Augustinos , B,ologyB.A., Hofstra Unitermy, Pacholoin-1 u:,sh co gam more knou:ledgeabouc the human bod,. Kathleen E. Bethin , Bux:hem1s1ryB.S., Unlt'ers11y at Buffalo, Biochemistn. l am a jomt M.D. ·. Ph.D. student. Reva Bhushan , BiologyB.S. and Chemistry B.S.. Si. FrancisCollege, MicrobioloJ::,'. 1 ha,e a ma.1ter'sdegreefrom Rhode Island m B,ologv. 1 am 1nten-s1ed m research,oil pam1mg and baiik. Manja H.E.M. Bouman , Biochemistry Engineer,Hogeschoolf nterstudie,Biochemistry. I'm from rhe Nerherlands.l pla, Korfbal. Margaret Christine Grabb, Bwlogv B.S., Un1<ers11y at Buffalo, M, fa,orue Physiolog:,·. sporesare u>lle-balland basketball. David A. Judd , B,otechnologv,RlT, B,ochemistn. l u·ould ratherbe d~mkmg. Chong-Hyun Kim , Microb,oloi('iB.S., Seoul Nauonal Uni,emiv, Physiology.M, fawrite spori is bou·lmg. Won-Ki Kim , PharJungsook Cho Lee, 1rtac\ B.S. and M.S., Pharma" B.S., Seoul Seo,;!Na11onalUn1te~,- l\'auonal Unn.ersH~. t), Pharmacolog:,. l like Pharmacnlog,.I came plavmg iennis l am a from Korea. neu· Ph.D. studenl in pharmacolog,. Laura Jane Nicho lson, B,olog:, B.A., l.lni,·erm, of · Delauare, Micmbwlogv. l came 10 Buffalo from· ~for.land and for UB's .\1.0. • PhD. program. Xin Sun, B,ochemism B.S., Fudan Uni,·e"uy: ShanghaiProunce, B,ochemistr..;'..h faiher is a professorm • biochemiscr..1 ihmk I'll uork on biomedical Miriam Helene Tiktinsky , Phy1ical Theraf1\B.S., Washmi:conUni,m11y, Pms,olo![).Afier eight w,m as a P.T.,I'm gomg back co school10 do research. Meng-Hang Xia , Tox1cologv B.S., ShanghaiMedical Unn ern1,, Pharmacolog,:I'm from Chma. 1 am a Ph.D. Meiheng Yang, B1ochemmr.B.S., Sichuan Uni, mu,, B,ochemmr.. l came here on July 26. Zhaohui Yang, Biochem,sm·B.Sc., Pe- science. 1ruden1no-.,·.I u·ill enjO\ B,ochenmrnB.S.,Norih• em M,ch1gan Unit·mir,, Parholog:,. I ha,·e an M.A. m biolog,. I ha,e an miere.<tm research. Shih-Ping Yang, M.D., NarionalDefense Medical Cenrer, Physiolog:,. l am a graduaresrudentof rhe departmentof pms,ology Yuan Gao, Medicine B.S.C. PekingUnion Medical College, B,ochemmr.. I chose UB becauseu's a famou~umt'ersuy. king Un1ternr,, Bioch,mmr.. I am onginalh from Chma. 10te l.!B. If. Photoswere unavailablefor: John Delyani , Physiolog:, Haiping Mei , M icro&iolog,. �People 20 Offbeatand Proudof It Ettinger will do anything to spark students' interest "1 try to convey in an emotional way, what's exciting about the subject. I do a lot of 'offbeat' things to stimulate excitement and interest; Murray Ettinger, professor of biochemistry, said from his laboratory. "I have no pride. I'll do anything to create interest and understanding." Ettinger was describing some of his offbeat methods of reaching. "[ meet people ten years lacer and one of rhe first things they mention is collagen superstar~ Ettinge r said a former student gave him this title. "I go overboard crying to get people to understand why collagen (a structural protein) is so exciting," he said. But collagen isn't the only subject to get Ettingcr's unusual treatment. "There is a concept of how enzymes work called induced fit. I used a thinly disguised analogy ro mutually happy sex." Bur Emnger's offbeat approach isn't limited to a single class. "I taught an advanced graduate course and I decided nor to give any exams. Then I found out what rhe great motivator is: a berter motivator than grades ... • Ettinger paused with a twinkle in his eye. "I said, 'Put your hand on the buzzer as soon as you chink you have the answer. Whoever understands it first will get a dozen doughnuts:" Pastries, apparently, motivate students better than finals. These methods apparently are working. SUNY Central recently named him a distinguished teaching professor, one of the highest honors in the system. This is not the first rime that Ettinger's EARLYWINTER 1989 By DAVID M. SNYDERMAN teaching excellence has been recognized. He has received two Louis A. and Ruch Siegel Teaching Awards and many letters of commendation. "Put your hand on the buzzer as soon as you think you have the answer. Whoever understands it first will get a dozen doughnuts," Ettinger told his students. Pastries, apparently, motivate students better than finals. T he medical school class of 1979 dedicated its yearbook to him and he received the S.N.M.A. Award for Service co Minority Students in 1988. "I really felt good about that because I have spent a lot of rime trying co help minority students; Ettinger commented. Ettinger has serious accomplishments co his credit. He has developed several classes, one of which is an elective honors biochemistry course for medical students. "Several students said they were just bored with the first year of medical school. "It's an informal, graduate level course where the students learn from each other. Two co four students identify a disease that they arc interested in. I help chem a licdc bit finding papers about the disease," explained Ettinger . The class has examined such diseases as Down's Syndrome, sickle cell anemia , systematic lupus, Parkinson's, diabetes, muscular dystrophy, and schizophrenia. "lc'swhatever the student wanes. Everybody in the class reads the papers. All that the people who choose the diseases do is lead the discussion. They learn by informal conversation about what they read. And then the following week, we get together with a physician and a patient." This helps the students get a better understanding of the disease, Ettinge r noted. "I've (also) organized a summer program for people who have failed biochemist ry. The objective is not only to learn and pass biochemistry but to learn an approach to understanding any subject," he said. Ettinger teaches methods of learning in this biochemistry course. Students are told they should take the lectures and then, "paraphrase BUFFALOPHYSICIANAND BIOMEDICALSC!ENTIST �People 21 1nternah:c 1t, ~ct II mto vour m, n word . Iii he a good ,tudent, vou have to lome up \\ 1th your O\\ n 'ICU point. \\'hnt a good tcachcr dOC! 1s ,umul tc you to do chat. •t \\ould like p,.:opll' t<> undcr,t.md what I'm t.ilking .,bout ,o that tlll'y rnuld solve a rnrn• plctch nc-., problem• 11, or Emnger, tead11ng add, 'Pile to life. "I like the \'ancty of mv Job. I enJO) my I would go re5c:mh but 1f I did Ju t r=rch, half hall), Teaching gl\cs me rnntan \\1th F people." "1th111 a teach mg exist Et unger' order to "In hO\\L'\er. frame-.,ork of rc,,carch, get a J1 t 111guished te,1<hmg pmtc sor,h1p, fir<t of nil \'<)U han· to hen prof<'S50ran<l vou can't he a profo-or "1thout being a uccessful researcher." Trained ,1, n protl'III < hem1,t, l:tt111~crmm \\Orb "11 h rnecalocn:ymc,, •pc-c1ficallvtopper o:1:idasc. "I'm intl'f('!,tcd m the role of copper m h1ology," lw ,,ud. "Sumulatcd h, quCl>t1on, from m\ O\\ n graduate cudcm,, our work in recent ~car has dnhl·d towards H'llular hmchem1<trv ol ,oppcr; th,ll 1,, how cdl move nroun<l and use copper, and mhcmcd d1,-ca~ of copfl<.'1' b1ochcm1 try (,uch a \X'1l,-0n'sdt l-a,e). "\\'c u,l' the d1,ea,l' ,1s :- rool," he ,ay,. "If not only rnn we cure figure out the d1!-<:asc, the d1~. se, but \\C find out 50me1hmg tm portant about hm, normal cells u e copp~:r." EmngL·r\ n>mmllrnl'lll ro re<l'.lr<h makes lum a be Iler m,cruc1or, he said. "The old a~~c that tcachmg and research complt:mcm <':I<h 01 her 1~ true." Hi, 1ead1111gmetho,.h ure ha L'd on mak• ing an 1mprcss1on, Emngcr ,aid One of his former student, rold Emngcr that one of the pmfc,,or's 5ta1cmcnt ,ihuuc "ho\\ ,Hw1h111g that can r,lllonallv happen probahh \\tll be bsencd in 50mc Lanett <)<tern• had become the ha~• for that phys1c1an's pracucc ol 0 med1eine. "It reall) madc me feelgood." § for Ettmscr,teaching rs a =pons1b1ht~ n t R t,) fic takl·n lightly. "I'm t hL·onl' \\ ho 1< ,urn• lt 111,m:mgI he wholc ,rnw of knowk<lgc about the ,uhJcct. \XO\\! That' rcalh a prl\'llcgc: • ,,c I \furra~ Ettinger, Ph.D. BUI!'AID PHYSICIA~ A~D lll0\1EDICAI SCJE:-:TIST EARLYIX'ISTER198'1 �People 22 Keep It Fresh Severin wins Chancellor's Award for Excellence in Teaching //E ach student has his limitations. You have co adjust your teaching to the student," says Charles Severin, associate professor of Anacomical Sciences. His willingness co adjust, along with his excellent teaching methods, have won him a Chancellor's Award for Excellence in Teaching. One of rhese adjusrmenr, occurred wirh the student of a colleague. Severin, who teaches gross anatomy (primarily to medical and dencal students), was asked for suggestions by Judith Tamburlin, clinical instruccor in anatomy, who teaches the undergraduate gross anatomy class. "A couple of years ago, she had a blind student enroll in a class," Severin began. "Anacomy is a visual subJect; there are areas in anacomy that are cough for a sighted student to understand. "After finding that there weren't any teaching aids at this level for her, we designed this for her." "This" is a braille, raised relief, gross anatomy textbook made especially for Lisa Hoffman, Tamburlin's student. Accompanying the raised drawings are explanations both in braille and on tape. Severin and Tamburlin recently received a two-year, $154,000 gram from the National Science Foundation to develop and assess a similar book for high school students. Writing the accompanying texts was a task that beneficed his regular teaching duties. "Ofren the descriptions we used co teach her, we now use co teach the sighted because they were clear and concise," Severin said. EARLYWINTER 1989 By DAVID M. SNYDERMAN Bue Severin maintains his efforts co help students day in and day out and doesn't limit those efforts to an occasional pupil. Because medical scudenrs have long, unusually inflexible schedules, Severin found it difficult to find office hours agreeable co everyone involved. As a result, he now meets most of his students by appointment. 'I've met with students at seven in the morning, eight at night, and on weekends, if they need help,"he explained. "Some people would call it great lengths, but I Just consider it pare of my job. "I try co make my hours as flexible as possible; I cry co help students as much as I can.• S everin said he has found the students extremely dedicated, once they have come co him for help. "I would make appointments for seven in the morning. I would get here sometimes at ten minutes to seven and I never bear the students here." Severin cakes the special insights he received as a student and passes them along to his pupils. "I try to present co the students little rricks and techniques that I use co remember the subject," he said. One of the "tricks" is co draw the anacomical structures from memory. In fact, Severin asked Lisa Hoffman co cry to draw the pictures that he and Tamburlin had transcribed for her. Hoffman walked up to the blackboard and drew the structure, he said. "There was lots of overlap," Severin said, "but she could do it." Another trick that Severin suggests is "to place chem in the body. You can sit there and memorize rhe conrenrs of the anacomy text, but it's just words." So, he asks students co imagine chat they are inside the body, telling them to look around at the structures that arc there. "Anatomy allows you to do that because it's basically a visual subject." This technique, he said, help, students to remember the anacomy long past the final exam. To Severin, it is important that they "remember it ten years from now~ One of his teaching practices has been to revise a lecture every year - even if he was happy the way it went the previous year. Severin said he was taught not co teach like some professors, who use the same lecture year after year. "After doing that for five or six years, they're bored - you can cell they're bored - and the students are going to sense that as well; he said. Severin said he respected the efforts put in by one of his own professors when he was a student. "He spent a minimum of two hours preparing each lecture after IS years." As for professors who just read a prepared text, Severin says, "that's not teaching. There is no sense in coming co an 8 a.m. lecture if the guy is just going co stand up there and read. "We both know it's readable. The object is to try and get the student to remember it." Often, after the lectures in which he presents his tricks, Severin finds that students present him with approaches they've devised to learn the material. "In effect, they are teaching me ways of teaching." • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �People :!J sc1plinary He ,~ d1rc1.tor of 1hc ~1ul11d1 and coUB ,II Agmg of I~ Stu the for Cenrer d1rcctor of r '" \\ cm :-:c:."\\'rink Genamc • Educauon Ccmcr :it the Um\.-rsny. M.D ., ho, lx·cn Lebenthal, :-.:anonal ,ttc:. ,. [n,mute of Child Health and Human De ,dopmcnt rhat \\ 111re, tcw grant ,1pplicar1011s involvmg nutm1onal therapy (or inborn errors of mctahoh m. Profc sor of pedrnm at UB, l..ebcmhal LS ..rologv and , h1cfof 1ht•Ol\1,1011nt Gastroc:·111 :-.:um11011,tt ChtlJn·n's Hosp11al ,md J1rc:.'C• tor of !IS lmernauonal ln,mu1c of lnfa111 :-.:um11on and Ga tromrestmal D1sca,c. • Emanuel hc r ry Leitch , a S<.'tond-vearuuJrm. won a n·lkl\\sh1p 1ha1 Tr.IV lcr Gcnamcs Rl.'5Carch • S3,000. of award carries an Trevor Litchmore , a third-year •tude111, \\<>nan American Ht·art A<so,1111on\ Stu• Jent S.:holar,h1p m Ccrcbrova,cular Oisca c • thnt came,. an award of $1,'it"lO. Edwin A. Mirand, Ph.D., J rc-ctor of the Dcparrmcnt of Ec.lut,1t1onanJ dc;in of the of UB, re• Ro,\\cll Park Graduate D1v1s1011 A,,_,-ardm \\ehr H. 1lh \X Dr. CCl\t-d the M tr~h tor h1<conmhuuom to Roswell Park • Memorial Im.mute. Chc1rlt•\ Set•erin, Ph D Ph .D ., meal mmucJudith Tamburlin, tll<< , ,,on I L1llv St anntomKal ror ol n-llo"•h1p for her mno\'amc "hanJ,-on" tt-achmg mcthcxh. In a prQgr.!m mlcJ •Undcrgrnduate Human An.11omv Dcmo11s1ra11on Lahormory and RclmcJ Tt-achmg ~latcrial<~ Tamhurhn ,, ne:umg ,pcc1al materials for lnhorator\' Jcmon<1ramms h) prc,cn mg human 11--uc, ,uch a, hcan and lung , m a hfchke •cate. This 1sdone chrough pla,1mauon, the prote,s o( rt·plauni: dw "acer Ill 11'-U<"'"II h a • ,iliu1111ypc ma1cri,1I. 0 0 John Acquavella, a Ph.D. tudcm m the of Social and Pn:vcnnvc Department McJ1c me, rccc1vcJ the award for the best pa~ pri:5ented on a di<scrcauon m the :-:n- BCHAI.O PHYSICIAS ,\SD lllOMEDICAI uonal Compc:uuon of the Ep1dcmiolog1t Rc~earth. S. ty for • Ra)'mond P. Bissonette , Ph.D .. soc1me tam1lv mcd1c11 ,c l B, was ,..._r of the hoarJ oi dm."ttor, ol idem pre dt-ctcd 1he Un11cd CerchrJI l'al y A ,oc1auon ot • 'ri1rk, Inc. \\b1crn :,.:<"'' ob-,or and heaJ of faan Calkin,, M.D., , anJ Gcromologv n of Jcr ch D, :it UB, h,1, h,cn nanwd ,t ma,1.:r of the American Colkgc of l'h\sitian,. C-.alkms, chief of the Gcromolog~ cc11on nt the \r\ Mcd1cal Cemer, wa, urcd for pron mcJ1<:al '1dmg d1rcc11on and 111<p1ra11oco ,rnJcncs and residents and for hi, le;1Jcr,h1p and '>t!n,cc m rhe field of genamcs. SCIESTISI e prt..,.1dem for John '\aughton, \1 0.. t c mcd1cal school rs and d cln a1 UB, h," hct•n n.11ned pre,1dt·nt of I ht Amcman Heart A~soc1,1tion,:,.:t"\I ); rk S1,1tt ,\ffihatc. ~aughcon ha, puhhsht-d c"renmdv on ex t-rCN' and phy,1cal acuvnv m the prevcn• • 110n "' c,,ronarv ht-:irt disease. Tracy Perapato, 0.0., a th1rJ-vcar family t Buffalo Gencr1I med nt rc,1dcnt Ho•pnal, 'J.On the annual ~c" ); rk Statt Atadcmy of Family Prarnce Rcstdent A-1~arJ • for Rt.,.carth. cudcm, won arac , a fourth-war Timur !-1.'(lmdpn~e for h1~po,.tcr prt'!-1.'lllattona1 the E,1,tcrn Srudenc Rest•;trch Forum 111 Florida m :',.1r h • EARLYWINTER l<l~<l �Research 24 Surfactant Helps Tiniest Preemies UB researcher coordinates national study on IN FASURF By ARTHUR PAGE A single dose of calf lung surfactant extract. inJ_ected into their lungs ~t bmh s1gmficanrly reduces the incidence and sevemy of respiratory distress syndrome in premature and low-birthweight infants, according to a national study coordinated by a UB researcher. Involving 2,506 newborns eighr weeks or more premature treated at 13 medical centers, 1t showed that the infants responded favorably to a form of calf lung surfactant extract called INFASURF. The most dramatic results were in the smallest and most premature newborns, those at greatest risk of developing problems. Edmund A. Egan 11, UB professor of pediatrics and physiology, said chat among premature infants born 12 or more weeks early, INFASURF significantly decreased che respiratory death race, incidence and severtty of acute lung disease and chronic lung problems. For example, the study included 712 infants born 12 co 15weeks early, average birthweight 2 pounds, who received 100 milligrams of INFASURF at birth, and 96 infants who did not. The incidence of severe respiratory disease and respiratory death were halved in the treated group. Among the treated infants, 16 percent developed severe respiratory disease and 8 percent died from respiratory failure, compared to a 33 percent incidence of severe respiratory disease in the untreated infants and a 19 percent death rate from respiratory failure. "Current modification of the continuing EARLYWINTER 1989 The ONY Company was created to make the surfactant available even if it isn't patentable. study incorporates more than one dose oflNFASURF if a premature infant develops respiratory disease even with treatment at birch. This 'rescue' approach promises to further improve the outcome for these premature infants; Egan said. Respiratory distress syndrome, also known as hyaline membrane disease, is a leading cause of death and disability among premature infants. le is estimated to occur in 50,000 of the approximately 250,000 infants born prematurely each year 111 the U.S., k1ling about 5,000 of them. The third child of President John F.Kennedy died of respiratory distress syndrome in 1963. Because of their prematurity, the lungs of affected infants do not produce natural surfactant, a substance that coats the insides of che lungs, preventing them from collapsing when the baby exhales. INFASURF is one of several surfactants granted invescigational new drug (IND) status by the U.S. Food and Drug Administration and is being studied in medical centers across the U.S. The FDA in July approved making one of these surfactants, a synthetic form manufactured by Burroughs Wellcome Co., available for wide use prior co its receiving approval for marketing because of surfactant's potential benefit to infants born with respiratory distress syndrome. INFASURF and ocher surfactant macertals arc still classified as INDs and cheir use is limited to specific study centers. However, their sponsors also arc seeking approval from the FDA for wider use. Egan and UB colleagues in the Division of NL'Onatology at Children's Hospital of Buffalo and Goren Enhorning, M.D. and colleagues at Women's College Hospital in Toronto first used calf lung surfactant extract in the early 1980s. Carefully controlled studies, reported in medical journals, showed that injection of che calf lung surfactant extract protected tiny premature infants from respiratory failure. The 13-center study conducted under the FDA's designation of INFASURF as an IND involves 2,506 infants to date. INFASURF is produced by ONY Inc., a Buffalo-based company of which Egan is president. le wa~ incorporated in 1985 to seek FDA approval for calf lung surfactant extract for treatment of infants at risk for respiratory distress syndrome because, according co Egan, major pharmaceutical companies were not BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Research 25 willing to sponsor ir because 1r was not patentable. "The pharmaceutical industry basically has two issues in its product development or selection," Egan said. "One is that a product or drug offer some benefit to people and the other is char it make money for the company. ONY was created to make this surfactant extract available to children, even if it isn't patentable, because we believe it's the most cffecti ve." ONY is a "graduate" of the University at Buffalo roundarion Inc. "incubator." The incubator was created to encourage development of small businesses in high-tech areas. Its offices are located in Baird Research Park, adjacent to the UB North (Amherst) Campus. Both the incubator and rhe research park are managed by the Western New York Technology Development Center. • RESEARCHERS STUDY COMPOUNDTHAT Aas LIKEINSULIN I nsulin can be used co treat diabetes, but how docs it work? UB scientists are trying to unlock that secret by studying a compound called vanadate. To many researchers' surprbe, vanadate, an oxygen-vanadium anion, has been shown to mimic insulin's acnons both in cells and in diabetic rats. Insulin is a hormone rhat causes body cells co take in glucose (a sugar) for energy production and storage. "When you have something that everyone describes as insulin mimetic, it naturally leads you to examine diabetes," explained Gail Willsky, associate professor of biochemistry at UB. She recently received a grant from the American Diabetes Association to investigate vanadium's properties as an insulin ,mitaror, yet Willsky's field of research is nor diabetes. "I'm a vanadium person; she explained. "I'm using rhe diabetes, in a sense, ro understand how the vanadium compounds affect metabolism." The similarity between vanadium's actions stimulating a rt.-ceptoron the outside of a cell. They act in much rhe same way as a key opening a lock. Only a similar key will acnvate chat same receptor. Once the receptor is activated, it will cause certain other things to happen, like increasing glucose transport. lnsulin is a long molecule, while vanadate 0 is much smaller. As a result, vanadacc can't ~ - fit in the same "keyhole" as insulin. Instead it seems as if vanadate acts on a different Ioca'. cion of the receptor. •One hypothesis is thac it is stimulating the ~ protein kinase that's part of the insulin rccepcor inside the cell. Where insulin 1s binding "' ac the extracellular, vanadium effects would be intracellular: Willsky explained. Vanadium would he tripping an internal latch of the lock, while insulin opens the door from the and insulin's came as a surprise LO medical outside. researchers. Willsky said she is looking closely at how "They not1ced in cell culture systems that vanadium alleviates cardiac symptoms of vanadace had an insulin mimetic activity, diabetes in rats. such as stimulating glucose transport; Willsky "The heart, the kidney and the eye are the said. maJOr target tissues of diabetes," Willsky said. Eventually, vanadate was med in animal "I'm working in che heart w1th Robert J. systems. "Ir wasn't until it was realized that Mentzer (professor of surgery and physiology). it had a lot of multiple hormone effects rhar "With James Lohr (assistant professor of it was tried m diabetic rats." medicine) and Margaret Acara (associate proInsulin must be inJeCted, while vanadium fessor of pharmacology and therapeutics), can be ingested orally. Will vanadate ever we're also studying how vanadium treatment supplant insulin? Not likely, Willsky said. alleviates kidney symptoms associated with "I don't envision this in any way replacing diabetes." insulm. Since insulin 1s the body's natural Currently, no drug company 1sinvestigating answer to diabetes, 1t 1s the drug of choice:' vanadium as an insulin substitute "due co the Vanadate might be used to treat diabetics face rhat it is so expensive" to meet Federal who don't respond to insulin treatments, but Drug Administration (FDA) guidelines for that would be many years down the road. drug approval, Willsky said. "My efforts are focused on this very basic science, the result of which could be used in "The problem is the vanadium structure is so ~,mple that they don't see how they can a clinical setting," Willsky said. The vanadium compounds may cause maintain their rights to 1cafter they've gone stomach problems and may make people who for FDA approval. That's what I was told by are hypertensive (prone to high blood research and development people in the drug pressure) even more hypertensive. companies." As a result, Willsky said that the "We're a long way from being able co predict drug companies are afraid that they would how a diabcnc would react to chis drug," not be able ro recoup their research and Willsky said. "I think its higher potential is, development expenditures. However, there if you can really understand how insulin arc companies that are looking at vanadium works, you might be able to eliminate as a tool ro investigate insulin's activity, she said. • diabetes some other way." Hormones, such as insulin, act by -By David M. Smderman BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST § f ! EARLYWINTER 1989 �Alumni 26 Medical Pioneer Alumni Associationhonorsone of its own A m1.'Cl1cal pioneer whose achievements as clinician, scienrist and teacher have spanned 60 years, George W. Thom, M.D., was honored Sept. 21 as the first recipient of the Distinguished Alumnus Award given by the UB School of Medicine and Biomedical Sciences. A 1929 graduate of the UB School of Medicine, Thom 1scredited with establishing the foundations of modem endocrinology and metabolism and with pioneering what 1s believed co be the world's first organ transplant as well as bringing kidney dialysis to the United Scates. Thorn al'-0 initiated one of the first "health plans,• a forerunner of today's group practices and health maintenance organizations. Thom received the award ar a dinner in the Buffalo Club. Joseph L. Kunz, M.D., president of the Alumni Association, made the presentation of a specially designed crystal buffalo. Thom was introduced by John P. Naughton, UB vice president for clinical affairs and dean of the medical school. A professor emeritus at Harvard, Thom is chairman of the Howard Hughes Medical Institute, which he founded with the late Howard Hughes in 1953.The institute has "expanded tremendously," Thom says, and has developed a strong research program "in 40 medical centers throughout the country." Thom is vice president of MIT's Whitaker Health Sciences Fund and chairman of the Whitaker Foundation's Scientific Review board. A member of several visiting commit• EARLYWINTER 1989 By JOAN DANZIG A specially designed crystal buffalo was presented to George W. Thorn, M.D. tees at MIT, he is a life member of the corporation. A Buffalo native, Thom's career as ~ researcher began while he was anending the UB medical school. As early as his second year, he began assisting Dr. Frank A. Hartman in the preparation of adrenal extracts, developing the first workable assay for adrenal cortical extract activity. Thom looks to his work in Buffalo as the start of one of his most significant achievements, "the excitement of developing the use of corcin for treatment of Addison's disease which was an extension of my work with Dr. Hartman at Buffalo.• After graduation, he remained in Buffalo for five years, first as a house officer at Millard Fillmore Hospital and chen as assistant in the departments of physiology and medicine at the medical school. In 1934, Thom was offered a Rockefeller Fellowship, which cook him to Harvard Medical School and Ohio Stace University, where he rejoined Professor Hartman for one year before leaving for Johns Hopkins Medical School. Thom became an associate professor of medicine at Johns Hopkins in 1938.In 1942, after service as a major in the Johns Hopkins Medical Unit of the U.S. Army, Thom accepted an appointment as Hersey Professor of the Theory and Practice of Physic at Har• vard Medical School and became Physicianin-Ch1ef at the Peter Bent Brigham Hospital. His life-long interest in renal disease brought the pioneering dialysis techniques developed by Kolffin the Netherlands to Peter Bent Brigham, where, under his leadership, the now world-wide standa rd procedure of dialysis was put into use. His successful work cleared the way for the development of a program of kidney transplantation. High on his list of lifetime achievements, Thom says, is "the unique experience of developing the artificial kidney for kidney dialysis.• He was appointed Samuel A. Levine Professor of Medicine at Harvard in 1969. At Harvard, Thom initiated the Harvard-MIT Program in Health Sciences and Technology, which culminated in the Whitaker College of Health Sciences. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Alumni 27 A recipient of many national and international awards, Dr. Thorn received the American Medical Association's Gold Medal in 1932 for his work with Professor Hartman on cortin and again in 1939 for his studies on desoxcorticosterone and pellet implantation. In 1946, UB Chancellor Samuel Capen paid tribute to Thorn as a "leader ... master of the arr and science of medicine" in awarding him UB's Chancellor's Medal for "eminent services in the alleviation of human suffering which have won for you high personal distinction, and through you, have dignified Buffalo in the eyes of the world." A teacher of distinction, Thorn has had a major influence on medical education, particularly during his years at Johns Hopkins and Harvard, \\'here he trained more than 5,000 medical students. Most medical students "know" Thorn, though they may not have mer him, sweating CALLFORNOMINATIONS J Immediately above, Dean John Naughton, left, and Alumni President Joseph Kunz, right, congratulate Dr. Thorn at the dinner. their way through the "Bible of Medicine," Harri.Ion'sPrinciplesof lncemalMedicine, which Thorn edited for 31 years. One of its original editors in 1946, he served as chief editor of the 1977 edition. • BUFFALDPHYSICIANAND BIOMEDICALSCIENTIST unc I is the deadline for nominations for the second annual Distinguished Medical Alumnus/a Award. The award is presented to a graduate of the UB medical school who has distinguished himself or herself nationally or internationally in the eyes of his or her peers and has made an oursranding contribution to medicine, the arts, or humanity during his or her career. The selection will be made during the summer and the award will be presented in the fall at a special dinner. Please forward the name of your nominee as soon as possible on the attached postcard. Your cooperation is viral if this is to be a true alumnus / a award. The 1989 winner is George W. Thorn, M.D., a medical pioneer whose achievements as a clinician, scientist and teacher have spanned 60 years. • EARLYWINTER 1989 �Alumni 28 SPRINGCLINICALDAYAND REUNION WEEKEND T he graduates of the UB medical school have won their share of local, national, and international awards for achievement, but it took an enormous amount of effort, toil, and sweat. Wouldn't it be nice if, just once, someone gave an award for something easy, like going to a party? The Medical Alumni Association is doing that for the first time at its reunion weekend. The reunion class with the highest percentage of attendees will win a trophy engraved with irs class year, which will be displayed in the medical school. Now, don't let the daces throw you. The next Spring Clinical Day and Reunion Weekend will be held in April, not May. It starts off with a cocktai l party Fri• day evening, April 27. Spring Clinica l Day will be held Saturday, Ap ril 28. Arnold Reiman, editor of the Neu: EnglandJournal of Medicine, will deliver the Stockton Kimball Memoria l Lecture. The theme for Spring Clinical Day is "Changing Aspects of Medical Practice~ • Class of 1940 Class of 1945 Class o 1955 "Saturday,April 28, 1990, the evening we hat·e all waited 50 )'earsfor. Let u.s make it our best reuniondetails lacer." William Hildebrand , Jr. "45 )ears! Tempus fugit. Time co renew, time co refreshold friendshipsand memories from the most significantyearsin our lit·es - the Class of '45." Herbert E. Joyce "We are lookingfor a big turnout for our 35th reunion. Plan now to meet with your classmates." James R. Nunn Class o 1950 John A. Winter "Togetherwe canmake our 40th a real winner. Lookingforu:ardto seeing)Ou all in April." Ro bert J. Patter so n EARLY WINTER 1989 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni 29 Class o 1960 Class o 1965 Class o 1970 Class o 1980 Class o 1985 "It is with a great deal of pleasure and anticipation chatwe lookforu:ardcoour 30th reunion. Near coca! parcicipacionu:ouldbe an added bonus." Roger S. Da yer "Come cosee hou· we, the school, and Bt1ffalohat·e changed in 25 "ears. \\1/e u:ot1ldl0t·e co hat·e :,ou in Buffalo." Joseph G. Cardamone "You can't ignore20 :ears. Step back into the pascand reneu·friendshipsfrom chat hapP) ume. Duse off ,ot1r memoriesand bnng chem along. Come back co reminisceand share some lat1ghs." Donald P. Copley "BAMMO! Ten:-a:11:1 hate gone Ir:,·.Let's gee together and .1eeif che chemiscryis the same." "Lee'sget rogecher and auch up on uhac'shappenedin che lase/ite )el!TS." John E Coyne Margaret Paroski I Jame s R. Kanski Robert M. Moskowitz Class o 1975 Theresa Stephan Hains Joseph A. Zi.zzi "I 0-:,earreunion «:asgreac. 15 will be et·en better. See )'OU acSpringClinicalDa:, m Buffalo." Jack Cukierman BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST EARLYWINTER 1989 �Medical School 30 LIGHTINGUPIN STYLE: LIBRARY CHANDELIERS AREANTIQUETREASURE 0 nee they glittered above nights of music-making in a fabled Buffalo house. Now they shine above studems and researchers poring over books in the Health Sciences Library. Located in rhe HSL:s main reading room, the restored twin antique chandeliers are believed co dare from the 18-¼0s.Robert L. Brown, M.D., associate professor of medicine emencus and a member of the medical school's class of 1944, made the restoration possible through a donation to the UB Foundation. The silver-placed fixtures came to che HSL as pare of the original furnishings of che old Lockwood Library, which was opened in 1935 and was designed by Edward B. Green, also the architect for the John J. Albright house, a huge Tudor mansion on West Ferry Street. These chandeliers once dominated the Albrights' music room, but were moved in the 1930s when che Albright estate was broken up, after the family suffered financial reversals. Originally candle chandeliers, they were electrified when brought ro the old Lockwood. The mansion, built at the cum of the century, was torn down in the 1930s. Albright, a pioneer in the development of electric power and automobile manufacture, gave more than $1 million for the construction of the Albright Art Gallery. While hardly a Morgan, he was, in che words of his grandson, "symbolic of the day~ of the city's greatness." A donation from Robert L. Brown (M'44) made the restoration possible. buildings, was responsible for moving the chandeliers out here; said Brown. He added chat when the old Lockwood Library was rehabili1tated as part of che Health Sciences Library project, "there was no provision for che restoration of the chandeliers. There was even a question whether they would rehang chem, 01rif they did, whether they would electrify chem. By chat time, they were black from age:' Brown, who 1salso che medical school's archivist, wanted to preserve these elegant reminders of the old Lockwood. "After· the library occupied the space, I started making inquiries about having chem restored, but che problem was chat no placer had facilicies co cakc care of :.uch large pieces; he explained. "We also would have had difficulty lnnding someone who would do the rest of the restoration. "Bue as a result of the restoration of the Bueler Mansion downtown, I called the man n 1934, a reporter for rhe Buffalo faening who did their major chandelier. I also located Neu,~described the house's sad end: "l..cav- Marlette Placing, a local firm chat does coming the house, the visitor carries with him a mercial plating." Finding Marlette was a big reverence which is as melancholy as the place advantage since the firm, headed by Edward itself in the face of rhe dissolution it is Marlette, had the large placing baths needed undergoing .... He (Albright) gathered the for the job. beautiful things of rhe world around him and his aestheticism overflowed to give the dry orne idea of the chandeliers' value can be 1rs noted temple of arc." surmised from the pre-restoration ap"We assume that Green, who designed both praisal. I S EARLYWINTER 1989 "Wewanted insurance when che chandeliers were being taken down; said Brown, "while they were off che premises, until they were put back up, that is, for che duration of rhe restoration. They were appraised at $25,000 apiece."The value, of course, "is way up now." Beyond moneta ry considerations, however, was a reverence for the University's past. "We were all concerned about preserving as much as possible of the old Lockwood, which was really an elegant building, the best the University has ever built. The craftsmanship couldn't be equaled today and it would be unaffordable if it could be," Brown said. "Our concern was co preserve as much as we could, and the chandeliers were a significant part of chat main reading room. I wanted to restore them co a scare chat they were ongmally in." In a charming comc1dence, the mother of Edward Marlene's wife, Norma, was the longtime assistant ro Charles D. Abbott, director of University Libraries from 1934 to 1960. Her name was lvah P. Sweeney. The restoration work was done by Jack Kiener, a highly-regarded craftsman who has been restoring antique lamps for 17years and is the owner of Antique Lighting in Clarence. "I'm quite sure these chandeliers are English; said Kiener. He noted, coo, chat the chandeliers have hcen kept together from the beginning, an unusual occurrence in the chandelier world. He explained: "Every piece chat's removable is numbered . Every arm has its spot to fir in. Each piece was made by hand and made for its O\\'n counterpart. "When we disassembled the fixture, there were 20 arms. On che number I arm, for instance, we have a bobeche, a candle cup, and some finials. All are numbered so that they fie back on number I. The numbers are scamped m. Whoever made the fixture numbered them in; this is the mark of a good craftsman. Nothing is interchangeable:' The arms on one chandelier are numbered I through 20; the arms on the ocher are numbered 21 through 40. "Sosince the 1840s, the fixtures have stayed together all chis time; he said. "This is very unusual." It cook Kiener "close ro 90 days" to com- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �;\fedical School 31 - --- ..---= ------- -=- unrestnued endowment to help meet uncx• peered financial needs and opportunities. Accordmg to Prc,1Jenr Stewn B. Sample. "The S5Z million \qll enable L'B to meet needs char have been identified a, cr1ucal ro the growth of rhe Untvcrsiry, hut for which t.lte funds arc limacd or una\ailable. "State budgetarv Imes cannot meet all rhe needs of the University, nor can they provide the flex1h1hrvchat i, ahsolutcly csscnrial for rhe U111vcr,1rvto rhnvc. Joining pm·atc support w1ch~rate dollars will permit the Umvers1tv at Buffalo ro achieve its go,11of bccommg one of the nation•~mp ten public rl"5Carlh uni\'er--iucs bv the end of the ccnturv." The St hod of Mcd1e1nc and Biomedical Soence, ha, received some of the largest gift, co the campaign rhus far. Ont of the mo,1 rl'CCntwa, a $1 million l;,mmitmlnt from the The chandelien once graced the ,\lbnght Mamion. James H. Cummmg, Foundation, Inc. ro rhe of assist m the funding of a Positron Emis.,ion dav, glorv the n:calling One writer, plerc rhe work on the first chandelier. "This (PEn lrnagmg Cc111cr,a joint Tomographv the remembered mansion, Alhright involved preparmg ir for plating and med1<al slhool and the VA thi: of project her m husr to l1h-d Albright Mr;. •mu"lalc,," reassembling 1r, ,rraighremng all the arm,, Medical Center. This 1,1ranris the largest ever mu,1c room. This was rhe "golden age" of the rewiring it, lacquering it. Also, because 1t wa, awarded m rhe 26-\·ear hi<torv of the Cumhouse, he ,aid. a candle chandelier, we had ro devise ,ome mmgs fuundar1on. ch.mdcl1er,, rhc,e that One like,. ll) chmk way of holdmg the ~ker, m and \\e handOcher significant rnnmbutions mdude a renewed found ha\'e shadow,, the in so long shaved wooden plug, to fit mro the candle of ,ecurmcs valued at nearly 53 million gift • home. UB their in glory socket,." a ml'OI<11school alumnus who wishes from \\"h11chcr Ann B, --ctfor "wa, chandelier \1an,1on The Burler anonvmou<. This i, the larJ:esr gift remain co elecrric1rv." Kiener commented. "At l.iB, \\e md1\1dunl ever rcn·1\·ed in the l1v111g a from had ro put the wire on the outside of rhe fixU111\'er,1tv.both a, a private the of h1,rorv er ,1h wa, that ture. Ir's a solid c:<1,tfixture according to Jo,eph msnruuon, puhhc and w1rcwav,." no \\ere e plart.-d.Ther the Uni\crsirv at of president J. \lansficlJ, fur the expcriencl-d Kiener, the UB proJclt he used to will It Foundation. Buffalo brought its own reward,. "le\ inspiring when to help endowment unrestricted an e,tablish wnR-d vou on rake ~mething frc.,munre,.to he. Unt\'er,1rv ar Buffalo Foundano .n's nc\\ rl-cru1t ,cholar,hips. ,rudenc pro\'1de has \\a< It ampaign black. pach wa, GR'3tnl.._s•C le ro 1t. fim,h "Pathwav< and dinon rcchno)Ojly high purcha,e mcmbcrs, faculty million Ill gift, ratscd more than ..,z1.z nor taken care of hccau,e of how high tt wa,; equipment and support various needs of the and pledges as of Sept. 15, according to no one could keep it up, and it was ht·avily R. Knox. national campaign medical ,-chool for wh1lh other funds arc coated with lacquer and ~arni,h (applied) 111 ~onhrup limited or una\'a1lablc. ,av would 1c.I . prescne cha1rpcr-,on Knox, who 1sLhairman ui rhe hopes char thi, \\OUIJ Another anonvmou, SI million !!!ft ro hoard of !lilarinc Midland Bank, ,aid this that 40 of the hours were ,pent just ,mp' Pathw;w, to Greatness' C-impmgn was the represents more than 40 percent of chc ramping the lacquer off the 20 arms." for rhe Slhtol of ~fodK1ne. dc,11:natt.-d goal. m1lhon pa1gn'<five-year, 552 The refurbished chandeliers alR-adv arc colthe ded1~Jt1on and lcaJcr~h1p of "Through Lampa1gn the ,1fter 19~i. day next 0-.robcr m very "The Launched leccmg rave review,. and members of rhe Cam• Knox Northrup ,eeks ro increa,c permanent endowment the first chandelier was inscalll-<l;said Histtiry we an· well on Commmee, xecutl\'C E pn11,?n funds for the U111\'ers1tvtO pro\'ide pmfc,'-Or• of \fod1cmc Librarian Lilli Sent:, "one of the uhiect1\'es," our achic~mg tL wav our (cllowsh1p,, po,tgraduarc ,1nJ ,h1~. graduate mamtenancc men who hod been 1molvcd re is snll much co be noct.-d."The :-.tansfield grantsarhlcti< holar,h1p,, s, e sra1r,, undergraduat the up running came w1chthe hanging, Jone, bur we arc confident of attninmg our 111-a1J.fine an, programming, aJJ1riom to saying, 'I've got to see that chandelier: Th,tt • and has been the reaction of the ,cudcnt,. roo." library and pocrrv/rare hook collccnons. TOGREATNESS' 'PATHWAYS TOPS$21.2 MILLION T BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Medical School 32 VAN RIDESFASTTRACK FORCANCER EDUCATION W hile black and Hispanic women have a lower incidence of breast cancer than white women, they are more likely to die from the disease, according to Noma Roberson, director of community in• rervention and research at Roswell Park Cancer ln,tirute. One reason for the higher death rate among these women is that "they tend to get into the health care setting only at a very late stage of the disease," she explained. To get minority women into this semng sooner, Roberson has developed a mobile health care program. It operates from a 34-foot recreational vehicle which has been renovated to include examination and counseling rooms, along with a library and classroom. The transformed RV, which has been named the "Health Express," travels around Erie County bringing health education and disease-detection services into poor and minority communities. Roberson, who received a Ph.D. in experimental pathology with an emphasis in epidemiology from UB in 1985, said she has been interested since early graduate school in "women who are underserved (by the health care system), women who are hard to reach." Her doctoral research at UB focused on the specifics needed in breast cancer programs to reach minoriry women. After graduate school, Roberson continued to be preoccupied with the problem of how to reach poor and minority women who might be at risk for breast cancer. "Over the years,"said Roberson, "we've had a number of programs chat have involved major recruitment efforts to get people to come in to use the health care services at Roswell Park. Yet while we've been successful, we have not been as successful as I would like." And then one day, "out of the blue," Roberson came up with the idea of a mobile van. While there are other mobile health care units in the country, the "Health Express• is unique. "Most mobile units are geared to providing EARLY WINTER 1989 Developer Noma Roberson meets the press at the opening of the Health Express. X-rays,"said Roberson; "this one will not (pro• vide them). Instead, it will provide the first step - education and clinical breast examination. "\Y/ewill emphasize the importance of early detection. The women will come in for a 45-minute to an hour program. They will listen coa brief presentation and then actually work with the breast models on a one-to-one basis. They'll learn how to find a lump, see what a lump looks like, what it feels like." Besides learning how to examine their own breasts, the women will also be able to receive clinical breast exams in the examination room of the mobile health care unit. According to Roberson, "a nurse will check the woman's breasts thoroughly to see if there are any problems. If there are, the woman will be referred to Roswell Park or a physician of her chokc.• At Roswell Park, Roberson continued, "a physician will examine the woman even more thoroughly and will make a recommendation if there is a need for X-rays and further examination." All of these services, the classes, the examinations in the van and at Roswell Park, as well as Pap cests, are free, Roberson noted. In addition, she said, the program will provide free mammographies for women who lack insurance. These women who fall through the cracks, a situation which is more and more common, merely must prove that they are needy and that they are at least 50 years old. She added that free mammographies mighc also be provided for younger women, depending on the case. "A 30-year-old woman whose mother died of breast cancer, whose sister died of breast cancer, and who now has suspicious findings on her breast would probably be a candidate; Roberson said. Finally, to help women who have been diagnosed as having either breast or uterine cancer survive "the devastating rehabilitative phase," Roberson said there will be a support group and counseling program. To gee the women to use the van, field workers introduce rhe program to directors of neighborhood centers or schools, then work with the directors to publicize the van's arrival. The "Health Express" has been financed by a grant of $205,190 for two years from the New York State Department of Health. The grant is part of a $1 million fund that was set aside by the stare last year to develop brea,t cancer detection programs. "The intent for chat money; Roberson explained, "was to service the state by developing model programs that would focus on the early <leccction of breast cancer and that could be used in the future across the state." Of the eight programs awarded grants by the Department of Health, Roberson said hers is the only one that uses a mobile unit. In addition to the grant from the Health Department, Roberson has received services from Roswell Park, and from various community agencies, including the Erie County Health Department, Sheehan Memorial Hospital, the American Cancer Society, the Medical Society of Erie County, and rhe Geneva B. Scruggs Health Care Center. "As I add up the contributions of all these agencies, including my own institution, we're talking about a program that is really about a $400,000 program, which we've done for about $200,000. "And that," Roberson concluded, "is just a demonstration of the importance of community coalition for these kinds of health care projects." • - By ElisabethSheffield BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Briefs 33 SEMINARS SET ON THEAGING A series of faculty development seminars will be held by the Western New York Geriatric Education Center and the Multidisciplinary Center on Aging from ~bruary to April m Beck Hall on UB's South (Main Street) Campus. Continuing Medical Education credit of category I (CME) will be given for each seminar attended. For more information, contact Patricia M. Krupp, Beck Hall, 831-3176. i MFH OPENSCENTER FOR AMBULATORY SURGERY M illard Fillmore Hospital has opened the first multi-spccialcy, freestanding ambulatory surgery center in Western New York. It's one of the first of its kind in the State. Located m Amherst, the center is designed to accommodate most types of nonemergent, uncomplicated elective surgeries. le has the capacity to perform more than 7,000 procedures a year, including ophthalmologic surgery, breast biopsies, arthroscopic surgery, plastic surgery, hernia repairs, pediatric procedures, and oral and nasal surgery, among other types of minor surgeries. "le is estimated char by the mid-l990s, -15 to 50 per cent of all ,urgical procedures will be performed on an ambulatory basis," said Jared C. Bario", M.D., president and medical director of the center. • ~ A~lllllll~lf should not only be checked by doctors and nurses at the operating room door, hut removed before the surgical scrub, according to Thomas S. Beam, M.O., associate professor of medicine and microbiology at UB. Whtie such mfccnons invariably arc caused by bacteria colomzing the patient, rhc source of infection of a wound may be questionL-d if surgical gloves tear during an operation. Stressing the payoff of an ounce of prevention and noting chat removing a rmg is a mammal inconvenience for most people, Beam wrote in the Journal of the American .'vledicalAssocwtionrhac the most prudent approach i, not to wear jewelry in the operating room. • AN ONLYCHILD OPERATING ROOMIS MAYHAVEHIGHER No PLACEFORJEWELRYBLOODPRESSURE Add co the long list of potential sources of nosocomial infections chat band of gold on a surgeon's ring finger. Because it may harbor bacteria char can trigger a postoperative infection, jewelry BUFFALO PHYSICIAN At-:D BIOMEDICAL SCIENTIST A dulcs who were only-children are more likely to have higher blood p_ressure than those who grew up with siblings, according to a study conducted at UB. The researchers found chat adults who were iii ~ 6 only-children had significantly higher mean systolic and diastolic blood pressures than those with brothers and sisters, regardless of number of siblings. The results were presented at the fourth scientific meeting of the American Socierv of Hvpertension held in New York Cicv. Maurizio Trevisan, M.D., associate professor of social and preventive medicine, said the higher blood pressure found among adults who were only-children could be responsible in part for the finding ma ,eparate srudy of a higher incidence of coronary heart disease deaths among adults without siblings. He postulated thar the higher blood pressure m adults who were only-children may be a consequence of stress resulting from inLreased expectations placed on an onlv ,hild and/or growing up m a limited social network due ro the lack of siblings. The UB researchers investigated the rela• tionship of birch order to blood pressure in 676 white males and 796 white females, aged 20 to 70 years, participating in che Buffalo Blood Pressure Study. • § ECMCOPENSCENTER FORBURNTREATMENT T he Regional Burn Treatment Center of Western New York opened in March ac che Erie County Medical Center. This is the culmination of a two-year planning process berween ECMC and Sheehan Memorial Hospital, which closed its burn service. The medical director of the new burn center is Jorge Rodriguez, M.D., who received his training in the management of critically ill patients at Columbia University and the University of Louisville. The center has eight beds: six for critical care and two for intermediate care. The unit includes cwo hydrotherapy rooms and scareof-the-art monitoring equipment, as well as staff and family conference areas and administrative space. Construction and renovation for the center cost about $1 million. • EARLY WINTER 1989 �Classnotcs 34 held in Hyderabad, India. Harold F. Wherley (M'36) • of Stone Creek, Ohio, writes chat his grandson Rob, (son of Benjamin J. Wherle y, M'65 } 1s starting medicine at the Univer• my of Cincinnati. Albert P. Sutton (M'48 ) • pre;idenc of the New York Section of che American Uro logical Association, organized the Annual ~ieeting held in Lausanne, Switzerland, on Occobcr 22-29. Matt A. Gajewski (M'39) • wa>honored by t he Erit: County L..-i::i,laturewhen tht:v named the Human Scn1c1.:,Center on Buffalo\ East Side the "Dr. ~1att A. St:n ices GaJewsk1 Human Center." Harte) C. Slocum '36 1920's L. Maxw ell Lockie , Ph.G . (M'29 ) • profe"or <.memu, of therapeuttc, at UB, ha, been named to the prestigious rank of "ma<rer•bv the American Colk,gc ofRheumatology. P:iruallvrenred, he now serves as a consultant m rheummology at t he Erie Counry Med1Cal Centl"r, Buffalo General and ~1illard Fillmore hosp1ral,, and Children\ Hospital of Buffalo, where he founded one of chi, country\ first clinic, for children with arthriu,. During hi, medical career he developed method, of diagno,rs and treat• menr for arthrms now used world-wide. 1940's EARLYWINTER !<13Q Andreu• A. Ga~e '44 Edward G. Forgra ve (M '45 ) • informs us I hat he remed from acm·e practice m 1985,but i, still doing somr UR work of the Phi Lambda Kappa Mc<l1rnlFraternity, he was ell-cted to the po,ition of \'ice chairman of the board of the two orizani:anons. Dr. Levy is currently m the Geo rge A. Poda (M'45 ) • private practice of psychiatry m reured aftt:r 381/z years as m1.-dical Buffalo, chairman of che Depart• of Du Pone's ,uperintcndent ment of Psvch1atrv at the ~1illard Savannah River Plant. He i<no\\ Fillmore Hosp1tab, and a clmical teaching at Oak Ridge A,,ouated associate professor of psychiatry Universine, and doing contract at the UB medical school. work for the Department of Energy - "th1, 1s fun!" Andrew A. Gage (M'44) • one C arl J. lmp e lliti e r (M '46 ) • a thoracJC 'C\ surgeon, Joined the scaffof the M.iyo Clime in Scorudale. An:. 'Grear wav co cut back on a surgical pranice. Heare and hand arc still steady!" Annabel Miller Iron s (M'46 ) • of Chevenr e, \\ vo., rctm.J 'rom the Veteran, Adm1ni,trat1on Joseph R. Saab (M'34 ) • of Hospital and 1s now doing Hamburiz, N.Y., celebrated h15 \'olunrecr medical work in the 80th birthday m August. Dr. Veteran, Admm1stracion\ Nur~Saab rccentlv attended hi< ;sch mg Home. Dr. Irons 1, pre,1dent class reunion . of the Woman's Club of Cheyenne, the oldest (201 years) Harvey C. Slocum (M '36 ) • 1s federated cluh in Wvommi:;. profe5sor emeritus of the University of Texas Medical Branch and Harold J. Levy (M '46 ) • Afte r a Colonel (Ret.) in the U.S. ,ervmg as president of the Army. Dr. Slocum live, in San Medical Student Aid Society, Antonio, Texas. which 1sthe ph1lanthro1 < hranch 1930's Paul T. Buerger (M'49) • of Young,cown, ~ .Y.,writes, "I have jomed the Anthropology Depart· ment of SUNY as a graduate stu• dent." of the developer, of the implantable cardiac pacemaker, rClcnrly received two awards. Gage was honored in March at the annual meenng of the American Society of Contemporary Medicine and Surgery in Florida. In April, he was honored during the s<.'<.ond annual Thoracic Surgical Teachmg Days program, co-sponso red by UB and Buffalo Genera l Hospital. Gage is che deputy director of the Roswell Park Cancer Institute and a profc,,or of surgery at UB. Arthur J. Schaefer (M '47) • delivered the fir,t Dr. P. Ramchander Memonal Oration at the Annual Ophthalmolog ical Meet• ing given by che Kanchan Eve Hospital and &-search Cente r 1950's H e r b e rt L. Berman (M'SO ) • has retired from the active practice of plastic and reconstructivc surgery and is now r~iding in Scocc,dale, Ariz. Vict o r A . Panaro (M'52) • was elected to the board of director, of Blue Shield of W1.-scernNew York and Community Blue and serve, as a counci lor for the American Coll~e of Radiology. Roy J. Thurn (M'52 ) • wmes "As a captain in the USP HS Ready Reserve, I recently com pieced a two week ,horc tour of ducy at the Crownpomc, N .M., Indian Health Facility on the NavaJo Indian Reservatton. It was a very rewarding experience." 11 P. Hamilton Thomas (M'S?) • was recalled to active duty by the Unaed Scares A rmy in 1984 as deputy commander, Center, Army Aeromedical followed by an assignment in Saudi Arabia. He is currently chief of the Preventive Medical Service at Brooke Armv Medical Center m San Antonio, Texas. John B. Ander son , Jr. (M'58 ) • medical director for Centerior BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Classnoces 35 pleasure: patients and che opportunity for flight time again. Also appointt-d to che admissions committee, School of Medicine, uni· formed Services University of the Health Sciences." Energy Corporation, ha, been clencd president of the hoard of trustees for the Andrew, School, an independent girls' boarding and day school in Willoughby, Ohio. 1960's Je rro ld D. Canto r (M'69) • \\as ek"<.tedchief of the medical ,raff , t C:ia,ral Communttil-,, Hospital, Santa Ana, Calif. Algirda s Gamziuk as (M'60) • has been appointed ass0<.iaceadministrator for medical affairs at St. Joseph Ho,pital in Check• towaga. 1970'., Seba stian Co nti (M'70) • has Rob e rta M . G ilb e r t (M '6 2) • was named ml-d1cald1rt-ccorof che Georgetown University Family Center. Dr. Gilbert presented a Add1ltion,: Put pap.:r "lat~cn ting the Patient m Charge" at the Midwest Family Theory Sympo,1um in Chicago. Harold J. Le,,y '46 Rob e rt W. Hamilt o n (M' 63) • ha, moved co Tc,k-do,Ohio, where he 1, professor of mt•1.hcineand chief of the ncphrology division of the MedJl'll Coll~l' of OhK England area in chc fall of 1989 after serving a, chief of the ob/gyn department, Supreme Allied Powers Headquarters, Europe (S.H.A.PE.). Belgium. of both the American Lung Associauon ofWC!SternNew York and the ~ev. York Trudeau Sociery. Jeffr ey S. Ro ss (M '70) • \rntes Ro be rt M . Tabac hn ikoff "I have rl"\.Cnth·t-,.-ln apooinwd (M'66) • returned co the :-,.:ew professor and chairman of the Steph en C. Sc heiber (M'64) • R a n da ll A nd e r so n John ha, been ele1.1edto Who'i Whom (M '67) • wa, rt<. nclv bo'lrd certhe \\'orld. He ,en·es a, eXl"CUtl\"C in cmergcn1.y med1unc. He secretary of the Ameman Board of Psychiatry and Neurology and president of the As.soc1auon for Academic P,y<hiacry. Dr. Scheiber 1, also a member of the Award, Committee of the American College of P,ych1atri,ts. Al an Saltzm an (M'66) • has been named clinical director of the Department of Medicine at the Erie County Medical Center. He is chief of the pulmonary disease section and associate chief of mc.-dtcal-.er-viceat the Buffalo \½ Medical Center. Dr. 5almnan serves on che board of che Amencan Lung Association of ~ew York Scatt and is president a pnv,ire practice ,11(:cializin~in \"ascular surgcr\' and IS an associate clmie.tl professor of ,urgerv at the Umvcr,uy of California at Davi,. tified i, a clinical assistant pmfc,,or of familv medicine at UB. D av id Fuga zzo tt o (M '6 7) • is part Jf a group pral CJ<e in ped1atr1t, in Birmingham, Ala. Dr. Fugazmcco w;i, elected to the executive committee at the ;\1ed1calCenter Ea,c Ho,paal. Capt. Elias Rose nblatt (M'68) • write!',"Just completed a tour as director of medical services and executive officer of the Naval Medical Clime in Washm~on, D.C. and have begun a clinical position with the Naval Air Facil• icyat Andrews Air Force Ba<e.A BUFFALO PHYSICIA:-: A~D BIO~EDICAL SCIESTIST Department of Pathology at the Alban\' ;\1t-dicalCenter Ho,p1tal and Albanv Medical Colk-ge, Albanv, N.Y." Roy M. Oswa ks (M'7 l ) • was elected c h1cf of surgery ac Bayside, Hospnll Humana V1rgm1a Beach, Va. W illi am Hru shes ky (M'73) • wnres, "Aftu a do.en years, t the University ofMmnesota m MPIS, I haw returned co ~cw York and profe"<Jr of am currently medicine and m1lrobiologyltm• munobiologv at Albany }..1ed1cal College of Union Lim\er,1tv. While in Mmnc,oca I captured a :--=orwegian Amencan pr~ncc,s, Pamc1a A. \'food, \1.D., Ph.D., and we have recently had our first M.uie Cassandra daughtl·r, :-,.:1Cole.• Melvin R. Pratter (M'7 3) • is head of ch division of pulmonarv John B. Anderson, Jr. '58 and cmical care and profe,,or of Rohen medicine ,11 UMDNJ Sl hool of \"food Johnson ;\1cd1cmeat Camden. Dr. Praucr has two children, Chtusen, age IO, and David, age 6. Michael Row land (M'75) • is president clelt of the North of the Chapter Carolina Amcncan College of Surgeom and was also clccced into of the ~orth membcr,hip Carolina ':,urg1calA"oc1ation, a group limited to a maximum membcr,hip of 100,urgcons. Dr. as chair• Rowland currently scrv<.-s Commmee man of the Cancer and Outr, atienc Commmee at Hospnal. Regional ~loJre Pinehurst, N.C. Na n cy H .• ie lsc n (M '76) • a 'fX"(talisc111 internal ml-dicincand infcccious d1sc3ses, is the new president of the ;\icd1cal Societv of the Countv of Eric She is the first woman 10 lead the organtza1 'on in 1t, 165-vear history. Kev in C. Gree nidg e (M'77 ) • 1s currently an associate professor of clinical ophchalmologv at the ~e\~ York Medical College and lhtef of the Department of Ophthalmologv and director of EARLY Wlt-:TER JQ8Q �Classnotes & Deaths 36 from che NIH in support of my research on hepatic glucose metabolism. Paula and I now have cwo children, Isaiah, 8, and Steven, 3." He served four years in the U.S. Army, entering as lieutenant and bemg discharged as major. He spent 28 years as an instructor for surgical technicians and served with the 96th Field Hospital in India and China. Walter R. Siemien (M'80) • of Winter Park, Fla., is certified hv che American Board of Plastic Surgery. Thoma s J. Sy racuse (M'33) • James F. Twist (M 'SO) • has moved his office for the practice to 2156 of ophthalmology Sheridan Dr., Kenmore, 1'!.Y. Nancy H. Nielsen '76 Jack Hajjar '85 D eni se M. Goo dman (M'83) • glaucoma services ac Metropolitan Hospital Cencer in New York. He recently had a book chapter, "Head Pain Associated with the Eye,"published in Managemencof Facial, Head and Neck Pam, published by W.B. Saunders Company, Philadelphia, 1989. wrnes, "After completing pediatrics at CHMC Cincinnati and a critical care fellowship in Pittsburgh, I am now assistant professor of pediatric critical care at the University of Minnesota, and I practice at the University Hospical." Jo n ath an H. Woo dcoc k (M '77) • has been appointed Eri c P. W ittkug el (M' 83) • has completed his training in pediatrics, anesthesiology, pediatric ancschesiology, and cncical care at che University of Pennsylvania and the Children's Hospital of Philadelphia. He is currently an assistant professor of clinical anesthesiology and pcdiamcs at the University ofCincinnaci and the Cincinnati Children's Hospital. medical director and clinical leader of the Neurobchavioral Inscicuceof che Rockies in Louisville, Colo. Roge r Kaiser (M'7 9) • has been named clinic:JI director of anesthesiology at the Eric Coun• ty Medical Center. 1980's Eric Ten Broc k (M'SO) • has been appointed director of Pulmonary Funccion and Blood Gas at Buffalo General Hospital. He is also director of the Medical Intensive Care Unit at BGH and assistant professor of medicine for the Division of Pulmonary and Critical Care at UB. Robe rt Sha lwitz (M'SO) • of Creve Coeur, Mo. writes, "I was recently awarded a FIRST grant EARLYWINTER1989 Jack Hajjar (M'85) • writes, "On Dec. 13, 1988, I left for the earchquake-devascaced region in Soviec Armenia wich an ICU team from Montefiore Medical Center (where I am doing my fellowship in anesthesia) sponsored by the State Department. The team participated in rescue efforts and worked at the Republic Hospital, the largest in Soviet Armenia. We equipped their ICU with $1 million worth of equipment donated by several industries." He went back to Armenia in April co scare a longterm training and exchange program in order to establish a fully equipped ICU Departmenc at the Republic Hospital. a member of the UB Athletic Hall of Fame, died Feb. 26. He was 79. As an undergraduate at UB, he was a member of the undefeated 1930-31basketball team. He lacer cook up golf, winning the Erie County Medical Society championship. Three years ago, he retired after practicing medicine for more than 50 years. Syracuse was a member of the UB Bison Head Society and Erie County Medical Society. Abrah am S. Lem:ner (M '41) • Deaths Marvin A. Bloc k (M'25) • a retired clinical assistant professor of medicine at UB who was a pioneer in persuading physicians to treat alcoholism as a disease, died Feb.28 in Buffalo at the age of 86. Block wrote widely on alcohol abuse and addressed groups throughout the world. His efforts led co the 1956 vote by the AMA House of Delegates co declare alcoholism an "illness" and to urge doctors to treat its "victims." Ronald Walt er Steub e (M' 3 l ) • died July 9, in Naples, Fla. Jo hn Ca lvin Inman (M '33) • died July I, 1989. He was on the staff of Mercy Hospital, Lake City, Md., for 40 years, serving as chief of surgery and chief of staff. died in June 1989 of heart failure. He served in World War II from 1942 to 1946 as a lieutenant commander, MCUSNR in the Pacific Theater. first as a Seahce, then aboard LSTs. He received eight major campaign scars and a Purple Heare. He was adjunct professor of clinical psychiatry at the Dartmouth Medical School, a member of the psychiatric staff at Mc. Ascucney Hospital and Health Center and served on the Commiccec on Aging of the Vermont Scace Medical Society. In addinon to his pnvate practice in psychiatry, he devoted suhscantial voluntary time locally and nationally to the growth and development of psychiatry. A pioneer in methods of outpatient care and the treatment of psychosomatic illnesses, Lenzner was a Life Fellow of the American Psychiatric Association. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST ��~oo-Prof1 Ori; L, Po.ta Buffalo Physic ian & Biomedica l Scientist PAID Buffalo,NY 1\-rm t =-- lll State Untvers,ty of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address CorrKtlon Requested 3 581 DR L. MAXWELLLOCKIE 925 DELEWAREAVE BUFFALO NY 142 0 9 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/a14d1a5b2686ae6df94b63e41b3a9872.pdf 34b832c7ebf16b2c680afb2b1ec4d17a PDF Text Text \ol. 24, !'-:u.I PINS & . NEEDLES / ._ NEEDLES & PINS· · .: ___,e----- • • • • . . ' . . ,. . . .. .,_ . �::,,,\I I ()IRH'TOROF rt llUl <\TillN', DearFriends: Nann Tol•n T he current ,.,,,uc of the Ph'ljs1cranmc.luJcs ,m .,mdc det,111 mi: the <,1rccr ,uu:e,~ ot three ,1lumnt ,, ho ,ire me<l1c.,1l <c.hool de n<. M mh 111A. Ltc.hrm n, M D '60 at the Um, er,11\ of Rol.hNtcr, Eui:n1e M '-1i:m m. M () •i;z at tht· Um,ersll\ of Conncd1cu1, ,md F-r.mklyn G. Knox, M.n., Ph.D. '65 di rlw M,1\0 Ml.'d1, ,I -.;._hool L'B l'rNrdcm "11.'H'll R. unplc h.i, rbccJ .i m 11orcmph "' on reuunment , t faLuh, ,, uh rec.ord, , f Mgnthc.mt ,Khre\C mcm Also., p,m of 1h.11t,ISk is the de,elupmt'nt 111mdr\"lduab who rcpn·wm Buftal1),II ,>1hcrqualny m,111u1101iThe thrtt mdr, ,duals pr. filed m<lccJ rc.-presem the be,1 m tC"rm<uf J'C'r.<n 1I md pr< fc ,ron 1I , ,luL,, wrecr pr,>ducu, II\ ,md ,1ch1e,cmC"nt,.mJ (,....,1du,h1pskill-. Oi each \\C"<hould not only take i:re,11pndC",hur IH' should cxpre.,,, to th C"m,iur hc.rrt• tel1 gramudc tor commntmi: their hH"li tu purp<™-"li "c ,1l1hold so dear EPIT\ R C.inn1c (.),,.JIJ 'I ,tl ART DIRECTOR AbnJ Kr,:lcr \\ RITI RS D.i, iJ I limmcli:rttro Anhur r'I:'" Jdtm. Tr,M, "U<'\luctchn r1tun X,RAl'I lERS l'ld·hcHu >- n l..,. Rot...-rt'iJ. 10n AO\'J-.;()RY BO .\RD Dr John N ,u •hhm, l h.:unnan Dr II ,IJ Br~ ~b. """''(,I«' Dr J K.nd, Dr J,...,,h L Kur Dr Ch irk r, mdl, M• I Jul () l'dl<n<•n Dr !\nt It< rcren Dr ( hark, rnrr Dr Luther R >hn ,n Dr Tl1011u,Ru,cnth.il Dr :,,.,Jccb"ur<>h Dr Run n "•~nn.m Dr "r<f'hm "f<'ulJ, John :-.au ght on, ~t.D . Dr l'-cl "' Tom, Mr EJ,. rJ 'iJ.cn,lc \'rec l'rts1d..•mfarClinu-alAffa," Dean, Schoolof i\fofu.11\t' ,md B1omcdic.1/S,,cncts Dr J.-r.....,YJ10 T~\ C lll:-.;G Hl ) '-l'ITA ~ ,\:,;() l.lc\l~O:-;s BarI\ ,a\ A Medic.ii Center Buffilo Umcral lfo,rn l \like \hau Buff k \ !\ ~lahc.il C.cnm I Pu l1i IJrm H..--..rirI K4r Ory '>t. E.rc C ty McJ I ( .enter Manon"-lamnou-,,_, M, rev llo,pnal, C.hu.k r,bw M,llarJ f, !more II r11al,J ""f'h R uffa R ,.,. II r: rl C: nccr In lute /,J,, /uo:c, m Ht,,r11al M.{.anfn Pr .lu«J i....w f\nuan of l 111h-ntt'f Rd.:J k11M>R141rh W XMuf of \ltd, ..mt nd IU,r\S ffl "-"'" l'nil ~ "' Tl II' Bl ff ALO rHhlC.1AN A?-.l) BIO MEDICAL SCIENTIST (USPS m MO) SrrinK 1990, \, 1 umc 24 Numl,cr I PuM ,hcJ '"" tum, nnu;,11, '-rnlll: Summer Atrt n. Luh- \l mr.-r, ,mJ Late \l ,nrcr I') rhc Sc -. I 111M<J1emc anJ B1omcd1ol x,cnc , S1,1c l nl\et>II) f Ne,. ,.,,l II llufl I. • l4}5 M 1nSrr«r Rull lo, Ne,. h-.,l 14214 ThuJ hull r< 1 raiJ II Bufr lo, c• Yorl s.-nJ ,Jdu ,hant< 1 THE BLFFAl(l rmsll lAN AN[) BIOMEOIC'AL S<.1 D.'Tl'-T, 146<~ AJ.lmon. 1415~bin "-trn-t Buff rt l ◄Zl4 cu i-;..,.,' DearColleagues: I I \\ould lakC"to ,h re "uh }OU ex1..crp1, from I IC"ttfr "c r«cl\cd from I m1.'tll~r, t the i:raJuJtmg c.Li, th,mkmi: us tor the -.cnrur rcc1.-p11on "Dc,t r nwmhi:r, ,if tlw ,1!11111111 .i,,oc 1,1t1110 "As stu<l1.·nt,,... 11e le 1mmg th 11 1p1rt from the obi IOU' furu:.11n,, f kecpmi: tr.id, ,,t waJua1~ md org.m,:mg reunion< our ,1lumnt ,ire trul\ mtcrcstcJ m the ,tud1.-nL, mJ the ,;chool 11,clt ~I.mi ,1lumrn ,1ss,x1,111o n, 1h,11111.• h,11·e ,,h,cn c<l m rhC" p,1 I nnohe them,,che, m m.11m.11nmi:the rcput 1110nof 1hc1r alma m llt'1' h\ m ,kmi: ml•ne1,11; Jon 1110n, to the ~hool md c-.1,1hlt,hmi: ,m 'olJ h.,) ncl\\Ork' for gr,1duates. \Vh1le 1he-e ue clfecme mJ o.ll.'-ept.IMCmethoJs, " our lumm h,tH dim.en to h.• more J1redh 1mohl..J. "Through the -.enior rccepttun, the ~pnng Clmrc. ,I n.i, an,1 m,m\ oth,•r ,1lumnt ,1ff 1rs, \OU h,1H· set ,m ex mple for u, ot hlm our ,,lumnr .1ssoc1a11unc.m be "hen 11c..ircs to go furthl·r th1n tht· 1r,1d111on,1,ICU\ I 11,e,. 'wur J<.11\CpnJc ,md concern c.h1llenge, u< to hcconw 11:u,e ,1lun1111 .md contmuc 10 ,!um the s..hool .md the communn, \,h.11 "1mport,mt 10 rh,,1u.in, ,,ho gr Juatc from 1hr, s..hool" ( !,'UCSS thts ~1y, II .ill &-...1",~hes to the ( •1.1.,,, ol '90 .ind to ,111rhc ,1lumnt/,1c .ir,· ,/ <.·ordialh u~LK ::.u Pusidenr, 1',itdirolAlmmuAssoc1a1on �Vol. 24, No. I Srrmg 1990 Research briefs.Sodium and stomach cancer; elderly blacks need more health care; soaking in the tub; healthy wheelchair ; active endothelium. Onpinsandneedles.It's not until everything else Pinpointingpain relief, page6. has failed to relieve their pain that patients tum to acupuncture and UB's June Oh, M.D. Theboywholiveda miracle . No one had ever recovered from such an injury. But Brian Fitzpatrick, a 1986 graduate of the UB medical school who helped treat the boy, was able to see him walk out of the hospital. Microscopes to microchips. From practicing diagnoses The caseof ihe "miracleboy," page 12. to recognizing heart murmurs, computers have emerged as the UB medical schoo l's newest teaching tool. Moreresearch . A major study suggests that olive oil is more "heart smart" than butter and another project investigates temporary shelters for the homeless made of corrugated cardboard. Talentintriplicate. UB boasts three alumni who are currently medical school deans. Take a glimpse at their careers and their recollections of UB. Alumni. A member of the Class of 1971 honors a teacher through a gift to the UB medical school and two members of the Class of 1930 are remembered through gifts. Computers:the UB medical school'snewest teaching tool, page 18. Classnotes . Cover:Illustration by John Ripa UB boasts three alumni who are medicalschooldeans, page26. �--- :® :---.r E t. ~ 2 ·,., •...,1t1;':-ii SODIUM INTHEDIET MAYINCREASE THERISK OFSTOMACH CANCER t's prohably not good fnr your heart, and now 1t looks like higher levels of sodium m the diet mcrease the risk of gastric, or stomach, cancer, according to a ~tudy by researchers al UB. They found a dose-response increase in risk for men and women related to sodium, as well as related to fat and retinol, a form of Vitamin A. Puhlbhed in Nutrition and Cancer, the study of diet in the ep idemiology of gastric cancer was conducted by Saxon Graham, Ph.D., professor and chair of the UB Department of Social and Preventive Medicine, and colleagues. Based on extensive interviews with 293 patients with gastric cancer and carefully-malched controls, It showed "suhstantial reductions in ri,k were associated w1th 111gest1on of carotene ... as well as with increased use of low-temrerature food storage." Vegetables, some nf them rich 1n carotene, identified by the UB researchers as decreasing nsk were celery, cucumhers, carrots, green peprers, tomatoes and oniom. Noting that the incidence of gastric cancer has dropped "drastically" in recent yean., the re-earchers sa1J "the promulgation nf preventive medicine recommendation.-,is less urgent than formerly. "Certamly, however, limiting caloric intake, especially fat, limiting sodium, and increasing intake of vegetables, particularly those containing carotene, are suggested as steps in the direction of inhihiting nsk of stomach cancer. The same may be said for use of refrigeration . "A number of other cancers, such as cancer of the colon and lung, as well as cardmvascular pathok1gies, might also be controlled by these dietary suggestions." The UB researchers found a doseresponse increase in nsk with increases in ingestion of total number of calories, as well as total carbohydrates, fats and protein. "Consistent wnh our finding of increased risk associated with fats and protem, was an incrt::ase in risk associated wirh increai-es in ingestion of meats," they said. The researchers also noted "a numher of high-search foods were associated with increased mk of gastric cancer, including potatoes, potato chips, french fries, pe;u;, nee and pasta." Graham said improvements in the refrigeration of food since the early 1900s may be a maior factor in the drop m gastric cancer. "Both refrigeration and carotene could inhibit oxidation products which could act as carcinogens 111 the stomach," the researchers noted. Other UB researchers participating in the study were Brenda P. Haughey, Ph.D.; James R. Marshall, Ph.D.; John R. Brasure; Maria A. Ziele:ny, Ph.D.; Jo L. Freudenheim, Ph.D., and James P. Nolan, M.D. Also authors of the paper were Dee West of the Bay Area Resource for Cancer Control in Alameda, Calif., and Gregg Wilkinson of the University of Texas School of Medicme at Gah·estnn. - B)· Anhur Page ELDERLY BLACKS HAVE GREATER NEEDS Bur GETLESS HEALTH CARE he elderly black residents of New York State receive far fewer health and social services than elderly whites, even though the blacks' needs are much greater, according to a landmark study by UB's Mult1disc1plinary Center on Aging. Conducted hy Arthur Cryns, Ph.D., professor of soCial work and senior research professor with the center, and Kevin M. Gorey, research assistant professor, the study was the first comprehensive attempt co examine the health and social needs of blacks acr~ the state. The researchers found: Black elderly people arc 4.5 times more "vulnerable" than elderly in the general population, with vulnerahility defined as having three or more unmet health or social service needs. Gorey said needs were simply the "necessit1es of daily living, ranging from transportation, housekeeping and food preparation among the social services, to the health care provided by a physician, hospital or nursmg home." 13.9 percent of elderly blacks are health care "dependent," compared to 8 percent of the elderly in the general population. The proportion of elderly blacks considered self-sufficient is less than one-half that found among the elderly �3 in the general population. Elderly blacks have only half of their social services needs met. Economic reasons were listed as the most potent factors explaining the variation in services among the elderly. "Medicaid does essennally what it was designed to do, but that means nothing for the near-poor, those severely impoverished but unable to meet the criteria for aid," Gorey explained. "Forty-six percent of tho e surveyed lived under the U.S. povert) line. Unfortunately, 26 percent are very close to the po\'erty line and can't meet expenses from their pocket." The study was funded by the New York African-American Institute, a component of the State University of New York established in 1986 to initiate, conduct and coordinate applied and historical research on blacks, especially New York State resi<lents. Japhet M. Zwana, Ph.D., director of research and special proiect for the institute, termed the study ""ery important" and hoped it would be applied co policy decisions addressing the disparity in ser\'ices. The study "demonstrates the magniwJe of the problem and confirms our worst fears," said Arthur Eve, deputy speaker of the New York State Assembly, who added chat he planned to hold public hearings on the issue. "The existing institutions are making a concerted effort. bur the minority community must <levclop our own support network," Eve said. "We must be empowered." He acknowledged the need for more black doctors within the black community, recommending more ,cholarsh1p money to thb end. "Above all, we need more resources and stronger institutiom," E"e said. "It's an unequal system." The study was based on responses to a lengthy questionnaire by 1,542 elderly blacks, 1,057in New York City and 485 in the upstate cities of Buffalo, Rochester, Syracuse, Albany and Binghamton. In most cases, the upstate participants were found to have greater unmet needs than those in New York City, a trend that may reflect the fact that more services are in place in the latter. - By JeffreyTrebb the body to excrete large amounts of water and salt and could he useful in treating people who have fluid retention disorders. For instance, in pregnant women with rnxemia, immersion has been found to lower blood pressure significantly and increase the excretion of salt and water without drugs that coul<l harm the fetus. 'That's the nice thing about immersion- 1r's not a pharmacological treatment," Krasney pointed out. As a person sits in a tub of water, the water preswre squeezes the blood from the legs up into the chest, until the volume of blood in the heart and lungs is coo high. How does the body adjust? It eventually tries to reduce the blood volume by getting rid of fluid through urination. "Water immersion produces a very profound and sustained diuresis," Krasney said. "If we didn't have kidneys, when we sat in water, our blood volume m the body would ri,e enormously." Da\'id Pendergast, Ed.D., professor of physiology, has shown that the response of the kidneys is reduced in athletes, particularly in swimmers, though it's not clear why. The body excretes fluid not only from the blood, bur from cells as well, Krasney belte,·es. A subject immersed for six hours excretes so much fluid, he'd have very little plasma left if all of the tluid came from the blood. Another indication that water is shifted from cells is the fact that people's skin gets wrinkled m water, he said, though the wrinkling coul<l be caused hy the temperature of the water or other reasons that aren't clear. "Our major area of interest i, why chi,; major fluid shift occurs and what implications H has for therapy," Krasney explained. SOAKING INA BATH WARMSPHYSIOLOGIST TOITSBENEFITS ince ancient Rome, people have touted the curative powers of a long, relaxing soak in the tuh. Now scientists are taking a second look at the medicinal properties of the bath in treating high blooJ pressure, inflammation of the kidney, cirrhosis of the liver, and toxemia during pregnancy. Data resulting from this renewed interest in "head-out water immersion," as scientists call 1t, was reviewed in September at the first international symposium on the topic. John Krasney, profe.ssorof physiology at UB, delivered the keynote lecture. Scientists are interested in heaJ-out water immersion, Krasney explained, because soaking in a rub of water causes �--- :(]}---.,. E ._ \. 4 There are probably ma1or shifo in blood flow patterns from one part of the body to another, he added. Krasney's immersion scudtes are pare of a program project from the National Institutes of Health called "Environment and Oxygenation: Delivery, 0iffw,ion, and Toxicity." The principal investigator is Suk Ki Hong, M.D., Ph.D., professor of physiology. The Physiology Department at UB abo uses water immersion in ocher ways: As a t0t)l for studying temperature regulat ion. As a way to study the effects of increased blood volume without actua lly adding fluid to the blood. § To simulate the weightlessness t JosephC.Moll endor f, Ph.D encountered by astronauts. Water immersion is also used in I physical therapy, Krasney noted, and more work should he done to understand how it may affect blood flow to injured muscles. II ealchy" wheelchairs chat do a "The whole area is exploding clinilot more than provide a cally," said Krasney. There are only means of mobility are the goal about 30 researchers in the world study- of UB researchers. ing head-out water immersion now, but Incorporating a patented system they he expects that there will be many developed that enabled a young paramore when a second symposium on the plegic to ride a tricycle, che prototype topic b held in Italy in 1991. wheelchairs being developed by the At the September symposium, researchers would exercise the muscles Krasney received an honorary life mem- of users' legs as well as strengthen their bership in the Doctor Richard Bright heart and lungs. Society, the group formed to perpetuate Wheelchair modifications being research in kidney disease that sponinvestigated by the UB team include :;ored the symposium. the addition of hand cranks and Ironically, the symposium was held in replacement of conventional footrests Bristol, England, co honor Bright, the with pedals. The wheelchair~ would be father of renal medicine. But Bright moved by a combination of the user didn't think very high ly of water operating the hand cranks and his feet immen,ion, noted Krasney. pushing on the pedals as a result of electrical stimulation of muscles in his legs. - By Connie OswaldStofko "This is a new concept to incorrorate exercise inw the normal daily activities of the wheelchair-hound person," ! I explained Frank C. Mendel, Ph.D., associate professor of anatomical sciences and founder of the UB Spinal Cord Injury Research Interest Group. "It would allow the paralyzed or weakened lower limbs to be exercised on a regular and habitual basis," he added. "Every time users move che wheelchairs, they would exercise their lower limbs. This would pump blood pooled in their lower legs upstream so the re would be less swelling of the legs. It also would move their joints so there would be less likelihood of decubitus ulcers forming." Turning the hand cranks and movement of the legs also would provide aerobic exercise strengthening the heart and lungs. Wh ile wheelchair users currently may derive such benefits from costly exercise devices, usually limited co hospitals or clinics, the system proposed by the UB researcher~ would provide them dunng routine activities in the home, at work and elsewhere. The work dates back to a discussion between Mendel and his accountant, father of a then 6-year-old girl who was confined to a wheelchair after her legs were paralyzed at age 3 . With hopes that she someday will walk again, her parents wanted co mamtain the integrity of the girl's leg muscles. The UB researchers' solution also provided a means to strengthen rhe youngster's heart and lungs and, literally, a vehicle for joining her siblings and friends for a spin around the block. They replaced the Big Wheel's handlebars with hand cranks synchronized with the tricycle's pedals using chains and cams. The trike was propelled by a combination of the youngster moving the hand cranks and her feet, held in stirrups, pushing on its pedals as a result HEALTHY' WHEELCHAIRS REALLY GETLEGS MOVING BLFF:\LO PHYSICIAi-.::\1'D lllL1\{Ei'IC\L !-CIE!-.Tlq �--- :CE} ---J'E,.q. s of electrical stimulation of two secs of muscles in the thigh of each leg. Electrical stimulation of the users' leg muscles is a key factor in the benefits derived from the modified trike and the wheelchairs envisioned by the UB researchers. "If we don't stimulate them, che lower limbs would simply go for a ride," Mendel explained. "They would get no exercise." ln addition to Mendel, members of che team are Dale R. Fish, Ph.D., U B associate professor of physical therapy and exercise science; William Tanski Jr., director of the UB Health Sciences Instrument a nd Fabrication Shop; Robert Kell, retired electrical engineer formerly with Calspan Corp.; Joseph C. Mollendorf, Ph.D., UB professor of mechanical and aerospace engi neering and Darold C. Wobschall, Ph.D., UB associate professor of electrical and computer engineering. The work is funded by grants from the New York Stare Science and Technology Foundation, Gaymar indust ries Inc. and Index Electronics Inc. - ByArchur Page Endothelium can respondto variousstimuli, notonlyas the productofinjury,as we havealwaysthought, but:alsoby undergoing 'activatwn . . ,' says RarnziS. Cotran, M .D. endoithelium. BLOOD VESSELS' LINING of Cocran is the Frank Burr DOESN 'TJUSTSITTHERE Professor of Pathology at the he endothelium isn't just a coat for the blood vessels, but is a very active protagonist, according to Ramzi S. Cocran, M.D., who delivered the fall Harrington Lecture at UB. Cocran is a recognized leader in the study of endothelium, which is the lining of the cavities of the heart, the blood vessels, lymph vessels, and other organs. With Guido Majno, M.D., he did pioneering studies on the structu re lll:FFALl ) rHY~lCl:\N ASD 810 \IEDI CAL :;... :tESTl~T Mallory Harvard Medical School and chairman of the Department of Pathology at Brigham and Women's Hospital, Boston. He and hi colleagues found that ''the endothelium must be doing something more than just sitting there as a passive bystander as was previously thought," Cocran said. Endothelium can respond to various stimuli, not only as the product of injury, as we ha\'e always thought, bur also by 1Jndergoing "activation." Endothelial acti\'ation means there are quantitati\'e changes in specific gene products which endow the endothelial cells with new o r altered capacities co perform specific functions. This is significant because the activated endothe lium can express new molecules that weren't expressed before on the surface. These newly expressed molecu les can influence: coagulation adhesion of blood cells co the organs, which can produce inflammation new antigens, especially antigens that can influence rejection in transplanted organs This endothelial activation occurs in the boJy as well as in cell cultures and may lead to vascular inju ry, Cocran said. Endothelial cells can be activated by cytokines, which are stimulating factors (such as for growth) that are released by cells in the immune system (such as lymphocytes) or by endothelial cells. Cocran focused on the cycokines interleukin- I, tumor necrosis factor (TNF), and gamma interferon. A member of the Institute of Medicine of the National Academy of Sciences, Cocran also is a past president of the American As:.ociation of Pathologists and on rhe board of trustees of the American Board of Pathology . He serves on the editorial boards of several medical journals, including the American Journal of Pathology. Dedicated co medical education as well as being a researcher, he is coauthor of a very popular medical pathology book, Pathologic Basis of Disease,which is used at UB and other medical bchools. - By Connie OswaldScofko FormoreResearch • seepage23 �6 and feeingnopain BY ANTHONY Cl I A'-if. ,rn1~(, 1990 c.:upunc111rl•\ ad\'1K·,11e, m,1,1 1hat 11 ,me rt.·ali:6 that nw,t of thc:,e patiench,1, bencfitted b11l1on, ,m1.e It \\a, ~cek Oh\ hdp onl} a, a la t rc-.ort. mtrl,duccd mnre th,1114,000 \e,1r, ago. "The,e pafll'llt ha\·e often heen to \Vhy, tlh·n, Jo "1 m,1ny A llll'ric.in man) doctor,," c:xpla1m Oh. "They'n• ph},ic1,m, remain shpt1c,1l of 11? "~1a}bcthe} feel that other science, h,1\"Cmm1.•de,n-cut prooh l>I hm\ thq work," ,uggc,ted Ju1\l' (Joung R,1) Oh, ~1.D. On the other hand, ,he ob-.:r. e,, "Once ( pl ,1c1 1 ) h,1\ e rcicrred a p.1t1ent, ,1nJ ,een g110J re,ult,, thq h:coml' nh1re c.:onhdult." Oh, as I tant professor of rl.'hab1l1ta• t n • 1.•d11. me at UB and ,mending phy,1cnn m rehah1l11,111onml·d1cine ,1t the Erie Count\' ~kd1c.1l C1.·ntl·r, h.1, CIIJO}cd t,trtlmg re ulb u,mg thl' tedt• nique 1111r1.',II a d1\as1.· r,mcc ,111.hmnu.: p,11n:bur,111, lo\\ l'r b.1d: ,tr,un, t ngem• m,11neur,1lg1,1,m1gr,111w he,1d,1dw, neck and ,h11ulller [Min, Bell\ p,il,), had ph\,1cal thl·r<1p\ and nothing h,1p• o,tco.utlmt 1,, te111H dbm\ ,md e\ l.'n pened; med1c,1wm, and \Ct the problem Mnu, hcacbchc. ,nil per,1,red. The\ come 111 de,1,craIn De1.l'lllher, EC MC opem·d .1 nl'\\' t 1011,\\ 111 mg to g1,·e anyth mg ,\ try." ,11.upun1.tur1.· center, the onh ,ud1 cen• P,111enr,m·I\ come co hl•r 111 de,pcr,1• ter in ,1 \Vcstem Ne\\ York ho,pnal. Oh tlOn, I t the u,uall\· lc,t\ C harr}, able rt. •r1' h.11 5 percent of her patient, to funcuon better, ffillre cncrgeuc, and there l'XPl"rienn· g,111dr1.",t1lt-. The: in ,ome tnsl,lll<.:l'' ahl1.• to return to t 1t1,tH. 1 e,peci,1lh impre~,l\'t.• \\ hc:n wnrk for the tir,1 tune m ,1gc:,. llU!FAI0Pll\'1<1AN A~lll\l \IIDI c\L~lf~TIST �7 / JuneOh, M.D. , left, an assistantprofessorof reh1abilitationmedicine at UB , is oneof the fewM.D.s in the Buffalo areawho usesacupuncture. Aboveis oneherpatients , a 6!;-year-oldwomanwithosteoarth ritis. P n 0 t OS BUFFALO PHY~ICIAS A~O BlmlEDIC.-\L ~IE.'-:Tl~T b 'Y b 0 b \\ a 0 n :SPRISG1990 �8 Torelievekneeandanklepaincausedbyosteoarthritis, needlesareinsertedintothewoman 's legs, above,andhands , right. "My specialty here (at ECMC) is neuromuscular problems," says Oh. "Multiple sclerosis, strokes. Pain resulting from car accidents, whiplash, amputatiom. Anything dealing with muscles or neuroproblems. "I see occupationally related pain X-ray technicians who do a lot of lifting, those who lift a lot of patients they have pain in the shoulder blade, and yet the X-ray shows e, •erything to be O.K. Nobody can find anything, but '<PRISGIWJ acupuncture relieves the pain. I do see a lot of that." "Acupuncture is a respectable, safe approach to chronic pain," said Glen E. Gresham, professor and chairman of rehabilitation medicine at UB and director of rehabilitation medicine at ECMC. Acupuncture is Just one of many different therapies, ranging from drugs to electrical stimulation, that are a\'ailable to doctors to treat pain, and no ~ingle therapy worb for everyone. "Acupuncture is an accepted and respected alternative in this array of approaches," Gresham said. The technique, notes Oh, is almost painless. A number of very fine needles are inserted at designated points that are mapped out on a chart in Oh' s office. (In Chinese, the points have names; in English, they have numbers.) Most people find the acupuncture treatment very relaxing; some of them even fall asleep. �ECMC. She joined the staff of the hospital m 1972 as an assistant attending physician. le wasn't until Oh had lived in Buffalo for several years that she decided to study acupuncture. In a search for alternatives for patients who did not respond to available treatment, she embarked on a specialized 300-hour course in acupuncture at UCLA in California. That course allowed her to become licensed last year to use the procedure in New York Scace. The pink licensing certificate is proudly displayed on her office wall. "Ir took three years to get that paper," she exclaimed. Today, acupuncture constitutes between 30 and 40 percent of Oh's practice. Western physicians do not yet trust acupuncture completely and imurance doesn't co\'er the technique. Perhaps it's not accepted because it's not clear how it works. "No one knows exactly how acupuncture blocks pain," Oh confirms, but ventures a theory. "Pain appears to involve multiple systems including peripheral nerve endings, brain stem, midbrain reticular formation, thalamus, and prefronral cortex. "When I insert needles and manipulate and twist with my fingers, there ts an area that stimulates the pain pathway to I A native of Korea, Oh grew up in a culture that accepted acupuncture. When she was a child, her parents took her to an acupuncturist for successful treatment of stomach pains. She studied medicine in Korea, graduating from the Ewha Women's Medical School in Seoul. Then she completed an internship at the Bronx Lebanon Hospital in New York City before coming to Buffalo to do a residency in rehabilitation medicine at BUFF,-\Ll) r t-n~l(' I -\~ \!',;l) RIOMEPICA I. :;(: l~ Tl'-T Ele<trocles are oftenattached to theacupunctureneedles.In thiscase, Dr.Oh said,thepatient• wasableto get around without herwalker , walkfaster , and evengo shop· pingaftera few treatments. the middle brain and the spinal cord. The concentration of certain naturally occurring hormones (such as endorphin) is increased and the pain is controlled." Successful acupuncture, notes Oh, depends on the integrity of nerve function. About half of all known acupuncture points are in some way directly related to the peripheral nerve, and more than 35 percent are located close to the peripheral nerve. This is not the first time an acupuncture clinic has been housed at ECMC. An earlier clinic was started at the hospital in 1974, back when it was known as the E.J. Meyer Memorial Hospital. The clinic closed after a little more than a year when the initial high demand for acupuncture slacked off, said Ross Markello, M.D., who headed the anesthesiology departments at the ho pital and UB. There were also some doubts about the effectiveness of the treatments, noted Markello, who is now an emeritus professor at UB and an associate medical director at Independent Health, an HMO. A review by psychiatrist~ showed that 33 percent of the patients felt they had some improvement - exactly what you'd expect from a placebo. Oh bristles slightly at the suggestion that acupuncture might be a kind of hypnosis or a placebo. 9 �10 I Inanotherpatientsufferingmusclespasmsandpainafter backsurgery , acupuncture needleswereinserteddirectlyintotheback. Thepatientreportedfeelingwarmandrelaxedafter thetreatmentandthe spasmsstopped. �"It's not a placebo effect at all," she states matter-of-factly. "You can see in China where surgery is performed on alert patients using acupunctu re that's no placebo. "In Western New York it's not as common as it is on the West Coast," adds Oh. "In California, a great deal of acupuncture is practiced, not only by Chinese acupunctu rists, but by physicians as well. Western New York is more conservative, anJ nor as accepting of acupuncture as a medical treatment. "Since I started here at ECMC, and the patients who have come here have had good results, word of mouth has been good. In fact, a neurosurgeon at ECMC has begun to send patients who still have back pain after surgery to me." Doctors' relatives and doctors themselves also go to Oh for treatment. She was able co relieve the "tennis elbow" pain from which one doctor's wife had suffered for more than a year. A physician sought her help for Bell's Palsy, a disorder that leaves one side of the face weakened - the face becomes asymmetrical as one side droops. After six treatments his face is balanced again. Although behavior moJificacion is not really in her lme, Oh has even been able to assist the efforts of hospital employees to quit smoking. "Somehow, acupuncture b very effective to help people quit smoking," says Oh. "People have been able to quit smoking after 30 years!" When acupuncture needles are manipulated in the patient's ear, body chemistry is altered and the desire to smoke is diminished. she said. "Once people start smoking again, they're back in the habit," warned Oh, "but the technique works beautifully. I did it for cwo patients who are employees of the hospital. "I did it reluctantly, because l am not exclusively an acupuncturist. I am a physician who uses acupuncture as a tool in her practice. My practice at ECMC is a medical practice. Thirty or 40 percent of my practice is acupuncture, as indicated when these patients need pain control." Those who are exclusively acupuncturists and do not hold an M.D. or D.D.S. travel a different route ro ger licensed in New York Scace, according to T homas J. Monahan, executive secretary of the State Medical Board. They muse already have an acceptab le acupuncture license from another state or country, along with appropriate training in acupuncture and 10 years of experience outside New York Stace. Because of the way the statute is written, most acupuncturists licensed by New York were trained m Easr Asia , Monahan noted. Licensed acupuncturists outnumber physicians who use the technique in Western New York - Oh has heard of only one besides herself. But perhaps one Jay it won't be so rare. "Acupuncture is not yet completely accepted in the medical profession, bur pretty soon it will be," she predicts. Anthony Chase is the coordinawrof Academic Services for the Educauonal Opponumt)' Programat BuffaloState Collegeand a prolific free-lancewriter HowMANYDIFFERENT WAYS(AN You SPELL RELIEF? cupunctu re 1s 1us t one alternat1\'e for treating pain. While no single method can claun to be JOOpercent effect1\'e, "a ll of these th ings work \'ery well for some people," noted Glen E. Gresham, professor and c h airman of rehabil1tation medicine at UB and director of rehahd1tat1on med1c111e at ECMC. Dru g th e rap y co m b in ed with ph ys ical th era py. This 1s the most common methoJ, according to June (Joung Ra) Oh, M.D., assistant professor of rehabdnation medicine at UB anJ attending physician m rehabilitation med1c111e at the Erie Count) Medical Center. TEN S - tran sc utan eo us el ec tri c al n e rve s timulati o n. An electrode 1s pasted on the skm which deliver, a low-\'oltage current. "A Im of people gee relief from this method," noted Gresham. "l think there's a physiologically similar mechamsm to acupuncture." Tri gge r-po int inj ec ti o ns . "This 1s \'ery fashionable for people who ache all over," noted Gre:;ham. If a physician can find a pomt on the skin that cause:. this allO\'er achines, when pressed, he can inject the point with a local anesthetic or corticoscero1d, or both. The trigger pomts mav coincide with acupuncture point~. Freez ing. Freezing the area \\ ith a \'apocoolant spray bricth frec:cs and numbs the spot. The muscle can be stretched to relca:ie ,1spasm. ., 11 �Timmy Mathias'mother,Kerry,talksto herson as he recuperates. �13 BY EDWARD J.SYLVESTER Noonehadeverrecovered fromsuchan iniury. Theboy'sheadwasattachedto his bodybyonlyhisspinalcord,a fewmuscles, andskin,andhisbrainstemwasdamaged. Butthanksto theworkofa UBalumnus andotherneurosurgeons inPhoenix, the boyeventually walkedoutof thehospital, smiling and talkingto reporters. ... Timmy Mathias 'mangled bicycle �Spnng had arnved in Phoenix, Ari:ona, and the weather on April 26, 1989, was sunny and inviting. But neurosurgery resident Brian Fitzpat rick didn't have 14 time to notice. It was 8 a.m. and he was already in the middle of his bu,y morning rounds at St. Joseph's Hospital when he was ,ummoned to the emergency room: A young boy on a bike has been hit hy a pickup truck and had JUH been airevaced from the accident sm: m suburban Phoenix. In the emergency room, the trauma ream, paramedics, and nursing staff worked on the unconsc10us 10-yearold hoy who was strapped to a hack board and protected by a cervical co llar. X-rays indicated that the boy had suffered ltfe-rhreatening internal injuries and needed to be rushed into general surgery. Fit:patnck, a 1986 graduate of the UB med ical school on a pediatric neurosurgery rotation with Barrow Neurological lnstttute m Phoenix, was called co check for spine and neck injuries, and he began the first medical workup of the case that would dub his patient "the miracle child." At first, doctors had only hmt:, to the extent of the injuries suffered l,y Timothy I. Mathias Jr. From the X-rays 111 the emergency room, taken Fit:patrick and spine specialist Steven Papadopoulos, M.O., saw evidence of a !X)tentially lethal separation of the boy's neck vercehra from his skull. Timmy was sent for CT scam, which offer a much finer resolution than ordinary X-rays. From chose, the doctors suspected somethtng even worse: a fa111tshadow suggested blood on the hmm stem. A, Fit:patr1ck accompanied the unconscious hoy's gurney, rushing from the emergency mom to the CT scan to general surgery, the hoy's condition worsened. He didn't blink when hts eyes were toucheJ anJ his pupils didn't contract m respome to light, a sign of hram stem miury. In genera l surgery, physicians were able to sa\'C moM of the hoy's ruptured spleen, mended his li\'er and kidney, and stopped hi, internal bleeding. was rushingX-rays and CT scans among the specialistsof Barrow's neurosurgery team, but he was deliveringincreasingl y bad news. "It becameapparentthat Timmy's headhadbeen separatedfrom his spine," Fitzpatrickrecalls, "and that the brainstem hadbeen damaged as well." A review of the medicalliterature confirmed what everyone now suspected: No one ever recovered from such an injury. Meanwhile, Fit:patrick was rushing X-rays and CT scans among the specialists of Barrow\ neurosurgery team, but he wa.....deli\'ering increasingly bad news. "It liecame apparent that his heaJ had been separated from his spine," Fitzpatrick recalls, "and that the brain stem had heen damaged as well." A review of the medical ltterature confirmed what everyone now suspected: Of thme accident victims whose skulls had broken loo,e from their spines, a tmy proport ion suffered no bram stem injury; if immobi lized quickly, the, recovered. But of those who suffered any bram trauma what oever, none reco\'ered, no marter how quickly they were immob1li:ed. All either died or remained vegetative. Timmy haJ pulled through general surgery, but Fitzpatrick and his colleagues still faced a challenge. They needed to know precisely where the suspected brain stem inJUI)' was located. There 1s no such thing as exploratory brain surgery, Fit:patnck pointed out later in an interview; the neurosurgeun mu,r know exactly where he is headed tiefore he starts surgery. Only a magnetic resonance image (MRI) would disclme the 1nJury plainly enough for surgery, but the powerful magnet required to take such a scan would disrupt the respi rator, killing the boy. "Our fin,t break was in having a new, experimental MRI scanner," Fit:patrick explained. "This was a low-field scanner, Jes1gned not to interfere with a respirator. The question was, would it work?" It d,d, enabling Fitzpatrick and Papadopoulos to rush a set of cryscalclear scam to the viewing screen. But as each MRI scan was placed m the light in the early afternoon, recalls Harold Rekate, M.O., the pediatric neurosurgeon under whom Fitzpatrick Web working, "the news got worse. We were shocked," he says, a word not frequently heard among neurosurgeons. The separation of Timmy's neck from his skull was more severe than any of them had ever seen, and a walnut-si:ed blood clot pressed against the front of the boy's brain stem. By m1d-afcernoon, a growmg ream huddled around the MRI scam on the lighted wall panels. There was Robert Spet:ler, Barrow's chief, who is known for his aggressive and successful treatment of aneurysms and stroke; Volker Sonntag, the spine surgeon who had in\'ented an implantab le pin that would be used to reconnect the boy's spine to his skull; Rekate, chief of pediatric neurosurgery; Fmparrick, and Papadopoulos. �IS Thethinblackarrowsshowhowthe skullwas separatedfromthe spine.Thefat whitearrowindicatesthe bloodclotpushingonthe spinalcord. RL'FFALOrHYsJCI-\'\ A'\ll f\l0\1ElllC-\l ~-IE'\Tl'-T �16 "Granted, there is little chance we can save him," Spetder told the group. "Bue 1f we do nothing, he will surely die. If we do these things, we're going to lose mo,c of the t11ne.Bur if we don't do chem, we'll lose all the time. "What are we waittng for?" To Fitzpatrick, ,uch a moment marked one of the intangihle values of his residency. "le is reall, that accicude at Barrow that's important," Fir:patnck sar. "And that's Sperzlcr's attitude. He b very aggressive. If there's a chance of saving someone, you take it. "There were three things chat made the surgery possible. First, the aggressive workup as soon as the boy was admmed, mcluding the lo,\,-field MRI scan. There was the assumption that the worst might be true, hut we still might save him. "Second, the aggressive approach Barrow rakes in brain inJttry ,·icttms, especially children." And the third ingredient chat was needed co make the surger,· succcl-sful,of course, was expertise. "Especially Sonnrag's and Spetzler's," Fitzpatrick said. Timmy's head had been immobilized in a cervical collar and a backboard at the accident scene, and 1n the late afternoon Fttzpatrick and Papadopoulos labored to fit him into a halo brace. The halo hrace resembles a medieval torture instrument, with a steel halo chat encircles the head, held by pins screwed into the bone. Four rods ristng from a tight leather vest run through loops 111the halo. Fitzpatrick and Papadopoulos had co make sure they didn't Jar Timmy's head or spine, or they would destro~ the unprotected delicate fihers of the brain stem. Nothmg held Timmy's head on but his spmal cord, a few mw,cles, and skin. And the sp111alcord, to a neural expert, is simply spidery filaments of hra in ttssue. Fit:patrick noted that the location of Timmy's clot was a further complication. Ar the from of the brain stem, tt lay directly hehmd the mouth cavity, and the normal approach for surgery would have heen through the mouth. Bur raking that route would rhk infecttng the brain w1ch mouth hacteria, Above,Brian Fitzpatrick, a 1986graduate of which would certainly be fatal. Spet:ler had developed a technique theUBmedical school, checked Timmy's progress dailyandsawradical improvement. for reaching previously inoperable aneurysms through an approach from Within theconfines of hishalobraceanda the back of the neck. That meant legcast, nmmywasableto laughandplay likeany10-year-oldandeventually walked Fit:patrick and the ochers had co roll the boy onto his stomach hefore outof thehospital. surgery, another reason why the halo brace was critical. It was nearly 5 p.m. as Fitzpatrick and Papadopoulos wheeled Timmy into Operating Room 2 and scrubbed in. Across the hall, Spetzler was completing eight hours of delicate surgery, clamping off a blee<lmg aneurysm deep within a 64-year-old man's brain during a procedure known as a "scambtill" - a complete cardiac arrest in which the bram is drained of blood and chilled to hring metabolic activity below the normal threshold of life. Spetzler scrubbed out, crossed the hall, scrubbed in and hegan again. The doctors cue down to the spme, parred rhe neck muscles, and worked around to the front of the bram stem. Fmally, the clot could be seen. The only hopeful sign they found was that there had heen no new bleedmg. The clot was drained and the doctors began the arduous task of reattaching Timmy's skull and spine with Sonnrag's V-shaped pin. The open ends of the "V" were wired to the vertebrae and the �the surgery, Timmy was essentially Fitzpatrick's patient. "He began to show signs that his paralysiswas improving almost immediately," Fitzpatricksaid. "But the really 1 l big moment came severalweeks later when we asked him to show us two fingers, and suddenly two fingerspopped up. That was the first time we knew he was awake. " "V" point was fastened to the skull with wires looped through tiny holes drilled through the bone. The surgery took about five hours. It was well after midnight, 16 hours after Timmy was brought in, by the time Rekate and Fitzpatrick met with Timmy's parents. They had been told there was only a 1-in-20 chance chat Timmy would survive. Now it appeared he had beaten those odds. Bue how far he would come back was completely unknown. Timmy was now essentially Fitzpatrick's patient, on Rekate's pediatric neurosurgery service. "He began to show signs that his paralysis was improving almost immediately," F1t:patrick says. The morning after the operation, Timmy began moving, though he was too dee p in a coma to follow commands. Timmy's movement was amaz ing enough. "Bue the really big moment came several weeks later when we asked him to show us two fingers, and suddenly two fingers popped up. That was che first time we knew he was awake." Fitzpatrick visited Timmy twice a day on rounds and saw radical improvements day by day. In mid-May, a press conference was scheduled to discuss Timmy's condition. The story of Timmy':, rema rkable surgery had already been told in newspapers and magazines and on television around che world. Speeder had even been inte rviewed by Tass, the Soviet news agency. Tim my was pictu re d , while sti ll comatose and in halo brace, on the cover of Stern, Germany's major news magazine. Tho ugh cheered by Timmy's progress, Fitzpatrick still was as surprised as the rest of the medical staff when Spetzler confidently said at the news conference, "Timmy will walk out of here." Within a month after the accident, Timmy was acting like any I 0-year-old, chatting and laughing. He moved as much as he could while wearing the restrictive halo brace and a leg case, which had been applied a few days after the accident to mend his broken leg. Because several vertebrae are fused with the V-shaped pin, Timmy will always move his head as if he has a stiff neck, but there doesn't appear to be any permanent brain damage. Speczler's prediction was correct, and Timmy finally walked out of the hospital on June 23. Reflecting on that surprising forecast, Fit:patric k finds a lesson for neurosurgeons. "Timmy had a le:,ion we could see, that we removed. That tell you that a more aggressive workup may show a hopeless problem to be treatable, in some cases even curable," Fitzpatrick said. Neurosurgery has appealed to Fitzpatrick since his first year of medical school at UB when he conducted research at Millard Fillmore Hospital with Nick Hopkins, M.D., now chairman of the Depa r tment of Neurosurgery at UB, and James Budny, M.D., vice chairman of the department. "Working with them was very exciting," he said. "It showed me the direction to take." His decision to become a doctor goes back even farther; way back to Amherst Central Junior H igh. His biology class had shown him for the first time "new insights instead of just a continuity, a new way of looking at the world," he said. The son of Robert C. Fitzpatrick, director of research developme nt in the UB School of Dental Medicine, Fit:patrick the n majored in neurobiology at Cornell. After graduation, he did his required year of general residency at Millard Fillmore. Fitzpatrick chose to continue his neurosu rg ica I training at Barrow Neurological Institu t e in Phoenix, A riz., because he wanted a bu y neurosurgica l service. And, he had heard, unlike Barrow, many better-known institutions don't allow residents to perform surgery until their final year. Another drawing card was Robert Spet: ler, Barrow's chief, o n e of t he world's leaders in vascu lar neurosurgery, the area in which Fitzpatrick was most interested. "The staff was young and aggressive, and they were up on the latest technology," Fitzpatrick says. "And technology proved important" in Timmy's case. Soon after Timmy was re leased, Fitzpatrick finished his pediatrics rotation in neurosurgery at St. Joseph's Hospital in Phoen ix and began a sixmonth rotation at trauma-hea\'y Maricopa County Hospital in Arizona. He is now chief neurosurg ical resident at University Hospital in Tucson. Then it will be back to Phoenix and Barrow again, and three more years to complete one of medicine's lengthiest apprenticeships. EdwardJ. Sylt•ester,a memberof the Naaonal Associationof ScienceWriters,is the authorof The Gene Age: Genetic Engineermg and theNext lnduscnal Revolution, «:ith Dr. Lynn C. Kloc;:,and Target: Cancer. 17 �18 STETHOSCOPES TO MICROSCOPES TO MICROCHIPS Computers emerge as medicalschool's newest teaching tool BY DAVID HIMMELGREEN he three-pound preemie is suffering from respiratory distress syndrome. Her breathing is lahored and her skin casts a bluish tint. She's hooked up to a res-ptrator,but the monitor shows that her viral signs are not gO(.xl. This is the medical student's first experience with life-or-Jeach decisions in the intensive care nur ery. Hands sweating and heart racing, the stress 1s almosl unbearable. The student must choose the right course of action. Fortunately, even a bad decision has no fatal comequences. This babv is made not of tlesh and blood, but bits and bytes and pixels - she exists imide a comrucer program. The student types in an instruction to pass a rube down the computer bahy's air passage. The computer responds, mdicaung that oxygen 1s l:,eing delivered to the lungs, and che baby's respiration is returning to normal. The student also breaches easier. Other complication., anse for the preemie, and tomorrow's physician contmues to make decisions, typing in further imrruct1ons. This "dialogue" between student and computer contmut:s for p.:rhaps an hour, simulating four days in the baby's life. Both a confidence builder and valuable experience for the future, this program 1s just one example of the cools now available co UB medical student!\ in the wake of the computer revolution of the lace '70s and early '80s. Today, even computer novices can use powerful software programs to assist them in medical education, research and administration. said John Loonsk, M.D., director of academic computing for the medical school. ILLUSTRATIONS compu· tersimulat ion allowsstudents to honetheir diagnostic skills andevenmake mistakes without endangering a human life. BY Computers can simulate patients and have the potential tl> cut down on the number of animals used in teaching. They can look at X-rays or slide~ 111 new \\ ays and access large amount~ of information, almost instantaneously. And computers are becoming sophisticated enough to help come up with soluc1ons to problem:.. Personal computers (PCs), which are more accessible and user-friendly than mainframe computers, are popping up everywhere in hosritals and cl1111cal practices. AnJ the software programs are relanvely easy to use and more powerful lhan ever. Physicians of the 21st century will be faced with a field of medicme thac 1s more and more complex and speciali:ed. Computers will help them wade through the mass of information and paperwork that they'll encounter, Loonsk predicts. "Future rhysicians are going to need to be computer capable," he said. The UB medical school has been usmg computer, to assist in pre-clinical coursei., ,uch as physiology and biophysics, since the 1970,. During those early days, computers were loaded on rumbling cam anJ wheeled down the hallowed halls to labs and lecture rooms. Today, the medical school has a computer lah, now 111 ib third year of operation, located in the Cary-Farber-Sherman Addition on the South (~fain Street) Campus. Loonsk, who graduated from the UB medical school 111 1986, b director of the lab and the newly appointed chairman of the medical school computer mstruccion committee. The computer lab 1s a multtpurpose facility that uses and de\'elops computer programs. It offers LI SA HANEY I\CHA LO f'HY•ICI ·I' .-1'.'\11BI0 \1f.()ICAL :,c 1E:-.'ll q �computer-aided instruction tn many subjects, teaches "computer literacy," and teaches how to use computers in medicine. "Our students arrive with very wide and varied backgrounds in computers," stressed Loonsk. The objecttve is to bring student:, up to speed on the computers and then introduce them to the power of computers in educat ion, research, and adminbtration. One of the biggest benefits of computers is the way they can manipulate the pictures thal medicine already uses, such ai, rhotos, slides or X-rays. Using a 51bill, Loonsk demonstrated a machine called a digiti:er, which scam. rictures and convens them into informanon that the computer understands. After scanning the bill, the computer presented a super-high quality image of George Washington's face on rhe monitor. The digitizer enhances the image and can :oom in on minute details that may not be seen b, the rhysician at first glance. Currently, Loomk and lrn, colleagues are busy digitizing images that will eventually be used by facully to teach students about things such as the identification oi kidney stones anJ what different tyres of bacterial infections look like. Studenls and faculty ah.o have acces:, to four ,·iden-disk players that interface with computers. Recently, the Medica l Students' Parent:, Council, a group of parents of medical students that conheUnitributes time anJ money to a wide variety of medversityplansto ical school activitie~, donated an lBM eventuaUy tinkthe lnfowindows worbtation with video-disk rlayer, computers computer and touchscreen monitor to the comthroughout the medical schooland puter lab. Medical students use the lnfowindows touchbeammultimedia screen system in their introduction to clinical imagesrightinto meJicine course to study different types of heart classrooms and laboratories. Gone sounds and the cardiovascular system, said Loonsk. A video of real patients being examined 1splayed arethedaysof heftingequipment through the video-disk rlayer. Students can also request images of the heart anatomy simply by oncartsand couching the menu that's disrlayed on the monitor. wheeling it down When the students touch the heart on the thehalls. screen in different spots, the computer plays the different heart sounds that emanate from those areas. Students can abo request graphs of heart sound cycles, Loonsk said. Students also have access to seven CD-ROM players, which are similar to CD-music players found at home. Instead of reading disks that have captured the sounds of Verdi or the Beatles, they read disks that contain computer data. Like the video-disk plaver, CD-ROM players use lasers to read information. But CD-ROM players tend tO be more text-based and rely less on images, though that may change in the future. One use of the CD player is to provide a textbook on a disk, Loonsk said. Scientific American now offers its consult textbook of medicine on compact disc. This CD is regularly updated so that students can get the most recent medical informa- omputerscanenhance an image , whether it's theportrait of George Washingtonona dollarbill oranX-rayof a tibia . Dodorscan thenmanipulate theseclear images , zooming inandetailsthey mightotherw ise havemissed. 19 �tudents canfistentocfdfer· entheartsounds bytouching the various areasof theheartshown onthecomputer screen.Thisis one useof an lnfowindows workstation, whichwas donated bythe Medical Students ' Parents Council. 20 tion with high-rel>Olution images almost instantaneously on the computer. There are also a number of medical Journals publishing on CDs so that access to current rel;earch is becoming easier than ever, Loonsk explained. The computer lab offers a numher of databases, including the Physician's Desk Reference (PDR). Loonsk pointed out that it is important to expose students to the PDR program because It provides them wtth a wealth of information on brand name and generic medications and drug interactions. Medical students are given a worksheet with items about a patient's medical history, such a~ age, sex, symptoms and lab results. After reading the information, the students must consult the PDR to determine drug interactions and decide which medications are best suited to the patient. Students then write down their diagnosis and therapeutic regimen on the worksheet for evaluation by faculty. Loonsk envisions a time when patient medical histories are integrated w1ch many different programs like the PDR.Information from many different oources could then be brought up on the screen at the same time, without having to make cumbersome conversions herween different programs. In the future, the miniaturization of computer hardware may provide the physician with almost .instantaneous access to medical information. "Hypothetically, there are devices chat flip over one eye and allow you to view data as it's projected directly on your retina," Loonsk mentioned. Perhaps one day a physician will be able to use this device to view a patient's medical hi. cory, lab tests, and refer to the PDR in one fell swoop while the patient is on the exammmg table. tudents cangaineasy accessto huge amounts of information using databases suchas thecomputer versionof the Physician 's Desk Reference. There is also a program that reaches UB students how to call up patient lab data from the computer system of the Erie County Medical Center. Soon students may get the opportunity to work on various local hospital computer systems before they begin their clinical rotations, Loonsk added, making the student's transition co real-life medical situations easier. Another clinical database program available co students and faculty 1s MEDLOG, which allows a physician to examine specific charactemcics of his patient pool. For instance, if a physician wants to test a new blood pressure drug on patients with specific characteristics, he can use MEDLOG co find the names of the most suitable patients for chis drug. After the test 1s done, the program can also be used to analyze whether the drug was able to effectively lower blood pressure for the sample of patients, Loonsk said. Another tool used in academic computing and within l>Omemedical schoob is known as "multimedia." Multimedia integrates images, animation, sound, and text on a screen using multiple windows. At UB, multimedia projects will llSecommercially available sofcv:areprograms and reshape them for an individuali:ed solution to a specific problem. One problem is visualizing anatomic relationships. The meandering route of the cranial nerves, for instance, is as confusing as a New York City �ersonol computers con helpdoctors send a letterorcon suggesta possible diagnosis ina porticulor case. road map. Traditional textbook descriptions, illustrations, and the dissection of cadavers all help, but still some students struggle. Now, imagine a multimedia program where a student can view a high-quality three-dimensional rotating image of the cranial nerves, along with a text description, while conducting a dissection with classmates. While chat's in UB's more-distant future, a simpler version of multimedia is expected to be in use at UB by the fall. A eady Loonsk and his colleagues are using the digitizer to create images. For example, images of cirrhotic livers incorporated with text descriptions will be useJto teach students about liver disease. These images and text can easily be manipulated so that students can scan variations in the disease process and compare images to different types of liver disease, all on the screen at the same time. Another plan for the UB medical computer lab is the eventual linkage with computers throughout the medical school complex. Faculty will be able co utilize the lab's resources from classrooms and laboratories in the building. Addmonally, a video distribution network will beam multimedia images and descriptions of things such as disease pathologies and anatomical structures to students while they are in lectures or <lomg laboratory work. Using even simple PCs, the sky's the limit to what students and faculty can do in the medical school computer lab. The lab maintains more than 35 IBM-compatible and Apple computers ypotheticolly , there couldbedevices thatflipoverone eye andallowa personto view dataas it's projected directly ontheretina . and a wide variety of software applications. One program teaches about human heart sounds. Students can choo e to listen to specific preprogrammed heart murmur with the "patient" lying down, sitting up, and breathing in or out. A drawing of a patient's chest appears on the monitor. The computer simulates the sounds a physician would normally hear if he or she were to place a stethoscope on different anatomical points outside the chest. Another helpful tool for students 1sa problemoriented program called Quick Medical Reference (QMR) that'~ run on an IBM-compatible personal computer. Like the systems in banking that decide whether or not a customer is a suitable loan risk, QMR makes decisions about medical diagnoses based on specific clinical findings. "lt (QMR) allows you to look at medical information in a totally different way than if you were to read a textbook or other resource," Loonsk said. "We can put up a disease and then sort the clinical findings in many different ways. "For instance, we can determine the most frequently cited symptom in a large group of patients or the finding that would most strongly indicate that srecific disease." For example, a -rudent can plug in the clinical findings for a pregnant woman who is over 30 years old, obese, and experiencing high blood sugar, excessi\'e urination, and acidosis. Then the student requests the QMR program to make a diagnosis. QMR will interpret these findings and suggest gestational diabetes mellitus (diabetes in pregnancy) 21 �a potential Jiagnos1s, a,, well as lbt other d1sea:,e:, from which the patient might be suffering. The computer lab also offers tools for medical anJ health related research. One project, still in its embryonic stages, is the Scoliosis Tempora l Imaging Project, which bassociateJ with the work of Robert Gillesp ie, M.D., professor anJ chairman of the Department of Orthopaedics. The goal in this pro1ect is co demonsuate, through three-dimensional images, the progression of scoliosb (a curYature of the spine) through time. Even ordinary software used in business offices can be helpful to physicians, though many aren't yet familiar with what's available. "We have word processing, Jesktop publishing, databases, spreaJsheets, and graphics programs," Loonsk said, a,, well as electronic mail. Combined, these programs can help a physician set up long-term appointment schedules, present well-written and concise consults, monitor illness trends within a patient pool, and keep track of billing and payments. In the long term, Looru.k hopes that computers will assist in the nuts and bolts of medicine by quickly retrieving the most pertinent information the physician needs to help a patient. A big complaint in rneJicine today is that physic ians are so specialized and medicine is so technological char there is little time for physicians to per,onally interact with their patients. Loonsk hopes that in the future compurers will free more time for physicians to spend with their patients. a,, 22 WHATS ON THE l\1ENU 7 I f you can't cell the hardware from the software without a scorecard, take a look at this lbt of items being served up at the UB medical school'~ computer lab. Di git izer. This machine scans photos, slides or X-rays and converts them into information that the computer under~ranJs. Then a superhigh quality image appears on the monitor. The d1git1:er can manipulate the image in many ways, :,uch a~ enlarging a portion of rhe image for cloi.er inspection. Tou ch screen monito r. This 1s similar to the monitors found in grocery scores that shoppers can press to finJ in which aisle the anchm y p1::as are located. Vid eo -di s k playe r. V 1Jeo-d1sk players use lasers co read informauon from a disk anJ send moving image, to a television-like monitor and hecomputerlaboffers toolsformedico! researchers and clinicians alike. Byhelping physi· ciansquickly retrieveinformation, computers mayenablethem to spendmore timewiththeir patients . send sound to a speaker. They can also score thousand, of ,nil 35 mm slides. They allow users to see moving images of real people, or a computer-generated image, and move easily between the two. CD -ROM playe r. Compact disk read-only memory players are similar to CD-music players found at home, but imteaJ of reading disks that have captured the sounJ~ of VerJi or the Beatles, they read Jisks that contain computer data. Like the video-disk player, CD-ROM players use laser, to read information. But CD-ROM players today tend to be more text based and rely less on images. Multimedia. Multimedia integrates images, animation, sound, anJ text, and can use multiple windows. Dat·1d Hnnmelgreen, tl'ho i, comple1inghis Ph.D. m anthropoloff'.\' at UB, has done researchon numuon and food habits in Lesothoand Kashmirand plam w remm to Africaw completehisdisseriacion m chefall. �---- :(]}---.; E J. ~ 23 TEMPORARY SHELTER f OR HOMELESS ATUB TESTED portable shelter Jesigned ro prov1Je temporary protection from the elements for homeless persons passed its first fielJ test with flying colors in January, according to physiologists at UB. The device could be used by hnmele:.s person., who refuse to go to a formal shelter or cannot find room m one on cold winter nights. "We certainly con · ider something like this as a la;,t resort," said Tom Harmon, who came up with the idea. Harmon was a street person for three years and is now executive director of the Friends of the Night People shelter for the homeb,. Researchers ,aid that whether it can provide adequate shelter when the tempera tu re drops to near zero Jegrees Fahrenheit and pre\·ent hypothermia - a precipitous drop in core body temperature - remains to be determined in additional testmg. Suk Ki Hong, M.0., Ph.D., professor of physiology at UB, anJ four colleagues monitored Harmon, who \'olunteered for the tesl, for sign, of hypl)thermia. Not only Jid Harmon's core body temperature remain normal. but the temperature wiLhin the two-piece corrugated "pup tent" never dropped below 50 degrees Fahrenheit. The low temperature during the all-night test was 30 degrees Fahrenheit. The idea for the temporary shelter originated with Harmon. He proposeJ a corrugated shelter based on his own experience: One of the hest night's sleep he had while homeless, he recalled, was in a discarded corrugated cardboard box that had been used for shipping a hot-water tank. The corru- gated material is insulating and holds in the warm air. The "Harmon Hotel" being tested by UB physiologists resulted from discussions between Harmon and Peter Pellegrino, sales manager for Great Lakes Container Corp. of Lockport, N.Y., a \'Olunteer at Friends of the Night People, during the bmer cold snap that hit most of the nation in December. The prototype is a two-piece tube that folds flat anJ is easily carried. When a confining band is cut, the tube "almost self-erects," resembling a triangular pup tent. The two telescoping poruons of the tube adjust to the height of the user. Although the user is completely enclosed in the tube, he or she can get out of the tube easily. TomHonmon stayedwormthrough one of Buff ollo' s winternightsinsidethe "Hormo1~ Hotel. " Although the tubes are biodegradable and Harmon envisions using them only once or twice, they can be reused and can be carried after the metal band 1scut. Harmon said he e1wi:iions carrying a suprly of the corrugated pup tents in the trunk of his car and handing them out to homeless people who need chem. He also would like to make chem available to police, fire and ambulance personnel, as well as ocher shelters and soup kitchens. Great Lakes Container designed and developed the prototype at no charge, Pellegrino said. A charge will be assessed if the company eventually manufactures it, he said, adding chat Friends of the Night People will receive part of any profits obtained if the device is sold co any group other than the Buffalo shelter. Assisting Hong in the first field test were Richard A. Morin, director of facilities for the UB Physiology Department; Donald R. Wilson, senior lab equipment designer; Walter S. Marshall, lab equipment designer, and Donald R. Rennie, UB professor of physiology who also 1sa UB vice president and vice provost for research and graduate education. M. Steven Piver, M.D., UB clinical professor of gynecology-obstetrics, sen·ed as medical director for the testing. Chief of gynecologic oncology at Roswell Park Cancer Institute, Piver also serves as vice president of the board of directors of Friends of the Night People. Piver said that during the night Harmon spent in the corrugated shelter in a courtyard on the UB South (Main Street) Campus, "his body stayed as warm ru; if he was in his own bed." For his night tn the corrugated pup tent, Harmon bundled up in a manner he ~aid reflects that of home le ' S persons spending a cold winter night outdoors. He wore two pairs of pant:,, two ,hires, a sweatshirt, two pairs of socks, a coat, gloves, and a pair of heavy boots. - By Sue W111etcher �--- :(]}---J'EJ.q. 24 GOODBYE BUTTER, HELLO OLIVE OIL UB researcherssuggestthe switch could lower the risk of heart disease mericans intent on lowering their risk of cardiovascular disease would be wise co use olive oil instead of butter or margarine, according co a major study by researchers at the UB medical school. The study, repo rt ed in the Feb. 2 issue of the Journal of the American Medical Association, represents a major contribution to the scientific literature. le indicates chat use of o live oil in the diet in lieu of butte r and margarine not only co rrelates with lower blood cholesterol levels, but appears to lower blood pressure and blood glucose levels. The UB study is che first large-population examination of the association between consumption of mono-unsaturated fats like olive oil and risk factors BY ART HUR PAGE for corona ry heart disease, according co Mauri:io Trevisan, M.D., principal author and associate professor of social and preventive medicine. Oche r UB researchers participating in the study were Vittorio Krogh, M.D., Jo Freudenheim, Ph.D., and Alma Blake, Ph.D. The Italian researchers included Paola Muri, M.D., Sal\'atore Panico, M.D., Eduardo Farinaro, M.D., Mario Mancini, M.D., Alessandro Menotti, M.D. and Gio rgio Ricci, M.D. The study has received national attent ion, in part because of the growing interest among the public in hearthealthy eating, but also because the public relations office at JAMA christened it the prestigious journal's storyof-the-week. A film crew from the AMA spent a day in Buffalo, interviewing Trevisan and filming at local restaurants and scores to prepare a video chat was distributed co JOO television stations. On cop of that, the JAMA public relations office distributed a news release about the UB study to about 3,000 people. The landmark study was conducted in conjunction with Italian researchers affiliated with the Italian Nine Communities Study of risk factors for atherosclerosis. The data, collected by the Itali an study, was analyzed by the UB researchers. Resu Its were based on a n a Iyses of BUFFALOPHYSICIAS A)',;[) BIOMEl'IC'.Al ~IE.''TIST �--- :®: ---J' t ~ ~ 2S data derived from dietary interviews and physical examinations conducted with 4,903 Italian adults ages 20 to 59. The subjects included 2,365 men and 2,538 women. Trevisan explained that conducting the same study focusing on the eating habits of a similar number of Americans would have been impossible on two counts. First, very little olive oil is consumed by Americans, although sales have increased in recent years following reports on its lmk with reduced cholesterol levels. Second, Trevisan said, there is very little regional difference between the use of fats m the diet of Americans. In Italy, on the other hand, the researchers were able to compare data for those living in the northern portion of the country where butter use is widespread and little olive oil is consumed - with that for those living in the south - where olive oil is used almost exclusively. "Because of this variation," the authors wrote in JAMA, "we were able to find relatively strong associations despite a relatively crude measurement of dietary intake." They added, however, that "the cross-sectional nature of this study needs co be taken into account in analysis of the e findings. While the results are suggestive of a protective role for unsaturated fats for cardilwascular risk factors, other unmeasured confounders may be the actual etiologic agents." Trevisan said that in their analyses, the re earchers attempted to identify such an influence by taking into consideration confounding effect· of other risk factors for cardiovascular disease, such as age, body-mass index, alcohol intake, moking and consumption of fatty foods. RCFf-\LO PH)SICI.-\S -\Sl1 BIO\IEl'ICAL ~IESTls. Maurizio Trevisan, M.D. The study found that "in both sexes, higher consumption of butter and margarine was associated with increased systolic and diastolic blood pressures and increased serum cholesterol levels." Those associations reached statistical significance only in men. "In both sexes, higher frequency of consumpnon of butter and margarine was associated with significantly higher levels of blood glucose," the researchers said. Increased consumption of olive oil, they wrote, was associated with significantly lower leveb of systolic blood pressure, blood glucose and blood choles terol in both sexes. In men but not in women, diastolic pressure was significantly neganvely associated with olive oil consumption. While the study found that consumption of polyunsaturated fats, such as vegetable oil, correlated with consistent and statistically significant lower cholestero l and blood glucose levels, the association was not consistent for blood pressure. Arthur Page is associate director in che UB News Bureau and farmer medicalreporter at cheBuffaloNeu·s. �--- ·,®~--// ~ 26 Talent in Triplicate UB alumni are at the helm of threemedicalschools BY JUDITH B. HERMAN "I would say there is no highercal/in~1han ministering to the sick. But it is useful, and occasionally importanl, for someone to be a dean." - MarshallA. Lichtman, M.D. orientation and programs for Jevelopmg faculty to <lo research m academic settings {some of whom may well become deans), the cltmate m the '50s and '60s was different, Naughton explained. "At the time these three graduated, Sandberg at Roswell Park. Lichtman wanted to set up an assay for aldosterone, a hormone that had recently been discovered to play some role in hypertension. Referred co Sandberg, a hematologist also trained ith the recent appointment of the school \\ ' ab very small and pnmanly in endocrinology,he then began to get Marshall A. Lichtman, M.O. '60 as <lean of the University of Rochester School of Medicine and Dentistry, the UB medical schlx1l now boasts three deans among its graduates. The other two are Eugene M. Sigman, M.D. '52, Jean of the Univen,ity of Connecticut School of Medicine smce 1985, and Franklyn G. Knox, M.D., Ph.D, '65, who has heen director for education of rhe Mayo Foundation and dean of the ~layo Medical School m Rochester, Minn., since 1983. UB graduate~ achieve dist1nct1on m many areas. Is it so noteworthy to find three of them heading medical schools? John Naughton, dean of the medical school and vice president for clinical affairs at UB, thinks it is. "There arc only 126 medical school <leans at any one time," Naughton said. "Prohably most of them come from the older medical schoob. For Buffalo ro have three of irs graduates at that level of recognition 1snoteworthy mdeeJ." While today UB has a strong research clinically oriented, with comparatively lmle facility and faculty to support a big research endeavor," he said. "Then it was a matter of bright, motivated people somehow finding the right connections and bemg stimulated to do things. "All in all, there have been a lot of things done to enlarge opportunities and create a nourishing atmosphere for UB students to pursue careers 111 research and rbe to positions of leadership in academic medicine," Naughton said. "Sigman, Knox and Lichtman stand as forerunners and models." invol"e<l in some of Sandberg's hemologic clinical work. Sandberg was a major influence and launched Lichtman's career m hematology, hut Lichtman has tributes for a numher of UB faculty members. "l recall with respect and affection nor only Sandberg, but Oliver P. Jones, chair of anatomy, who was very actively involved with students; Douglas Riggs, chair of pharmacology, one of the best teachers I ever encountered; Ernest Wttebsky, Herman Rahn, and Cornell Terplan, all very distinguished teachers who developed outstanding departments which provided rich environments for students in terms of research opportunities," Lichtman said. Lichtman is the author of research papers on various aspects of blood cell biochemistry and physiology and has been engaged in NIH-supported research on blood diseases since 1967. He 1s editor or co-editor of three textbooks of hematology, including the recent fourth edition of Hematology published by McGraw-Hill. MARSHALL LICHTMAN n internationally recognized authority on blood dbeases and the new dean of the Universit) of Rochester Medical School, Marshall A. Lichtman, '60 got his first opportunity to conduct re~earch when he was a student 111 the UB medical school. After his first year, he worked as a summer research fellow under Avery IICFMLO r m~K IAS AS I) 111 0 ~1F.l l1CALSCIENTI:-., �------- :®: -------27 Marshall A.Lichtman , M.D. '60 A scholar of the Leukemia Society of America from 1969 to 1974 and immediate past president of the American Society of Hematology, he is currently chair of the National American Red Cross Biomedical Research Program Scientific Council. Lichtman's training as a physician anJ his activity as a teacher, together with his work in both basic science and clinical departments, have been important preparation for his new 106. "My experience means that I can he comfortable, say, working with molecular biologists on our molecular medicine Rlc ff.-\L O PHY'-ll lAS AS[ ) Rl<JME[)I C AL ~ IESTl~T programs, as well as with physicians in general medicine on the issues that are important to them," he explained. "It's helpful to have had actual experience in all the areas and among all the various constituencies that look to you for leadership. It's helpful to have been in all the trenches." Licht:man joined the faculty of Rochester Medical School in 1965. "I chose to pursue an academic career because I developed an early interest in research as well as in patient-care and teaching," he noted. Dean of the medical school in Rochester since January, Lichtman finds the challenges of his new position are as varied as the satisfactions are great. "As dean, I oversee the school's mission in regard to education, research, and the patient-care activities of our faculty," he said. "A dean has to set priorities among the different departments and programs, establish standards for appointments and promotions and adjudicate various disputes. "But I also have to be a fund-raiser, a cheerleader and then some kmd of role model for the faculty." What makes it so worth while? "I �--------- :®:--------{/ \t- 28 "I went to medical schoolto pursue a careerin research, not necessarilyto become a dean," saidFranklyn G. Knox. Franklyn G. Knox , M.D ., Ph.D'65 enjoy sccmg to other people," Lichtman explaineJ. "I thmk that h an important charactern,t1c of anyone who rakes on any kmd of leadership position." FRANK LYN G.KNOX went to medical school to pursue a career m research, not necessanly to hecome a Jean," said Franklyn G. Knox, since 1983director for education ot the Mayo Foundamm and dean of Mayo Medical School. "My undertaking an M.D.-Ph.D. program, hecommg department chairman and then Jean - none of that was laid out 111 some sort of master plan at the hcgmnmg. There was just a general inclinamm in that direcuon. It JepcnJeJ on hooking up wnh a sympathetic mentor and the em ·1ronmenr making 1t possible for those inclmations w tum mto something." II excretion, rena l phosphate handling and renal hemodynamics - Knox has served on the scientific advisory board of the National Kidney FounJation and the board of directors for the American One of Knox's first mentors as a UB Heart Association and as president of for underii:raJuate was Gerhard Levy, a pro- the Federation of American Sl">Cieties Experimental Biology. fessor of pharmacology. As a UB mediHe has served in numerous capacical stu1dent, Knox workeJ summers in the lab of DonalJ Rennie, now profes- ties with scientific organizations sor of physiology and vice pro\'ost for national and international - and is currently on the Nationa l Research researc:h and graduate education. "I sQ much enjoyed that kind of Council, U.S. National Committee for acti\'1ty," Knox recalls. "I said to myself, the International Union of Physiological Sciences. 'If there's any place you'd like to he, Being dean uf Mayo Medical School where 1, 1t!' The amwer was the lab." Undler Rennie's guidance, Knox pur- 1s not the largest of Knox's current responsibilities. As director for educasued a Ph.D. 111 physiology, as well as an M.D. The Cllmbined Jegree was neces- tion of the Mayo Foundation, he also sary, Knox felt, 111order to be able to do oversees the programs and activities of the Mayo graduate schools in health basic iresearch m disease-related areas sciences and medicine. and ce:ach in a medical school. Despite his administrative responsiKnox joined the Mayo Medical Schcx)l faculty in 1971after doing basic rt"l>earch bilities, Knox is able to continue teachmg as he has every year in the medical at the Natmnal Heart Institute and ,chool for the last 19 years. And, more reaching at the Univer..1ryof Missouri. unusual for someone m his position, he A ditstingubhed anJ highly productive researcher m the field of renal physiology is able to spend half his time on - particularly the regulation of sodium research supported by the National �------- f!J--------29 Institutes of Health. Knox's career is something of a balancing act, perhaps, but he is good at it. "Everything is arrange<l in such a way that I have been able to maintain the research and teaching activit ies as well as carry out my administrative responsibilities, although at any one time any of these could be all-consuming," he said. "So it's a matter of organizing and delegating things so everything comes out even." EUGENE M.SIGMAN // had no aspirations to go into administration or to join a fulltime faculty. I just wanted to be like the rest of the pack, a physician of one kind or another in private practice," said Eugene Sigman, dean of the Uni,·ersity of Connecticut Medical School since 1985. Eugene M. Sigman , M.D . 'S2 Afteir Sigman finished his residency and began m practice urology at Buffalo Genera I Hospital, however, he became involve·d in research and in 1961joined che faculty of the UB medical school m urology. He was awarded Buswell Fcllows,hips tn 1963and 1964 to pursue research in urology and nuclear medici ,ne and was recruited by the University of Connecticut m 1969, a year after the school opened, to head its urology department. "I backed into academia from practice," Sigman said. "But l was deeply interes1ted in medical education, more than anything else, and that's what drew me back." As a new school, Connecticut offered opportunities to develop innovative approaches to educat10n, Sigman said. Courses were multi-discipli narv, based on an organ-syHem approa,ch, with 10 to 12 faculc} members te:achmg a course. The curriculum also included courses in the social and beha\'ioral ~c1ences. Although Sigman has done important work and written numerous papers tn urology and nuclear medicine, his chief interest 1s education. He is a meml;,er of the Association of American Medical Colleges, the AAMC Council of Deans, the AAMCAMA Liaison Committee on Medical Education Site Visit Team and the AAMC-AMA Oversight Committee on Me<lical Education. Sigman traces his own commitment to educatton to the influence of the committed faculty and practicing physicians he studied with at UB, including John H. Talbot, chair of the UB Department of Medicine and chief of medicine at BGH; the late Oliver P. Jones, professor of anatomy, and George Miller, professor of medicine. "My own education at UB led me to appreciate the value of education. The commitment that [ saw - department heads taught the basic science courses - very much impressed me. "In the clinical years, there was only a very small full-time faculty. Instead, practtcing physicians provided free time for educating medical students. That really struck me. In spite of their very busy schedules, they were able to find time to give to students. "I took my residency in the same system. I came to see chat what you got out of the system you had to pay back by contributing to the education of the students who followed you. That's probably what impressed me more than anything else about UB. Plus there are a lot of nice people there." ]11dichB. Hennan is a B1,ffalouriter wah a special interest m medzcme. She has been a 1niter-ediwr w1th the Western Neu York HealrhS~swmsAgency. �--- -/tJ---IJ \t, 30 ALUMNUS' GIFTTOUB HONORS FORMER TEACHER "I will give to my teachersthe respectand gratitwlewhich is theirdue." - Oath of Hippocrates emember chat spec ial teacher who recognized your potential, wh o encouraged your best efforts, and who, through h is or her interest and influence, left a last ing effect upon your life? One way co show your respect and gratit ude is through a gift co the UB Foundation in honor of that special teacher and friend. Jerald A. Bovino '71 recently gave a $500 gift to the UB Foundation in honor of his former teache r, Philip Weis '41. Weis, a clinical professor of surgery, is a general surgeon in private practice, a member of the University Council, and chis year's annual fund chairman. Bovino wrote: DearDr. Weis, I was pleasedto receiveyour recent letter for support for the Unit•ersity at Buffalo Foundation. I would like w tell you why your letter has personal significance. On a cold and snowy autumn day 23 years ago, I flew to Buffalo for my medical school inten,•iew.Like so many of the applicants, I was apprehensii•eabout m)' prospects for acceptance to a school of medicine. My undergraduategrades were good but not outstanding, but my MCAT scores, especially in the sciences, were very high. I was mten·iewed by three members of chef acult:y,but I specificallyremembermy interniew with you. I felt that you u•ere warm and sincere,and you made me «•ant to aLtend the Unit·ersit)' at Buffalo. Analumnus remembers thewarmthandsincerity shownto himbya teacherat UB. �--------- ~®:--------// tt. 31 Although I was subsequentlyacceptedto ocher medical schools, ( many of them more prestigious), I chose to attend UB largely on the basis of our personalcontact. . .. A check is enclosedwhich l would Likeyou to submitfor me in your honor. Warmestpersonalregards from a gratefulstudent, JeraldA. Bovina, M.D. Bovino rece ived nume rous Mosby and Lange awards for outsta nding performance while at UB, and was elected to Alp ha Omega Alpha. C urrently, he is in a vitreoretinal surgical tertiary care hospital-based practice in Toledo, Ohio; has published extensively on the subject of retinal surgery; has se rved as vice president, president and secretary of the Vitreous Society (a professional group), and is an associate clinica l professor of surge ry a t the Medical College of Oh10 at Toledo . ship fund will be used for UB medical studen ts who show academic promise and have financial need. "Both my brothe r, Harold, am l myself ne,·er married or had an y child ren," Miss Sanes explained. "We wanted to do something to he lp others and to show that we had walked across this earth. Since our brother taught at UB, we thought it would be nice to do something for the Uni\'en,ity." The late Winfield Louts Butsch '30 is remembered through an endowed lecture fund established in his memory by h is children, John L. Butsch, M.D., David W. Butsch, M.D. and Janet F. Butsch, and various friends and relatives. Butsch, a prominent Buffalo surgeon and clinical professo r of surgery at UB, died Oct. 24. The gift will be used to sponsor an annual lecture series in clinical surgery. IT'SLAST CALL FOR WORKOF1930GRADS AWARD NOMINATIONS GOES ONTHROUGH GIFTS wo graduates of the Class of 1930 who cherished their work with medica l students are remembered by gifts that will he lp continue that work through a scholarship fund and a lecture series. The late Samuel Sanes '30, a noted physician and professor of pathology at the UB medical school for mo re than 30 years, won numerous awards for his service and contributions to the field of teaching. He is remembered through a scho lan,hip fund in the names of his brother and sister, Harold S. and Thelma, set up through a gift of $100,000 from Miss Sanes. The permanently endowed scholar- here's just a little nme left to make n ominations for the second annual Distinguished Medical Alumnus/a Award. June 1 is the deadline to suggest a name of a graduate of the UB medical school who has made an outsta nding contribution to medicine, the arts, or humani ty during his or her career. The selection will be made during the summer and the award will be presented in the fall at a special dinner. There's a postcard at the front of the magazine for your nominatio n. Hurry! ERRATUM Editor: In the Early Winter 1989 issue, you have a picture and a short note on a classmate of mine, Dr. Har\'ey C. Slocum. You have it labeled class of '36. This is incorrect as he graduated with me m 1932. He is a renred professor of anesthesia m Texas. While in the service at Walter Reed General Hosp ital, he gave the anesthesia to President Eisenhower durmg his surgery for ileitis. - Elmer Friedland , M.D. , F.A.C.P. The Buffalo Physician and Biomedical Scienast welcomes letters from its readers. Address chem to Buffalo Physician and Biomedical Scientist, 136 Crofts Hall. Unit1ersity at Buffalo, Buffalo N.Y. 14260. From leh, Nedra Harrison, M.D.'77, treasurer of the MectKal Alumni Association, chats withShawnCotton andEllen Giampofi oftheOassof 1990at a re<eption inJanuary forthe graduating doss. About 250people attended. �32 1960. Paul J Loree '62 - recent!) 1lwrrad1u' "-:,,,ml •""-x1:ttl,I 111 ,,t ,1phth.1l1rniloi:vw11h Kcnncth Amhonc, M I) m Tort.'lwand,1. fr,1nl E. Ehrl1d, '61 - 1, ,lin·uor ,,t the di\ 1,10n ,,ftr.Ill• m I md prof,,, or of urger) .it Uni\ er 1q in Hahnemann rhit.1,ldpht.1 . D 1\ 1d Ci. l'ublo\\ '65 .- ,, pre 1clcnr-dect ,11 rhc ;,,.e" 1l 1m1hire Onhop-Jt.•,fa::X>Cll'I) Lmu,nle A. Gol,lschl,1gcr'65 .1, board ll"rt1hcd in cma.cenq ml-d1-.mcan<l \\,IS cb:1,-d 11 (cl. lo" , t 1he Amcncan Collct;c of Ellll'f)!l"lll\Ph) ll 1,111'. E.Jordon 't 5 mi:: 11 text book, Dm:,1sc,oJth<' km Ro~'fl t.-dulogic Roger \X'. Sc1hel '66 .- ha been named m1er11n clm1-.al ,l1rnrnr ,-it ,urgcn ,It thl· Eric ( ,1111\1\!1.lcJ1l,1ICcnll'r. Dr. " I •I 1, an ltlcndmg trauma • •1 I and director of state 11 thl• ho,pttal. pra,on 'l'r\lll' ,md ,, c11rrcntl, 1clm1c.1I,l,'<X 1• ,Ill' prof, ,,,,rof both ,urger) and nt UB or1hClp.1C<l1,, J,1u1h D. R,,:hrud, 'i l .- 1, the I\C\\ ,h1cf of orrhop 1cd1c ,uri::cr, Jt Docior, Ho,p1111, lkth l,r.1d !l.1,d1,.il cl'llll'f, fork. ~l'\\ 1 1 Jame M. L,·\\ 1 ' 5 .pri,,ltl' peJ1.1m, pr llflll' ,111h.1 ,pl'll 11mrcr,·,t III dHnllll l lrl'. Dr I t \\ 1., ha, four lh1ldren A 11orld tnl\ cll·r, skillc,I pho• to.gr11lll'r ,mJ ,1 p.11ron of thc an,, Jlcoh,en Jomcd an,lther ,\ \V1lmo1Jacob.--cn,M I) , 1 doctor on an .ucheologac,tl I rot,-.,-orol r,·d 1,llrll s ,II U fl "' w ,1n·mntc rcg11>1\ t,ir m,1n, ,c,1r, ,,h,"c ,.1r1,·,I cxpcd111lln II\ 195". ~1cXICll m1cre,1, m luJed mro1cal,111.!1<"' of the de 11hof Prcs1dem\V1lh1m 1ed ~hron J. D)hich ' McKmlq, d1,.J D« .. Ii, 19"9, 1989, m ::-dll'ncl.1.1<1\ Ou.lo, .1ftcr,1hnd 1llnc". lll·\,,is91 . afrl·r a I, ng I IIn,·~ . Attn recl.'I\mg ht, h.1chdor's md mcd1c,1lJq::reo from John, \ irgmia Pa" lak '36 - \\ ho Hopl..m, Un1\l:r,11), he ,,·i',d pr,tl t 1< ,·d medll 11\l'undcr hcr Ill the u.~ Arn\\ d11rmc\Vnrl,I m.11,I,11 n,1me of R1.:hrcr. d1l•d \Vir I tor I\\O ,car, . Atll'r th,· Jm I , 1990, m Cl ircn ...e. ~ Y, " ir, he 1rnmc<lan mcd1cmc anJ J airer il loni: tllnc,, pcd1atr1l.,a1 John, Hopkm,. , M.D. A. WilmotJacobsen sl11.•111.11nta1mdhl·r rr1, lie In 1926, Jncoh,,·n c.11nl·to c tor 2i \l 1rsunul 19hl, rrat11 Huttilo r., ,..,1,1hh,hin outra11cm she bc.:ame d1re.:1or of "hen dcronmmr ,11Oul,hn'.. llc,,pnal d1n1l 1<1rthe E11l l., mtq In JQ~~. hl' rn,1mcd fael)n '-he also I o a peda uric 1an. Health Dl'partmn Hench, I H •art 1aui::h1 ar sic honorl,I rhc ....I _,.. ,I St.,,[Jnt Children's I ln.i-p11.1l Ste\ l'll T, 11,:h Acndl'lll). thc hr t• n.unmc h, 19:-4 p,11rm ,11Ohio ,urcln of profr"or '-tare UntHr•tt) ,111da11,•nJmg tloor ou1p.111en1 d1111l th, rd Harold MC)cr, ·5-; " ph1,11.:1anm the [)q,;1rtmen1 of Jacob-1.'n•Hcath Ambulatoq ocmx. An:, a P.")l.h1am1, l lime. Ped1a1r1csurgcr) m Columbus 3, 1991.l J1l d J,111. In thl• I 92l',, J,1.:,,h,cn ,,,1, l 'luklrcn\ 11.,,pttal. crcd1tl..J,1uh m1xmi:ii druc from Tamm) J Lm<ncr - a lir•t• German, 10cure a )OUngBuff1lo P 1ulm, A Wall, ' I - 1 )C3r mro11.:al,1udem, wa, \ailed OO)"11h memng1115", h1ch ,, as M,,orkmi: hard" m her prl\ ate m ,1l,lr ,Kc1Jcm I\:·.:. 21 \\ lllll• 1h,,ught 1<1Ix- t.11,11ll"0 l'l'rH·111 (~1l1t..m1a, pr.1lt1u• mt ).1kl.111,l. 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The q m mtl'm 11ml.J1c1ne m June, o teochondro,h,tropln 1:e l'tnpha "ill that le" g d1sca,e " 1, uh-equcntl) nanwd 1990. hl· \\Ill he con1m11111h,, Ir'-..calk-d . m<' meJ1 prcHm1,c . honor h,, m Ja«>h,en\ d1,,a,c 1r,1mmg\\1th a 1dlo\\,h1p 1n g:i-• which ,rand, tor \ 1!?orou e, en at the age of H E.A I I ~.G., II'()(ntl.'l'Ok,i:,i.llthl· Um, cNt) cl n, and Leamu~ Edlll.-a.111 lll-ahh. 91, Jal.oh,cn mamt 11neJ othle at '-m Dil.1,'<l ( 1hfom1::i Gm,\lh ~I.'" lmoh-mc ll(lur, ,1x d,1)' .1\\cek Till' ,111,lcnti:r,,up I\1ht1 \\Ill J.1«1kcn wa.~ m l.''\l'(n ,m the Pd,M,1h t\. \Vh1tl' 'f-.7 - ol a plaque, "rnc,, ~ ..) commH-n.) OH'I' whether medical pl mt a tree, rnarh-d h\ Tona\\cmd.i, ""holJr A I) mem ner'led 10 1he death ot m Lm J \'( hue and 1ncomptctl."I\Cc "Chri,tophcr .11',1 ha, menH>r\ her 111 ,hip l1eh,ir,1h t\. \\'hire ,11\11<,un.:e l'rl·,1d1.:nt~1d(mlc) ,liter hi.' l\,h 1d: 11.irl\l 11 up ,c1 h.:'l'I\ 1 1'111• thl• •hot m 1 hll at rh,· h1rth ,,t ,1 ,on, \ndre\1 <'.ollct;e Ruffalo E.xposmonm 19 6, \mencan ~i't ,n Fr:m1.:1,, Ohituarics I9SC1- 0 ��I( Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 3581 I d n Requeste Correctio Address II II II I LOCKIE DR L. MAXWELL 92.;i DELEWAREAVE ~UFFALO NY 14209 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. 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Research briefs On pins and needles The boy who lived a miracle Microscopes to microchips More research Talent in triplicate Alumni. Classnotes. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v24n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1990 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/c54c897a51f284ea0d7cb674f8718b11.pdf 5358dd230af28e29b828ec67532e163d PDF Text Text Vol. 24, No.2 and Biomedical Scientist The medical profession struggles with maternity leave �STAFF DIRECfOR OF PUBLICATIONS NancyTobm EDITOR Connie Oswald Stofko ART DIRECfOR Alan J Kegler WRITERS Joan Damig David Htmmelgreen Jeffery Jackson Arthur Page Mary Beth Spina JeffreyTrebb Sue Wuetcher PHOTOGRAPHERS Debbie Hill Antoinette Mucilh Stmon Tong Robert Walion ADVISORY BOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. NancyGlteco Dr. James Kanskt Dr. Joseph L. Kunz Dr. Charles Paganelli Mr. Michael Aronica Dr. Antoinette Peters Dr. Charles Pruet Dr. Luther Robinson Dr. Thomas Rosenthal Dr. Salecla Suresh Dr. Burton Smgerman Dr. Stephen Spauldmg Dr. Nelson Torre Mr. Edward Wenske Dr. Jerome Yates Dear Friends: T he.1989-90 academtc year was another busy and producttvf year for the medtcal school, as evtdenced by the flurry of spring activity. It began wtth Sprmg Clinical Day, sponsored by the Medical Alumni Association. The association's efforts culminated successfully with Dr. Arnold Reiman's keynote address at the Stockton Kimball Lectureship luncheon and an excellent fundraising effort on the part of the five-year reunion classes. The weekend was highlighted by the dedication of a wing in the department of Pathology in memory of Dr. Samuel Sanes by the Class of 1945 and the presentation of the first Samuel Sanes Scholarship Award, which was made possible by a generous gift from his SISter and brother, Thelma and Harold Sanes. We were fortunate and honored that hiS wtdow, Mildred, participated m the event. Graduation was highlighted by once agam conducting the Honors Convocation m the Austin Aint Reading Room of the Health Sciences Library. An eloquent commencement address was given by MorrtS Abram, United States Ambassador to the United Nations in Geneva. His remarks were enlightening because of his own experiences wtth acute leukemia in the mid-1970s. The third annual reception honoring and recognizing the many contributions of the volunteer faculty was held at the Albright-Knox Art Gallery. Approximately 200 faculty and their spouses attended. The second annual Graduate Medical Dental Education Consortium dinner· dance completed the Spring's activities on June 22. Each resident graduate received a set of bookends with the UB logo on one and the consortium's title on the other. We look forward to an even more exCiting and productive academic year m 1990-91. As always, the staff and faculty are grateful for the tremendous support provided by our alumni and friends. TEACHING HOSPITALS AND LIAISONS Batavia VA Medtcal Center Buffalo General H<l>'[Htal, Mike Shaw Buffalo VA Medical Center, John Pulli Children's Hospital, Karen Oryja-Swierski Ene County Medical Center Mercy Hospttal, Chuck Telesco Millard Fillmore Hospttal, Joseph R. Ciffa Roswell Park Cancer Institute, ]wl.y Rice Sisters Hospital, Dennis McCarthy Produced by the DitJisum of Unit'f'TSity Relations in association uith the SchOOl of Medicine and Biomedical Saences, ~rate Unit'f'TSity of New York al Buffalo. Editorial office is in 136 Crofts Half THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST (USPS 55I-860) Autumn 1990, Volume 24, Number 2. Published by the School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk postage paid at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 CFS Addition, 3435 Main Street, Buffalo, New York 14214. John N aughton, M.D. Vice President far Clinical Affairs Dean, School of Medicme and Biamedical ScienCes Dear Fellow Alumni/Alumnae: T he spring of 1990 marked the anniversary of the 53rd year of Spring Clinical Day. In my opinion, this event has been marked by ever-increlli>ing maturity and sophistication for which all alumni can be justifiably proud. The clini· cal and reunion weekend provtdes a major focus for your Alumni Association and this year's program was especially timely, informative, and prognostic. As your new president and on behalf of all medical alumni, I would like to express our appreciation publicly to Dr. Bob Reisman, Class of'S6, for assembling such a superb program. Our outgoing president, Dr. Joe Kunz, served his term with distinction and our gratitude goes to him as well. I would be most remiss if I didn't communicate to all of you how grateful we are to Dr. Jack Richert and to Nancy Druar of the Alumni Office. Without their help and guidance, this asso· ciation would be a far less healthy organization. I look forward to servmg as your prestdent and I hope to continue ro work actively with alumnt, medical students, faculty, and administration as we all work to support and strengthen our medical school. Sincerely, D~ Bertram A. Portin, M.D. Class of'53 �Autumn 1990 Vol. 24, No.2 IJ Research. A $4.5 million grant to study treatment of multiple sclerosis; AIDS fear and drop in blood transfusions; diving for science. II Mommy track? The number of women attending Cover: Photos by Robert Walion. Story starts on page 6. medical school has steadily increased, but is there room in the system for their babies, too? UB women discuss the problems and pressures they've faced balancing family and profession. IIJ Cutting red tape. American doctors have the power to change the medical delivery system in this country, said Arnold S. Relman, M.D., editor,in, chief of the New England Journal of Medicine. He spoke at UB's 53rd Annual Spring Clinical Day and Reunion Weekend. Ill Rubbish. From hypodermic needles to patients' Orientation follows gradWltion. Page 26. facial tissues, the amount of medical waste is growing daily, and it's getting harder to throw the stuff away. ~~ Medical school news. How a 19th,century anatomist got tangled up with couple of body snatchers was the topic of a lecture sponsored by Alpha Omega Alpha. At commencement, diplomat Morris Abram told graduates to "listen with heart." And Match Day was better than ever. m People. Marvin I. Herz, M.D., chair of psychiatry at UB, got a new perspective on the workings of Washington bureaucracy. America's ailing medical system. IIJ Classnotes. Page 13 . Trashing medical wastes. Page 20. �: -------------------------------------------- 2 UB Takes a $4.5 Million Shot at MS UB research pioneer heads team investigating treatment for disease that hits young adults BY ARTHUR PAGE 0 ne of the largest grants ever received by the UB medical school will study a promising treatment for multiple sclerosis, the most common crippling disease of young adults. The four-year, $4.5 million federal grant from the National Institute of Neurological Disorders and Stroke was announced in May. UB is the coordinating center of the multi-center study that will involve 288 patients at Millard Fillmore and Buffalo General hospitals in Buffalo, as well as hospitals in Washington, D.C.; Cleveland; Denver, and Portland, Ore. It will evaluate the effectiveness of intramuscular injections of beta interferon in the treatment of a form of multiple sclerosis characterized by alternating periods of flare-ups and inactivity. Results of the study could lead to the approval of the experimental treatment by the U.S. Food and Drug Administration, according to Lawrence D. Jacobs, M.D., principal investigator and UB professor of neurology. There currently is no effective treatment for multiple sclerosis, which affects an estimated 250,000 Americans. Jacobs has gained international recognition for pioneering work showing the effectiveness of beta interferon injected intrathecally, or into the spinal fluid, in treatment of multiple sclerosis patients with exacerbating-remitting disease. His AUTUMN 1990 co-investigator on the new study will be Frederick E. Munschauer Ill, M.D., UB assistant professor of neurology. The study will involve patients at the William C. Baird Multiple Sclerosis Research Center of Millard Fillmore Hospitals, of which Jacobs is chief, and the Buffalo General Hospital, where he is head of the department of neurology. Other participating centers include the Mellen Multiple Sclerosis Center of the Cleveland Clinic, Cleveland, Ohio; Walter Reed Army Medical Center, Washington, D.C.; University of Oregon Medical Center, Portland, Ore.; and University of Colorado Health Science Center, Denver. Carl V. Granger, M.D., UB professor of rehabilitation medicine, will serve as a consultant on the project. He also is co-director of the Bernard B. Hoffman Multiple Sclerosis Center at the Buffalo General Hospital and chief of rehabilitation medicine at Buffalo General. Data management and statistics will be coordinated by scientists at UB and Roswell Park Cancer Institute, under the direction of Diane Cookfair, Ph.D. Jacobs has been investigating the use of beta interferon to treat individuals with multiple sclerosis since the late 1970s. His work and that of others using beta and other forms of interferon - a substance produced by the human immune system to fight viral infections - is based on, and reinforces, a growing body of scientific evidence that multiple sclerosis is caused by a viral infection that is not effectively countered by an individual's immune system. In two earlier studies, Jacobs and colleagues showed that treatment with beta interferon given by spinal taps reduced or prevented exacerbations in patients with exacerbating-remitting multiple sclerosis. Follow-up analysis of the patients in the first study showed beneficial effects persisting in some patients for up to five years after treatment. The second study, in conjunction with BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �: ----------------------------------------------- 3 researchers at the University of Rochester Medical Center and at Walter Reed Army Medical Center, was considerably larger and double-blinded, with neither participants nor researchers knowing which patients received interferon or placebo treatment. At the end of the controlled study, the disease flare-ups of those who received beta interferon had been significantly reduced, compared to those in the control group receiving placebo treatment. The clinical condition of three-fourths of 69 patients who received interferon was improved or unchanged. In some cases, symptoms disappeared and patients regained lost functions. Jacobs said those studies focused on intrathecal administration of beta interferon because it was believed the substance did not cross the blood-brain barrier and that the only way to get it into the central nervous system was by injection directly into the spinal fluid. He said subsequent studies in animals have shown the same positive changes in the immune reactivity of the central nervous system whether beta interferon was administered BUFFALO PHYSICIA AND BIOM EDICAL SCIENTI ST by spinal tap or intramuscularly. As a result, his focus is now on intramuscular injections. "Even though the intrathecal injections worked and were well tolerated by patients, people don't want to undergo multiple spinal taps if they can avoid it," Jacobs added. Participants will be assigned randomly to two groups -- 144 will receive weekly intramuscular injections of interferon over two years, and 144 will receive intramuscular injections of a placebo once a week for two years. All participants will be followed for two years following their last injection. The study will be double-blinded. Researchers affiliated with a multi-center study at the University of Maryland are conducting a similar study with intramuscular injections of beta interferon. However, there are important differences in the studies. Participants in the Maryland-based study receive injections of larger doses of beta interferon three times per week, while those in the UB study will receive substantially lower doses only once a Lawrence D. Jacobs, M.D., principal investigator, is studying a treatment for MS. week. Jacobs noted that the UB study will utilize substantially lower doses of beta interferon based on a pilot study by his group that indicated the lower dose given once a week will produce the same immunological response as higher doses given thrice weekly. In addition to monitoring participants for exacerbations of their disease, the UB study also will assess progression of disease and disability. Jacobs noted that multiple sclerosis "most often affects individuals at or near the peak of their productivity and consumes substantial societal and health care resources. Fifty percent of patients with multiple sclerosis will be unable to walk or conduct normal work activities within 10 years of disease onset." In addition to previous support from the National Institutes of Health, Jacobs' earlier studies were supported locally by the Baird Foundation; William C. Baird Multiple Sclerosis Research Endowment AUTUMN 1990 �:-------------------------------------------- 4 of the Millard Fillmore Health, Education and Research Foundation; Millard Fillmore Hospitals; Delaware North Corp.; )arne H . Cummings Foundation; the Buffalo General Hospital and the Bernard B. Hoffman Foundation. The late t grant "underscores the commitment to excellence in clinical neuroscience of the UB medical school and its department of neurology," said Michael Cohen, M.D., UB professor and chair of neurology. "In granting this award, the NIH ha firmly recognized Buffalo as a center of excellence in neurologic research. John P. Naughton, M.D., UB vice pre ident for clinical affairs and dean of the medical school, said that while Jacob provided the initiative for the study, "the cooperation of Millard Fillmore and Buffalo General hospitals provided an impetus for getting this off the ground. It's an example of the kind of thing that the medical school can do with affiliated teaching hospitals in the community, with each maintaining its unique focus while coming together for common research projects." Care of people with multiple sclerosis in Western New York is coordinated through the University at Buffalo Multiple Sclerosis System, formed two years ago under the auspices of the UB Medical School and its departments of neurology and rehabilitation medicine. The program unifies the services of the William C. Baird Multiple Sclerosis Research Center of Millard Fillmore Hospitals, the Bernard B. Hoffman Multiple Sclerosis Center of Buffalo General Hospital and the Western New York Chapter of the National Multiple e Sclerosis Society. Arthur Page is associate director in the UB News Bureau and former medical reporter at the Buffalo News. AUTUM 1990 DROP IN TRANSFUSIONS LINKED To AIDS THREAT F ear of AID has decreased not only the amount of blood collected in the United States, but also the amount physicians use, researchers at UB and the Center for Blood Research have determined. The researchers, reporting in the June 7 issue of the New England journal of Medicine, found that blood transfusions have declined significantly since 1984, suggesting that physicians and surgeons are altering their practices. The findings of the research team, led by Edward L. Wallace, professor of management sy terns at UB, and Douglas M. Surgenor, M.D., senior investigator at the Center for Blood Research in Boston and former dean of the UB medical school, were based on national surveys of transfusing and blood-collecting activities in the United States in 1982, 1984, 1986, 1987, and 1988. The findings indicate that some transfusions performed in the past may have been unnecessary, particularly those single-unit transfusions that are given to patients to make them feel better, Wallace noted. Physicians and surgeons now seem to be weighing more carefully the risk of not giving a transfusion versus the risk of transfusing a patient with blood that may be infected with HIV or other transfusion-transmitted infections, he added. "Patients, blood donors and the public at large are apprehensive about the safety of the blood supply, about acquiring AIDS through blood transfusion and even about the safety of donating blood," the researchers said. "Physicians, increasingly aware of the risks of HIV and other transfusiontransmitted infections, are reconsidering the risks and benefits of transfusions, and are turning to alternatives to transfusion of homologous blood, including not transfusing at all." Transfusing fewer units of blood is one way of reducing the risk of contracting AIDS through transfusions, but the risk is already low, Wallace said. In the national surveys of blood transfusing and collecting activities, Wallace and Surgenor found that transfusions of whole blood and red cells peaked at 50.6 units per 1,000 population in 1984 and fell to 4 7.6 units per 1,000 in 1987. Collections of homologous blood (donated for use by other people) was growing rapidly until 1982, when the growth slowed. Collections peaked at 13.4 million units in 1986 and declined to 13.2 million units in 1987, the researchers found. Meanwhile, collections of autologous blood (blood to be used by the donor him elf) -- less than 30,000 units in 1982 -exploded to 397,000 units in 1987. That's equivalent to 3 percent of the homologous collections that year. The researchers concluded that the unprecedented decline in transfusions, coupled with the importation of packed red cells from Western Europe and the effect of autologous collections, forestalled serious shortages of blood due to the lackluster collections of homologous blood. Other re earchers contributing to the study were Steven H. S. Hao, M.B.A., of UB and Richard H. Chapman of the BUFFALO PHYSICIAN A D BIOMEDICAL SCIE TIST �------------------------------------------- - : -------------------------------------------- s Center for Blood Research. The research was funded by a grant from the National Heart, Lung and Blood Institute. The grant, in its fifth year, will be continued for another five e years, Wallace said. - By Sue Wuetcher DIVERS IN UB CHAMBER HOLD THEIR BREATH IN NAME OF RESEARCH W hen the Majorcas hold their breath, it's worth studying. The family team of deep breath-hold divers from Italy took part in tests at UB's Center for Research in Special Environments as part of a research project under the direction of Claes Lundgren, M.D., Ph.D., professor of physiology and director of the center. Data from tests in the chamber will provide scientists with information on changes that occur when the body is subjected to increased pressures in the BUFFA LO PHYSICIA AN D BIOMEDICAL SCIENTIST ocean's depths. That promises to improve water safety techniques for divers as well as benefit patients who have heart arrythmias and other heart-lung problems. Pressure on the body increases as divers go deeper. If a breath-hold diver stays down too deep for too long, he could lose consciousness and die. At greater depths for more than a minute, pressure can compress the lungs, forcing blood into the heart and lung capacity, causing internal bleeding and severe cardiac arrythmias. The Majorcas-- Enzo, 58, and his daughters Patrizia, 30, and Rossana, 32, are athletes who hold their breath for two or three minutes as they dive to depths of 150 feet or more in quest of world records. A sport in Italy since the 1930s, champions of early deep breath-hold diving contests claimed their prize money from an underwater cage placed by weights at a depth that proved a record-setting dive. Enzo Majorca, record-setting diver, floats in UB's hyperbaric chamber. Enzo still holds the record, set in 1976, for the deepest unassisted breath-hold dive of 197 feet. In "assisted dives," the athletes are lowered to the ocean's depths on a small platform. The divers use a lever to control their rate of descent, explained Massimo Ferrigno, M.D., who was instrumental in arranging for the Majorcas to be tested at UB. "They hold their breath only the two or three minutes it takes for them to enter the water, reach the desired pre-determined depth for a record and then ride the platform back to the surface," explained Ferrigno, an anesthesiologist and a former UB Buswell Fellow. The three divers' work at UB took place underwater in the environmental chamber, which has the widest pressure capacity of any in the western world, simulating the pressure of 5, 700 feet underwater to 100,000 feet in altitude. The divers were allowed to go only to the equivalent of 240 feet in the chamber for safety reasons, said Lundgren, and the Majorcas were in full control of their rate of descent. The research team also is studying how water depth relates to triggering of the mammalian diving reflex that has saved people who fell into icy waters. While the coldness of the water constricts peripheral blood vessels, diverting available blood supply to feed vital organs such as the brain or heart, there may be other changes which the pressure of the water may trigger. Italian scientists and physicians in Buffalo as part of the research team were Paolo Cerretelli, M.D., Guido Ferretti, M.D ., and Mario Costa, M.D. The research project with the Majorcas is funded by the National Oceanic and Atmospheric Administration through the New York Sea Grant Institute. e - By Mary Beth Spina AUTUMN 1990 �6 ~MMY~ACK IN MEDICAL SCHOOL? y years ago, few women's faces women in their prime childbearing looked out from med school year, years, medical schools and women books. Then, in the 1970s, barriers have had to face a difficult issue - to traditional male professions began time off for pregnancy and maternity to fall, and today women repre, leave. These stories look at sent more than a third of UB's the problems and pressures medical school classes. and how some UB women With the arrival of so many By AUTUM 1990 D ebo r a h have dealt with them. Willi a m s BUFFALO PHY !ClAN A D BIOMEDICAL SCIENTIST �7 Usa Benson, M.D. '88, spends some quiet time with daughter Eve Guterman. ult's a tough situation, 11 Benson says of maternity leave. ulosing a resident for any length of time can be difficult and we are sensitive to our peers and their work loads.11 Photos by Robert Walion BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST AUTUMN 1990 �9QUGH ~EING 9 HORT-STAFFED 8 t one time, Lisa Benson, M.D., a 1988 UB medical school graduate and third-year resident in medicine, considered ob-gyn. But because she wanted to combine a medical career with a family, he decided she didn't want those long hours. Benson, 28, had her first child in September and returned to her residency training in April. Her husband, Lee Guterman, M.D., is a resident in neurosurgery. "Initially I intended to only take six months, but there were complications with my pregnancy and my daughter was born early," she explained. "I never thought of only taking ix weeks off. It was an in tinctive thing with me. I just couldn't leave my daughter o soon. "As soon a I knew I was pregnant I let my director know so preparations could be made for my ab ence. When we are short-staffed because people are out on maternity leave there are comments from some residents. It's a tough situation - losing a resident for any length of time can be difficult and we are sensitive to our peers and their work loads. My training will take longer but ~ that's OK." g 'TRUGGLE IS Jf OTHING EW discrimination against women in obtaining residencies then, but with the war and the men, including my husband, being sent overseas, I got the residency." Henrich took 10 years off to have her children, but kept her hand in the field by doing some clinical work. 'W q?HILD ~ARE fZIFFICULTIES Mary Henrich, M.D., displays photos of her sons "I'll just stay right at the hospital and have my child and be back at work three weeks later. I wouldn't recommend . " zt. to my patzents. - Ortman--Nabi J/ he problems women doctor face trying to combine family and career are nothing new. Mary Henrich, M.D., struggled with them half a century ago. A 1941 UB medical school graduate, she was one of only four women in her class. She met her husband, the late Daniel Bot ford, M.D., in medical school, and wanted to have a family. "I very cold -bloodedly chose ophthalmology as my specialty because I decided I could control the hours and it would combinr well with raising a family," explained Henrich, 74. "Then I faced the problem of getting a residency in the field. There was definite AUTUM 1990 Judy Ortman·Nabi, M.D., and her daughter, Jasmine udy Ortman-Nabi, M.D., 34, who has struggled with a system that didn't work for her, supports the call for changes. She is a second-year resident in obstetrics-gynecology and a 1989 graduate of the UB medical school. She was a first-year medical student in Ohio when she had her daughter. Her husband, Hani Nabi, M.D., was living in Seattle. "It actually worked out fairly well because at least I had the summer off, but it was difficult going back to school and caring for my daughter with my hu band so far away," Ortman-Nabi recalls. "Then my daughter had to be hospitalized for respiratory problems." Family members, including one who is a nurse, were able to help care for the child, but that meant the girl had to be taken to their homes, a four-hour drive. "My husband took her the next year, but he had a great deal of difficulty with child care," Ortman- abi said. "It was very complicated and I ended up taking a year off from school. We moved to Buffalo where I fini hed medical school. I've continued to have problems finding reliable child care and my husband travels about one week out of every month." As Ortman-Nabi related her experiences, she was busy arranging for interviews for someone to care for her second child, who was expected shortly. "I'm doing my rotation at Children's right now and I'll just stay right here at the hospital and have my child and hopefully be back at work three weeks later," she said. "It's not something I would recommend to my patients. I'm just taking vacation time. The program that I'm in really isn't flexible. The system definitely needs to change." ~ BUFFALO PHY !CIA AND BIOMEDI AL IENTIST �- 9 UPPORTIVE q?OLLEAGUES [7?ELPED or Heidi DeBlock, 27, who graduated from the UB medical school this spring, life as a medical student and new mother worked out a lot better than she had expected. Despite taking six weeks off during her pregnancy and three months after her daughter was born a year ago, she graduated only a month late. "I had some extremely supportive and kind attendings who helped," she said, "except for one who asked me whether my pregnancy wasn't all a big mistake. I was quite sick during my pregnancy and even had to be hospitalized. "My husband is a pastoral counselor in area hospitals and a minister in Rochester. He commutes there several days a week but he's off on Monday and watches her then, and the other days she's in day care. I nursed her for quite a long period and during days when I was on a surgery rotation from 6 a.m. to 9 or 10 at night my husband would bring her to the hospital or sometimes I would go to her." DeBlock plans to specialize in internal medicine and spent May working at the Johnson Space Center. She took her daughter with her and her husband joined them for a couple of weeks. She wants three or four children and is planning the next one at the end of her third year of residency. "I think it would be too difficult to be pregnant earlier, especially if I am sick again," DeBlock said. "I thought about picking a specialty that would work out well with a family but I decided I had to go with what I liked. Hopefully, there will be part-time positions for me." ~ Heidi DeBlock, M.D., with daughter Alexandria "I have been able to combine medical training and motherhood. I don't have any free time, but it can be done if you want to. " -Brown q lD 9 URGERY AT 'llTH :JCOUR' essica Brown, M.D., 35, an orthopedic surgeon who graduated from the UB medical school in 1984, was doing surgery right up to three weeks before her daughter was born three years ago. It's still relatively rare for women to BUFFALO PHYSICIAN AND BIOMEDICAL SCIE TIST Jessica Brown, M.D., and her daughter (orina enter the field of orthopedic surgery and ra rer yet for a resident in orthopedic surgery to be pregnant. Brown was able to do both because of the support she got from Robert Gillespie, M.D., chairman of orthopedics, she said, adding, "I think I had an easy pregnancy and delivery because I'm a jogger and also lift weights, which l continue to do whenever I can." Brown said she didn't consider the specialty's effects on raising a family; she chose orthopedics because she liked it. "I didn't want to compromise my career," she said. "But once I'm in private practice my hours will be more controlled since many orthopedic surgeries are elective and scheduled. "l took eight weeks off when my daughter was born, and with the support of a good babysitter and my husband, who is a Marine recruiter, I have been able to combine training and motherhood. I certainly don't have any free time, but it can be ~ done if you want to." q/(AITED10 ~VE ~HILDREN rucy Borowitz, M.D., 36, clinical assistant professor at UB, said she waited to have children until after her residency because she felt it was just too hard to combine both. "I've had a zigzagging career which has included study and work in various cities around the country," she said. "But I've always worked part time including when I was in private practice. Right now I am supposedly working 80 percent time, although it is probably more than that." Borowitz is director of the Cystic Fibrosis Center at Children's Hospital, mother of two children, ages four and six, and wife of Philip Glick, M.D. "This is a creative country and certainly programs could be developed to accommodate the needs of physicians and their families," said Borowitz. "It's unlikely that l will climb the academic ladder, but that has been my choice. Medicine is really a wonderful profession and I have been able to combine my family with intellectually stimulating work." ~ AUTUMN I990 9 �10 Susan Graham, M.D., holds her son Peter ._qRAYS A .c71AzARD IN d'JREGNANCY S usan P. Graham, M.D., 36, assistant professor of medicine at UB an~ director of the Coronary Care Umt at Buffalo General Hospital, faced the problem of protecting herself against X-ray exposure during her pregnancy. "I was pregnant and in my third year of a fellowship in cardiology and the official policy was that pregnant women were not to be anywhere near X-rays," she explained. "But I was working with angiograms, so I took extra precautions. I wore extra lead shields and wore a radiation badge to detect any radiation." Graham had her first child last summer soon after coming to Buffalo. Her husband, Jon Kucera, M.D., is an internist on the staff of Health Care Plan. "I worked up to the day I delivered. In fact, it was a Saturday morning and I was AUTUM 1990 making rounds. I was feeling pains and went home and waited for my husband who had also been making rounds. I ended up arriving at the hospital just an hour before I delivered my son. I took off six weeks after he was born." Graham says she feels under pressure to do research and publish to advance her academic career, but right now research has to have the lowest priority in her life. She will continue teaching as a clinical professor if she finds it's just not possible to advance on the traditional academic ladder. "Hopefully, I will find the time to do research, but there are limits to the day and one's energy," Graham said. e qHE f?'YSTEM IS fNHOSPITABLE 1D ~(OMEN ANDdfABIES Ill he system (of medical education) has failed to adequately address the needs of women physicians who also want to raise a family," said Linda Brodsky, M.D., assistant professor at UB and co-director of pediatric otolaryngology at Children's Hospital. "Women face the real issues of their biological clock and a system that really hasn't been able to accommodate their needs." The system's many critics argue that it hinders women who want to combine a medical career with family. Obstacles include a lack of flexibility in training programs, long hours which make breast-feeding difficult, rigid timetables in academic medicine, difficulty in finding part-time positions, and a general shortage of reliable day care. Nationally, women make up more than a third of medical school students and nearly a third of residents, according to Anne E. Bernstein, M.D., director for members-in-training of the American Medical Women's Association and professor of clinical psychiatry at the Columbia University College of Physicians and Surgeons. Two-thirds of practicing women physicians have children. Half of them had their first child during residency training and one-quarter had their second child during that period. Bernstein added that few women reduced their working hours during pregnancy. Women physicians have been struggling for a long time with the issue of maternity leave policies, said Glenda Donoghue, M.D., APFME director of Continuing Medical Education and Professional Development at UB and a director of the National Council on Women in Medicine. "There are certain limitations inherent in the education system," explained Donoghue, who is also co-chair of the Committee on Academia of the American Medical Women's Association and served as chairman of the Committee on Women in Medicine of the Medical Society of the County of Erie. "Residents must work for a set period of time before they can sit for their boards and there is a similar limitation in medical school. Thus eight weeks is probably the outside limit (for maternity leaves) without extending the training period." At UB, the majority of women medi- BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �cal students and residents who choose to have a baby during training are able to take time off and get back on track within a year, according to Maggie S. Wright, Ph.D., assistant dean for student affairs at UB medical school. Most request eight weeks off, although some take less time and others more. That agrees with the national statistics, according to Bernstein, who said women take an average of between two and eight weeks. While schools should have written leave policies, Bernstein wrote in the 11 Journal of the American Women's Medical Association, there aren't enough facts to decide how long that leave should be. The data does suggest that a maternity leave of six weeks is recommended for recuperation from noncomplicated pregnancy and delivery, she noted. "We also feel strongly that while maternity or child care leave is not a disability unless there are medical or surgical complications, the housestaff member taking a sanctioned leave is entitled to reimbursement just as if she had sustained a fractured leg," Bernstein said. But residents who seek leaves because of pregnancy create real problems with scheduling and with other residents, noted Margaret McAloon, M.D., clinical associate professor of medicine at UB and medical director of the University Medical Practice Services P.C. "Someone has to pick up the work and it's natural (for other residents) to resent having to work harder," McAloon said. "Right now there aren't any part-time programs that could accommodate pregnancy and child rearing more easily. Pregnancies during residencies definitely play havoc with schedules, especially when three or four women are pregnant at the same time." The system still has its problems, but McAloon notes that some attitudes toward women physicians and their families have improved over the years. "When I was applying for residency programs in the late '60s, I actually was asked about what form of birth control I was using," she recalled. "Of course, I dismissed applying for those programs after I was asked those questions. No one would dare ask anything like that today." BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST Undo Brodsky, M.D. with her children Jeremy, left; Dana, right, and Rebecca, foreground A number of suggestions have been offered to help physician-mothers. These include part-time and shared residency programs, longer parental leave programs, a flexible approach to the tenure clock, and improved day care options. "I think the idea of the 'mommy or daddy track' is a great one," said Brodsky, a 3 7-year-old mother of three children, ages seven, five and two years. "By this I mean a more flexible system that would be available to all physicians who want to have more time for their families and still pursue academic careers." She decried the "arbitrary timetables" that exist in academic medicine and believes academic medicine imposes the greatest demands on physician-mothers. "I was very lucky with each of my children - uncomplicated pregnancies," Brodsky said. "I took a month off for each and breast-fed for six weeks, but all women pay a great price. They are often constantly tired and worn-out." Brodsky, whose husband, Saul Greenfield, M.D., is head of pediatric urology at Children's Hospital, said she has been able to balance the conflicting demands of her many roles only with reliable full-time live-in household help, plus two part-time assistants at home. Writing in a November 1989 New England Journal of Medicine essay, Carola Eisenberg, M.D., a Harvard Medical School psychiatrist, argued for more choices for both women and men. She supports parental leave and day care programs throughout medical school, residency training and employment. She also calls for stopping or slowing the tenure clock in academic medicine while doctor-parents take off to bear and rear children. "Women will bring into academic medicine a greater emphasis on the importance of the physician's family life," she wrote. "The beneficiaries of this concern will be men as well as women .... Restructuring medical careers to recognize the legitimate needs of physicians' families will be to the advantage of all."'i' AUTUMN 1990 �~· ·~ . · .....,. , ;;..«. : �for America's Ailing Medieal System 8\' CO,~lE OSW.\LD ~OFKO Today's doctoring is no Norman Rockwell scene Their hands may be tied with red tape, but American doctors have the power to break those binds by helping to change the medical delivery system in this country. That was the common thread weaving through talks at the 53rd annual Spring Clinical Day • -.. sponsored by UB's Medical Alumni Association. -- theme of the session held April 28 in the Buffalo - • I "Changing Aspects of Medical Practice" was the Marriott Hotel. �'PAYORS' REVOLT' SPAWNED RED TAPE I I D octors are right in perceiving that there are increasingly intrusive and harassing restrictive conditions being put on the freedom to practice," affirmed Arnold S. Reiman, M.D., editor-in-chief of the New England Journal of Medicine and considered by some to be America's most powerful doctor. Despite the red tape that makes doctors' lives miserable, "medicine doesn't need more micromanagement," said Reiman, who advised his colleagues "to recognize the problem and participate in the solution." Physicians need to work actively toward a system that lowers costs, regains the public's trust, and delivers care to all citizens. "Let's stop fighting managed care and quality assurance," said Reiman, who advised doctors to enforce quality control, rather than fight it. That would get the malpractice monkey off doctors' backs, he said. The seeds for the restrictive climate were sown after World War II, Reiman said, when medical facilities expanded rapidly and specialties became more sophisticated. As health care became more available and more expensive, third-party indemnity-type insurance became popular. By the late 1960s, roughly 85 percent of American had some kind of health insurance, usually through their employers or through Medicare and Medicaid. Businessmen could build hospitals, make it attractive for doctors to practice there, accept only the in ured, and charge what the market would bear. There were no incentives for consumers to keep costs down, and there were enormous incentives for doctors to provide services, the]oumal editor said. "You had the inevitable ingredients for enormous inflation," Reiman said. This led to the revolt of the payors. "When Mr. Iacocca (the head of Chrysler) has to pay $700 per car that he manufactures to pay for his workers' health care coverage, he's not happy; he doesn't like that; he didn't choose to do ~.:~~· .-,.JSJ), . ·~ ·~· ~ "It's a thinly disguised, sanitized version of the kickback. It's an example of what's happening in the conversion of health care from a social service to a commodity. " that," Reiman said. "He was taken kicking and screaming into that arrangement." Uncle Sam is just as unhappy to pay approximately 8 percent more each year for physician services for Part B Medicare, Reiman added. In addition, the public has doubts about the quality and necessity of the tests and procedures doctor are performing. All of this is driving payors to insist on more and more regulations to control costs and increase effectiveness, said Reiman. Doctors are responding by seeing themselves as businessmen: doctors making extra profit by dispensing drugs in their offices; ophthalmologists buying a certain brand of lenses at a discount and charging the insurance company full price; doctors investing in facilities to which they refer their patients- the more patients they refer, the bigger their profit. "It's a thinly disguised, sanitized variation of the kickback," Reiman said. "It's an example of what's happening in the conversion of health care from a social service to a commodity, and doctors accepting that philosophy." Despite the emphasis on commercialism and a free market economy, costs aren't going down because health care is not an industry, Reiman said. "Doctors should support and enforce ethical codes that make it clear that they aren't businessmen," he urged. He suggested several other things doctors can do to remedy the restrictive climate in American medicine. First, every doctor should join organized medicine, become active and vote- in the public interest. "Don't vote the way the longshoremen's union would, or the electrical workers - everybody else be damned, we're going to take care of our own," Reiman said. He added that while doctors should be concerned about the millions of people who are uninsured and should push for more access to health care, they must also help figure out ways to pay for it. Reiman noted that despite today's restrictive climate, doctors still enjoy a monopoly, much independence, the ability to self-regulate, a virtual guarantee of a good living, and enormous power. Their education is subsidized, research for the new techniques doctors use was paid for by somebody else, and hospital-based physicians don't have to pay for the technology that they use, he said. In exchange for all of that, Reiman said, doctors have the obligation to erve the public's interest. They must accept that they have a moral contract with society. Physicians must help find a better system "regardless of whether it's in our particular economic interest or not," he �said. "And if we do, we'll make out very well." Society is happy to pay its experts and heroes - doctors should have no problem getting compensation. Another suggestion is to let young people experiment with group arrangements - they're not going to be lazy because they're salaried, he said. Fee-for-service practice will remain an option, but it won't be the main method of payment because it's impossibly expensive. Specialists shouldn't be paid ten times as much as primary care physicians. He also urged doctors to push for no-fault insurance. "We can afford health care if we make the system efficient and rational," Reiman concluded. "We doctors have to play a role. We'll either help with the solution e or be judged a part of the problem." SCRAP THE SYSTEM T he United States should start over and re-create its medical system, using the best points of the Canadian setup, suggested Robert L. Dickman, director of the Department of Family Medicine at Mt. Sinai Medical Center in Cleveland. In Canada, the government runs the insurance and physicians have great clinical freedom and less paperwork. I ~ ~~ .··~· That's what we're spending our money on now. I think we can do better." Medical care isn't a commodity to be dispersed by doctors the way a baker sells bread, Dickman said. Advertising is fine for hamburgers, but many people find promotions for medical care questionable. He cited the "Baby Grand" program in which a Cleveland hospital gave mothers $1,000 to deliver their babies there. He also noted that in a free market system, McDonald's doesn't wring its hands over the millions of people who can't afford a Big Mac. "If we believe that health care is a commodity, it makes no sense to even talk about the 30 million or 40 million uninsured," Dickman said. "Why worry - unless, of course, there's something special about health care. "If you don't think we're in the business of selling used cars, if you think there's something noble and special about our profession, maybe we ought to think about the possibility of starting over so that we don't find ourselves dealing with patients over and over again about their insurance requirements. "It is my belief that the only way to solve our problems in American medicine is to develop some kind of unitary system that preserves the doctor-patient relationship." Physicians should lead the way, he said, noting that there is already a growing organization called Physicians for a National Health Program. e GRouP PRACTICE Is THE BEST CHOICE I.G . .i Their system can't be transplanted wholesale, Dickman said, but "I believe we can take the best of it and make it work for us. "About 10 percent of our budget in health care is to pay insurance companies so they can build those big buildings in downtown Cleveland and Buffalo. roup practice is, if not the best, one of the best choices for us to deal with complex technology and the incredible pressure on cost of care we face in this next decade," said Edward J. Marine, M.D. Marine is medical director of Health Care Plan of Western New York, a health maintenance organization, and served as associate dean of the UB medical school. Society won't add more resources for health care; it will simply reallocate the resources we have now, he predicted. By the turn of the century, Marine believes, most doctors will find themselves involved in the managed care system. We need managed care; that is, managed costs, Marine said. Managed care refers to any health-care financing plan that attempts to manage costs through controls and influences on services and on payments for services. He pointed out that more than 30 million Americans have no health insurance, and 30 million to 50 million are underinsured. "Everyone agrees that something must be done," Marine said. "Everyone also agrees that someone else should pay for it." The prevailing view in the medical profession is that doctors should ignore the cost of care, Marine said. Instead, he suggested, the push toward lower costs in health care should be led by a group of well-trained physicians dedicated to the best values of the profession who are prepared to apply the best principles of management to medical care. e DISCIPLINING DocToRs T he current system of handling complaints against doctors is not working, said Peter J. Millock, general counsel, New York State Department of Health. It's time-consuming, it addresses too few physicians, it wastes money, and it's so complicated it's unintelligible to patients and doctors. The average case lasts 20 months, Millock noted, and almost all physicians, including those whose licenses �are ultimate ly suspended or revoked, remain in practice during this time. In 1989, there were 67 such cases. The state is now examin ing way to streamline the system. M illock also sees oth er sources of change for the physician discipline system. There may be new ways to identify substandard physicians, including recredentialing. Standards of care may become more precise, he said, and deviations from those standards easier to e tablish. But a member of the audience took exception to the idea of tightening standards of care. "What bothers me is that standards are going to be set and your performance is going to be monitored by how many inches you deviate from the standard. As an individual, that's the most disturbing thing for me. If I wanted to be a robot, I'd be a robot." The comments were greeted by applause. Millock urged the speaker to work his concerns into the changing system. • MALPRACTICE CRISIS T he next malpractice crisis will come in 1995, predicted Donald W. Aaronson, M.D., an allergist who is also an attorney. Though he's not sure what will cause it, Aaronson said it will be child's play compared to the 1975 crisis, when doctors wondered whether insurance would be available, or the 1985 crisis, when prices skyrocketed. Aaronson offered up another depressing tidbit: physicians in general have a 3 7 percent chance of being sued for malpractice during their lifetime; those in ob/gyn have a 57 percent chance. However, there are several things doctors can do to avoid getting sued, said Aaronson, who is also clinical Quality of care soon "I don't believe the old a rt of medicine is lost," Aaronson said. "We care about our patients, but often we don't know how to show it." e may be judged by how Connie Oswald Stofko is editor of the far a doctor deviates from precise standards. One physician's comment: "If I wanted to be a robot, I'd be a robot. " assistant professor of internal medicine at the University of Illinois College of Medicine and editor of Medica l Malpractice Prevention. They include: e Reduce patient injury. This can be done by raising the skills of incompetent doctors. Training programs should retain the physicians' dignity, but bring them up to the level they should be, he said. e Share responsibility. Doctors shouldn't make decisions for the patient. Instead, they should spend time presenting the alternatives. Doctors should also listen to other health professionals, such as nurses and pharmacists. e Keep good records. For instance, carry paper at all times and record phone prescriptions, he suggested. e Improve communication. Patients complain that doctors are concerned only with disease, they don't listen, they don't explain things, and they're inaccessible. Buffalo Phys ician and Biomedical Scientist. PATHOLOGY WING DEDICATED To SANES T he Class of 1945 dedicated the pathology wing in the Cary-Farber-Sherman Addition to the memory of the late Samuel Sanes, M .D., a much-admired professor, during the Spring Clinical Day and Reunion Weekend. The plaque marking the wing paid tribute to Sanes, who died in 1978, as a physician, acting chairman of pathology, and community leader, as well as an outstanding teacher. It contains a quote from Hippocrates: "To hold him who has taught me this art as equal to my parents and to live my life in partnership with him." Those attending the ceremon y included Mildred Spencer Sanes, his widow; Thelma Sanes, his sister; other members of the Sanes family; about 15 members of the Class of 1945, and Barbara Kearney, the first recipient of the Harold S. and Thelma Sanes Scholarship. The cholarship was established by Sanes' brother and sister for students with academic promise and financial need. e �WELCOME BACK G etting together with old friends ts always a highlight of the annual Spring Clinical Day and Reunion Weekend. A reception to welcome return, ing alumni was held Friday, April 2 7 in UB's Center for Tomorrow, followed the next day by the alumni luncheon at the Marriott. The trophy for the reunion class with the highest percentage in attendance went to the Class of 1960, whose chairmen were RogerS. Dayer, M.D., and James R. Kanski, M.D. Special recognition was given to mem, bers of the 50,year reunion class, who wore festive straw hats to mark the occasion. Reunions were also held for graduates of the Classes of 1945, 1950, 1955, 1965, 1970, 1975, 1980 and 1985. Mark your calendars now for next year's celebration. The reunion weekend starts Friday, May 3, 1991. From left, seated: Henry Severson. Morshall Ointon. John Benny, Stanley Urban. Bernard Juveher, James Schaus. Standing: Warren Montgomery, MaHhew O'Brien. Norbert Roberts, Charles Mincks, Robert Hubbard, Wilham Hndebrand, Fritz Guenter, Evan Molyneux, Albert Rekate, Harold Polanker. 1940 From left, on floor: Jacob Steinhart, Ivan Kuh~ Herbert Joyce, Wilham Mcintosh, Robert Schopp. Seated: Raymond Barry, Wilr10111 Loeser, Gearge Thorngate, Wilham Andaloro, Richard Adler, Edward Fargrave, Earl Cantwell. Standing: Donald Groft, Joseph Sheedy, George Elhs, Wayne Templer, Hnton Jacobson. Charles Wiles, Wilham Taylor, Joseph Tannenhaus, Norman Chassin. Theodore JeweH, Albert Rosso, John Hartman. Edward Valentine, John Ouinhvan. John Robinson. Vito Lagr10. 1945 �From left, seated: William Webster, Robert Kling, Helen Sikorski, Richard Leberer, Bob Patterson, Leo Manning, Joseph Mattimore. Standing: Roland Anthone, Henry Pech, John Graf, Robert Bergner, Richard Lyons, James Curtin, James Brandl, Robert Benninger, Vincent Scamurra, Del Dunghe, Roy Robinson, Sidney Anthone. From left, on floor: Franklin Glockner, Francis Klocke, Gerard Diesfeld, Thomas Guttuso. Seated: John Lauria, Robert Malatesta, James Kanski, Roger Dayer, Naomi Leiter, Harold Brody, Marshall Lichtman. Standing: Harry MetcaH, Daniel Rakowski, Donald Donius, Joseph Antkowiak, Algirdas Gamziukas, Andre Lascar~ John Tuyn, Joseph Chazan, Robert Sauer, Eugene Rivera, Harris Faigel, William Abramson, Edwin Lamm, William Stein, Donald Hammel. From left, seated: Robert Martin, John Peterson, John Winter, James Nunn, Richard Carlson, Winifred Mernan, John Baker. Standing: James Garvey, Ray Schiferle Jr., John Foley, Albert Franco, John Kent, Larry Beahan, Robert Pittell, Frank Guzzo, Shedrick Moore, Eugene Whitney. From left, seated: Wilt.am Adler, Patrick Houston, Louis Trachtman, Joseph Cardamone, George Moore, Robert Schultz, Michael Feinberg. Second row: Harry Yerby, Barry Feinblatt, Kenneth Kim, Steven Berman, Calvin Marantz, Ralph D'Amore, Ira Hinden, Jerald Giller, George Strauss. Third row: Gary Jeffery, W. Scott Walls, H. Elt.ott Larson, Wilt.am Bucher. 1950 1955 1960 1965 �From left, seoted: Wilr.om Fiden, Robert Ungerer. Second row: Michael Uppmann, Laurence Lesser, David Rossman, Agnes Szekeres, Roger Forden, Dennis Krauss, Robert E. Lee, Alan Fink. Third row: Jan Novak, Ronald Zmyslinski, Donald Capley, Sebastian (anti, JeHrey Ross, Dennis Dubois, Shafic Twal, Arthur Goshin, Arthur Seigel. Not pictured: Donald Gabel, Neil Garroway. From left, on floor: Mark Borer, James Twist, George Tremiti. Second row: Theresa Stephan-Hains, Barbara Hirsch, Ellen Tedaldi, Michael Grant, Morgoret Paroski, Harvey Arbesman, Constance Lentz. Third row: Nancy Colligan, Maryanne Kiernan, Katherine Jasnosz, Cynthia Parlato, Donald Switzer, Paul Trainer, Donna Oehman, Lynn Steinbrenner, Irene Snow, James Conway, Vivian Fasula, Timothy McCullough. Fourth row: Mark Gilbert, Thomas Masten, Robert Shalwitz, Thaddeus Wojcik, Martin Hale, Eric Tenbrock. From left, seated: Marguerite Dynski, Wilr.am Cohen, Mary Lou Meyers. Second row: Jack Cukierman, James Burdick, Henri Woodman, John Stubenbard. From left, on floor: Sabino Torre, Jack Coyne, Kevin Donovan, John Fudyma, Joseph Zizzi. Second row: Shirley Galuck~ Lynda Stidham, Wendy Delaney, Thomas Cowan, Claudia Fosket, Thomas Medige, Lucie DiMaggio, Adriana Alvarez. Third row: Michael Lahood, Timothy Wacker, Donald Flemming, Ira Handler, Thomas Szalkowsk~ Margaret Reidy, Er.zabeth Maher, Barbara Deuell, Carl Turissini, Amy O'Donnell, Edward Cheslow, Margaret Ubby, Donald Tingley, John Leddy. 1970 1975 1980 1985 ��21 a nurse gives a vac~ cination, a lab technictan uses a Petri dish, or a patient discards a tissue. Medical waste is created. And it's not just hospitals that generate medical waste. Physicians' and dentists' offices make it, and so do laboratories. Finding safe and economical ways to dispose of medical waste is a growing concern for health care providers, research institutions, and universities, as well as for government agencies charged with guarding the public from exposure to potentially toxic substances. Getting rid of such waste isn't as easy as it used to be. Most experts agree that there's more of it, thanks to the proliferation of disposables and single~service items such as disposable syringes, bedding, IV bot~ des, and other supplies. And the percentage of waste requiring special handling has climbed dramatically since 1985. The public's concern about medical waste heightened after medical~ ly related material washed up on beaches during the summers of 1987 and 1988. In addition to aesthetic concerns, fear of AIDS contributed heavily to the public's anxiety regarding medical waste, according to a report from the Agency for Toxic Substances and Disease Registry. However, only a small fraction of persons infected with HIV (the AIDS virus) are hospitalized. At any given time, more than 99 percent of all potentially infectious HIV~infected persons are living in their homes in the community. Thus, body fluid waste eliminated by persons with infec~ tious conditions is primarily being discarded from private homes, accord~ ing to a 1988 Oregon Department of Human Resources study. HANDLE It's getting harder to throw away By Paula Voell CARE �22 Only five year ago, according to 1985 Centers for Disea e Control guidelines, less than 10 percent of total hospital waste needed to be treated as infectious. Today, the percentage varies, depending on whose parameters are used. "Three or four years ago the medical waste given pecial handling was mainly from people in isolation," said William D. Pike, vice president of the Western New York Hospital Association. "They may have had an open wound, hepatitis, pneumonia, AIDS. Now we're handling almost all patient care waste as medical waste." This can account for as much as 50 to 80 percent of total hospital waste if Centers for Disease Control universal precautions guidelines are followed, said Lawrence G. Doucet, a professional engineer with Doucet and Mainka, hospital management consultants in Peekskill, N.Y. Categorizing the wa te ha also become more complex. The terms "infectious," "medical," and "hospital" waste often are interchanged inappropriately. Hospital waste is the broadest category and includes all solid waste. Medical wa te describes materials such as soiled dre sing and intravenous tubes. Infectious waste is that portion of medical waste that could transmit an infectious disease. About 15 percent of ho pita! waste is estimated to be infectious by Environmental Protection Agency (EPA) definition. Experts tress the importance of viewing infectious waste in its proper perspective. All waste, including that from homes, may contain pathogenic organisms. Hospitals in the eight Western New York Counties produce about 60 tons of solid waste daily - that includes the potato peels from the kitchens and the memos circulated throughout the facility. Of that, about 16 tons is treated as infectious waste, according to William Pike. Many of the larger hospitals and the University incinerate their waste, but smaller hospitals use private haulers. David Balbierz, vice president of BFI Waste Systems, says his business has steadily increased. BFI is a private hauler with 80 medical waste disposal sites in the United States. Private physicians and other small hazardous waste generators (less than 50 pounds of waste a month) have also had to change their disposal habits. "You can't put it in the trash any more," said Balbierz. "For a long time this stuff was going out to the curb, into dumpsters or into the sewer." Now physicians, dentist , veterinarians and others must register with the state, fill out tracking forms and submit annual reports. The waste has to be packaged and marked with the generator's name and addres . As the waste travels to its final disposal, the form goes with it. "The tracking system is intended to work as a burglar alarm, alerting EPA and state officials whenever waste has not reached its intended destination and leaving a paper trail that will lead to the violators," according to discussions in the Congressional Record. "THREE OR FOUR YEARS AGO THE MEDICAL WASTE GIVEN SPECIAL HANDLING WAS MAINLY FROM PEOPLE IN ISOLATION. NOW WE'RE HANDLING ALMOST ALL PATIENT CARE WASTE AS MEDICAL WASTE." As regulations become more tringent, skyrocketing costs of disposal take a bigger bite out of hospital and university budgets. A study by the management and technology consulting firm of Arthur D. Little in Cambridge, Mass. notes that nation-wide, disposal costs could rise from $3.7 billion in 1988 to $10.7 billion in 1991. To complicate the problem further, hrinking storage capacity in landfills puts more emphasis on incineration of wastes. "As we approach 1992 and there is less available (storage) capacity in the marketplace, prices will jump considerably for a period of time as new incinerators come on line," said Melissa Forgione, vice president of Medical Waste Services, a Buffalo waste disposal firm. "Then I think prices will decline, and stabilize." In the Buffalo area, almost all hospitals burn waste, said William Pike of the Western New York Hospital Association. Before the waste is incinerated, regulations state that it must be handled with caution. At Buffalo General Hospital, for example, waste is placed in red plastic bags that are transported to a holding room on each floor in a large cart that is eventually rolled to the incinerator. A bracket system on the bottom of the cart allows it to be latched onto the incinerator. "We have a pretty unique system," aid Richard Kerling, director of plant operations at Buffalo General. "Once the waste is in those containers, it's not handled again." The hospital burns six tons of solid waste a day, everything from garbage to paper, at an estimated co t of $240,000 for 1990, according to Kerling. Before the incinerator was operative, it cost the hospital 60-65 cents per pound to have its waste hauled to a landfill in South Carolina. "Since the incinerator went into operation in September 1988, to be conservative, - - - - - - - - - the hospital has saved a quarter of a million dollars in medical waste disposal costs," Kerling said. Despite such savings, Buffalo General and other local hospitals are facing a crunch because the Department of Environmental Conservation has tightened regulations on incinerator emis- �sions. By January of 1992 even hospitals such as Buffalo General, which has one of the newest incinerators, won't meet the new code without costly modifications. "Our incinerator is just a year old, but we'll have to upgrade it to meet the standards," said C. J. Urlaub, Buffalo General's vice president of operations. Installing a scrubber 23 (a device placed on an incinerator to remove air contaminants with water) may cost the hospital as much as $800,000. Other hospitals will pay from $1 million to $3 million for new incinerators, depending on size, Pike said. Adding to the cost is the sophistication of the new machines, which need expensive stack monitoring and engineers to run them. "You can't have the housekeeper light a machine and throw the bags in," Pike said. Hospital administrators are exploring the option of joining with other facilities to cut costs. "If 14 hospitals are spending $70 million, it would be far cheaper to have a few larger sites," Pike said. Some environmental officials favor such a regional approach because it means there are fewer incinerators to operate and monitor, but public outcry has been intense against accepting waste from outside the community. The ot In My Back Yard ( IMBY) cry has become so strident, some wonder if it's turned to NOPENot On Planet Earth. Recently, Medical Waste Services was negotiating to build an incinerator to handle waste from several hospitals, nursing homes and physicians' offices in the southern part of the state. The project was defeated because of citizen outcry. Medical Waste Services picks up 10,000 pounds of waste each week from small generators as well as from Our Lady of Victory and Columbus Hospitals, facilities which do not have their own incinerators. "We provide the packing, permitted hauler and insurance," said Forgione, the company's vice president. Boxes for waste storage and disposal provided to its clients by Medical Waste Services come in three sizes and include a three-millimeter liner. A box 18 by 18 by 24 inches that holds 30 pounds costs $27 for disposal. On average, private physicians produce one box of infectious waste every two weeks, according to Forgione. BFI workers who pick up medical waste are given extensive training in how to handle the waste and what protective clothing to wear, said Balbierz. "Actually, the people who pick up regular (curbside) trash are less protected because they don't know what's in it," he said. Waste haulers point out that ordinary garbage from private homes can include needles (it is estimated that one billion needles are discarded by diabetics annually), as well as waste from infectious di eases such a hepatitis. Misconceptions about treatment of hospital waste abound, despite increasing amounts of attention to the problem, Pike said. "I think people assume that hepatitis will be coming out of stacks and that hundreds of trucks will come to a property and that's just not true," he said. �HOW UB HANDLES MEDIC 24 The University produces about 35,000 pounds of medical waste annually from its 60 laboratories, mainly utensils containing culture media from labs in the schools of medicine, dentistry, and nursing. "The state regulation in relation to the University seem very stringent," said Robert E. Hunt, director of Environmental Health and Safety at UB, which has an incinerator on the South Campus. "For a long time the state regulations said that once infectious waste was autoclaved (sterilized with steam) it could be treated as trash and go to a sanitary landfill. That was no problem for us except for a few labs who had to find a way to autoclave. "But recently a sentence was added to the regulations to require that all regulated medical waste has to be made nonrecognizable, so it has to be incinerated or ground up. We are using incineration but it's causing considerable problems because a big share in poundage is plastic - flask tubes, pipettes and Petri dishes. That's extremely difficult to incinerate efficiently, to bum up at high temperatures efficiently enough so you don't get a lot of byproducts in the air." To cut down on the amount that has to be incinerated at UB, labs are advised to put all clean glass and plas:~m~ tics in special containers 'glass,' Hunt says. These are collected puncture- Balbierz estimates t h at only two to five percen t of waste is pat h o l ogica l waste, but con cedes t h at t h e public has a different perspective. "Th ey h ave t h e misconception that o ur AU11JM 1990 resistant cartons to be disposed of in permitted landfills. Hunt doesn't think the health industry will revert to reusable supplies. "I've thought about it, but there's just so much expense involved with the handling, cleaning and storage of glassware that maybe a lot of researchers would find it impossible to continue." William Pike, vice president of the Western New York Hospital Association, agrees it's unlikely that hospitals will go back to reusables. "The reason we use disposables is sterility. If there was a fault in the autoclave, would you want a needle reused? "And I think that there would be a concern for infection with blood products if we switched from the use of throwaway plastic bags." Pike said that hospitals are more likely to look for ways to cut down on disposable items and encourage recycling in areas other than patient care. "There are other things hospitals could do in such things as packaging for food - eliminating the use of Styrofoam, for example," he said. trucks are filled with body parts, when actually most of our waste is rubber gloves, disposable gowns, the paper used on examinating tables, masks and tongue depressors." Before all the dust settles on how best to dispose of hazardous waste, Melissa Forgione says, people will have to become better informed. Paula Voell is a reporter for the Buffalo News. BUFFALO PHYSICIAN AND BIOM EDICAL SCIENTIST • �... ----------------------------------/f 0 25 The Body Snatchers Elwood lecturer tells how grave robbing and murder charges ensnared a famous anatomist BY JEFFREY TREBB A • 19th century anatomist whose illustrious career was destroyed by charges of grave robbing was the subject of the Charles L. Elwood Memorial Lecture in March. The lecture was delivered by Sherwin B. Nuland, associate professor of surgery at Yale School of Medicine, whose visit to Buffalo was sponsored by the Alpha Omega Alpha national medical honorary society. According to Nuland, it was only stubborn self-assurance that allowed the Scottish anatomist Robert Knox to become implicated in a series of murders committed to furnish specimens for dissection. In his lecture, "Goodness Tainted: Robert Knox and the Anatomy Murders," Nuland told his audience: "Robert Knox (1791-1862) was a paladin destroyed by his own code of honor, for although his drive and talent seemed to promise a glorious academic future, his destiny became his downfall when he was scapegoated for a series of crimes instigated by the medical science of his time. "By confusing egotism with purity of conscience, by believing compromise signifies cowardice and by equating pragmatism with weakness, Knox sacrificed great achievement on the altar of vanity," Nuland said. The actual "scoundrels" were two navy workers on the Union Canal between Edinburgh and Glasgow, William Hare and William Burke. Nuland called both "familiar with all BUFFALO PHYSICIAN A 0 BIOMEDICAL SCIENTIST Detail from "The Anatomy Lesson of Dr. Tulp," Rembrandt, 1632 In 1828, corpses of murder victims were sold for about seven British pounds apiece. the woe, wretchedness, guilt and pollution" life contains and said they embarked on a spree of killings shortly after Hare filled an already-dead neighbor's coffin with tanner's bark and sold the man's corpse to the medical college, becoming quite impressed with the simplicity of the deed. All colleges in Great Britain early in the 19th century were facing an increased need for corpses owing to the growth of surgery with its new emphasis on detail, and also to the higher standards of care legislated by government. AUTUMN 1990 �... If ----------------------------------------- 0 26 And procuring bodies for dissection, Nuland pointed out, usually meant resorting to illegal measures of some variety since the two legal sources, the bodies of executed criminals and those of the unclaimed dead in hospitals, never approached the demand. "The need was insatiable. You just couldn't teach without corpses," he said. Grave robbers, or "resurrectionists," supplied what they could, but eventually graves became clo ely watched over by relatives of the deceased, said Nuland. So Burke and Hare turned to murder. Burke even gave his name to a style of suffocation: To "burke" someone meant strangling him while sitting atop his chest. In all, Burke and Hare killed about 30 persons in 1828, netting about seven British pounds per body. The pair brought suspicion upon themselves after murdering several well-known prostitutes. An elderly woman they brought home from a tea shop, plied with gin, and killed after an evening of dancing and singing, was their last victim. Unfortunately for Knox, the body, purchased by assistants, was found in his dissection cell. Nuland described Knox as a "man of solitary self-regard, endowed with an air of authority, possessed of charm, cultivating distinctiveness." He had studied in Paris with Georges Cuvier, the French zoologist and statesman, who established the sciences of comparative anatomy and paleontology. Shortly after returning to Edinburgh in 1822, Knox established a museum of comparative anatomy at the Royal College of Surgeons in Edinburgh. "Knox's enviable command of language and his showman hip drew students in huge numbers; not only anatomists but artists and divinity students. He was a tourist attraction for AUTUM 1990 cultivated travelers and at the threshold of an illustrious career," aid Nuland. "The greatest anatomy teacher of his day, he was also skilled in paleontology and comparative morphology." But because the body was found in his room, Knox "faced all the frustration built up by a century of grave robbing. He was scolded for every sin ever committed in every aspect of medical science," said Nuland. The press derided him, he was burned in effigy, he was forced to walk through creaming crowds to give his lectures. A folk song closed with "Burke's the butcher, Hare's the thief, Knox is the boy who buys the beef." Few colleagues came to his defense. Even his admiring students left his side. This despite the fact that he was acquitted in court late in 1828, according to Nuland. (Burke was found guilty on Hare's testimony and hanged before 20,000 onlookers. His dead body was sent to the anatomy school for dissection.) Nuland claimed the anatomist was brought low by pride and vanity: "Knox cast ridicule on the opinions and men of the time and flaunted his talents, inviting bombardment. He believed it beneath his dignity to respond to the charges, and the reverberations followed him the rest of his life." Knox lost his job as curator of the anatomy museum and was forced to resign from the University of Edinburgh. He rambled about the country barely surviving by lecturing on anatomy and fishing and writing for magazines in London. He was expelled from the Royal Society of Edinburgh for non-payment of dues. This career as a perennial free-lancer was relieved by only one respectable position as a fellow of the Ethnological Society of London. In 1862, long after his wife and all his children were dead, Knox e died of a stroke. BUFFALO PHYSICIAN AND BIOMEDICAL IE TIST �27 MILGROM OUTLINES WoRK ON ANTIANTIBODIES A t one time, it was believed that the body's immune system could not make antibodies that would be destructive to the host's own tissue. But Felix Milgrom, a distinguished professor of microbiology at UB, helped to prove that theory wrong through his work with antiantibodies. Milgrom delivered the 20th Annual Ernest Witebsky Memorial Lecture in May at the Center for Tomorrow on UB's North (Amherst) Campus. "The theme of antiantibodies is something that I have been pursuing for 44 years," Milgrom said, outlining his research career. "It is something that I have been pursuing from the very beginning of my research." In outlining his research, Milgrom Felix MUgrom, M.D. BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST issued a caveat to his capacity audience. "The lecture," he said, "was not designed to be a comprehensive treatment of this topic." Milgrom noted that the audience would require a graduate seminar in advanced microbiology if they wanted to really understand what the topic encompassed. Milgrom worked at UB from the 1950s through the mid-1960s with the late Ernest Witebsky, whom Milgrom called "the world's most brilliant immunologist." Their work made great strides toward disproving the old theory about autoimmunity. Another "first" for Milgrom was demonstrating in the laboratory that some forms of kidney graft rejection are caused by antibodies present in the circulation of presensitized recipients. That was an important piece of information in 1968 when the field of human organ transplantation was new. His research also clarified the structure of rheumatoid factor, an antibody. Milgrom noted that over the years, UB's Department of Microbiology has attracted hundreds of students. About 40 or 50 now head departments or institutes focusing on immunology in the U.S. and abroad. A native of Poland, Milgrom was chair of the Department of Microbiology at Silesian University School of Medicine in Zabrze, Poland, and a professor and acting chair at the University of Wroclaw in Poland, before coming to UB. Milgram has authored about 600 professional articles and has served as editor for several books. He was awarded the Paul Ehrlich Prize in 1986 in recognition of his distinguished service in the fields of immunology and chemotherapy. After Milgram's lecture, the Ernest Witebsky Memorial Awards for proficiency in microbiology were given to Seth Dewey, a medical student; Jennifer Kuracina, a dental student, and Haiping Mei and Ai Shih, both graduate students in microbiology. e AUTUMN 1990 �28 LISTEN WITH HEART, ABRAM TELLS GRADS A very personal message came with this year's commencement speech to the School of Medicine and Biomedical Sciences. The 145 medical students, 25 doctoral tudents and their familie and friends heard diplomat Morris Abram advise graduates to "shorten your stethoscopes to hear what patients are saying and feeling." Abram, the U.S. representative to the European Office of the United ations and Other International Organizations, Geneva, and former Diplomat Morris Abram addresses graduates. president of Brandeis University, keyed his address to the relationship between doctor and patient. But it was more years, had shortened the listening tube than a theoretical overview from a sani- of his stethoscope. tized ivory tower. Abram shared his per"One day a young resident came up anal experiences with the graduates, to thi wise old man and said, 'Doc, talking about hi own bout with why do you use such a short stetholeukemia that lasted five years. scope? Did you buy it that way?' He "The relationship between doctor and said, ' o son, I just had to keep cutting patient is one of extraordinary psycho- it off.' He was a man who paid very litlogical and emotional interplay," Abram tle attention to technology and a great said, reflecting on the sometimes-anx- deal of attention to what he was hearious encounters with hi own team of ing," Abram said. physicians during chemotherapy. In looking at patients this way, Anguish, frustration, and reverence are Abram said, physicians will be able to all felt by the patient toward his physi- determine how much information they cian, he said, pointing out that, in time, can give the patient, whether or not especially with diagnosis of a disease that the patient has the "instinct and will to can be fatal, patients begin to scrutinize fight to survive," and if the patient is the doctor's every word and nuance. realistically facing the severity of his ill"I remember the anxiety of sitting by ness, he added. the phone waiting to hear the results of The historical and technological my bone marrow from my hematologi t. changes that have taken place in I would sit by the phone and think, medicine since 1846, when the UB 'Why hasn't he called? What's wrong?' medical school was established, have Finally he called and he said, 'The bone affected the doctor-patient relationmarrow looks good.' I said, 'What does ship, Abram said. that mean? Does it mean it doe n't look The first hundred years were marked great?'" Abram added with emotion. by a small arsenal of treatments, and The speaker recounted the story of a bedside manner was sometimes the best learned physician, who, through the medicine, Abram said. Technology has AUTUMN 1990 moved ahead in leaps and bounds, but to orne extent it has caused the physician to focus on body parts rather than look at the whole human being. Abram referred to some of the frustrations today's physicians face - the increasing risk of malpractice, bureaucratic red tape, immense amounts of information to be absorbed - all of which result in le time for patient interaction. There is precious little time for "rumination about the symbiosis between the healer and healed" in the cour e of medical training today and among practicing doctors, Abram said. But he urged the new physicians to listen and study their patients, not just from a biomedical standpoint, but also from an emotional one. Abram told the audience that during hi bout with leukemia, he was under the care of James E Holland, M.D., former chief of medicine at Roswell Park Memorial Institute and former director of Roswell Park's Cancer Clinical Research Center. Holland, who wa also research professor of medicine at UB, is now at Mt. Sinai School of Medicine and Hospital in New York City where BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �29 he is professor of medicine, chief of the Division of Medical Oncology, and director of the Cancer Center. A lawyer by training, Abram is a man of many accomplishmen ts, said John Naughton, M.D., vice president for clinical affairs and dean of the UB medical school, who introduced the speaker. Abram is a Rhodes scholar, a former president of the United Jewish Appeal, and has served on state, local, and in ternational commissions including a presidential-appo in ted committee examining medical ethics. This year's commencement was highlighted by the graduation of the medical school's first M.D./Ph.D candidate, Edwin Heidelberger. The first graduates of UB's Early Assurance Prog ram, which allows qualified students to apply early, also crossed the threshold from e student to resident. - By David Himmelgreen Richard Condit, Ph.D., associate professor of biochemistry, listens thoughtfully. Dennis Nadler, M.D., associate dean, witnesses the signing of the Book of Physicians by Constantine Petrochko. BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST AUTUMN 1990 �30 a Martha Pierre, left, shares her exciting news with Shiau-Wen Pien and Jase Rivera. 89°/o GET ToP CHOICE AT 'BEST' MATCH DAY T hey streamed through the doors of Butler Auditorium like the ancient Hebrews making their way through the parted waters of the Red Sea. Some had bottles of champagne, others had babies and spouses. They were all buddies who just completed four years of training in quest of becoming fine physicians. And now they were about to embark on another journey. March 21 was Match Day, the annual event held at medical schools across the country where fourth-year students find out where they'll spend their residencies. The UB students had to wait through the announcements - yearbooks, graduation speaker, and in tructions on how to sign the alumni scroll - before they would get those coveted envelopes telling them where they would be going. AUTUM 1990 Then they waited some more as Dennis Nadler, associate dean for curricular and academic affairs for the medical school and director of the office of medical education, reported on the statistics. The tension was mounting. There were 141 students who participared in this year's match, said Nadler. It was the best year since 1979, when Nadler first began keeping records. This year 67 percent of the students got their first choice, up 2 percent from last year, said Nadler. And another record was broken with a whopping 89 percent of the students getting one of their top three choices. (Five students didn't enter the match: one was a military match, one was a student in the Medical Scientist Training Program who began a residency in January, one chose graduate study in physiology, one accepted a part-time position in Vermont, and one got a position after the match.) The applause thundered through the auditorium as the students realized just how good a class they were. UB students are going to some of the best and most highly competitive residency programs in the country. Nadler exclaimed that UB finally cracked the prestigious residency program at Massachusetts General in Boston. He added that UB is also sending students to other top-notch programs such as Duke and Johns Hopkins. But Nadler had to make the students squirm just a little more. As he clenched the envelopes that would tell them of their fate, he said with a grin, "I made an effort to randomize them." The students booed as if they just saw a Bills player drop a pass. Then, one-by-one, they came up, some with trepidation, but many with beaming smiles splashed across their faces, to get the sacred envelopes. Cheers broke out and champagne corks flew through the air. There were plenty of hugs, smiles, and celebrations. "I got my first choice - Syracuse," said Anthony Navone, a medical student, who added that "after five years and $75,000 it was all worth it." Heidi DeBlock, another student, who brought along her husband Scott and daughter Alexandra, was ecstatic that she was going to Rochester, her first choice. Ralph Augustini, who's a glutton for cold weather, will be spending the next several years at the University of Michigan. He was full of good cheer and drenched with champagne and kisses from well-wishers. "I just want to congratulate all of my classmates," he said. Nadler summed it up: "We have a strong class. We did well, exceptionally w~ll. It was an impressive result especially because the competition is getting tighter every year." e - By David Himmelgreen BUFFALO PHYSICIA A D BIOMEDICAL SCIE TIST �0 " 31 Dr. Herz Goes to Washington UB psychiatry chair tightens up mental health grants BY LOIS BAKER A stint as a senior science advisor at the National Institute of Mental Health (NIMH) has given a UB professor new perspective on the workings of Washington bureaucracy. Marvin I. Herz, M.D., professor and chair of the Department of Psychiatry at UB's School of Medicine and Biomedical Sciences, spent September through December at the NIMH as advisor to the director, Lewis Judd. He found the work in Washington interesting, but prefers to be closer to the front lines. "I got a close look at how the federal bureaucracy works," said Herz, "and I enjoyed meeting people and exchanging ideas. But it's much more rewarding to be in a setting where you can actually work with patients, actively direct their care, and do the research. "These people administer programs that other people do. They don't work with patients, students or faculty. They are far away from where the action is." Herz was invited to NIMH headquarters in Washington, D.C., for work with the Division of Education and Service Systems Liaison because of his expertise. He is one of the few physicians in the United States who has devoted his career to researching new treatments for schizophrenia and other serious mental illnesses. BUFFALO PHYSIC IA AND BIOMEDICAL SCIE TIST "I got a close look at how the federal bureaucracy works , but it's much more rewarding to be in a setting where you can actually work with patients. " Herz's mission was to bring a more scientific orientation to the division's projects.The largest task of this division is to fund clinical trials that try to find more effective ways to treat seriously mentally ill children and adults. The funding is channeled through state Departments of Mental Health. "The problem in the past with these demonstration projects has been that they were never scientific enough to be reported in the literature so they could be replicated," said Herz. One grant that Herz reviewed was an extension of some of his own previous work. It proposed to study schizophrenic patients and the benefits of intervening in their treatment at the first signs of relapse. Herz said that traditionally, professionals treating schizophrenics tum to crisis counseling for the family and an increase in medication for the patient only after the patient has suffered a full relapse which usually sends the patient to the hospital. "When early signs of relapse appear, several days or a week usually pass before the episode progresses to full relapse," Herz said. "By intervening early we expect a decrease in hospitalization as well as less family burden and improved functioning of the patient." Herz said, "My job was to tighten up the demonstration grants - define the population, give a clear description of the grant's intention, make sure they were using randomized control studies, if possible, and valid and reliable instruments to register change. "In the past they couldn't describe what was actually done because the results weren't clear." He also advised the demonstration project staff on ways to treat seriously mentally ill patients, and helped sharpAUTUMN 1990 �0 v 32 PoRTIN Is PRESIDENT OF MEDICAL ALUMNI B ertram A. Portin, M.D. '53, has been elected to a one-year term as president of the UB Medical Alumni Association. edra J. Harrison, M.D. '77, was elected vice president, and Donald P. Copley, M.D. '70, was elected treasurer. Portin, a colon and rectal surgeon, is a UB clinical professor of surgery and chairman of the division of colon and rectal surgery in the Department of Surgery. Certified by the American Board of Surgery and American Board of Colon and Rectal Surgery, Portin is an attending surgeon and chair of the Division of Colon and Rectal Surgery at Buffalo General Hospital. Harrison, a general surgeon, is a clinical instructor of surgery at UB. Copley is a clinical professor of medicine in UB's Department of Cardiology. e Robert M. Barone, M.D., a general surgeon, has been elected president of Millard Fillmore Hospitals' voting medi~ cal staff for 1990-92. Barone is a clinical ~ assistant professor of surgery at UB. e § Q Sister Angela Bontempo, pre ident of Marvin I. Herz, M.D. en the focus of training programs for psychiatrist , social workers and other mental health professionals. He continue to serve a a consultant to the institute. Herz developed an interest in treating serious mental illness during his directorship of the inpatient unit of New York City's Montefiore Hospital from 1961-1963. He later spent 12 years as director of community p ychiatric programs at Columbia College of Physicians and Surgeon and New York ::W.iiiiiiliiiiiiiiiiiiliiiiiiiiiiliiol State Psychiatric Institute. In addition to his UB position, Herz currently i director of psychiatry at the Erie County Medical Center and Buffalo General Hospital, as well as consultant at the VA Medical Center. He was elected recently to the Board of Regents of the American College of Psychiatry. Herz's research has earned accolades in the past. In 1988 he received the American Psychiatric Association's Psychiatric Institute of America Foundation Award for Hospital Research. e ~ Sisters Hospital, has been appointed to the state's Public Health Council. The 14-member council advises the State Commissioner of Health and considers matters relating to the preservation and improvement of public health. e Gregory Branch was one of 10 medical students nation -wide to receive a Metropolitan Life Foundation Award for academic excellence in medicine. The honor includes a 2,500 tipend. He· is now a fourth-year student. e Kandala Chary, M.D., has been elected pre ident of the Sisters Hospital medi- AUTUMN 1990 BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �0 ' 33 cal staff. Chary is a clinical instructor in medicine and otolaryngology at UB and has served as president of the Asian American Physicians Association. e 1918fLU EPIDEMICGRAD WAS THERE Thomas J. Dougherty, Ph.D., director of radiation biology at Roswell Park Cancer Institute and associate professor of pathology and radiobiology at UB, received the Gustavus John Esselsen Award for Chemistry in the Public Interest. Dougherty was recognized for his research leading to the development of photodynamic therapy (PDT), a potential new approach to the treatment of certain types of cancer. The award was presented at the annual meeting of the American Chemical Society in April. e Leonard G. Feld, M.D., Ph.D, associate professor of pediatrics and physiology at UB, has been elected to the American Physiological Society. Feld is also chief of the Division of Nephrology at Children's Hospital and director of the Children's Kidney Center of Buffalo, which is located at the hospital. He recently received a $96,600 grant from the Juvenile Diabetes Foundation International to study the long-term effect of the drug aminoguanidine, which will be used to prevent glucose from damaging the membranes within the kidney. e John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, has been named Physician of the Year in Academic Medicine by the alumni association of the University of Oklahoma College of Medicine, where he received his medical degree in 1958. aughton was cited for "outstanding contributions and leadership in furthering scholarship, administration and research." e BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST John D. Pigott, M.D. John D. Pigott, M.D., a specialist in congenital cardiac surgery, has been appointed chief of the Division of Cardiovascular Surgery at Children's Hospital and associate professor of surgery at UB. With this appointment, Buffalo is now offering state-of-the-art heart therapy for children that is not available elsewhere in the state. Pigott had been a cardiac surgeon at the Children's Hospital of Philadelphia. e James J. Reidy, M.D., has been named director and chief-of-service for the cornea service in the Department of Ophthalmology at UB. e John P. Visco, M.D., a cardiologist at Buffalo General Hospital, has been elected president of the hospital's medical staff for 1990. Visco is also a clinical assistant professor of medicine at UB. e Gentlemen: Thank you, sincerely, for publishing the article, "Flu," written by Deborah Brunch Bucki, R.N., M.S. It sure brought back many memories of my early life in Buffalo. 'I was there,' so to speak. In the fall of 1918, I was a member of the senior class, South Park High School. I became ill at school and was excused. I walked home a distance of one-half mile. On arrival home, my mother took my temperature - it was 104. It was diagnosed as influenza and I recovered after one week- no complications. I graduated from the University of Buffalo Medical School in 1925 interned at the Buffalo City Hospitai and remained there 20 years (1925-194 5), except for a two-year period in the mid-1930s when I attended the Johns Hopkins School of Public Health where I was granted the degree of Doctor of Public Health (D.P.H.). I succeeded Dr. Walter S. Goodale on his death in 1941 as superintendent of the City Hospital and professor and head of the Department of Preventive Medicine at the University of Buffalo. All of the doctors mentioned in the article: Goodale, Fronczak, Gram, Cott, Meyer, Sherman and Jacobson, were friends of mine - great men, all of them. I departed from Buffalo in 1945 and for the next 21 years served as superintendent of the New York State Masonic Home and Hospital, in Utica, N.Y. I retired in 1966 and since then have lived in "God's Country," the foothills of the Adirondacks at Woodgate, N.Y. I was 89 years of age in August and enjoy good health. William T. Clark, M.D., D.P.H. AUTUMN 1990 �0 ' 34 most advanced in the world. It features a unique environmental chamber which simulates the equivalent of depths of 5,600 feet beneath the sea or 100,000 feet in altitude. It also includes a centrifuge capable of simulating up to 10 "Gs" or gravities and a submersion basin which provides underwater observation of subjects against specified rates of currents. HERMANN RAHN DIES; PHYSIOLOGY PIONEER LooKED To SKIES, SEAS H ermann Rahn, Ph.D., whose pioneering research in environmental physiology helped provide the foundation for today's aerospace and undersea medicine, died June 23 after a brief illness. He was 77. Leon Farhi, M.D., chairman of UB's Department of Physiology, has noted that while environmental physiology was on the books for a long time, it really blossomed in the early 1940s when Hermann Rahn made his contributions to the field. Rahn, distinguished professor of physiology at UB, served as chairman of the Department of Physiology at the medical school from 1956 to 1973. A native of Michigan, Rahn received an A.B. degree from Cornell in 1933 and a Ph.D. degree from the University of Rochester five years later. Joining the UR faculty after teaching briefly at the University of Wyoming and spending a year as a fellow at Harvard, Rahn, with his colleagues, conducted research which benefited Allied pilots and soldiers in World War II. The Rochester team assisted the U.S. Army in determining the amount of water and other essentials needed for desert survival prior to the landing of U.S. troops in North Africa. Later, the researchers used a converted brewery tank as a primitive altitude chamber to study hypoxia, which caused pilots to lose consciousness at high altitudes. Although he officially retired in 1985, Rahn continued to put in six-day workweeks in his lab until shortly before his death. His research in comparative respiratory physiology involved work with eggs ranging from those of the ostrich to the hummingbird. During 15 years of research in this field, he served as a consultant to the poultry indu try and to those interested in the field he founded, incubation physiology. AUTUM 1990 Hermann Rahn, Ph.D. Although Rahn's scientific interests spanned a range of subjects within biology, his primary interests were comparative physiology and pulmonary physiology, in which man or animals adapt and interact with different environments. Basic knowledge he provided in this area advanced the understanding of lung dysfunction in patients with pulmonary diseases. For this work, he received the American Lung Association's prestigious Trudeau Medal. A device he invented led to development of the self-guided cardiac catheter used today in diagnosis of cardiovascular problems. Rahn's vision, enthusiasm and determination helped build UB's Department of Physiology into an international center for environmental physiology. The Hermann Rahn Laboratory, housed in the UB Center for Research in Special Environments, is one of the Rahn's research earned him many honors, including the U.S. Air Force's Meritorious Civilian Service Award, the highest given a civilian; election to the prestigious National Academy of Sciences and the American Academy of Arts and Sciences; and honorary degrees from the Universities of Rochester, Bern (Switzerland), Paris, and Seoul (Korea). He was the first recipient of the Under-Sea Medical Society's top honor, the Benke Award. During his career, Rahn had been a visiting professor at several institutes abroad and was a president of the American Physiological Society and vice president of the International Union of Physiological Sciences. He was the author of more than 200 scientific articles and four major texts. A dedicated teacher as well as a researcher, Rahn inspired many graduate students and fellows who studied with him at UB to follow successful careers in physiology. A Hermann Rahn Memorial Fund has been established and contributions may be sent to the Department of Physiology, 124 Sherman Hall, University at Buffalo, Buffalo, N.Y. 14214. e BUFFALO PHYSICIAN A 0 BIOMEDICAL SCIENTIST �35 1940., Stanley L. Olinick '40 :l> writes that his busy schedule includes a half-time practice, teaching, writing, friends, tennis and music. Anthony M. Aquilina '44 :l> of Amherst, N .Y., was elected president of the Baccilli Medical Club for 1990. William D. Loeser '45 :l> is now retired from private practice. "! work part time for a nursing home ... love it!" Albert J. Rosso '45 :l> writes, "My wife of 41 years and I have eight wonderful children and 16 fine grandchildren." David J. Shaheen '45 )> retired in 1986 and is now living in Titusville, Fla. Jacob M. Steinhart '45 :l> of Clarence, N.Y., writes, "Still enjoying the private practice of pediatrics, but in a six-man group!" Gilbert B. Tybring '45 :l> who has been retired for five years, edits the Wisconsin Psychiatrist. Vernon G. mith '48 :l> of Orchard Park, N.Y., retired from his private practice in pathology in 1987 due to a severe fracture of the right femur. Max A . Schneider '49 :l> who is known internationally for his work in the field of addiction medicine, was recently appointed an associate clinical professor of psychiatry at the University of California College of Medicine at Irvine. Henry A. Thiede '49 :l> appears in the videotape "The History of Certification in Emergency Medicine" produced by the American Board of Emergency Medicine. This tape was made to celebrate the recognition of emergency medicine as a specialty and to commemorate the individuals involved in the history of certification. Robert Benninger '50 :l> is now retired and enjoying life in Cape Coral, Fla. George P. Bisgeier '50 :l> former medical director of New Jersey Bell, is semi-retired and doing part-time occupational medicine. Karl L. Manders '50 :l> of Indianapolis, Ind., recently published "Indications for Surgery in Back Pain" in Seminars in Neurology. In addition to his practice in neurosurgery, he continues as medical director of the Community Hospital Rehabilitation Center for Pain. Dr. Manders is currently president of the Midwest Pain Society. Ernest H. Meese '54 :l> was elected president of the board of trustees of the American Cancer Society Ohio Division. He has been a volunteer with the Cancer Society for 26 years. Dr. Meese has a private practice of thoracic and cardiovascular surgery in Cincinnati and is an assistant clinical professor of surgery at the University of Cincinnati Medical Center. Milton Alter '55 :l> left his position as chairman of neurology at Temple University and is now professor of neurology and director of the residency training program at the Medical College of Pennsylvania. He holds an NIH grant to study the epidemiology of strokes and was BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST recently awarded a supplemental grant to study risk factors for recurrent strokes. George L. Mye Jr. '55 :l> of Yelm, Wash., retired in July from general surgery and a partnership in a Southern California Permanente Medical Group. David L. Palmerton '55 :l> of Clarence, N.Y., writes, "! retired six years ago, but I am into starting up home health care agencies in Florida and Virginia." Jerome P. Kassirer '57 :l> the Sara Murray Jordan Professor of Medicine at Tufts University School of Medicine in Boston, has been elected to the Board of Regents of the American College of Physicians. He began a threeyear term in April. Daniel C. Kozera '59 :l> a clinical assistant professor at UB, is acting chief of ob/gyn at Mercy Hospital and a consultant for ob/gyn to the Erie County and New York State Health Departments. 1960.\ Franklin Glockner '60 :l> is now working full time in the Division of Orthopaedic Surgery at Albany Medical College and is chief of orthopaedic surgery at the VA Hospital. Edwin R . Lamm '60 )> was elected president of the medical staff at Lakeland Regional Medical Center in Lakeland, Fla. Eugene T. Partridge '60 :l> of Buffalo has 12 grandchildren and is expecting more. Joseph A. Chazan '60 :l> director of the Division of Renal Diseases at Rhode Island Hospital and associate clinical professor of medicine at Brown University, took office in April as governor for the Rhode Island chapter of the American College of Physicians. Jeffrey E. Lindenbaum '66 :l> has been appointed clinical director of a new joint venture adolescent medicine program with Children's Hospital and Medical Center in Seattle, Wash. Stephen E. Langer '67 )> of Berkeley, Calif., is medical editor of the National Examiner. His column reaches 6 million people per week. Dr. Langer is currently president of the American Nutritional Medical Association. John E. Shields '68 :l> is a consultant at the Seafield Alcohol Treatment Center in Westhampton Beach, N.Y. 1970s Jan Novak '70 :l> has been reelected president of the medicaldental staff of the Erie County Medical Center. He is an attending in medicine and heads the gastroenterology unit of the hospital. Kenneth Solomon '71 :l> associate professor in the Division of Geriatric Psychiatry at St. Louis University School of Medicine, presented at the Department of Psychiatry Grand Rounds at the Erie County Medical Center and the VA Medical Center in Buffalo April 20. Patricia K. Duffner '72 :l> has been elected president of Children's Hospital medical staff, the first woman elected to AUTUMN 1990 �36 the post. A professor of neurology and associate professor of pediatrics at UB, she has coauthored a book with Michael Cohen, M.D., on brain tumors in children. past 11/z years she has also been involved in public sector work. Dr. Turner has 2 sons, 5 1/z years and 2 years. Her husband, Alan, is a member of the Dallas Symphony. Arthur W. Mruczek '73 > has been appointed director of the contact lens service at the Erie County Medical Center. The service will include therapeutic as well as co metic contact len es. Mark Chung '82 > writes, "I am a practicing pulmonologist at Los Alamitos, Calif., having graduated from Harbor-UCLA training program, and have been appointed lieutenant commander with the U. . Naval Reserve." Nancy H . Nielsen '76 > has been named to the State University of New York Board of Trustees. A clinical assistant professor of medicine at UB, Niel en practices medicine with the Buffalo Medical Group. She is a medical consultant to the bacteriology laboratory of the Buffalo General Hospital and is a delegate to the New York State Medical Society. Niel en wa the first woman president of the Erie County Medical Society. A member of the board for Professional Medical Conduct, ew York tate Department of Health, Niel en i a longstanding volunteer for the Buffalo and Erie County YMCA. 1n 198 7, she received the Outstanding Achievement Award from UB's Community Advisory Council. Angelo Del Bal o '78 > is the author of an 800-page text for physicians and dentists called Maxillofacial Imaging. It describes imaging techniques used to detect and identify diseases and di orders of the head and neck area. An associate professor in UB's Department of Radiology, Del Balso is also the author of Panoramic Radiography, published Ia t year. AUTUMN 1990 Patricia K. DuHner '72 1980.~ Mark . Borer '80 > is starting a new organization "P.E.A.C.H.," People Educating and Advocating for Children. Robert Braco '80 > will receive an M.P.H. degree in May from the University of Texa School of Public Health in an Antonio. Katherine Jasnosz DeCaria '80 > write "My hu band Anthony and I are the proud parents of Daniel Joseph, born on Sept. 15, 1989." Dr. DeCaria is a forensic pathologist with the Allegheny (Pennsylvania) County Coroner's Office. Walter iemian '80 > is certified by the American Board of Pia tic Surgery, and is now an active member of the American Society of Pia tic and Reconstructive urgeons. Sylvia Turner '80 > of Dallas has a private practice in child and infant p ychiatry. For the Albert Speach '82 > is currently assistant professor in the division of otolaryngology at the University of Kentucky. Jo Ann Pravata Pullen '83 > and her husband, William Pullen, M.D., are the proud parents of William icolas Pullen, born Oct. 14, 1989. William is in private practice in internal medicine and endocrinology in Santa Monica, Calif.; Jo Ann practices medicine at Cigna Health Plans in Los Angeles. Mark C. Steckel '84 > is a clinical instructor in ophthalmology at New York Medical College, and director of pediatric ophthalmology and strabismus at the Metropolitan Hospital of New York, N.Y. In addition to his academic positions, he has a practice in adult and pediatric ophthalmology at 4699 Main Sr. in Bridgeport, Conn. Deidre J. Greene '86 > of Pennsylvania writes, "My husband, Rob Dixon, and I jojned ABC Pediatrics last July in Allentown. We also now have a beautiful son, Patrick, born in October." Janice J. Pegels '86 > write , "Married James Jewell, M.D. on June 10, 1989; enjoying the lake and mountain view from our home in Seattle." James J. Shaughnessy '86 > writes, "I'm living in rural Massachusetts and commuting to Providence for a two-year fellowship in child and adolescent psychiatry. Dale Radka '86 is in the same program." Jill E. Koehler '87 > announces the birth of her son, Alejandro Daniel MarenoKoehler. Dr. Koehler is chief pediatric resident at Hurley Medical Center in Flint, Mich. Obituaries Mitchell!. Rubin, M.D., a kidney specialist instrumental in the development of Children's Hospital as a modem medical center, died April11, 1990 in Charleston, S.C. after a long illness. Rubin, 88, a teacher, clinician, re earcher and pediatrician, was well known for his work in pediatric nephrology. He was a professor and former chairman of the Department of Pediatrics at UB. Pediatrician-in-chief for Children's, he retired in 1972 after 27 years of service. After retirement, he returned to his native Charleston, joining the Medical University of South Carolina, where he established the Division of Pediatric Nephrology. The author of Pediatric Nephrology, Rubin published more than 70 articles in professional journals. He belonged to 14 professional societies. BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST ��Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Corredion Requested Non-Profir Org. U.S. Posrage PAID Buffalo, NY Permir No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1990 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1990-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v24n02-1990-Autumn Table Of Contents A list of subunits of the resource. Research. Mommy track? Cutting red tape Rubbish Medical school news People Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v24n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1990 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/cc44c68c949906d40cb4e81db435df64.pdf f718e6a1097fa2829afb11d5b66d915f PDF Text Text Vol. 25, No. I �STAFF DIRECTOR OF PUBLICATIONS Nancy Tobm Dear Friends: EDITOR Connie Oswald Stofko s we enter 1991, concerns that previously required only speculation now reqUire appropriate attention and resolution. This transference will be accelerated because of increasing fiscal constraints from all of our usual sources of support and the changing world in which we hve. Chtef among those concerns are a need to foster more independence and self-responsibility among medical students and physiCians for their learning, continued development of a research environment which will ensure continued proJuctivtty of the scientific faculty well into the 21st century and the important need to guiJe clinical training programs to be more responstve to social needs without harming the tremendous contributions made to the age of specialization developed smce World War II. For a medical schcx1l faculty, these area' of concern, as well as a multitude of other problems which must be addressed, seem bxh overwhelming and contradictory. Nevertheless, each of this country's 126 medical sch(Xlls shares these issues and each must present options for solutions. Given the unique circumstances at UB, it seems that these areas of concern will receive our focus and attention throughout the current decade. The faculty are initiating curricular changes, and the school is providing the necessary technology and faciltties whtch will foster educational change; the plans for the construction of a modem research facility to be completed in 1994 are well underway, and a maJor tnstitutional commitment has been made to mcrease the emphasis on educating and training a larger cadre of primary care physicians while recruiting and returning an increased prop.1rtion of residents from minority and socially disadvantaged programs. Thus, while UB and its teaching affiliates will not be protected from the onslaught of constraints that will continue to rx:cur, we have initiated strategies to prepare and deal with the changing environment as we meet its challenges. Best wishes for a happy and successful 1991. ART DIRECTOR Alan j. Kegler WRITERS Peter Askew Lots Baker David Htmmelgreen judson Mead Arthur Page David Snyderman Laune Wolf PHOTOGRAPHERS Mark Dcllas Stmon Tong Robert Walion ILLUSTRATORS Thomas Hutchmson Thomas Rtxmey Dan Zakroc:emskt ADVISORY BOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. Nancy Glieco Dr. James Kanskt Dr. oseph L. Kunz Dr. Charles Paganelh Mr. Michael Arontca Dr. Antoinette Peters Dr. Charles Pruet Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr. Burton Singerman Dr. Stephen Spaulding Dr. Nelson Torre Mr. Edward Wemke Dr. jerome Yates TEACHING HOSPITALS AND LIAISONS Batavia VA Medteal Center Buffalo General Hosrital, Mike Shaw Buffalo VA Medtcal Center, John Pulli Chtldren's Hospital, Karen Dn]a-Swterskt Ene County Medical Center Mercy Hospttal, Chuck Telesco Mtllard Ftllmore Hospttal, Joseph R. Ci{fa Roswell Park Cancer Institute, Judi Rtce Sisters Hospttal, Dennis McCarthy Produced by che Dim ton of UnivmiN Relanons m associati<m with the School of Medicme and Biomedical SCiences, Swte L'niverstty of New Yark at Buffalo. Eduorial office is m 136 Crofts Hall THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST (USPS 551--860) Winter 1991, Volume 25, Number I. Puh!tshed by the School of Medtctne and Bwmedtcal Sciences, State Untverstty of New York at Buffalo, 3435 Main Street, Buffalo, ew York 14214. Thtrd class hulk postage patd at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 CFS Addttton, 3435 Main Street, Buffalo, New York 14214. A ~L+-s: John Naughton, M.D. Vice President far Clinical Aff01rs Dean, School of Medicine and Biomedical ScierlCes Dear Fellow Alumni/Alumnae: I n September, we were happy to present the Second Annual Distinguished Alumnus/a Award to Dr. David Nichols '47. Professor and chairman of the Department of Obstetrics and Gynecology at Brown University, David is a world-recognized authority on female pelvic relaxation disorders and has been a prolific contributor to the literature in hts specialty. It's time to start thinking ahout next year'~ honoree. Please use the enclosed postcard for your nominations. Our programs for students are going well and we were well represented at the orientation sessions for the incoming University residents and for the freshman and )Untor classes. Mark May 4, 1991 on your calendar for Spring Climcal Day and Reunion Weekend. This year's program, "Bridgmg the Gap Between Medicine and Law," will be highlighted by the Stockton Kimball Lecture, given by Sol Wachtler, chief judge of the New York State Court of Appeals. It promises to be an exceptional program. Smcerely, D~ Bertram A. Portin, M.D. '53 �Vol. 25, o. 1 Winter 1991 In Praise of Housecalls Once a staple in medicine, the housecall is alive and well and making a comeback. New hours could hurt continuity of care, page 10. The resurgence of housecalls, page 4. Residents' Hours State~mandated changes haven't caused the havoc educators thought they would. Epidemiological findings need close examination, page 24. Making a Team for Michael The Craniofacial Center, a multi~disciplinary team of health care professionals, improves the quality of life for a six~ year~old boy and a host of other children. Danger in the Locker Room With illegal anabolic steroid use on the upswing, reliable investigation into its health risks is urgently needed. Thomas B. Tomasi, M.D., Ph.D ., receives Stockton Kimball Award, page 27. Do Bad Habits Breed Disease Saxon Graham, Ph.D., lectures at the 1990 Annual Faculty Meeting. Medical School News Alumni Classnotes Illegal anabolic steroid use is rampant, page 22. Craniofacial Center brings a smile , page 14. �- - - ---®:- - - .r E ~ '1- 2 INTERNATIONALLY KNOWN RESEARCHER TO SPEAK AT (HOB LECTURE STUDY LINKS BALDNESS, BLOOD PRESSURE LEVELS study of Italian factory workers has indicated an association between male-pattern baldness and higher cholesterol levels and diastolic blood pressure readings. Maurizio Trevisan, M.D., co-principal investigator and associate professor of social and preventive medicine at UB, cautions that although the study is the first showing an association between baldness pattern and risk factors for coronary heart disease, it doesn't indicate whether there's a link between baldness patterns and the disease itself nor does it reveal the reason for the elevat~ ed readings. Men with male-pattern baldne s had slightly higher levels of serum cholesterol and diastolic blood pressure (the pressure measured in blood vessels as the heart rests between beats) than those with either no hair loss or frontal baldness only. He said the differences reached statistical significance when the average readings for men with male-pattern baldness were compared with those for the men in the e other two groups combined. - By Arthur Page WINTER 1991 rancis S. Collins, M.D., Ph.D., associate professor of Internal Medicine and Human Genetics and associate investigator and chief of the Division of Medical Genetics at the Howard Hughes Medical Institute at the University of Michigan at Ann Arbor, has been chosen as the inaugural speaker for the Rose and Al Pastor Lecture Series. The lecture, scheduled for March 26 at the Hyatt Regency, is sponsored by The Children's Hospital of Buffalo. Internationally recognized, Collins' work in recombinant DNA technology has led to several important advances in the field, including the location and isolation of the genes for cystic fibrosis and neurofibromatosis type 1. The lecture series is an annual event that focuses on public health issues affecting the Western New York community. Collins is slated to speak from 4 p.m. to 6 p.m. A reception will follow. For more information, call the Public Relations Department at Children's Hospital at 878-7543. e space for about 34 physicians and researchers working on approximately $3 million worth of medical research grants. V AMC's medical research program includes a wide spectrum of both clinical and basic studies. Its proximity to the UB medical school has fostered collaborative investigations within a variety of specialties and departments. In addition to providing new research space, the project included the refurbishing and expansion of 25,000 square feet for clinical activities, outpatient care, and administration, plus an additional 10,000 square feet for animal research. SURVIVORS OF (ANCER IN CHILDHOOD (AN HAVE HEALTHY KIDS dult survivors of two forms of childhood cancer - Hodgkin's disease and Acute Lymphocytic Leukemia (ALL) -are capable of conceiving and giving birth to healthy children, according to the results of two recent studies conducted by Daniel M. Green, M.D., professor of pediatrics at UB and director of the Long-Term Follow-up Clinic at Roswell Park Cancer Institute. VAMC DEDICATES NEW RESEARCH (ENTER he Buffalo VA Medical Center last November formally dedicated its new Research Building as part of a $16.5 million expansion and refurbishing program. The new $13.1 million facility, located north of the medical center, provides BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �- - - ---CID:- - - .r t ~ ~ 3 In the study of former Hodgkin's disease patients, some male respondents reported medically-documented decreased sperm counts and some female respondent reported unusual menstrual cycles. But children born to respondents (who averaged 29 years of age) showed no more congenital defects than children born to parents with no history of the disease and none had been diagnosed with childhood cancer at the time of the study. The ALL study, although conducted among former patients who were younger than those in the Hodgkin's ~ study, showed the same results for ~ ~::; childbirth. "Our study suggest that children treated for Hodgkin's disease and ALL lead essentially normal lives after the disease is cured," Green says. The ultimate goal of these and future studies is to follow these patients and their offspring throughout their lives to determine whether there is a genetic risk involved with these types of cancer and whether these former patients develop other malignancies as they grow older. Counseling is an important part of the clinic's work. "Some women who have had these types of cancer as children are afraid to conceive and give birth because they believe they may have a sickly child or a child who will develop cancer," Green says. "We are able to reassure these patients." The studies were conducted with Michael A. Zevon, Ph.D., director of the Department of Psychology at Roswell Park and associate research profes or at UB, and Brenda Hall, R.N., P.N.P./0., Department of Pediatrics. The Hodgkin's disease study was reported in Pediatric Hematology and Oncology and the ALL study in Cancer. e BUFFALO PHYSICIAN AND 1\IOMEDI AL , GooD NEws, BAD NEws: BOTH LIVER AND BEER IMPLICATED IN CANCER IENTIST § matched controls, the researchers identified a "substantial increase in risk" related to the ingestion of vitamin A in the form of retinol from meat and dairy foods like milk and ice cream. On the other hand, the researchers found no risk associated with vitamin A derived from vegetables in the form of carotene. In fact, the study showed risk of esophageal cancer was lower for persons whose diets regularly included lettuce, other greens and tomatoes. e - By Arthur Page STATISTICS DEPARTMENT JOINS MEDICAL SCHOOL 1£ f you resented your mother's admonitions to "eat your liver," you'll find solace in a recent study out of the UB Department of Social and Preventive Medicine. Organ meats, like liver, head the list of foods that appear to increase the risk of cancer of the esophagus, according to the team headed by Saxon Graham, Ph.D., professor and department chair. On what others might consider the down side, beer (which also scored high in an earlier UB study of dietary factors increasing the risk of rectal cancer) also ranks right up there in terms of riskincreasing food fare. The study, reported in the American Journal of Epidemiology, also uncovered what appears to be the Jekyll-and-Hyde personality of vitamin A, which not long ago was being hailed by some scientists as a factor that would reduce cancer risk. As the result of an in-depth comparison of the diets of individuals with esophageal cancer and carefully he University's Statistics Department has joined the medical school, ending uncertainty about its fate. Now located at 2211 Main t., the Statistics Department is adjacent to the Department of Social and Preventive Medicine. This proximity is expected to enhance research and scholarship, school officials say, since the two departments have complementary interests. John Naughton, M.D., dean of the medical school and UB vice president of clinical affairs, says that the school will soon seek new department chairmen for both Statistics and ocial and Preventive Medicine. He calls this an opportunity to recruit chairs who can bring their departments clo er together. Associate Provost Kenneth Levy is currently acting chairman of Statistics. Saxon Graham, chairman of Social and Preventive Medicine, plans to retire. Levy said that no changes in Statistics Department courses or programs are anticipated in the near future but that a faculty position will be added. e WINTER 1991 ��s The physician housecall is alive and well in Western New York. After years of de . . cline, the popularity of the home visit may be on the upswing again, though it isn't the same as the housecall of the horse and buggy days. Instead of traveling miles to check out a bellyache, physicians now see mainly the chronically ill, newborns, and the frail elderly. "It's really a time..-saver to see homebound elderly folks right in their homes," said David Holden, M.D., professor and chairman of UB's De... partment of Family Medicine. "Frankly, it takes longer for them to get maneuvered out of their beds into wheelchairs, then into ambulances, out of the ambulances, back into the chairs, into the offices, and up onto examining tables - then repeating all these steps - than doing the home visit. "With newborns, I find it's nice to do the first visit in the home, where I can get a good look at the preparations the parents have made, and a better view of the baby's home environment. It's obviously a convenience for the family not to have to bring the baby out of the home when it's two to four weeks old." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST The physician housecall "still has a very important WINTER 1991 �6 role in health care," agreed David A. Silverstein, M.D., assistant professor and director of undergraduate education in Family Medicine. "It's extraordinarily useful to see a patient's surroundings." For example, if an elderly patient falls frequently, a doctor on a housecall could observe that rooms are cluttered with potential booby traps to trip the forgetful resident. A medicine cabinet may reveal medications the patient doesn't bring to the office, but which may be contraindicated. "You're better able to make an informed decision as to whether a patient - despite what he or she tells you in the office - is comfortable and able to make it at home," concurred Daniel Lasser, M.D., M.P.H., clinical director of family medicine at the Erie County Medical Center and director of the Urban Family Medicine Program. Seeing one patient is useful, and visiting couples yields some extra benefits, noted Holden, who with his wife, Carol, a nurse practitioner, often visits couples in their 80s and 90s. "I gain as much information about how one (spouse) is doing by asking the one not being examined," Holden said. "You can really learn what type of support system surrounds the patient by seeing the home and talking to the people living with your patient, whether it's a spouse, another relative, or a friend. "For example, if you ask an elderly female if she's eating, the answer is almost always 'yes'. If you ask her daughter who's actually watching her eat, you may get a different, and more accurate, answer. Such added insight isn't often available in an office visit where a doctor's questions are directed only at the patient." Holden believes that housecall are becoming more common again now that doctors don't have to worry about whether they can fit all of their equipment into a little black bag - everything a doctor needs is a phone call away. During the last 10 years, the full range of services of practically all labs is availab le for dispatch to a patient's home on a physician's phone order. The services often are performed faster at WINTER 1991 Eugene A. Steinberg, M.D., feels house<aDs help redU<e the fear and isolation of many terminally mpatients. "You can really learn what type of support sy stern surrounds the patient by seeing the home and talking to the people living with . " your patrent. home than in a hospital. The physician also can arrange for physical therapy, occupational therapy, and intravenous therapy in the home. Lab work and therapy visits are covered by major in urance carriers, Medicare, and Medicaid. Home visits help make many people comfortable, and reduce the fear and isolation which many chronic or terminally ill patients face, said Eugene A. Steinberg, M.D., clinical assistant professor of medicine and family medicine and a member of UB's Division of Geriatrics and Gerontology. "We talk to people, listen to people, and deal with the fears that block the learning in the hospital," said Steinberg, who is also medical director of the Buffalo VA Medical Center's Hospital Based Home Care Program. The program at the VA is special because patients are seen in their homes not just by a doctor, but by a team that includes nurses, social workers, a dietitian and a physical therapist, Steinberg noted. Many of the patients the team sees have chronic illness and are stable, such as those who have suffered a stroke or multiple sclerosis. There's also a growing group of patients who are discharged from hospitals sicker and unstable and who are continually readmitted. The team finds that early intervention, such as making small changes in medication, often makes a big difference and can even keep the patient out of the hospital. This not only helps the patient, but saves the hospital money. The team works closely with the oncology unit at the VA Medical Center, providing compassionate posttreatment care for terminal patients, in areas such as pain control, psychological issues, and generally aiming to improve the quality of life. "It's a very different focus from acute care," Steinberg noted. Another group of patients seen by the VA team is those with multiple medical problems. BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �Assistant professor and director of faculty development and continuing education in the Department of Family Medicine, Roseanne C. Berger, M.D., prepares students 0 to determine exactly what they can learn from a housecall." "The housecall by the full team is extremely valuable in untangling confusing symptoms," Steinberg explained, "and in addition provides an excellent opportunity for effective one-to-one education with patients on their turf on how to watch their bodies." If housecalls seem like a well kept secret, it's because physicians haven't promoted or advertised that they make housecalls, said Robert A. Baumler, M.D., an internist, cardiologist, and clinical assistant professor of medicine at UB. That's because many people mistakenly think they can routinely call a physician to their house for whatever's wrong with them. Doctors can't make housecalls for everything because the travel time would consume their day. Another drawback to housecalls is that they may keep patients from getting much-needed activity - there is therapeutic value in getting dressed up for an office visit and getting out for some fresh air, some doctors assert. BU FFALO PHYSICIAN AN D BIOMEDICAL SCIENTIST Critics also argue that medical insurers, including Medicare, don't adequately acknowledge the value of housecalls. Reimbursement rates don't come close to covering costs. Marshall Clinton, M.D., emeritus clinical professor of internal medicine at UB, recalls he "used to make a lot of housecalls, and was trained to do so. You could do a lot for people at home that you couldn't do any other place." Although he still makes calls on selected longtime patients, Clinton says he's one of the physicians who is fed up PRESCRIBING HOUSECALLS House calls are best used when: e It's helpful to assess the home situation, especially for the elderly and newborns. e A patient's condition would be adversely affected by being transported to the office. e A terminal illness affects a longtime patient who may not require hospitalization, but may need a medication change or other support. e Transporting the patient for an office visit would be a hardship or impos- sibility for family members or friends. e It's more convenient for the physician. If a parent calls at 5 p.m. about a fairly well-defined condition in a child that's not likely to require extensive lab work, such as an earache, the doctor may find it easier to pay a house call than wait for the family to get to the office. -Thomas C . Rosenthal, M .D., clin- ical associate professor and director of residency education in family medicine at UB WINTER 1991 �8 Early intervention, often possible only through home visits, tan signifitantly improve outtomes. with government regulations and inadequate reimbursements. "I rather expect I'll be retired within a year," Clinton confided. Despite the drawbacks, the Family Medicine Department remains convinced that there is a place for the housecall. According to a survey by Roseanne C. Berger, M.D., 16 of 26 full-time faculty members in the department visited patients' homes during the past year. Starting this year, all new family medicine interns are receiving an orientation lecture on housecalls by Berger, who is assistant professor and director of faculty development and continuing medical education in the Department of Family Medicine. "We need to prepare (future) physicians to determine exactly what they can learn from a hou ecall," she said. WINTER 1991 "It's important to get students in their formative years to become familiar with what can be done for people in the home . " Some students in family medicine already accompany faculty members on housecalls, and Berger would like to see that opportunity extended to all medical students. "It's important to get students in their formative years to become familiar with what can be done for people in the home," she said. There are many resources available to provide care for people at home, such as visiting nurses or X-ray services, but "I don't think students appreciate it unless they see that in action," she said. Berger notes that doctors are trained in a very high- tech world, and may appreciate being exposed to the low-tech surroundings of a patient's home. Janet V. Johnson, a fourth-year medical student, said she "found it refreshing and mildly surprising to learn that BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �physicians - not just visiting nurses alone- actually make housecalls." She says she not only finds housecalls interesting and helpful, but after making just one call was firmly convinced they'll be an integral part of her own practice. "On my first visit," Johnson recalls, "we were going to see a 51-year-old bedridden man who was cared for by his 78-year-old aunt. When I saw her age in the written report, I was naturally concerned about her ability to function effectively at her age. "But when I saw the aunt at work in the home, my mind was immediately placed at ease because she seemed much younger than 78- and fully capable of handling things. Instead of her age being a concern, the visit put fears to rest." Johnson's evaluation of the home visit summarizes that of many practicing physicians: "I enjoy it, and you can learn a lot from it." e TIME-HONORED PRACTICE DESERVES TO MAKE A COMEBACK orman Chassin, M.D., '45, muchhonored senior statesman of the Western New York medical community, considers housecalls so valuable that when poor health robbed him of the vigor to continue them, he ceased practicing medicine altogether. "I never lost anything from going into a home, and I a lways gained immensely," Chassin said. "There is no questioning the rewards in terms of new information about the patient's lifestyle. This information is the cement that fills in the cracks of one's understanding of a patient." "The whole physician-patient relationship is fundamentally enhanced," he continued. "The physician has answered the patient's call totally, bodily. That is not the same as answering the phone or being in the office. The whole transfer phenomenon, the psychological aspect of the relationship, is benefited." Chassin is respected by patients and physicians alike. When he retired, his patients established the Norman BU FFALO PHYSICIAN A D BIOMEDICAL SCIENTIST "There is no question the housecall is a plus. The primary concern of the physician is problem--solving for the patient, and there is much that can be learned from the patient's setting. We are sometimes surprised with entirely new information that affects management of the patient's problem." Chassin Endowment Fund at the Erie County Medical Center, where Chassin spent more than 20 years as attending physician. The fund provides an annual stipend to the outstanding intern in internal medicine at the center. He holds the Kenmore Mercy Hospital Foundation's highest award for service to his patients and the community. James Nolan, M.D., director of medicine at ECMC and chairman of the Department of Medicine at UB, considers Chassin one of the leading clinicians in internal medicine in the Western New York area. Chassin was instrumental in forming the Committee on Human Values and Medical Ethics at UB, and with organizing the first meeting of clinical chiefs of medicine from area hospitals. Hundreds of medical students have benefited from Chassin's knowledge, which is imbued with extraordinary compass ion and concern for the patient's emotional, as well as physical, well being - an outgrowth of Chassin's long interest in psychiatry. He was headed for a career in the field when he switched at the last moment to internal medicine. Chassin believes that medical treatment should be personal, that ideally physicians should form long-term relationships with their patients, garnering as much information as possible about their lives. Rooted in this belief is his respect for the value of housecalls. "There is no question the housecall is a plus," Chassin said. "The primary concern of the physician is problemsolving for the patient, and there is much that can be learned from the patient's setting. We are sometimes surprised with ent irely new information that affects management of the patient's problem. "Physicians must be aware of the social factors- the patient's immediate family, as well as cultural, ethical, legal and economic constraints. Rarely can one attend a patient in just the physical sense." Making housecalls meshes w ith another Chass in opinion of h ow medicine should be practiced - slowly and patiently. "Nowadays new students and physic ians feel they n eed to do something quickly," he said. "I teach that certain diseases and illnesses take a basic natural course, and that time is an important element. Sometimes it is better not to jump in with aggressive therapy, but to wait for the appropriate moment. "And for many patients, home is a better, even safer, place to heal than the hospital," he said. "Considering all the risks of being in a hospital today - technology gone wild, infection running rampant - home can be better for certain given conditions. "Obvious benefits aside, if housecalls are returning to favor now," Chassin said, "the impetus is probably economic." "The government and other payors have realized that in certain instances, the home call will benefit the payor more than some sort of call in the doctor's office," he said. "If you make the econom ic rewards high enough, the housecall will return." e - By Lois Baker WINTER 1991 9 �10 n 1989, New York became the first state government to step in and tell medical hools and teaching hospitals how to run their residency programs. intervention- intrusion to some- came in the areas of work hours, supervision, and credentialing. (See box for details.) After living with the regulations for a year, the reaction ofUB faculty and residents is still mixed, depending in great part on specialty. But many concede that the regulations aren't as bad as they had feared. SURGEONS ARE STILL UPSET "What you see now is more attending staff working with more junior residents," Hassett said. "In the past, a third-year Surgery was- and is still- the medical service that is least comfortable with the regulations. resident might have helped a first-year resident, but now the When the regulations first-year resident is likely to be getting instruction from a 40were proposed, Lewis Flint, or 50-year-old attending physiM.D., who was chairman of cian who has far more experisurgery at UB, said that they ence. We might get an educawould damage surgical educational windfall out of that." tion so much that it would be But he is troubled by the better to close the program than overall effect of the regulation comply. Flint delivered himself on surgeons' education. from their restrictions by ac"There is a practical fivecepting a position at Tulane year limit on post-graduate University in New Orleans. education in surgery because "My sense is that most of coulf/ ~UtH! &~n U LOP.)P. you can't get anyone to pay for our residents are not happy with more," he said. "And if you cut them," says James Hassett Jr., ~a/~ 'o/,,& /io/bJ an> .;h~~ the amount of time available to M.D., associate professor and residents in those years, you cut chairman of the Task Force on clinical exposure." Graduate Medical Education According to Hassett, the in the Department of Surgery. BY JUDSON MEAD bottom line is how indepen"They don't like anything dently the resident can act when forced down their throats. They he or she is finished with the just want to operate and anyresidency. Hassett worries that some of a resident's education thing that restricts their chance to do that is perceived as a negative." may be shifted from residency to practice. "The essence of surgical education is repetition," Hassett Some residents simply ignore the rules, Hassett said. If said. "The important thing is how many complex procedures they aren't finished with their work, they stay beyond the time allowed, even though the new regulations have built in extra has a resident been exposed to and how many times a resident time for surgical residents. has repeated simple procedures." Surgical residents are allowed to be on call past the normal hours limit if they are "generally resting" with "infrequent" OTHER DEPARTMENTS ARE CONCERNED interruptions for patient care. The exceptions apply only if The view is generally more positive outside of surgery, but residents are on call no more than two time a week and have people's concerns haven't vanished. a 16-hour rest period after they go off duty. In the Department of Medicine, the move to an SO-hour In its attempt to comply with the new regulations, UB's week for residents was coming one way or another - its surgery program has created a patchwork of different rules in national accrediting body implemented the change nationdifferent hospitals, such as instituting a regimen of night wide shortly after the New York regulations were put in place. coverage. The side effect is that there are fewer residents on 'The house staff likes the changes," says Alan Saltzman, duty during the day, spreading them thinner. M.D., clinical associate professor of medicine at UB and Even if the hours requirement has surgeons steaming, clinical director of the Department of Medicine at the Erie some of the supervision requirements are viewed as positive. County Medical Center. "They've clearly been 'decompressed."' :7/ WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �In addition to giving residents a more humane schedule, the changes have "put more emphasis on the role of the attending physician, which is a benefit." But there are still worries about the effects on education and patient care. Gerald Logue, M.D., chief of staff at the Buffalo VA Medical Center, calls the regulations "a detriment to education." The problem Logue sees is with continuity: continuity of patient care and continuity of resident education. If a patient comes in at night, the night float (a resident who covers two or three different specialty services) does the workup, a different team sees the patient the next day, and yet another team sees the patient the next night. Because residents must take a whole day off every week, they often have to drop out of a patient's care, which decreases its educational value. "It's hard for residents to follow a case," Logue says, "and hopefully patient care doesn't suffer." Even if patient care hasn't suffered, there is no evidence that it has improved now that hours are reduced, notes Saltzman. Yet the state based its regulation of hours on the assumption that long hours were detrimental to patient care. A Minnesota study published in the November/December 1990 edition of the ]ournal of General Intemal Medicine showed that the outcomes for patients who were cared for by the admitting resident were the same as the outcomes for patients who were admitted by a night float and cared for by a different team of residents, Saltzman noted . However, disrupting continuity of care can be expensive, he added. The study found that patients who weren't treated by the admitting resident stayed in the hospital longer and received more lab tests. "It's hard to say whether we've gained as much as we've lost," Logue said. "We don't have people walking around who haven't slept for 36 or 48 hours. But the law encourages a shiftwork approach to medicine that is incompatible with what residents will encounter in practice in the real world." would be. "The mood is settling out," Naughton said. "The initial mood was that this would be disastrous for training, but this has not been borne out. "As far as education is concerned, I think the effects have not been adverse. In fact, what's happened has probably been positive." Whether the regulations are driving the best young doctors from choosing New York State residencies, as some had feared would happen, is difficult to tell, Naughton noted, because other factors also affect residents' choices. Downstate, for instance, the biggest problem in recruiting residents is the large number of AIDS cases. "My feeling is that recruiting for Buffalo has gone fairly well this year," Naughton said. INFLEXIBILITY IS A DRAWBACK In Obstetrics and Gynecology Myroslaw Hreshchyshyn, M.D., professor and chairman of the department, says that, on balance, the regulations have benefited resident training and patient care. However, there are drawbacks. "The negatives are cost, loss of flexibility in handling things as we (the departments) think best, and the creation of expectations that are not always reasonable," he said. Hreshchyshyn thinks the residents in his department are generally pleased with the regulations, but adds that he senses that they are coming to regard the limitation on hours as an entitlement. "The law takes away flexibility in terms of assignment and continuity of care," Hreshchyshyn said. "In this respect it is no different than any other work rule specifying when you can take a coffee break and so on." MOOD IS SETILING OUT Well before last year, Obstetrics and Gynecology was moving toward voluntarily providing supervision by faculty members at the level now mandated. When the regulations were implemented, Hreshchyshyn warned that the cost of requiring, rather than encouraging, the increased supervision would be a problem. His view is the same now. Summing up the situation, John Naughton, dean of the medical school and vice president for clinical affairs at UB, says most people think the regulations aren't as bad as they thought they "This is a costly proposition for the hospitals," he says. "With time it will become routine. The net result is that we have added a very costly component to hospital services." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST WINTER 1991 11 �12 SUPERVISION, NOT HOURS, IS THE KEY Supervision, not the hours requirement, is the key part of the change, according to George Ennis, senior hospital administration consultant at the New York State Department of Health. "The hours-business got distorted out of proportion at the expense of the supervision issue," he said. Most hospitals in the state are working assiduously to comply with the regulations, Ennis said, and most residency programs have provided the funds needed for supervision. The department has received some complaints about non-compliance and has cited some programs. It is the consensus in Buffalo that local hospitals have had an easier time complying with the regulations than downstate hospitals. "Teaching hospitals in Buffalo have always had rather rigid standards," said Luther Musselman, M.D., director of medical education at Millard Fillmore Hospital and clinical associate professor of medicine. He thinks the changes have worked for the better elsewhere, especially with respect to tightening supervision downstate. HURRAH FOR CREDENTIALING Of the three components of the law, the one concerning credentialing has generated the most enthusiasm locally, even though it has also generated more paperwork. "The credentialing has been positive because it forces us to scrutinize more closely what residents can and can't do and how good they are," said Hreshchyshyn ofOB/GYN, adding that his department is now doing a better job of monitoring both residents and their supervisors. The department absorbs the extra cost this entails. In the Department of Family Medicine, which was already in compliance with the hours regulations, the credentialing requirements have caused the department to formalize what it was doing by keeping better records, noted Thomas Rosenthal, M.D., director of the family medicine residency at UB and clinical associate professor. The internal medicine program at Millard Fillmore Hospital developed an extensive credentialing protocol in 1988 before the new regulations appeared. It specified the criteria for gaining privileges for each procedure a resident encounters during training. WINTER 1991 The internal medicine protocol was then used by UB as a model for the rest of its departments in the Western New York Consortium for Graduate Medical/Dental Education, which coordinates all of UB's residencies at the various hospitals. Credentialing decisions are made by the director of each program. Among all of the training programs in Buffalo, there are 275 procedures which require credentials (for example, inserting an IV line). Keeping track of the credentials of the 615 residents has been streamlined by centralizing the information on computer. All consortium hospitals have access to that computer information. "What this has led to is the possibility of much more information exchange between members of the consortium," says Saltzman of ECMC. "But whether we're teaching better or just creating a better paper trail is a question." Musselman of Millard Fillmore says that the formalization is a good idea because credentialing in the past was more impressionistic. Now computerized data on procedures completed is forwarded to the chairman so he or she has better information on which to base a decision. COST IS A HURDLE While New York is still the only state to directly regulate residency training, others are watching. "The issue has to do with the whole structure of postgraduate medical education," said Ennis of the Department of Health. "The American College of Physicians, the American College of Surgeons, other states, and the federal government are all looking hard at what New York is doing." Indeed, the 80-hour limit on residents' work hours is either under legislative consideration or discussion in several states, including California, Pennsylvania, Illinois, Minnesota, Connecticut, and New Jersey. And in] une 1989, the AM A's House of Delegates passed a resolution by its Resident Physician Section endorsing the SO-hour limit. The biggest hurdle for the states is cost. About two-thirds of the expense the regulations impose on hospitals has been covered by increased reimbursements, either from the state or, in the case of the VA hospitals, the federal government. At the Erie County Medical Center, Assistant Adminis- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �trator Thomas J. Faith says that at the moment money is not his chief concern. "The money is there to hire ancillary staff, but the problem is finding them," he said. Marcia Brierly, administrative director in the Department of Medical Education at Millard Fillmore, believes that the financial impact will show more clearly in the future. "It's dangerous that the hospital is absorbing so much of the cost of the regulations," she said. RESIDENTS' MORALE IS HIGH But Brierly has also observed a positive change on a human level. "The biggest impact of the regulations on residents is in their morale," she says. "I hear the same thing from people around the state: we didn't see the mid-winter depression we're accustomed to in residents." Lisa Benson, M.D., a thirdyear resident in internal medicine, credits the hours limit with some improvement in the quality of her life. "There's been a real difference - for the better," she said. "There may be a slight deficit in continuity of care, but I don't think it's been significant, and I don't think the change has had an adverse impact on education, either." While surgery residents complain that the regulations make their hours too short, some residents think it's still not short enough. Timothy Gundlach, M.D., who started his residency in surgery, moved to anesthesiology this year, a department that was already in compliance with the regulations before they took effect. There's a camaraderie among surgery residents that tends to minimize complaints about the long hours, he said, but that wasn't enough for him. With only 50 or 60 hours a week spent outside the hospital, there wasn't enough time left for reading or even to conduct a personal life. Gundlach noted that there's a general feeling that if more support staff, such as IV teams, could be hired, it would take the pressure off surgery residents. People are leaving because there's too much work. NashatRabadi, M.D., chief resident in medicine at ECMC, says of going home to bed after being on call: "That was a real pleasure." e BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 13 HOURS Residents may be scheduled for no more than 80 hours a week, when averaged over four weeks. They may be scheduled forno more than 24 hours in a row. On-duty assignments must be separated by at least eight hours of non-working time. Residents must get 24 consecutive hours off each week. Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. In certain departments that don't have a high volume of acutely ill patients and where the resident is able to get enough rest, there is more flexibility in scheduling. (Excluded from this clause are anesthesiology, family practice, medical, surgical, obstetrical, orpediatricservices.) Surgery residents can be on call past the hours limit if they are "generally resting" with "infrequent" interruptions for patient care. The exceptions apply only if residents are on call no more than two times a week and have a 16-hour rest period after they go off duty. ON-SITE SUPERVISION A sufficient number of supervising physicians must be present in the hospital 24 hours a day in the acute care specialties of anesthesiology, family practice, medicine, obstetrics, pediatrics, psychiatry, and surgery. Supervising physicians must be board certified or board admissible, or have completed a minimum of four years of postgraduate training. The supervising physician may be a resident in his final year of post-graduate training if the patient's physician can get to the hospital within 20 to 30 minutes of being called. CREDENTIALING The medical staff must provide written documentation of patient-care privileges granted to residents. e WINTER 1991 �14 B y D v A M H D M E L G R E E N ts beginnings were casual meetings in the halls and conversations in the OR lounge at Children's Hospital about five years ago. Sometimes the discussions were prompted by a special patient who had a disfigured face along with problems hearing, speaking, and eating. Other times, the physicians would talk about patients who had more common disorders involving the head and face, such as cleft lip and palate. The doctors were concerned because these patients were being shuttled from specialist to specialist almost unendingly and some of the older children were out of school for surgery more than they were in school. p H WINTER 1991 0 T 0 s B y s M 0 N T 0 N G BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��16 The disconnected conversations finally found a direction with the development of the Craniofacial Center of Western New York. The center, begun in 1988, maintains a unique interdisciplinary team approach to diagnosing and treating patients who have disfiguring and disabling conditions of the head and face . It is based at Children's Hospital and has ties throughout the University and community, according to Joseph Bernat, D.D.S., M.S., who heads the center's board of directors and is chairman of pediatric dentistry at the UB School of Dental Medicine. One of the patients who influenced Bernat and colleagues to start the center is six-year-old Michael Manthey, who has presented one of the center's most challenging cases. Many of the doctors now associated with the center have been treating him since his birth, and continued treating him when the center was organized. Michael was born with a rare genetic disorder known as Nager's syndrome. This disorder is characterized by severe underdevelopment of the lower face, hearing loss, and limb abnormalities, according to Robert Perry, M.D., clinical assistant professor of surgery (plastic), otolaryngology, and oral/maxillofacial surgery at the UB medical school and member of the Craniofacial Center's board of directors. Michael had almost no chin; his lower jaw was deformed and retrusive. His tongue is small, he has hearing problems, and he is missing fingers on each hand. His treatments aimed first to help him breathe and take nourishment. The later therapy helped him to communicate and to chew, as well as improve his appearance. When Michael was born he had to receive a tracheostomy to open an airway, as well as a gastrostomy so he could be fed using a tube that entered his stomach through the abdominal wall. He only needed the gastrostomy as an infant to ensure that he got adequate nutrition, but he may always need the tracheostomy. Since his birth, Michael has undergone multiple surgeries on his hands, and has WINTER 1991 been evaluated for laryngeal problems. "Last year we began to organize a treatment plan for reconstructing Michael's lower face," said Perry. Because Nager's syndrome is so rare, the team consulted specialists from craniofacial centers in New York, Toronto, and Dallas, he added. The first course of action was surgery to examine Michael's airway and expand his chin and neck tissue to make room for his new jaw. The next step was to begin expanding the jaw bone, Perry stated. The team used a technique known as the llizarov procedure, which was developed in the 1950s in the Soviet Union to stimulate bone growth. Until recently, this procedure was primarily used to lengthen limb bones. It uses an externally fitted apparatus that is placed over the area where bone growth is required. In 1987, two UB physicians, Monroe Strong, M.D. and Robert Gillespie, M.D., were the first in North America to use the MonticelliSpinelli External Fixation System to promote bone growth in a patient who had a badly infected broken leg. Michael wore a modified version of that device that was fitted over his head and face, said Bernat. It looks like a halo and is securely anchored to his skull. Surgeons cut through both sides of the lower jaw bone, creating fracture sites. The apparatus holds the fracture sites open. As in a broken bone, new bone grows BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �between the fracture sites. As new bone is laid down, the apparatus is adjusted daily to open the space slightly between the fractures, stimulating more bone growth. The result is that now Michael has a more fully developed lower jaw and chin. The next step will be to reconstruct his jaw joints in order to get his jaw to open wider. When the joints are reconstructed, he will be able to chew better. Michael also received help for his other related problems. He wears a hearing aid and communicates through a combination of speech, sign language, and a computerized speech board, noted Sanford Nusbaum, D.D.S., clinical associate professor of oral and maxillofacial surgery at UB's dental school and a board member at the Craniofacial Center. "He pushes a button and it says 'Hello Dr. Nusbaum,"' Nusbaum reported. In spite of his disabilities, Michael is attending regular first grade and doing quite well emotionally. Michael's family is a pillar of support and very much involved with the success of his treatment, the staff noted. Michael's case is one of the few times mandibular (jaw) bone elongation has been done on patients in the U.S., Perry said, noting that the success of Michael's treatment reflects just how important it is for specialists to combine their expertise and resources. This is what sets the Buffalo center apart from the others. "Most centers revolve around a single surgeon who does the majority of the work," Perry explained. Bernat said that this individual becomes "the dominant force, and then the team takes on the personality and flavor and the bent of that individual profession." "We wanted to get away from that model so that everybody's contributions are considered and nobody feels as if they're left out," Perry said. "You can see that in our conferences. Everybody's opinion is respected." "No one part of the team is more important than any other part of the team," Bernat added. "So, the psychologist is just as important as the surgeon." One of the most common congenital disorders treated at the center is cleft lip and palate (CLP). BUFFA LO PHYSIC IAN AN D BIOMEDICA L SCIENTIST Michael'S case is one of the few times mandibular bone elongation has been done on patients in the United States. The success of his treatment reflects just how important it is for specialists to combine their expertise and resources, and it is what sets the Buffalo center apart from the others. CLP, which arises during the embryological development of the fetus, results in the incomplete closure of the palate and an abnormal cleft between the upper lip and the nose. CLP occurs in about one in every 700 live births. The relatively high incidence of this birth defect accounts for about 61 new cases every year in Western New York. Some children with CLP also present other associated problems which could be overlooked and come back to haunt these children later, noted Linda Brodsky, M.D., who is associate professor of otolaryngology and pediatrics at the UB School of Medicine and Biomedical Sciences and is on the board of directors of the Craniofacial Center. For instance, some children born with CLP also suffer varying degrees of hearing loss which may affect their speech development. Many physicians and dentists may not be familiar with the subtleties of these syndromes, Brodsky commented, and they don't know about new treatments and procedures. The center serves as a repository for tried and tested treatments as well as for new technology and the sharing of seminal ideas. And in no better forum can the sharing of ideas and opinions be heard than during the monthly patient conferences, which are held at Children's and open to all individuals interested in craniofacial disorders, said Bernat. At each conference, a lecture on a specific topic is presented to the audi- ence. Then one or more cases are reviewed with the actual patients present. Any of the specialists can examine the patients and review their histories and charts. After the patients leave, the specialists begin their debate about the best plan for treatment. The goal is to get a variety of opinions from all the specialists. "We talk it out - sometimes fight it out," Brodsky said. In the end, everybody must be satisfied with the treatment plan, she explained. It's not enough for an oral surgeon to get up and say "I want to do a bone graft now." Not only does he have to convince other oral surgeons in the group that this is the right thing to do, he must convince the other specialists as well. Most children born with craniofacial disorders are seen by team members immediately- right in the delivery room at Children's Hospital. (Those born at other hospitals may be transferred to Children's if the condition is severe.) In the delivery room, the breathing of newborns with craniofacial disorders is checked. If there's a problem, an otolaryngologi t is called in and may perform a tracheotomy to open an airway in the neck. A few days later, once the physicians are sure the infant is breathing and feeding properly, Luther Robinson, M.D., examines the infant for possible genetic disorders. Robinson, director of Clinical Genetics and Dysmorphology WINTER 1991 17 �18 llizarov's Procedure, developed in the Soviet Union in the 19SOs to stimulate bone growth, was used to lengthen Michael's jaw through the use of an externally fitted device. in the Division of Human Genetics at Children's and assistant professor of pediatrics at UB, is also on the board of directors at the Craniofacial Center. Once this diagnosis is made, the team will have a better idea of how the disorder will behave and progress. From there the doctors are able to make a prognosis. Craniofacial patients generally require years of treatment. For example, patients with CLP may require between four and six surgeries to repair the lip and palate, and may also have to have their dental arches expanded through bone grafts. Treatment will last through their teen years, said Nusbaum, the maxillofacial surgeon. Many of these procedures are timed according to the eruption pattern of the permanent teeth, he added, and this stretches out the treatment period. ln addition, these children "have to be monitored for speech and often they need the help of a speech and language pathologist," commented Nusbaum. Because people are concerned about their looks, a person who has never looked right or sounded right or chewed right may need counseling, as may their families. Success for a patient may be measured in small victories, resulting in a great deal of stress. Older children and even adults are treated at the center, Nusbaum said, adding that the younger patients tend to respond somewhat better to treatment because they're still growing and WINTER 1991 I don't have to relearn speech habits. The coordination of the center's activities requires a monumental effort on the part of support staff. Two of the people who are responsible for keeping the center running smoothly are Deborah Green and Janice Rockwood, R.N. Green, who handles secretarial duties, is helping to set up a fee structure that should save patients money. Patients will be charged a flat fee for evaluations by the team, rather than being billed by individual specialists. The treatments themselves generally are covered by insurance, and patients with congenital deformities often are BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST \ �eligible for state assistance. Rockwood, a nurse at C hildren 's fo r 15 years who h as worked in just about every department, began working at the center last year. "I am a patient advocate," sh e sa id. "Th a t 's m y m a in jo b . I h ave th e responsibility of sch eduling pa tie nts for their appo intments and surge ries, t h e ir preo p e ra tiv e proc edures, a nd patient education ." Rockwood also gives invaluable advice on things such as referrals and payment, and acts on behalf of the patients when they see doctors who are not part of the center. Finally, Rockwood se rves as a sounding board for patients to air their frustrations, fears, and hopes. Because of their enthusiasm fo r the interdisciplinary approach , the team is lobbying lawmakers in Albany to find resources so that other craniofacial cen ters can be started up through out th e state, Perry said. In creating a state-wide network of centers, patient care will be enhanced, the number of surgeries reduced , and costs will come down, Brodsky added . The center has already taken on an international flavor. During June 1989, members of the craniofacial team spent two weeks in the Dominican Republic on an informational exchange miss ion . They spent time diagnosing patients and even operating on nine children . S ix footlockers of supplies and equip- ment , which were don ated by S isters H os pital a nd C hildre n 's H ospita l of Buffalo , we re delivered to C hildren's Hosp ital in the Dominican Republic, Perry said . 19 The team also tra ined some of the loca l phys ic ia ns on n ew techniqu es. Th e t ea m will b e returning t o th e Dominican Republic in N ovember to strengthen ties and share more of their information, he added. Future success of the C ra niofacial Center depends upon continued integration of the various fields of expertise. The team encourages those interested in treatment, education, or research of craniofacial disorders to get in to uch with the center at (716) 878-7149. e Craniofacial Center's Aim: lmproYing uality of Life W hen people usually think about a craniofacial treatment center, they think about corrective surgeries that change the way a person looks, noted Linda Brodsky, M.D., who is associate professor of otolaryngology and pediatrics at the UB School of Medicine and Biomedical Sciences and is on the board of directors of the Craniofacial Center. Here, the concern is not just with correcting deformities, but more importantly, making sure that the patient functions reasonably well, stated Brodsky, who is also a co-head of the Department of Otolaryngology at Children's Hospital. The aim is to improve the overall quality of life. "The center is multidisciplinary in that there are many disciplines involved, but it's also interdisciplinary in that all of the disciplines are intertwined," said Joseph Bernat, D.D.S., M.S., who heads the center's board of directors and is chairman of pediatric dentistry at the UB School of Dental Medicine . "We work very closely with one another, and that's something that we stressed from the very beginning." BUFFA LO PHYSICIAN AN D BIOMEDICAL SCIENTI ST More than 20 health care specialties ore represented in the Craniofacial (enter. In all, more than 20 health care specialties are represented in the Craniofacial Center, including genetics; pediatric dentistry; speech pathology; audiology; psychology, and plastic, oral and maxillofacial surgery. The center currently treats over 200 patients, most with congenital deformities. Treatment generally starts at birth and lasts through the teens, though some adults are also treated. The center also focuses on education for the team members and residents, and it's beginning an aggres- sive research program as well, added Robert Perry, M.D., clinical assistant professor of surgery (plastic), otolaryngology, and oral/maxillofacial surgery at the UB medical school and member of the Craniofacial Center's board of directors. The research program includes a new investigative project on the efficacy of various procedures to lengthen the jaw bone. Initially, researchers will use animal models to test these procedures. Eventually they hope to apply their findings to e humans. �:···················· • • ••••••... . .....•••••••••.•••.......•• • •............•••••...............•.•••••••••••••••.........•.••••••••••••.•........••••••••.•.........•• ! .. 20 .: E R H E I1D A N D N_ T - ;:· .:. --:--:.. : - .- - - .:. - ~- ::. --- ,_ - -~ - -' ( L 0 K ' - w - v. ~<._~- E R ILLUSTRATIONS: THOMAS HUTCHINSON R 0 0 M ........................................................................ ....................................... ..................................................................... I \ �S DE ~ B y LAURIE 0 WOLF 21 <:) """ n 18~year~old body builder takes several types of black market steroids and gains 130 pounds of lean muscle over the next three years. He also experiences fits of depression, violence and I \ delusions of grandeur. Convinced of his omnipotence, he drives his car into a wall at 30 mph, after enlisting a friend to videotape the crash. BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST WINTER 1991 �22 ................................................................................... These are just two examples of the increasing misuse of anabolic steroids and human growth hormone that have come to the attention of researchers W. J. Kraemer, Ph.D., director of research at Pennsylvania State University'sCenterfor Sports Medicine, and Karl Friedl, Ph.D., a research physiologist with the U.S. Army Institute of Environmental Medicine. Presenting a paper on the topic at last August's Congress of the International Society ofPsychoneuroendocrinology, which was co-sponsored by UB, the pair said that reliable investigation into the health risks of steroid use is urgently needed. Mere scare tactics in the media, Friedl noted, are unlikely to discourage athletes from pursuing a competitive edge with hormones. Instead, the negative publicity surrounding steroids undermines their legitimate applications and impedes scientific study. Kraemer, a member of the U.S. Olympic Committee and the National Strength and Conditioning Association, made a plea for increased drug testing, better role models in athletics, research into alternative training methods, and rehabilitation for athletes habituated to steroid abuse. Anabolic steroids are synthetic de- increased significantly among athletes, mostly male, and has even spread to nonathletes who want only to improve their appearance. Friedl cited a recent study of 12th-grade males in the United States that showed that almost 7 percent use or have used anabolic steroids. Sixteen percent of those were not involved in any competitive sports. In another study of steroid use among male high school seniors, 38 percent reported beginning anabolic steroid use at age 15 or less. Naturally, few steroid users are willing to talk openly. Among those who do admit to using steroids, few will accurately report the amounts, strengths and combinations taken. Anecdotal reports suggest athletes take doses that are from four to more than 100 times greater than those approved in therapeutic treatment. In fact, noted Kraemer, an underground subculture exists to share information on experimental combinations and strengths of different steroids. "Stacking," the taking of multiple steroids at once, is common. Eighty-five percent of these drugs are acquired from pharmacists, doctors and veterinarians. The remainder are mailordered black market drugs, smuggled, stolen or secretly manufactured products. M ere scare tactics in the media are unlikely to discourage athletes from pursuing a competitive edge with hormones. Instead, the negative publicity surrounding steroids undermines their legitimate applica, tions and impedes scientific study. ................................................................................... WINTER 1991 rivatives of the male hormone testosterone and are FDA-approved for treating a small number of diseases. Human growth hormone, somatotropin, comes from the pituitary gland and is sometimes prescribed for children who are not growing properly. But athletes use the substances more than doctors do: to promote muscle growth, to improve athletic performance, and to prevent or speed recovery from injury. Reportedly, the first use of anabolic steroids occurred during World War II, when they were given to German troops to increase strength and aggressiveness. Based on anecdotal reports, steroids were first used in athletics by the Russians in 1954, Friedl noted. Since then, the use of these drugs has BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �"In a controlled research setting, there's no way to study the superhigh doses these athletes are taking," says Kraemer. "It is simply not bioethical to administer the drugs in such massive doses." Hence, most of the information on the health risks of anabolic steroids comes from the treatment of patients who have taken comparatively smaller therapeutic doses, or from the observations of sports physicians. Friedl noted that one important area that needs more research is steroids' effect on the prostate gland. Because the prostate gland is a target for steroids, researchers suspect that repeated use might cause enlargement of the gland or even cancer. He sees many parallels between men's use of steroids and women's use of the contraceptive pill and predicts that it will take a long time for all of the effects of steroids to emerge. Not much is known about the effects of steroids on musculature and skeletal muscle growth. However, it is suspected that prepubescent children and adolescents who take steroids may be in \..l,~. danger of stunting their growth. There are some effects that are more well documented, Friedl said. Heavy users face an imbalance in high- and lowdensity lipoproteins, which may promote arteriosclerosis and heart disease. There have been everal case reports of strokes that seem associated with steroids. Orally administered steroids have been implicated in the development of benign tumors and blood-filled cysts of the liver. Reproductive function and sex characteristics are affected. Males may suffer from atrophy of the testes, low sperm count, and increased libido. These effects may gradually reverse when the drugs are stopped. However, gynecomastia, the enlargement of the breasts, may not. (To rid themselves of this feminizing effect, some body builders resort to surgical mastectomy, Friedl noted.) Females may exhibit increased hair growth on the face, enlargement of the clitoris, deepening of the voice, and loss of menstruation. Acne in users of both sexes is common. The use of human growth hormone is less prevalent than anabolic steroids, partly because it is less available on the black market. In adults, it causes acromegaly, a condition characterized by enlargement of the hands, feet and face. Another area that researchers don't I I \ know much about is the psychological effects of steroids. Kraemer noted that anabolic steroid users report increased energy, greater endurance to stress and a keener desire to compete that can lead to habituation. However, they also report various forms of psychoses: delusions of grandeur, paranoia, auditory hallucinations, depression and mania. Stopping the drugs usually brings an end to paranoia and mania, but may increase depression and apathy. "There is no question that steroids build up bodies," noted Kraemer, "but at what price? The young men and women taking these drugs don't appreciate the serious health risks they're taking, not the least of which is potential psychological damage. There hasn't been a careful ex- perimental study in this area, and one is badly needed. The people at this congress are in a position to take that next step." 23 DNTIERNATDCNAIL CON ff:IERIENCIE RIEFlllECTSS SSIHID ff:T ON SSIP>IECDAILTY "There's been a definite shift in the field of psychoneuroendocrinology ,"explained Uriel Halbreich, M.D., professor of psychiatry, research professor of gynecology/ obstetrics, and director of Biobehavioral Research at UB. Halbreich chaired the 21st Congress of the International Society of Psychone u roe ndoc r in o logy, which wasco-sponsored by UB. The congress brought almost 450 scientists and clinicians from around the world to Buffalo last August to address the theme ofhormonal modulation of the brain and behavior. Research during the past 10 years has spotlighted new mechanisms of brain function, Halbreich said. "We used to measure the peripheral hormones, for example, cortisol, to learn whatwasgoingon in the brain,"Halbreich said. "It was thought that the brain created hormonal changes which then influenced behavior. "But in the early 1980s we discovered receptors for hormones actually in the brain. Now we also study how the hormones, themselves, affect the brain and cause changes in behavior." This exciting shift has advanced the management of mood disorders. In studying this new mechanism of brain function and dysfunction, better drugs are being developed, along with more effective treatments. • WINTER I99I BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �DO BAD HABITS Sometimes, but beware of the correlations 24 pidemiology helps to answer some of society's questions, but its findings need to be closely and carefully examined. That was the message that Saxon Graham, Ph.D., professor and chair of the department of Social and Preventive Medicine, delivered as the Stockton Kimball Lecturer at the 1990 Annual Faculty Meeting last spring. y Graham is an epidemiologist who received the 1990 Distinguished Achievement Award of the American Society of Preventive Oncology for his pioneering research. He has developed most of the epidemiologic methods that are currently used to investigate the relationship between diet and cancer, and he and his group identified many of the foods and food components that increase or decrease the risk of cancer. Graham is the principal investigator of a $6 million, five-year study funded by the National Cancer Institute to investigate the link between diet and cancer. While obviously an advocate of the usefulness of epidemiology, Graham warned his audience to be cautious when dealing with epidemiological findings. WI TER 1991 BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �BREED DISEASE I you make, warns epidemiologist Saxon Graham. 2S "The most fundamental fact of epidemiology is that it is a very inexact science," he said. Physicians should be aware of the trouble spots that could make a study suspect, Graham explained: Too little replication of a result. Replication is especially important in epidemiology because this field is particularly prone to errors in observation, Graham said. These errors often occur in studies that rely upon reporting by patients themselves. Memories of past exposure or behaviors are suspect and "even patients' current observations are not made with the precise tools that clinicians and bench scientists are often able to use," Graham explained. e .,., 'Z ... Too few subjects in the test. "Individuals are so idiosyncratic that it is difficult to generalize a finding to humans as a group from only a small number of observa~ tions," he said. The element Of time. (CONT.PAGE26) W INT ER 199 1 BUFFALO PHYSICIAN AND BIOMEDICAL SCIE TIST �(CONTINUED FROM PAGE 2S) 26 t seems obvious that a study must allow enough time for a pathological effect to show up, but Graham said that this is frequently forgotten. In the case of Love Canal, for example, Graham said, "the convincing evidence probably will not be available for a good many years simply because the diseases these exposures might cause have such a long latency and such low incidence," When researchers do allow enough time, it's possible to make strong conclusions. For example, "one of epidemiology's major accomplishments was to show that cigarettes can kill people after many decades of smoking," Graham said. -{:{Lack of a "dose-response." In other words, risks should increase with higher dosages. -{:{ Inconsistent results. Several years ago, people became concerned over a study that linked saccharine with bladder cancer in one sex. Study after study failed to replicate that finding. Finally, "the most definitive study of the subject showed no relationship," Graham said. He also warned that although animal studies can be useful in corroborating effects found in humans, "what is true for animals is not necessarily so for people." Several studies have shown a relationship between tumors and alcohol in humans, but "so far as I know, the many attempts to cause tumors in animals with potable alcohol have been unsuccessful," he noted. In a case such as this, "where there is a strong association and many replications, I believe the prudent clinician would base his behavior on the epidemiology" instead of on the animal results, Graham said. -{:{ Potential confounders. Other factors can affect the results of a study, and must also be taken into account, Graham noted. For example, lower cancer mortality rates in the Los Alamos population does not necessarily mean that plutonium is good for you. A better explanation for this phenomenon is that Los Alamos residents are much more highly educated and probably have stopped WINTER 199 1 He warned t1uu aitnough animal studies can~ useful in corro"OOrating effects found in humans, "what is true for animals is not necessarily so for ~ople. '' smoking in larger numbers than the comparison populations, Graham said. Finally, Graham warned against throwing out a set of studies just because one or more members of the set has a weak conclu ion. An example is a study that looked at whether exercise can help prevent a second myocardial infarction (heart attack), conducted by John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB. Although the overall death rate and the death rate due to cardiovascular disease both decreased after exercise, they did so at a rate of "borderline statistical significance." However, Graham said that statistical significance should not be the only criterion applied to this study. "There has been replication of this finding in 22 studies," Graham said, "and the benefit of exercise under medical supervision probably outweighs any potential for harm. "Where there has been much replication of a given finding and all the findings are in the same direction, even though some of them are not quite statistically significant, that finding bears consideration." Thi is especially important when the proposed remedy isn't harmful. UB's epidemiologist isn't the first Graham to win fame for his theories on food. In 1839, the Reverend Sylvester Graham blamed red meats and refined flours as a cause for the rampant sexuality of his day. As a result, "Great-greatuncle Sylvester," as the epidemiologist jokingly called him, concocted his own type of flour, which is known today as graham flour. The idea of fiber as a nutritive additive has come up several times in the past century and a half. Although today you can "taste them again for the first time," as the slogan goes, back in 1888 you really could taste corn flakes for the first time. That was when "Dr. John Kellogg, also to cool the hot blood of Americans, advocated the replacement of white flour by whole grains and invented something close to what we know today as Kellogg's Corn Flakes," Graham said. Fiber has been more recently advocated as a preventive measure for colorectal cancer, but "epidemiologic research on fiber, per se, has been minimal and the results contradictory," Graham said. Fats are being linked to cancer, in· part because countries with high average dietary fat intake also have high colon cancer mortality rates. "But a simple correlation does not neces arily indicate a causal relationship," Graham cautioned. He pointed out that "a significant increase in the stork population in two counties in California paralleled an increase in the birth rate in those counties." The same nations that have a high fat intake also tend to be highly industrialized, Graham explained, and the increased risk could be due to the industrialized nature of the countries, rather than their high-fat diets. And there are possible confounders in the studies linking fat and cancer. "Thus, we need to study not only fats, but also high caloric intake, high body mass, and high energy expenditure through physical exercise in relation to a number of cancers," Graham noted. For the most part, epidemiologists can't make precise recommendations about diet, Graham explained. But epidemiology, through studies which are carefully conducted and interpreted, can "suggest clues for prevention of disease." e BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �-------------------------------------------~®~I~~- -------------------------------------------C .,. ~ (" If 0 27 Giving birth, rejecting a transplant: Torrwsi sees intriguing similarities By LAURIE WOLFE ould birth actually be a mother's immune system finally rejecting the fetus as it would, say, a skin graft? If so, what prevents rejection for nine months, and could that factor be useful in transplant acceptance? These are some of the current questions that intrigue Thomas B. Tomasi, M.D., Ph.D., director of the Roswell Park Cancer Institute. Known internationally for his landmark discovery of the mucosal immune system, Tomasi was given UB's Stockton Kimball Award in recognition of his 25 years of research in immunology and over 30 years of teaching. He will deliver the 1991 Stockton Kimball Lecture at the Annual Faculty Meeting in the spring. In addition to his administrative duties at Roswell Park, Tomasi is a professor of medicine and microbiology at UB and head of the Molecular Medicine and Immunology Division in the UB Department of Medicine. He maintains a busy and productive lab that is looking into several questions on immunology, including the riddle that has always puzzled scientists: How is it that the fetus survives inside the maternal womb in spite of the fact that it carries the foreign chromosomes of the father? Tomasi may have discovered the answer while looking at a different problem. Thomas B. Tomasi, M.D., Ph.D. "Infants of almost all species, including humans, are born without any antibodies on their respiratory and other mucosal tissues," said Tomasi. "Two of our current projects stem from the initial question , 'Why are newborn animals deficient in their mucosal immunity, and could this deficiency be due to a circulating factor?'" Tomasi and his fellow researchers suspected that the factor circulated in the blood . But, working with mice, it was too difficult to get enough fetal blood to proceed. Instead, the researchers used amniotic fluid because it is more plentiful and contains many fetal proteins. Sure enough, they found a substance in the amniotic fluid that suppressed WI TER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIENTI ST �------------------------------------------- ~@~~~ -------------------------------------------.,. r I r It 0 ..... ~ 28 the immune response. This factor is either identical to or closely related to TGF-13 (transforming growth factorbeta.) Now that they knew what they were looking for, they were able to go back and identify the same factor in fetal serum. The findings were published recently in the Journal of Experimental Medicine. Using molecular techniques, Tomasi's lab has found that TGF-13 stays localized in the uterus. These discoveries led to the next question: Could the factor that makes babies deficient in their mucosal immunity be the same factor that keeps the mother's body from rejecting her fetus? "What we found was amazing-really exciting," Tomasi said. "This substance was present in the pregnant uterus and not in the normal uterus. It appeared at about the ninth day of a 20-day gestation period, reached a peak at 15 days, and then fell off rapidly as birth approached." He speculates that this may be the mechanism by which pregnancy is allowed to persist. "This has important implications," Tomasi said. "It's probably the hormones of pregnancy that are generating this suppressive factor in the uterus. We have found that this substance checks the expression of certain antigens controlled by paternal genes - the antigens that would normally stimulate the graft rejection phenomena. "Now we're wondering if birth actually is a rejection phenomenon. We're also wondering, if you lack enough of this substance, does a miscarriage occur? Up to now we could only speculate. But we're about to begin work with an antibody that will neutralize TGF-13, and this may give us an answer as to whether or not TGF-13 is involved in spontaneous abortion." Within a year, Tomasi hopes to take WINTER 1991 ~~what we found was amazing- really exciting. This substance was present in the pregnant uterus but not in the normal uterus. It appeared at about the ninth day of a 20-day gestation period, reached a peak at 15 days, and then fell off rapidly as birth approached." This may be the mechanism by which pregnancy is allowed to persist. this research further by seeing if TGF-13 is useful in preventing transplant rejection. Studies in his lab have already found that if a skin graft is performed between two incompatible st rains of mice, and the animal is treated with TGF-13, ordinary rejection of the graft is suppressed. "Naturally, this could have tremendous impact on the future of organ transplants," notes Tomasi. "We're just starting experiments with heart and kidney transplants." Interesting ly, in skin graft observations, Tomasi has found that the addition of TGF-13 can be stopped after a certain time without causing subsequent rejection. So once beyond an initial rejection stage, the suppressive agent is no longer necessary. "Of course, further studies have to be made into the toxicity associated with this naturally occurring immunosuppress ive factor," he noted. These experiments are bui lt on Tomas i's earlier ground-breaking work. He fo und that mucous membranes in the body produce antibodies that are distinct from the antibodies found in the bloodstream. T his mucosal immune system provides the body with a vital first line of defense against microorganisms that cause disease. The mucous membranes l ine the areas that come in con tact with the external envi ronment wh e re fo reign organisms can naturally and easi ly invade - the eyes, ears, nose, mouth, and gastro intestinal tract. Today hundreds of scient ists a re building on Tomasi's d iscove ry by research ing various aspects of the mucosal immunity mechanism, the structure of these particular antibod ies, how they are transported, and the mechanisms of vacc ination. Tomasi received his M.D., magna BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-------------------------------------------:~:-------------------------------------------­ ~ It 0 29 cum laude, in 1954 from the University of Vermont. He then started working on his Ph.D. at Rockefeller University, where he began studies that led to his discovery of the mucosal immune system. As a profe sor of medicine and a research professor of microbiology at UB from 1965 to 1973, he further advanced his work. He left Buffalo to become chairman of immunology at the Mayo medical school, and returned to Buffalo to head Roswell in 1986. Tomasi will soon return to another area of research that he began at Mayo: the immunology of exercise. A casual remark by a friend, a physician associated with the Olympic Nordic Ski Team, was the catalyst that sparked Tomasi's interest. At any one time, the friend said, 20 percent of his cross-country skiers were out of commission with upper respiratory infections, whereas downhill skiers did not suffer the same setbacks. From his own experience as a competitive skier, Tomasi knew that cross-country skiing was far more exhausting than downhill, the equivalent of running a marathon as opposed to the 300 meters. Building on what he already knew about the mucosal immune system, Tomasi found that in athletes pushed to the limit, there is essentially a disappearance of antibodies on the mucous surfaces of the upper respiratory tract. He also saw changes in the circulating immune cells, the natural killer or "Nk cells" that are involved in resistance to cancer. Initially, there was a tremendous drop which then returned to a normal level in about 12 to 24 hours. So, in effect, severe physical stress caused a temporary immune deficiency. Conversely, if a person backed off on extreme exercise and did moderate workouts (this level was naturally different for each person), the person actually enhanced his or her immune response. This phenomenon could have considerable relevance in the treatment of chronic diseases. Of special interest to Tomasi is how physical and emotional stress affect the immune systems of cancer victims. After surgery and radiation, he wonders, why do node-negative breast cancer victims have a survival rate of 80 percent? Is there a mechanism that is damping the immune response of the other 20 percent, and could this be affected by stress? Tomasi is in the process of assembling a team of researchers to tackle these questions, and the many more that are sure to follow. e ANNUAL FACULTY MEETING HoNoRs ToP TEACHERS FoR 1990 he Annual Faculty Meeting held each spring provides an opportunity for the UB medical school to honor those who have made outstanding contributions. Honored in 1990: Roland Anthone, M.D., and Sidney Anthone, M.D., clinical professors of surgery, were named recipients of the third annual Robert S. Berkson Memorial Award in the Art of Medicine. The award recognizes excellence in patient care and teaching by volunteer faculty members. Bernard Eisenberg, M.D., clinical associate professor of pediatrics, received the Dean's Award for service to the medical school and the University and outstanding research. A longtime volunteer faculty member, Eisenberg is a member of the school's admissions committee. Evan Calkins, M.D., professor and head of the medical school's Division of Geriatrics/Gerontology, received a special award as founder of geriatric medicine at UB. A plaque in his honor that will hang in the medical school describes Calkins as "an energetic, imaginative leader with demonstrated qualities of humanitarianism, compassion and a fondness of learning and giving. A true role model for the medical leaders of the 21st century." Louis A. and Ruth Siegel Teaching Awards for teaching excellence were presented in four categories. The recipients were: Pre-clinical award: Alan Lesse, M.D., assistant professor of pharmacology and therapeutics. Clinical Award: Fred Luchette, M.D., assistant professor of surgery. Volunteer award: Thomas Westner, M.D., clinical assistant professor of medicine. House staff awards: Frederick Kohn, M.D., resident physician in obstetrics/gynecology; Robert Erickson, M.D., resident physician in family medicine; Maheswar Rao, M.D., resident physician in medicine; and Karen Drake, M.D., resident physician in obstetrics/gynecology. • CASSEL TO VISIT UB AS HARRINGTON PROFESSOR hristine Cas el, M.D., an expert in medical ethics and gerontology, will visit UB on May 29 and 30 as the second Harrington Visiting Professor. Cassel is one of two women regents of the American College of Physicians and chief of the section of genera l internal medicine at the University of Chicago School of Medicine. As the Harrington Visiting Professor, she will give several talks and seminars.e WINTER 1991 BUFFALO PHYSICIA AND BIOMEDICAL SCIENT IST �-------------------------------------------~@~I~~-------------------------------------------"' r C If 0 ~ 30 Cooperation, not Competition Thomas Riemenschneider strives to unify teaching hospitals around common goal By LOIS BAKER agging along after his father in rural Berea, Ohio, 50 years ago, Thomas Riemenschneider saw firsthand the tie between physician and community. Those early impressions grew into a love for medicine and a commitment to pushing his profession beyond its traditional boundaries, a dedication that Tom Riemenschneider, M.D., M.B.A., brings with him as the new associate vice president for clinical affairs and associate dean at UB Medical School. "Most medical schools will tell you their missions are teaching medical students, research, and patient care," he said. "As far as I'm concerned, there are four missions. That fourth mission is relating to the community -- identifying community health care needs and responding to those needs." His goal here is ambitious: To develop a unique model for delivering health care to the community. As liaison between the medical school and area hosp itals, his job is to convince everyone to work together through a cooperative consortium, for the benefit of all. That effort is already under way. The hospitals' CEOs are meeting to discuss common goals. Next will come meetings between medical directors and department heads. If the effort is successful, Western New York could serve as an example for other communities across the nation. WINTER 1991 "The degree of cooperation here is unique," he said. "Out of 128 medical schools in the country, only a few are close to the model we're looking at here." "The traditional model is one university hospital designated as the primary teaching hospital for students and residents," Riemenschneider said. "My own feeling is, that in recent years, that traditional model has become outmoded, in part because there is an ivory tower around it," he continued. Because the traditional model never existed here, he saw an unusual opportunity to move health care delivery and medical education into the community. In this approach, Riemenschneider has the full approval of John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, who has championed a consortium for 15 years. "Riemenschneider comes highly regarded and is well versed in his field," Naughton said. "We think he is going to do a very fine job." Riemenschneider replaces Don Larson, M.D., whom Naughton credits with helping to organize the medical school's Office of Clinical Affairs, and with helping to implement its faculty practice plan. Larson has returned to teaching in the Department of Biology. Riemenschneider earned his bachelor's degree from Baldwin Wallace College and his medical degree from SUNY's Upstate Medical Center, now called the Health Science Center at Syracuse. Now a professor of pediatrics at UB, he developed an interest in pediatrics as a college student, watching his father deliver babies. To test his commitment to medicine, his father got him a job emptying bed pans, where he didn't like the work but loved the excitement of the hospital. At his father's urging, he took a summer job working for a cardiac surgeon. A chance meeting with a physician friend of his father led to a residency and three-year pediatric cardiology fellowship at the UCLA School of Medicine. At UCLA, the appeal of the diversity of practicing medicine in a university setting was obvious. "People had something different to do every day," he said. He was hooked. There he immersed himself in his particular research interest -- adaptation of the newborn heart to extrauterine life. After completing his fellowship and a two-year commitment as chief of pediatric cardiology at Scott Air Force Base in Illinois, he took his first job in academic medicine at the University of Utah Medical Center. He remained three years as assistant professor in the medical center's Pediatric Cardiology BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �------------------------------------------- ~@~ ' ~~-------------------------------------------r .r r If 0 .... <::. 31 Tom Riemens,hneider, M.D., M.B.A., asso,iate vi'e president for dini,al affairs and asso(iate dean at UB Medi,al s,hool. Division, and directed the center's pediatrics honors program. In 197 5 the University of California at Davis offered Riemenschneider the opportunity to become its chief of pediatric cardiology and set up a program in his specialty. He spent the next 15 years translating into action his ideas concerning a broader role for academic medicine. At UC Davis he built the program from scratch; then, to care for the needs of the largely rural population served by the medical center, he set up a network of clinics stretching to the Oregon border. In I982 he returned to his home turf to rebuild the pediatric cardiology program at Case Western Reserve's School of Medicine in Cleveland. During eight years there he made two important career decisions -- to earn an M.B.A., which he received from Baldwin Wallace in 1987, and to become a fulltime medical administrator. He was appointed associate dean of the medical school in 1986. At Case Western Reserve, with the aid of a $425,000 grant from the National Institutes of Health, he started a health education program in the Cleveland Public Schools, using medi- cal students as teachers. That initiative resulted in 17 health care modules being incorporated into the district's curriculum. The chance to build a better health care system that could reach throughout Western New York and beyond was too attractive to refuse. "Most places across the country are still in the old competition model," he said. "In Buffalo the eight CEOs are meeting in our conference rooms and talking collaboratively about what's best for the people of Western New York. Now we've got to bring the medical directors together, and encourage them to begin to talk collaboratively." One of Riemenschneider's major initiatives is to meet with department chairs scattered throughout the teaching hospitals to determine where UB medical school faculty should be placed to best meet community needs and to tackle specific community health problems. This is the kind of challenge that, for Riemenschneider, makes life interesting. He also enjoys spending time with his large extended family, playing tennis and golf, jogging, and country music. He delights in the fact his daughter Laura performs at Nashville's Opryland. He also has a daughter Karen, an art teacher, and a son Jim, a senior at Baldwin Wallace, in business. Riemenschneider admits he sometimes misses working with patients. Knowing he continues to touch patients' lives in a larger context, however, compensates for any sense of loss. "In a way I'm still involved with patients," he said, "but on a larger scale. If I'm able to help organize this consortium and this system of health care, think of all the patients I will have an impact on by providing a better health care environment." • WINTER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIE TI ST �------------------------------------------- ~@~ I ~~-------------------------------------------C .J' (" .... <:) If 0 32 Dennis A. Nadler, M.D., '71 A mandate to develop a curriculum plan for the next decade By LOIS BAKER ennis A. Nadler, M.D., '71 looking relaxed in his shirt sleeves, glasses dangling from a cord around his neck, is talking with considerable passion about his work as new associate dean for curricular and academic affairs at the UB medical school. "I'm happy," he said. "I'm having fun. It's interesting, and I'm accomplishing things." If it weren't for his salt and pepper hair, parted boyishly down the middle, Nadler could, at 44, be mistaken for one of the medical students he is charged with supervising as head of UB's medical education program. He was appointed associate dean in January 1990, after serving in an interim capacity since the previous July. A pediatrician with a specialty in developmental difficulties, Nadler comes well-suited for the job. He is personable and ea y going, with an empathy for young children that transformed easily into an understanding and appreciation of young adults. The promise of daily contact with students was one reason he took the job. This enthusiasm was not lost on John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, when he was searching for a replacement for Peter Ostrow, M.D. Ostrow left the associate deanship to return to teaching in the Department of WINTER 1991 Dennis A. Nadler, M.D., '71, associate dean for curricular and academic affairs. Pathology. ''Throughout his career, Dennis has had a long track record of interest in students and teaching," Naughton said. "I think he has gotten off to a very good start." Nadler said he was programmed since birth to be a physician. The son of a would-be doctor who turned to pharmacy because he couldn't afford mediBUFFALO PHY ICIA AND BIOMEDICA L SCIENT IST �-------------------------------------------~@~~~-------------------------------------------.,. .... I C r If 0 () 33 cal school, Nadler avidly followed the path his father relinquished. Medicine appealed to him and he never gave serious thought to anything else. A Buffalo native, Nadler earned his bachelor's degree in psychology from UB in 1967 and entered the UB medical school. He was headed for a career as an ear, nose and throat specialist until he spent the summer before his senior year in medical school in the pediatric outpatient clinic at Children's Hospital of Buffalo. He decided to become a pediatrician then and there. "There's just something special about children," he said, explaining his switch of specialties. A devoted father, Nadler spends as much time as possible with his sons Noah, 17, Jacob, 10, and Benjamin, 7, and his wife Susan. After completing his internship and residency at Children's, Nadler in 1974 accepted a position as pediatrician-inchief at the Jesse Nash Family Health Center in Buffalo, became an attending physician at Erie County Medical Center (ECMC) and joined the UB medical school's full-time faculty. He served as director of the Department of Pediatrics at ECMC from 1977 to 1988, when he stepped down to devote more time to the University. He had been serving as assistant dean for student affairs at the medical school since 1985. In addition to his current University post, Nadler is medical director for the United Cerebral Palsy Association, and an attending pediatrician at ECMC and Children's Hospital. As the medical school's associate dean for curricular and academic affairs, Nadler is responsible for everything that involves the education of medical students - from basic science and clinical education, to evaluation of teaching methods, to preparation of students for "Teaching students how to learn is at least as important as teaching them what to learn. " residencies, even to financial aid. He finds today's medical students more sophisticated and better educated than their counterparts of 20 years ago. Sophistication aside, he asserts that the basic motivation for becoming a physician remains the same - a wish to aid humanity. "I don't think the majority of students today gravitate to medicine because of the money or because of the prestige. I think they gravitate to medicine because they want to help people. "I came out of the '60s, and we were going to save the world," he said. "I think there is still a lot of that around." Nadler relinquished the rewards of caring daily for young patients for the chance to influence the training of the next generation of physicians. His mandate is to develop a curriculum plan for the medical school for the next 10 years. Toward that end, he has organized a task force to review all medical education - faculty development, student affairs, advising, and several other areas - in addition to curriculum. The task force will also assess the medical school's external resources, such as the area's teaching hospitals and health related professions. He brings to the job a strong conviction that medical schools must change the way they educate students. "The curriculum has always been very hospital-based, "Nadler said. "When I was a medical student that was just fine. I took care of all kinds of fascinating and mundane problems. "But today, people aren't admitted to the hospital unless they are in crisis or in some form of deteriorated condition. So what we're getting in the hospitals is a very skewed population of the extremely ill and extremely old . You can't give students a broad-based medical education anymore if you just put them in hospitals." Nadler favors placing students with volunteer faculty in their offices, and making better use of community-based clinics and hospital ambulatory programs, in addition to using the traditional hospital setting. He also advocates a new classroom approach: stressing creative problem solving over memorization. "Teaching students how to learn is at least as important as teaching them what to learn," he said. "Developing problemsolving skills, clinically based basic science education, reducing lecture time, and placing greater emphasis on independent learning- these are the challenges." Nadler concedes that not everyone views his mission in the same light. "Some think we should continue to be a very traditional medical school. Some think we should become a very innovative medical school. I suspect there is an appropriate balance to be struck," he said. "I hope I will be able to find that balance." • WINTER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIE TI ST �---------------------------~~: --------------------------" \t- 34 LAW vs MEDICINE SPRING CLINICAL DAY TO Focus ON LEGAL IssuEs ridging the Gap Between Medicine and Law" will be the the theme of 1991's Spring Clinical Day and Reunion Weekend, which will be held the weekend of May 4. The unique Spring Clinical Day program, to be held May 4 in the Buffalo Marrio tt, was planned with the help of the Bar Association of Erie County. Topics will focus on the legal issues in the physician-patient relationship. "Striking a Balance Between the Rights of Patients, Doctors, and Society" will be the title of the Stockton Kimball Lecture, to be delivered by Sol Wachtler, the chief justice of the New York State Court of Appeals. The weekend opens with a reception for all reunion classes on Friday evening, May 3, in the Center for Tomorrow on UB's North (Amherst) Campus. Take the advice of the reunion class chairmen: Mark your calendars for May 4. e "50 years - one-half century. Let's all come to the reunion Saturday, May 4, 199 1." Donald Hall '41 "Old friendships renewed, old memories revived, reflections on life tracing back to our days on high. Come to our 45th reunion." Harold Levy '46 "40 -wow! Looking forward to seeing all of you again. We're not ge tting older, we're getting better." Marvin Pleskow '51 ALUMNI To HosT RECEPTION IN BosToN he UB Medical Alumni Association and the Department of Neurology will host a reception in Boston, Mass. on Monday, April 22 in conjunction with the American Academy of Neurology Meeting. All alumni/ae in the Boston area are invited. e WINTER 1991 I "Long time, no see! Come join your classmates for our 50th reunion." Gene Hanavan '41 "In the past 40 years, the world, the school, medicine have changed. Have we? Let's get together and find out at our reunion." Allen Goldfarb '51 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �---------------------------~~:--------------------------- 35 "35 and still alive! Please return for classmate jive." Edmond Gicewicz '56 "A great time with a great bunch of people." Harold Brody '61 "The 20th was good, let's make the 25th great! Join us May 3-5 to renew old friendships and memo ries." Jared Barlow '66 "We are looking forward to seeing all the I5 -year alumni and renewing friendships." Russell Bessette '76 "Surprise! Five years have already slipped by. It 's time to touch base and catch up on what's happened. Look forward to seeing you in May." Jim Schlesinger '86 Carlo DeSantis '61 "20 years is a long time. Hope we can get together for a good time and to renew old friendships. " "Take a break after I 0 years! Shuffle back to Buffalo to share in the old and the new!" Joel Paull '71 Bruce Cusenz '81 WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-------------------~~: ------------------- 36 DAVID H. NICHOLS '47 RECEIVES DISTINGUISHED ALUMNUS AWARD avid H. Nichols, M.D., internationally recognized expert in the field of reconstructive gynecologic surgery, received the second Distinguished Alumnus Award from the UB Medical School and Medical Alumni Association. A 194 7 graduate, Nichols is professor and chair of obstetrics and gynecology at Brown University. A lecturer in obstetrics and gynecology at Tufts University School of Medicine, he also is obstetrician and gynecologistin-chief at Women & Infants Hospital of Rhode Island, Providence, and surgeonin-chief in the Department of Gynecology and Obstetrics at Rhode Island Hospital, Providence. Nichols served on the faculty of the UB medical school from 1954 to 1980 before joining the faculty of Brown University. He was head of the Department of Obstetrics and Gynecology at The Buffalo General Hospital from 197 5 to 1980, chief of the Department of Obstetrics and Gynecology at Sisters Hospital from 1971 to 1974 and associate cancer research gynecologist at Roswell Park Cancer Institute from 1953 to 1960. He also was previously associated with the old E.]. Meyer Memorial Hospital, St. Francis Hospital, and the Veterans Administration Medical Center. Certified by the American Board of Obstetrics and Gynecology, Nichols is a fellow of the American College of Obstetricians and Gynecologists, American College of Surgeons, and International College of Surgeons. He is a past president of the Society of Gynecologic Surgeons, Buffalo Gynecologic and Obstetric Society, and Erie County Unit of the American Cancer Society. WINTER 1991 David H. Nichols, '47 (ALL FOR NOMINATIONS FOR ALUMNI AWARD arch 1 is the deadline for nominations for the third annual Distinguished Medical Alumnus/a Award. The award is presented to a graduate of the UB medical school who is distinguished nationally or internationally in the eyes of his or her peers and has made an outstanding contribution to medicine, the arts, or humanity. The award will be presented at a special dinner in September. Please forward the name of your nominee as soon as possible on the attached postcard. Your cooperation is vital if this is to be a true alumnus/a award. e DoNoRs HEAR TALE oF UB MED ScHooL fOUNDER edical professors of the early 1800s were restless folk who moved from town to town, noted Richard Lee, professor of medicine and pediatrics at UB. When the founding fathers left, the schools often went under. Few schools founded in that era exist today. Buffalo is an exception because one of the founding fathers of UB, James Platt White, was committed to the community and remained active here for almost 50 years. "James Platt White and Buffalo had a remarkable association," Lee said. "If anyone could claim the Buffalo medical school as his child, it was he." Lee spoke at the fifth annual meeting of the James Platt White Society in October honoring members who have made an annual contribution of $1,000 or more. The members of the James Platt White Society from Oct. 20, 1989 to Oct. 18, 1990 are: Dr. Richard H. Adler Dr. Kenneth M. Alford Dr. Kenneth Z. Altshuler Dr. William S. Andaloro Mrs. Rose Bakow Dr. & Mrs. Jared Barlow Dr. Alphonso L. Barragan Dr. Charles D. Bauer Dr. Eugene L. Beltrami Dr. Richard A. Berkson Dr. Willard H. Bernhoft Dr. Theodore Bistany Dr. Willard Boardman Dr. Dennis L. Bordan Mr. & Mrs. Leroy B. Bornhauser Dr. & Mrs. Harold Brody Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. & Mrs. Irwin Burstein Dr. David W. Butsch Ms. Janet F. Butsch Dr. John L. Butsch Dr. & Mrs. Evan Calkins Dr. & Mrs. Joseph G. Cardamone Dr. & Mrs. Joseph A. Chazan Dr. Donald P. Copley Dr. Daniel E. Curtin Dr. James A. Curtin Dr. Peter S. D' Arrigo Dr. Roger Dayer Dr. Thomas A. Donohue Dr. Sterling Doubrava Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. & Mrs. George M. Ellis BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �------------------------------~~:------------------------------ 37 Dr. & Mrs. George M. Ellis Dr. Daniel Fahey & Dr. Maria Runfola Dr. Lucille M. Farrar Dr. Robert E. Fenzl Dr. Donald M. Fisher Dr. Jack C. Fisher Dr. Grant T. Fisher Dr. Edward Forgrave Dr. Thomas F. Frawley Dr. Matt A. Gajewski Dr. Kenneth L. Gayles Dr. John W. Gibbs Jr. Dr. Daniel Goldberg Dr. Seymour Grauer Mr. Wilson Greatbatch Dr. Thomas J. Guttuso Mrs. Marion B. Hague Dr. Martin E. Hale Dr. Eugene J. Hanavan Mr. & Mrs. Edward A. Hansen Dr. & Mrs. Gerald Hardner Dr. Thomas H. Hayden Dr. Reid R. Heffner Jr. Mr. John L. Hettrick Dr. Gary Jeffery Dr. & Mrs. Kenneth L. Jewel Dr. Stephen T. Joyce Dr. James R. Kanski Ms. Catherine Kresge Dr. Marvin Z. Kurian Dr. Vito P. Laglia Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. & Mrs. Harold J. Levy Mrs. Ursula Lichtenstein Dr. Jack Lippes Dr. Hing Har Lo Dr. Fred A. Luchette Dr. Robert L. Malatesta Dr. Milford C. Maloney Dr. Don L. Maunz Dr. Harry L. Metcalf Dr. Merrill L. Miller Dr. Eugene R. Mindel! Dr. Joseph Monte Dr. Shedrick Moore Dr. Robert M. Moskowitz. Dr. John D. Mountain Dr. Arthur W. Mruczek Sr. Dr. Richard L. Munk Dr. Richard J. Nagel Dr. Masao Nakandakari Dr. Richard B. Narins Dr. & Mrs. John Naughton Dr. Benjamin Obletz Dr. Elizabeth Olmsted Dr. Dean E. Orman Dr. JohnS. Parker Dr. Jacqueline L. Paroski & Dr. Paul A. Paroski Dr. Margaret W. Paroski Miss Olga E. Paroski Dr. & Mrs. Robert J. Patterson Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. James F. Phillips Dr. Frederic D. Regan Dr. Frank T. Riforgiato Dr. Charles Riggio Dr. Eugene Rivera Dr. Richard R. Romanowski Dr. & Mrs. Charles H. Rosenberg Dr. Albert Rowe Miss Thelma Sanes Dr. Arthur J. Schaefer Dr. Robert N. Schnitzler Dr. Joseph I. Schultz Dr. Roy Seibel Dr. Elizabeth Serrage Dr. & Mrs. Samuel Shatkin Dr. John B. Sheffer Miss Alice Simpson Dr. Richard A. Smith Dr. John J. Squad rita Dr. William Sternfeld Dr. Gerald Sufrin Dr. Eugene M. Sullivan Dr. Michael A. Sullivan Dr. Syde A. Taheri Dr. Joseph Tannenhaus Dr. MichaelS. Taxier Dr. JacobY. Terner Dr. Charles S. Tirone Dr. Anthony C. Trippi Dr. Stanley Urban Mrs. Victoria Van Coevering Dr. Barbara von Schmidt Dr. Coolidge S. Wakai Dr. Franklin E. Waters Dr. Paul Wierzbieniec Dr. Gary Wilcox Dr. Richard G. Williams Dr. John R. Wright Dr. Franklin Zeplowitz Dr. & Mrs. David C. Ziegler REUNION (LASSES' GIFTS HELP MEDICAL STUDENTS edical students will benefit in many ways from the generosity of the alumni. As of Sept. 11, the classes that marked their five-year reunions in 1990 donated $123,211 to the University. Class of 1940: Scholarship in the amount of$ 7,3 25 Class of 1945: Gift of $20,810 for the Vincent Capraro Lectureship Class of 1950: Scholarship in the amount of $7,750 Class of 1955: Scholarship in the amount of $6,700 Class of 1960: Unrestricted gift of $43,700 Class of 1965: Unrestricted gift of $8,975 Class of 1970: Unrestricted gift of $9,225 Class of 1975: Unrestricted gift of $4,925 Class of 1980: Gift of $12,251 for the John Paroski Memorial Scholarship Fund Class of 1985: Scholarship in the amount of $1,550 WI TER I991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �---------------~~:---------------­ }0._ J' S II () 38 Philip Goldstein '31 ~ in memory of Or. Goldstein, an annual memorial lectureship in hepatology and an award to a graduating resident have been established at Millard Fillmore Hospital. The Goldstein Award is given annually to the graduating resident "demonstrating the highest degree of humanitarian qualities in the approach to, and treatment of, patients." The lectureship and award were made possible by Kenneth Goldstein '39, Gerald Goldstein '64, Harvey R. Goldstein '77, Rabbi Brett Goldstein and Mrs. N. Stiller. Murray A. Yost '33 ~ received a certificate and a gold medallion when he was honored with lifetime membership/fellowship in the American Psychiatric As ociation. John M. Constantine '34 ~ of Oneonta, N.Y., retired from active practice in November 1989. Robert J. Krug '35 ~ writes from Tarpon Springs, Fla., "had a mild stroke, affecting left side, but I still get around OK without a cane." Bennie Mecklin '35 ~ writes "Why no news from the class of 1935? I am still lecturing, writing and enjoy traveling." Or. Mecklin resides at 6711 Starkeys Place, Lake Worth, Fla. 33467. Charles A. Bauda '42 ~ sent an article from the Palm Beach Post telling us that at the age of 74 he received a master's degree in WINTER 1991 Milton Alter, 'SS Donald W. Burkhardt '68 William K. Major '69 theology from St. Vincent de Paul Seminary. Dr. Bauda practiced family medicine in Buffalo for 40 years before moving to Boynton Beach, Fla. recurrent trokes. In I 989 he became editor-in-chief of the journal Neuroepidemiology. gy at the University of Southern Alabama. Arthur J. Schaefer '47 ~was a vtstttng professor at the University of Washington Medical School, Seattle, Wash., where he lectured on the pathophysiology and the surgical corrections of malpositions of the upper and lower eyelids. Victor Panaro '52 ~ of Amherst, N.Y., has been elected Councilor for the American College of Radiology. Milton Alter '55 ~ former chief of neurology at the Minneapolis Veteran's Hospital and former chairman of neurology at Temple University Hospital is now director of re idency training in neurology at the Medical College of Pennsylvania. He holds an NIH grant to study the epidemiology of strokes and a supplemental grant to study risk factors for William J. Sullivan '55 ~ is a diplomate of the American Board of Psychiatry and Neurology and is certified in psychiatry and psychoanalysis. He is now specializing in forensic psychiatry. Mary Ann Zavisca Bishara '59~ was appointed president of the medical staff at St. Mary's Hospital, Lewiston, N.Y., for 1990-1991 and continues as chief of anesthesiology at the hospital. Kenneth E. Bell '61 ~ was recently named clinical professor of obstetrics and gynecology at the University of California at Irvine. Or. Bell is medical director of the Kaiser Permanente Medical Center in Anaheim, Calif. F. Robert Weis Jr. '64 ~ was appointed a full professor and director of clinical anesthesiolo- David R. Dantzker '67 ~ is now chairman of internal medicine at Long Island Jewish Medical Center and professor of medicine at Albert Einstein College of Medicine. Donald W. Burkhardt '68 ~ retired from emergency medicine at Kenmore Mercy in Buffalo and moved to Morocco. He is living in a villa in the foothills of the Middle Atlas Mountains. His new address is Villa William & Ruth, 141 B.I.S. Route de Fes, Sefrou , Morocco. John E. Shields Jr. '68 ~ is medical director of the Seafield Center, an 80-bed alcohol and drug rehabilitation center in Hampton Bays, N .Y. Or. Shields was certified in addictionology in 1988. William K. Major '69 ~ a cardiothoracic surgeon, has been elected president of the Medical Society of the County of Erie. BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �------------------------------~~:------------------------------~'C::l .f S II () 39 Edward J. Coleman '83 );>completed a fellowship in thoracic and cardiovascular surgery at UB in June and joined a practice in Green Bay, Wis. Melvin Pohl '76 );>- is the author of a book The Caregiver's journey: VVhen You Love Someone VVith AIDS, published by Hazelden. Dr. Pohl is chief of Clinical Services at the Pride Institute in Minneapolis, Minn. Russell J. Van Coevering 11'77 Russell J. Van Coevering II '77 );>- is president of the New York State Society of Obstetricians and Gynecologists, Inc. and serves on the board of directors of the Buffalo Civil War Roundtable. Dr. Van Coevering is a member of the President's Associates of the UB Foundation and the James Platt White Society of the medical school. Russell P. Massaro '70 );>- relocated to Albany, N.Y., where he is director of medical services for the New York State Office of Mental Health. Cliphane W. McLeod '77 );>writes, "Looking for a partner for a busy ob/gyn service." Dr. McCleod can be reached at 227 Topi Trail, Hinesville, Ga. 31313. Jay A. Harolds '71 );>- is chief of radiology and the radiology residency program of Baptist Medical Center of Oklahoma City and president of the Oklahoma State Radiological Society 1989-1990. Richard T. Irene '79 );>- of Columbus Ohio, was recently initiated a fellow of the American College of Surgeons. Donald H. Marcus '71 );>- of Sepu lveda, Ca lif., has been elected to a three-year term on the board of directors of the Southern California Permanente Medical Group. Roy M. Oswaks '71 );>- continues as chief of surgery at Bayside Hospital in Virginia Beach, Va. Joseph A. Dunn, Ph.D. '71 );>a senior research scientist at Eastman Kodak, has started a two-year sabbatical in the Biotechnology Center of Cornell University. Robert Braco '80 );>- writes, "Completed my MPH in May and started working for the University of Texas School of Public Health in Houston, looking after the health of employees of major petrochemical companies in the Houston area. It's great, I highly recommend it." Jonathan C. Felsher '80 );>- has a private practice in cardiology and is associated with the Crozer-Chester Medical Center and the Bryn Mawr Hospital. He and his wife, Lisa, have two children: Matthew, 2, and Marisa, 9 months. Renata Wajsman '83 );>- writes, "After working for a year as a gastroenterologist, I am moving on to Israel to take a full-time position in gastroenterology in Tel Aviv-lchilov Hospital." Robert Braco '80 Bruce J. Cusenz '81 );>-is a member of Buffalo Plastic Surgery, a practice specializing in cosmetic surgery as well as traumatic and reconstructive surgery. The practice has two offices: 2800 Main St., Buffalo and 1321 Millersport Highway, Williamsville. Helena Reichman '81 );>-former full-time member of the faculty at the University of Massachusetts Medical Center and private practitioner, is relocating to Brandon, Fla. to join a ob/gyn practice at Humana Hospital. Nora Meaney-Elman '84 );>- of Amherst, N.Y., writes, "Upon completion of residency, I am joining the Highgate Medical Group and practicing full-time in family medicine." Herbert B. Newton '84 );>writes that he finished at Memorial Sloan-Kettering Cancer Center in June , then became the neuro-oncologist for Ohio State's new cancer center in July. "Go Buckeyes!" John Picano '84 );>- completed a neuroradiology fellowship at Massachusetts General Hospital in June and moved to New Hartford, N.Y. to enter private practice. He and his wife, Lynn, have two children, John Daniel and Cara. Lloyd D. Stahl '81 );>- of Leawood, Kan. writes, "Jackie and I were in New Orleans when I was inducted as a fellow into the American College of Cardiology. We have three children: Michael, 8; Mara, 6, and Danny, 2. We are enjoying life in the midwest." Maritza Alvarado '85 );>- writes that she and her husband, Andrew Knoll '84, moved to Syracuse, N.Y. this summer. He began his residency in internal medicine and she started a fellowship in neonatology. Manuel L. Saint Martin '82 );>completed law school and psychiatric residency in Los Angeles simultaneously! He is now conducting a joint medical and legal consulting practice in Los Angeles and Forest Hills, N.Y. Timothy Wacker '85 );>- of Tonawanda, N.Y., has completed a fellowship in gastroenterology/hepatology at the University of Pittsburgh and is looking forward to starting a private practice in the Southtowns. WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �--------------- ~~~ --------------­ ~'0, s s " () 40 Douglas J. Floccare '86 Douglas J. Floccare '86 ,_.. has been appointed the aeromedical director of the state med-evac helicopter fleet operated by the Maryland State Po li ce. Dr. Floccare currently serves as fire surgeon for the Baltimore County Fire Department's Division of Emergency Medical Services, and co-medical director of the paramedic education program at University of Maryland at Baltimore County's Emergency Health Services Department. Clarence Durshordwe '23 ,_.. an anesthesiologist for more than 40 years in Buffalo, died Sept. 24, 1990. He had served in the U.S. Army during World War I. Joseph F. Kij Sr. '27 :;;;... died July 29, 1990. Dr. Kij treated five generations of patients as he became one of the patriarchs of Western New York's Polish-American community. His many community endeavors included helping to found the former St. Rita's Home for Children and serving on the Lackawanna School Board. He continued his private practice in Lackawanna until I 988. WINTER 1991 Ramsdell Gurney ' 29 ,_.. an organizer of the Buffalo Medical Group, died July 30, 1990. The group is now composed of 70 physicians. Dr. Gurney was an associate professor of medicine at UB. "He was an exceptiona l human being," said classmate Victor L. Cohen. "He was thoughtful, dignified, and devoted to his wife and family and to the art of medicine. His conduct lent dignity to the practice of medicine and to the associate he so skillfully chose." William G. Ford '31 ,_.. an internist for almost 50 years, died Oct. 14, 1990. He worked as a physician for Bethlehem Stee l and was in private practice in Buffalo. During World War II , he served as chief of medicine on the U.S. Army's first hospital ship as well as the USS Ernest Hines, a luxury liner remodeled as a hospital ship. He retired from private practice in 1978. Helen Toskov Wolfson '31 ,_.. a former Buffalo clinical pathologist, died April 10, 1990 in Ambler, Pa. Dr. Wolfson was the only woman in the C lass of 1931. She opened her own laboratory in 1933 and remained in practice in Buffalo until 1974. After retiring in 1974, she moved to West Palm Beach, Fla., where she lived until 1986, when she resettled in the Philadelphia area . Hugh J. McGee '32:;;;... a retired neurologist died, January 27, 1990 in jackson, Mich. Edward Shubert '39 ,_.. died May 18, 1990. William D. Dugan '39 ,_.. a retired orthopaedic surgeon, died April 15, 1990. He practiced medicine at Buffalo General, Children's and Mercy hospitals in Buffa lo and our Lady of Victory Hospital in Lackawanna. He was a member of the Ruffed Grouse Society and the Buffalo T ennis and Squash Club, where he was a champion. Maurice M. Maltinsky '44 ,_.. d ied Jan. 25, 1990. Vernon G . Smith '48 :;;;... a pathologist, died Ocr. 20, 1990. He founded and directed Western ew York Analytical Laboratories 1nc., with offices throughout Western New York. He had also been honored with a team of doctors for early research in cryogenics. Alfred Berl '49 :;;;... a psychiatrist and horsebreeder in Bu llvi lle, N.Y., died suddenly in Puerto Rico on May 9, 1990. Dr. Berl was a former teaching psychiatrist at Yale, former chief psychiatrist of the Manhattan House of Detention and, during the Korean War served as chief psychiatrist of the Far East Command. With a partner, Dr. Berl founded Excelsior Farms in Bullvi ll e in 1965, and bred many top pacing horses, including Fly Fly Solly, who earned over $700,000 and the former world champion pacing gelding Magna Bird. Until the time of his death, Dr. Berl served on the Advisory Counsel of Camp Blueberry Treatment Center for Autistic Children. Haluk Caglar '56 ,_.. assistant professor at UB and a specialist in gynecologic oncology, died june 30, 1990 after a lengthy illness. He was 45. Born in Turkey, he came to the United States in 1971 and attended the UB medical school and Georgetown University Medical School. He received many teaching awards at UB and wrote numerous chapters in medical textbooks. An artist, his paintings were exhibited in galleries in Toronto. David E. Pittman '64 :;;;... a member of the James Platt White Society and supporter of the University at Buffalo Foundation, died on October 26, 1989. He held a number of University appointments, including clinical assistant professor of Medicine at the University of Pittsburgh and the Medical College of Pennsylvania. He was a senior attending cardio logist and the associate director of the cardiovascular laboratory at Allegheny General Hospital and served on the Editorial Board of the Catheterization and Cardiovascular Diagnosis Journal and the Journal of Angiology. He authored 56 scientific papers. Lawrence J. Emrich, Ph.D. ,_.. associate research professor in biometry at UB and a biostatistician at the Roswell Park Cancer Institute, died June 23, 1990. He was 35. Emrich received his doctora l degree from UB in 1983 and was a consultant to the School of Dental Medicine's Ora l Biology Department and to the Department of Psychiatry. At Roswell Park, he headed the statistical consulting and statistical computing laboratories. He was also a statistician for the DineSystems Co. in Buffalo. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��~- - ~- - Non-Profit O rg. U.S. Postage Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 PAID Buffalo, NY Permit No. 3ll Address Correction Requested 2194 ~EDICAL HISTORICAL LIB. ABBOTT LI3RARY, SERIALS DEPT. CA. PIJS IIIAIL � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Winter 1991 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v25n01-1991-Winter Table Of Contents A list of subunits of the resource. In Praise of Housecalls Residents' Hours Making a Team for Michael Danger in the Locker Room Do Bad Habits Breed Disease Medical School News Alumni Classnotes Alternative Title An alternative name for the resource. 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Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f7637e05266ebe45ca028c9c4e902f83.pdf b0f56d0ca8e43b3eda329c73e56e1884 PDF Text Text Vol 25 Spnng1991 2 ~iomedic �TH h FF\Ll'Pl-'I'.., ,\l"'-l"lfl'-,T l\"<A.[l f1.\'f 1 \, Ol< L R~, ,)R {' Pl "ll( \ ll' J.., ', II le t 'IT "< \r I- • ... \ ,.., ' \It l'F " F\\ E'-. 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I\ I I Ul rt " 1c dth, ,11,ltnt fll, Et Tl'K \'-,'-...'t ,Aft \U cl , RI • O rn. JL\dl Ix ch th< tK Tr I fr1, ne • the prton te ,IL,. then l t DearAlumni andSupporters of theUBMedical School, ~ l'-L L • M •~t \ \H Is, x,k (() h~lr tht \\lit II l n •t. tnel'lc.1' t r_.r; 1' f1 lrl p ,nrt r I~ ·t C. 1rcJ n•ht tdt.,ns,lcxrrc• of,, 1\\l,,\\nuJ.1kctl'sh1r~mth \er Ix r,garJs Ill \ IC lll T,, rh "lc.,11 llt.nc. 11r11.:c 111,t•t1t :11 pr rt\t<,k11,k1 I, .... «•I• necJ <L h -•-rr rt " m ,~, h ,r, i,, 'I ·1 'vi 11' I)\\,, <r '"\~ l > H \, 1-11'-.(,H ,.., ITA .., ,~ ·LI \IS{''-" I t \ \ \1e, 1( e • fi It I lll T'<F I . •t \hl f ' ), l 1 \ I 1 .•n ' ',f\ \! , l 1 ' r ! I' ,I l'r,, \ i, ·t I I \j, llc l John N.mghton, M.D. 1 • • r C 111 I \ff.1 r, ,1 l .! I< U.. 11 ~LI l t ' DearFellowAlumni/ Alumnae: \ M ,knr, I thL \I mn1 \, K 111 ,n 1, rn F< th ,n h It \ r 1hLfl m llnm m 1,1h, "d I ,1-r,Lt J ,c \lumn R,un, 11\Xuh11l ml1l,1r, runt.r..,1rm•l l1111,II 1 l\,111tth1, ,c ,r Ill, 1..11.1m 11n rhru,t I 1 ,, 1 t f "l , , 111th ,, 11 ru,n1t th< \lltk<n n It r ,, u. "' " 1 11,k, ,, u di 1 , mr11 " I ,nu l Ir lmun, the \lumn \, ,1111 n h.i k.l I rucpl n Irr, \X, h I I ,Im , ~l'\' ,n, n l' \\ c In I th 1 , < , ti, ,rud,nr, durm tic 1r m tn 111,11, n. l h, e 'l'lll , , t, r 1d1 I cir'-' me tr, ,, 111, rh, ,!11,, md \ ur L 11 ,n, I. \ur di rr, 11111 l l, 111"\\I t ,clt,,l I , 11'< 1, r, m, ,, mx1 1 f, r 1111h, tu ILnt, I I tun< u1 n r ..!11111ll. lll\t nunl r" trh <\I 1111111\ x:1111 1 TI1<\ I I\L K"-l" kn<.« I, ur\\ llm Ill" II -f I 1l1t rl11, ~" 1 II --1H, \• 11 hLIr ntr1h111 rill 11 '" 11111 "rnn th II l Im,< 11I k\ I.I I, r thl t !l 11 I 11 '1rr rt 1h II Ill 1h, "I\ Bertram .\. Portm, M.D., '5, �B UFFAlD P!JY§1~!6iN Srnni.: 1991 II Research II HospitalNews On art and medicme, page 18. II HealingtheSpiritIn sickness, more than just the physical side needs to be addre-.;sed. BJDaggersoftheMind:Shakespeare andNeurology Lance Fogan, M.D., '65, catalogs the Bard's knowledge of the field. m A Curefor Malpractice HeadachesFull-rime SUNY Hmpicalchap/amsare a ma/ pareof the healthcareteam, page6. faculty physicians and dentists form their own insurance company. DJTheChnkalPktureRichard V Lee, M.D., on the affinity between medicine and art. E!J FromShin Splintsto HipPointersUB's new Sports Medicine Institut e helps weekend and professional athlete':> alike. BJCharting theQuality of LifeHarrington Physicumsned a <W)' to quancihquabryof life issues,page 24. lecturer Alvan Feinstein, M.D., laments the inability of basic science to measure the qualit) of life. m m Medical School News Alumni EEJ Research m m m People MatchDay Shakespe,art.' on neurology, />age 13. Classnotes Dand W'.Bt'ntb, M.D . focmes chcmedicalschool on healthcare[or the agm(!, page26. �----:(]}---- ., E I\. ~ 2 ten by a one-year $15,689 grant from the STUDY TOSURVEY HEALTH Great Lakes Protection Fund, which will IMPACT OFEATING GREATfocus on how consumption of fish from the Great Lakes affects risk of malignant LAKES FISH and benign thyroid disease. B researchers chis spring will survey 30,000 New York State anglers anJ their spouses in the largest study ever conducted on the health impact of caring fish from the Great Lakes. The study, funded by the Great Lakes Protection Fund, will focus on the consumption of fish from lakes Ontario and Erie by residents of 16 counries, according to John E. Vena, Ph.D., princi pal investigator and University at Buffalo associate professor of social and preventive medicine. Vena said researchers want to determine the characteristics of the population that consumes fish from the lakes, how their perception of risk relates to their consumption and rhe health effects of that consumption. "There is a long overdue need for a large populationbased survey of anglers to establish a cohort of fish carers," Vena added. The study is funded by a one-year $157,800grant from the Great Lakes Protection Fund, the United States' only multistate environmental endowment. Vena also is the principal investigator on a second study, underwrir- U Vena said the survey of anglers and their spouseswill focuson a random sample of anglers between rhe ages of 18 and 40 who live in the 16 counties and were issued a fishing license in New York since October 1990. The self-aJministered questionnaire will be mailed in May, he added. The 16 counties are: Cayuga, Erie, Genesee, Jefferson, Lewis, Livingston, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Sc. Lawrence, Seneca and Wayne. Despite advisories issued by New York State that certain species offish caught in Lake Ontario should not be eaten or consumed not more than once a monrh, Vena said it's estimated that at least 15 percent of anglers eat these fish as often as once a week. He added chat among the Great Lakes, Lake Onrario "has a unique contaminant profile with the highest documented levels in fish of contaminants including pestipol ych lor inated biphenyls (PCBs) and methyl mercury." Vena said that m o s t studies to dace of consumption of contaminated fish from the Great Lakes "have been based on small, convenient samples in ocher states. For New York Seate, there is a lot of data on how much fish is caught, but no data on how much is eaten . We want to know who are the fish eaters and how much they eat and what do they know about the advisories." Once chose who consume the fish are identified, Vena explained, researchers will be able ro look at the associat ion between past and current consumption of contaminated fish, whether consumption has added to their body burden of chemicals and how consumption affects their risk for health problems. Barbara Knuth, Ph.D., assistant professor of natural resources and policy management at Cornell University, will be co-investigator in the study. Also collaborating on the study will be Germaine Buck, Ph.D., Maria Zielezny, Ph.D.,James Marshall, Ph.D., and Jo Freudenheim, Ph.D., all of che the medical school's Department of Social and Preventive Medicine. In the study, Vena's co-investigaro rs will be John M. Lore, M.D., professor and former chair of the UB medical schoo l' s Department of Otolaryngology, and Manuel H. Castillo, M.D., UB assistant professor of otolaryngology. Their study of the consumption of contaminated fish from the Great Lakes as a risk factor for malignant and benign thyroid disease will look at lifetime fish consumption from the Great Lakes in 58 people with cancer of the thyroid and 237 people with endemic goiter not due to iodine deficiency and a matched number of controls. 'This study will be one of the first to systematically evaluate the hypothesis chat consumption offish from the Great Lakes is related to risk for either malignant or benign thyroid disease," Vena said. • - By Arrhur Page �- ---:(]):-- -- .,. E ~ ~ 3 LINK BETWEEN CANCER, ELECTRIC BLANKETS NEEDS MORE STUDY W hile there appears cobe no general increase in breast cancer risk among women who have used electric blankets for several years, there is a higher yet not statistically significant risk among women who use the blankets throughout the night, according to researchers in the UB Department of Social and Preventive Medicine. John E. Vena, Ph.D., and colleagues studied 382 postmenopausal women with breast cancer and 439 controls who were asked about electric blanket use in the previous lO years. The UB researchers say further studies must be done co obtain an accurate picture on the relationship between electric blanket use and breast cancer risk. It has been hypothesized chat chronic exposure to electromagnetic fields increases breast cancer risk by suppressing the normal nocturnal rise in pineal melatonin. • - By Arthur Page More than 500 scientific papers will be presented at the meeting sponsored by the medical school's Department of Social and Preventive Medicine. Graham will be honored at a reception and banquet at 6:30 p.m.,June 11, in the A lbright-Knox Art Gallery, Buffalo. The symposium honoring Graham will explore the directions chat research should cake to define the role of diet in the etiology of cancer. Registration is being handled by the Office of Conferences and Special Events at the University at Buffalo. • - By Arihur Page SYMPOSIUM TO HONOR SAXON GRAHAM A symposium on diet in the epidemiology of cancer will highlight the 24th annual meeting of the Society for Epidemiologic Research co be held June 11 to 14 at the BuffaloConvention Center. The meeting will include a "Symposium on Diec in the Epidemiology of Cancer: Future Directions" in honor of Saxon L. Graham, Ph.D., professor and chair of the Department of Social and Preventive Medicine, who will retire in May. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST mal imaging equipment and accompanying computer software chat result in che simultaneous production of matching thermal and visual images. "The same electronics that generate the thennal imaging data also provide the visible imaging data," he notes. "The same optics that are used to generate the thermal imaging data are used co generate the visual imaging data." The computers used in today's thermal imagingequipment interpret the body's radiation patterns in terms of temperature, producing readouts of numbers, shades of gray or colors keyed co specific temperatures. Hejazi notes that the image produced is not a visual one, but a "picture" based solely on temperatures that muse be interpreted. Hejazi's electronic and optical equipment modifications result in simultaneous production of thermal and visual images that share a common perspective and size. He said further modifications may provide an ability co superimpose one image over cheoch~ • THERMAL IMAGING DRAWBACK OVERCOME A major drawback that occurs in interpreting the results of thermal imaging has been overcome with technology developed by a researcher at UB's medical school. Shahram Hejazi, Ph.D., has developed patented modifications to standard ther- - B)' Arthur Page SPRING 1991 �---------------------·ffi------------------+E 'll" 4 For most of the last l O years, the hospital's annual births hovered around the 2,400 mark. Births rose steadily over the psychiatric expertise for patients who canlast three years, from 2,472 in 1988, to 2,706 in 1989 and ove r 3,000 last year. nae be properly treated at the Community Sister Angela Bontempo, president of Meneal Health Center because of their Sisters Hospital, attributed the dramatic medical condition," or patients who canincrease to changing patterns in available noc "receive adequate psychiatric care on obstet ric services, a rise in area births, a a regular medical floor." The opening of the new facility increases strong OB residency teaching profile, dedco70 the number of beds operated by BuJfulo ication and hard work from nurses and General for patients with psychiatric illness- physicians and high-profile marketing. She noted that the hospital has been es. The other 60 beds are located in the working very hard over the years to Community Mental Health Center. • strengthen its residency progra m. "We have built up our residency program on obstetrics and gyneco logy," she said, addi ng, "we have improved our facilities and capab ilitie s, invested in people and let the physicians and public know about or the first time in recent history, Sis- what we have. Obviously, we are very proud of our obstetrica l service and are ters of Charity Hospital del ivered • commi tted to its future." 3,000 babies in a calendar year. The milestone delivery came down to the wire as the 3,000th baby arrived on New Year's Eve as I 990 drew to a close. problems," he added . SISTERSMAMMOGRAPHY Noe said the new facility "makes it posUNITACCREDITED BYA(R sible to integrate internal medicine and isters Hospital' s Mammography Unit has been accredited by the American College of Radiology. The unit, part of the hospital's Department of Diagnostic Imaging and located next to its Breast Care Center of Western New York, is one of 1,500 facilities chat have been accredited nationally. Requirements for the three-year accreditation include a peer review eva luation of the facility's staff qua Iifications, equipment, quality control and quality assurance programs, image quality and breast dose. Mammograms are recommended by the American College of Radiology,the American Cancer Society, the American Medical Association and nine other major medical organizations, every one to two years in conjunction with a physical breast exam every year for women between 40 and 49, and every year in conjunct ion with a physical breast exam for women over 50. • S SISTERS HOSPITAL RECORDS 3,000THBIRTH ONNEWYEAR'S EVE F ROSWELL PARK CANCER INSTITUTE RECEIVES NEWNCI DESIGNATION STATUS BGHOPENS 1O-BED MED-PSYCH UNIT B uffalo General Hospital has opened a new l 0-bed acute care medical-psych ia tric unit as part of a 47-bed expansion approved by the New York State Health Department. The new unit, located on the 12th floor of the hospital's 16-scory medical cower, began admitting patients late lase year. Philip C. Noe, administrator of BGH's Community Meneal Health Center (CMCH), said, "ll1e unit is among on ly 20 such facilities in the entire country. Currently, the Erie County Medical Center is the only ocher upstate New York hospital with an acute care unit dedicated to patients who are diagnosed as having both medical and psychiatric R ... . .. _,,.· srtmm 1'191 oswell Park Cancer Institute has been approved by the National Cancer Advisory Board for status as a National Cancer Institute-Des ignated Comp rehensi ve Cancer Center. One of the first three cancer centers co receive the designation under a dual-level eer review system and guidelines estab··hed injanuary 1990, Roswell wasfuvorly recommended for the comprehen·ive designation by NCI's Cancer .;:;:::. fi/ Support Grant peer review com•·. mittee. Fox Chase Cance r : Center in Philadelphia .) and Yale University ...... :-':" Comprehensive . �s Cancer Center in New Haven, Connecticut, are the other two. All three institutions had been NCI comprehensive care centers under designated guidelines issued in the early 1970s. "As one of the original three centers designated as comprehensive following the passage of the National Cancer Act in 1971, it is most gratifying that we are also one of the first centers ro receive redesignation under the new peer-review process," said Roswell direcror Thomas B. Tomasi, M.D., Ph.D. 'The mark of'comprehensive cancer center' is one that the Institute bears proudly." The new guidelines required each center to be judged in new redesignation criteria, including: • A strong core of basic laboratory research, • A viable mechanism for facilitating links between basic/clinical research and outside organizations, • A proven record of innovative clinical research trials, • A significant amount of cancer prevention and control research, • An effective research training and continuing education program, • A wide range of cancer infonuation services for patients, health professionals and the surrounding community and • A substantial commitment ro community service and outreach activities, especially those directed coward underserved populations or those with disproportionate cancer rates. • CHILDREN'S HOSPITAL ANNOUNCES ER APPOINTMENTS hildren's Hospital of Buffalo has announced the appointment of two physicians ro its Pediatric Emergency Room. C BUFFALO Pl IYSICIAN AND BIOMEDICAL SCIENTIST OTOLARYNGOLOGY RESIDENTS RESEARCH DAYSETFORJUNE T Eugene W.Yates,M.D. PaulaMa1ur-Ellis, M.D. Paula Mazur-Ellis,M.D., clinical assistant professor in the Department of Pediatrics, and Eugene W. Yates,M.D., clinical instrucror in the Department of Pediatrics, have been appointed attending physicians. They will be responsible for patient care and supervising the pediatric residents. Mazur-Ellis received her medical degree from the University of Pinsburgh and did her post graduate work at Mercy Hospital of Pittsburgh. She has had extensive training and education in various classifications of life support. Prior to her new position, she was an associate pediatrician in a private practice in Beaver, Pennsylvania and a college health physician at Duquesne University. Mazur-Ellis is a member of the American Academy of Pediatrics and has written articles and abstracts about intellectual development status postHaemophilus Influenza meningitus. Yates was an assistant attorney general for the South Carolina's Attorney General's office prior ro obtaining his medical degree from the University of South Carolina. He completed his pediatric residency at Richland Memorial Hospital in Columbus, North Carolina. A member of the American Academy of Pediatrics, Yates is the co-author of publications on child and adolescent psychiatry. • he Seventh Annual Residents Research Day for Otolaryngology/ head and neck surgery will be held Wednesday, June 5, from 8 a.m. to 3 p.m. in Palmer Hall at Sisters Hospital. The day will include presentation of otolaryngology residents' research papers and will feature visiting professor Guy M. Osoff, D.M.D., M.D., Guy M. Maness professor and chairman of the Department of Otolaryngology at Vanderbilt University Medical Center, who will speak on "The Role of Laser Technology in the Upper Airway 1991." • SISTERS HOSPITAL NAMES CHIEF OF DENTAL MEDICINE ayne C. Jarvis, D.D.S., has been appointed chief of dental medicine at Sisters Hospital. He previously was direcror of the hospital's division of oral and maxillofacial surgery. A graduate of the University of M ichigan and the University of Michigan School of Dentistry, Jarvis completed his residency in oral and maxillofacial surgery at UB's School of Dentistry. He is a faculty member at the Misch Institute for Advanced Implant Dentistry, Dearborn, Michigan, and the Implant Center of the University of Pittsburgh School of Dentistry, as well as UB. He was recently certified and awarded diplomat status by the American Board of Oral Implantology/ Implant Dentistry. • W ~PRING 1<191 �6 YLOIS ASTRAINED PROFESSIONALS , : SIMON TONG CHAPLAINS ARE PART OFTHE HOSPITAL TEAM SPRING 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��8 arher Richard Augusryn's first patient when he was a chaplain-in-training threw a bedpan at him. "I told my teacher, 'I only have one suit left,"' Father Richard said after returning home to change."[ can't afford this." Father Richard returned to the hospital and to the room to learn the reason behind the thrown bedpan. The patient, he discovered, had just been cold by a physician that she would need a double mastectomy. After delivering his report, the doctor had abruptly walked out. And the next person co enter the room a few minutes later received the patient's wrath. She apologized; the chaplain-intraining learned he hadn't done anything wrong; she is alive and well today. "That's the creative edge in pastoral care," said Father Richard relating the story years later. "You really don't know what the agenda is going to be." In a setting where most professional staff members have clearly defined duties, the job of hospital chaplain is an anomaly because it deals with the human and rhe spirimal rather than the scientific, and consequently defies easy definition. Local directors of pastoral care describe their work in spiritual overtones: "the soul of the hospital" and "the heartbeat of the hospital." Father Richard has been director of Buffalo General's Pastoral Care Department since it was formed in 1988, and was a volunteer chaplain for several years before char. With the help of a cadre of volunteers, he attempts to meet the spirimal needs of patients in that l,000-bed facility. "Yes, you have doctors; yes, you have nurses," says Father Richard in his tiny Buffalo General office. "You have all kinds of fancy technical things in a hospital. But in sickness there's more than just the technical char needs co be addressed, and chat's the human. "You have ro look at where people are coming from psychologically and spiritually. You cry co put all chose areas in sync, so the healing process becomes alive and real." In an attempt co define what hospital chaplains do, it is easier co state what they do not do. They do nor proselytize, preach, or attempt co convert. "We don't hand out rosaries," says Sister Lucille Socciarelli, director of pastoral care at Mercy Hospital in South Buffalo. "I can spend a whole visit and nor mention God." "I don't have a religious mission," says the Rev. Jackie Lewis, a Presbyterian minister and full-time chaplain at Children's Hospital. "We divorce ourselves from iniriaring the 'Jesus love~ me; Yes I know; For the Bible cells me so' sort of thing, because that's not where everyone is at," agrees Father RicharJ. Humans have cared for the sick since they Jevelnpcd the capacity for compassion, bur the position of professionally trained hospital chaplain is relatively new. As recently a~ the 1940s, ministering to the spiritual needs of Lhe hospitalized was a job often relegated to problem ministers anJ priests. That situation changed in 1951 when a group of Protestant denominations began training ministers for hospital work. The group was incorporated in 1967 as the Association of Clinical Pastoral Education. A similar Catholic organi:arion - the National Association of Catholic Chaplains - was incorporated in I 965. Today most hospital chaplains have at least one year of training and are certified by a board to practice in a hospital setting. Modern hospital chaplains are members of the treatment ream. They serve the needs of the patients, the staff and their families, rather than representing a particular congregation or denomination. They have access to patients' records, and as is the case at Children's, particularly in the Intensive Care Nursery, are encourageJ to record observations on patient charts. Chaplains serve on committees on ethics and institutional review. They receive referrals from physicians likeanyorherspecialisr. The main work of a hospital chaplain, however, is listening. "If nothing else, I'm company," says Eliot Marrus, rabbi at Temple Shaarey Zedek and a volunteer chaplain at Buffalo General. "Most of all, people wane someone co talk co. My role in the crnwersarion is almost negligible." His favorite story about listening involves a visit with an elderly woman in a wheelchair who had no family co visit her. "She looked exceedingly frail," relates Rabbi Marrus. "She J\UFFAL,1 PllYS!CtA:-.:.~Nil ll!OMElllC.~L '<'IE.'-JT!ST �Ina settingwheremast professional staff members havedearly 9 defined duties , thejob of hospital chaplain is ananomaly because ii dealswiththehuman andthespiritual rather thanthescientific, and consequently defies easydefinition. Atleft, Father Richard Augustyn. Atright,Rabbi Eliot Marrus. sort of put out her hand, I took it rather gently, and felt this viselike grip. She pulled me into the chair beside her and then maneuvered her wheelchair so that I couldn't stand up. I was her prisoner for the next 30 minutes while she gave me her autobiography." Rabbi Marrus's experience illustrates a basic tenet of the chaplain training program: lee the patient sec the agenda . 'That might mean being kicked out," says Father Richard. "That might mean listening to how the pastor of their church has raked them over the coals for something. That might mean being with someone who is dying and not saying anything." Father Richard has been a chap lain for 11 years. Ac Buffalo General he manages a staff of 10 trained volunteers. "The national average is one chaplain for every 40 pacients,"he said. "In light of that I shou ld have a staff of 42." His chaplains are assigned to particular floors in order to develop a relationship with staff and long-term patients. They go from door-to-door regardless of denomination. Most people receive him well, Father Richard says, but he has been ejected from rooms on occasion. He figures the negative reaction stems from preconceived notions about a chap lain's purpose. HosPITAL CHAPLAINSWHo PAYS? ospital chaplains are members of the hospital staff and are paid by the hospital. In add ition, many hospitals supplement their pastoral care staffs with trained volunteers. These chaplains are primarily interdenominational and serve the hospital staff and their families as well as patients. Ministers from specific congregations serve their own members as pare of their routine pastoral responsibilities. Father Richard Augustyn, director of pastoral care at Buffalo Genera l Hospital and president of the National Association of Catholic Chaplains, says all Buffalo-area hospitals had at least one full-time paid hospital chaplain as of April 1, 1990. Buffalo General established itsdepartmento nly two years ago. Since then, Erie County Medical Center has elim inated the salary of its director of pastoral care in an effort to cue its budget. He is staying on temporarily as a volunteer . Meanwhile, Millard Fillmore Hospital has just hired its first full-time director of pastoral care. "In Buffalo we're swimming upstream," says Father Richard . "Throughout the country they're cutting departments. All hospitals are feeling the crunch and we just don't know how it's going to pan out . ECMC'ssituation reflects the trend nationwide. "The bottom line is, pastoral care needs to be an integral part of the hospital. We're on the right track. That's what keeps us going." • - BUFFALO PHYSIC IAN AN D BIOMEDICAL SCIENTIST SPRING 1991 �"The concept of many people is that we're here 1roevangeenhance what is going on physically." lize, to slap their hands for not being a good Christian," he says. Chaplains at Mercy try to see all new admissions within 48 "The biggest egg to crack is to get beyond the hurt they bring hours. Currently they are not entitled to record observations with them concerning religion." on patients' charts, but hope to acquire that privilege. While hospital chaplains do not want to be seein as repre10 Sister Lucille said she is received well most of the time. senting a particular religion, Father Richard is of ten called "We always ask 'Is this a good rime?"'she said. "I've only been upon for priestly duties. One of his warmest memorie s as a tossed out of a couple of rooms. chaplain centers around performing last rites for a dying "Usually when people are sick, they are so vulnerable that woman. if anyone can help them, they grasp on to that straw." He had just returned home from the Stratford !Festival in She speaks of being called to visit with a 30-year-old Ontario, where he had seen A Streetcar Named Desire. One woman who had to have a double mastectomy; of comforting of the play's central characters is the unstable woman of a wife whose husband died of a heart attack after going out for questionable character - Blanche DuBois. a Friday night fish fry. Father Richard was in bed when he got a call saying that a Recently she stayed with an only child at the bedside of her Mary DuBois was dying. "I went to her room, krnelt down, dying mother. "The daughter just talked out loud to herself, anointed her and went through the whole thing call ing her and l was there," Sister Lucille said. Blanche," he said. "Her husband came up to me "Lots of times people tell us things they wouldn't afterward and asked if it made a difference that her tell anyone else. After being through something with name was Mary, not Blanche, and I was devastated. a patient, you can be closer than family." Oneof thegreatest "I got back down on my knees, and I'm apologizChildren's Hospital has had a Department of ing and explaining to this woman, who is extremely serviceschaplains can Pastoral Care for at least 20 years, now headed by thin and emaciated, why I cal led her Blanche, and al I Father Frank T uchols. offer is theirtime. of a sudden she got this very wide smile on her face Jackie Lewis, who has been a Presbyterian chaplain - and she died. there for a year, recalls that she was called "Sister" by Otherhospitalstaff "Now I've got all these guilt feelings. I apologized everyone, even when she was pregnant with her first mustrush off lo to her husband, but he put his arm around me and child. said 'Father, you've given me the best gift anyone According to Rev. Lewis, a chaplain's responsianother medical crisis ;a could give me. That's the first time I've seen my wife bilities at Children's can range from providing supchaplain canstay smile in six month s."' port for a woman experiencing a miscarriage, to At Mercy Hosp ital a pastoral care department performing a baptism in the intensive care nursery, to behind. has existed since 1975.Sister Lucille has directed the tending a small child so the parents can be with an Below , SislerLucille. injured sibling. full-time staff of two priests and four sisters for sil< years. The chaplains are part of what Sister Lucille She says that she is received well more often than Atright , Rev. Jack ie calls the "holistic hea lth care team." she would expect. lewis andherson. "[ believe so much in the ministry we are doing,'"' "When I first began as a chaplain, I thought 'Boy, she said "We try to reach people inside of themselve:s if some stranger walked in when I was having a crisis, - spiritually, psychologically, emotionally - to I'm not sure how I'd feel.' But people are very receptive." SPRING 1991 I\UFF.-\LO Pl IYSICI.-\N ANO BIOMEDICAL SCIENTIST �say hello. "A lot of the time I end up playing with the younger kids. While we're playing things come out . Adolescents can be really open and talk a lot, but some of them don't want to talk at all." Rev. Lewis says she loves her work. She could be speaking for all hospital chaplains when she explains why. "There is always a situation popping up that we hadn't dealt with before. That stretches us all the time, and it's exciting. We discover what we really believe about humandignicy, pain and the ultimate value of people's lives." • CHAPLAIN TRAINING ATSISTERS A isters Hospital currently offers the only hospital-based Her first call as a chaplain while doing her clinical training in the pediatric ward at Strong Memorial Hospital left a last- '' chaplain training program in Western New York designed for all religious affiliations. The program at Sisters, accredited by che Association of Clinical Pastoral Education, or ACPE, took in its first students in September 1990. Seven people have gone through the program to dace, and six more \ are enrolled for the summer. \, Sister Margaret Dougherty, directorof pastoral care at Sisters, supervises the program. Would-be students need ing impressionconcerning che nacureof che human response at least a year of theological background to enroll. Her to crisis. "The call was for a baby who had died in the intensive care unit," she says. "When l walked into the room, the doctor was sitting on the floor with the baby in his arms, the parents were sitting beside him, and they were all crying. "I walked in and told them who I was. The doctor handed me the baby and they made space for me in their circle. I could have fainted when he handed me the baby. I didn't expect that kind of hospitality at that moment." One of the greatest services chaplains can offer is their time. Other hospital staff must rush off to another medical crisis; a chaplain can stay behind. Rev. Lewis tells of being with a husband whose wife was killed instantly in an automobile accident. She mer him at the bedside of his 18-month-old child injured in the same accident. "At first he didn't say anything," she says. "Eventually he started to talk about his wife, about how long they had been married, about how the accident happened, about going to the morgue to identify her body - a lot of derails he needed to talk about. "I think he knew that because of my role, I'd be comfortable hearing his pain. All I really did was spend time with him." If there is time remaining after caring for emergencies, Rev. Lewis visits children on the floors. Often they don't know what to make of her. "I'm pretty low key with them," she says. "I tell them I'm not going to do anything to hurt them. That l just came in to students are an ecumenical lot, representing a wide range of experience . "So far we have had a priest, a Lutheran seminary student, an Episcopal deaconess, a Lutheran deaconess and three Catholic laymen," said Sister Margaret. "This summer we have an Assembly of God seminary student, two Baptist seminary students and two Daughters of Charity sisters." Trainees receive 400 hours of instruction per unit, with a minimum of cwo unit s required to become qualified as a hospital chaplain. Students spend 25 percent of their time in group work or individual supervision and the rest of their hours visiting patients. "Students learn about the process of illness, grief, coping, the role of emotions in illness, interpersonal relationships and give each ocher feedback," Sister Margaret said. "What's really exciting to us is chat along with ministering to acute patients, we have some students interning in the methadone clinic. They are really working on the spiritual dimensions of people in treatment. Ir's been a good experience for them." Chaplain training for Catholics is a lso offered through the National Association of Catholic Chaplains, or NACC. A multi-denominational parishbased program certified by ACPE is offered through Lutheran Social Services. • BUFFALOPHYSICIAN AND BIOMElllC -\L SCIENTIST SPRINO 1991 11 �FIG <MIV: SUl'OIK>' l'IIOffTAI. \ UN IMtl!IOII Fl'O'f f Al. GYII\/S ................ 1,AT(II.Al,..,. ~mi&l h~ ,, ./ • I • Ii, �Daggcern of theeMmJg ~ §kJkcespcearce ~ anJ Nce1Li1Jroliog 13 Pox and plague, double vision and dementia: Lance Fogan,M.D. , '65, hasstudiedthemall- throughthe eyes of William Shakespeare.<JIAn award~winning study written by the West Coast neurologistexamines the neurologicaldisordersdescribedin the dramatist's greatestplays. Among "Dr. Shakespeare's" diagnoses: tremors, the neurological complications of syphilis, encephalopathy, dementia, epilepsy, disturbances of srage IV sleep, cerebra l hypoperfusion, sciatica, pharyngeal abnormalities and cranial nerve lesions. "The plays of Shakespeare are the greatest mirror of mankind, reflecting all of our emotional and psychological complexity and diversity," Fogan says. "They give us the fullest possible picture of our nature. "Shakespeare was not only acquainted with the signs, symptoms and courses of diseases of the central and peripheral nervous systems," Fogan says, "but he also understood them well." Indeed, Fogan argues, "Shakespeare could have been a Renaissance neurologist." So careful and complete has been Fogan's research in support of chis contention that he has won widespread recognition from neurologists and Shakespeareans alike.His paper, "The Neurology in Shakespeare," won the American Academy of Neurology's j 32 7 Lawrence C. McHenry Prize in the hisrory of neurology. The study, which examines references ro neurology in32 of Shakespeare's 3 7 plays, not only impressed neurologists, but also attracted the attention of the Los Angeles Daily News, the Washington Post, the Chicago Tribune and KABC-TV in Los Angeles, which invited Fogan to appear on a health series. Fogan's work has also piqued the curiosity of the venerable Folger Shakespeare Library in Washington, D.C., which has expressed interest in having him make a presentation. "Shakespeareans from all over the country wrote co me. Even my mother read about it in Florida," Fogan says. Fogan attributes the widespread interest to the universal appeal Shakespeare holds and the endless curiosity about his life, his sources, his works and his influences. In the Los Angeles area, where Fogan lives, there aregroups of Shakespeare devotees - "geologists, newspaper critics, lay people," Fogan said, who meet to explore different approaches to reading him. While Fogan is pleased with the SPRING 1991 �14 reception to his paper, he is modest about chinking, ideas, motivations, fears. Anhis own contribution to Shakespearean thropology gives one a perception of how studies. There are over 700 references to all of chose facets of a human being demedicine and psychiatry in Shakespeare's velop. The knowledge of the body plays, Fogan says, and other researchers biology and anatomy - is one thing; but have gone over some of the terrain . He in making the person accept your diagnocites studies on Shakespeare's knowledge sis, your ideas about causes, testing and of chest diseases, obstetrics, gerontology, treatment, the physician needs to be able ped iacrics,rheumatology, orolaryngology, co understand the who le person. radiography and dentistry, plus countless "Shakespeare and literature heighten analyses by psychiatrists. But Fogan's study highlights a dimension of Shakespeare not fully recognized before - Shakespeare's breadth of knowledge of medicine, the accuracy of his observations of neurological signs, symptoms and diseases and the appropriate use of this knowledge co depict his characters. "The fullness and accuracy of Shakespeare's observations of behaviorcannot be overemphasized," says Fogan. Or overadmired, as the vo lume of Fogan's mail from Shakespeareans all over the country would seem to testify. Fogan's interest in Shakespeare, he expla ins, grew out of a life-time Lonee Fagan, M.D. , '65 interest in anthropology. "When I was an undergraduate at UB, I wanted to be broadly educated. I my awareness of certain aspects of human knew I cou ld meet the science require- nature and help me to recognize the huments for medica l school without having manity around me, giving me a new to major in a science. What I really wanted awareness of motivations and feelings and to study was mankind, so I decided to helping me to perceive, absorb and share what other people are feeling," Fogan major in anthropology." says. Though a pre-med student, Fogan Fogan became seriously interested in found encouragement for his interests from anthropology professors Henry Lee Shakespeare in the summer of 1977, when Smith Jr. and David Stout. The advisor to he spent a three-month study leave in London and was able co make weekend pre-med students, Roger Gracwick, thought his interest in anthropology co be visits to Stratford. Upon returning, he a fine, if unusual, foundation for medical enrolled in a night course on Shakespeare at the local community college - the studies. Looking back, Fogan values the for- College of the Canyons in Valencia, mative liberal arts education he received California - which offered a six-year course covering the complete plays and ::tsa UB undergraduate. "My backgrou nd in anthropology and poetry. Fogan faithfully attended for all linguistics served as an excellent founda- six years. "I started to notice the double vision, tion for me as a physician. A physician's primary responsibility is working with the dementia, the headaches occurring so people and trying to understand a person's frequently in the plays, and I began co SPRl1'G 1991 takenotes,"Fogansays. ln 1987,asoucgoing president of the Los Angeles Society of Neurology and Psychiatry, he used the occasion of his final address to present his research on Shakespeare. le was so well received that he expanded it into the prize-winning paper. Since that presentation, the paper has been published in The Archives of Neurology(August 1989) and in The New Scientist, the British equiva lent of ScientificAmerican, under the tide "The Neurologist of Avon" (January 1990). le was also presented for a medical benefit at the Old Globe Theater in San Diego (where Fogan appeared in Renaissance costume for the occasion), at the Institute of Neurology of the National Hospital, Queen Square, London and for the UB Medica l School's Department of Neurology in 1989, as part of the annual lecture series. In 1983, Fogan established the Edward Fogan Lectureship/Prize in Neu;!; rology at UB in honorofhis farher. 0 ~ Fogan enjoys balancing his lit< erary interests with his professional 0 responsibilities as chief of the Department of Neurology of Kaiser Permanente Medical Center in Panorama City, Ca lifornia, and assistant clinical professor of neurology at the UCLA School of Medicine . His research interests include cluster headaches and atypica l mycobacceria, a subject he studied for his M.P.H. (Unive rsity of Oklahoma School of Public Health, 1968). His other research in the history of neurology includes a study of John Cheyne, the lace 18th-century Scottish physician and one of the founders of child neurology . Among his many interests outside medicine Fogan includes windsurfing and cooking. But history and literature are his special loves. An<l what is he planning next? "Well, I've been reading Keats with special attention since my last visit to England. And then there's the Bible. I cook a course in literature and the Bible, and found a lot of passages of special interest co physicians there." • ! i BUFFALO PHY~ICIAN AND l\lOMEOICAL SCIENTIST �1\le Ji cali 01seiryaf i ons firom a R en&-issa irn.,c e l.\'lan "Shakespeare might have been a neurologisc. .. he was so good at ir ...His wonderful descriptions and delineations in this great field of our science shows that he had thoroughly mastered the subject in all its branches." The preceding quote is from O.W. Owen's 1893 medical journal "The Medicine in Shakespeare." And while this may have been the first word on "Shakespeare as Neurologist," certainly the current, dominant work on neurological references in Shakespeare belongs to UB alumnus Lance Fogan. His award-winning paper, "The Neurology in Shakespeare," supports Owen's recognition by noting and discussing the various observations, symptoms, signs and disease states of the nervous system that appear in Shakespea re's 37 plays and poetry. Fogan points out that "Shakespeare's works are replete with information and references of particular interest co physicians." The following has been excerpted from Fogan's masterwork: OntheNeurological Complications of Syphilis: The "pox," referring to the venereal disease, is mentioned in many of the works. It became known in Europe in about the year lSOOA.D."Timon of Athens,"which was written sometime between 1604 and 1609, contains many references cosyphilitic symptoms. Timon shows a marked personality change himself; he initially is a cultured and prominent Athenian leader. As the play proceeds his intellect pathologically weakens and at the conclusion he is angry and violent and as his steward Flavius cries out, "a ruinous man .. .full of decay ... " Evolution of a syphilitic into a pare tic clement, I offer in pointed speculation. I\UFF.-\LO PHY,ICl.-'.l--AND lllO MErnL AL S<.'18': Tl~ Of special interest, which again emphasizes Shakespeare's power of observation, are symptoms included in Timon's malignant tirade directed at two prostitutes. He encourages them to give them (men) diseases "and co cause lawyer's voices to 'crack."' Tertiary syphilis can cause aneurysms of the ascending thoracic aorta which can compress the left recurrent laryngeal nerve and paralyze the left vocal chord; this clinical entity is known as "prostitute whisper." Is this what the Bard described, or was it gummas of the larynx which could result in the ninth part of a sparrow." A locus for the foundations of memory appear in "Love's Labor's Lost" IV,2,66: "These are begot in the ventricle of memory, nourished in the womb of pia macer. .." Nearly 400 years later can we be that much more precise in "locating memory?" OnSciatica: One of the several references co this affliction is offered by the "deformed and scurrilous Greek" Thersites in "Troilus and Cressida" V,1,25, as he includes sciaticas as one of the "rotten diseases of the hakespeare was not only acquainted with the signs, symptoms and courses of diseases of the nervous system, but he understood them well. same symptoms? In IV,3,153: Timo n"...Crack the lawyer's voice,/ That he may never more false title plead/ Nor sound his quillets shrilly ..." Tabes dorsal is is the neuropathologic form of the disease responsible for the lightning-like pains in the extremities, and for impotency, which also did not elude the great author. In IV,3,152: Timon"...strike their sharp hins and mar men 'sspurring ...Plague all/That your activity may defeat and quell/The source of all erection ..." OnNeuroanatomy: Shakespeare shares with us his awareness of some neuroanatomy in mentioning pia mater, which in Eli:abechan England referred not only to the membrane covering the brain but also to the brain itself. In "Twelfth Night" 1,5,108 the clown says " ...whose skull Jove cram with brains, ...one of thy kin has a most weak pia mater." In "Troilus and Cressida" Il,l ,66 Thersites exclaims "I have bobbed his brain more than he has beat my bones ...an<lhis pia mater is not worth the south" (i.e., of the southern end of the body). Results of treatment of sciatica must have been frequently disappointing in Shakespeare's day, just as today, for Thersites expounds " ...sciaticas, limekilns i' the palm (or arthritic calcifications), incurable bone-ache ..." Again, in "Timon of Athens" IV,l,25: Timo n"...Thou cold sciatica,/ Cripple our senators, that their limbs may halt as lamely as their manners! ..." On"Extraordinary Measures'': How current his ideas are, even though they were written almost four centuries ago. In 1988, as we minister to our poly-intubated and venrilarory-assistcd patients in incensi,·e ca re units, as we sometimes agoni:e over the appropriateness of our life-prolonging activities, the Bard of Stratford-Upon-Avon admonishes us, as did Kent in "King Lear" V,3,314: "Vex not his ghost. 0, let him pass! He hates him/That would upon the rack of this tough world/ Stretch him out longer." • SPRING !WI �f.l FFALOMn, OAS A'-D Ill MEDICAL"'-""IL'-"Tl'• �• 17 or nearly 20 years, physicians in New York Scace have grappled with the problem of malpractice insurance. Now, chat is changing for full-time faculty physicians and dentists ac four SUNY Health Sciences Centers, thanks co an innovative new insurance company the faculty formed itself. The new company, the Academic Heal ch Professionals Insurance Association (AHPIA), is the only one of its kind now operating in che United Scates, according to its chairman, William P. Dillon, M.D., associate professor of gynecology-obstetrics at UB and chief of the division of maternal/fecal medicine at The Children's Hospital. AHPI/\ began issuing binders in January of chis year. Dillon, who was instrumental in spearheading the development of the company, noted that New York State's malpractice insurance crisis of 1973 began the chain of events that eventually led co the AHPIA's formation. The early 1980s saw malpractice insurance for New York State physicians targeted specifically at full-time University faculty. With their lower exposure and, as state employees, indemnification under Public Officers Law 17, full-time facu Icymade an attractive market, Dillon said. Indemnification under state law, however, has not been interpreted as such by the state's attorney general, leaving SUNY faculty physicians and dentists potentially at risk as the issue is tested and appealed in the courts. In 1986, as part of the United University Professions state contract negotiations, a Labor Management Committee was formed to investigate the availability and feasibility of self-insurance. "The labor-management group concluded it would be to the faculty's benefit co form our own captive insurance comBUFFALO PHYSIC IAN ANO BIOM EDICA L SCIENTI ST licensing of AHPIA. AnewSUNY programformal The company, in the short time it has operating, is doing very well. "More insuresfacuity been and more faculty are joining us. this company as safe or physicians & dentists safer"Wethanmade any other out there," Dillon said. "The New York State Insurance ACADEMIC HEALTH PROFESSIONALS Department is not going to license us if INSURANCE ASSOCIATION FACTS they think we're going to fail," he added AHPIA: • Isa reciprocal insurance company. • Is operated by a board of d ireccors made up of representatives of the medical centers, dental schools and United University Professions who are also subscribers. • Offers both occurrence and claimsmade policies. • Handles all claims occurring from private clinical practice as well as those occurring from a faculty member's employment. pan y," Dilion said, noting the group based its conclusions on two main premises: that the insurance be available only to full-time faculty in the practice plan and that those faculty who joined the company would benefit in the form of lower premiums and, in time and with the approval of the state insurance department, the realization of dividends. Through the efforts of a steering committee of dentists and physicians from the four medical schools and two dental schools and support from the deans, the initial capital was raised. Reinsurance by Lloyds of London, cogether with that raised capital, met all capital obligations under state regulations. "After that," Dillon said, "we submitted our application for a reciprocal insurance company to the Scace Insurance Department," in a process that would culminate over two years later with the In developing this company, he said "we made sure it has belts and suspenders." The Academic Health Professionals Insurance Association writes both occurrence and claims-made policies. Occurrence policies are those that cover incidents occurring during the policy year without regard to when a claim is filed and are available only to physicians and dentists currently holding them with their present company. Claims-made policiescoveronly incidents that arise and are reported during the policy year, but extend back to any incident since the inception of the insured's first claims-made policy (retroactive date). By law, physicians and dentiscs who now hold claims-made policies, as well as those subscribing for the first time in New York Seate, are required to purchase claims-made policies. Dillon stressed that besides the potential for dividends and the benefits offered by self-governance, AHPlA has selected specialist attorneys and would encourage subscribers in the same specialty from other SUNY sites to act as expert witnesses. Its philosophy is co work closely with SUNY Central, the faculty union and the state's attorney general co develop guidelines for the division of responsibility co defend and indemnify losses. "This is a company by and for the faculty," Dillon said, adding, "This is pioneering work. We're taking a problem and responding to it." • SPRING 1991 �Ediwr's Note: Followingare excerptsfrom an articleby RichardV. Lee, M.D. publishedi;ntheMay 1990Journal of Clinical Epidemiology. Lee, a professorof pediatrics and cwUunctprofessorof anthropology,is basedin theDepartmentof Medicineat The Chilclren'sHospira!of Buffalo. n exquisite Van Gogh painting is played at the Albright-Knox Art Gallery in Buffalo. The 0/cl Mill was completed in 1888, two years before the artist's death and over a century before the composition of chis essay. There is nothing medical about it; no earless, demented, bandaged or sick people; no hint of plague fears, no angst . Rather it is a welcoming, friendly landscape, full of warmth and color. It is about two feet square, a cozy painting, incense, arresting . 1am unable to walk along the gallery corridor in which it hangs without stopping. Dissecting my affection for Van Gogh':; painting, or any painting for that matter, probably seems clinically obscure for young modem physicians schooled in "hard science." Van Gogh, I admit, does appear a bit removed from biostatistics, magnetic resonance imaging, coronary angioplasty an<l DNA probes. Aesthetic sensibi1lity,however, ought not co be excluded from clinical medicine. Indeed, how doctors perceive and appreciate art is not merely significant. I maintain that a well-developed aesthetic sensitivity, an awareness of beauty and of ugly, is clinically essential. Physicians are caught not to regard their patients as beautiful creatures, but as creatures to be dissected, poked an<l observed with suspicion . The idea of the human bo<ly as a work of art smacks of religion; that the manifestations of illness might be considered aesthetic seems callous and disrespectful. Art can be triv iali:ed. Medicine is coo serious and too scient ific for such antics. Medicine is too real to be contaminated j $PRING 1991 •►lriiiMIP or distracted by the ethereality of arc. Still, the mythic "art of medicine" continues to circulate and to remind us of a more complete, perhaps humane, medicine. And medicine without aesthetic sensibility and sensitivity is transformed into a kind of neutral tinkering: routine, colorless, boring. Viewing Van Gogh is more than a dissection: individual brush strokes, individual colors combine into a comprehensible whole. The painting reaches out, sei:es my eye and captures my attention. There is immediate comprehension, instantaneous intuition, active awareness. Perhaps it is this intuitiveness that makes physician-scientists so suspicious about introducing notions of art in clinical activities. Yet my comprehension of the nature of a patient's misery is no less intuitive. Examining a patient, looking at a painting, listening co music, share a sense of being possessed, totally engaged, intuitively immersed in the object and the ace of observation. Clinical medicine and looking at a painting unavoidably include my personal interpretation of symbols and symptoms. Boch activities require a storyteller patient or storyteller artist, visual intimacy, time and me. The clinical picture is a unique blend of the patient and the physician: both acting as artist, observer and viewer. The pat ient 's description of che intensity of pain is colored by fear and anxiety, the hope chat this is "just something minor." The doctor's relation of the description and clinical interpr etation is colored by the "fit of the story;" does the pain I\UFFALOPHY~ICIANA"l() BIO~tEL11CAL --C:IENT!ST �19 has more to do with ways of knowing as opposed to ways of doing, with intuition not with technique, with episteme, not f t praxis. match the events and the findings on examination, is the patient asking for relief of something other than pain? Clinical truth, like a Van Gogh painting, is a composite. Master physicians do more than master the craft of medicine. They use it in waysthat inspire, that expand our knowledge and our vision. One connection between art and medicine is epistemologic. Both depend upon intuition, the nonquantitative apprehension and comprehension of beauty and of ugliness. Art proclaims its intuiti\'eness; modem medicine attempts to camouflage it. Van Gogh uses blues, yellows and greens to make a verdant, fecund sensual image. A patient tells me ofarthralgias, allergies, abortions, bruising and photosensitive skin chat has malar telangiectasia and atrophy. Even before the confirmatory laboratory tests have been taken I can tell her I have her clinical picture, a diagnosis. Van Gogh's Old Mill is stunning. My patient's lupus erythematosus is stunning. But different artists, different patients and different physicians can make different pictures of identical scenes and diseases. Our notion of disease and health is the same. The clinical expression oflupus erythematosus varies from patient to patient, the clinical picture is shaped by the powers of description and observation by patient and doctor, but we do not doubt that there is a fundamental biologic disorder that generates the disease, the clinical picture. So the affinity between me and Van Gogh, between my medicine and his art, Academic medicine devotes enormous amounts of energy, time and verbiage to the praxis of medicine: the design and statistical evaluation of experiments and experience, the performance of delicate surgery, obtaining and preserving anatomically precise, computer-enhanced images, the definition and imposition of what is called "quality control." The officiously objective burdens of utilization review and quality assurance ask only about technique and outcome. They do not ask about intuition or interpretation. Compassion and comfort, beauty and joy, are not concerns of "quality control." More importantly, those moments of exhilarating, humbling clinical intuition are not concerns of medical educators and administrators. Because it eludes measurement by standard scientific, statistical studies, clinical intuition is nor taught, or even talked about. We assume it is a gift, an endowment students bring to medicine, not something we teachers impart to them. Despite my lamentations, contemporary medical education works. Perfectly adequate doctors are produced ... never having attended a symphony concert or strolled through an art gallery. Why bother about Van Gogh's Old Mill or Lewis Thomas' LateNight Thoughtson Mahler's Ninth Symphony? Because without them medicine is ugly. And without intuition, and beauty and ugliness, without art, what I do wouldn't be medicine at all. Reprintedwichpemiissionfrom The Journal of Clinical Epidemiology, Volume43, RichardV. Lee,M. D. , TheClinicalPicwre,Co/J)'righr1990, PergamonPress, Inc. SPRING 19'11 ���sawacauliflower earinanybody -= I never --- butawrestler. Sore shoulders and elbows a.> '--' 22 cs a.> E common ailments inpitchers. c:s are ..... a.> -= a.> C:S> ---= -c:s = -= c:s E -= C ~ "There is no place like this in Western New York," says Edmond J.Gicewic:, M.O., of the 13,000square feet of space in Farber Hall that houses UB's new Sports Medicine Institute. The innovative program on the South Campus is designed for the specialized management and treatment of athletic injuries. A joint effort between the UB Medical School anJ the Division of Athletics, it operates under the aegis of the Department of Orthopaedics. Gicewic:, an assistant professor of orthopaedics at UB and the University's team physician for 25 years, says the lnstitute's mandate is three-fold - education, service and research. Its benefits, he adds, will extend to the Western New York community at large. The Institute brings an extra dimension to the practice of sports medicine in the region. Assembled under one roof are all the personnel and facilities necessary to treat athletic injuri es on the spoc: physicians experienced in sports medicine to examine and diagnose, X-ray and casting rooms, physical therapists to supervise recovery and $300,000 worth of rehabi Iitation equipment co help the athlete return co playing form, including a motion laboratory, a $52,000 Biodex machine that assesses range of motion via computer and whirlpools for partial and whole body hydrotherapy. It also offers the University's Athletics Division the quicker anJ more extensive care to its athletes it will require for the planned move m Division ]. As an educational facility, the Spores Medicine Institute is a training ground for students in various specialties who need experience treating athletic inju ries. "We have family practice residents come through so they will know how to handle these things if they are the only physicians in a small community . We hope to rotate our orthopaedic residents through as part of their training. We may have some surgical residents. We will have medical sru<lenrs, nursing students, physical therapy students, athletic trainers," Gicewic: notes, ad<ling, "Athletes sustain many ailments not seen in general me<licine. I never saw a cauliflower car in anybody but a wrestler. Sore shoulders and elbows are common ailments in pitchers, and there's jumper's knee in basketba ll." The lnstitutc's founders, which include Robert Gillespie, M.O., chairman of UB's Deparnncnr of Orthopaedic Su rgery, who pressed vigorous ly for the facility, hope to set up a fellowship in sports medicine to round out the teaching component . Service is the broa<lesr and most public of the lnstitute's mandates. Any person injured in any sporting activity- in competition or personal recreation may come to the Institute for care. Patients are charged a fee for service, as at any other clinic. Although treating people who get hurt participating in sports is not the lnstitute's sole reason for existing, tending coathletic injuries is the its most imme<liate mlc, and UB's athletes were the first to benefit. HeaJ athletic trainer Mike Rielly, who is also program coorJinator for the Institute, works with the athletes <laily. For him the Institute is a tremendous as·er. It provides professional care of the highest quality immc<liarely. During football season, for example, the Institute remained open much of the weekend to rend to high school and college players hurt during Friday anJ Saturday games. Time is critica l nor only for rhe athlete's comfort but for proper assessment of an injury, Rielly says. "If an injury is acute, the quicker it can be evaluated, the better the chance of proper diagnosis. Some signs can be masked if the injury is a llowed to sit for an exten<led perio<l." The Institute also conducts an outreach program for high school athletic trainers, and sponsors symposia for high school coaches in various sports. The research arm of the Institute will study new ways to treat certain ailments for which current treat- Rt.:FF:\LO PllY~ICl:\N :\N[) RIOMEnlC..\L SCIENTl~'T �23 ment is considered inadequate, and take on other projects. One of its most ambitious goals is to establish an injury registry for Western New York's young players. "Every h igh schoo l athlete who gets hurt will fill out a rather detailed form telling how the injury occurred, what the acti\'ity was, whether the field was wet or dry, whether it happened on Astroturf or grass, and when during the game it happened," notes Gicewic:. "We will put all this information into a data bank and study it so we can eventually draw some conclusions." Gicew ic: is pleased with the response the Institute has garnered so far since it opened last August. "We are getting patients from Barker, Medina, Jamestown, Ellicottville. We are seeing a lot of people from all age groups and all walks of life. I think the Institute will be really helpful to the Western New York community." • BUFFALO PHYSICIAN AN[) BIOMEDICAL SCIENTIST Assembled under oneroofareall thepersonnel andfacilities necessary lo treatathletic injuries onthe spot. SPRING l9<ll �24 • ua1 Alvan Feinstein callsfor the creation of a new basic science. By Laurie W Wo I f e hen patients arc diagnosed with a disease, they want to know how it will affect their lives. Will they be able to work, to drive, to parent the1rchildren?Will rhe pain stop? When? And patien~ aren't the only ones looking at chose kinds of questions. In this era of declining economic resources, with its concomitant soaring medical costs, economists and insurance companies are concerned with cost/risk/benefit ratios, noted Alvan R. Feinstein, M.D., when he delivered the 1990 W. D. Harrington Lecture lase October. The distinguished professor of Yale's Department of Medicine and director of its Clinical Epidemiology Unit noted chat if clinicians are co offer evitlence of benefits w the quality of life of their patients they must have a coherent way of describing, measuring and quantifying even simple things like "being able w breathe comfortably" or"beingable to walk without pain." A life may not have been s rRIN l, ! <NI extended by a procedure, but perhaps that life's quality has been measurably improved for the patient. "The current challenge," Feinstein noted, "is in mensuration and quantification. We need a language for drawing fair and relevant comparisons, for example, for the severity of an illness, for relief, for comfort. We must create models that fit the observed phenomena, rather than forcing clinical events into models chat may not be appropriate." Part machematic ian, part philosopher and part provocateur, Feinstein is renowned as thoughtful critic of the established doctrines and practices of clinical medicine. His capacity to "stir things up" was admiringly noted by James Nolan, M.D., professor and chair of the department of medicine, as he introduced Feinstein to an audience of UB faculty, alumni and students. Attending the University of Chicago, Feinstein earned a master's degree, and, in 1952, a medical degree. He trained in internal medicine at Yale and the Rockefeller Institute. After five years as a faculty member at New York University, Feinstein returned to Yale where he has remained except for a two-year visiting professorship at the 0eparcmencofClinical Epidemiology and Biostatistics at McMaster University, Montreal, Canada. Feinstein's lecture was peppered with humor and insight, focusing on the inadequacy of "basic science" to assist practicing physicians in making decisions about managing disease. He urged creative thinking to develop "an additional basic science for observing, quantifying and comparing clinical phenomena" to fill that gap. Feinstein noted that basic science presents two very different challenges: to explain phenomena and to intervene upon chem. The latter is the realm of the practicing physician, who predicts how to manage the phenomena . Feinstein predicted that the clinical observations of practicing physicians will become more important as medical care becomes more expensive and the competition for research dollars increases. While the last century has seen tremendous advances in technology and experimental methods that benefit explication, Feinstein said, "in general, clinicians have not developed a set of basic scientific strategies for making and eva luating managerial decisions" about the prevention and treatment of diseases. As a result, "controversies and doubts regarding the optimal usage, benefits, risks and costs of technology exist at BUFFALO PHY~ICIAN AND BIOMEDICAL SCIENTIST �2S u 5 t every level of clinical decision-making, from the care of a newborn to the care of the octogenarian, from the care of the common cold to the care of a patient with disseminating cancer." In the past, rhe biomedical paradigm has generally been the search for "hard data," obtained wirh a subject or specimen that is preservable (so as ro be reexamined). The results are usually expressed in dimensional terms, and the measurement procedures are objective and made preferably by machine. Absent from the literature on therapy arc what Feinstein referreJ to as "soft data," descriptions of human beings and human life made by natural observation in clinical practice. Soft data, he cautioned eloquently, have a great effect on good clinical decision-making. They are "the crucial harbingers of prognosis. Without soft data we cannot achieve scientific reducibility and identify the people under treatment. BUFFALO PHYSICIA1' AND BIOMEDICAL SCIENTIST a 0 n 5 8 "Does it matter if a congestive heart failure consists of some relatively mild peripheral edema, or whether the patient is gasping with pulmonary edema? Of course, it:does . And yer congestive heart failure, as one part of spectrum of coronary disease, is often described without those distinctions." In arnother example Feinstein remarked rhat cancer studies often fail to distinguish between patients labeled "inoperable .." The category may combine people who will not tolerate surgery and people wlhocould tolerate it, but refuse it. Feinstein challenged his audience to create indices and rating scales to identify clinical phenomena and, in effect, "harden" soft data. In need of indexing are such phenomena as different types of symptom.s within the spectrum of disease, rhe severity of those symptoms, rhe chronometry of the symptoms' manifestations, rhe auxometry (rate of progression of the ailment), rhe co-morbid asso- y T m L e e ciated ailments, rhe reasons for diagnostic or therapeutic decisions and the reasons for a patient's functional limitations. While praising the value of randomized clinical trials in remedial therapy, Feinstein stressed they are not adequate "in an era of burgeoning technology and unstable therapy." High costs, cumbersome logistics, lengthy study durations and the great number of subjects required make randomized trials impractical in prophylactic therapy, especially where the goal is to prevent the adverse progression of a present disease. "It is our job as clinicians - nor rhe mathematicians, statisticians or computer experts - but our job to develop an observational substitute for randomized experimental trials in cause and effect reasoning. If we don't do it, it won't be done, or it will be done badly by people who don't understand the problems." • Sl'Rl1'G 19~1 �---------------------- - ~ ~ ~ I ( ~~ ---------------------- .,. r /f 0 <) 26 The Greying of Medicine David W. Bentley, M.D. 's Mandatefor the 21st Century D avid W. Bentley, M.D., has set an ambitious goal for himself as the new head ofUB's Division of Geriatrics/ Gerontologyto help prepare the University community for the major health issue of the 21st century - health care for the aging. "Geriatrics and long term care is the name of the game in health care today," said Bentley. "TI1e next 25 years are going to be focused on these two domains. The typical health care community and university community have nor been interested in these two domains, ever." Since assuming his position September l, Bentley has sought to make UB an exception to that rule. One month into 1991, he and his colleagues had already submitted four major research granc proposals dealing with issues affecting the elderly. Two have already been funded. In addition to his position as profe ·sor and head of geriatrics, Bentley also serves as director of the University's Multidisciplinary Center on Aging, co-director of the Westem New York Geriatric Education Center and chief of the Geriatrics Service at Buffalo VA Medical Center. He was recruited to increase the research activities of a division already strong in clinical affairs and education. Even before moving into his offices in Beck Hall and the VA Medical Center, Bentley was busy convincing 19 senior faculty in several disciplines to gear their research in progress toward problems of the elderly and to accept postgraduate fellows in gemmology to work along with them. The effort culminated in a $259,200 grant proposal cothe National Institute on Aging which, if approved, would set the University on an ambitirn.1i; course of incorporating age-related research and education throughout the University's disciplines. Bentley came ro gerontology rather late in his career. A graduate of the University of Rochester Schtx)l of Medicine and Dentistry, he took his residency in internal medicine at Vanderbilt University Hospital and did postdoctoral work in infectious diseases at the University of Illinois. After a two-year appointment at the University of Manitoha, Bentley returned to Rochester in 1972 to head the infectious tliseases unit at Monroe Community Hospital, known intemationally for its work in geriatrics. He remained there until coming to UB. He was abo an associate professor of medicine at the University of Rochester's School of Medicine and Dentistry. Bentley became a specialist in geriatrics "by osmosis," he said . He worked closely with its medical director, D. Franklin Williams, now director of the National Institute on Aging. His expe riences at the Rochester hospital convinced him to change his career and hi~ research to focus on the elderly. When the first boards for certifica1ion in geriatrics were offered in I 987, he took them and passed. Bentley said the move into geriatrics was prompted by his own inclinat ions and a look into the future. "For anyone in healrh care, the demographics were very clear," he said. "The most rapidly growing segment of the United States is 85 years of age and older, and the population 65 and over is also growing very rapidly. The epidemic of Alzheimer's disease, for examp le, is much more serious, much larger and more costly than the epidemic of AIDS." Bentley and his sraffhave already scored some successes in steering the University toward the concerns of an aging population. One of his plans for the future is to attempt codevelop a cadre of researchers outside the Center who will apply for and receive funding from major grant-giving organizations such as the National Institute of Aging. "There are only a handful of people at the University now who have those types of awards," Bentley said. He credited the cooperation of his colleagues across the University for the accomplishments of the Division and the Center so far. "The problem chat one has in academics," he said, "is that you have to be good in teaching, good at research, you arc expected to beexemplary in patient care and to be a very good administrator. That is a very difficulr chore for the average person. Without so much support around me, we could nor have achieved all we have in these few months." • - B)' Lois Baker llUFF:\LO PHYSICIAN A:-.111 llll'MEl11CAL !'CIE.Vfl~ �----------------~@~ () ('" If Davidw.Bentley,M.D., (above): ... I ( ~~-- "' ---- -- -------- 0 "The epidemicof Alzheimer'sdisease' for example,is much moreserious,much largerand more costlythan the epidemicof AIDS." BL:FFALO PHYSICl.·\N ~ND BIOME[)IC.~L SCIENTIST SPRING 1'/<ll �--------------------- ~~~I C~ ~--------------------.,. .... (" II o I) 28 The High Expectations of Eddie Hoover New Surgery Chairman Plans for the Future <ldie L. Hoover, M.D., new chairman ofUB's Department of Surgery, credits two people with helping him get where he is today: a college professor who sent him on the right path and a surgeon who inspired him to follow it. "I didn't have any idea about becoming a surgeon," said Hoover, a native of Charlotte, N .C. "I went to college to get away from farming." Hoover chose pharmacy as his major when he enrolled at the University of North Carolina at Chapel Hill, because he knew what pharmacists did . A sophomore history teacher, seeing Hoover's grades, suggested medicine instead, and introduced him to the clean of Duke University Medical School. "My idea of a physician was ro go somewhere where you were needed, open an office and treat patients," sai<l Hoo\'er. "Even when I was looking into medical schools, there were no black specialists." But he eventua lly enrolled at Duke, where rhe emphasis was on turning out people who would stay at medical schools, teach and do research. There, Hoover lancle<lby accident under the tutelage of Paul Ebert, M.D., a dedicated surgeon who woulJ have a lasting influence on his life. "He operated on children's heart s," Htx)Versaid. "I thought that wa~the most exciting thing a per ·on could do in life. I decided I was going to do it if I had to beg, borrow or steal." E "I get fairly immediate gratificationfrom what I do. A person's appendix hurts , I take it out. I like the fix-it approach." As luck would have ir, surgery suited Hoover's personality nicely. "I get fairly immediate gratification from what I do," said Hoover. "A person's appendix hurcs, I take it out; a person has lung cancer, I cure them, rather than readjusting pills because somebody's blood pressure is out of control. 1 like the fixit approach." Hoover did his internship with Ebert at Duke University Medical Center, and when Ebert left Duke for Cornell University Medical Center, Hoover followed. He completed his residency and thoracic surgery training there and at MemorialSloan Kettering Cancer Institute. He went on to hold academic appointments at SUNY-Downstate Medical Center anJ Meharry Medical College in Nash\·ille, as well as Cornell. He has served on the surgical staff of New York Hospital, Kings County Hospital and State University Hospita l, all in New York City; VA Medical Centers in Brooklyn and Murfreesboro, Tennessee; Woodhull Medical and Mental Health Center in Brooklyn and G.W. Hubbard Hospital in Nashville. Hoover assumed his UB position and was named chief of surgery at ECMC on September I. He also is continuing his research, which currently centers around the role of prosraglandins in gall stone formation and hypertens ion and kidney damage in heart transplant patients. The new head of surgery has several goals for his department. "First, we must continue to provide the highest quality patient care, and make sure all the new technology that is safe and makes sense is available to people in Western New York," he said. "Second is resident education. We must provide the kind of training programs that allow us to attract the highest quality residents." His third goal is to make UB preeminent among major public universities, he said. "We need to rum out excel lent physicians and academicians, so we can hold our own in the scientific field." The drive char pressed Hoover onward to success as a surgeon surfaces when he speaks of his plans to move UB toward new surgical frontiers. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �----------------------- ~e~ - I ( ~~ - .;, (' If ~ ------ ----------------- 0 29 EddieL Hoover , M.D. "We need ro start doing lung transplants," Hoover said. "We have approva l from the state but we haven't gotten it starred . We need to move into more laser applications in medicine. Ten years from now, a lot of what we do in surgery will be replaced by laser techniques." Preparing for that inevitability, Hoover lll.:FFALO PHYSICIAN AND BIO~!EDIC.-\L "l"IE.'1Tl!-T has established a study group with the physics and electrical engineering departmen ts to develop appropriate laser research projects. To improve the teaching of surgery, Hoover wants to incorporate the newest audio-\'isual techniques. "The new equipment is so good you can see a lot more watching a TV screen focused on the field than by standing at the operating table," he said. "Now, some students may stand there for six hours and hardly see anything. "We're going to start that by July," Hoover said. "All I need is $30,000. Somehow I'll get it. • - B)' Lois Baker ~l'RllsG 1991 �----------------------~@ - ~I r~~------------------- .,. r /( 0 - -- I:> 30 UB PHYSICIANS USENEW PROCEDURE ToSAVE GEORGIA POLICEMAN rill wearing an eye parch to stave off double vision, a Savannah, Georgia, police officer thanked God and "the doctors in Buffalo" for saving his life after he was shot in the head pursuing a shooting suspect in early March . G. Scan Freeman, 28, was investigating reports of domestic violence in Savannah when the shooting occurred . Fifteen days later, Freeman was airlifted co Buffalo to undergo an expe rimental procedu re in which "micro-bal loons" were placed in his internal carotid artery to keep him from bleeding co <leach. The procedure was performed by L. Ne lson Hopkins, M.D., chair of the Department of Neurosurgery and chief of neurosurgery at Millard Fillmore Hospital. Hopkins use<la micro-catheter co place the silicone micro-balloons co occlude a bu llet-damaged section of Freeman's left carotid artery. "The bullet tore open the left caroci<l artery ... and penetrace<l the upper part of the nasal cavity, where it came co rest" allowing blood co escape out the nose and th roat, Hopkins said. A clot surrounded by soft tissue formed, temporarily closing the com artery, but creating a potentially lifeth reatening situation. Usually, Hopkins said, "the clot will dissolve and the arte ry would again begin hemo rrhaging. If chat happened, I th ink he likely would have bled to death." Freeman's Georgia physic ian recalled that UB neurosurgeons were using to coronary a technique similar angioplasty co prevent an<l treat stroke. T he new technique, however, uses miniaturized catheters and balloons to ac- S srRINU19'11 Top,G.StanFreeman andhiswife,Nancy,lookat X·raysandangiograms of hisskull.Bottomleft,a leftlateralinternal carotid arteryangiogram showsshrapnel scattered adjacent to thetornarteryand thebulletlodgedinthesinus.Bottomright,a lateralskullX·rayal theballoono«lusionwitharrows marking thethreeballoo ns inthe internal carotid. commodate the finer vessels in the bra in. In a four-hour procedure guided by X-ray images, with Freeman totally awake, surgeons th readed a tiny catheter through his femoral artery to the carotid. Hopkins then inflate<l three micro-balloons one primary and two backup- to occlude the tear. They will be left in place and eventually will be walled off by the body. The permanent occlus ion of the blood supply through the carotid will not affect Freeman, Hopkins ad<le<l,exp laining he has sufficient collateral circulation. The bullet will be left in place . The UB team performs about 100 balloon occlusions each year at Mil lard Fillmore Hospital, most designed to prevent stroke and intracerebral hemorrhage from arceriovenous ma lformations an<l aneurysms. The procedure is also used as an adjunct to surgery to de liver chemotherapy to or tie off the blood supply of tumors. The procedure was developed by Grant Hieshcmia, M.D ., professor of ra<liologyat the University of Ca lifornia at San Francisco, and lnrerventional Therapeutics Corp. It was first used five years ago. Nationwide, about 1,000 such surgeries are performed each year. • Bl.JFF,\L,1 rllYSl<:IAN ANDRIOMEnlCAL SCIENTIST �IJ "' 31 KASSIRER TOHEAD JOURNAL NEWENGLAND OFMEDICINE erome P. Kassirer, M.D., a 1957 graduate of the University at BuffaloSchool of Medicine and Biomedical Sciences, has been named the new editor-in-chief of The New EnglandJournalof Medicine. Kassirer will take over the helm of the journal in July, succeeding Arnold S. Reiman, M.D., who has served as edicor-inchief since 1977. He was named on Jan. 29 following an extensive worldwidesearch by a distinguished panel of medical leaders. J The New EnglandJournalof Medicine, published by the Massachusetts Medical Society, is the oldest continuously published medical journal in the world and is considered the nation's leading journal of medical research and opinion. "l am deeply honored and pleased to accept this position," Kassirer said. "Some of the most illustrious names in American medicine have brought great distinction to the pages of The Journalduring their tenure as editor. I hope robe inspired by their examples, and am ready co meet the exciting challenges that lie ahead." A specialist in nephrology and internal medicine, Kassirer is Sara Murray Jordan Professor of Medicine and vice chair of the Department of Medicine at Tufts University School of Medicine, Boston, where he has been on the faculty since 1961. He also is associate physician-in-chief ac the New England Medical Center, Boston. A Buffalo native, he attended UB as an undergraduate from I 950 co 1953, entering its medical school following his junior year. He received his medical degree magnacum laude. Since 1986, he has served as a regional member of the governing board of the UB Medical Alumni Association. Kassirer received several honors while ac UB, including the Freshman Chemistry BLFFALOPHY~ICIANANO lllOMEDIC.ALSCIE?\TIST Jerome P.Kassirer , M.D. , '57 Award in 1953 and the Bausch and Lomb Science Award in 1953. While in medical school, he was named co the Gibson Anatomical Society and Alpha Omega Alpha and in 1957 he was recipient of the C.V. Mosby Award and the Roswell Park Award in Surgery. He did his internship and served as assistant resident in medicine at The Buffalo General Hospital from 1957 to 1959. Kassirer has received national recognition for his work on diagnostic reasoning and therapeutic decision-making. He is considered a national expert in many aspects of clinical medicine, especially kidney disorders. Board certified by the American Board oflncernal Medicine, Kassirer is a member of che board of governors of the American Board oflncemal Medicine and the board of regents of the American College of Physicians, which named him a master in 1990. A member of the editorial board of The New England Journal of Medicine from 1972 co 1975, Kassirer is editor-in-chief of Ciment Therapy in Internal Medicine (3rd edition) and co-editor of Clinical Forum. He ProblemSolvingand Nephrolog)' has authored or co-authored more than 100 editorials, scientific papers, book chapters or case studies on various aspects of clinical medicine. • - ByArthur Page About300 guestsattended theMedical Alumni reception inhonorof the seniormedical doss,held 12inthe January 38thFloor Restaurant of the Marine Midland Center. �__________________ ____ ,,, :z:---------- ----- ----- -- 1., 32 COLLINS LECTURE TOUCHES ON ETHICAL IMPLICATIONS OF GENETIC RESEARCH s researchers unravel the mysteries of human genetic makeup, society must start making decisions about how chat knowle<lge will he shared and app lied. That's the opinion of Francis S. Collins, M.D., Ph.D., associate professor oflncernal Medicine and Human Genetics and chief of the Division of Medical Genetics at the Howard Hughes Medical Institute, University of Michigan at Ann Arbor. Collins spoke to more than 100 physicians, researchers and others interested in genetics on March 26 at Buffalo's Hyatt Regency Hotel. Internationally known for his contributions to recombinant DNA technology. Collins was the inaugural speaker for Children's Hospital's Rose and Al Pastor Lecture Series. "DNA is an elegant scheme for storing information," he said. "Every genetic disordercan be traced tosomethingwrong in the DNA." Collins reiterated his work on isolating Lhe gene for ncurofibromatosb T ypc I a severe disorder of the nerves char affects one in every 3,000 people worldwide. He followed that with an explanation ofhow he isolated the gene for cystic fibrosis using a technique called "chromosome jumping" chat allows investigators co take "large steps across the vast expanbe of a chromosome." It is now possible rn screen for CF carriers, who number one in 25 in this country, he said. Carriers carry the gene A Francis S. Collins , M.D. , Ph.D. for CF but do not manifest the disease themselves. Each baby conceived by two carriers has a 25 percent chance of having the disease, a 50 percent chance of being a carrier and a 25 percent chance of being neither a carrier nor having the disease. "Genetics is not familiar territory to a lot of folks," he said, adding that a pilot counseling program of 2,000 people, such as the one undertaken by Richard W. Erbe, M.D., professor of pediatrics at UB, may give clues as rn how the issue should be approached. Collins suggests chac couples should be screened before a pregnancy is attempted. "The tricky part is that we have to be really careful when we Jo ·omething like this so that people really understand what the information means and there are all sorts of ways chat that information can get confused in people's minds," he said. "We could righc now start a screening program that would detect 85 per- cent of CF carriers," Collins said, but added that a program of this scope has to be carefully planned because it affects so many people and there aren't nearly enough trained counselors to impart the information. "People who are carriers may go away thinking that they are going to become sick themselves. And there are concerns about stigmatizing - that people will feel rhey are personally defective." Collins said he is afraid physicians might be pressured into offering the test if couples who have babies with CF sued rheir physicians, claiming their doctors were aware a test was available. Collins said he knows of an insurance carrier that sent a couple a letter after they tested rn be CF carriers that implied they would be "expected to use the information responsibly." Ir implies that if they had a child, the company wouldn't pay for medical expenses, he said. 'There arc areas where a lot of people get uncomfortable, includingmc,"Collins said. He included sex selection among them. "l do occasionally have people come in co my genetic clinic for just chat reason," Collins said, "and they look very surprised when l say I'm not going to participate. To me, it is an affront tO all the reason · I went into genetics ." He quoted from a Newsweeksurvey on "made coorder" babies chat showed chat I percent of couples would abort if the baby was rhe "wrong" sex; 5 percent would abort if the fetus had a predisposition to Alzheimer's disease (even if the onset was in old age) and 11 percent would abort if the child were predisposed co obesity. "Thar's when we have to ask where to draw the line," Collins said. "When you are looking at selection for traits rather than the elimination of disease. • - By PaulaVoe/I I\UFFr\Ll1 PIIYSltl-\N A1'D lllt)~IEl'IL'.-\l SCIEt-:TIST �---- •,ll ----0 y 33 Midd leton's internationally known research has included studies of the biochemical characteristics of allergic diseases, especially asthma and rhinitis; chemical mediators of allergic reactions; clinical assessment of new anti-allergic drugs, and effects of naturally occurring plant flavonoids on immunologic reactions. • - ByArthur Page MINDELL RECEIVES TwoHONORS ormer Chairman of the Department of Orthopaedics Eugene R. Mindell, M.O., received che Distinguished Service Award from the University of Chicago Medical Alumni Association last June. Mindell, currently professor and Director of Orthopaedic Oncology ar Buffalo General Hospital, was also elected a vice president of the American OrthopaeJic A sociation at its Boston, Massachusetts meeting the same month. • F NOENAMED TOHEAD DEGRAFF REHAB UNIT ohn E Noe, M.D., '84, has been named medical director ofDeGraff Hospical's new 20-bedmedical rehabilitation unit. The unit, which opened last December, is the first of its kind in Niagara County. leoffers an aggressiveapproach cothe rehabilitation of patients who suffer strokes, neuromuscular diseases such as multiple John F . Noe , M.D. , '84 lliott Middleton, Jr., M.D., received sclerosis, some spinal cord injuries or those the Distinguished Service AwarJ of with major joint replacements or amputhe American Academy of Allergy and tations, Noe notes. "Rather than emphaImmunology at the academy's annual si:ing their level of disability what meeting held in March in San Francisco. patients can't do for themselves we Middleton, professor of medicine and adopt strategies so they can do as much for pediatrics and director of the Allergy Divithemselves as they possibly can," he adds sion in the Department of Medicine The new unit, which occupies the ho received the award for lifelong contribupital's entire second floor, provides incense, tions to the academy. high ly focused therapy plus coordinated, A fellow of the American Academy of follow-up home and outpatient care. It Allergy and Immunology since 1961,he has cakes a multidisciplinary team approach, served as the academy's president, treasurer Noc explains, adding "Members of the and editor of its journal, TheJournalof Allerteam include a physiacrist, physical therHe is a member of the editorial ad,·isory gy and Clinical/mmunolog) '. He is also a board of the Journal of lmmunopharmacolapists, occupational therapists, speech clinical professor of pharmacy at UB. Director of the Allergy and Immunology ogyandClinicalAdvancesin the Trear:mem therapists, nurses, a psychologist and sometimes social workers." of AllergicDisorders and international adviDivision at The Buffalo General Hospital, sory board of the Asian Journalof Allergy The former director of the medical rehahe is a consultant in allergy at Children's bilitation unit at Sisters of Charity Hospital Hospital of Buffalo and Buffalo VA Med- and Immunology.He previously served on the editorial board of the Journalof Allergy. and clinical director of inpatienc services ical Center. Author or co-author of more than 190 at BuffaloGeneral Hospital, Noc is cert ified A fellow of the American College of by the American Board of Physical scientific articles and l 7 book chapters, Physicians, Middleton is a diplomate of the and Medicine and Rehabilitation and is a memAmericanBoardof InternalMedicineand the he is senior editorof Allergy:Principles AmericanBoardof Allergyand Immunology, Practice (C.V. Mosby Co. 1988), now in ber of the American AcaJemy of Physical Medicine and Rehabilitation. • its third edition. of which he was an original director . J MIDDLETON RECEIVES DISTINGUISHED SERVICE AWARD E Ratherthanemphasi zing theirdisabili ty...we adopt strategiesso theycan do as muchas theycan. BUFFALO PIIYSICI:\:- .~NP lll0~1EPI< AL SCIE~Tl:-T srRJN(o JQQI �-- --•- ~l--0 -- y 34 DanielM.Green , M.D. GREEN TOHEAD NATIONAL WILMS' TUMOR STUDY COMMITTEE aniel M. Green, M.D., UB medical school professor of pediatrics, has been e lected chair of the National Wilms' Tumor Study Committee. The committee determines what combination of therapies is best for treatment of all types and stages of Wilms' tumor, the most common form of kidney cancer in chi ldren. The committee's protocols are useJ by all hospitals participating in two national childhood cancer study groups, the Pediatric Oncology Group and the Ch ildren's Cancer Study Group. An international authority on the late effects of cancer th erapy in children, Green is chief of the oncology section in the Department of Pediatrics at Roswell Park Cance r Institute and director of the institute's Long-Term Follow-up Clin ic. D Board certified in pediatrics and pediatric lhematology/oncology, he has been a member of the UB medical school faculty since 1978. He also is directar of the Section of Oncology in the Division of He·matology-Oncology at Children's Hospiical. Green is a member of the Scientific Committee of the International Society of Pedliatric Oncology, Society of Pediatric Research, American Society of Hematology and American Society of Clinical Oncology. He has written more than 60 scienrific articles and two books on pediatric oncology. A graduate of Massachusetts Institute ofTechno logy,Green received his medical degree cum laude from St . Louis University School of Medicine in 1973. He did his residency in pediatrics at Boston (Mass.) City Hospital and then completed a fellowsh ip in pediatric oncology at Sidney Farber Cancer Institute, Boston; a fellowship in medicine-hematology/oncology at Child ren's Hospital Medical Center, Boston, and a fellowship in pediatrics at Harvard Medical School, Boston. • - By Arthur Page UB ALUMNI ASS ,OCIATION To UPDATE DIRECTORY h,e UB Alumni Association has contracted the Bernard C. Harris Publishirng Company to produce a comprehensive alumni directary. Scheduled for release at year en<l, the d irectory will inclu de current name, address and telephone number, class year and degree, plus business information (ifapplicable) bound in a library-quality e<lition. All alumni who completed an alumni directory questionnaire mailed earlier this year will be contacted by the Harris Com- T pany to verify the information and take book ordering information. If you prefer not to be listed in the directory, contact the A lumni Association in writing as soon as possible. • ALBINI NAMED FULBRIGHT SCHOLAR, To TEACH, Do RESEARCH INAUSTRIA oris Albini, M.D., professor of microbiology and research professor of medicine at UB, has been named a Fulbright Scholar. Under an awar<l from the Fulbright Scholar Program, Albini, began teaching and research in the Department of Experimental Pathology at the University of Innsbruck in Austr ia in March. He will collaborate with Austrian researchers on studies of immune responses to bacterial components and lymphocyte function in aging. Albini is one of936 academics, professionals and independent scholars from the Unite<l States who have received awards under the Fulbright Scholar Program to lecture, consult or conduct research abroad in I 990 and 1991. A member of the faculty of the UB School of Medicine and Biomedical Sciences since 1975,Albini was a BuswellFellow in the Department of Microbiology in 1975 and a Max Kade Fellow in thedepanmcnt in 1974. Before joining UB, he was a clinical assistant professorat the Institute for Genera l and Experimental Patho logy at the University of Vienna, Austria . A member of the medical school's admissions committees and its M.D./Ph.D. program, he is a member and former chair of the University's Laboratary Animal Care Committee and a member of the UB Faculty Senate. He has served on the orga- B BU~'FALOPHYSICIAN AND BIOME()ICAL !'CIENTIST �---- -~l----0 ' JS nizing committee for several of the biennia l international convocations on immunology sponsored by UB's Ernest Witebsky Center for Immunology, of which he isa member. Albini is president of the Buffalo Collegium oflmmunology. The author or co-author of more than 110 scientific articles, Albini isa member of the editorial board of Immunological Communicationsand /nr.ernationalArchives of Allergyand AppliedImmunologyand a fonner member of the editorial board of Clinical and ExperimenwlImmunology.• - B)' Arthur Page the Hisroryof Orolaryngology,he has been a consultant to the Gillette Corp. and the Ministry of Public Health for the State of Kuwait. In 1975 he served as chief of surgery and assistant hospital director at Yuka Hospital for Tuberculosis and Leprosy in Kalabo, Zambia. Author or co-author of more than 65 scientific articles,Simpson isthe author of texts on common problems,emergenciesand laser surgeryin otolaryngology.He has conducted extensive researchon lasersurgeryand laser interaction with tissue to deal with tumors and ocher disease processes. • - By Arthur Page SIMPSON NAMED (HAIR OFOTOLARYNGOLOGY eorge T.Simpson, II, M.D., has been named professor and chair of the medical school's Department ofOtolaryngology. He will also serve as chief of otolaryngology/head and neck surgery at Sisters Hospital. He previously was acting chair and associate professor in the department of otolaryngology at Boston University School of Medicine and instructor in ocolaryngology at Tufts University School of Medicine, Boston. He also was otolaryngologist-in-chief at Boston University Medical Center and director in the Department of Otolaryngology, Department of Health and Hospitals for the City of Boston and Boston City Hospital. Simpson is certified by the National Board of Medical Examiners, American Board of Otolaryngology and American Board of Laser Surgery. He isa founding fellow of the American Society for Pediatric Ocolaryngology and a fellow of the following organi:ations: American College of Surgeons, American Academy of Otolaryngology - Head and Neck Surgery, American Academy of Pediatrics, American Society for Head and G BUFFALOPHYSICIAN AND IIIOMEDICAL SCIENTI~ GeorgeT.Simpson, II,M.D. Neck Surgery, American Bronchoesophagological Association, American Academy of Facial Plastic and Reconstructive Surgery and American Academy of Cosmetic Surgery. He is a 1969 graduate of Loma Linda University, where he received his medical degree in 1973 and a master's degree in public health in 1975. Simpson completed an internship in general surgery at the University of Alabama Medical Center and residency in head and neck surgery at the University of California at Los Angeles. He was a fellow in pediatric otolaryngology at Boston University and Children's Hospital Medical Center and Harvard Medical School, a U.S. Public Health Service/Association of American Medical Colleges Fellow in Yugoslaviaand American Society of Anesthesiologists Fellow at the University of Alabama Medical Center. Former vice president and secretaryrreasurer of the International Society for TwoALUMNIELECTED TO ST.JOSEPH HOSPITAL MEDICAL STAFF ichael). Gianturco, M.D., '55, has been elected president of the medical staff of St. Joseph Hospital. Gianturco, a board certified genera l surgeon, has been a staff physician there for more than 27 yearsand served as vice president of the medical staff in 1989 and secretary in 1988. Also elected as vice president was Irving Sterman, M.D., '64. • M Michael J.Gionturco, M.D. srRINO 1991 �36 Match Day '9 1 saw the suspense end for fourth-year students as they found out where they will do their residency training. SPRING !'I'll BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-- ---- 37 Thisstereogram of a humingbird in flightapproaching a feederhaswon severalmedals andhonorable in inter· mentions national competi· lions.Theoriginal colorphotograph S. is byBernard Stell, '36. 1930s Joseph R . Saab '34 ► writes, "still alive and looking forward to my 60th anniversary." Bern ard S. Stell , '36 ► has won several medals in international photo competitions. Stereo closeups are one his specia l interests . Information on his stereogram and its innovative technique will be published by the Internaciona l Stereoscopic Union. "According to my research, what I have accomplished in getting these multiple images in one picture has not been published before in any pare of the world." The reproduction of the stereogram containing three hummingbirds against a black background is really a stereo of a single bird with rapidly beating wings on a single approach to the feeder. Ic has been captured in three separate positions by three closely spaced bursts oflight from the flash units. Walte r Z. Schwebel ' 38 ► is still practicing pediatrics and is direccor of the Physically Handicapped Children's Program for Rensselaer County, New York. 1940s John D. Whit e '4 0 ► of Tavernier, Florida, presented a "Talking Book" project at the Mariners Hosp ital Health Fair in January. Frank A. P falzer ' 49 ► is retired and now living on Amelia Island Florida. He writes chat he is enjoying travel and several hobbies . Ra phael S. Good '48 ► a clinical professor of psychiatry and obstetrics and gynecology at the University of Miami Schoo l of Medicine, is president-elect of the South Florida Psychiatric Society. Dr. Good is a former president of the Miami Obstetrical and Gynecological Society . BUFFALO PHYSICIAN ,~ND BIOMEDICAL SCIENTI ST K e n n e th N i sw and e r ' 4 8 ► received an award for the best anicle in 1989 from rhe magazine Comem/)orary ObscemcsandGynecologyfor his article, "Neurologic Deficits on Trial: What Response." Dr. Niswander is professor of obstetrics and gynecology at the University of Ca lifornia at Davis. Law r en ce M . Ca rd e n ' 49 ► retired on Jan. I, 1990 and is now living in Sarasota, Fla. 1950s Fr ed Lee '56 ► of Ann Arbor, Michigan, was named a fellow of the American College of Radiology. Ge rmante L. Bonca ldo ' 5 7 ► is direccor of the Millard Fillmore Rhcumacology Center, Buffalo, New York, "an out-patient facility for rheumatology patients in a patient satisfying consulcaci ve atmosphere." Th omas P. H amilt on II '5 7 ► has been named Deputy Commander and Direccor of Medical Education ac the Brooke Army Medica l Center, Fort Sam Hous• ton, Texas. W a r r en E. Lev in so n ' 57 ► writes, "I was elected to the Mill Valley City Council in April 1990. and My book MedicalMicrobiology Immunology was published in August 1989." Levinson is professor of microbiology at the University of California, San Francisco. Ga ry Co h en '58 ► has been appointed chief of the Division of Chi ld and Ado lescent Psychiatry at Children's Hospital of Buffalo. A clinical associate professor of psychiatry and pediatrics ac UB, Dr. Cohen previously served I0 years as acting directo r of the divi• sion. John T. Korn ' 58 ► "Entered solo ob/gyn practice in Novato, California in 1964. Mary and I raised and educated four sons. Having accomplished that successful career, I closed my private practice in l 990 and am now enjoying an interim second career of OBG locums tenenswork. In a year or so I willbegin concentrating full time on all my other neglected lifetime goals, such as aviation, sailing, scuba diving, deep sea fishing and traveling. Mary, being relieved of children and household chores, enjoys her days in commercial retailing of ladies accessories." John W. Kosteck i '59 ► an associate clinical professor at UB, received certification in general vascular surgery from che American Board of Surgery. SPRING 1991 �----------------------- ::,,,. _::: --------------- -- - ------ s ll 38 Law rence E. Gra ss ' 63 ► was just elected chief of family practice at Phoenix Baptist Hospital for a two-year term. John J. LaMar '63 ► is senior attending pediatrician at the Memor ial Hospital of Salem, New Jersey, where he has been on staff for 2 5 years. John A. Schriv er '63 ► has been appointed head of the section of emergency medicine at Yale University and director of emergency services at Yale New Haven Hospital. Dorothy C.Rasinski , M.D., 'S9 William E.Abramson , M.D.'60 Do roth y C. Rasinski '5 9 ► will be a participant in the morning program on Spring Clinical Day in Buffalo on May 4. An internist, attorney, educator and author, she recently received a special recognition award from the American Society of Internal Medicine. TI1is award is presented to an internist who has made a significant contribution to the social and economic aspects of interna l medicine. Rasinski's flair for translating dry legal accounts of malpractice suits into interesting vignettes has made her "Legal Briefs"column one of the best-read pages in The lncemisi:HealrhPolicy in Practice.She has been an editor for the Journalof LegalMedicine, son has a private practice in psychiatry and is senior psychiatrist at the Sheppard Pratt Hospita l, Towson, Maryland. z. Ronald J. Kallen '60 ► is direccor ofthe Division of PediatricNephrology and Hypertension at Lutheran General Children's Medical Center in Park Ridge, Ill. Robe rt L. Malat esta ' 60 ► of Warren, New Jersey, has been appointed associate direccor of Drug Safety and Surveillance at the R. W.Johnson Pharmaceutical Research Institute. H arold L. Metca lf '6 0 ► is vice president of the American AcadeLegalAspectsof MedicalPractice, my of Family Physicians FoundaClinicalOiabeies, Journalof Clinical tion with headquarters in Kansas City, Mo. EihicsandHospical EthicsCommit- Willi am E. A br a mso n ' 60 ► "attended my first class reunion and Spring C linical Day in April 1990 and had a ball. Will :me nd in 1995, God willing." Abram- :-PRINUl'l'll Bert A. Lies, Jr. ' 64 ► of Santa Fe, New Mexico, continues to practice orthopaedic surgery with a special interest in disability evaluation aml rehabilitation. He is presently the orthopaedic consultant for the Aspen Ski Company, and is joining the Orthopaedic Associates of Aspen on a pare-time basis as a consultant in rehabilitation and disability evaluation. Saar A . Porrath '6 1 ► of Beverly Hills, Calif., \vaselected president of the National Consortium of Breast Centers . Murra y A. Yos t Jr. '66 ► has been elected vice chairman of the Buffalo Section of The American College of Obstetricians and Gynecologists. Yost is an associate clinical professor of obstet rics and gynecology and assistant clinical professor of psych iatry at the UB School of Medicine. J ohn L. Kiley ' 6 2 ► is medical director of Charter Hospital in Las Vegas, Nev. John E. Spoor '6 6 ► was named a fellow of the American College of Emergency Physicians, appoint- tee Forum. 1960s Mar vin Ku r ia n '6 4 ► has been named to membership on the Board of Governors of the American Biographical Institute Research Association . This prestigious board position carries with it the tide of Deputy Governor. ed assistant clinical professor of medicine at Columbia Un iversity and listed in Who'sWhoin rheEast. T homas P. O'C onn or '67 ► has returned to Western New York to become directo r of radiation therapy at Western New York Medical Park, a new facility in West Seneca . Paul S. Schu lman '68 ► of El Cajon, Cal ifornia, was named a fellow of the Ame rican College of Radiology. S.K. Bosu '69 ► has returned to the United States after serving as a consultant to the Lagos State Government in Nigeria. Da vid M. Sherer '69 ► writes, "Took a trip around Lake Erie last summer with my 13-year-old son, saw baseball in Cleveland, Detroit and Toro nt o and stopped in at Capen Hall. Had a brief reunion with professor Milgrom. Otherwise l'm involved in our Credit Union Board,ski patrol, Golf Club Board and have sung with the Seattle Opera. Am having fun with my wife Barbara and th ree chi ldren. I love Scanle." Sherer isdirecto r of Clinical Laboratories, Group Health Cooperative of Puget Sound. 1970s Elliott Brender '70 ► was elected chief of the depa rtment of surgery at Garden Grove Hospital, Garden Grove, California. Jam es M. Bak er '7 0 ► writes, "Besides a small town family practice, I am do ing phase Ill cli n ical studies for phannaceutical companies in development of new drugs. Miko, my wife, and two children are doing well." BUFFALOPHYSICIANAND BIOMEDICAL SCIENTIST �________________ _______,.... .... 39 I ra L. Salom '77 ► was elected a fellow of the American Co llege of Physicians and certified in geriatric medicine. Russell J. Van Coevering II '77 ► was elected president of the New York State Society of Obstetr icians and Gy neco logists. Salvalore A.DelPrete , M.D.,'78 Leela nd A. J ones '73 ► after completing a residency in psychiatry, Jones left his North Caro lina family practice to return to Buffalo, where he was named director of the medical-psychiatry unit at Buffalo General Hospital. Michael Rad e '75 ► has been elected to the Board of Governors of the American Co llege of Su r• gcons as a Governor-at-Large from Western New York. He is a clinical instructor in surgery at the UB School of Medicine and Biomedical Sc iences. Elaine S. Chirlin '77 ► has a private practice in chi ld, adolescent and adult psychiatry in Cincinnati, Ohio, where she also works in pub lic sector mental health. Ch irlin has three daughters. OrestesG. Rosabal '77 ► waschosen to represent the State of Florida as Co uncilor for the Southern Medical Association, a multi-specialty associat ion providing continuing medical education and practicerelated benefits for physicians. Salvatore A. DelP rete '78 ► of Fairfield, Connecticut, was the 1990 recipient of the Dr.Melville G . Magida Award, presented annually to a Fairfield Cou nt y physician fo r "demonstrated notable capability in patient rre-at• menr and care." 1980s Robe rt Brac o '80 ► is the occupatio nal medicine physician at the SW Center for Occupational Health and Safety of the University of Texas School of Public Health in Houston. William N. Capicotto '80 ► of Buffalo is a fellow of the Ame ri can Academy of Or th opaed ic Surgeo ns. Daniel Paul Schaefer '81 ► has written rwo chapters in che new Adas of Con t emporary Op h tha lmic Surge ry. He is an assistant clinical professor in the department of ophthalmology and assistant clinical professor in the department of ear, nose and throat at the State University of New York at Buffalo. Mark Ch ung '82 ► is in private practice as a pulmonologis t in Lo Alamitos, California. He is a lso a lieutenant commande r with the U.S. Naval Reserve Medical Co rps. BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST Mich elle D. Leon '82 ► is the new assistant program director of the integrated reside ncy in eme r• gency medicine currently being establis hed at the University of Co nn ecticut Medical Cente r. Paul N. Rosenberg '82 ► writes, ''Living happily in Rochester, New Yorkarea with my wifeSuzanne and d1ildren,Aaron, 6,andShelby,3. My practice is limited to oculoplascic, reconstructive and orbital surgery." Adolph Soto Jr. '83 ► of Bronx, New York, was recentl y appo inted unit chiefoflinco ln Hospital, the city's first bilingual, bicultu ra l, inpatient psychiatric program. R obe rt W. Lasek '84 and Colette ► arc living in Danville, Pennsy lva ni a. "Colette has com pieced her cardiology fellowship at Geisinger Medical Center and joined the staff, specializing in echocardiography, rransesophageal echocardiography and imraopcrative echocardiography. I comp leted a fellowship in medical educa t ion at the University ofTexas-Southwesrem Medical Cente r (sponsored by the Emergency Medicine Found ation and the American Co llege of Emergency Physicians). I am active ly involved in teaching eme rgency medicine at Geis inger Med ica l Cente r. We recently celebrated our fifth wedding ann iversary." R. (Pruefer) Lasek '84 Joh n J. Picano '84 ► has completed a two-year clinical fellowship in neuroradiology at Massachusetts General Hospital and is now in private practice in New Hartford, New York. He and his wife, Lynn, have rwo children, John, 3, and Cara, 1, and are expecting their third child in May Marc J. Koblick '84 ► moved to Daytona Beach, Florida after completing an opht halmology fellowship in New Orlea ns, Louisiana. He proudly annou nces th e birch of a daughter, Jacqueline Ann, born July 13, 1990. Andrew C . Friedman '85 ► finished a ge n eral surge ry res idency in Buffalo and has started a plastic surgery residency at Case Western Reserve. Mark Ross Comaratta '85 ► has return ed co Buffalo afte r comp let• ing a retina fellowship. He and his wife Kate have two childre n. Kevin L. Donovan '85 ► was appo inted chief of the anes th esiology serv ice at VA Hospi tal in Nashville, Tennessee. He and his wife, Shar, are expec tin g their fourth child in March 199 I. Nicholas D' Avanzo '86 ► is enjoyi ng private pediatric practice with two partners in the H amptons, N.Y. Jean Ann (Comaratta) Marfurt '86 ► proudly anno un ces the birth of her son, Ryan William, born on August 25, 1990. She is practicing pediatrics with two partners at 1630 Maple Road, Williamsville, New York. Debra Ann Gould '87 ► finished a family practice reside n cy in Rochester,New York, andhasaccepred a two-year position as National ResearchService Awa.rdprimarycare fellowwith the department of family medicine at the UniversityofWashington, Seatt le, Washington. Jill E. Koeh ler '87 ► ann ounces the birth of a daughter, Alaina Joy Moreno-Kochler, on December 17, SPRING 1991 �------------------------ ::,~ ,:.:---------------------- --- s 11 40 D avid R. Bl oo m '89 ► announces the birth of a baby son, Annunzio Joseph, 7 lbs. 6 oz. on November I , 1990. Bloom is an assistant clinical instn1ctor of family medicine and clinical assistant for undergraduate affair; at the University of California at Irvine. Ca rlos Robe rto Jaen '89 ► is senior clinica l instructor and resident in the department of family medicine at CaseWestern Reserve University School of Medicine. Donnico L Moore , M.D.,'78 1990, weight 7 lbs. 11 oz. Koehler 1san attending physician at Hurley Mec.licalCenter in Flint, Michigan. Do nn ica L. Moore '87 ► writes, "Robe rt Man ella '88 was recently hired by Sandoz Pharmaceuticals as an assistant director of medica l operations in rhe cardiovascular area - the fourth UB MD to be hired by Sane.lo: in three years! (Other;: Evan Dcmest ihas '87, now at Bristol-Meyers-Squibb; Michael Sabo linski '88, a=iate director, medica l operations am! myself). Perhap;, this rrcnJ has to do with the required Medical Care Organization courses we cook." Moore now heads a new Jepartmcnt within Sandoz Pharmaceuticab - The Medical Educmion Center. The Center will develop eJucarional programs for physicians and medical student;, on osteoporosis anJ rdatec.l metabolic bone disorders. "My husband (Stan Bernard, MD, MBA) ,me.I! have settled in central New York and love the rural lifestyle while being close to New York City and Phi ladelphia. Sec y'all at our Fifth Reunion!" SPRINt11991 D ebra M. Omi atek ' 89 ► transferred from the program at St. Elizabeth's in Utica to finish two years of family practice residency in Niagara Falls at the Niagara Falls Memorial Medical Center. C harles Eve rett '89 ► and his wife, S,mdra Everett '88, and their son Kristian, delight in announcing the new addition, Nicholas, horn, August I 7, 1990. Obituaries Fr ancis M. C rdge ' 19 ► of Santa Barbara, California, died October 17, 1989 at the age of 95. Au gustus ]. Tranella '39 ► died October 30, 1990 at his home in Greece, New York, after a long illness. An obstetrician, Tranel!a delivered more than 2,000 babies at Highland Hospital before his retirement in 1978. John F. Moran, Ph.D. , associate professor of biochemistry at UB, died Wednesday, Feb. 20, 1991 in hi; home in Snyder. He was 55. Moran served from 1983 co L988 a;, assistant to the dean for facilities planning at rhe medical schlx>I. In that capacity, he wa, the coordinator between the school's faculty and the architect on plans for renovation of existing facilities and the construction of a $30 million addition to the medical school, completed in 1988. A native of Cleveland, Moran joined the UB faculty in 1964 as a research associate in the Department of Biochemical Pharmacology in the School of Pharmacy. He was named an assistant professor in the medical schoo l's Department of Biochemistry in 1967 and associate professor in 1970. From 1975 to 1976, he w,1sa visiting associate professor in the Department of Physiology at the Case Western Reserve University choo! of Medicine. Moran was the recipient of a Chancellors Award for Excellence in Teaching, Distinguished Service Award from the UB medical school and a Siegel Award Commendation for excellence in teaching medical students. Murray J. Ettinger, acting chair of the UB Department of Biochemistry, noted that Moran "put endless hours, energy and empathy into coume lling students. He was the sta lwart of the undergraduate biochemistry program and, more recently, the advanced biochemistry course for medica l and graduate students. Whatever he did, he put his heart, soul and humor into it. His persona l efforts helped countless students over the years." Director of undergraduate studies in the UB Department of Biochemistry from 1968 to 1984, Moran haJ served on the UB Faculty Senate, the medical schoo l's Faculty Council, the steering committee of the UB Department of Biochemistry and the curriculum committee of the UB School of Pharmacy. Moran also was active at Christ JohnF.Moran , Ph.D. the King Church, Snyder, where he was head of the usher's organization, a post he held since the late 1970s, and a former officer of the Christ the King Schoo l Parents' Guild. He also was a former treasurer of the Parents Guild of Villa Maria Academy. A 1958 graduate of John Carroll University, Cleveland, Moran received a master of science degree magna cum laude from the Univers ity of Ottawa in 1961 anJ a doctorate in biochemistry from McGill University in Montreal in 1964. An expert in metabolic biochemistry, he was the co-author of more than 30 scientific articles . He is survived by his wife, the former Karin Yax; two sons, Kevin and Patrick, both of Snyder, a daughter, Megan, of Snyder; and a sister, Martha O'Donnell of Cleveland, Ohio. Contributions in Moran's memory may be made to the University at Buffalo Foundation, designated for the John F. Moran Memorial Fund in the UB Department of Biochemistry, or the South East Community \Xlork Center, I 81 Lincoln Road, Depew, N.Y. lll 'FFALO PHYSIC IAN AND BIOMEDICAL ~IENTIST ��BuffaloPhysicianand BiomedicalScientist StateUniversityof New Yorkat Buffalo 3435 Main Street Buffalo,New York 14214 Address Corre<tioa Reqwested 958 MR. CHUNG - KA! HUANG HEALTH 5CIENCc LI RAqy A880 TT HALL CAMP US ,r1AI L Non-l'ro hc Org. U.S. l'osc~e PAID Buffalo,NY Pcnmt No. 3I I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1991 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v25n02-1991-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Healing the Spirit Daggers of the Mind: Shakespeare and Neurology A Cure for Malpractice Headaches The Clinical Picture From Shin Splints to Hip Pointers Charting the Quality of Life Medical School News Alumni Research People Match Day Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v25n02 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/8da3556d698c9e5d32463827512169d4.pdf 566020955cb0948d0fab04977a2bda6e PDF Text Text �--:--- I �VOL. 25 , NO. 4 ....................................... . .......................... . ........ . ....................... AUTUMN 1991 IJ Research II HospitalNews II TheResignationof NealRzepkowski.Forced out of Prescriptions for pain havechanged, andso havedoctors'attitudes aboutthis major patient complain t. Page20. Brooks Memorial Hospital in Dunkirk and caught in the storm of controversy that followed the release of the CDC's new guidelines governing HIV-infected health care workers, Neal Rzepkowski is a physician at peace with himself and his life. IEJInWhoseHands?The Patient Self-Determination Act should put patients more firmly in control of their own medical destinies. m Congratulations . YouHaveBeenAccepted! Getting into UB medical school is more com petitv e than ever. E3The Classof 199S. A special photo directory insert of the School of Medicine and Biomedical Sciences' entering class. E!J Ending the Agony• epidemic of pain. EJMedicalSchool EiJAlumni TheHopeClinic lets UB's medical studentsgive backlo their commu nity. Page24. ew techniques to treat the mPeople mClassnotes *TheJamesPlattWhite Neal Rzepkowski, M.D., speaks out onthecontroversythat cast himhis jab. Page 6. Societylavndtes its "'Thotsancl at a Thotsancl" campaign.Page28. �···· ··················· ··· ······ ············· ···•·· ········ ··············· ······· ·· 11 ., ' . Studyshowspetdogs aremorecalming thanclosefriends is that subjects with their pets presen t were apparently less psycho logically threaU!ned than were subjects with their friends present or subjects withou t a comp2mion," the researchers wrote. + he presence of man 's best friend - the four-legged variety - is a more calming influence during the performance of a stressful, evaluative task than , that of a close human friend, UB research ers have found. The researchers believe the resu lts of the study, published in a recent issue of the Journal of Personality MyFriend and Social Psychology,can be amibuted to the fact that dogs are seen as non-judgmental and non-evaluative, while friends are not. The study was conducted by Karen M. Allen, Ph.D., director of training for the Rehabilitation Research and Training Center on Community Integration of Persons with Traumatic Brain Injury; James J. Blascovich, Ph.D., director of the Center for the Study of Behavioral and Social Aspects of Health; graduate student Joe Tomaka, and Robert M. Kelsey, a post-doctoral fellow. The researchers measured autonomic responses of 45 women who reported close relationships with their pet dogs during two sessions in which the subjects performed stressful menta l arithmetic tasks. With pets present, participa nts' autonomic responses remained at baseline while performing the mental arit hmetic tasks. BULwith friends present , participants ' autonomic reactivity increased dramatically. "Our interpretation of these findings e B U FFA. L O PHYSIC I AN B Y SUE W U ETCHER UB1~esearcher receives gra11t fromACS UB researcher has received a $240,000 grant from theAmerican Cancer Society to study the relationship between diet and the development of cancer. ~ Jo Freudenheim , Ph.D., assistant professor of social and preventive mediC"ine, will conduct three studies under the two-year grant. One will examine the role of dietary intake in the development of premeno pausal breast cancer, endometrial cancer an,d pros tatic cancer by focusing on information on dietary intake and health and persona l factors collected in interviews with residents of Erie and Niagara counties with cance r and a group of matched controls. The sLUdywill look at the association betwe,~n the cancers and the intake of fat, calories, carotenoids, vitamins, fiber, zinc and cruciferous vegetables . A second study will focus on 58,000 older, llong-tenn New YorkState residents who completed a questionnaire in 1980 about their health and personal factors. "The group is being followed through the New York State Tumor Registry, " Freudenheim noted. "Sufficient cases have now occurred to allow for a prospective analysis of dietary factors in cancer of the lung, breast, colon, rectum, ovary ,endometrium and prostate. " The third study '<viiilook at data on controls from the first sLUdyto examine the correlation of factors such as energy expen ,diture, occupational time and lei- A.NO B I OMEDtCA L SC i sure time with dietary practices. Smoking, reproductive history and socioeconomic status also will be among the + factors to be studied . - BY A RTHUR PAGE Innovative technique usedto repairaneurysm eurosurgeons at the State University of New York at Buffalo used an innovativeendovascu lar procedure LO treat a cerebra l aneurysm in a mother of eight , eliminating the need for risky surgery and giving the woman a "second chance " at life. The neurosur geons , led by L. Nelson Hopkins, M.0., chair of the neurosurgery de partment at UB and chief of neurosurgery at Millard Fillmore Hospital, threaded a micro-catheter through the patient 's blood st ream and into the aneur ysm . A small coil of platinum wire was placed in the aneurysm and a low-voltage banery current passed through the coil , causing a clot to form and seal off the aneurysm. The coil was released within the aneurysm and left I EN TI ST A U TUMN 1 9 9 1 �····•·· ··········· ····················· · ··········································· · ······ m . WU .. low-up Clin ic and director of the oncology section at The Children 's Hospital of Buffalo. Also on the team were Michael A. Zevon, Ph.D., Geoffrey Lowrie, NinaSeigelstein and Brenda Hall. The study focused on 25 male and 35 female former cancer patients 18 or older who had been diagnosed with cancer five or more years earlier. Among the 39 children born to the male former patients, three had minor congenital anomalies. The frequency of BY ARTHUR PAGE single anomalies was 7.9 percent, compared with 13 percent for the general population, the researchers reponed. Congenital anomalies occurred in five of the 63 children born to the female former patients. The incidence of venuicular septa! defect as a single malfom1ation was 3.85 he use of chemotherapeutic agents per cent in female children of the white to treat children and adolescenLs with cancer does not appear to female formerpatients,ascompared with increase the frequency of con- 0.034 percent in white female infants in genital anomalies in their chil- the general population. The incidence of tetra logy of Fallot was 2. 78 percent dren, according to researchers among the male offspring of the white affiliated with UB and Roswell Park female former patients, compared with Cancer Institute. 0.024 among white male infants in the They report in the lead article in Lhe July 18 issue ofTlie New Englandjoumal general population. Both women who gave birth to a child of Medicine that with Lhe exception of one agent, dactinomycin, a higher inci- with a cardiac defect had received + dence of congenital anomalies was not dactinomycin in chemotherapy. BY ARTHUR PAGE found in a follow-up study of 60 former cance r patienLs. In the case of dactinomycin, structural congenital cardiac defects were found in 10 percent of the infants born to women treated with the drug compared with a 0.60 percent rate for infants in the general popu laLion. Daniel M. Green, M.D., professor of pediaLrics and chief of the oncology secLion in the department of pediatrics at Roswell is principal author of the study. Green also is director of Roswell's Long-Term Fol- behind to permanently seal off circula tion and protect against future hemorrhage. The neurosurgeons from UB and Millard Fillmore are only the founh group in LhenaLion to successfully perform the procedure on patients. "I feel like I'm lucky to be alive," says Jacqueline Talada, 49, who suffered from progressively severe headaches and seizures due to a "giant aneurysm" at the base of her brain. "I feel I got a second chance to be alive, Lhanks to Dr. Hopkins and th e medical field." Talada underwent the procedure July 29 at Millard Fillmore under local anesthesia. Discharged three days after the procedure, she has had no more seizures and her headaches have improved tremendously. The new procedure was developed in 1990 by Dr. Guido Guglielmi, M.D., and a team of neuro-radiologists at the University of California at Los Angeles. + SUE ~· ,. . BY ·~ sample ofBuffalo households. Also working with Trevisan, associate professor of social and preventive medicine and acting chair of the UB Department of Socia l and Preventive Medicine, were Vittorio Krogh, M.D., Linda Klimowski , Susan Bland and Warren + Winkelstein, M.D. Chemotherapy in childhood notshownto increase birthdefects ETCHER Lackof siblingsincreases riskof hypertension eing an only child increases your risk for high blood pressure, accordi ng to UB researchers. Ina study of 1,472 whiteadulLs, researchers found that the mean systolic and diastolic blood pressure and prevalence of hypertension were higher in those without siblings. In the case of systolic blood pressure and prevalence of high blood pressure in both sexes and diastolic blood pressure in men, the differences were statistically significant, Maurizio Trevisan, M. D., and colleagues reported in a letter in The New EnglandJoumal of Medicine. The UB study focused on 6 76 men and 796 women, age 20 to 70, who participated in a survey involving a random BU,.FALO PHYSICIAN ANO BIOMEDICAL S CIENTIST AUTUMN I SI 9 I 0 �1&n1·················· .... . ···· ~ SistersHospital begins modernization proiect ork began in mid-October on Sislers Hospital's $42 million modernizalion projecl. The 28-month project will provide enhanced patient treatment areas and improved seuings for visitors and employees. Major components of the project include new coronary and intensive care unilS, new operating rooms, ambulatory care wing, emergency depanment, head and neck center and a new lobby and elevator bank connecting corridors for easier access to all areas. The project will also address major code and safely issues along with increased cool ing capacity and air conditioning and medical gas systems. "Much of the work will be done within the existing structures so those passing by the hospital will not be aware of most of lhe work," said Timothy J. Finan, Sisters' executive vice president. The projecl will begin with lhe addition of lwo floors atop the hospital's skilled nursing facility to house a ..t;J ....,._I I new 16-bed ICU and eight-bed CCU. A ·' _! connecting corridor will allow for direct .;..W... access between the new intensive care units and operating suite to be constructed. Sisters will also consolidate its laboralories to the hospital's fourth floor. The present operating room space is slated for renovation to house pre-admission, urology , endoscopy and outpatient surgery. The project also includes construe- fl 0 BUf",.A.LO PHYSICIAN · ········································ · ············· tion of a 10, 760-square-foot building behind the hospital to accommodate the hospital's information systems and finance depanmenlS. Also scheduled for renovation and realignment is a significant portion of the hospital's first floor. A new main lobby will be constructed at the present location of the finance and information systems departments. Inpatients and visitors will pass directly through the new lobby to a new bank of elevators linking them directly with patient floors, surgery and critical care units. OutpatienlS will use the new entrance and connecting corridor to a completely remodeled ambulat0ry care wing which will incorporate the emergency department, outpatient department , women's services, corporate health services and satellite radiology and phlebotomy labs. The emergency department will also gain a new entrance to enhance traffic flow for walk-in patients. The project was designed by the Rochester firm of DeWolff Partnership, + Architects. ffi §~ ffl --,i~: Herzigto heodbone morrowtronsplontotion unitot Roswell eoffrey P. Herzig, M.D., has been appointed d irector of the Divisions of Hematologic Oncology and Bone Marrow Transplantation, Department of Medicine, at Roswell Park Cancer lnstitute. Former professor of medicine, division of hematology/oncology and head of the bone marrow transplantation program at Washington University School of Medicine in St. Louis, Herzig is an active member of many professional organizations, including the American Federation for Clinical Research, American Society for Clinical Oncology, American Association for Cancer Research and American Society of Hematology. He has written over 80 scholarly papers, monographs and book chapters. j:~:;!;~ ~-[ ~-___ .... ~-~r. W;~ 8 ►-- ~ ~~ ~ fj§ · ······· ell ~~ b f~~ ~o~ .Aili~~ Artist's rendering of Sisters Hospitol's newlobby. ANO 8tOMC:DICAL SCIENTIST AUTUMN 1 9 9 1 �- -------- ······ -- · ···· · ············ -- -- - -- · ················ A Phi Beta Kappa, Herzig received his medical degree in 1967 from Case Weslern Reserve Universily in Cleveland and his medical residency training at Bronx Municipal Hospirnl in New York. He also served as senior invesLigator, Pediatric Oncology Branch, at the National Cancer Institute. The bone marrow transplant program performs both autologous and allogenic transplantations and conducts research designed to improve long-term survival rates for transplant palients. The division of hematologic oncology treats pati en ts with leukemia , lymphoma, myeloma and other hematologic problems and studies the pharmacological and biological basis of disease progression and response. + BGHparticipates in JCOAH test proiect he Buffalo General Hospital has been selected to participate in the field testing of indicators , or "performance measures, " for theJoint Commission on Accreditation of Healthcare Organizations. The Lesting represents the firsl largescale evaluation of theJCOAH 's trauma care, oncology care, cardiovascular care, medication use and infection control indicators. The indicators are designed to support hospital efforts to assess and improve the quality of patient care. Buffalo General will participate in the testing of infection control indicators. Testing is expected to last about two years. The indicator development project is part of a JCAHO project begun in 1986 to modernize its accreditation process. The new process potentially uses both clinical and organizational performance data to measure an organization 's ability to deliver quality health care. BUF' F AL O PHYSICIAN - - -- ---- · ··· --- · ···· --- · ········ ·· ·· ···· BGH joins other test sites selected from volunteer accredited hospitals throughout the nation. Test site activities include evaluating hospitals ' ability to use computer systems to collect indicator data and to transmit the data electronically to the Joint Commission. A second activit y involves evaluating the reliabilit y and validity of the indicators to assess their potential usefulness to improve the quality of patient care and services. + ~ --- - - - ················· - -- • ·····lrBl - a primary physician. Referrals are based on patient need, geographic location and accessibility to follow-up treatment sites. Some of the benefits of the HIP program include early intervention and immediate response Lo potential problems while patients are still hospitalized, according to program counselor Kathleen McDonald, R.N. Early treatment of alcohol-related problems also reduces the chance of patients developing further physical or psychological complications , McDonald said. According to statewide data gathered since H!Ps were implemented in 1989, approximately 25 percent of patients admitted to hospitals have alcohol or drug-related conditions. + BGH adoptsalcohol intervention program uffalo General Hospital is one of 18 hospitals statewide to , developaHospitallnterven~ V tion Program (HIP) for pa- ,, ./. -~ tients with alcohol-re' lated problems . • f The new program , the first in Erie County , offers counseling , education and linkage and referral services based on inpatient screening on des~~~~ ignated units. Screenings con- , ~ :: ,. ff. ~ i~- ·~ff~ ~\\'- - sist ~f. a series of questions admm1stered by nursmg staff with the permission of a patient 's AND B I OM E DICA L · .~ .,;,..V $C1£NT I ST AUTUMN I 9 II I 0 �I eal Rzepkowski'.sstory is straightforward and only slightly bitter. The 40-year-old UB assistant professor of medicine spends his days in the Spiritua list haven of Lily Dale, New York, an oasis of tranquility amid the storms that have gripped his life. Diagnosed in 1985 as being infected with the human immunodeficiency virus the virus that causes AIDS Rzepkowski was thrust into the nationalspotlightlastsummer I �_I , ~-/ ~ r I I-:___/ _JJ_f I< · ~-- LlVin~ wltll tlleconsequences ofilieCDCsre~ulations new ~overnin~ HIV - osit ive pllysldans. �when he became the first physician lo disclose his HIV-positive status under new guidelines governing health care workers infected with the virus. The Centers for Disease Control issued the guidelines last July after months of delays and deliberations. As a result, Rzepkowski was forced lo resign his fulllime emergency room post al Brooks Memorial Hospital in Dunkirk amid a nurry of national press coverage. Rzepkowski does not, al this point, have AIDS, though he is realist ic about the likely outcome. The possibility of an early death, he says, "hangs over my head like the Sword of Damocles." Save for a half-day of work a week at the Immunodeficiency Clinic at Erie County Medical Center, Rzepkowski's practice is non-existent. "l suppose l could start a private practice. l know I would get a lot of I IIV-negative palienlS coming 10 see me. But a private practice and my past experience of having one means that you're on call with a full-time work week, on call al nighlS and up weekends." So Rzepkowski is careful to gua rd his resl and nutrilion. "I'm not going to have a private practice to prove a point." Monitoring and appropriate medical action, he knows, can delay the onset of AIDS. Rzepkowski iscoping with the stresses of sudden celebrity. He is perhaps a little weary of questions posed by yet another interviewer. His story has been reported by the national press, and further probed on talk shows by Oprah Winfrey and Jane Pauley in her "Real Life" series. Today, Rzepkowski feels fine though he's occasionally fatigued and does have hairy leukoplakia - a white, possibly precancerous, patch-on his tongue, "a sign of HIV-positivity/ he relates matter-of-factly. He is above all, an educator on the AIDS nightmare who doesn't shirk from the known faclS,even when they so impinge on the tranquility of the moment. There is no time for easy dissembling when his mission is the truth. "The average time between getting infected and becoming seropositive, and developing symptoms is 10years- that's the average time. Some people take a lot o eu,,.ALO PHYSICIAN longer. But it is thought that more than 90 percent of these people, eventually, given enough time, will go on to develop AIDS." Rzepkowski's own frank statistical analysis may mean he has only a few years left. So often, he notes, the public con fuses HIV positivity with having AIDS ilSelf. "l don't have AIDS. I have HIVpositive teslS. A lot of people confuse that. Like I say, you can be HIV-positive for 10 years before you have the end stage of that virus, which is AIDS." Rzepkowski has owned his small Lily Dale home for four years, living in the century-o ld community for metaphysical education for the last year and a half. He went to high school in Dunkirk, then moved to Troy where he began studying Spiritualism and earned his B.S. from Rensselaer Polytechnic lnsti tute in 1974. Then came medical school at what was then SUNY Upstate Medical Center in Syracuse (M.D., 1978), followed by a fam ily practice residency in Schenectady's SL Clare's Hospital and seven more years as director of the hospital's Family Health Center. ANO BIOMEDICAL SCllNTIST Board certified in Family Practice, Rzepkowski was drawn to Boston's Fenway Community Health Center in 1988, where he could care for AIDS pa tienlS in the sympathetic setting of a gay-run institution. Openly gay, he "wanted to go learn about the virus and care for these patients." In 1990, weary of high renlS and neighborhood crime, he returned to Lily Dale, where he could tend his garden and consider an uncertain future. By this time, of course, Rzepkowski knew he had the virus. "The odds are," he says, that he contracted it "in 1981 or 1982," before the human immunodeficiency virus was isolated and "safe sex" practices were advocated. Slowly he revealed the news to a circle of friends, and gradually lO professional people he thought should know. "In July 1985, I tested positive; the test first became available to the public that month. Wi thin a short time, I told the director of my program and the nurse epidemiologist at the hospital. They were the only ones who knew - at the time, they were the only appropriate people lO AUTU""N 1 9 9 I �----- - ---------- tell. I also had cared for HIV-positive patients ever since the test first came out. I shared the fact that they were not alone and that I was in their same boat. " This was the beginning of gradual disclosures that led to a front-page story in a New Hampshire paper and later, to blockbuster announcements in the local and national media last summer. "It was open, " Rzepkowski ins ists of the subject. "I also shared it \vith a few of my HIV-negative patients. When I applied for the position at the Fenway Community HealLh Center , I told them l was HIV-positive. " "At the end of 1988, I decided it was worth my while to educate the public in an even more direct fashion than I had. I had been giving lectures across the country on HIV-related topics, and had started to share with public groups that I, too, was an HIV-positive person and that peop le needed to put a face on this condition and see that human beings are walking around with this and are perfectly healthy. " Rzepkowski then took up a series of speaking engagements to public groups and medical assemblies, including the New York State Academy of Family Physicians lastJuly. "Just recentl y, I spoke to the Tennessee Academy of Medicine and the Tennessee Academy of Family Physicians. '' During these presentations, I would say, 'I am also HIV-positive.' In July of 1989, I gave a public forum in Keene, New Hampshire, sponsored by the American Red Cross, on AIDS, dealing \vith the blood supply and how you get the virus and how you don 't. There were news reporters there who asked if they could print this, and I said, 'I'm open about it,' and so I was on the front page of the Keene newspaper. "When appropriate, I put this information on my medical applications . The medical application doesn't ask specifically whether you're HIV-positive or not. So I didn't need to bother with that question. They do ask whether I'm capable of performing medical duties which I am. So that was put down. "LastJune , I went for a physical exam which doctors have to do as employees. I told the doctor in Buffalo that I saw, 'Look I'm HIV-positive and you should BU,-fl'ALO PHY SICIAN ANO -- - ~ - -- - --- know that..' When it was time to fill out my application for work, the question was, 'Are you capable of performing your duties medically ,' and he put yes. Asked for other comments, he said, 'You know doc, I have to put down that you're HIVpositive.' I said, 'That's fine."' Rzepkowski 's former employer, Joseph Gatewood, M.D., director of medical services for Spectrum Emergency Care of St. Louis, which sub-cont racts out to Brooks Memorial in Dunkirk to supply them with emergency room physicians, puts it this way: "This is a problem that goes beyond personal freedoms and rights to know. It's question of physicians and their capability of taking care of patients. The point is that the public is so frightened of this as an unknown fear that their demands to know whet her the doctor has a particular illness - when the statistical chance isso small - strikes me as an irrational reaction. It is much more dangerous to have a physician who's suffering a hangover from having had too much to drink the night before. " In applying for privileges at Brooks, Rzepkowski was asked whether he had been taking any medicine regularly. "Well, I had put 'no' on my original application last year. But this year, I am on AZT regularly. The next question is why, and I put down, 'because I'm immune deficient with HIV.' So that is when the administration knew , in April ~ Healtll Care Workers W'rthAIDS S ince the epidemi c ~egan . nearly a decade ago, the..CD C has reported AIDS in the Jol!owing fl.Umb ers of health care. wQrkei·s. ;J"h e numbers ofH IV~ positive het.ith care workers, which are not reported here, of course, .are greater. Nurses•···-·· ····· .. •··••···· 1,~ ;,- Health aides ......... ...... 1,101 Technicians •.•..•...•. .. ... ...1'41 Physicians ......... ........... . 703 ' Paramedics ......... ... ....... 116 Therapltrts ..... ..... .. ......... ~ 19' Dentists/hygienists ..••.•• 17 1 BIOME:DIC-'L SCI 4 ENTIST -- - - - -- of'91. The direct0r of ER and the appropria te doctors in the hospital knew Jor over ayear about this and had previously called the state health department, and had been reassured that, in fact, I was \vithin my rights to work, that I was not a danger to anyone. " Brooks Hospital Administrator Richa rd Ketcham acknowledges that Rzepkowski told the ER director of his condition shortly after he was granted privileges there in April of 1990. According to Ketcham , the administration knewofhiscondition when Rzepkowski completed his reappointment application in the spring of 1991. The piccure darkened, though, following the release of new CDC recommendat ions July 12. "I think the hospital administration became nervous at this point. According to the new recommendations, not law, but recommendations, HIV-positive health care workers should refrain from 'exposure-prone ' procedures. They ultimately left the definition of exposure-prone up to each individual hospital. At the time this came out, I was called by Dr. Joe Gatewood. He told me that umil we get this straightened out, I shouldn't work. 'We' re put ting you on administrative leave of absence.'" According to Rzepkowski , Gatewood requested input from Rzepkowski on what exactly constitutes "exposureprone " procedures, in view of his expertise on AIDS issues. He met with Ketcham, Gatewood and other officials at Dunkirk 's Sheraton Harborfront Inn . "I thought, this is nice, they're wanting my input on what 's 'expos ure-prone .' Well, I got to the breakfast meeting and they said, 'We've come up with a list of 35 exposure-prone procedures we feel you can't do; therefore you can't work in our emergency room. Therefore, wesuggesteitheryou voluntarily withdraw your privileges for an indefinite period of time, or we can dismiss you. But if we dismiss you, you'll have to put this on all your resumes and explain it all if you ever want to apply for privileges again. "'What is your decision, doctor? ' So, of course, my free will decision was to voluntarily withdraw. This looks nice in the paper- that 1voluntarily withdrew, AUTUMN I 9 9 I 0 �bm what would your choice be? 1f I didn 't voluntarily withdraw, I would have The possibility of an early deal gotten fired. " There is some anger in Rzepkowski's voice as he tells his story, but he claims to understand the "human emotions" that precipitated it. "Given the circumstance of a small hospital and their level of education about AIDS, and not having e)cpen input into the 35 exposure-prone procedures, it's understandable that they didn't want me to work there. " Asked to comment on Rzepkowski's story, Ketcham says, "It's a relatively accurate portrayal. I'd like to reiterate that Dr. Rzepkowski has handled (the matter) very well, superbly, in fact. He was honest and open with the hospital. We tried to be open with him. " The hospital 's list of 35 exposureprone procedures was not arrived at by which I'm afraid it is - then it's critical ln Ketcham 's view, the issue of inofficials at the Harborfront lnn meeting, that the needs of health care workers be formed consent is a compelling one in Ketcham states. Rather, they were deter- addressed. Because clearly the risks of the context of exposure-prone procemined before by members of an ad-hoc transmission of communicable disease dures. "Some ER patients are not in a committee appointed by the hospital 's from patient to health care worker are position to give informed consent. In medical executive committee. Members much greater than the other way around. other situations, if a patient chooses his represented "appropriate medical spe"I find it personally very distressing, or her private physician - and knowcialties" Ketcham said, who then pre- as does the board of trustees and the ingly chooses an HIV-positive physician sented their findings to the medical ex- medical staff involved in this issue, that - that is this person's choice. In ER, it is ecutive committee and later to the board HIV is not treated in a scientific manner. usually not a matter of choice. Thereof trustees for approval. Unlike any other disease , it is treated fore, we believe we owe an even higher In commenting, Spectrum's Gate- through the political process. This has obligation to the community in this rewood cited his own many years as an created a paranoia, hysteria, a level of spect." emergency physician. "It's not just a fear unlike that for any other disease. Of the 4,100 individuals who were business with me. My interpretation as Though much of this is unwarranted, sent letters alerting them to Rzepkowski 's an individual physician of the types of the reality is that hospitals must react to condition, 536 chose to be tested. None procedures that the CDC listed in their public perceptions as much , if not more tested positive, Ketcham reports. July document is that probably there are so, than scientific facts. Some may see In Rzepkowski 's view, the public up to five or six procedures that would this as ducking real issues , not being fair needs to be educated about the disease. be truly 'expos ure-prone ' by their defini- to the physician, but I also have an "It's transmitted in certain defined ways. tions, that an ER physician might do." obligation to the 18,000 ER patients who l think it's fearsome because it's ultiHe noted that he wasn 't criticizing were served by Brooks last year. mately so deadly. That's what people Brooks' list of the 35 procedures, nor the "We have tried to stress the educa- fear. But if you really think about it in process used in arriving at them. "I just tional aspects of this issue and the fact proper perspective , yeah, it's a deadly think that they 've listed some proce- that the risks are very small. The level of virus, but it's hard to transmit that deadly dures that , when beuer support and as- awareness is not what it should be. A virus." sistance is given to hospitals and there is much higher level of awareness is needed As he continues his battle for more better guidance from the speciality soci- ifan HIV-positive physician is to work in understanding of AIDS issues, eties and the CDC, some of the proce- an ER, particularly if he is the only ER Rzepkowski knows that "at any time I dures on the list would be taken off." physician on duty at any one time , as is could get sick. My allergies are acting For Ketcham , the dilemma posed by the case at Brooks." up. I ask myself , is this the allergies or do Rzepkowski'scondition has two aspects: And according to Gatewood, "Most I have pneumocystic pneumonia? ls this "First , there is the scientific approach, probably, of the 5,000 ERs in the coun- the end? Those kinds of things are alwhich would clearly indicate that the try, the vast majority have a single emer- ways lingering. But you have to deal with risks are so small as to not even exist. If gency room physician. An ER physician it and live one day at a time, live life to its the move is toward mandatory testingcan't limit himself to certain procedures." fullest." + «I!) BUFFALO PHYS1CIA.N ANO BIOMC:OICAL SCIENTIST AUTUMN 1991 �------------------ U~lli on·rue ·~.. l·leof · · H·· d• cl .·Too · • • 1 - _ · ,r:w • . - - · • IS • .. · • , ·' .,. 0 is What Do You TI1ink? The Buffalo Physician a11 d Biomedical Scientist wants LO know its readers' "Clearly,someth~•Speculiarwasgoing011in that office.'· Clarissa Cui111inghCl(11 , spohespcrsonfor t11e.AIDSAction Co1111cil,..refer1illgto Acer's,{a~/1 of w1ivetsalpreooutitl1L~ and sterilc·tecff11iq11c. -- · . , 11vFloridadentist.Ac~r. 011how s}iewould • "ILis 111ucl1 _mo1·edangerousta have <1'17hys'i-thaf .UP,'heldth~ Medical Center at cian wn~·ssufferinga l_1angover from having Princeton's policy requiring an HIV1nfected s~rgeoh to seek · informed had 100 m11cl1ta d~nk thci,ightbef~r'e."· JosephGatewood,M.D .. directorcf medical consent from his patients, effecscn•icesfarSpectrum£mergotcy Car~ofSt. .tively .-restricting his practice. Louis, which $1tlJ-comr0;c4· 11utt0 Brooks MemorialHospitalto supplythemwith emer- "The i11h ere11trilh1to know-forpaticn(a 11d e co,ifigency'ro~mphysicia1is,011the risks a pdr,ient doGtoralihe_: always bas ta SUPG{__Sed . facesfrom bei11gueatedbyan HIV-positive deniiality . •Tl1edoctordoc;sn't hal!e 10e11tup a signboard,but therehasto be inJonntd consent ph_y~ician .• ~le gai11gto do invasive proceduFcs. 'First'. "Unfortunatl!ly, this dentist ,did dono ha~· is the absolutebedrocnoJmedicine,. not use very strong aseptic techTIJeKimbei:lyBergalis~sof this~11 orlda,rovoidniques, 'did not use rubber gloves, ablc.·• SaiifordK1,vi1t,M.D.• vicr.cl1ainnan:of for in~ance." Louis _H .. Sulli .van, •the f'lational 'founclation.[or~1ifectious - Qis· Secretary of He.. h and Human ease~ Services, referri1'i to Florida de.ntist David J. Acer, who infected five of his patients with tflY before t dying of AIDS in Sel?tember 1990 .. - ~ .. . . · osure . ."'~ ,.... • • ,. --- tho ugh ts on the new CDC gu idelines on disclosure of HIV-posi tive heahh care workers under certain circum sta nces. Please take a few minutes to wr ite down your comments. We will publish selected responses in an upcomi ng issue. Please mail responses to: and BioEditor, The BiiffaloPhysicia11 medical Scientist, State Un iversity of New York at Buffalo, 136 Crofts Hall, Bu ffalo. New York l-+260. or fax the m 716-636-3765. ,;avefelt if herf1hysicianrejuseaLope1fon11 r;yesurgeryo11heraftershuo!Jliim$.hewas HIV-posi¥ve. Her pl1ysicialfdid ;heppera- "An exposure-prone procedure is one where- it Is likely, concpivable, possible that the doctor's blood will g~t into the patient's circulation. That ~n be through an open wound on the patie,;t, a sore on the patient, but the doctor has to bleed fresh blood ~f his into fhe patient, or get a~ instrument bloodied by himseff ;1ndthen, use it on the patient. Now whether you're wearing gloves or not, doctors don 't easil1 ble.ed when tfley're taking care of patients." N'e~I Rzepkowslti , M.D: " "Dcat.his going to catchme with my boo1~0 11. I'm ,wt going to,sitdown·a11a'dwindl~ away•:, 1 have a messageto pass on. The one 41ing thaL1 am 11otJoing,11owis the tbl11g1 lov~ most i11life and thµtis taking care ofpeople, b_fcaustmedicinehas 110placl.']or thosewho. our tale11.r." an; HIV t,ifcctep,regtirdlrss of,Y_ Aotm, M.D., o,; Baltimort carrliologisl'l\_cit, suffe1ingfi'omJull-blawnAIDS three years afier a rest tube full of HfV-contaminatcd bloodbroke and spilled qvel' his cutji,fgcr. Aoun sued after ad1>1inistr<1tors al the hospi· tal where /Je,was l[di11i1rg refusedco renew his ~ontract. The case was settledfor al!1111disclosed .s11m.· "Ethically and morally ; I think I. . , shouldtnot continue with my work without telling anybody." Dentist lll David J. Acer to a social worker during a hospitalization tor pneumonia a few weeks before selling ''Who do , I blame? l?,o I 'blame his lucrative practice ii:' the SU("~ • mys~lf? I sure don't. I never used • mer ot · 1989, but over .a year before telling his patients he had "Doctors .rre afraid. They want to IV drugs, neve~ slept ~ith anyone AIDS. A few days after telling · know the HIV status of their pa- and never h-?d a blood transfutients-, and doctors who work in slon. I blame Dr. Acer and every them 6y letter, Acer died . single _one of you bastards. Anysurgery ask us about it alfthe time. one that knew Dr. Acer was in"TIie lisFiclosely resembles Lhc-risli of n If we get the patient's permission, -~hicularfatalflJ' during transpoi'lationto . we give the information, oth~rwise : fected and had f~ll =blown "Jlu>S it's up to the surgeon to discover it and stood by not doing a' damn ' ahdfrom 1111 ;, hospital." Albert~Lowe,ifel , thing about it : You are-all just as .M.D.. of New Yorli'Mcdical College,calcu- on his, own. In many institutions, lating the risli of transmissionfrom ·a,1HI'v- blood is illegally and surreptitiously . guilty as he was. You've ruhted infe.:Ledsurgeo·11 t~ a patie11tat las(June's drawn on patients 1o find ou\ Jheir · ·· m]t . life and my .family's." Kiminte,:national~o,iference on AIDS held in status." Paul Rothman, M.D., presi- bedy Bergalis, the first patient to · dent -of Search Alliance, an Los An- contract AIDS from h.e( dentist, Plorcnce,Italy. • David Acer, in a letter to Florida geles . AIDS-res~arch organizatio& 11 :rhe ultimate risk to the \atient is be~lth officials. In a po,st script, tot~ll_va11dgo11e Berga I is also wrote, "If laws .are so abiiolute, so devastating, thfat "I 11ouldhm•e 1111derstot1d it ls unt'enable to argue against down to the AIDS clinic. A~d it_wouldn't ha;rc l\dt formed to provide protection, : inf~fll'led consent;' ; New ' Jersey botheredme at all to_go-dow11. I jusl gave him then .my ~uttering and death was \ Superior Court Judge Philip ·oicoption. Nobodygaveme the .option." Bar~, ..•~vain. Ca;at,man, in a· May 1991 ruling bara Wcbb~_aziotl1er patient infectedwith 1,;IIV "I'mdying guy,-. Goodbye.:t' • • . .. 8Ufl' F' A.LO P + • HYSICIAN A NO BIOMEDIC A L 5Clt::NTIST AUTUMN I 9 9 I G) �Dy Jess:i.e~ 8"te:i:n.. D:i.~moII.d. • ew legislalion may clarify lhe nation's debale over who makes medical decisions on behalf of lhe comalOse and lerminally ill, placing the power lO refuse or accepl lreatment more firmly in the hands of the patient. According to patients rights advocates, doctors, hospital administralOrs and auorneys, the Patient Self-Determinalion Acl, which Lakeseffect December 1, 1991 is likely to lead to more compassionate medical care by improving communicalion between patients and health care providers. Primarily an educational law, the PSDA mandales that federally funded health care providers publicize state laws on patient rights to patients and caregivers alike. But the PSDA also presents logistical, legal and educational hurdles for health care providers: specifically, how to educate and counsel patients so that their advance medical directives accurately reflect their unique circumstances and values. 4D BUFFALO PHYSICIAN A N D 8 1 0 M E O I c' A L S C I E N T I 5 T A U T U M N I 9 9 I ��L'sexcellent law from the perspective thaL more people will be infonned so they're able to make their own decisions, " says Daron Weber, former spokesperson for the national Concern for Dying and the Society for the Right LO Die. "The PSDA may lead to change by making people aware. The key factor is going to be compliance.just how much teeth does the law have." Although health care providers that receive Medicare and Medicaid funding must 11 comply with the PSDA Lo receive these monies, the circumstances under which money would be withdrawn have yet to be spelled out. Written into law as parL of the federal Omnibus ReconciliaLion Act of 1990, the PSDA mandates that health care providers give all patients written information about stale laws on living wills and their rights LO refuse or accept medical treatment. HealLh care providers must ask incoming patients for advance medical directives and place them in patients ' medical charts and also publicize their institution's policy on these state laws. For stales with few or no such laws on the books, the PSDA requires that health care institutions make this known. Simplifying these mandates, a spokesman for the Health Care Finance Administration (HCFA) recommended that health care providers develop clear statements of policies on advance directives, write detailed action plans for staff education and community outreach and decide logistically how LO enter patients' wishes into their medical records LOcomply with the PSDA. HCFA is responsible for writ- ing the terms of the law into regulations , In regulations scheduled to have been issued in October , HCFA was expected to specify how providers should comply,vith the law for patients who are unconscious at the time of admission as well as define exactly when hospitals should give patients information about patient rights laws - before a planned hospital admission, at the registration desk or at the patient's room. Other issues related to compliance with the law may be more difficult to solve. The PSDA spotlights the difficulties of obtaining truly tnfonned consent, says Susan Goldberg, ofMagavem & Magavem, medical treatment so it's harder for them to prove they're competent LO make a decision. There are an awful lot of people out there without the documentation and without families to speak on their behalf." In New York State, the Patient SelfDetermination Act will likely ensure that hospitals now routinely ask patients whether they have living wills LOenter into theu records. Buffalo area hospital administTators say they \viii continue and improve their ei,.,isting educational programs on patients rights for health care staff, incoming patients and the community at large. These educational efforts will focus mostly on two New York State laws: • The Do Not Resuscitate Act of 1988, referred LO the DNR law, which mandates that on admission all patients receive information on how to place their wishes regarding CPR and other "heroic measures " to resuscitate them in their medical records. • The Health Care Proxy Law, effective January 1991, which requires that all patients receive at the time of admission a form and explanation for how to designate a proi,.,-yor surrogate decisionmaker LO gu ide their medical care when they can no longer express their own wishes . These laws have already been gradually, a~d occasionally grudgingly, integrated imo hospital procedures. Peter D'Arrigo, M.D., vice president of medical affairs at Millard Fillmore Hospitals , recalls that when the DNR law took effect, doctors disliked discussing it with patients who needed sunple medical procedures such as having a mole removed. Some patients became alarmed that medical care would be withdrawn unnecessarily or that their health problems were more due than they believed. The proxy THE BURDENOFSUFFERING IN CERTAIN CIRCUMSTANCES APPEARS TO BESOGREAT THAT WITHDRAWAL OFTREATMENTAND WE'RENOTTALKING ABOUT ASSISTED SUICIDE- MAYSEEM TO BETHEONLYACCEPTABLE ALTERNATIVE'.' ~ eu,-FALO PHYSICI A. N legal counsel to Buffalo General Hospital. "There 's risk - particularly with living wills - that a person may sign a form entitled "living Will" and not have really understood what it might mean in a given situation. Sometimes a fonn may give duections that are ambiguous , and people should not sign them without first discussing the contents with their physicians. " Beaufort Williams, an attorney and director of Legal Services for the Elder ly in Buffalo, is frequently appointed to represent patients who cannot adequately express their wishes. He shares a similar concern . "Poor and uneducated people can't always articulate their objections to AND BIOMEDICAL SCIENTIST AUTUMN I 9 9 1 �law was more readily underst0od. But the burden of making medical choices can weigh heavily on prox'Ydecision-makers who now must make decisions on their own that were once made solely by physicians , observes Michael Noe, M.D., clinical assistant professor of medicine and social and preventive medicine and senior vice president of professional affairs and medical director of Buffalo General Hospital. "The burden of suffering in cenain circumstances appears to be so great that withdrawa l of treatment - and we're not talkingaboutassisted suicide- may seem to be the only acceptable alternative," he says. "Before proxy law, certain of these decisions could be handled by a doctor with perhaps a broader, more objective assessment of the medical issues." Hospital ethics committees often help proxy decision-makers who request additional legal, medical and ethical guidance. BGH's nursing, social work and medi- cal staffs are trained to discuss pro>..')' forms with patients. But the hospital strongly advises that patients discuss DNR forms, advance medical directives and living wills with their own physicians. "The types of decisions a patient has to make require an opportunity to have questions answered by a medical person familiar \vith their situation," says Noe. Medical professionals also mentioned a common misconception that educational efforts mandated by the PSDA may help correct: many patients don't realize that the living will is legally recognized in New York State most frequemly when it is accompanied by a proxy or DNR document, and it may not have a binding effect on a particular decision about medical treatment on its own. Stephen Wear, Ph.D., a UB professor who specializes in medical ethics, says, "The real issue people have to explore is the complexity of care for people with chronic degenerative diseases or critical Most medicalethicists believeNew York State's patients' rights laws, especially the health care proxy act, are best applied when physicians discuss them with patients as a matter of course, beforea hospitalization or crisis. Doing so can prevent the problems illustrated by the following recent casefrom a local fwspital. man in his 80s suffers a heart attack while watching a Bills game this fall. 911 is called and he is resuscitated at home and taken to the emergency __ ...___ ,,__ room of a local hospital where he is stabilized, placed on a ventilator and admitted to the intensive care unit. Subsequently it is found that the patient has suffered severe brain damage. Among other things, he cannot breathe for himself. When he is diagnosed in a persistent vegetative state, the patient 's ·wifeand adult children unanimously request that all treatment be stopped, including withdrawal of the ventilator. The physician asks the family whether the patient had made any prior statements while competent about what he wou ld or wouldn 't want in such a circumstance. They 8UFF'ALO PHYSICIAN ANO BIOMEDICAL illness. What does their remaining time look like, how should their care be managed?" Physicians should discuss with their patients exactly how the proxy, living will, DNR and advance medical directive forms are used in conjunction with each other and also how statements on these forms about specific medical procedures would shape the medical response to theirown specific situation, he notes. The PSDA, by tluowing the spotlight on state patient rights laws, is a strong indication , at least, that patients need no longer rely passively on the decisions of medical providers. Clearly, patient rights laws vary greatly from state to state. By providing patients with information about these laws, the PSDA takes a giant step toward helping patients retain control over their medical destinies - even in an era when medical technology has redefined the very nature of death and the process + of dying. respond that although he had never talked about it specifically, they are certain he wouldn't want aggressive medical intervention given his prognosis. The physician advises the family that without the patient's prior competent statements supporting the withdrawal of the ventilator and without an appointed health care proxy to make such decisions on his behalf, this couldn't legally be permitted. The family is aghast. The patient remains in the intensive care unit for several weeks and dies of a second cardiac arrest. Under two recent New York State laws, the Health Care Proxy law and the Do Not Resuscitate law, this patiem 's wishes, if clarified in advance, would have been protected. However, he had not appointed a health care proxy who could decide about treatment ifhe lost the ability to decide for himself. The prox y could have requested the removal of the ventilator. The Do Not Resuscitate law would have protected the family's right to decide whether ventilation could be used to resuscitate the hospitalized pati ent in an emergency but not whether ventilation could be used to keep the patiem alive. A UB professor of medical ethics who attends meetings of num ero us Buffalo hospital ethics committees says such heart-wrenching circumstances are not uncommon and that doctors are learning through these situations the importance of explaining these laws to their patients well in + advance of a medical crisis. SCll!:NTIST AUTUMN 1 9 9 1 4D �[ ~ Il ~ RH I ll1H I I ~ Il ~V~ llHHUf BffIlH[ [ fPI fIl... B R y H C R A D D y E Always prized, an acceptance from UB's School of Medicine and Biomedical Sciences is more sought after than ever by today 's medical school hopefuls. "The combination of the med school's growing national reputation and its affordability are making UB the school of first choice for most candidates we accept, " according to Thomas Guttuso, M.D. , assistant dean and director of medical admissions. "The class of l 995 's rate of 1.9 acceptan ­ ces per seat is the lowest since the early 70s when the medical school applicant pool peaked. That means that today more applicants accepted are saying yes to UB." 4D B U F FALO PHYS I CIAN ANO BI O MED ICAL 5C l £ NT IST A UTU M N 19 9 1 �Maria Bruno, a first-year medical student with a 8.5. in genetics from Purdue, has a long list of reasons for returning to her hometown to sLUdymedicine at UB. "I was impressed with a lot of the things SUNY Buffalo had to offer over higherranked schools," Bruno said. Guttusso points to favorable national rankings as one of the key factors that favorably disposes applicants toward UB. "We're rated the best of the SUNY med schools by The Gounnan Report , which is considered the leading independent 'authority ' evaluating American medical BUF'F ALO PHYSICIAN ANO schools. Nationally, Counnan ranks UB 30 out of 126 medical schools, pulling us in the top 25 percent of American med schoo ls." Guttusso also cites a recent ranking by the Association of American Medical Colleges (AAMC) placingUBas third among all U.S. medical schoo ls based on the AAMC's current institutional goals. Making UB even more attractive to prospective medical students is the school's track record in placing seniors in their preferred residencies. According to Guttusso, 90 percent of UB medi- 810M£0lCAL SC IENTIST cal school grads are currently placed in one of their first three choices, 15 percent to 20 percent above national averages. For first-year student Lew Foulke, a better chance at a prime residency was the deciding factor for coming to UB medical schoo l, despite the location of another school closer to his roots in Central New York. "Of the three schools I was seriously considering, UB's reputation and ranking were the best, which will give me an edge when applying for residencies in whatever my chosen spe- AUTUMN 1 9 g I 41) �cialty turns out to be." Cost, boLh from the standpoint of tuition and area cost of living, also gives a boost to UB's stature among medical school applicants. Tuition for in-slate residents is just over 57,100 which compares to a national average of about $16,000 for public and private medical schools; the most expensive schools charge over $20,000annually. Thecostconsciousness of most medical students has typically been raised by four years of undergraduate education, often at much more expensive private schools. Lara Akinbami, a Harvard University economics graduate is typical of this breed of student, but her career aspirations in medicine also moved her toward puuing even more emphasis on the cost of a medical education. "Having spent two years with the World Bank in Washington , D.C., my interests are in the public polic y of medicine , particularly in the areas of access and affordability," Akinbami said. "Since this isn't the most lucrative venue to take in the medical field, it made good sense to go with a very good school that was also affordable." Not surprisingly, being one of the country's best and most affordable medical schools is making the admission process for UB even more selective. Guuusso, who chairs the Admissions Committee noted, 'The Class of 1995 was the most difficult class to be accepted into in almost twenty years. 263 applicants were accepted this year; that 's the lowest number since 1974." About one in 10 applicants was accepted to the Class of 1995. Given the difficulty of geuing in , how does the Admissions Commiuee make its acceptance decisions? "Obviously, we're seeking people who are talented academically with ability demonstrated by both grades and MCAT scores," said GutLuso. "We also look for the personal qualities that are important for future physicians: awareness of problems in the profession, concern and empathy for their fellow man, the commitment to being a doctor. The final decisions are a balance of all these factors." The overall demographic composition of this year's first-year class hasn 't a, BUFFALO PHYSICIAN radically shifted since the mid-70s when the medical school first started tracking a wider range of student statistics. Women and minorities continue Lobe well-represented, renecting the University"s early commitment in this area. Over the years, the average age of the first year medical student has increased to 23.5 years from a low of 22.1 years in 1976. The class of 1995 has 22 people over 25 years old, indicative of a growing national trend for medical students to pursue other work and academic interests before entering medicine. Darren Caparaso,a 25-year-old Western New York native, who majored in VitalStatistics: Theclassof1995 ' Applicants ................................... 2693 S18 Interviewed.................................. Accepted ....................................... 263 ClassSize...............13SMedical School ................................... 4 MST Program Average Age............................... 23.S Men............................................... 79 Women ...........................................S6 Science Majors .............................. 100 Non-Sci enceMajors .........................3S business at UB as an undergraduate and completed a masters in biology from Buffalo Stale College, credits his work experience in a variety of hospital positions with his decision LO become a doctor. "Wor king in a hospital for several years helped me to focus in on medicine as a career. Being a first-hand observer of what goes on in a hospital environmem also gave me the confidence to know that medicine is the right choice for me. " Although academic performance as measured by GPAs and MCAT scores hasn 't changed significantly, one noteworthy change has been a marked increase in the number of non-science majors, 35 in this year's first-year class. ANO SIOMC:OtCAL SCIENTIST' Gullusso explained, "More than any one particular major, we're looking for demonstrated academic excellence along with leadership, compassion and exposure to the medical field. This gives students the opportunity to get a broader undergraduate education. Of course, to be admitted, non-science majors must fulfill core science requirements and perform well on the MCATs." Foulke, who studied the classics in college and worked in a hospital environment before medical school, explains the seeming discrepancy in his undergraduate and post-graduate fields of study. "I was drawn to medicine by an interest in the growing body of research showing a defin ite mind-body connection which affects personal hea lth. Because I was strong in the sciences during high school, I opted for a non-science major to improve and develop my verbal skills." Regardless of how favorably the Admissions Committee is impressed by the quality of candidates interviewed, the size of the first year class remains constant, having been set at 135 in 1971. Additionally, a maximum of five applicants are admitted to the Medical Scientist Training Program which prepares student for careers in academic medicine as well as medical practice. Guttusso, involved in UB medical school admissions for 16 years, noted that the number of applicants to medical schools has dropped dramatically from the early 70s at UB from a high of over 5,300 in 1974 to approximately 2,700 in 1990. "l think today 's applicants are very aware of the negatives affecting the general atmosphere in medicine: malpractice, government intervention and control over income and the AIDS crisis," Guuuso said. "Co nsequently, applications have fallen off from the early 70s, when.many students viewed medicine as a career for those smart in science to make a lot of money. I see this as a blessing because every applicant we're now evaluating is really com mined to being a doctor for all the right reasons. Ultimately, that 's a positive trend for the medical school and + the profession." AUT UMN I 9 9 1 �.c s s 0 \ l1 THE STATE;_ UNIVERSITY ' . OF NEW YORK SCHOOL AT OF BUFFALO MEDICINE ANO BIOMEDICAL SCIENCES �E ACH YEAR , THE YORK STATE AT BUFFALO BIOMEDICAL SCHOOL SCIENCES 135 ABOUT UNIVERSITY NEW OF NEW OF MEDICINE ACCEPTS STUDENTS AND TO BE AND TRAINS PHYSI- CIANS. T HEY FROM COME FROM SCHOOLS ALL ACROSS WALKS THE OF UFE COUNTRY. AND THEIR ,, DIVERSITY UNIVERSITY BER ADDS TO THEIR RICHNESS AND CONTRIBUTES OF THE TO TH El R CALI- AS PHYSICIANS. , H ERE , WE PRESENT WISH THE THEM WELL FOUR-YEAR THE ON THIS , THE JOURNEY. OF '95 AND BEGINNING OF CLASS �o OmolaroJeonAkinbomi AndrewLouisAllmon Economics Biology RobertAnlhonyBorroli• ScottJonolhonBelote CherylAnneBettigoie MiroslovPatrickBobek English Psychology Microbiology Biology HarvardUniversily SUNYCollege01 Hobartand William Universily at Buffalo YaleUniversily CornellUniversily Geneseo SmilhColleges A Blum Katherine AlbertJohnBonoIll e TrinaAden Biology BolomuroliAmboli Anthony Jomes BortkOWJO, IbrahimA Berhon Biology Biology Biology Biochemistry liberalStudies Vassar New YorkUniversily Universily ol Buffalo Universily al Buffalo IndianaUniversily al Universily of Pittsburgh Bloomington (t lhuomoUdoAlozie I BarryRussell Armondi,Jr Ross JosephBellavia Be1hBernell Biochemislry Biolog9 Biology Biology CUNYCily College Universily al Buffalo Syracuse Universi _ly UnionCollege I EricBlumon Biology MourilsSlevenBoon Biology Cornell UnionCollege ' I C a s s 0 f 9 9 5 �e J~,ief,nn Brounscheidel CherylDeniseBuck TimothyRaymondByrnes LiangRueyChong Biochemistry Biology Biology ChristineChruscicki LoriAnneCohen Biochemistry Biology/Psychology Biology University at Buffalo University at Buffalo University at Buffalo Uoiversity of Rochester SUNYat StonyBrook Carol ElizabethBrietzke TonyTruongBui DarrenMichael • Craig EvonCheifetz Sebastion James Ciancio DeniseKo\herineDoigler Humanities Caporoso Psyc_hofogy Biology Nursing Am~riconUniversity CornellUniversity NiagctroUniversi!{ RichardJosephDeAslo , University at Buffo!o e . 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Fitzsimmons Biology_ Business' University al Buffalo Universi!Y ot Buffalo SUNYColtegeal Old Biology - \ "Westbury (t AnthonyMale~")DiRubbo ChrislopberJonEast Psychology CornellUniversity . • AndrewStevenFeipberg Sho~nPatrickFerguson DovidFiorello Biology· Chemistry Biology Civil Engineering Syracuse University DukeUniversi'Y._ SUNYCollegeal DornoEvertonFlash NaturalSciences University al Buffalo Ford~omUniversity Buffalo - I J . ' C a s s 0 ,. f 9 9 �e Llewellyn AllynFoulke RondyJasonGoldstein T~omos J Guttuso ToreqShehodehHarb Nigel Ion Henry DouglasJomesHickox Classics 'Chel]ltSlry Psychology Physics Medicol Technology Biology SUNY01 Binghamton SUNYat Binghamton CornellUniversity CornellUniversity CUNYCollegeof University of Rochester i StatenIsland ' MichelleAnn Gome Biology JeffreyScottGron! 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Mdhoney Oemistry Physics Biology Psychobiology History P1~ FordhamUniversity Universityof Rochester SUNYot Binghamton SUNYat Binghamton CooisiusCollege Oral RobertsUniversity HelenMon Kim EricHeathKossoff Oono lim MicheleMlJrieMonka ModhuiikoMathur Electricol 'Engineering English NeuroS'cience Business Psychology Biology ClarksonUniversity CornellUniversity CornellUniversity CornellUniversity Ohio StoleUniversity TuhsUniversity (\) Christina Maureen Keaney JomesStephenKillius \ (t HeatherMicheleKeene ' ) ) C a s s 0 f 9 5 �19 e GregoryAlan NlcDoniel tv\ariaM.odico , Anthropology , 6iology RerieeNealy DavidMichaelOdell NaturalSciences Chemistry SUNYCollegeat BuffaloStateCollege Hobartand William tv\anhotton College Buffalo ' ' KathrynAnneNlcVicor Psychology University of Chicago NancyPerez Biology· ConisiusCollege Hobartand William SmithColleges SmithColleges· . 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PeterDamionRoy (t Science and GermaineNoncyRowe EvaHolinoSotell Foreignlanguage Biology I Non-Science CornellUniversity Rutger~ University Physics StephenPeterSorrentino LisaLynnStephens Biology ComputerScience TuftsUn°iversity SUNYat Albany JoelAllenShapiro St. Bonaventure t BostonCollege UnlVersity ~ , --.. 7· C a s s. 0 f 9 9 5 �Q ThomesWilliom Stone Eva Tokocs·Dilorenzo Ed9t,1ord JohnTrobulsi Eilene Velez TheresaMorie Wegman TimothyPatrickWhelan History Art Bioche,mistry MolecularBiology Nutrition Dartmouth College HamiltonCollege Univer:sily of Rochester longIslandUniversity CornellUniversily Scienceand Non-Science lof?yelleCollege o ErikJonStumpf Chemistry Wng TsangTong Rolph!Patrick Tufano Chemistry Biology University al Buffsilo HamiltonCollege SUNYat Binghamton TimothyE.Von Duzer , Chemistry BrighamYoong DennisDorrWeimer, Jr. EllenMorie Whyte Biology Biochemistry ConisiusCollege Universilyof Chicago• Universily, / (9RoyceRosanoSyracuse JeffreyMichaelTessier PoulFrederickUpdike Andrew WilliomWorner Bi(?logy Biology Biology Music HofstraUniversily Wendy LynnWeinstein LorraineS. Williams Biology , Psychology CornellUniversily le Mc,,1ne College Universily of Buffalo SUNYat Binghamton 8 C a s s 0 f 9 9 5 Universily of Buffalo �e Bror>Krig Zebrowsk rMJ e , ffrcyleeZo:d man z~bier Ml t~ Alo~Zuccolo Bology SUN 01 on 01AnnArbor 00!')' Gcreseo MJ ,e E @ 81oclie":1stry N?zoref, Co ::,geof R SfynPerry An opology lJnivers~ at & a o 9 C a s s 0 f 9 9 5 �o ATH 0 f Hippoc~ATES I SOLEMNLY SERVICE , I ' WILL PLEDGE MYSELF TO CONSE~.RATE MY LIFE TO THE OF HUMANITY. GIVE TO MY TEACHERS WHICH IS THEIR ( WILL PRACTICE THE RESPECT AND GRATITUDE OUE; MY PROFESSION T HE HEAL TH OF MY PATIE'NT •I WILL RESPECT THE I WILL MAINTAlN BY ALL WITH WILL SECRETS CONSCIENCE BE MY FIRST WHICH AND DIGNI_TY; CONS!DERATION; ARE CONFIDED IN ME; ·, AND THE NOTABLE THE TRADITIONS MEANS IN MY POWER, .OF THE MEDICAL THE HONOR PROFESSION;· ' MYCOLLEAGUES IWILL NOT RACE, PARTY PERMIT BETWEEN I WILL THE . MAKE HONOR. POLITICS, MAINTAIN TIME BE MY BROTHERS CON .SIDERATIONS MY DUTY AND THE THESE PROMISES SISTERS; STANDING NATIONALITY, TO INTERVENE MY PATIENT; UTMOST KNOWLEDGE AND OF RELIGION, OR SOCIAL OF CONCEPTION; MY MEDICAL I WILL RESPECT EVEN UNDER CONTRARY SOLEMNLY, FOR HUMAN THREAT, TO THE FREELY, LAWS AND LIFE, I WILL FROM NOT USE OF HUMANITY. UPON MY �V~llll~f ~IillfIll[Hl~TllilE Ill HillE Rl[HfIlifR~llB o the best of his knowledge, which is considerable, Balamurali Ambati, age 14, is the youngest medical student in the history of American medical education. A memberof the Class of 1995, Ambati was accepted at 13 to the medical sc hool 's Medical Scientist Training Program (MSTP), which on completion simultaneously awards M.D. and Ph.D. degrees. In discussing the historic acceptance, Thomas Guttusso, M.D., who heads admissions for the medical school said, "We believe that Ambati is the youngest ever admitted anywhere, certainly at UB. His application came to us through normal channels and his credentials were excellt:nc. Actually, the academic record for MSTP applicants must be outstanding; admission standards are more rigorous than those for applicants only applying to the graduate or medical school." He added that the one major consideration given to age was that the MSTP program takes seven years which would make Ambati about 20 years old at graduation. But although Ambati's age makes him distinctive, Guuusso said he will receive no special support. "Because the medical school strives to give a high level of support to all students, I'd expect no more than we give other incoming students. His ability to graduate from college with honors in two years is an excellent indicator that no extra support will be needed." Ambati, who modestly acknowledges the recognition and nurturing of his talents he received at an early age, is also quick to point out that a lot of hard work has contr ibut ed to th e considerable BUF"l"ALO PHYSICIAN AND achievements of his short lifteime. A magna cum laude graduate in biology from New York University (NYU), Ambati was on the dean's list throughout his short tenure at NYUand made USAToday'sAllUSA Academic 2nd Team. He plans to pursue both research in neuroscience and a medical speciality in ophthalmology. In addition to his academic successes, Ambati has also coauthored AIDS: The TrueStory, a book primarily aimed at high B IOMEDICAL SCIENTIST school students, wh ich examines the epidemiology, treatment and ethics of the disease. His collaborator on this project was his brother ,Jayakrishna, who started medical school at 17 and is now in the fourth year of an M.D./Ph.D. program at another school. For hls pan, UB's Ambati, on an even faster track, is now on his way to becoming the youngest doctor in the United States. + D RICHARD AUTUMN 1991 Y E fI:) �.._, ~ . ?, r., ~ } L L BUFFALO U S T R A T PHYSICIAN 0 N A N S D B y AL AN SCIENTIST , ,.. ~ -- E. COB AUTUMN ER t 9 9 l �PRESCRIPTION FOR B Y 5 C O T T PAIN : T H O M A S f all the symptoms that physicians are presented with, pain is the one that troubles the most patients and can be the most perplexing to treat. ► Reliable estimates say that one in three Americans suffers from some form of chronic pain - pain that persists long after its useful function as a warning sign has passed. Half of them will become disabled for days, weeks or longer. B UF F ALO P HYS I CIAN ANO 8IOMIEOICAL SC I ENT I ST A UTU M N t 99 t fl> �f pain were a disease, it would be an epidemic. But, of course, it's a symptom with literally dozens of diagnoses. Headache and backache top the list of the most common complaints. Pain also intrudes in the lives of people with arthritis, sciatica, degenerative spine disease , peripheral nerve damage, stroke, shingles and whiplash. And people with cane.er must cope with managing pain which, if left unchecked in the disease 's advanced stages, can be the most excruciating agony known to mankind. Increasingly , physicians in all specializat ions are recognizing pain for what it is: an insidious invader that works in a thousand ways to not only destroy their patients ' quality of life, but affect their physical well-being as well. And throughout the medical field, there's a new awareness that pain, unlike its root causes, nearly always can be controlled. "Up unt il the last decade or so, doctors were more focused on cure rather than care," says Mark. J. Lema, M.D. , who directs the Department of Anesthesiology at Roswell Park Cancer Institute. Lema , an assistant professor at UB's School of Medicine and Biomedical Sciences, is director of anesthesia research for the school's Department of Anesthesiology. "The body 's nervous system is the last medical frontier to discover, " Lema says. "One engram [a nerve bundle in the brain that serves as a switching area for pain I is more complicated than the most complex microchip. " Increasing the difficulty of assessing and treating pain is the problem of measuring an individual's pain. By its very nature , pain is subjective; what one person feels as a minor irritant, another might experience as an agony. Factors as diverse as individual biochemistry and cultural differences all affect what pain feels like and how it is tolerated. "There 's a sociocultural aspect to it - how does one respond to pain? - that 's built up in the early stages of life/ says Romanth Waghmarae, M. D., assistant clinical professor at the medical school and director of pain management programs at Sheehan Memorial Hospital and Kenmore Mercy Hospital. "In certain cultures, children are taught to be stoic, to 'tough it out'; in others, it's considered acceptable to Cl)' and wail and really feel it." Research has shown that Americans of Mediterranean heritage feel pain more deeply than their neighbors whose ancestors were Northern European. And it's widely acknowledged that most women have a higher tolerance for pain than most men, perhaps a blessing that toughens them for childbirth. But individuals' pain tolerances vary widely, even within families. The reasons remain a mystery of biology . Pain specialists, or algologists, sometimes use a simple 10-pointscale, asking patients to rate theirown pain. Though this doesn't make it any easier tO compare the experiences of different patients , it helps in assessing an individual ED BUFFA LO PMVStCIAN ANO B10Mco1cAL patient's progress during treaunent. The biochemistry of pain is simple enough: injured nerve cells transmit a "pain signal" to the dorsal horn of the spinal column. The signal is then relayed through the spinal cord to the thalamus, the pan of the brain that recognizes the impulses as pain. For people suffering chronic pain, though , the ordeal goes far beyond chemistry. They may find themselves in a vicious circle of tension , anxiety and further pain. Waghmarae says pain works subtly to disrupt the fabric of relationships, avocations and habits that make up daily life. It becomes a constant, an uninvited companion that causes people to function on a lower level. It is always present; even sleep doesn't bring relief. "You suddenly become abnormal," Waghmarae explains. "That in itself works against you." People who become disabled may develop a whole range of sympt0ms related t0 the pain that put them out of work. These people may snap at their spouses and children partly from frusuation, partly from edginess related to the pain itself. They might go out less , insulating themselves from any activity that might increase their pain. Their relationships suffer. They become sedentary, causing even more med ical problems , increasing the pain. Depression follows - and so on and on. After a wh ile, pain is only one part of a complex of misery that it has caused. "It changes your life," says Vivian Schiferle, a Town of Tonawanda woman who suffered wiLh chronic pain after a back injury several years ago. "I couldn't think because of the pain. "It's the liule things that change. The way you dress. You have LO learn LO like low nat shoes. Even· to go out to dinner, we would go where the chairs were good. We wouldn't go where maybe the atmosphere was terrific, or to that new place that jusl opened. It was always where the chairs were comfortable." Schiferle's pain has been controlled for over a year now, Lhanks to severa l epidural injections of steroids, a relalively recent innovat ion in pain therapy generally used for cancer and other severe, debilitating pain . In this procedure , an analgesic mixture - most often narcotics or steroids - is injected into the epidural space in the spinal column, deadening Lhe sensation by blocking transmission of the pain impulses. In recognition of pain asa distinctentity , treatable in itself, physicians and hospitals have begun to establish pain management programs. The goal is not only to eliminate patients ' pain as much as possible, but to teach Lhem how Lohave full lives despite pain that won't go away. One such program is the pain managem~nt center at Buffalo General Hospital. 1ts medical director, Gerald L. Peer, M.D., is a clinical assistant professor in the medical school's Department of Anesthesiology. SctCNTIST AUTUMN 1991 �ln addition, there are physical benefits. It has been re"It's very individualized," Peer says of the Buffalo General ported that patients who use PCA after thoracic surgery or program and others like il. "We tailor-make the treatment for repair of broken ribs are more likely to breathe deeply each pat ien L" reducing the risk of pneumonia - because their chest pain Peer says such programs may involve not on ly physicians , is better comrolled. but also psychotherapists, occupational therapists, social "Pain and suffering is second only to incurability when workers and nurses who specialize in pain managemenl. people think of cancer," says Lema, whose practice deals "Many times, " he says, "we can tell a patient that the pain is largely with cancer pain. "It's not even the prospect of dying no longer a sign of ongoing physical damage . The:n we find that scares [patients] so much as the thought of suffering." the best ways we can to help him live with it. " The solutions With some cancers, such as leukemia, the patient's pain is may be as simple as help ing the patient to arrange for relatively mild. But Lema says tissue cancers often encroach ho usehold help, or adjusting his medications , or fining him on nerves and bone , sparking constant and debilitating pain. with a body brace to take the pressure off the afflicted area. In addition, he says, cancer treatments - chemotherapy, The multifaceted approach of pain management programs radiation therapy and surgery is being [eltat the medi - all bear their own costs in cal school as well, says severe pain. Robertj. Schuder, M.D., Epidural mJections, he interim chair and assosays, work "much of the ciate professor in the Detime ." But until repartment of Anesthes iolcently, physicians ogy. shied away from prescribing "We're a pan these opiates, fearing that of the team, " Schuder patients would become ., :says of anesthesiologists. addicted. ~ "We serve as a buffer be::::"'-.. ~,;:;~ For those in end-stage ~ -:.:::::: .:::, tween the an of medicine : ::: cancer, it's a moot point. -:.:.~ ' and the technology of But even for patients with ·• '· : medicine. less advanced cancer, or "And we bring some those with non-malignant humanity to it. You can chronic pain, studies have not on ly do [the job I, you shown that narcotics taken can empathize as well. " only to relieve pain are Schude r says residents highly unlikely to result in in anesthesiology deal with addiction. a variety of acute and "It's very awkward some,· ,: -- ..... •. -,. ..: .• ,, chronic pain situations in ' ...:.·/~/ ~/ times, because we have a ' ,,.,. - ..:--- ~ ; • - ~ 'l ·•,; their work at Western New • , , ... II\\' = ;~ 'l°l/~, i 'l(L war on drugs right now, " '.u.~-...J..:..::.:....:..:.. .~~=-~~~~ ...:J. !.....:!4....:!a. ..:!!:J ~...2~--t York's teaching ----+ Lema says. ''Peoplearesayhospitals. There, to drugs .' Well , there 's a small minority of us ing, '.just say no he says, they are often exposed to what has been ,called the who are saying, 'Let's say yes to drugs when it's appropriate. "' most exciting innovation in pain management in decades: All sons of alternative therapies are availab le as well, from patient-controlled analgesia, or PCA. the widely accepted to the marginal. Besides the holistic Patient-controlled analgesia is most often used for postremedies some sufferers swear by - hypnosis, massage and operative patients , people who otherwise would depend on acupuncture among them - one frequently prescribed treata nurse and a needle for relief of their acute pain. With PCA, ment is transcutaneous electrical nerve stimulation, or TENS. patients regulate their own pain. By pushing a button on a This hand-held device delivers a m ild electric shock directly specialized pump, they self-administer an analgesi,c through to the afflicted area, affording relief by interrupting the an intravenous line. nervou s system's "pain circuit.'' Studies have shown that patients on PCA use less pain "The fact that you have pain limits you," Waghmarae says . medication - and receive bener pain relief - than those "No matter how hard you ti)' to be normal, your behavior who must request a shot. Patient-controlled analgesia changes. " For the patient , he says, the questio n is simple: also gives patiems a greater feeling of autonomy and involve"How do you manag e?" The answer, as physicians know all mem in their recovery- invaluable psycho logical assets as + too well, takes a little mor e consideration. they heal. _,_ -s -;:., 8 uFFAl.O PM vs1c1AN AN O u10M £01c>.L sc1ENTI S T AU TUMN 199 1 6) �················· · ······· ·············· ····· ·················· ············ ······ ····· [i] . ' year, except for the major holidays, " he explained. "We really have an overabundance of student enthusiasm for the projecL." The attitude of the students is "fantastic" according to Juanita Hunter, pro fessor of undergraduate nurse education, project director for the Nursing Center for the Homeless and coordinator of the clinic. "It must be understood that the students generated the idea and did all the work to get it established," she explained. "This situation provides a great opportunity for the students to understand how health care should be provided to such less-fortunate groups Medstudents establsh "Hope Clinic" attheOtyMission STUDENTS JOIN NURSING CENTER group of enthusiastic UB medical students has joined with the University's Nursing Center for the Homeless to provide extended medical care for the less fortunate of Buffalo. The "Hope Clinic," which meets every Saturday EI) BU FFALO PHYSICIAN FOR THE H OMELESS morning at the City Mission, has met with great student enthusiasm, according to, Joseph D. Kay, a second year medical student and co-director of the medical student contingent of the clinic. "We're working on a rotating basis. Four of us work every Saturday during the ANO BIOMEDICAL S CIENTIST AUTUMN I 9 9 1 �· 11 ·························································································· ~ I in our society." The ursing Center for the Homeless, a federally funded non-profit organization, was established by Hunter in 1988 to provide free nursing care for the homeless. The medical students, she explained, began organizing two years ago under the direction of Kayand fourthyear student Geraldine Rubin, third-year students Alissa Shulman, Kristen Paulus and Anne Comi and second-year studentjennifer Wargula. They joined the clinic last June. "The advantage of having a medical clinic to go along with the nursing program is that if you have a person who needs to cons ult with someone who has greater medical expertise, you can refer them to the Hope Clinic." The results have been encouraging so far, but it wasn't easy getting all the pieces in place to make the operation a success, said Kay. ''Our major stumbling block was recruiting community doctors who would volunteer to work for a few hours on a Saturday morning," he exp lained. "We wouldn't be able to do what we do here without a licensed M.D. present." Kay explained that any physician who wants 10 be a part of the program simpl y needs to obtain an adjunct appointment from th e medical school. "And that 's not difficult to obtain. With that, the doctor is covered by UB insurance. " Anthony Bartholomew, a professor at UB's medical school, said that the camaraderie established between the stud ents will be beneficial to them in the future. "I give them a lot of credit. It's great to see first and second year medical students working with senior students to care for patients. They've really made this work." Fourth year medical student Patricia Reddin said that the clients at Hope Clinic present unique problems for the stude n ts and doctors. "You see a very different population here from week 10 .. BUF fl"ALO PHVStCJAN ANO I w e e k . There a re often immigrants who have Iit tie command of the language and that is difficu It," she said while preparing to question a 40 year-old woman from Somalia who had never seen a doctor in her life and was complaining of a non-stop headache. Kay said that the range of ailments exhibited by the patients who frequent the cliniic are numerous but often predictable, given the conditions in which they live. "There are a lot of skin problems, especially the feet and fingers, because a lot of these people are outside a good portion of the time. And of course we see substance abuse cases. We've even had a few cases of tuberculosis, which is really scary." Elizabeth Brown, who works for the Nursing Center for the Homeless, said that the program's success hinges on the cooperation and stamina of all who take part in it. "The students are really hungry 10 get some clinical expe rience to go along with the theory. For the Mission, it's simply something they've never had before. It's really needed. And the potential of the program is just now unfolding.· • Part of the cooperative process that underlies the clinic's success lies in the generosity of various agencies around the city according to Kay. "We have an agreement with the Washington Street Pharmacy where they provide the medication at wholesale, which makes it cheap for us. Millard Fillmore Hospital gives us a lot of supplies that are essential here as well.·· The Hope Clinic examines between seven and 10 patients every Saturday, according to Kay. "But this is as much a learning tool for us as it is a community service. If we can incorporate ourselves into the medical school as a program, they'll provide us with the stability we + need." - S IO M!:D IC A t.. SCtCNTaST SY MA AUTUMN RK HAMMER 1991 e �• ············· · ································· ·· ·· •· ···································•· ' I Dr.James F.Mohn Ends His Distinguished Career atUB A LONG TENURE O F TEACHING is faLher and grandfaLher were both opposed LoJames F. Moh n's choice of medicine as a career. "They Lhought I was a born Leacher buL ever since I was a smal l boy I wanted to be a physician. 1 just never planned that I would combine my medical career with Leaching and thaL iLwould Lum into Lhe longesL teaching span of a full-time faculLy member in the medical school's history - 45 years and nine months to Lhe day." Mohn relishes recalling the smallesL details. AfLer graduating from Fosdick Masten Park High School, he entered Lhe University of Buffalo - helping pay his way th rough school by work ing in The University's maintenance depanmenl. "I remember I was weeding the peony bed in front of Foster Hall when I heard that Germany had invaded Poland." After only two years of pre-med sLUdies, he was accepted into medical school and during his freshman year came under the inlluence of Professor of Bacter iology and Immunology Ernest Witebsky who had lled the Nazis and his German homeland in 1936, arriving in Buffalo three years later. "Witebsky was th e most famous person on the staff of the medica l school, a pioneer in immunology. He took me LO Buffalo General Hospital and had me ster ilize boules - he believed in learning about research from the ground up. 1 stayed with him until he died. " While still in medical school, Mohn contracted pulmonary tuberculosis - e BUFFALO PHYSICIAN "They thoughtI was a born teacherbut ever , RESEAR C H AND SER V ICE he says he still remembers the patient who was the source of his infection. His internship at Buffalo Gene ral was cut short and he entered th e Niagara Sani tarium. JusL before entering th e sanaLarium he took Lime out for his wedding to one of his med -tech sLudents. "We honeymooned on Lake Canandaigua and then 1 went into the sana tarium. It was warLimeand my wife was working at Buffalo General as Wite bsky's chief technolo gist," Mohn recalls. While recovering from TB he rebuilt the institution 's diagnostic laboratory. On Apri l 1, 1945, UB president Samuel Capen appointed Mohn instructor in bacteriology and immunology, officially beginn ing his teaching career. Mohn likes to joke that he "knew all the buildings at UB as people - Capen, O'Brian, Crofts." As his mentor, Witebsky imbued Mohn with the ideals that have stayed with him throughout his professional career wh ich is s till ongoing despite his retirement in January, 1991 from his position as professor of microbiology and directorof the Ernest Wi tebsky Center for Immunology. "WiLebsky believed in the troika teaching, research and service as a necessity for Lhe best teaching of medical sLUdent s," Mohn said. Mohn 's research has taken him to Walter Reed Army Center while on active service during Lhe Korean War and Cambridge Universi Ly where he work ed wiLh Professor Robin Coombs, inventor AND 810ME01C.t.L SCIENTIST sinceI was a smallboy I wantedto be a physician. Ijust never plannedthat I would combinemy medical careerwith teachingand that it would tum into the longestteaching span of afull-time faculty memberin the medicalschoolshistory." of th e Coombs test. His blood group research led him LO make numerous visits to Finland and LO Lhe discovery of a new blood group variant - AFinn· ln 1988 he received the Nevanlinna Medal from the Finnish Red Cross for his co ntr ibuLions LO blood transfusion services. Mohn's expertise has been sought ou t by state, naLional and international leaders. He was one of th e co-founders of the International Society of Hematology, started in Buffalo in 1948. In 1974 he was appointed by the Governor and confirmed by the state Sen ate Lo a council fonned to regulate statewide blood trans- AUTUMN 199 1 �. .. .... . .... .. ......... . ..... . .... . .... . .. . .. . ... .. ... ... . ... .... .. ... .. .... .. . . ...... . .. fusion practices. I le remains chairman of the State Council on Human Blood and Transfusion Services and director of Buffalo General Hospital's transfusion service, named in honor of Witebsky. His blood research led to an mntation to the etherlands to help celebrate the 25th anni\'ersary of the Red Cross BloodTransfus1onScrvicesCentral Laboraton . The court Iv and dapper Buffalo nati\'e took tea with Queen Juliana. who was less well -turned out than he - her slip was showing . But Mohn doesn't mind donning work clothes and working as a carpenter and Bu,-,.Al.0 PMYIICIAN fl] the other way. Ifwe didn't have regional center-,. we wouldn"t be doing transplants and cardiac su rgery." Hi!>long record of Red Cross ser"ice includes a term as Greater Buffalo Chapter chairman He is currenth chairman of the Red Cross Medical-Scientific Advisor) Committee and the chapter fitra\'el nancial development committee. He ,s proud of his -f6 years of \"OlunOf all his honors and awards. though, teer sen 1cc,, Hh the Red Cross In the \tohn sa,d the highest mbute he ever earl} days he ,,as opposed to the Red came when \Vitebskv praised Cross concept of regional blood ser- received him the as a teacher-calling abilit) nces. but soon realized the wi.sdom of his + known. ever had best teacher he the approach. "If you're an objective LLIAMS WI DEBORAH -BY scientist. vou ha, c to face facts . I swung painter to restore his 1851 Elma farmhouse,, here he and his wife raised four children. He collects antiques and art as well as wines and has been working throughout the rear on another pct project of h,s - the Red Cro-.s· \'intage Affair-an auction ofwmes, dmingand ANO &1O,-.iC0ICAL $CIC:HT t lT AUTUMN 1091 e �·······•· ······ ······························· ················· ·•···· ······· [i] . ' Firstannual Southern Tiersurgery meeting heldinOlean hysicians and professors from The Cleveland Clini c Founda tion, George Washington University, Hanneman University Hospital, Buffalo General Hospital, Olean General Hospital and the State University of New York at Buffalo School of Medicine and Biomedical Sciences convened for the First Annual Upda te in General Colon and Rectal Surgery in October. Working with chairman and program director Adil H. Al-Humadi, M.D., adj unct clinical assistant professor at UB and colon and rectal surgeon at Olean General Hospital, were Eddie Hoover, M.D., chairm an of the medical school's Department of Surgery and Bertram Portin, M.D., head of the Department of Co lon and Rectal Surgery, who moderated the symposium. Designed to apprise primary care physicians, internists, surgeons and health care professionals of the most recent developments in the diagnosis e BUFFAL O PHYSIC1AN and management of selected surgical problems including colon and rectal surgery and gall bladder disorders, the Update was the first conference in general colon and rectal surgery held in the Southern Tier area. The program was designed by the Department of Surgery as part of its Continuing Medical Education program. + James PlattWhite Society seeks1,000 donors he Schoo l of Medicine and Biomedical Sciences and the James Plan White Society have launched a "Th ousand at a Thousand" campaign to raise funds for biomedical and clinical research, scholar ships for needy and meritorious students, state -of-the-an laboratory equip11 ment, educational p rogrammin g and unrestr icted support for special needs ichard S. Safeer, a second-year and opportunities. medical student, has received an The campaig n award from the Regional Center was la un ched in for Clinical Nutrition Education September, accordof The New York Academy of ing to Eugene Beltrami , M.D. '54, Medicine for \\tt,'*/JJ, James Platt White a paper on cardio- ~\\! Society Chairman. vascular disease. ~The James Platt Jam es PlattWhite Safeer, who is~,,~ .: • ~ th eoriginatorand ~ § White Society was formed in 1986 on directorofthe"Get ~ ~ the 140th anniversary of the founding of Heart Smart" pro- ~/ ~ the medical school to recognize dedigram, won in the Comcated alumni and friends of the medical munity Work category. + schoo l who contribute $1,000 annually. The James Platt Wh ite Society provides vital financial resources to help the medical school attract the best students, retain top faculty and strengthen biomedical research, educational and clinical programs , Beltrami said. James Platt White was one of the founding members of the University at BuffaloSchool of Medicine and Biomedical Sciences. An obstetrician and gynecologist, Wh ite contributed important improvements in the practice and teaching of obstetrics, conducting the first clinical demonstrations in obstetrics in the United States and advocating anesthesia in childbirth. He was professor of obstetrics for 35 years and dean of the school at the time of his death in 1881.+ Safeerwinsawardfor GetHeartSmart" program fll~ ~ 'fl//m~~ AND BIOMEOICA- SCIENTIST AUTUMN 1991 �·············· · ······· · ·············· · ···· · ····· · ··· · ··········· ··· · · ············· · ····· · ·■ · mm I Medical schoolhonors its facuitymembers even faculty members and six resident physicians were honored at the annual faculty meeting of the School of Medicine and Biomedical Sciences. Michael A. Apicella, M.D., director of the Division of Infectious Diseases in the Department of Medicine, received the Stockton Kimball Award for excellence in academic achievement. Apicella, UB professor of medicine and microbio logy, also serves as co-director of the UB Center for Applied Molecular Biology and Immunology . He will deliver the Stockton Kimball Lecture at next year's ann ual mee ting. Jacob M. Steinhart , M.D., clinical associate professor of pediatrics, was named recipiem of the third annual Robert S. Berkson Memo rial Award in the Art of Medicine. The award recognizes excellence in patient care and teaching by volunteer faculty members. Mary Voorhess, M.D., professor of pediatrics, received the Dean's Award for service to the medical school and the University and outstanding research. Codirector of the Division of Endocrinology at The Children's Hosp ital of Buffalo, she has served on various committees of the medical school and its department of pediatrics. Louis A. and Ruth Siegel Teaching Awards for teaching excellence were presented in the following categories: pre-clinica l, Charles Severin, Ph.D., associate professor of anatom ical sciences; clinical, Bradley Truax, M.D., clinical associate professor of neurology, a nd volunteer , Christopher Valencia , M.D., clinica l instructor of medicine. House staff awards were presented to: Maritza Cotto, M.D., resident physicia n in medicine;John A. Leone, M.D., resi- HislaAngela Bates UBmedical student winsNIMH award isla Angela Bates, a third-year medical student, has been chosen one of six medical students in the U.S. to receive an American Academy of Child and Adolescent Psychiatry James Comer NlMH Minority Fellowship Award. She rece ived a $3,000 stipend to support participation in research in child and adolescent psychiatry last summer. Bates, under the direction of Gary Cohen , M.D., clinical associate professor of pediatr ics and psych iatry, David Kaye, M.D., clinical assistant professor of psychiatry and Richard Clopper, M.D., clinical assistant professor of psychology and psychiatry , was involved in the prospective psychosocial screeni ng of children referred to the Pediatric Endo crine Clinic at Chi ldren's Hospita l for evaluatio n of growth problems or newly diagnosed diabetes mellitus. The Comer Award is funded through a grant from the National Institute of + Mental Health . BUl"F' A LO PH Y SICIAN ANO BIOM£01 C AL SC I ENTIST I dent physician in medicine; Michael Denk , M.D., resident physician in sur gery; Frank Green, M.D., resident physician in medic ine; Nashat Rabadi, M.D., resident physician in medicine , and Joseph Cinderella, M.D., resident phys ician in medicine. A special award was presented post humously toJohn F. Moran, Ph.D., asso ciate professo r of biochemistry and former assistant to the dean for facilities + planning, who died in February. B y A R T H U R P A G E Schwartz headsUB cardiology division effrey S. Schwartz, M.D., has been named chief of the Division of Cardiology in the Department of Medicine. A professor of medicine at the University at Buffalo and faculty member since 1987, Schwartz is the head of the Division of Cardiology at The Buffalo General Hospital. Prior to coming to Buffalo, Schwartz was associate professor of medicine and di rector of the exercise laboratory at tlheUniversity of Minnesota Medical JeffreySchwartz , M.D. School. A graduate of Rutgers Univers ity, he received his medical degree in 1968 from Albert Einstein College of Medicine and did a cardiology fellows hip at the University of Chicago. He also did research on narrowi ng of the coro nary arteries under a National Institutes of Health Young [nvestigat0r Re+ search Award. B Y A R T H U R AVTU-MN I P 9 9 A G 1 E 6) �Kassirer receives -1991 full-time people who were extraordinary teachers and doctors. The environment was very carefu lly designed for the student. l'm sure it's even more so today . After l had begun my career, it was apparent to me that these great teachers and doctors had become role models for me." As an acknowledged specialist in nephrology and internal medicine, Kassirer has received national recogn ition for his work on diagnost ic reason ing and therapeutic decision-making . He is the Sara Murray Jordan Professor of Medicine and vice chair of the department of medicine at Tufts Universi ty School of Medicine, Boston, where he has been on the facu lty since 1961. Kassirer also is associate physicianin-chief at the New England Medical Center, Boston . Kassirer has over 100 publications on a varie ty of aspects of clinical medici ne. A Buffalo native, he auended UB as an undergraduate from 1950 to 1953, entering medical school following his junior year. While attending medical school, he was named to the Gibson Anatomical Society and Alpha Omega Alpha and received the C.V. Mosby Award and the Roswell Park Award in Surgery. He received his medical degree magna cum laude, and did his internship and served as assistant reside nt in medicine at The Buffalo General Hospital. Since 1986, he has served as a regiona l member of the governing board of the UB Medical Alumni Association. He said that his multi-faceted career was a key factor in his securing the editoria l duties at The New England Joumal. "The experiences I had in my early Distinguished Alumnus Award NEW ENGLAND MEDICAL J O URNAL EDIT O R PR A ISES UB SCHOOL erome P. Kassirer, M.D., editor-inchief of The New England Joumal of Medicine, received the 1991 Distinguished Medical Alumnus Award at a Past President's Dinner on September 19 at the Buffalo Club. Kassirer replaced Arnold S. Relman, M.D., last July as editor. He was named following an extensive worldwide search by a distingu ished panel of medical leaders. The New England journal is the oldest continuously pub lished medical journal in the world and is considered the nation's leading medical research journal. Kassirer said that a combination of research and teaching excellence makes UB's School of Medicine and Biomedical Sciences one of the great academ ic centers in the country. "Buffalo is obviously veryimportantto me. It was herethatI developedmy idealsand my knowledgein the field of medicine." "Buffalo is obviously very important to me. It was here that I developed my ideals and my knowledge in the field of medicine," he said. "When I was in medical school here, there was a group of Farleft: Thoma s Riemens chneide r, M.D. , associat e vice president for clinical affairsand associat e dean. left: James Weerick , M.D., Class of 1949 Eit> BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST AUTUMN I 9 9 I �Alumni of theMedical n, , '77, president withNedraHarrisoM.D. , celebrates of Medicine Journal , M.D.,'57, editorof 11,eNewEngland e .Kossirer JeromP . Award us ed the1991DistinguishAlumn , afterreceiving Association her going, it was what she hadn't done LS and said that the one fundamental men yet that kept her going. That reprcsentS career, includinga lot of teaching, helped should be held b>·all docthat al pnnc1p ph) ." set me up for the Job I haYe now. I tors is to perform services ,, h1ch arc very clearly my philoso Associauon prei Alumn al interMedic very The me believe those things made useful and good for people ~rmsull a allydcs1gned aspeci ith en, said. he Kassir sented esung to the search commntec, doctor. \1\ responsibility 1sto do good. tion ofh1s emora in comm in gjob crystal buffalo "I think that it is the most amazin This 1san unparalleled opportunity LOdo ues colleag and friends award. About 75 medicine that there 1s." good 11·sa bit awesome to me," he said + were on hand to honor him. Kassircr, who addres!>cd the 145th "Martha Graham, when she was 80, R E M H A M M A R K B Y commencement of the medical school in II wasn't the awards that kept that said Ma}, made light of his own achic\"e- BurP'A.LO PHY.IC I AN ANO e1oiw:CDtCAL SCICNTl•T AUTUMN �.......... . . .. ....................... . ............ . ............ . ........................ .. Spring Clinical Dayand Reunion Weekend set he MedicalAlumni Associationhas seLSaturday, April25, 1992,for its 55LhAnnual Spring Wilensky, ClinicalDay. KeynOLespeakerGail direcLOrof LheHealLhCare Finance Adminisrration,will address "High Technologyand CosLConLainrnenL in Lhe1990s." Reunion Classes of 1942, 1947, 1952, 1957, 1962, 1967, 1972, 1977, 1982 and 1987 will meeL on Friday, April 24 for CockLail RecepLionsand Saturday, April 25 for Reunion Dinners. Those classes will be vying for the Best Attendance Trophy, won lasLyear by the Class of 1941. CLASS OF 1942 "It's hard LO lx:lievethat 50 years have elapsedsince we graduated./.£r'smaizethis reunion as meaningful ro us as tl1c day we received our diplomas!" RICHARD AMENT, M . 0. , CHAIRPERSON CLASS OF 1957 "The more rhc merrier. It's ce11ai11ly tme for class reunions. Thoseof 11swho have a1te11ded previo11Sreunions /mowhow mud1fm1theyare. l l1opeall my classmatesare pla1111i11gcocomeroour35th , in April '92." SOL M.0 .. MESSINGER. CO -CHAIRPERSON CLASS OF 1947 "A long rime has passedsince we fought rl1ebattle of High Street. Let's relivethosedays and share new stories at rhe 45th classreunion." WILLIAM M . BUKOWSKI. M . D .• CHAIRPERSON CLASS OF 1 952 "Comebacl110see how Buffalo, the School and your classmates have changed in -f0years.We needyou LOmalie r!1isthe bestreunionof all." NEAL FUHR . M . 0 ., CO -CHAIRPERSON "Don'tyou thinli dra1after40 yew:s<ISphysiciansour whole classought LOget cogether011 April25, '92 bac/1in B1if{alo?" ROBERT BAUMLER "Dr. Sol Messingerand I are /oohingfonvard with great expectationsto our 35tl1reose union. We hope that 1/1 auend the 30th who did 1101 will 111al1e every effort to renewoldfriendshipsandshare with otherswhat's happened ro them over t/1eyears." RICHARD MILLER. M . 0 ., CO -CHAIRPERSON . M . 0 .. CO-CHAIRPERSON "Fony years. Ir's beena long rime and a greatprofessional " career.Comea,u/ celebrate! BURTON 5TULBERG . M . D .• CO-CHAIRPERSON e BUFFALO PHY S ICIAN A N 0 8t0MEOICAL SCIENTIST AUTUMN 1 9 9 1 �.. . .... .. .............. CLASS OF 1962 .............. ..... .... ....... .................... .. ............ "It's hard to believeihatfive years have gone by. Lei'sall gel togeiher and renew 1l1e friendships we had. We hope to seeyou ihis Spring." FASANELLO, M . 0. , CO-CHAIRPERSON JACK C . FISHER, CO-CHA OF 1 987 CLASS "Theseare ow·vintageyears. D011'1 miss your 30th." SEBASTIAN . M . 0., IRPERSON THOMAS SMITH . M . O .. CO-CHAIRPERSON ALAN BEITLER. M . O .. CO -CHAIRPERSON OF 1 972 CLASS CLASS OF 1977 CLASS OF 1982 "Be an activist again! Co11taC1 your f rie11ds from rhe classof '72 and meer them i11 Buffalo. the ci1y of chichen wings, beef 011 wec/1 and America's premier football ream!" "Fif1ee11 years liavejlow11by! /-loware our classmatesdoing? Come to the reunion on April 25th and find out for yourself" MAR TIN BRECHER. "Fifteenyears? It can'! be! ELIZABETH BARLOG. Lei'sge1 togeiherbeforea11y M.0 .. CO -CHAIRPERSON more lime passes.Nedraand I loolifonvard10secingyou." "A special grce1i11g10 all of my classmaresll'irh the hope GREGORY YOUNG. M . O ., co-CHAIRPERSON 1ha11992will seeyoubachin Buffalofor our 10-year reunion." M .0 .. CO -CHAIRPERSON PATRICIA OUFFNER . M . D .. co-CHAIRPERSON N EDRA HARRISON. CO-CHAIRPERSON M.0. , ''Tl1esepasi 10 years have go11eby sofast and so muc/1 has happened in our lives. Won't ii be grear 10 get 10gether with old friends and find 0111what's been going 011?See you all al our 10ycar reunion!" KEVIN BARLOG, M.D .. CO -CHAIRPERSON CLASS OF 1 967 "\Ve all have a date with history. I-lopeto see you all at our 25th re1111 io11011April 25th, 1992. Be there if you possibly ca11 !" JOHN P. KELLEY . M.O .. CO-CHAIRPERSON THOMAS P. SHEEHAN. M .0 ., CO-CHAIRPERSON PHYSICl A N A N D BIOMEDICAL SCIENTIST A U T U M N I II 9 I E!) �··············•····················· [I] ' . NoenamedSeniorVP at Buffalo General ichael F. Noe, M.D., M.P.H., has been appointed a senior vice president al The Buffalo Genera l Hospital. A clinical assistant professor of medicine and social and preventive medicine at UB and recipienL of the Dean's Award in recogni lion of ou tstanding service to the medical school, Noe most recently served as BGH's vice president for professional affairs. He will continue to be responsible for that deparlment whi le also serving as the hospital's medical director. "He has received this appointment in recognition of his continued outstanding contributions to this inslitution, particularly with regard to medical affairs, the University-hospital relationship and the improvement of quality assurance," according to John E. Friedlander, BGH's president and chief executive officer. + M JosephChazen M.D. namednational fund drivechairman oseph A. Chazen, M.D., has been named National Chairman of the University at Buffalo 1991-92 Annual Fund Drive. The UB Annual Fund seeks support from alumni and friends across the country for University-wide needs such as scholarships, fellowships , classroom and laboratory equipment, library acquisitions and unrestricted funds. J e, 8UFFALO PHYSICIAN Chazen received his undergraduate degree cum laude in pharmacy from the University at Buffalo and medical degree from the School of Medicine and Biomedical Sciences. Currently he is clinical professor of medicine at Brown University, Providence , Rhode Island, medica l director of the Artificial Kidney Center of Rhode Island and head of Nephrology Associates. He also is co-director of the Division ofRenal Diseases, Rhode Island + Hospital. Milgrom awarded an honorary sciencedegree elix Milgrom, M.D., distinguished professorof microbiology, has been awarded an honorary doctor of science degree from the University of Medicine and Dentistry of New Jersey in recognition of his pioneering work in basic and medical immunology. Among Milgrom 's major contributions is research in the strucLUre and function ofanLibodies related to rheumatoid arthritis and the mechanism of hyperacute rejection in kidney transplants. A native of Poland , Milgrom joined the UB faculty in 1958 and served as chair of the department of microbiology from 1967 to 1985. He was previously chair of the department of microbiology at Silesian University School of Medicine in Zabrze and professor and acting chair a t the University of F 4NO Bt OMEOIC A L SCIENTIST Wroclaw, both in Poland. Milgrom's scientific contributions have earned him the prestigious Paul Ehrlich Prize, the Alfred Jurzykowski Foundation Award and honorary degrees in medicine from the University of Vienna, University of Lund (Sweden), Unive rsity of Heidelberg and University + of Bergen (Norway). Schaefer succeeds father inSt.Jose~hHospital Ophthalmology post aniel P. Schaefer, M.D., will succeed his father, Arthur J. Schaefer M.D., as director of the department of ophthalmology at St. Joseph Hospital, Cheektowaga. The younger Schaefer, a UB medical school graduate, has been a member of the SL.Joseph Hospital medical staff since 1986. His father was director of ophthalmology there since the hospital opened its doors in 1960. Daniel Schaefer served his resident training in oph thalmology al the New York Eye and Ear Infirmary , New York City, and was appoin ted chief residem in his third year. He served a fellowship in ophthalmic plastic , reconstructive , orbital and lacrimal surgery at Wills Eye Hospital, Philadelphia. A fellow of the American College of Surgeons and the American Society of Ophthalmic Plastic and Reconstructive Surgery, Daniel Schaefer is a clinical associate professor of ophthalmology and assistant clinical professor of + otolaryngo logy. D AU TUMN 1991 �-- -------------------- ----- -- - -- ·· · ··· · ··················· · · • ················· · ···························· ··· ············■ • 9 1 2 s 0 '27 , of B . KUITE GEORGE I Conway, New Hampsh ire, is dis ab led due to a fracture of the spine two years ago. L. MAXWELL LOCKIE '29 , is retired and lives in Escondido, California, where he enjoys playing bridge and meeting new friends. 1 9 IRVING 3 B . PERLSTEIN Louisville, s 0 '39 , Kentucky, of retired from practice and teaching in 1989. 9 1 4 HAROLD 0 s K . PALANKER '40 , has been invited to become a founding member of the Albu- left to right:AndyandHelenCappuccino '88, WayneWaz'88, hiswifeMarijonePetruzzi '86, TomBellomo '88, his wife,Cynthia Loya , Loriluizi'88, Margar et Morey'88, FrankLuzi , '88, JamieMusiker '87, herhusband, Michael Nemirov '88. of ogy at the University of Texas for children with cancer in San Amhers t , New York, retired after Medica l School, Houston, edited Diego, which has now been du- N . LUBIN ARNOLD '62 , 25 1/2 years in the US Air Force the textbook /mmwrologic Dis- plicated and spread through- and is now Erie County Health Commissioner. eases of tlte Shin, Appleton and out California with at least six other camps having been formed. Lange, 1991. I look forward to coming back querque Academy ofSurgery. He ROBERTA has been retired since 1987. GI L BERT '62 , read two papers this year: ''Toward a PAUL M. GOLD F ARB '67 , for our next reunion and look forward to hearing about other D . WHITE '40 , has been Natural Systems View of Trans- writes from San Diego, Califor nia, that he will be taking over as appointed to the Monroe County, ference" at the Midwest Sympos ium on Family Theory and Therapy, Chicago Academy of Pres ident of the American Can cer Society for the State of Cali- Sciences, and "Freud, Transfer- American Cancer Society in the ence and Differentiation" at the an United States . Over the last 11 sor and cha irman of the depart- Symposium on Differentiation at Lawrence years, his practice has been lim- ment of obstetrics and gynecology at Albany Medical Center, the Georgetown Fami ly Center, Andover, Massachusetts, is an ited to doing surgical oncology. Washington D.C. He has been a member of a JOHN Florida, Alliance For the Aged Advisory Committee. MYRON GORDON '48 , profes- will be on sabba t ical from JanuEHRLI C H '63 , is now ary 1992 to June 1992 in Lon- FRANK don, England, at Kings College deputy chairman of the depart- Hospital. ment of surgery and director of the division of surgical critical 1 9 F LOYD 6 H. LIPPA 0 '61 , s was care and nutrition at the Graduate Hospital, Philadelphia , Pennsylvania. fornia, the largest division of the aviation medical examiner. He also nies antique aircraft. versity in San Diego. He is active specialist, is di rectorof the respi- COLE '73 , a ratory department and sleep dis- doing surveys of hospital cancer orders center at North ridge Hos- programs. "Of the things that l pital in proud ofis having started a camp PHYSIClAN at Hospital , with the College of Surgeons years, the one that I am most 0 surgeon General pulmonologist and critical care pro- L '72. JEREMY fessorand chairman of dermatol- A N . WARNOCK o rt hopedic s 0 tained affiliation with the Uni- ROBERT I"' RICHARD 7 fort he last 10 years and has main- pital, Dearborn, Michigan. F 9 mu ltispecia lty oncology group three-year term at Oakwood Hos- U 1 orthridge, California. have done over the last several elected chief of surge ry for a 8 members of my class ." E . JORDON A H D '65 , BIOMEDICA\. SC ENTIST C . S GALIA '73 , of Hopedale, Massachusetts, is cur- AR T HUR AUTUMN �■ ·························································································· I OBITUARIES rently vice president for medical affairs and president of the medi- in 1988 and became board certified in 1989. She i's now medical Center. I have just published 'On a Radical Lesbian MATTHEW L. CARDEN ·19 , cal staff at Milford Whitinsville direCIOr of the young adu lt t reat- Feminist While Training in Psychiatry' in Women and Therapy. died August 27, 1991 in Sarasota, Florida. Dr. Carden practiced LAWRENCE 0 . RAMUNNO'87 , 60 years before moving lO Florida. received an M.P.H. from Johns While in Buffalo he served as Regional Hospital. He maintains ment unit for resistant patients at a full practice in internal medi- Four cine/cardiology, and is a clinical ins tructor at the University of Westchester, New York. Massachusetts. JoHN W inds Hospital v . Sosso Remaining in medicine in Buffalo for more than '85 . of Hopkins and is now in private Blauvelt, New York writes, "Re- practice, "near a covered bridge," cently completed a fellowship in allergy/immunology at Scripps in Conway, New Hampshire. in Health Policy and Administra- RONALD DAVID '75 , a lecturer chief of staff as well as president of the staff of Mercy Hospita l. He headed the Eric County Medical Society in 1954. Survivors in- tion at Harvard writes, "'I am re- Clinic in La Jolla, California. SUSAN L. BEHEN '88 . a fourth- signing my post as Acting Secre- Longing for the East Coas t , re- year general surgery resident at tary of Health in Pennsylvania 10 turned to open 'Orangetown Al- Johns Hopkins Hospital writes, clude a son, Dr. Lawrence M. Carden of Sarasota. return 10 academia, write a few lergy and Asthma' in Rockland "I will be doing a six-month fel- JUL IUS T . books and critically reflect on County, ew York. My wife lowship at Oxford University at died May 26, 1991. Dr. Markovitz health and medical care in the Oanel Piscitelli-Bosso, M.D.) and John Radcliffe Hospital, Oxford, had a private practice in Nonh new millennia." I recently had our first child, England fromJanuary'92 toJune Tonawanda, New York until 1955 Lauren Catherine." '92. Any fellow alumni welcome when he moved 10 Lauderda le- to stop by, if you arc in the area by-the-Sea, Florida. DAVIDFORSTER '85 , and Carol Hammer Forster '85 write, "We traveling . Sorry 10have lost touch ticed in Florida until 1980. He is with my classmates survived by his wife, Bernice. friends." cology. arc proud to announce the birth of our first child, Chriswpher JAMES R . MILLER '79 , was re- IRA L. SALOM'77 , ofE!mhursL, New York, has passed the first examina tion given by the American Board of Clinical Pharma- elected president of the New York State Association of County Health Officials. He is Commis- and old MARKOVITZ '28 , He prac- CHARL ES R . LEONE '29 , died May 4, 1991, in San Amonio Brandon, on May 18, 1991. We will be moving back to Northern MAJOR J OHN G . CHR IST IE '88 was deployed LoSaudi Arabia/ while attending a mass for his Virginia in August after two fun Iraq/Kuwait with the 1st Infantry deceased wife. Dr. Leone was an years in California. Division during Desert Storm. auending Carol con- surgeon at Saint sionerofHealth for the Onondaga tinues her practice as pediatri- He is currently in the M.P.H. Vincent Hea lth Center in Erie, County Health Department. cian, and David will be practic- Program at Johns Hopkins and Pennsy lvania, for 40 years. He has been selected for promotion rank of Lieutenant Colonel. His main civic interest for more ing ophthalmology." 1 9 B s O MIC HAEL E LLIOT CAN E '83 , has a pri va Le p rac1 ice cardiothoracic lO surgery in in Bethlehem, Pennsylvania. T INA was president of the staff in 1955. than 40 years was the Boys and MAR IE GAR D N E R '87 , . writes, Girls Club ofErie. He was a mem- Jacob, born July 25, 1990. She is "A large group of UB Medical ber of the board of directors for nowdoingou1pa1ien1 urgent care School graduates met on the sunny shores of Redondo Beach over -+Oyears and in February 10 celebrate the wedding of Tom bership. He was honored in 1983 announces the birth of a son, in Stony Brook, New York. E . O STROV '83 , an assistant professor at the Hershey LAURA BAR BARA MARGAR ET MOR E Y '88 1990 was given a lifetime mem - Bellomo '88 10 Cynthia Loya. 11 with the prestigious Silver Me- Medical Center, Hershey, Penn- chiatrist for Operation Concern was a fantastic evening of cham- dallion by the National Boys Club sylvania, announces the birth of pagne, fresh oysters, stir-fried shrimp, while being serenaded of America. her daughter, Meredith Buckley, in Alameda, California, writes, "I completed my psychiatry resi- inJu ly 1990. dency at UCSF/Langley Porter by a Mariachi band. Enclosed is P OST '87 , a staff psy- Ins1itu1e, and started a position CAROL WEINSTEIN '84 . com- as staff psychiatrist at a Lesbian/ pleted a residency in psychiatry Gay Community Mental Health ~ BUFFALO PHYSICIAN A N D BIOMEDICAL a photo of all the Buffalo folks." ALI CE B E NNE TT EMMA MURRAY'37 ,diedjuly3l, 1989, in Phoenix Arizona. 5C1£NTIST A U T U M N 1 9 9 1 ��YORK AT BUFFALO Permit No.311 :c _ , 5--1 L• Ry ., €PT � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1991 Subject The topic of the resource State University of New York at Buffalo.- School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine. 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Changes in version imply substantive changes in content rather than differences in format. v25n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/ea9203538521e2ddea354a4eecb3ca70.pdf 76d9e665fbe7bcc68b1dd07a99c7ea9a PDF Text Text �... DEARALUMNI ANDFRIENDS, BUFFAlD PtIY~I~!6N STAF F EXECUTIVE EDllOR UNIVERSITY PUBLICATIONS Ro~rt T. Marlett BUFFALO PHYSICIAN EDllOR Connie Oswald Stofko AR:r DIREClOR Alan ). Kegler ADVISORY BOARD Dr. John Naughton, Cluurman Dr. Harold Brody M, . Nancy Gheco Dr. James Kamk1 Dr. Charles Paganelli Mr. Gregory Zittel Or. Antoinette Peter-s Dr. Charle, Pruet Dr. Luther Robinson Dr. Thomas Rosenthal Or. Saleda Suresh Dr. Burton Sing~rman Or. Stephen Spaulding Dr. Nelson Torre Mr. Edward Wemke Dr. Paul W1er:b1en1ec Dr. )trome Yates T he school successfully completed its institutional selfstudy on schedule in mid-June in preparation for the November LCME survey visit. I am graceful to the department chairmen, faculty members, students, full-cime and voluntary faculty members, hospital directors, and board of trustee representatives who served on the Steering Committee and received the reports chat emanated from every aspect of the organization. This sixmonth effort served to establish the state of the medical school today and to develop an agenda of recommendations for casks which should be accomplished between 1988 and the next LCME visit in 1995. Indeed, I chink the process proved that the medical school is strong, the faculty and student body are committed co the achievement of scholarly excellence and meeting the needs of society, and chat each wants the school to improve even more in the years ahead. These are good signals chat the momentum developed over the past several years can be maintained. As has always been the tradition at the UB Medical School over the past 142 years, the multiple constituencies are committed to working harder to attain higher levels of excellence. This should bode well for the upcoming accreditation visit and for our future as we begin to think more earnestly and intently about medicine in the 21st Century. Sincerely, Joh n Naught on, M .D. Vice Presidentfor Clinical Affairs Dean, Schoolof Medicine and BiomedicalSciences WRITERS Li<a Josephson Clare O'Shea Mary Beth Spma David Snyderman Ann Whitcher ILL US TRATOR S M1chad Gelen Glyn,s Sweeny P H OTOG RAPH ERS Doug Levere Dan1d Morelli Ian Rcdmbaugh T EAC HI N G H OS PI TALS Batavia Veterans Admini~rrat1on Medical Center Buffalo General Buffalo VeteransAdmm1'-trat1on Medical Center Children's Enc County Medical Center Mercy Millard Fillmore Roswell Park Memorial lnsraute Sisters of Chamy Produced~ rhe Di<is,onof Um, en1h Relationsm as.<OCUUwn u:,rh,he Schoolof Medirine and BiomedicalSc,ence.s,Suu, Uni,m,r, of Nru Yorkat Buffalo. THE BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST (USPS 551-860) Autumn 1988, Volume 22, Number 3. Published five 11mes annually: Spring, Summer, Autumn, Early \\'inter, and Late Winter - by the School of Med,cine and Biomedical Sciences, Stare Univermy of 1':ew York a, Buffalo, 3435 Mam Street, Buffalo, New York 14214.Third class bulk postage pmd at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST. 146 C.F.S. Addiuon, 3435 Main Sm,et, Buffalo, New York 14214. Cove r Ph o to: Danit! Mon:11, DEAR FELLOW ALUMNI/ ALUMNAE: T his is the time of year when the Alumni Board develops the program for next year's Spring Clinical Day. Dr. Nedra Harrison is working with her committee on an excellent program for our scientific day, and Dr. Joseph Kunz is working with the reunion class chairmen to gee their plan5 set for their class reunions. Again this year, l will try to keep you abreast of the happenings on and about the Unive rsity through our newsletter, and I remain open to any suggestions you may have. In conjunction w1ch the dean's office, we are crying co establish an award for a distinguished alumnus of our University this year, and plans are being sec forth with the committee to select such an individual. If you have any suggestions as co a distinguished alumnus of our University, please forward the name with a brief biography of the person to myself, Dr. Jack Richert or the dean's office so that person can be brought into consideration. As this year seems to continue co slip by, I can only look forward co my 15th reunion this coming May, and I hope that the members of my class will be active and participate in this reunion celebration. Sincere/), Paul H . Wier zbieni ec, M .D. �Vol. 22, No. 3 Autumn 1988 Features 2 East Meets West. Emerging from years of isolation, China is reaching out to improve the medical care of its one billion inhabitants. Under a new exchange agreement, scholars from Beijing study Western techniques here while Buffalonians learn about Chinese techniques such as acupuncture. Page24 10 Medicineandthe Arts.The creativi ty of health-care professionals was the topic of a summer symposium organized by the UB Health Sciences Library. 14 TykeTrike . The colorful tricycle that six-year-old Sarah Tangelder rides has been modified by UB researchers to give electrical stimula­ tion therapy to her paralyzed legs. Departments Page 10 18 Research.The latest developments in organ transplantation and a new test to diagnose celiac disease were discussed at the 11th Inter­ national Convocation on Immunology sponsored by the Ernest Witebsky Center for Immunology. 21 Classnotes . MedicalSchool.Suk Ki Hong, M.D., discussed his "Thirty Years Underwater" when he gave the Stockton Kimball Lecture at the An­ nual Faculty Meeting. This year's winner of the Stockton Kimball Award was John R. Border, M.0. 24 31 People. Page22 32 Alumni . News of the reunions. 36 Events. �2 hinese B y CONNIE edicine OSWALD STOFKO raditional Chinese medicine has been largely ignored by the west, but seeing it practiced in Beijing has piqued the interest of a group from Buffalo who visited China in March. '~nything that's been going on for thousands of years must have some usefulness;' reasoned James M. Schlehr, a medical student who made the trip. Veronique James, another student, wou ld like to return to China to learn acupuncture after she finishes her residency in pediatrics. "It may be very useful in my practice;' she said. The two students were part of a group that spent a month in Beijing as a precursor to a new formal exchange agreement among UB, Millard Fillmore Hospital, and the Capital Institute of Medicine of Beijing. Other members of the delegation were Daniel Morelli, M.D., vice chairman of the Department of Family AUTUMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST ��4 Medicine at UB and director of the residency program at Millard Fillmore Hospital; William M. Healy, M.D., then a resident in internal medicine at Millard Fillmore Hospital, and medical students Ira Rock, Jerry Igoe, Charles Everett, and Wayne Waz. For treating chronic conditions like arthritis or curing the common cold, Chinese traditional medicine does as well as Western medicine, Waz said. He add­ ed chat there's a push in China to find which of the traditional techniques have a good scientific basis and which ones seem to work only because of a placebo effect. AUTUMN 1988 Waz has good feelings about one tradi­ tional technique, acupuncture. Because he once damaged the cartilage in his knee, it aches when he walks on it a lot. While in Beijing, he tried acupuncture and found it got rid of the pain for three or four hours. While it may offer good pain relief, acupuncture is no longer used in China as an anesthetic for surgery because it's not a good muscle relaxant, noted Hea­ ly, the resident. The herbal medicines hold promise, but even the Chinese admit that it's sometimes hard co get as true a dose with their herbal teas as we do with our pills, said Healy, who has long been interested in folk medicine. Sometimes a batch of tea will lower blood pressure well, but the next batch will not. Another traditional technique is cup­ ping. The group saw the treatment per­ formed on a woman with shoulder problems. A lighted alcohol wick is inserted in­ to what looks like a small, glass goldfish bowl. When the air inside the glass is heated, the wick is removed and the glass quickly placed on the patient's skin. A vacuum is formed and sucks the skin in­ to the glass, forming a nasty mark that can best be described as a giant hickey. BUFFALOPHYSICIANAND BIOMEDICALSClENTIST �hina's practice of med• icine is as distinctive as its architecture. Physicians con/ er over medical records penned in traditional Chinese characters, lef~ while a patient re• ceives acupuncture enhanced by elec • trical current, below. The technique is believed to draw harmful substances out of the body. Traditional Chinese massage uses manipulation to relieve pain and restore function. Massage is used for ailments such as arthritis. Because they were in China such a short time, the Buffalo visitors saw techniques being used, but don't know if they provided lasting results. But the patients generally reported feeling better initially, Healy said. B oth traditional and Western styles of medicine are used in the hospitals in Beijing, and patients don't see BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST saving?" Healy questioned. The Chinese doctors read western medical journals and are up on the latest techniques. But they can't use many of those techniques because they just don't have the resources. Needles, syringes, IV tubes, and surgical gloves are washed and reused. Before surgery, doctors soak their hands in an alcohol bath because the water isn't free of parasites . Even photocopy machines are rare commodities. "They do a lot with so little," Morelli said. "They squeeze very hard on every resource." Because they don't have the equipment we have here, Chinese doctors rely almost completely on physical exams rather than lab tests to make diagnoses. The Chinese are very skilled, and the UB students learned a great deal about techniques such as palpating an a conflict in combining them, Morelli enlarged liver or spleen . noted. A patient may receive a Western Waz had hoped to talk with a Chinese pharmaceutical preparation while also faculty member who was an expert in receiving an herbal preparation. medical ethics . What he found was that In rural areas, people often seek out the the Chinese haven't developed ethics intraditional practitioner before they see a to an academic discipline as we have. Inphysician who practices Western stead, Waz noted, they use what you medicine. The traditional methods pro- might call "medical pragmatism." bably ease the symptoms, and the peoSince the Chinese don't have our ple seem satisfied with the treatment. Yet lavish resources, they don't have the the Buffalonians saw people whose thorny ethical issues chat go along with disease had progressed beyond any them. They don't have co decide whether medical care, but who might have been a very sick infant should get intensive helped if they had had surgery earlier. care; they simply don't have any such "I wonder how many people were care to offer. ultimately hurt because they kept going Yet Americans would consider the to the traditional practitioner, delaying Chinese lavish in hospitalization policies. treatment that might have been more life Many people who'd be treated as outpa- AlJfUMN 1988 5 �6 IJ'lat ~cian I!' left, a phy sid em onstrat es tradi- ,. tional Chin ese massage for a pa tient suf- /.../ , f ering low back pain and, at righ t, a wo man rece ives a cup p ing I treatm ent. Note the marks tha t remain on th e w om an 's s kin. A bo ve, bi cy cl es are a c omm o n for m of t ran spor tati o n , th ough the numb er of cars is in creasing. tiencs here are hospitalized in China. A nd once in the hospital, patients stay a long time. For instance, a patient who has a gall bladder removed in the United States might stay five to seven days; in China, he'd be in a few weeks, noted Morelli. T he result is that hospitals run out of beds. Families keep bringing sick relatives back day after day hoping they'll be admitted. The hospitals also run outpatient clin ics that are very heavily subsc ribed, More lli noted . The Buffalo visitors saw some medical cond itions that aren't common in the United States, such as rheumatic heart disease and hepatit is and liver diseases that aren't alcohol related. They got to hea r the heart murmurs AlJTUMN 1988 associated with mitral stenosis . In the United States, residents might see one or two classic cases a year, Hea ly said. In China, they saw six or seven a day. "Now I can say I really hear the classic sounds - just the way it's written in the textbooks. That was a real thrill;' he observed . It was hard to get a hand le on just how common certain diseases are in Ch ina, Healy said. The Chinese would claim that a disease was very rare, then show them 10 cases of it . Healy wasn't sure if they were trying to gloss over the situation or if there was simply confusion over use of the word "rare." Since no one in the Buffalo group could speak more than a few words of Chinese , commun ication was a problem . Medical termino logy, especially drug names, was hard to translate . Sometimes they'd just give up on a point, Healy said. T he Chinese have a six-day work week, but also tried to prov ide relaxation for their guests. "After six days in the hospital, on the seventh day we toured," Morelli said. They visited the Great Wall, the Palace Museum in the Forbidden City, and Mads Tomb. The imperial sites are very colorful, almost gaudy, but it was a welcome contrast to the gray and dingy city. Since most people burn coal in their homes, a brown haze hung over the city on still days, adding to the March gloom. "It's a hard life in China overall," Morell i said . "They do without a considerable amount of day-co-day things we cake for granted ." T his includes simp le things like prepared foods or larger things like the freedom we enjoy. BUFFALO PHYSICIA N AND BIO MEDICAL SCIENTIST �7 #1' eijing physi- ~ cians struggle to care for the city's 10 million in­ At left is the well-baby nursery at a bus, • district hospital. After the rigors habitants. of a six-day work week, the Americans were escorted to popular tions Great and tourist attrac- such as the Wall, above, the Forbidden City, right. "It's like they're black and white and we're color," Morelli said. But the peole seem happy and hopeful. A favorite sight of Waz's was the old men who take their pet birds for a walk to the park. They'd hang the cages in the trees while they chatted with their friends. High rise apartment buildings are sprouti ng up all over Beijing. Communism is loosening up; a lot of consumerism is starting . People in the street are selling things and are allowed to keep the profits. People can voice disagreement with goverment policies, though not very loudly. The thing that stands out most in Schlehr's mind was the time he met a Chinese army officer who had a copy of George Orwell's 1984. The novel, a parable of the evils of communism, was, in all likelihood, banned in China. For BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST the officer to even have a copy means "things are opening up a lot," Schlehr said . The Buffalonians were impressed by the red carpet treatment they received from the Chinese. Few people in Beijing own cars, but the Americans were driven around in a modern Toyota mini-bus, belonging to the Capital Institute. Though it was winter, the Chinese tried to find the best selection of vegetables for their guests. The Chinese took them to operas, concerts, and tourist attractions. They had dinner at the fancy Peking Duck Restaurant with heads of all the city's hospitals. The group was photographed and videotaped at every opportunity . The process always entailed a bit of seatshuffling because each person had to be seated in a place that reflected his pro- per status, Morelli explained. Even parties in Beijing are very structured. There's generally some chatting, followed by some speeches, then entertainment. Th e Buffalonians decided to throw a thank-you cocktail party, but the Chinese guests were very uncomfortable because they didn't know what to do in such an unstructured setting, Waz said. The Americans salvaged the affair by giving some speeches and singing "America the Beautiful," "Under the Boardwalk," and "Take Me Out to the Ball Game:' The Buffalonians say they want to go back to Beijing; some in a few years, some in a few decades. They fully expect that things will be different, though it's hard to say in what way. "So many things cou ld happen," said Waz. "They have to try to get the best of our ideas and avoid our problems'.' AUTUMN 1988 �eets 8 a nu Bu hosp speci equi medi acup 0 right year! yean for E "H big l est Buffalo and Beijing exchange scholars in new program By CONNIE OSWALD smFKO n tiom Ul with Hig~ ~ lectric acupuncture needles combine the old and the new, the East and the West. They're a symbol of China today . China is a country coping with change . le clings co the traditiona l Chinese medicine used since ancient times, using techniques such as acupuncture and herbal medicines. Bue after years of isolation, the most populous country in the world is eager to adopt the medical advances of industrialized nations. To accomplish that goal, leaders from the Capital Institute of Medicine of Beijing on June 7 signed a new exchange agreement with UB's School of Medicine and Biomedical Sciences and Millard Fillmore Hospital. The agreement allows three faculty members from Beijing to visit Buffalo. Two will visit for about two months and the third will visit for a year. In return, six senior medica l students from UB, as well as two residents, will observe medical care in Beijing for one month. The exchange is the result of the opening of China to the outside world, said Du ]inxiang, the acting president of the Capita l Institute of Medicine of Beijing. The Chinese wane to learn the advanced technology of the West in order co develop their own science and technology. "In the past, China was isolated, occluded from the world," explained Gao Tienxiang, professor of cell bio logy and microbiology at the Capital Institute. "It's '8' ALm.JMN 1988 l i ll' ~ Q i From left: Peter Ostrow, associate dean for curricular and academ ic affairs at VB; Jan Jennings , pres ident and chief execut ive officer of Millard Fillmore Hospital; Du Jinxiang; Gao Tienxiang, and John Naughton. a pressing prob lem we feel." Gao is also head of the Institute's laboratory of electron microscopy and the laboratory of cell biology. He acted as the translator for the Chinese dignitaries during their June visit to Buffalo. Du and Gao were accompanied by Li Hui, Gads wife, who is a professor of microbiology and immunology at the Capital Instirue and head of the Department of Microbiology at Shandong Medical University. that the Cap Ki fessc nice prov broa Roa< Tl were an e: Zhe1 grad who ince1 Tl oth~ SL The exchange agreement is important because of the increasing ties between the two countries, said John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB. "As we go down the pike, the U.S. and China are going to have more intense relationships," Naughton said. "This exchange gives us an opportun ity to be part of it:' The Capital Institute was founded in 1960,said Du. Like UB, it's affiliated with jing dim a ne Mill Cap dela BUFFAW PHYSICIAN ANO BIOMEDICAL SCIENTIST BUFF/ 198i �number of hospita ls. But you'll find things in the Beijing ,spirals chat you don't see in Buffalo: ecialties in tropical disease, pharmacies uipped to fill prescript ions for edicinal teas, and departments of upuncture . Chinese students enter medical school :ht after high school and study for five ars, then work as residents for 5 to 10 ars. The Institute provides physicians r Beijing, which has 10 million people. "Health care for 10 million people is a g burden for us; Du noted . The Capital Institute also has affilia)nS in Rochester and Texas. UB already has a systemic agreement ith the Beijing Municipal System of igher Education . UB is the only university in the U.S. to have an agreement with the entire system, which is somewhat analogous to the City University of New York. O ther U.S. universities have exchange agreements with only one co llege in the system. About 100 students and faculty have traveled between China and Buffalo over the past seven years, studying such dive rse fields as music, education, engineering, physiology, and h istory. UB's Health Sciences Library is also setting up a cooperative relationship with China's nat ional medical library, which is part of the C hinese Academy of Medical Sciences and Peking Union Med ical College in Beijing. In anticipation of the new agreement with the Capital Institute, UB and Millard Fillmore Hospital sent a delegation to Beijing in March . In the delegation were Daniel Morelli, M.D., vice chairman of the Department of Family Medicine at U0 and dirt:ctur of the residency program at Millard Fillmore Hospital; William M . Healy, M.D. , who was then a resident in internal medicine at Millard Fillmore Hospital, and medical students Wayne Waz, James M. Schlehr, Ira Rock, Jerry Igoe, Veronique James, and Charles Everett. "This type of exchange buys us more goodwill than does military aid or other types of aid; said Morelli. "It would be a very productive thing for us as a nation to sponsor. It's a way of sharing the wealth we have in a way that goes beyond sharing money." UB mournstwo killed in trafficaccident By JIM McMUL LEN ~ Chinese professor and a UB staff 'II member were killed June l while driving home from a dinner party 1at celebrated the schedu led signing of 1e new exchange agreement with the :apical Institute of Medicine in Beijing. Killed were Sun Keji, an exchange prossor in anatomical sciences, and Berice Poss, execut ive assistant to the UB rovost, the driver . Thei r car was struck roadside by another veh icle on Maple oad in Amherst . Three othe r passengers in Poss's car ere injured. They are Yong-Huan Shen, :1exchange scholar in mathematics ; Yahen Gu, his wife, and Xijou Hou , a -aduate exchange student in education, ho had attended the dinner as an 1terpreter. The dr iver and a passenger in the rher car were also inju red. Sun, 57, had been at UB since August }87 under an agreement with the Bei:1gMunicipal System of Education . The inner party anticipated the sign ing of new three-yea r agreement among UB, 1illard Fillmore Hospital, and the :apital Institute . That formalization, elayed because of the accident, took JFFALO PHYS IC IAN A N D BIO MEDICAL SC IEN TIST Sun Keji place Jun e 7. Born in Sha nghai, Sun received his degree in medic ine in 1954. He served as cha irman of the Department of Histology and Embryology at the Capital Institute of Medicine, where he was recently promoted co full professor. Sun was considered the best teacher at the Institute . Here he was also valued as an excellent teacher, a meticulous researcher and a friend of rhis Universiry, said Harold Brody, chair of Anatomical Sciences . At UB, Sun conducted research on neuroendocrine control of liver regeneration. His work will be compiled and published later this year. He also taught in a medical and dental histology class. "His teaching in the lab was interesting," Brody said. "He had some difficulty in communicati ng because his command of English was not so good. But he was a kind, patient man, excellent at working one-on-one or with small groups of students." He voluntarily tutored several minority students in histo logy. As one stude nt said, "You couldn't help but like him." Sun was scheduled to return to Beijing in mid-August . A memorial service for Sun was held June 7. He is survived by a wife and two children. AUTU MN 1968 9 �MEDICINE AND THE ARTS 10 Many health-careprofessionalslead double lives. Not only do they work in the lab and treat the ill, they also write novels, sing, collect art and build crystal models of nature. Their creativity was the subject of a June 4 symposium on "Medicine and the Arts," sponsoredby the UB Health Sciences Library. ~, .,,-.....,""" -:-- -~""- .... . ~ Carh knew. itation S''. \ ~[ ( ~-~,--- w ~- ~ ~- :.. .. a cour out a most i .. C.. Easing Pain hat makes a musician? It is "neither nature nor nurture; said Karen Miller Allen, associate health sciences librarian and former principal clarinetist for the Mannheim Chamber Orchestra in West Germany. "Boch must be present before musical and other abilities can emerge." A UB doctoral candidate in health psychology, Allen lost the ability to read music after she suffered a head injury . She has long been interested in the psychological and physical aspects of music. "Twenty years ago it was possible only to speculate why music such as Bach's Massin B Minor makes most people feel a certain way. Now it is known that specific chemical changes are taking place, such as the production of endorphins and enkephalins. "Music's role in psychoneuroimmunology is just beginning to be explored, and it is being found that music can influence important changes in this area, too. In Germany, music often is used during anesthesia and during the post-operative period . It has been found that, especially when the patients pre-select their own music and hear it through headphones, that they require less medication, and report reduced pain levels." Alll1JMN 1988 Ci ly the, to writ into a Two U A: -· ·" Ye figure , tionab Notice earth. tanr a A1 gleane, (1896-l and se L "He As me disease TheS~ By CLARE O'SHEA & ANN WHITCHER .... ,.,..."'."r-'"3!!=~-~~,:,£' dent's A1 thur C detecti tives 61 \Yj W. Somerset Maugham mong the world's physician writers, few are as well known as W Somerset Maugham, whose writing reflects the "tremendous bitterness and pain in his life," said John Gaeta, chief of pathology at Roswell Park Memorial Institute and professor of pathology in the medical school. Throughout his life, Maugham was a man of sear ing ambivalence. Born in France of British parents, he was orphaned at IO,taken to England where he was raised by an uncle, and educated at King's School, Canterbury. As a youngster, Maugham stammered and endured the pain of being mocked by other children, said Gaeta. In fact, stammering was to be a lifelong affliction, so severe that the author avoided the telephone entirely, Gaeta said. In Heidelberg, Maugham learned German and acquired a "tremendous philosophical background ."He decided to study medicine and graduated from Sr . Thomas' Hospital medical school in London. His experiences as a young intern in obstetrics are reflected in his first novel, Lizaof Lambeth(1897), the modest success of which prompted him to abandon medicine. The author of novels, short stories and plays, Maugham is perh aps best known for his semi-autobiographical novel Of Human Bondage (1915),the story of a medical stu- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST by Kat and d Unive A was b, his de; ed the and C them tice, J "1 medic tainec claim< Ir: tions, "P by pe1 and n work, rested ing. 1 interfi dri nk BUFFAU �r's painful maturation. Another famous physician writer, Gaeta said, was Sir Arr Conan Doyle, who created the personality of the ideal !Ctive in Sherlock Holmes. "The literature is full of detecs but none has had the popularity of Sherlock; said Gaeta . Yet Doyle created an interested counterweight to this re of Holmes, who is so smart that his humanity is ques1able, Gaeta noted . "Watson was created for balance. :ice that he's a doctor. He would bring Holmes down to :h. The personality of Sherlock Holmes is not so import as the balance between the two men:' Anoth er writer who infused his writing with observations ned from medicine was the Scottish physician A. J. Cronin >6-1981),who was educated at the University of Glasgow I served as a surgeon in the Royal Navy during World War :-leis an example of tenacity and optimism; said Gaeta. medical inspector of mines, Cronin studied occupational :asesin the coal industry. One of his many popular novels, · ScarsLook Doum, was set in the Welsh coal mining region. Cronin began a London practice in 1926 but quit shorthereafter because of ill healch . He then used his free time vrite his first novel, Hatter'sCastle (1931), which was made > a film, as were five other Cronin novels. Adventures in > Worlds is an account of his years in medicine. As a young man about to begin medical training, William fos Williams showed his poetry to an MIT professor he :w. "Stick to medicine; the professor told him. "Your imions of Keats are very good but you'll need co earn a living~ Williams did stick to medicine, and spent a lifetime in >untry doctor's practice. He also stuck to writing, turning a lifetime of work that would earn him the title of "the st influential American poet of the 20th century." Williams was the subject of the keynote address delivered (athryn Montgomery Hunter . Hunter is associate professor 1 director of the Division of Medical Humanities at the iversity of Rochester School of Medicine and Dentistry. A prolific writer of prose in addition to poetry, Williams : born in 1883 in Rutherford, N.J., and lived there until death in 1963. Later that year, he was posthumously awardthe Pulitzer Prize in poetry for his Picturesfrom Brueghel, ' Ocher Poems(1962). His poetry, which often concerned most ordinary of subjects, benefited from his medical prac·, Hunter said. "Throughout his life, Williams maintained that his :lical practice sustained his poetry and that his poetry sus1ed his daily practice of medicine," she said . "He always med he became a doctor in order to write." In his autobiography, published in 1967 by New Direc1s, Williams wrote: "As l say, often after I have gone into my office harassed :>ersonalperplexities of whatever sort, fatigued physically 1 mentally, after two hours of intense application to the :k, I came out at the finish completely rested (and I mean ed) ready to smile and to laugh as if the day were just start. That is why as a writer I have never felt that medicine :rfered with me but rather that it was my very food and 1k, the very thing which made it possible for me to write." 'ALO PHYSIC IAN AND BIO MEDICAL SCIENTIST Daily, close observation of the mundane and of the rhythms of ordinary American speech often provided the poet with the subject s and themes of his works, as well as the sounds transferred to the dialogue of his characters. And somehow Williams found time to gee it all down on 11 paper. That could mean jotting down poems on prescription pads (some of which are among the 20,000 pieces of Williams' writing stored in UB's Poetry/ Rare books collection). By keeping a sheet of paper rolled into his typewriter at all times, he could even snatch a few minutes of writing in between patient visits. Many important moments of his practice are captured in poems such as "Complaint" and 'The Last Words of My English Grandmother~ Bur it is Williams' first-person doctor stories, including the memorable "Use of Force; that were the most "medical" of his works, according to Hunter. These short stories, written in the '30s and recently collected in paperback, are often told from the point of view of"a crusty, curmudgeony pediatrician." Music Th erapy usic is an extremely personal yet totally universal experience;' said Jill Scott, a nurse who uses her voice and guitar to soothe the pain of the elderly and terminally ill. Interspersing her talk with performances, Scott said "music is a powerful tool char can leave one defenseless. One must respect a person's right to choose the type and amount of music, or even not to hear any music at all. "Some clients respond superficially, some emotionally; said Scott, on-site coordinator of the RN Satellite Program at Fredonia State College . For some it is an intellectual experience, in which the composer's style and technique are topics for discussion. For ochers, it is a physical sensation in which they beat time or move their bodies co the music. The music therapist, she says, "needs to trust music to perform the healing. When music is chosen carefully, words can become totally unnecessary~ In using music therapeutically, Scott first tries to "convey a sense of trust." She then attempts to help the patient express his or her needs and desires. Sometimes, of course, the music is just for fun . Lastly, Scott tries to help her clients find "self-fulfillment and some relief, to help them take care of unfinished business before they die." AUTU MN 1988 �... .., .. . 12 .... ~·,\"t :, cian. Ac Union College, he was a disc jockey, program director and general manager at the campus radio station. At one time, he even considered a broadcasting career . .·.::•-/:\: -: · i, ·, Singing aritone Brian Zunner, D.D.S., the recipient of a B.F.A. degree from UB, performed four songs by Brahms, accompanied by James M. Bigham. Zunner, who has been a soloist with the Buffalo Philharmonic, is in the Dental Residency Program at the Veterans Administration Medical Center of Buffalo. UB assistant professor of clinical pediatrics and otolaryngology Joel Bernstein presented a short recital of diverse works including three lieder by Schubert, arias by Mozart and Offenbach, and a Rodgers and Hammerstein song. He was accompanied by pianist Marjorie Lord. Bernstein is a lecturer and consultant to the Music Department. He has studied vocal performance for the last fifteen years and has performed throughout Western New York. Jan ichard (Dick) Judelsohn finds fulfillment in both jazz and the healing arts. The Buffalo pediatrician, who has hosted a jazz program on WBFO since 1976, seeks to educate the public on jazz from 1945-1965, the focus of his show. Whenever possible, he tries to include commentary about the artists, sidemen, and arrangers, in addition co the date of the recording. In shore, he looks for clues that will give his listeners "optimal enjoyment." Judelsohn, a 1967 graduate of the Medical School and associate UB professor of pediatrics, collects his knowledge through listening to jazz radio programs, talking co musicians, going to clubs and his own playing of the saxophone. Jazz has been his passionate interest since high school when he became interested in the art form as both a fan and a musi- Atm.J MN 1988 Herbert A. Hauptman (p/ q) (q/ p) = (left) (-1)1 /2 (p-l)xl/Z(q-1) he Law of Quadratic Reciprocity, a formula from number theory, is "the supreme example of the art of mathematics," according to Herbert A. Hauptman, UB professor of biophysical sciences. "Youcan see this beautiful formula has a great deal of symmetry just by looking at it. It is well-worth spending the two to three weeks it would cake to prove its validity:' Mathematics is an art, not a science, said Hauptman, who is also president and research director of the Medical Foundation of Buffalo and a recipient of the Nobel Prize in Chemistry. "The great 20th century philosopher and mathematician Bertrand Russell wrote: 'Mathematics possesses not only truth but supreme beauty, a beauty cold and austere, like chat of sculpture, sublimely pure and capable of a stern perfection, such as only the greatest art can show: " Unlike any ocher art, however, mathematics appeals not to the senses but to the intellect, Hauptman pointed out. le is also a more demanding art. "It requires nothing less from the viewer but chat he participate in the creative process itself because the act of understanding requires this participation. The demands on the viewer are great but the satisfactions and the pleasures are correspondingly great." Certain patterns found in the visual, literary, and musical arts, Hauptman said, which "almost always have a regular or repeating motif and show varying degrees of symmetry," are analogous to "the patterns of logical inference, the very essence of mathematics. "It is the recognition and appreciation of these patterns and these symmetries, as well as their significance, which gives pleasure when viewing a work of arc, listening co a musical composition or reading a poetic one, or comprehending usually after a great deal of effort - a mathematical exposition." Hauptman pointed to geometry as a more readily accessible area, combining the intellectual features of mathematics BUFFAlD PHYSIC IAN AND BIO MEDICAL SCIENTIST �and the visual appeal of art. "For many years I've been intrigued by the construction of these extremely beautiful, fascinating geometric solids; he said. "I first made them out of cardboard, then I learned co work with stained glass - using the colors to enhance the symmetry and beauty of the geometric forms. "Was it then only coincidence that my life's work as a scientist was concerned with crystals and their structures which often mimic their geometric counterparts in the world of mathematics?" Transparent models of crystal s created in rose and blue, pale green and white, were projected in slides during Haupt· man's speech. Several were also on display at the Health Sciences Library. 13 Art Collec ting ow does one build an art collection? In the case of Donald A. Lar son, UB's associate vice president for clinical affairs, it came after years of study, observation, and family consultation. Larson said his collection is varied in terms of media, artists, styles and origins. It runs the gamut from comfortably decorative works to tension-producing abstracts . In the view of Larson and his wife, Mimi, art serves to differentiate Ph ysician Wr iter o all those physicians leading double lives as artists, what does the artistic impu lse cost? It doesn't matter, according to Martin E. Plaut, novelist and UB professor of medicine . "le is still better to try than not to try; he said. "Many people who have somehow suppressed the artistic impulse have a feeling of loss, of what might have been. To me, the cost of not trying is greater." Plaut knows of what he speaks. He has published four novels, several under the pseudonym Paul Marttin (a scrambling of the letters of his name), including Cocoa Bll1fles, called "a stunning novel of love, sex, corruption ." He is also the author of The Doctor's Guide to You and Your Colon: A Candid, Helpful Guide to our #1 Hidden Healch Complaint. But he's known failure, too. "I sent off stories in manila envelopes for years; he said. "Editors handled submissions like they were samples of stool. "But there are those little epiphanies, coo; Plaut added. "Like when you walk into a library and find your book listed in the card cata logue." The artistic impulse is not limited co the printed word, Plaut emphasized - or co any of the so-called arts for that matter. "It may be an attempt to grow roses, or to describe a sunset after four days of clouds . Even if it's the way you tell stories or sing in the shower - if you possess it and ignore it, it will cost you more." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST the spac e within their home. Accordingly, said Larson, "the collection should be controlled in its hanging to provide that differentiation which supports our various needs . Without this selectivity, there would be discordancy both for ourselves and our guests." From the beginning, the Larsons wanted theirs to be a teaching collection for their children . The Larson children would often return to college with a piece of art, bring it back a year later and take another painting or drawing . As a result, Larson joked, "we have a satellite collection in New York City, Austin and Chicago ." Occasionally, the Larsons' taste diverged, but they were able to find common ground nonetheless. "We have learned things about ourselves." Pho tos by Nus baum xhibitors in the Medicine and the Arts symposium were: lvan L. Bunnell, UB clinical professor of medicine and watercolor artist; Karen Flynn-Miller, dentist and mixedmedia artist; Herbert A. Hauptman, UB professor of biophysical sciences and glass sculptor; Anthony Keller, nurse and harpsichord builder; Sanford L. Nusbaum, UB clinical assistant professor of oral surgery and photographer; David ]. Triggle,dean of the UB Pharmacy School and photographer, and Peter L. Weinmann, UB clinical assistant professor of dermatology and photographer . • AUTUMN 1988 �14 TYKE TRIK E Patent,pending device makes paraplegic one of the gang AlITTJMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �.. he colorful tricycle chat perky six-year-old Sarah Tangelder rides around her suburban Clarence neighborhood looks similar co ocher "Big Wheels" popular with kids her age. But the dark-haired youngster in the purple sweatsuit quickly explains that her bike is different, special, one-of-a-kind . Equipped with a device based on a patent-pending concept developed at UB, the tricycle provides her with mobility while simultaneously delivering physical therapy for her legs, paralyzed by transverse myelitis. As she pedals around her driveway, she gets one hour of electrical stimulation to her leg muscles each day without having to set aside extra time for her therapy. Until the UB team, led by Frank Mendel, Ph.D., and physical therapist Dale Fish, Ph.D., designed the concept for Sarah, her mobility was limited to a wheelchair. "We felt it would be ideal if she could have therapy as she played; says Mendel, an associate professor of anaromica l sciences in the School of Medicine and Biomedical Sciences . lc's hoped che therapy will strengthen her muscles and cardiovascular system. Aided by health sciences instrument shop director William Tanski, Jr., and retired engineer Robert Kell, the team studied and modified a child's big-wheel tricycle . Handlebars were replaced by hand cranks, which are connected by chains ro the foot cranks, allowing Sarah co use her arms to propel the tricycle. Cams mounted on the common axle linking hand and foot cranks activate microswitches that in turn activate a pair of battery-powered po rtable electrica l stimulators which send electrical signals co selected muscles. Because the speed at which she turns the hand cranks controls the pedals and stimulation co her legs, she can increase or decrease the speed at which she trave ls, but her leg muscles will always be stimulated at the correct arcs of movement. Use of electrical stimulation for therapy is nor new. It's often recommend- BUFFALOPHYSICIAN AND BIOMEDI CAL SCIENTIST ed for individuals who, because of illness or injury, cannot independently exercise weakened or paralyzed muscles. As carefully controlled current flows from a stimulator via electrodes caped co skin, underlying muscle is activated. Although this is an effective form of therapy, it is often inconvenient for a patient to travel several times weekly to a hospital or rehabilitation center where such therapy is typically administered. Even if portable models are used at home, the individual usually reclines or sits during therapy. "The design can also help prevent pressure sores, which develop in chose who sit or lie in a single position for long periods of time," says Mendel. The sores, often referred co as "bedsores; occur IS when lack of body movement cues off blood supply and nourishment co areas of the skin. Sarah's parents, Jim and Melanie Tangelder, report that her neurologist, James Teter, M.D., has detected improvement in muscle strength and increased sensibility since the child began using her special Big Wheel this winter . When it's coo cold to ride outdoors, Sarah switches the tricycle ro a stationary mode, which allows her to ride in place while her muscles receive their alternating JO-revolution stimulation and JO-revolution rest cycles for an hour daily. The stimulation-rest cycles and selection of muscles co be stimu lated can be tailored to the individual's needs . As Sarah gains muscle endurance, the Sarah Tange lder and Frank Mende l, Ph.D. stimulation cycle will be increased . "Being able to connect the portable While Sarah uses her purp le padded stimulator to a mobile vehicle, which the wheelchair to get about much of the paraplegic individual can incorporate in- time, she's able to stand with the aid of to normal activity, encourages consistent specia l, sturdy braces. therapy; says Fish. The UB team estimates that the cost Because the Big Wheel is inappropriate to equip the Big Wheel, excluding labor, for older children and adults, the UB ranges from $1,200 to $1,500. The major team is working on application of their expenditure is for the portab le electrical design to wheelchairs . stimulacors priced from $500 to $800 "The hand cranks could be incor- each. porated near the area of the brake Fish and Mendel be lieve the patenthand les typically found on the pending concept might also benefit wheelchair; Mendel explains. The chair's others whose legs have become paraconventional footrest could be replaced lyzed or severely weakened by certain inwith pedals, which would be connected juries or one of a hose of neuromuscular co the handcranks and electrical disorders . stimulators much as they are on the Big As long as the nerves from the spinal cord co the muscle are intact and the Wheel. Fish notes the team is particularly en- muscles are healthy, electrical stimulation thusiastic about chis work because could be beneficia l. People with multiwheelchairs are the primary mode of ple sclerosis, stroke, or other neurologiclocomotion for many paralyzed people. ally induced paralyses may be candidates Thus, a wide variety of individuals could for this kind of program, they say. receive electrical stimulation while The team hopes there will be a way to engaged in their everyday activities . produce the design for manufacture so For the very young, an all-metal tri- it's easily available in the future for others cycle fitted with the UB design might be like Sarah. sturdier than the all-plastic Big Wheel. The concept was presented in a scienAs Sarah rides with sister Grace, 5, and tific session at the American Physical nine-year-old brother Tom, she's also ex- Therapy Association meeting in Las Vegas on June 14. ercising her cardiovascular system. AUTUMN 1988 �ONE STEP FURTHER 16 Electricalstimulationtechnology movesfrom rehabilitationsetting into the realmof everydaylife By MARY BETH SPINA computer specialist whose lower right leg was partially paralyzed as the result of a spinal inju ry 32 years ago is now able to walk more normally because of the efforts of a research team at UB. The team has adapted existing electrical stimu lation technology, bringing it from the rehab setting to everyday life, to benefit UB staffer Jay Leavitt. (The same team has enabled a para lyzed sixyear-old to ride a tricycle - see accompanying story .) Despite his spina l cord injury, which resulted from a freak tumbling accident in college, Leavitt has maintained an active lifestylebut was somewhat hampered by an inability to lift his right foot from floor surfaces as he walked. "Every 12 days, I had to have the sole of my right shoe replaced - sometimes more often if I walked a· great deal on rough surfaces," he relates. In addition to the cost of shoe repair, Leavitt, who trave ls a great deal in his work, grew impatient with the amount of time it required for him to cross a parking lot or a large carpeted area. UB anatomist Frank Mendel, Ph.D., and physical therapist Dale Fish, Ph.D., worked with Leavitt to reduce his AlJTUMN 1988 decades-old pro blem by electr ically stimulating various muscles in his partial ly para lyzed limb. "We reasoned that if stimulation could be activated by a heelswitch in his shoe that could cause his affected foot to clear the floor, he could walk more normally," said Fish. "And ... save a lot of shoe leather in the bargain," added Mende l. A lthough portable battery-powered electrical stimulators are availab le, they are typically used in clinics as individuals sit or recline during therapy. The team, which includes retired engineer Robert Kell and Leavitt himself, decided to modify a commercial functional electrical stimulation system (FES) called Respond II equipped with a heelswitch to activate stimulation duri ng the "swing phase" of gait wh ich occurs when the heel is not in contact with the floor. The heelswitch is connected to the electrical stimulator which is in tum connected to surface electrodes applied over leg muscles and the top of the foot. Electrical pulses cause the muscles to contract and help lift Leavitt's foot and leg during the "swing phase ." An associated goal is to improve con - BUFFALO PHYSICIAN AND BIO MEDICALSCIENTIST �venience and durability of the system, says Mendel. Ordinary modular telephone cables, equipped with standard snap cpnnectors, connect the stimulator to the electrodes. The cables 17 and connectors allow fast connection and disconnection to facilitate dressing and toileting. The cable system worn under Leavitt's trousers connects to the stimulator and eight AA nickel cadmium rechargeable batteries which are compactly stored in an ordinary camera shoulder case. This arrangement is more convenient than wearing the stimulator on the belt because it does not bind while sitting or block access to pockets. The team concedes there are still some "bugs" to be worked out with the durability of the heelswitch, which must be replaced every two months . Although the basic techno logy for th is system is readily available and used in clinics, few individuals use such systems on an everyday basis. "Companies which developed the FES did not have a person like Jay Leavitt in mind - an active person who will subject existing units to heavy-duty use day after day," says Mendel. The UB team notes that Leavitt is able to walk more normally without lurching and without his mechanical leg brace. Further, the stimulated muscles are becoming stronger and therefore will continue to improve his gait over time. Although his physician, James Teter, M.D., notes improvement in gait and muscle strength in the affected leg as a result of using the stimulator, Leavitt will continue to need the device in the future. Leavitt, who with his wife, Ginger, raises Morgan horses on a farm in Elma, outside of Buffalo, finds the use of electrical stimulation to be a tremendous improvement. "Before I began using the device; says Leavitt, "I was burdened with a heavy brace, and my foot wouldn't clear the ground . Walking was time- and energyconsuming." ~ This research was also presented by the l!I ~ UB team during the scientific sessions of ~ the American Physical Therapy Associa~ tion meeting in June. ! AUTU MN !988 �18 '' yclosporine isn't the end of the (transp lantation) story. The crusade goes on; according to Thomas E. Starzl, M.D., who is known for his work in human organ transplantation . Starzl addressed approximately 250 immunologists and scientists at the 11th International Convocation on Immunology on June 15, sponsored by the Ernest Witebsky Center for Immunology at UB. Delivering the Ernest Witebsky Memorial Lecture at the event, Starzl AUTUMN 1988 said that a new drug, FK 506, cou ld be an improved medication for maintaining the fine line of avoiding donor rejection of the organ without appreciable toxic side effects. Both cyclosporine, which is now given to organ recipients, and FK 506, discovered only a few years ago in Japan, are immunosuppressants . Cyclosporine, however, has severe side effects leading to kidney damage. But, Starzl said, cyclosporine and FK 506, used together, promise to be a significantly improved combination for treating patients who have undergone human organ transplants. FK 506 has not shown toxicity in most animal studies, including non-human primates. Starzl, a professor of surgery at the University of Pittsburgh, noted that one interesting thing about modem drugs is that interrelations with other drugs can be analyzed much faster because of modern techno logy. Thus a major breakthrough in the technique of assessing immunosuppressive potent ial of drugs was the development, by Starzl's collaborators, of a standardized system of employing cell cultures . Using this system, all information now available on FK 506 with cyclosporine A was acquired within six to eight weeks. Within the first year that liver transplant patients were given cyclosporine in combination with steroids, the survival rate doubled and then tripled. There were never any steps backward, said Starzl. "I th ink cyclosporine and FK 506 will be soul-mate drugs because of their synergism (the interaction of the drugs produces an improved effect over those found in each drug separately); he said . "The 64 dollar question is, is FK 506 toxic in humans?" Starzl said . According to Starzl, in rats and baboons it isn't, which leads scientists to believe it won't be toxic in humans . In vitro experiments strongly suggest that FK 506 in combination with cyclosporine A will allow use of both drugs in such low doses that toxicity is extremely unlikely . lmmunosuppression is the part of transplantation that gives this specialty a kind of peculiar identity all its own, ac- ORGAN TRA New drug, FK 5( for avoidin ''I think c and FK 50c because oft synergism,''1 explained. I 64 dollar qi is, is FK SC toxic in hun BUFFALOPHYSICIAN AN[ �cording to Starzl . There are two other areas essential for successful transplantation. One is tissue preservation and the other is tissue matching. Improved tissue preservation techniques have made it possible to preserve organs longer so that a possible matching recipient can be found, and the donor organ can be transported to the recipient. In 1959 scientists described an organ profusion technique (putting fluids through the organ) by which organs could be preserved for several hours . This process has been continually improved. Donor livers could survive for up to 10 hours in 1976, bur using a new profusion solution described in 1987, donor livers now can survive for 24 to 30 hours, allowing transportation between Europe, the U.S., Canada, and South America , as well as between South East Asia and Australia and New Zealand. "The whole conduct of liver transplantation was revolutionized because of this preservation process; said Starzl. "Although this is a truly revolutionary development in liver transplantation; he added, "it's not the end of the line because greed is everywhere . I mean greed in a nice way, beca use no one is ever satisfied. It should not be long before donor livers will surv ive for a week or more.'.' The th ird essential aspect of transp lantation is tissue matching . However, convent ional matching has gone to the back burne r with improved and powerful immunos uppressants, such as cyclosporine A. A cross-matched test in which the seru m of t he prospective recipient is tested with the donor's cells before transplantation is important in preventing a certain number of very early rejections. Starzl pointed out that Felix Milgrom, disti nguished professor of microbio logy at UB, contr ibuted significantly to identifying antibodies in the recipient as the cause for h yperacute rejection; this is rejection of the organ within a matter of minutes after grafting. Cyclosporine and FK 506, no matter how effective in cell-mediated rejection, cannot prevent hyperacute syndromes . There cross-matching seems essential. ~$PLANT ATION 506, shows promise ing rejection ~ 1---1 ---- "'fi -----.! ....;i ~ .., cyclosporine 06 will be drugs their question ,06 imans?'' /\ND BIOMEDICAL SCIENTIST T he final major po int Starzl made was that there is new hope that intestinal transplants will be a 19 reality some day. Prospects for intestinal transplantation include patients with sho rt bowel syndrome, in which uptake of nutrients is severely impaired or impossible because of lack of intestinal mucosa! surface (lining of intestines) . Altho ugh there have been no completely successful intestinal transplantations, Starz l and his team are working diligently to find out what the problems are and how to solve them . Last November Starzl transp lanted small intestines into a two-and -a-halfyear-old girl. The donor intestines, because of the large number of immu nologically reactive cells present in its tissues, were pretreated with monoclonal antibodies to T-cells. The transplant was accepted and was functioning. Then, about three months after the transplant, the child became sick and doctors discovered lesions in her liver. Upon biopsy, they found extended lymphomas, usually associated with the Epstein-Barr virus, a member of the herpes virus family. "We have no idea why the little girl developed the lymphomas in her liver or if it had any connection to the transp lant, but we intend to find our; said Starz l It was of interest that the cells of the lymphoma were of recipient origin . It could be that reactivity of donor lymphocytes to recipient cells facilitate development of lymphomas . T his child was the first one who lived over six months and had a fully functional intest ina l transplant. "Everyone loved this child and was very sad when she died; expressed Starzl. "Bur I feel at least an attempt was made.'.' What is the difference between the bus iness of medicine and the crusade, asked Sta rzl. Th e business of medicine is what successful transp lantation seemingly always becomes, he answered, and the crusade is what hasn't yet been achieved . Intestinal transplantat ion is currently one of the transplant surgeon's majo r crusades . AUTUMN 1988 �20 to have an allergic reaction to gluten and muse restrict it in their diets, they do not form the damaging antibodies which differentiates it from gluten sensitive enteropathy (celiac disease); Kumar explains. There may be many undiagnosed cases among adults who've never shown clinical symptoms of the disorder. "By using our test as a simple screening device, we may find celiac disease is more prevalent than previously believed; .,. __ ""'1 z Kumar adds . The test may also be used ., __ .. ~ to monitor effectiveness of dietary treac'----l j ment for diagnosed celiac patients. § Or. T P. Chorzelski of the Warsaw ~ Academy of Medicine in Poland and his lllliiiiiiiill .. ___ .,~ ~ colleagues initially identified the antibody which is triggered by gluten figures on incidence in the U.S. popula- intolerance. tion . Studies by others suggest it is more A long-time collaborator of Kumar prevalent among certain Israeli popula- and Ernest Beumer, Ph.D., of UB, tions and may be found in one of every Chorzelski found chat the antibody ap300 persons in Ireland . peared in the blood of 70 per cent of To confirm diagnosis, a biopsy is now those diagnosed with dermatitis taken of the mucosa lining the small herpetiformis, a rare skin condition bowel with another biopsy taken six associated with chis specific intolerance . months after the individual is placed on "Ou r research together on skin a gluten-free diet. Additional biopsies disorders with immune system commay be required. ponents led us to investigate the possibiliThe new test, on the other hand, uses ty the antibody would be detected in a small amount of drawn blood . Not on- blood of those with celiac disease as well," ly is it less painful than a biopsy, it is in- Kumar explains. expensive and less time-consuming. Blinded studies conducted in conjunc"With conventional biopsy techniques, tion with Buffalo Chi ldren's Hospita l alternated with dietary challenges of giv- showed the new test revealed the aning the patient gluten products, diagnosis tibodies in the b lood of two previously may take 18 months compared co a day diagnosed celiac patients in a group of or so using our blood test; Kumar 100 persons . Subsequent blood tests on explains . ocher groups with unfailing accuracy Treatment of celiac disease consists of identified diagnosed celiac patients in putting the patient on a gluten-free diet group studies which included patients which eliminates the offending protein . with a variety of other disorders. Those who do not have the autoimmune Also involved in the ongoing studies disorder, which appears co run in as well as refinements in the test are scientists at the School of Medi cine in families, do not make these antibodies. "While some people have been shown Haifa, Israel. TESTDEVELOPED FORCELIAC DISEASE By MARY BETH SPINA A safe, accurate, inexpensive blood test to diagnose celiac disease has been developed by a team of UB researchers in collaboration with colleagues in Poland and Israel. Find ings of studies conducted on the new test were presented by Vijay Kumar, Ph.D ., of UB's Departments of Microbiology and Dermatology, at the 11th International Convocation on Immunology June 16. The convocation was sponsored by the Ernest Witebsky Center for Immuno logy at UB. The test, which has been developed over the past three years, has been shown to be 100 per cent accurate and promises to replace intestinal biopsies (surgical procedures) now used to diagnose the disorder . Kumar says the immunofluorescence test is now being adapted so it can be marketed in convenient test kits in the future . The test is now available at a cost of $40 through UB and a few other medical centers. Test results are generally available within 24 hours, he said. Celiac disease, characterized by weight loss and diarrhea, causes changes in the small intestine due to a reaction to certain proteins called glutens found in wheat and other types of grain. 1n medical terms, the disease is known as a gluten sensitive enteropathy . The test detects antibodies formed in the small incesti!"}ein reaction to the gluten protein. The antibodies appear as cell-tale markers only in blood of celiac patients and those with a rare skin disease called dermatitis herpetiformis. Primarily a disorder found in infants and young children, celiac disease is considered rare, but there are no accurate AlTl1JMN 1988 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST i �21 small general hospitals in rural communities. Or. Nelson is now living at 2734 Miradero Or. in Santa Barbara, Calif. 93105. Steven G. C line (M' 4 7) • of Atlanta, Ga., has retired after serving as chief of radiology at South Fulton Hospital for 25 years. M. Luther Musselman (M'3 7) John C. Inman (M'33) • writes, "I would enjoy news from classmates." Or. Inman retired in 1971due to a coronary. His winter address is 18 Palm Drive, Lake Worth, Fla. 33461. M. Luther Musselman (M'37) i • is president of the Medical Society of the County of Erie for a one-year term . He is also the president of the Buffalo Academy of Medicine. Dr. Musselman is director of medica l education at Millard Fillmore Hospital and an associate professor of Medicine at UB. Carl J. lmp e llitt er (M'46) • writes, "Following a 27-year thoracic surgical practice in Scottsdale, Ariz ., l have been invited to join the Mayo Clinic, Scottsdale, Department of Ca rdiovascular Thoracic Surgery." Linc o ln D . Ne lson (M'46) • has retired after serving 35 years as a medical missionary in the Philippines, where he was directly involved in establishing th ree Raphael S. Goo d (M'48) • was recently elected vice president of the South Florida Psychiatric Society. Or. Good is professor of psychiatry and obstetrics and gynecology at the University of Miami School of Medicine. Yale So lomon (M'50) • a New York ophthalmologist, periodically takes time off from his busy practice and his work at Southside Hospital, where he's chief of ophtha lmology, and his teaching at the State University of New York at Stony Brook Medical School, to go to India, Thailand, and the Caribbean, where, paying his own way and operating gratis, he has restored sight to hundreds of indigent people. Or. Solomon is the founder of a tax-exempt organization, Volunteer Eye Surgeons International (VESl) - with the express purpose of raising funds to cover the costs of travel and living expenses for eye surgeons on onemonth assignments to needy areas of the world. "VESl is unique among the large number of groups involved in providing eye care in developing countries in that it's the only one to cover volunteer expenses." For further information about Volunteer Eye Surgeons International, contact VESI, 375 East Main Street, Bayshore, New York 11706. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST Stephen C. Scheiber (M'64) And rew Norr is (M'82) Myra R. Zinke (M'SO) • writes, "I am home on disability because professor of medicine in the University of Texas, San Antonio Family Practice Department. of cancer and would love to hear from friends and colleagues." Dr. Zinke resides at 4401 Roland Ave., Baltimore, Md . 21210. Andrew Nor ris (M'82) • of Stephen C. Scheibe r (M'64) • professor of clinical psychiatry at Northwestern Medical School, is president-elect of the Association of Academic Psychiatry . Or. Scheiber is also chairman of the APA Committee on the Impaired Physician, co-chairman of the Fellowship Committee of the 11linois Psychiatric Society, and has been elected a member of the Committee on the Study of Evaluation Procedures of the American Board of Medical Specialties . Fort Co llins, Colo., has published "Cyclotorsional Oiplopia Following Retinal Detachment Su rgery" in the journal Pediatric Ophthalmologyand Sirabismus. Jos eph Ke ith Miller (M'83) • writes, "I have completed a fellowship in EEG and epilepsy at the Un iversity of Illinois at Ch icago. I will be joining the Johnson Neurological Clinic in High Point, N.C. in June." Joseph P. Ri enzi (M'85) • writes that after three years of a genera l diagnostic radiology residency, he began a fellowship in nuclear radiology on July I at Yale-New Haven Hospital, Yale Univers ity School of Medicine. Kenneth Lee Gayles (M'73) • M ichael S. Mill er (M'86) • has been elected to fellowship in the American College of Cardiology. Or. Gayles is an assistant professor of medicine at UB. writes that he is a psychiatry resident at the Medical College of Virg in ia H ospitals . His wife Pamela has just received her master's degree in mental health nursing from the Medical College of Virgin ia. Tone Johnson, Jr.(M'75) • has been appointed clinica l assistant AUTUMN 1988 �22 R ''!:I q.._ pan ahe It's a , CPR, tor of fessio1 The Biornc suppo "It's reside, vance matte prepa1 T h, waso1 schoo' held i goes I: intub: body! heart Wh vance years: cy pro requir "It's quire UB "It ii noise The the ac best ~ "It I Mary "Yo, Pocha I!! ~ g ~ AlJl1JMN 19& BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST BUFFAL �23 IBSIDENTS SUPPORT LIFE > Gettinghands-ontrainingin advanced cardiac life supportwasone of the best r 1rtsof a new orientationprogram,say UB residents i ~ UB placeditself one step 1ead of State regulation s by requiringthe trainingof all of its residents. ~ ·~ r r a common myth that all doctors know 'R, noted Glenda Donoghue, M.D., direcof continuing medical education and pro;ional development at UB. ~he UB School of Medicine and ,medical Sciences gives training in basic life )port skills, but not all medical schools do. It's our perception, and the State's, that idents should know not only basic, but ad1ced cardiac life support," she said . "No teer what your specialty is, you should be pared." ihac's why advanced cardiac life support , one of the topics covered by the medical ,ool's new orientation program for residents d in June . Advanced cardiac life support !S beyond CPR and uses methods such as ubacion, IVs, and medications to keep the :ly functioning for a prolonged period after m failure. XlhileUB's medical school has offered ad1ced cardiac life support for a number of 1rsand it has been required in some specialprograms, chis is che first time it has been 1uired of all residents in all programs. lt's virtually unheard of for a schoo l co reire it of all of its residents," Donoghue said. JB is getting a jump on Scace regulations. It isn't required by the State yet, but there's ise chat it will be," Donoghue explained . ihe new residents were enthusiastic about '. advanced cardiac training, calling it the ;c part of a fine orientation . It totally demystified a code," remarked 1ry Ann Millar, M.D. You definitely need it," added David :hatko, M.D. "I thought we needed it at FAI.O PHYSIC IAN AND BIOMEDICAL SCIENTIST the end of the second year" of medical school. The orientation was offered through the graduate medical education program, which operates under the auspices of the Graduate Medical-Deneal Education Consortium . ln order to attend, residents had co arrive for work a week early and the hospitals agreed to pay them for an extra week. "The hospitals are behind it 100per cent," Donoghue said. The purpose of the program was co prepare the residents for their work in the affiliated hospitals by educating them on the particular issues of practicing medicine in New York Seate, she explained. That includes: Creating a cohesiveness among the residents, who work in several different hospitals. "They're often confused about their relationship to the Un iversity," Donoghue explained. "They know intellectually they're in a University-related program, but they hardly ever see anything of che University." The program also aims co help the residents gee to know each other . Data suggests that if they' re brought into the hospitals as strangers, it takes a week or 10 days for them co function efficiently. If they know each ocher, they work in teams from day one, she explained. "That may be one of the biggest pluses," Donoghue noted. All of the residents from both halves of che orientation were invited to a picnic reception. It was a hot blustery day and the residents joked and mingled and noshed their way co peak efficiency. "It's a good way to get co know each other before you start the rigors of residency," Dennis Dejesus, M.D., a resident in general surgery, said of the orientation . Between sips of an icy drink, Constance G reene, M.D., a family medicine resident, noted that getting co know the other residents was especially helpful to her because she'll be working with so many of them from different departments . Teaching chem to be teachers. In the past, residents went from being students co being teachers overnight without any training. Now they get intensive training. The small-group teaching sessions and presentat ions on how co evaluate students were effective, said Jeff Sceinig, M .D., a resident in surgery. The orientation also videotaped the students to show them using good techniques and co point out flaws. Making su re the residents are aware of the regulatory climate in New York State. The Health Department regulations and credentialing requ irements may be much more stringent than in other states, Donoghue noted. "For a person from outside the country like me, the re was a lot of information," said Bharat Jain, M.D., who is from India. He found the discussion on defensive medicine versus cost control "very progressive." Even American students are unfam iliar with things like DRGs and cost containment . "The nurses would always yell at us about how much money we were running up with these tests,"said Millar. "Nobody ever cold us how much they cost . Now we know." AVTUMN 1988 �THIRTY YEARS UNDERWATER 24 By CONNIE OSWALD SlDFKO olding her breach, the woman plunges below the surface of the frigid ocean water, swimming deeper and deeper in search of abalone, snails, sea urchins, and seaweed. She is one of the Arna - the professional women divers who harvest the fruits of the seas that surround their homelands of Korea and Japan. They may dive as deep as 15 to 30 feet while holding their breach for as long as a minute. Bue what was fascinating co Suk Ki Hong, M.D., Ph.D., a professor of physiology at UB, was the Ama's indifference to cold. In the winter, the water is as cold as 50 degrees Fahrenheit, yet the Ama would wear only cotton bathing suits. About 25 years ago, Hong began co study the Ama . After a decade of research, he demonstrated that they had indeed become acclimatized to the cold, something that physiologi sts had doubted was possible. Hong discussed his findings on the Ama and his other research when he presented the Stockton Kimball Lecture at the Annual Faculty Meeting of the School of Medicine and Biomedical Sciences on May 25. There are 30,000 professional women divers called Arna in Japan and South Korea. The profession has existed for 2,000 years, Hong explained, showing a slide of an ancient Japanese print which depicts an Ama with an abalone knife AUTUMN 1988 clenched in her teeth. Just as their predecessors had done, the Ama studied initially by Hong wore no protective clothing, just cotton bathing suits. Even in the summer, the water never gets warmer than a cool 75 degrees Fahrenheit . "They're exposed to cold all year round," Hong noted. "I went in the water to measure the temperature. I wore a wet suit, but I still felt cold, though the women didn't seem bothered by it." Hong and his colleagues estimated the Ama's daily heat loss to be about 1,000 kilocalories a day. That's an enormous amount - about a third of their daily caloric intake. "This amount of voluntary heat loss is the largest ever measured in human subjects and provided strong rationale for our subsequent studies on human acclimatization to cold;' he explained . The women would voluntarily leave the water when their body temperatures reached about 95 degrees Fahrenheit, Hong said. If asked to stay in the water, they slowly lost consciousness. Hong measured the Ama's critical water temperature, that is, the lowest water temperature the subject can tolerate for three hours without shivering. In general, the fatter the subject, the lower the critical water temperature. Yet the critical water temperature of the Ama was low even if there wasn't a thick layer of fat under the skin, he found . Hong also found that the blood vessels in the divers' hands constricted more quickly in icy water and remained constricted longer than did the blood vessels of those in a control group . Another finding was that these divers had 30 per cent greater basal metabolism rate in winter than did non-divers. All of these factors created a pattern that indicated that it's possible to become acclimatized to the cold. But to be convinced, the researchers had to show that these unique deviations from the norm disappear when cold is removed. In 1977, the divers in Korea began wearing wet suits to insulate themselves BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �25 I Suk K i Hong, M.D., Ph.D. from the cold. This created the perfect laboratory for the second part of the experiment. Through a grant from the National Science Foundation, Hong stud ied the women again and found that by 1982 they had indeed lost their acclimatization. Hong dubbed his talk "Thirty Years Underwater." His career, devoted to studying humans' adaptation to life underwater, has divided itself rather neatly into decade-long segments. In the second decade, he examined the mechanism unde rl ying hyperbaric BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST diuresis, which is the increased urination that occurs when the body is subjected to high atmospheric pressure, as occurs underwate r, for long per iods . T hese experiments were conducted in highpressure chambers in Hawaii and Japan. The diuresis was puzzling because the divers didn't increase their fluid intake to make up for the increased urination, yet the total amount of body fluid remained the same. Hong fo u nd that the primary mechanism for chis diuresis is a suppression of the process called insensible water loss. Normally, peop le lose water vapor through their skin. Hong found chat at higher pressures, the divers lost less water vapor through their skin. His third decade of research centers on explaining, at the cellular level, how the mechanism causing hyperbar ic diuresis works . He and his colleagues at UB have constructed a specia l mini-hyperbaric chamber to study sodium transport in cells under high pressure. The experiments so far indicate that high pressure may indeed interfere with active sodium transport, Hong said. AUTUMN 1988 �26 ext year's Stockton Kimba ll Lecture will be delivered by this year's winner of the Stockton Kimba ll Award, John R. Border, M .D., who is acknow ledged as one of the fathers of modern trauma surgery. Border, a professor of surgery at UB, pioneered ground-breaking treatment methods that dramatically improve the chances of surviva l of patients who suffer severe multiple trauma, such as occurs in traffic accidents . "Few surgeons are recognized as having ch anged a n d imp roved their disciplines; said Lewis M . Flint, Jr., professor and chairman of surgery, as he presented the award. "Dr. Border has improved his discipline nationally and internat iona lly." Several other awards were presented during the annual meeting. Michael E Noe , M.D., clinical associate professor in social and preventive medicine and clinical assistant professor in medic ine and family medicine, received the Dean's Award for his leadership in the Graduate Medical-Deneal Educatio n Consort ium, for his leadership at Buffalo Genera l Hospital , and fo r h is teaching contributions . Distinguished Service Awards went to: Glor ia L. Roblin, Ph.D., clin ical professor of psychiatry; John W. Cudmore, M.D., clinica l associate professor of surgery; John E Moran, Ph.D., associate professor of bioc hemistry; and Peter Nickerson, Ph.D., professor of pathology . The first Robert S. Berkson Memor ial Award in the Art of Medicine was presented to James E Phill ips, clinical professor of medicine . T he award recognizes a volunteer faculty member for excellence in patient care and teach ing. AWARD-WINNING PROFESSORS By CONN IE OSWA LD STOFKO "Few surgeonsare recognized as having changed and improved their disciplines,"said Lewis M . Flint. "Dr. John Border has improved his discipline nationally and internationally." Border,a fat her of modem trauma surgery, received the Stockton Kimball Award at the annual Faculty meeting. AUTUMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �27 John R. Bord er, M.D. Phillips said he was very deeply honored to accept the award in the name of all the great teachers who went before him. he Louis A. and Ruth Siegel Teaching Awards were presented in four categories: The preclinical award went to John R. Wright, M.D., chairman and professor of the Department of Pathology. Commendation letters were given to Alexander C. Brownie, Ph.D., professor of biochemistry; Murray Ettinger, Ph.D., professor of biochem istry; Leon E. Farhi, M.D., professor of physiology, and T BUFFALOPHYSICIAN AND BIOMEDIC AL SCIENTIST Charles M . Severin, Ph.D., associate professor of anatomical sciences. The clinical award went to Margaret W. Paroski, M.D., assistant professor in neurology. Commendation letters were given to John A. Brach, M.D., clinical assistant professor of medicine; Ralph J. Doerr, M.D., assistant professor in surgery, and Frederick Munschauer Ill, M.D., research assistant professor m neurology . The volunteer award went to Thomas A. Raab, M.O., clinical assistant professor in medicine . A commendation letter was given to Takuma Nemoto, M.D., research associate professor in surgery. House staff and special awards went to Matthew Antalek, M.O., clinical assistant instructor in medicine; Jon B. Bishop, M.D., clinical assistant instructor in surgery; Robert A. Gianfagna, M.D., clinical assistant instructor in medicine, and Sathyazathi Reddy, M.D., clinical assistant instructor in medicine. Also at the meeting, Mrs . Char les Schen, president of the Auxi liary of the Erie County Medical Society, presented a $10,000 check to the school. The money was raised by the wome n's auxiliary for scho larships and unrestricted funds. AUTIJMN 1988 �28 'DEMYSTIFY SCIENCE: GRADUATES ARETOLD By DAVID M. SNYDERMAN B ecause physicians are the health scientists who most regularly come in contact with the lay population, the UB Medical Class of '88 must do their best to demystify science, according co the noted evolutionary geneticist Rebecca Cann. Cann, an assistant professor at the University of Hawaii, was part of the ream char formulated the "Eve Hypothesis~ the theory that claims that all humans share a common ancesror. She addressed the 142nd commencement of the School of Medicine and Biomedical Sciences on May 22. President Steven Sample also addressed the graduates, reminding them how much they are indebted to their parents for making their college and medical school educations possible. The class speaker was Stephen Hughes, who delivered a farewellco and from the class. Along with 140 doctor of medicine graduates, there were 25 doctor of philosophy degrees conferred. At the University's General Commencement, held earlier in the day, National Heart, Lung, and Blood Institute director Claude Lenfant received an honorary Doctor of Science degree. Lenfant, who received his M.D. in Paris, did postdocroral work at UB during the late 1950s. He did work on pulmonary physiology under Hermann Rahn, distinguished professor of physiology emeritus in the UB medical school. Commencement speaker Cann emphasized the need for physicians co be educators. This need exists, she said, because mosr Americans lack scientific knowledge. This knowledge gap is seen in the inability of many Americans co understand scientific theories, including Cann's own research on evolution. Cann recently was part of the team which "concluded that modern humans can trace the evolution of (mitochondrial) genes to a single female who lived in Africa around AlJfUMN 1988 200,000 years ago; she told the graduates. Known popularly as the "Eve Hypothesis~ the theory indicates that all mankind shares a common ancestor. Cann noted that "mitochondrial genes differ from classically defined genetic systems in that they are exclusively maternal in their mode of inheritance; meaning that all of an infant's mitochondria and their accompanying genetic material come from the mother. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �29 A bove, Rebec ca Cann, a memb er of the t ea m t hat f o rmulat e d the "E ve Hypot hesis," spoke at th e 142nd comm en cem en t of th e m edi cal sc hool. evidence of our own evolutionary history better known as biological certainty to the general public; Cann said . She also noted that specialists have developed different "jargons and a vocabu lary that provide an efficient mode of communication benveen peers but that also provide an effective barrier quite impenetrable" to understand ing the developments by non-specialists . Physicians "play an important role in the struggle for scientific literacy in the Ame rican public. Your daily activities will affirm the importance of science and techno logy on B human society today," Cann emphasized . ; She also noted that many college biology ~ students form their attitudes about science i very early in life. "These attitudes largely stem from their exposure to TV and their family physicia ns; she said . Cann instructed the graduates to "use your cited the Office of Technology Assessment's special ab ility and your everyday working report for the National Science Foundation know ledge of the human body to help foster that states that "somewhere between 43 and a bette r understanding of the biolog ical 45 per cent of high school-educated closeness which we humans share." Americans do not believe in human In order to help educate as many peop le as biological evolution and estimates that even possible, Cann urged the physicians to "read, about 25 per cent of college educated travel widely, and talk, not just to your colAmericans hold similar views." leagues but to community organizat ions, It is in light of this that physicians shou ld do everything possible to "make the physical school boards, polit icians, an d lawyers about i Mitochondrial genes "code for a small number of proteins that function in the production of energy for the cell."Cann said the importance of this is symbolized by biological essayist Lewis Thomas's statement that "you cou ldn't lift a finger or think a thought without those genes." However, Cann noted, much of America's population can't fully understand the implications of this type of scientific research. She BUFFALO PHYSIC IA N AND BIOMEDI C AL SCIENTIST AUTIJ MN 1988 �30 your informed (scient ific} opinions." Sample reminded the graduates of the large debt chey owe their parents for encourag ing them co pursue an education as well as seeing them through their schooling, both financially and emotionally. According co Sample, graduation "is an excellent time for you co express appreciation to the many individuals whose leadership, loyalty, and support have played such a significant role in helping you co reach your goals~ Sample feels chac it is imporcant to recognize thac "che individuals who are unquestionably rhe most important members of chis team, and who are deservedly the proudest of all on chis wonderful day are your parents, who throughout your lives and your lifetime educational process have provided direction and support." His sentiments were echoed by the dedication of the annual yearbook, The Iris, to "our parents" by rhe student body. The dedication was presented by yearbook co-editors Lisa Benson and David Brock and accepted on beha lf of all parents by Dr. and Mrs. Dav id Greene, rhe father and mother of a member of the graduating class. Brock said that the graduating class decided co dedicate the yearbook to parents "for instilling the values of caring and self-sacrifice and nurturing our love of learning; for pro• viding emotional and financial support and encouraging us when we needed it most, for giving of your selves so chat we could give to ochers and for just being the re." The class speaker, Stephen Hughes, suggested chat graduates shou ld link their alumni donations co pet causes. "For four years we have complained about our lack of power as medical school srudents; Hughes said. "Each of us has things in the curricu lum or about our education we would like co see improved. I am suggesting thac when you give - and I do encourage you co give - you make your suggestions known, and judge your futu re donations by che response to your suggestions." The graduates were welcomed into the alumn i association by Franklin Zeplowicz, president of the organization . AUTUMN 1988 The Hippocratic Oath was administered to t he new physicians by John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. The 165 proud new graduates received their diplomas and joined the ranks of more than 4,500 alumni. "This bu ilding is impo rtant if we're going co continue to develop as a majo r biomedical research center; said John Naughcon, vice president for clinical affairs and dean of the medical school. "\Y/eneed facilities and equipment that will provide for ou r immediate needs for development and for a possibility of expansion over a 10-year period or so." SCHOOL PLANS NEWLABBUILDING T By LISA JOSEPHSON J use when you thought the sawdust had seeded, the UB School of Medicine and Biomedical Sciences is planning co build a $50 million research building that will contain approximately 150,000 nee square feet. The building will be 50 per cent larger than the Cary-Farber-She rman addition, which was completed in August 1986. Ir will be almost as large as UB's Recreation and Athletics Complex. The new building will consist primar ily of laboratory and research space. The building probably will be located somewhere co the south of the present medical school complex. It will connect to the Cary-Fa rber-Sherman complex, but there is almost no vacant land nearby, so exactly where to locate che new building poses some problems. Valdemar lnnus, UB associate vice president for resource planning, said the specific site will be decided by the architectural firm. Medical schoo l officials are currently in the process of developing an outline describ ing what activities will be housed there, said Innus . The Ca ry-Farber-Sherman addition, which cost $19 million, was said to be "the cornerstone of the medical schoo l's expansion program ." Alchough medical school officials had hoped che addit ion would satisfy che school's needs well into the 21st century, it does not have the facilities, equipment or space needed for the schoo l co become the major research institution that officialswant it to be. he University had planned a major renovation of the Cary-Farber-She rman complex, but the comp lex doesn't lend itself to the type of renovation requ ired, Innus said. For example, there isn't enough room between the ceiling and the floor for all of the pipes for electricity, gas, water, sewage, heating, cooling, and ventilat ion . Wee labs, which use special fume hoods and sinks, need mo re pipes than office buildings do. Officials want to hurry the building project along because there's a growing need for research space in the medical school. To speed up the process, they've set some guidelines for construction. One is chat the new building shou ld be designed co allow any space to be converted into wet lab space if needed . Another is there should be minimal finishes co provide flexibility. The planning process is expected co be completed sometime this fall, according co lnnus . Ac chat time an archi tectura l firm will be chosen. The schedu le for construction of the building depends on the complexity of the outline given to the architect. Usually co nstruction of a facility of chis type cakes about three co four years. Officials say the building could be completed in as sho re as four co five years or as long as eight years. "le really depends on how long we cake co design the building; said lnnus . "Our approach is co move as quickly as possible through the design process. We will sec ambitious timetables to make the building availab le as soon as possib le." "This is an exciting addition chat makes it possible for us to move forward on plans we've had for a number of years," remarked Naughton . BUFFAIDPHYSICIANAND BIOMEDICALSCIENTIST �31 Frank Schimpfhauser, Ph.D. , assistant dean and director of the Medical School's Education Development and Research Unit, received a 1988 Chancellor's Award for Excellence in Professional Service. A member of the UB staff since 1976, he has helped his faculty apply for federal grams, including several subsequently awarded for research in cancer education and cancer prevention. He served as Faculty Senate secretary for two years and chaired the senate's teaching quality committee for two terms. He also oversaw a review of the Gifted Math Program. Schimpfhauser has co-directed the summer development program for new and recently hired faculty for the past five years. He has published articles on medical education and evaluation and teache s two graduate courses through the Department of Social and Preventive Medicine, where he is associate professor. Schimpfhauser holds his Ph.D. and M.A. degrees from Ohio State University. He received his B.S. from UB in 1965. Russell W. Bessette, M.D., D .D.S., has been appointed head of the Division of Plastic Surgery at the Buffalo General Hospital and UB. A member of the Buffalo General medical staff since 1981, Bessette has broad clinical and research experience and an avid interest in re-establishing graduate education programs in plastic surgery. Bessette will continue his active role in UB's Health-care Instruments and Devices Institute (HID!) as director of the IDEA laboratory at Buffalo General. He also holds faculty appointments in the Department of Surgery and the Departments of Oral Medicine and Oral Pathology at the University. C h ar les F. Dewitz (M'14) • who practiced medicine until the age of 100, died June 29 at the age of 103. As a teenager, he worked for one of the doctors who assisted in treating President William McKin ley when he was shot in 1901, and who treated Mrs. Jefferson Davis, the wife of the president of the Confederacy, in 1903. Dewitz opened his own practice in 1921.He closed his office when he was 92, but continued to see a few patients for eight more years. He is survived by two sons, Charles S. and Robert G.; a daughter, Esthe r D. Eddy; nine grandchildren, and nine great-grandchildren . Frank Schimpfhauser, Ph.D. Peter T. Ost row, M.D. , was moderator for the 22nd annual John J. O'Brien, M.0., Research Symposium held at Mercy Hospital. He is associate dean for curricular and academic affairs and associate professor of pathology at UB. The patient medication information sheets written by sophomores Craig Na rin s and Laura Nic ho lso n were the top entries in the annual c,ompetition held in the spring by the Department of Pharmacology and Therapeutics. Eugene R. Mindell , M.D. , professor of orthopaedic surgery, was named president-elect of the Musculo skeletal Tumor Society at the society's recent annual meeting in Minneapolis . DEATHS Linda Hawkin s, M.D. , Ph.D. , assistant professor of psychiatry, received the 1988 Hyman L. Levin Award at the annual luncheon of the Mental Health Association of Erie County. She is a psychiatrist U and director of the Department of Psychiatry's Education and Training/Medically Ill Chemical Abuser s Program at the Buffalo Psychiatric Center. BUFFALOPHYSICIAN AND DIOMEDICALSCIENTIST Francis R. Daniels (M'24) • died suddenly Oct. 20, 11987,from a heart attack at his home in Sama Ana, Calif. Dr. Daniels practiced general surgery in Rochester, N.Y., until 1954. In 1955, he moved to Sama Ana, where he practiced until 1981. He is survived by his wife, Irma, a son, Dr. Mar cel F.Danie ls, and a daughter, Chantal. Mauri ce B. Gordon (M'34 ) • died on July 31, 1987, in Brunswick, Maine. He was superintendent of Cleveland State Hospital until 1951 when he became director of the Veterans Administration Mental Hygiene Clinic in Newark, N.J. Or. Gordon maintained a private practice and served as assistant director of social rehabilitation at the Postgraduate Center of Mental Health. He is survived by his wife, Ellen, and daughters, Marcia and Judith. Donald M. Secr ist (M'65) • died of cancer on Dec. 6, 1987. After serving as a captain in the U.S. Air Force, he began a private practice in gastroemerology in Aspen, Co lo., in 1973 and continued that practice until his death. Or. Secrist is survived by his wife, Maryellen; a son, Peter, and two daughters, Jennifer and Katie. Georg e W. Fugitt (M'45) • died May 30. The Kenmore urologist was on the staff of Kenmore Mercy and OeGraff Memorial hospitals and had served as president of the medical staffs of both facilities. F-orfive years he was chief of the medical staff at DeGraff and was a member of its board of trustees. Fugitt was chie f of urology at Kenmore Mercy. At UB he was a clinical associate professor of urology. H e is survived by his wife, Betty; two sons, Or. Robert G. Fugitt and David P. Fugitt; a daughter, Diane Fugitt Pugh; a broth er, Warren Fugitt, and two grandchildren. AUTIJMN 1988 �32 TOTAL 1988 AWMNI DONATIONS SPRING $77,980AT ANNUAL REUNION /CLASS DAY CLINICAL he class reunions are a high point of the annualSpringClinicalDay held each year by the School of Medicine 1928 Fromleft, seated: Thelma Brockand RaymondRick/off.Standing:Bmno and Biomedical Sciences. It's a time Schutkeker and Walter King. for chatting about family and mutual acquaintances; catching up on classmates'careers,and talking shop. It's also a time for the traditionalgifts. This year the anniversary classes generously donated $77,980. . $5,750 Class of 1938: ......... $11,460 Class of 1943: ......... $6,900 Class of 1948: .......... $10,930 Class of 1953: ......... $14,400 1938 Class of 1958: ......... seated:Eustace c. Phillies,Leo]. Doll, Walter z. Schwebel, $8,725 Fromleft,Lieberman, Class of 1963: .......... L. ]. Foit, and \\1/alter , ClarenceStraubingerNorman Samuel 5>·doriak.Standing:Charles Donatelli, Vincent L. Rutecki, Russell]. Cla5S Of 1968: · · · • · · · · • · $7, 575 Catalano,SanfordUllman,H. RobertOehler,Carl Hertz,JohnH. Geekier, Harry C. Law, CharlesF. Becker,William H. Tatem, Harold]. Elliott, RichardTerry. and $8,200 .......... Class of 1973: $3,525 Class of 1978: .......... $515 Class of 1983: ........... AUTUMN 1988 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �33 1943 1953 Fromlefc,seated:Erwin R. Chillag,Kevin M. O'Gorman, Morris Unher, amd EdmundM. Tederous.Standing:Marvin L. Bloom,PaulJ. Wolfgruber, Ivan L. Bunnell, Joseph]. Ricotta,CharlesJ. Tanner,PaysonB. Jacobsen, JohnC. Ninfo,JohnR.Williams,AnthonyJ. Marano,and RobertW. Moyce. From lefc, seated: Herbert W. Simpkins, Marvin Wadler,JosephF. Ruh, Thomas E. Comerford,Molly SeidenbergPanner,Jack Gold, RichardJ. Nagel, and Donald L. Ehrenreich.Standing:Thomas G. Geoghegan,John N. Strachan, Curtis C. Johnson,John W. Handel, Milford C. Maloney, Howard C. Smith, Bertram A. Partin, Michael A. Sullivan, Robert A. Peacock,ReinholdA. Ullrich,RobertS. Sobocinski,StanleyL. Cohen,James M. Orr, James R. Coleman, FrancisT. Oliver, Donald 0. Rachow,Harley D. Lindquist, James W. Carlin, and Raymond M. Smith. 1948 From lefc, front row: Lester H. Schiff, Raphael S. Good, Norman Paul, Albert P.Sutton,Darwin D. Moore,EdgarC. Smith, and CliffordW. Gates. Secondrow:JamesG. Borman,Michael Dzubaty, Norman Minde, Judith B. Landau, Oliver P.Jones, Leon Graff, Mary Alice Smith, and David P. Buchanan.Third row: Warren L. Hollis, Cletus J. Regan, Vernon C. Lubs, FrancisPeisel,SeymourZola,Daniel J. Fahey,Robert]. Hall, Myron Gordon,Harry C. Essig,Glenn B. Doan, Ansel R. Marcin, RichardProplesch, B. Edward Heckmann, and Thomas J. Enright. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 1958 From left, front row: Richard Romanowski, Michael Mazza, Frederick Dischinger,GaspareAlfano, RichardRahner,RichardC. Boyle,and Joseph Bellanti.Secondrow: John W. Float,JohnArmenia,JerryWeisberg,Samuel Shatkin, Marie L. Kunz, Melvin Brothman,Jacques Lipson, and Roger M . Baretz.Third row:JosephZizzi, HaroldZimmerman,ReinhardtWende, Alfred Stein, Gerard Guerinot, Franklin Zeplowitz, Eugene Friedberg, RichardD. Wasson,John J. Giardino,Leo Kane, Dominic Falsetti,James S. Williams, RobertC. Dickson, ElroyE. Anderson,John P.Murphy, Lucien Potenza,and Lloyd H. Leve. Fourthrow: RobertJ. Perez,Franklyn Campagna, Thomas G. Cummiskey, BensonEisenberg,Morton Spivack, and Michael Genco. At.rrUMN 1988 �34 1963 1973 Fromleft, front row: JosephC. Tutton,John Schriver,Mike Sullivan,George Fromleft, seated:RobertLaMantia, PaulKuritzky,SharonKuritzky,Jeremy Lockie, and Joseph Herbstrict.Middle row: Albert Maggioli, Anita ]. Cole, and Stephen Nash. Standing: LeelandJones, RobertFugitt, Patrick Herbert,FrankV DeLaus,AnthonyFoti,CharlesS. Tirone,David Malinov, O'Connor, David H. Breen, and Joseph Mylotte. Robert8. Spielman,and Donald Levine.Back row: John LaMar, Richard B. Narins, William Heyden, LawrenceSobocinski,John R. Fanelli,John Wadsworth,Jason E. Rudisill, Stephen Joyce,and Ernest Fatta. 1968 1978 Fromleft, front row: RaymondMarlin, Thomas]. Cumbo, Sara R.Sirkin, RobertA. Milch, BruceGesson,and GeorgeCohen. Middle row: PaulS. Schulman,Kenneth Jewel, John Gold, Stephen Edelstein,Julian Karelitz, Harold Kulman, and Kenneth Eckhert. Back row: Peter A. Mansk)', Jonathan Reynhcut, Lawrence]. Dobmeier,Brian Joseph, Robert White, and Gerald Daigler. Fromleft, front row: PaulParoski,Mathew O'Brien, RonaldSomogyi,and John R. Valvo. Second row: Richard Elman, Gregory Roberts, Roberta Meltzer, Elizabeth Doherty, Lois Polatnick,Judith Baron-Stone,Franklin Gillig, and Covia L. Stanley. Third row: Gary Eggleston,Steven M. Seidman,]. Thomas Amo, Mario Santilli, FredH. Geisler,RichardSternberg, SimonShaham, PaulWopperer,and Nelson Isada.Back row: HarveyGutman, Stewart Altmayer, Stephen Gawronski, and Alan Koslow. AUTUMN 1988 BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �35 1983 From left, front row: Galvin Andmon, Borys Loza, JonathonA. Graff, ElaineHuber,Sue MeyersTanbakuchi,and FrankMezzadri. Secondrow: Gwen Nichols, PatriciaFlanagan,Jill Lindner, Andrea Manyon Wild, SharonAlger, YoungheeLimb, CatherineGood/ell.cw, and KarenHorowitz. Thirdrow: Mark Schwager,RichardAmiraian,MelindaS. Cameron,Robert Smolinski,Stephen Kinsman,James E. Wild, RobertStall, Kenneth Zimmerman, Neal Smith, RichardCollins, Michael Michotek, PeterAccetta, Kevin Ferentz,John Feldenzer,Carl Grant, Michael Cane, Marc Levine, and Ronald Marcus.Back row:Allen Rosen,Mark Venditti,and Frederick McAdam. NEWOFFICERS ELEOED TO MEDICAL AWMNI GROUP aul H. Wierzbieniec (M'74) ha s been elected to a one,year term as president of the UB M edical Alumni A ssociation. Other officers are Joseph L. Kunz (M'56), vice president, and Charl es S. Tirone (M'63), treasurer. Wierzbieniec, an orthopaedic surgeon , is clinical instructor of orthopaedics at UB . Kunz, a clinical assistant professor of medi cine at UB, is a specialist in interna l medicine with su bspecialties in gastro enterology and endoscopy. Tirone is a clinical assistant professor of radio logy at UB. BUFFALOPHYSICIANANO BIOMEDICAL SCIENTIST From left, Eugene Be l trami, Robert Patt e rson, and Harold Brod y . JAMESPLATTWHITESOCIETY FORMSEXECUTIVE COMMITTEE he James Platt White Society has formed an execut ive committee made up of society members . T he purpose of the comm ittee is to help guide the society in the nurturing of the medical school, both financially and emotionally. Dr . Robert Patt erson ha s been named chairman . He is joined by Dr . Eugene Beltrami, Dr . Harold Brody, Dr. Marvin Kurlan, Dr . Richard Narins, D r. Clayton Peimer, Dr. Richard Romanowski, and D r. Robert Bernot. Membership in th e society is open to those contrib uting $1,000 to the schoo l an, nually . Currently, ther e are 66 member s. Those interested in mo re information regarding the society can contact any board member . AlJfUMN 1988 �36 OCT.13 OCT.20 ................... T he H arrington Lecture will be held at 4 p.m. T hursday, Oct . 13, in Butler Audito rium . Edwin D. Kilbourne, M.D., Distinguished Service Professor of Microb iology at Mt . Sinai School of Medicine, will speak . Kilbou rn e is a member of the National Academy of Sciences . "Elevated Cho lesterol: A Public Health Crisis?" will be the topic of a conference sponsored by the UB Schoo l of Medicine and Biomedical Sciences. It will be held from 1 to 5 p.m. Thursday, Oct . 20, in Butler Aud itorium. Registration is at 12:30 p.m . For more information, call 831-3714. . AD IMPLIEDNO ENDORSEMENT he Buffalo Physician and Biomedical Scientist, Volume 21 #5, carried an advertisement for Ph ysicians for Social Respon, sibility that caused concern among some readers. While we have previously covered the activities of this group, to which a number of Medical School faculty belong, we had never before run an ad of thi s nature that invited membership . Did this constitute an endorsement of the group on the part of the University, we were asked? The answer to that, of course, is no. The ad was run through a misunderstanding on the part of the Director of University Publications who at that time was func, tioning as interim editor of the Physician. The ad was brought in by a faculty member and the interim editor assumed that since the professor has been referred by the Medical School Office that referral somehow indicated an approval to run it . This was an error because when the magazin e appeared, the dean was sur, prised to see it. In any case, the respon sibility is that of the in, terim editor and the appearance of the ad was not meant to state or imply an endorsement on behalf of the Univer sity or the School of Medicine and Biomedical Sciences. • T ��BUFFALO PtiX§!~~ State University of New York at Buffalo 3435 Main Street Buffa lo. New York 14214 c. K. HUANG BA 57 TREESROOKer. WILLIA SVILLE NY 14??1 -- Address Correction Requested Non-Prof U.S. Po" PAID Buffalo.l Fnm11 N �Profit Org. Postage lo, N.Y. , No. 3JJ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v22n03-1988-Autumn Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Table Of Contents A list of subunits of the resource. East Meets West Tyke Trike Classnotes Research Medicine and the Arts Medical School People Alumni Events Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n03 Extent The size or duration of the resource. 41 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/309fd2b415ac66de1778e2cee3cea5a5.pdf 5d8f530f9e067b5b683c7541997a7ea2 PDF Text Text Selections from the Wisdom Mind Series Read by Gail Sher (recorded 11 May 2017) Introduction: “Between 2009 and 2013 I wrote a series of eight books, beginning with The Tethering of Mind to Its Five Permanent Qualities, and culminating in The Twelve Nidanas and Mingling the Threefold Sky that are rooted in Tibetan Buddhist philosophy and dedicated to “stretching” English in order to create gaps so that Wisdom Mind might flow through to the reader. The idea in these poems is to not-quite-make-sense. The beauty (hopefully) of the surface language plus the strategy of “approaching narrative” first intrigues, then holds a reader, allowing, in stillness, the dawning of a new kind of intelligence. As a poet, I feel that this body of work is my most important.” Print source: Sher, Gail. Reading Gail Sher. Night Crane Press, 2016, pp. 3-4. File name: sher gail intro wisdom mind.mp3 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Selections from the Wisdom Mind Series : introduction Description An account of the resource Recorded May 11, 2017 Date A point or period of time associated with an event in the lifecycle of the resource 2017 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2017 Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_120 Extent The size or duration of the resource. 1 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings SherInterview https://digital.lib.buffalo.edu/files/original/5cb166e182aa8612b5995a9138c5b0e8.pdf dda7142c8aeb7233df8fd5aa437ef6ed PDF Text Text Mingling the Threefold Sky Gail Sher night crane press 2013 �Y E L L OW 7 �A vein of sun hits a woman’s cheek. What is her face, she wonders, a blush of cheek beneath the long hair of her goldenness. How sunlight fills the sky is how the mind myelenates appearances to her. Whose milt is on the edges. It stands in front of sky such that all she sees is sky. The absolute knowing of sky, weather and sky, like a prerogative that’s said against which she may stroke her child. 8 �Though she sits facing away, as if it is in her, one feels the age of this away as her. The painter paints time locked away from its material, like her own personal face exiled from her face. As if away without location is the real time, the real completion, a recrement of sky, the other loneliness of sky. Rangjung dorge’s face. Its light is not what is in me that way. 9 �As the moon releases into sky, shedding yellow back to sky, you see a person’s face deep in the heart of the eye of one. Day walks out of day losing track of its intelligence, the part of day held back from day or the end of his life which is so heartbreaking. Sound at a distance extends from in front of him. The arc of his face leaks into shape. The space between her face, the moon’s display of face. (The features of her belie her apparent face.) 10 �* The color of day, two figures in a plain, as if two were possible outside of itself as a number. As if day were a point dabbed like paint onto the brief cortex of togetherness. A pattern of her in yellow, such that she too, though he, the he of how they came to be here forever. Where clouds are yellow and birds are yellow, a double portrait of her, which is them as who she is. 11 �It’s like these two things, the way light throws itself over land, them as a pulse, a stream of apposite colors. The metaphysics of grey within a yellow space, or closeness, the duo of her body coming to be the grey. For this she’d received an empowerment. A doleful space of air. A prosody of air. The belly of the mind leaks the containment of them, as how the painter lifts the them of them and simply puts it on a piece of paper. 12 �Waiting is the movement. Waiting is not resting because the aspect of pair, a person’s hat of hair, the tip of the world at the edge of his hair. The man is not. He is thinking about something else. His hat facing light holds the tension of his being there. The skirl of light obscures to fading light. A vague sense of waiting hangs over his elbow. Now he is home listening to its softness as if inside me I have finally found my bedfellow. 13 �* The fold of a tree over light on a road, if she is in the road, the sense that she would be there anyway. An old live tree, like the life of someone screaming, is the language of the tree pushed outside its form. What colors grow untouched in her, her and her, what she sees on the Paris streets. Old registers hard even in a bit of shade. 14 �What is it in a tree that seems to be erased, as if emotion were space, and the subtlety that is part of the tree, the great washing over of space. The way time holds light on the inside of her which is how color organizes itself toward a person. It makes me question whether sky is the same since movement is not limited (I begin to see sky as limited). Fifty three skies settle in my backyard may simply be sky pouring out sky. 15 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mingling the Threefold Sky Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2013 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2013 Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_121 Extent The size or duration of the resource. 15 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/72a7fd334c6fa7fc4a65a584b494d251.pdf 86d1ccd907607b31c9e237fa401d4c7d PDF Text Text The Twelve Nidānas Gail Sher night crane press 2012 �III I walk through trees, a series of squat willows, and see the space between the willows as time. Because it’s not the space, it’s the emptiness of mind (whose energy is grounded to its darkest possible color). Taking birth beneath a tree, I want to feel my longing for the tree, my deep thought of you in its disentangled precision of stillness. One bends, taking its time, a full earth of time. How do I wander into its leaf? 9 �Merely touching earth, gently touching the awareness of earth, like the beginning of day in earth. Leaves stretch to sun, the full breath of sun, but I am left gasping. My reference point is fading. The underleaf is blank. But blank itself catches me in a kind of double-take. A gap exists but she refuses to see it, which is a third sort of fuging, like the darkly yellow on the leaf ’s bottom. 10 �That yellow cala lily, earth and earth-consecutivewith-darkness, a coincidence of blood and dark and color, such a yellow, heavy and unknown. Indexed to light, this card of light folds around the sleeve of your body. We take shelter in abyss, which looks like a color, magenta calligraphed in a cala lily’s cup, deep in the cup, its fire. Color filters light is not the net color that the cala lily tells by way of its earth sign. 11 �IV Night is her skin, its pleats the quiet fold of her. Background and foreground are the memory of a skin wearing dynasties of her. A bird touches night and her skin moves as if it were tied to this. As if a mass accumulates in a narrative of space. Now preserves as a robin opening out of its capacity in me. I want to pet it. I want to cry. The intimacy of a word before it is a word, so that it’s now, in the interval, wears its own full body. 12 �How many tiers live in a word and the hues of the tiers in the space of the word’s awareness. I, the word, in the space of my form, imaging my form, like a lion in its death throes. I swallow you and emergence in a word. (The word’s shape is how death looks like this image.) A cold press of wind through a word’s tired body could be hell or a word separate from its word. 13 �To feel into a word, which may be neutral, but may be like an animal who gets the word, as if the word were a lesion in its body. The lesion could be freedom because a word has no location, like a break in the hills. (Mostly our words are skeletons of themselves.) One senses the transparent quality of its body, an unchangeable power that runs alongside its body. I am a word. I am the ultimate fearless word, beauty or sky so that there is nothing in the way. 14 �A word lands on her cheeks. Unspeakable is the word. Unspeakable is the crutch, the cane of the word, the transparency of the word that relates to her as a body. As how several letters cast a sense of time, like a painting casts depth, which is the image of death in a room. Then the dream of the word amalgamates. First there’s sky, then the full comportment of a body. Sky-swaddled words catch the light of death. I want to believe each word, like pray to the word, because you want to believe in its denial, forgiveness, everything. 15 �A word lay in snow. If you lift the snow and suspend your idea of the possible, it’s like space linking space to all constellations of that word. The sheer resplendence of a word, as how the daughter of a word, a whole lineage pouring out from its god-father. A child picks up a word. It’s the enjoyment of the word, the shape of all commodious expressions that the mind living in that word carries. In a tapestry of texts, I am in the moment of one, as if I had gone to sleep. 16 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The Twelve Nidānas Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2012 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2012 Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_122 Extent The size or duration of the resource. 9 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/f594c528e72f77d68f1245e3360857f1.pdf 638e846a857ad952c93309ac9fccd2f7 PDF Text Text Figures in Blue Gail Sher night crane press 2012 �DAFFODILS A woman alone at a large open window gazes at the sky. The soft flesh of her arm folds around a basket. If she is dead, the colors may be alive. Her soft flesh holds a premonition of her, calls its form within the form of its space in sky. She is miming sky with her body. Taming its color, like a double her of color. There is a sense of intense activity in the buildings and neighborhood, so familiar, yet her skin is not that. 1 �Angst from the street, but what prevails is the face of a person waiting. An agony of light chugs through her body. If she could roll out her body, like make a road of her body, there is the sense of that being all there is. As if her flesh were a habit, a woman stands in sky, catching it in the drape of her dress. 2 �As she rests in the bare window she is dead. I (am dead) she says. It stands like a point of view. A strip of death is on the woman’s arm. She wants the death eagerly, like time tucked in her arm. On the crest you can just touch death, she feels. She sees an arm (the boundless ordinary nature of her arm) in a gown, in the sky, wrapped in a column of the unsaid. 3 �Sky like sea, around a woman hugged by sea. A man is a response (like sky and a sea wall). The float of him sinks, then appears on the horizon. I am exempt from sky if I empty myself toward it. The flaccid man’s ribs absorb the thick musculature of her arm. Daffodils range, placated by time, but it is the habit of deep slumber. 4 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Figures in blue Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2012 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2012 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_123 Extent The size or duration of the resource. 5 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/323a0537bfdf16a399f8bbd48e94c549.pdf fa4669ade19b0d7e0c88f0175920dbb3 PDF Text Text The Bardo Books Gail Sher night crane press 2011 �Bathing Suit �A woman begins, is the value of space, like a child in a pool, shuffling air in which hard wood is air. She breathes through wood, taking sharp quick breaths. I want the soft cloth of children, she’s saying. Her breath has height and the texture of children swimming, new swim, out and out, yet clearly touching the bottom. The mind of wood may rest itself to completion, she murmurs. Wood and air is swimming there, in the space of air filtered through a dark forgotten memory. 16 �She is complete air. She tucks herself in air, as in the taste of breath, the babysteps of breath. She is anterior to her air and tries to tie air like a ball. Someone gives me a ball and I tie up the ball. I feel certain that I want to tie the ball. She calls it air because it’s there like air, but actually it’s a kind of stupidity. 17 �Swimming is like a captivity in its body. Every minute in a row I am swimming everywhere and wanting to spend my time swimming swimming swimming. Because death, too, is an integer. I say ‘grass’ and it follows me into longevity. The absence of time, like grass without time, or a lizard in its skin but outside time so that its purity lay in its body. The brain of the sky snaps an instant to its purity because everything perceived is Buddha Vairochana. 18 �My mind vanishes then. Inside its skin it has its male and female aspects. A pool of mind is a passage of light, raw light, the membrane between the watery part of light. A person flows through wood and is the breath of a swimmer, like two dead people in love. Air in a heart is the same air resting there. 19 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The Bardo books Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2011 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2011 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_124 Extent The size or duration of the resource. 6 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/520af15a469240fbc4c25ff7ac9e7528.pdf e8c862c9b0558fbf6461a6da97af8005 PDF Text Text White Bird Gail Sher Q night crane press 2010 �1 A man wearing birds, sitting in birds, inside the birds’ flow. Together they’re called White Bird. White Bird grows tall. White Bird hugs his own legs back. The meditation of sky streams into his heart so there’s a passage of heart into which he may relax. White Bird relaxes back into his heart, breathing white, like the beauty of a seed or wind in a bird’s hair. A man sits in wind wearing few clothes, but the birds come and sit on him like clothes. 57 �White Bird stops. Summer light swarms his shell and the blue shell breaks. The beauty of his wing fills with sky. A gull too drags its sky. As if it were an ear gathering in sky. Beauty is sky. Beauty is rain in sky’s past sky. 58 �My mother’s arm is pure, its curve of sky seeping into structures. Then later someone says, That person is a dead person. So then I think, The beauty of sky’s color flows from her arm reminding me of her arm. I want to wear sky, I holler. (I am in tune with degrees of my mother hanging from death like a soft shoe.) Her yellow armpit sags, like old newspapers would be lying fallow as they do on distant fields. 59 �A man buys socks but it is really death lurking in sky. I want to dust sky out so that my limbs swallow themselves. He looks, passing by death, as if he is new, in sky now, as he puts it. O look at the birds! They’re combing each other’s hair! (He’s watching a bird gather its gorgeousness.) My mother is a line. Within the death-lines she is one. But a node on her blackens and then she is not my mother. 60 �I know a bird whose color is sky before the sky admits itself. Like the brain of a color if sky admits the bird. A mountain is visible inside the bird then. Its color dies then. A queen bird releases into sky. There’s the sky! someone says, as if there is sky, the location sky. That bird knows me well, I’m thinking, because the bird is mostly dead. 61 �Here is a corner of sky, mother says, fondling a dead bird wrapped up in her pocket. (The bird had lost sky. That’s why it died.) I am the oscillations of a flower, inside, like a flower’s brevity, she whispers. A tall bird tumbles through sky. The touch of its voice is like a raw egg folded into zero. My mother feeds me air, the tablature of air, doubling air, forcing it to become air to something. 62 �I dream of air (a box of air) because I conflate air with my dead mother. She could taste the flavor of the box and in her mind suck out the box. (Secretly she criticized people who didn’t suck.) Her feet swell in air. The ascending foot, like you could crawl inside the foot. Who is the end of my mother? Who is the end of my death? (I am organizing myself backwards.) Flowers fall, but mountains blossom in air. Born in air, I’m in air already, like a broken piece of air. 63 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource White bird Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2010 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2010 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_125 Extent The size or duration of the resource. 8 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/67125cd41265b840e85b745acd74ea9b.pdf 3f50323259074a698850aff1c2263a62 PDF Text Text Mother’s Warm Breath Gail Sher Q night crane press 2010 �ii My mother is a place. And a being from there having qualities, as if she is also from there. From the inside of her being her, gradually becoming her in the same taste as russet-pink. Russet-pink is a field carrying one’s pure essence, like a whiff, oh! that’s her! Maybe some pawmarks. Totems of her gaining belly from herself. 83 �A place is by chance (like pain is a guess). Like a lid with its definite jar, she’s attached to this, thinking maybe there’s no other jar. The lid has a slogan, which she wears and thinks it’s not right if her family does not. Like a birth word, say. Every person has one word. 84 �Held adrift by old old hearing. Don’t touch you! says her own face. (For she recognizes the previous resentment and its marks on her old face.) As if spring follows summer and we are already at the beginning. If my father is murdered, does that mean I am dead or (like one’s face in sound) about to be dead? 85 �A legacy of light is separate from reflection, like a legacy of dog only sees itself. So there is mourning but not knowing. She could be a dog thinking she’s a dog. Her formless growl cracks like a flower, like shards of voice but one hears only the thinnest outermost skin. I harbor myself in the familiarity of something, air, leaves, peacocks running across a field. 86 �People coming in like the last second of her knowing. As if she’d snapped her teeth. Stealing knowing, she becomes simple. In the interstices of a plan, like knowing skips to what’s there anyway. The value of her in the real actual sitting down, till she rests. 87 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mother's warm breath Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2010 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2010 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_126 Extent The size or duration of the resource. 6 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/4c50546673596aea46a95b58702bd20f.2 2d23e4ead1d55271decf07d1bc2cfb7e PDF Text Text The Tethering of Mind To Its Five Permanent Qualities Gail Sher Q night crane press 2009 �ii A gull circles a wedge of water, marking the water with her eye. The memory of her skin is limitless, like the memory of her cry, before a kill or later for the sake of others. Wind, too, gains qualities by its forcefulness with things, its hand, say (a piece of sun cut off). A crack in light, like a painting of light. The palette of wind is gold, she mutters, the boundary of a man playing chess in light being the dead person. 65 �A flower emits voices behind falling sun. A flower is soft and the pain of soft reminds her of a sea of heads. As if her life dreams its own violence. If a bird disappears, she may have asked for this to happen. She begins to think that mountains wash out mountains. That the sea of heads form a land on which to walk, which she calls the isthmus of larks. 66 �So a bird flies flat and what is it about its sleek blue mind. Is a bird a bird or quality of place dawned by the bird? you mutter. You look at a chirp, though it could be surreal. A tree comes just at the point of sky. Phenomenology of the tree rides not so much on the stature of the tree but like the tap of a cane, where it goes after it is hidden. 67 �A sycamore branch in late light sheds, as if sun splashes scattered shards of larks through needles of light-fall. Time is little drops like from a spout drip-dropping the bough. Its stem is underground, someone says, and I have a memory of a double stream flowing deep beneath the earth. You tap on the stream to awaken the stream so that the leaves stop shaking their light out of it. 68 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The tethering of mind to its five permanent qualities Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2009 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2009 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_127.2 Extent The size or duration of the resource. 4 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/e352da3b0f0f091d6be77062c6e000cd.pdf 7d3dc78118ecca6bbdce57da32d9774a PDF Text Text though actually it is the same earth Gail Sher Q night crane press 2008 �Tiger Dream Sun from behind the mountain falling on the threshers and reflecting from the lake gains depth from the sound of falling. The sound of water over stones at the lake’s edge is like a darting bird. If she wakes, she couldn’t say the bird disappears, but its breath dissolves, like an undertow at sea. How igneous (fiery) and lucid are the bodies of tigers, she muses. 21 �Commentary Each day the sun slips over the crest of the hill and lights the yellow grass. A cat climbs the hill as though dawn were in its head, entwining pieces (petals in branches). A day-moon slides below low tide. Fall-out from one’s skin protects it from further harm. Tide emits tide as she wanders down the coast, empty as a battered jug. 22 �A woman carries a jug dexterously embroidered on silk. The woman’s skin shines like the interior pink of a river. The dimensions of the jug’s magenta is implicit yet exacting. Out is not a direction but an aspect of conference around the jug’s battered aggregates. Bringing yellow out, where out is a structure of color and light, intensifies out, as if its DNA changes. 23 �There is an hour in which her memory will be there, where light falls in rain on a tiger’s flickering head. A stone woman prays, hearing sun in sun. (She dreams its precise nest.) A magenta flower glows so that I feel free at last. A magenta flower glows, disappearing in its skin. Light jumps back as if she has that person again. 24 �Death is color-added-to-color. Color learns color by touch, like the feel of rain from one’s bed. What if the occurrence of harm refers to the difficulties of offering the harm? In the broad space of an animal, a wound in a woman’s thumb feels like embroidery of jasmine and honeysuckle. The necessity of something and its form is the tiger sleeping, tail to tail, in tandem with something. 25 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Though actually it is the same earth Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2008 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2008 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_128 Extent The size or duration of the resource. 6 p Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/226f0cc85e4a7256ff5bcacf08714c94.pdf 50abf35af71a2bd58f9b0e6d942dde8c PDF Text Text Mary’s Eyes, a new voice in the radical language experiments Gail Sher has been exploring since 1981, joins the ancient passion of devotion to the cutting-edge linguistic so characteristic of her work. In addition to her poetry, Gail Sher is the author of One Continuous Mistake: Four Noble Truths for Writers (Penguin), the first of a widely-praised series of books on the craft of writing, informed, as is all her work, by the practice of Zen Buddhism, Tibetan Buddhism and Yoga. Her poetry is archived in the Poetry Collection of the University at Buffalo, library.buffalo.edu/collections/gail-sher. For more information and to read her poetry online, go to gailsher.com. Gail Sher Mary’s Eyes �Mary’s Eyes �Also by Gail Sher PROSE Reading Gail Sher Poetry, Zen and the Linguistic Unconscious One Continuous Mistake: Four Noble Truths for Writers The Intuitive Writer: Listening to Your Own Voice Writing the Fire: Yoga and the Art of Making Your Words Come Alive From a Baker’s Kitchen POETRY Elm Early Work Pale Sky Five Haiku Narratives Ezekiel Sunny Day, Spring Mingling the Threefold Sky The Twelve Nidānas Figures in Blue The Bardo Books White Bird Mother’s Warm Breath The Tethering of Mind to Its Five Permanent Qualities The Haiku Masters: Four Poetic Diaries though actually it is the same earth East Wind Melts the Ice The Copper Pheasant Ceases Its Call old dri’s lament Calliope Who, a Licchavi Watching Slow Flowers DOHA Birds of Celtic Twilight: A Novel in Verse redwind daylong daylong Once There Was Grass RAGA Look at That Dog All Dressed Out in Plum Blossoms The Moon of The Swaying Buds Marginalia la KUKLOS Cops Broke Aide Rouge to Beak Having Me (As) on things which (headpiece) touches the Moslem From another point of view the woman seems to be resting �Mary’s Eyes Gail Sher night crane press 2018 �Copyright 2018, Gail Sher gailsher.com All rights reserved Night Crane Press 1500 Park Avenue, Suite 435 Emeryville, California 94608 No part of this publication may be reproduced or transmitted in any form without permission in writing from the copyright owner and publisher. ISBN: 978-0-9978313-2-0 �For Brendan ��contents Mary’s Eyes 1 Sing 13 ��Mary’s Eyes ��i cold and snow. the sound of snow falling. the young novice’s eyes it’s (the) forgiveness that she notices (an old noticing) she feels thinks about Christ. will she marry him. she has already married him (she feels) asks if she is sure [bells sound in the background] figures appear. the clink of plates, spoons, hush of nuns eating the rule of the meal (omitting) the meal the weight of the prioress’s eyes readings turn to time (the word Mary repeated) verse empty of her suddenly 3 �ii a tall girl and her girl (their “astrology” of brotherhood) the eyes of one watching from a second-floor window what the watching girl is thinking versus the couple— walking, carrying books, talking loneliness and time. more loneliness and time “crippled time” she muses opening the sash for a better view as if time and her ribs—as if time stopped her ribs “see” she presses placing a hand on one a girl within the girl arrives behind the color orange “break it” she is yelling, throwing food at birds (she is always throwing food at birds) “grandpa fed the birds” she explains she says “the” as if the birds were his or always the same (or something) “the” (the article) making the thing “definite” pinning it down like a thumbtack 4 �orange and birds all curly like his hair mishmash of thoughts underneath grandpa’s car, intelligence, newspapers, noise the grinding of sound inside his head [inside her the smear of his aloneness or what must have been his aloneness] maybe he felt the birds would understand—if they would die or if HE would die “my feelings belong to sky they go up and are swallowed by sky” he would rail (being a person inside out or that his gravitational pull was wrong) as if words were too tight for his body or that he’d say, but instead of words there’d be sadness “the infant Jesus screams can’t you hear him screaming” he’d cry (actually I think I did hear) 5 �iii lines & squares, the enchantment of their honesty the certitude of straight untarnished by thought carves one on her thigh like a symbol of something important then forgets the thing that was important the mark (tattoo) is blue stands for Christ’s feet that eventually turned that color the turning of one color into a second color the brown of his feet still in Mary’s eyes the transmutation of space infected by what happens in it or the imbuing of a form with the means of a previous form touches a line forcing it to speak to say what she forgets (because she really can’t remember) the violence of gone (actually gone is impossible) what is its shape before it becomes its line or if the line is an amulet holding (probably-irrational) reverence beauty this thorough 6 �the image of his feet nailed to the sun its ball of red rising [here the landscape becomes an action that moves aggressively toward her] cups her ears so that it’s paused thinks of the letter F then E E and T summoning them to her so that she is not alone “with a letter I can be WHEREVER I want when I hold one in my mind I forget everything else” [the alchemy of WHERE versus the unawareness of a leg (for example) as if the leg were a mermaid’s rubbery tail (i.e.) a memory from the past trying to be from some other past] “maybe words are stars secretly” (she is thinking) turning one around (handling) it carefully because lightly let go a word suffers “words glitter and shine all by themselves in the middle of the night (seemingly) like a winter star all by itself (hanging by itself) seemingly” 7 �interlude alone in an open room water and wind (their) hardness in time wearing out time replaced she feels with time the freshness of wet blows around her lightly [her sense of the sea (awareness) of time (her presence in the room) co-adjacent with time] her dog too on the rug below one eye opening then closing (seemingly) content the sand covering its body and what the sand says about its life the dog’s ear and what the dog is noticing (waiting) for something to end sees the waves of the sea melt into sea its song vanishing to nothing the rhythm of the vanishing repetitive (prayerful) the earth (too) which the sea hears 8 �listens to sea (the sound of the sea breathing) the implacability of sea time its power and its blueness circling her like a tiger the tiger’s immaculate stealth 9 �iv blue late-April sky, sound of waves lashing the girl’s jaw remembering something ungraspable the sea itself ungraspable thin (soft) time which she dreads the coming of harm, ripening and then, moonlit coming to know (coming being its own naked color) “soon” she thinks but it’s vague the upshot of vague like a portion of a color notices sky, a shadow of a tree, the mind of the tree transferred to a form what the form may imply and whether or not she generalizes its significance reads the clothes for clues 10 �sees Jesus in his robes rising a little (bowing) toward her (slightly) sees herself seeing the vivid reality of his form the body of Christ (touching) it with sight (its) aperture and tone with regard to so much happening the event—Jesus rising—and then again rising— “toward her” had been there the first time (she is realizing) as if his life took place (in her mind a lion yawns) [but it’s clapping. someone is bowing to an act seemingly ended the impossibility of blue (since it stands for itself) ending] authority of blue (standing for itself) attentive (to) what we call color which may have taken place previous to time or even in some other time “what is my color before there was color” ransacks blue as if it were light instead 11 �she is what one is inside of drawn to what is known also sense of fallowness even her hair as if once it was some other color such that it’s cheap the slut factor of hips seeing the calling flammulated then, covered with feathers her name flying away away = coherence (as in food afterwards) the aura of a plate lingering there but in her mind it’s the girl’s blue-feathered shoulders “an owl at night, me the shrew” her shrew has no snout however 12 �Sing ��i a cow hangs toward the end of sky its green moo dead (a social cow) the archer thinks splotches of blood recede into sky his bow too recedes holds feelings of cow cordons off sky so that cow can rest “wipe the blood off ” someone says the cutting of time as if time comes in the slow tones of a woman the subterfuge of having it leans into seriousness (as if) time is a joke then “getting” the joke “what about eggs” someone says, pretending time is a koan 15 �“mind may eat without time mind may eat with neither food nor time” (as if food were time told by the throat making her have some) pleading YES as a motion citing this or that as others pass unnoticeable in her mind’s eye intends again, to eat (again) [a fool eats in slow-motion footage, reel continuous maybe something crawls out of tight dark space] the bag of her (she feels) socks in a silly pile burglars appear. what should she do is someone there. am I there police fence her yard barring her off, warning her probably. hoarding occurs probably + images of climbing—there’d be rain—without footholds, without grab-able bars 16 �reflected in (slight) convexity of ovary area (eating) off the knife, laughter off the knife the pregnancy of knives, cans wrapped in paper or things wrapped in whitish paper 17 �ii a bluebird’s song and then the sky afterwards propelled through time as if they were together blocked by shade, the shade carrying light anyway (its bullying white getting in anyway) its white versus ordinary white white releasing white such that the white of white is freed (white separate from “white”) releasing significance nonverbally white without releasing significance [having freed a color (separate from freeing) refers to alaya of existing like the black part of white such that snow exists for black also] scabs of snow on tree tip also the way it bunches on a branch, a bird in the branch if it moans (in the extreme heart of a woman) 18 �“the sound of snow could be air weeping” as if music were there but then it is over “over” as an idea turns into sky, the gray of mouths opening sings sky forward into treetops the method of sky, voice, snow in choral time no sound but sky the liturgy of sky (and before sky) mimes the One in a row silent canticles in a row 19 �iii moments of snow devolve into blue asleep to itself as if its brain were blue also slow (into the basket) slow into her (as if) trees are following her but the trees are narrowing up to her she will be a bird (she is saying) an ultra bird thought by one in pain one bird walks from shadow into shade tipping the balance slightly one bird versus no bird or if the bird doesn’t sing or fails to sing creates an absence of the bird loops of birds fight wears necklace of birds-in-a-row fighting wears necklace of birds-in-a-row dead 20 �an abstract bird clears in her mind [GEORGIE but her voice is slack] solemnly (solemnly) ice + the vague marrow of its bones “was there time” like a swan (leaves) its name in the air feathers & bones mute “lay dead, lay dead” snips time touching its feathers “poor Georgie” said (a bit bleak) sings in wind (adds it to the bird) 21 �iv [fades to black winter lake, swan (in it) swimming the midriff of the lake (its) hollowness in space] “look a crane” someone says taking out binoculars she turns to see the crane but SHE is the crane the hood of her head covered with snow offers condolences to her but SHE is the one offering condolences “cranes are always offering condolences” dancing in snow with their tracheas screeching bony rings rattling the emblem of her throat arched high in the full moon escutcheon of moon with medallion of her throat sings to moon which she feels is SO watching (hopes to hear the moon) 22 �the sound of a thumb presses back softly, the silence of a thumb in the pit of her stomach the sound moves to her throat its thumb speaks in her throat like a second throat aware of a thumb as a mouthpiece of pressure sees with her mind it being in a grave the lowering of the thumb (loaning color to earth) frill of snow covering it up [a drawing of the thumb: graphite on paper 1963 is written near the bottom the writing is cracked though] 23 �Mary’s Eyes is set in Minion, a typeface designed by Robert Slimbach in the spirit of the humanist typefaces of fifteenth-century Venice. Minion was originally issued in digital form by Adobe Systems in 1989. In 1991, Slimbach received the Charles Peignot Award from the Association Typographique Internationale for excellence in type design. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mary's eyes Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2018 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2018 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_129 Extent The size or duration of the resource. 33 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherPublications https://digital.lib.buffalo.edu/files/original/c8068b1ae70a9a2cc37105c8bc41c7d6.pdf 978989a5dfec233c09e3634317feeae5 PDF Text Text Gail Sher interviewed by James Maynard, Curator of the Poetry Collection at the University at Buffalo, Emeryville, California, March 19, 2018 JM: Well, to begin today, this is Jim Maynard, Curator of the Poetry Collection at the University at Buffalo, home of the Gail Sher Collection, interviewing Gail Sher at her studio in Emeryville, California on Monday, March 19, 2018. Gail, we are having this conversation at what I think is a very interesting point in your writing career, in that you have recently been consciously reflecting on your development as a poet and reissuing some early work, while also, simultaneously, producing new writing, which I know you do on a daily basis. I think this provides us an excellent opportunity to talk about your poetry and poetics, as they may have changed over time to where you are today. After studying music for several years, followed by undergraduate and graduate work in English and Middle English, and then 11 years of practice between Tassajara and the San Francisco Zen Center, you made the conscious choice to focus your attention on writing. Your first published poems appeared in the magazine Credences in 1981, followed a year later by your first book, From another point of view the woman seems to be resting. Since then you have published a total of 37 books of poetry and several works of prose, including in 2016 Poetry, Zen, and the �Gail Sher-James Maynard Page 2 Linguistic Unconscious and Reading Gail Sher. Both of these, and especially the latter, provide your readers with a remarkably useful set of contexts for exploring your work and its “habitats,” as you say. And my questions here today in many ways depart from these two texts. In Reading Gail Sher you describe your work in retrospect as taking shape in four phases: Radical Language Experiments, 1982 to 1997, Asian-Influenced Work, 1997 to 2008, the Wisdom-Mind Collection, 2009 to 2013, and Late Work, 2014 to present. When discussing the first, you write that early on you realized that your “concerns” as a writer were “of a poet, not a novelist, short story writer, or essayist.” And that you “came to understand that [you were] a poet because [you thought] like a poet.” What I wanted to ask you first is, what does it mean to think like a poet? GS: Poets care about language. That may sound simple, but it's a life's preoccupation. So when I hear anything, even you reading that introduction, I hear the particular choices of words, like you used “depart” in an interesting way a few sentences ago. And there will be rhythms that are particular to who you are as a person and onomatopoetic inflections that typify who you are and where you're coming from. And that's what I hear. �Gail Sher-James Maynard Page 3 And then later I'll go back to the import of what you are saying, which is what most everybody else would hear. It's like a giraffe is oriented in the world in a very different way from a lion. And I'm like a giraffe, in the sense that I just don't function, I don't receive my experience in the same way as other people. And it's a constant problem. JM: Well, the word that keeps coming up for me, and I think I'll come back to a couple of times in these questions, is attention, which I can't hear the word attention without also hearing the word tension inside of it. So based upon what you just said, then, how would you say poetry, then, differs from prose or fiction or nonfiction? GS: Well, I can't speak for poetry in general because I don't think all poets come from the same place. And I'm not saying this place is a better place to come from. I'm saying I can't help it. It's just like who I am. But it differs in the sense of a novelist is thinking about character development and ethics and who is going to fall in love with whom, and who is going to reject whom, and how subtly all of these things take place in society. None of those things are my concern. In fact, in my poetry I have to bend over backwards to leave the story out so that people will pay attention to the language. �Gail Sher-James Maynard Page 4 JM: That brings me to my next question in terms of thinking about language, in hearing it first before understanding, as all good giraffes do. GS: Right. JM: I know from early on you were very actively engaged with music, having played piano and harpsichord and having studied music theory and composition. How do you think these experiences may have shaped this thinking about poetry and, in particular, your own reimagining of Eastern literary and musical forms from your Asianinfluenced work? GS: I actually formally gave up music when I was a Zen student at Tassajara, so that I could use all of my musical ability for writing. And I believe that I do do that. And it's only been in the last few months that I've taken up a musical instrument, but it's also only in the last few months that I've consciously ended my career as a poet. And in order to emphatically do that—because I did that once before and it didn't work; I ended up writing yet another poetry book—so I decided to write a novel. I used to hate poetry. And, in fact, I distinctly hated poetry and all I read was novels and literature that wasn't poetry. And so when I took up writing, my idea was to be a novelist. And I only had to learn later by default that my interests just weren't that of a novelist. �Gail Sher-James Maynard Page 5 And so now you're probably wondering, "How can I write a novel then?" Well I hired a tutor and I'm taking lessons. JM: So have you found yourself, then, inverting what you just said? GS: No. What I'm actually finding is that the lessons are completely boring, and I can't do anything that they're really asking. And I've got it down to sort of the way they've got it organized. And so I just flip to the back page and I read what the assignment is, and I hand them not the assignment, but I hand them what I've written already in between when they read my work the last time until I'm going to turn in this batch. They really want my next chapter and I'm really sending them an array of pieces that sporadically cover, basically, what this story is going to be about. It is not really a story, actually. JM: So how do you feel having so long tried to suppress that narrative in your radical language, to now be jumping in that side of the pool? GS: Here's what I really think. I think that the best novels are actually poetry anyway, but they're not language-based poetry. They're more maybe rhythm-based poetry or meaning-based poetry, which I have never written. So in a way, you could say I'm just writing a different type of poetry. But this is not my passion. I better stop and say something else. And this may be because you haven't gotten to the Wisdom Mind part yet. �Gail Sher-James Maynard Page 6 JM: My next question. GS: Okay. Well, I'm going to answer that question right now. That's really important. It's why I can stop. It's why I can officially say I've done everything I set out to do as a poet and I don't need to do it anymore. What I set out later to do as a poet, when I realized that it was my job and it kind of fell to me to do, uniquely, because of my, not only Zen background, but even more particularly Tibetan Buddhist background, I became aware that other languages like Tibetan and Sanskrit have the ability to convey wisdom in such a way that English can’t. For example, in Tibetan there are 15 words for love, and in English there's like one. So I set for myself the poetic task of enlarging English. So I feel like what I've accomplished as a poet, primarily, is stretching the English language. And the way I've done that is by leaving meaning out, but using language so that it implies a meaning, that it makes you think there's going to be one there any second. So if you sit with a very open mind, almost like a meditative mind, and read my Wisdom-Mind poems, you will find yourself going beyond the language into some other place. And that other place could be a wisdom-based place which is beyond language; whatever it is that's beyond language. And that's what I've strived to do. And �Gail Sher-James Maynard Page 7 by the time I got to The Twelve Nidanas, I felt like I had done that exponentially. The Twelve Nidanas takes place on about five different levels. And I felt like I was never going to do it any better than that. And there are a number of books leading up to The Twelve Nidanas, and there's one that follows it that's sort of a coda [Mingling the Threefold Sky]. I felt like I don't need to do this anymore. This is really, really hard. And the pitfalls are, since it doesn't quite make sense, it can also sound like nonsense, or it can sound silly or something like that. And that's not what I was after. So I had to toe this really careful line to neither be silly nor nonsensical, and also not quite make sense, so that the reader would make his own sense, but beyond language sense. JM: This always reminds me of, I think you find it in both Eastern and Western discourses that there is this long-time animosity between poetry and philosophy. That poetry makes a kind of experience possible. That philosophy wants to valorize and describe. GS: Yes, that's right. JM: But in describing it it cuts it off from its life force. GS: That's right. Because wisdom can't be described in language. Wisdom goes beyond language. So that's where my way of being a �Gail Sher-James Maynard Page 8 poet can do that. If you were like a novelist you wouldn't be able to do that, or if you were a regular poet who talked about anything. Really, I'm not talking about anything. I'm making something happen for the reader by the way I use the language. So I'm distinctly not talking about anything. So when I stopped writing that kind of poetry, the first thing I wrote was Sunny Day, Spring, which is way more prose-like. But what I loved about that book is that I said to my friends, "So it's 113 pages and it doesn't say anything." And so I was very happy about that. But then later I was still determined not to write poetry. And then I wrote Mary's Eyes, which, actually, I'm very fond of that poem, and it is a poem. And it took a year-and-a-half to write those 22 measly pages. But it's unique in a completely different way from my other poetry. JM: Just hearing you speak now I'm reminded, too, of the great Cage line, "I have nothing to say and I'm saying it." GS: Right, right. Yes. JM: This notion of interrupting the mind's habitual activities of sensemaking, that, for me, when I talk about that as a reader, both your attention and your use of tension, that's the tension. GS: That is the tension, right. �Gail Sher-James Maynard Page 9 JM: This demarcation between making sense, but deferring it, and kind of going back and forth. GS: Exactly. JM: So this space for wisdom that can be possible through language, do you think of it as a non-conceptual type of knowing? GS: Yes. JM: It's hard to talk about outside of its performance, but could you say a bit more about that space? GS: Well, that space, what got me started on that was the 12 years I spent, or 11 years or whatever it was at Zen Center sitting a lot of zazen and feeling at the end like, ugh, this is a total waste, basically. And then later I had a glimmer, actually. When I was at Zen Center I actually had a glimmer of, "Oh! I know what this is about. This is about the body. The body is what is understanding here. If there's anything to be understood you do it with your body." I had flickers of that when I was at Zen Center, but nothing like that was ever talked about, and so I never dwelt on it. But later I realized for absolute sure that it was the body that understood Zen practice, and that I actually had gotten everything. I actually had gotten everything. And I feel that was later confirmed, and I won't go into �Gail Sher-James Maynard Page 10 that story. You asked me how Zen practice and Tibetan Buddhist practice informed . . . JM: Uh-huh, and just to hear you talk more about this, what I think of as kind of a non-conceptual or non . . . GS: It's not conceptual. My first glimmer into non-conceptual came with the understanding that it was the body that got this kind of knowledge. And then my second, not just glimmer, but in depth round of it came with Tibetan Buddhist spiritual practice, which is very emphatically non-conceptual. And there's a huge portion of it that's just simply rote practice. Like to do the ngondro, which in Tibetan Buddhism you aren't even given your first anything until you complete what's called the ngondro. And each lineage has its own ngondro, so there are different ngondros. But the ngondro that I was given has five practices that you repeat 100,000 times. JM: Wow. GS: That's a lot. It took three-and-a-half years. These are called preliminary practices, before you even get to the first real practice. And so throughout all of that, and then also finally getting to the real practice, one gets a feel for where this wisdom lives. And it's that that I was working with in the Wisdom Mind series. �Gail Sher-James Maynard Page 11 JM: Do you think there is a connection in any way for yourself between writing and Buddhism and psychotherapy? Is that too much of a leap to make? GS: I would say the connection is there, but it goes from Buddhism to psychotherapy, and Buddhism to writing. I don't know that it goes full circle like that. Buddhism, definitely, informs my psychotherapy practice, absolutely 100 percent. More so than any theoretical model or this and that. It's informed me and I'm the tool for psychotherapy and that is how I work. And so not everybody likes me and so be it. But the people who do really do and their lives really change for the better, and I see it every day. And Buddhism informs writing in the way we've already talked about, like this whole Wisdom Mind thing. I don't know if there's like a circle there. JM: But it sounds like Buddhism is the key. GS: Buddhism is the key. But I've practiced Buddhism at least 40 years pretty intensely. So you can't be that intense about something and not have it be in your blood. It's the way I live, really. JM: That kind of study must re-hardwire your brain and your attention patterns. �Gail Sher-James Maynard Page 12 GS: It does, even to this day, when I'm not doing formal practice anymore. I made a conscious decision to just accept that writing was my way. And poetry is a Way with a capital W. And so I finally came to peace with that. JM: Thinking about poetry as a Way, I've heard many writers talk about their feelings, however sometimes vague, that all of their books, no matter how different they may be from one another, are somehow all part of an overall or overarching continuing project that they see taking shape through different parts or fragments. As we talk here today, do you have that sense of your own trajectory as a writer, or do you think of these four phases as distinctly separate periods of your work? GS: No. I definitely have the sense of them building, and then culminating with the Wisdom Mind series. And I feel like that book, The Twelve Nidanas, is the culmination of my writing practice, plus the one right after that [Mingling the Threefold Sky]. And from there, I decided to just have fun after that. The only book that I would put in a serious poetry category after that is Mary's Eyes. The others [“Late Work” 2014-2016] were just fun and I'm doing fun now. JM: I'm quite fond of Mary's Eyes. I think through the language there is a real construction of a space for contemplation in that book that I find quite powerful, actually. �Gail Sher-James Maynard Page 13 GS: Thank you. JM: Almost in an artistic sense, in that there is something almost dramatic about it. It's as if you're creating a stage for something to happen, for something to take place, a performance. GS: Yes, I was. That voice is different from all my previous work. And that's what I'm so pleased with, that it is distinct, and that I felt it was successful. But it took everything out of me, and so I'm writing a novel now. JM: And here's a question that I've actually wanted to ask you about for a long time. I've always been struck at how across your work these 37 years I keep coming back to use of parentheticals. And in Reading Gail Sher you say the “parentheses don't contain, they shield.” And then quote Kathleen Fraser on their ability to destabilize a text. Could you talk a little bit more about your use of these parentheticals in all of your work as both sheltering and disrupting something. GS: Correct. And, interestingly, for the very first time in my whole writing career, in my novel, I'm not using parentheticals at all. And every time I'm tempted to, I go, "No, no. It's not right." Isn't that interesting? It's interesting to me. I think parentheticals were right all the way from my very first work. I bet you, when we discover that first piece, whatever it is. �Gail Sher-James Maynard Page 14 JM: We'll track it down. GS: I bet you're going to find parentheticals there. JM: Well, I read them all so differently. Sometimes for me, as a reader, they give a multivoicedness to the text, as if there's a different voice speaking. Sometimes they have a tendency to shift the point of view from an interiority to an exteriority. GS: Yes, correct. JM: And sometimes they seem to shift things altogether in terms of register and tone and voice. GS: It does all of the above, yeah. I know. That's why I'm shocked it's not happening in this book that I'm writing now. It's not happening. JM: Well, I'll be curious to see how the novel ultimately ends up. In addition to always being interested in your use of parentheses, from the first time I read it my absolute favorite line of yours from Poetry, Zen and the Linguistic Unconscious is the following: "My biggest responsibility to myself as a poet is to remain in the realm of the unknown." GS: Yes. �Gail Sher-James Maynard Page 15 JM: "I don't write from an idea or concept or from any other analytical place. My writing arises, and I am constantly surprised by it." Now, I have to admit as a long-time reader and enthusiast of Robert Duncan's, this seems where you and Duncan are almost sitting in the same chair together. And this, certainly, I think, has many indications for thinking about the Buddhist element you've been talking about, as well as the psychotherapeutic, but could you talk about writing as a process of discovery? GS: Oh, yes. That is what it is, which adds another dimension to everything I said about the Wisdom Mind series because it is about the unknown. And even in doing it, you're dealing with that every single day. I don't have this difficulty anymore because I've been doing it for so long, I think. But I know for my students the hardest thing is to keep them not knowing because they want to know. "We have to have a plan for this and we need an outline and we need dada-da-." And then I tell them, "No, no. Just stay where you are and just see what happens." And they'll say yes, and then the next time they come in they'll forget they said yes and they'll go back to, "Well, but you know, I can't figure out . . ." But it takes place on a whole lot of levels. There's that level of what's going to happen next, so to speak. But there's also the level of just the mystery of language and your psyche and “allowing” in silence and allowing space for anything to happen. �Gail Sher-James Maynard Page 16 Not to mention, a skillset that's developed over many years. And then you put all that together in a set period of time on a regular basis and something does happen. Mary's Eyes just happened though it took a long time. Something does happen. I almost can say that it's just impatience at this point that keeps me from—I'm sort of almost tired of sitting there. And I'm still sitting there--and more is happening. JM: Duncan has a great line for it. He calls it the intellectual adventure of not knowing. GS: That's right. That's good. JM: But it's difficult. GS: It's very difficult. It's like the artist's blank page. JM: Well, I think of Dickinson’s “I dwell in possibility,” or Keats’s “negative capability.” GS: Yes, negative capabilities, exactly. JM: This is something that poets and artists come back to quite a bit. GS: Right. �Gail Sher-James Maynard Page 17 JM: I'm hoping we've got time for just a few more. I know we've been talking a lot about more theoretical considerations and your approaches to poetry and language. And I wanted to take a minute or two to talk about what your practice might have looked like in the past or now. You've talked a bit about exercises and activities as a way of preparing oneself to write. But for yourself, how does a poem begin? GS: Oh. It doesn't begin. The whole thing is a process and you just start wherever it happens to come out. And then it keeps coming out dayafter-day as you're sitting in your writing practice. And then you go back at a certain point with a different state of mind, with an editing state of mind. And you start finding where the energy is in the language. And then you throw everything else away that's not those parts that are marked with energy. And then from there, you start building a piece. And it's actually the writing that does the writing. The writing puts together the piece. The writing tells you, if you listen, "Oh, I don't need to come last. I need to come first." Like, "Oh! Really? Well, let's see." And then it either works or it doesn't. But usually it does if the language is saying so. And that's completely how I -- I never know what the piece is until it's the piece. I actually am the last to find out. JM: That sounds very different to me than other Buddhists' approaches, which I think sometimes put the emphasis on first word, best word. As if that extemporaneous outpouring is somehow purer. �Gail Sher-James Maynard Page 18 GS: Yeah, no. No. I totally disagree with that. In fact, I would go so far as to say that, unless it's crafted, it's not writing. Because who wants to read that kind of junk that just comes out? It's just junk that comes out. JM: My last question. I think we've been talking about this a couple of different ways, but I'll end with this. It's another line of yours that I really am quite fond of. You've written that poetry is dangerous. Do you want to say anything at the end here about the dangers of poetry for hapless readers like myself? GS: Well, I don't remember saying that. (I'm still back on the last thought, actually.) This idea of if it's not crafted it's not writing. The craft part of it is what identifies the voice. And so when I'm crafting, I don't even know when I first start what voice this poem is going to assume. And then as I'm crafting, the voice identifies itself, and then it takes over. And so then it tells you what's allowable to be in this piece and what isn't, and what's going to be first and last, and so forth. So the only danger would be forgetting to let the poem write itself. Then you could fall into the trap of thinking that you know what the poem is. And as soon as you do that, you fall into your mind. And regular mind is not as powerful as wisdom mind. This is my beef with academics. �Gail Sher-James Maynard Page 19 JM: Get in line. GS: Yeah, I'm sure. What's most important to know can't be known with the mind. And so it's all just chatter, really. So that's why I feel my poetry is so important, because I'm using language to get beyond language, which is where all the important stuff is. JM: The way I've interpreted that remark of yours, to go back to this notion of Wisdom Mind, and I think it's in Reading Gail Sher, you say, "Poetry is dangerous, after all.” It's our vulnerability before language. GS: Yes, exactly. JM: Language has the capacity to change us, or to become a transformative experience. It isn't premeditated; it can't be controlled. GS: It's raw, and it's really like being naked. And so that is vulnerable. JM: Well, Gail, thank you very much. This has been an absolute pleasure to speak with you today. And I can't thank you enough for your time and your generosity. GS: Well, thank you. It's been my pleasure, too. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher interviewed by James Maynard, Curator of the Poetry Collection at the University at Buffalo, Emeryville, California, March 19, 2018. Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2018 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2018 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Maynard, James, 1974- Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_130 Extent The size or duration of the resource. 19 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherInterview https://digital.lib.buffalo.edu/files/original/1ce4904792205c69f38fd6af0ac75968.pdf e64f4d34c645ae0d4900488a52d45a14 PDF Text Text ���� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource An exorcism of representational language Description An account of the resource From the magazine L=A=N=G=U=A=G=E, January 1980, no. 11 Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1980-01 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1980 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_131 Extent The size or duration of the resource. 4 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/7e9438949c69a35fa946579f6f92e45b.pdf 8b12884f5ce20fdddfa585fbb73737d1 PDF Text Text ��� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Aware of this as a social act Description An account of the resource From tramen 2 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1984-05 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1984 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/6c8f4731b52e4f37383f829c366a9241.pdf 1ef7cb09d74de9e9c88247e207f8a8d5 PDF Text Text ������ Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The poetics of emptiness Description An account of the resource From Jimmy and Lucy's House of "K", no. 9 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1987 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1987 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/b250b524659a11352c09b1d99dd3792f.pdf 8020757fb9d06729f1250b50a6cca07b PDF Text Text ������� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Review of "Jailbait" by Brad Gooch Description An account of the resource From Jimmy and Lucy's House of "K", no. 3 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/7d4c43c15fafc87ac410fcaff221a768.pdf 9e20ebe3780b8596d3479164fe82e4fb PDF Text Text ���� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ocker marginalia Description An account of the resource From Jimmy and Lucy's House of "K", no. 6 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1986 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1986 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/b4cd1f4c7fb4ec0091cff083a9fdb43f.pdf 8eaf8cda7cd440c7cfaf9ecfbb963073 PDF Text Text ���� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource From Kuklos Description An account of the resource From Oblek: a journal of language arts, no. 6 Publisher An entity responsible for making the resource available The Garlic Press State University of New York at Buffalo. Poetry Collection. Date Created Date of creation of the resource. 2018-10-30 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/7f948441c5fd0257f3c2cbbc5555b944.pdf 13e2cdc25efba57662880c85b5ac946f PDF Text Text �� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Foal the water bush Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date Created Date of creation of the resource. 2018-10-30 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. 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LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/27c5079dd6e1c2b6d1f73575b9c59d12.pdf 20c16df46ebf3881319a202dd51a85d9 PDF Text Text �� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Chests in exact spiritual Description An account of the resource From tramen 2, 1984 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1984 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 1984 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_138 Extent The size or duration of the resource. 2 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/eb03b185a4639dcbe8dcfb14b6916f65.pdf 095f4fa7d400af2efa8b597ddb078d46 PDF Text Text ����������� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Broke aide [excerpt] Description An account of the resource From tramen 3, June 1985 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource application/pdf Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context LIB-PC011_139 Extent The size or duration of the resource. 11 p. Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Gail Sher Collection Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 SherMagazine https://digital.lib.buffalo.edu/files/original/7d1cc61c0a143912614c4015495f1f52.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/ab5a513395f8b89a7709bea708d10b61.txt c57d18e96a4e9c7b65f1fb783e083f5a Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Selections from the Wisdom Mind Series : introduction Description An account of the resource Recorded May 11, 2017 Date A point or period of time associated with an event in the lifecycle of the resource 2017 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2017 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_141 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_141.mp3 Audio/Video Recordings SherInterview https://digital.lib.buffalo.edu/files/original/3feb0b24701075e5921e65e7244baf15.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/6014cea0e5080c6c33af0f4c4126a1c9.txt 9847f502c4e5c637d5c93dc11e8459ad Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mingling the Threefold Sky Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2013 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2013 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_142 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_142.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/f5580e7447b07dd921b64e0c73cda531.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/eb3ef85d9c60c917519d67d103c5caa8.txt ea5e30808d6aecd482ea3852e77ac400 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The Twelve Nidanas Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2012 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2012 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_143 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_143.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/bcbd6359d090f90f7fdaa1af0a74ba59.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/89aa5272a593687a0838b4d550a89f28.txt 7f0abd345d48e91243a373f557214b8d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Figures in blue Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2012 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2012 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_144 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_144.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/e6f40f24eacb5ab5a173b8a3dc8de2a9.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/5c23d39b0da56b67b1c34a108165d67b.txt d7537a562ac7528151290ad727e0b535 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The Bardo books Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2011 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2011 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_145 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_145.mp3 LIB-PC011_145.mp3 LIB-PC011_145.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/44d2847d8755708243b5f46526a5a988.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/dff418bc61181014ce0f63d77e5bd08f.txt 5c91aaefb7d56d9b38353acb51982b18 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource White bird Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2010 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2010 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_146 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_146.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/30512fbc34ce2f0f81a3357a54cd1c6e.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/65d6e6aa29841cb67a6d0fd821a427c0.txt d48b337578867c23d6c59f70aa8ff6fb Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mother's warm breath Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2010 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2010 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_147 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_147.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/e3c550a6d19b8484e601ab7e3a67ebf9.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/817647b965e65f82c6d0429bf8a6aa9f.txt 5a80efa6a342db0d325a8937988dd7e6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The tethering of mind to its five permanent qualities Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2009 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2009 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_148 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_148.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/c06bbcc1fa98634100af0c87fd619ecd.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/c37cb912c348dd96680d2fe114066ea9.txt 301f133be07fb60b1c8a0d8bc9419d82 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Though actually it is the same earth Publisher An entity responsible for making the resource available Night Crane Press State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2008 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2008 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_149 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_149.mp3 Audio/Video Recordings poetry SherInterview https://digital.lib.buffalo.edu/files/original/5af154f18bd4c1c4a9d3b1a5ec6ecee9.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/a1375abbe5eb34813bdd01cfa9bec2e7.txt e644a321c8bcdecf32059af16aa92cc7 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher interviewed by James Maynard, Curator of the Poetry Collection at the University at Buffalo, Emeryville, California, March 19, 2018. Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 2018 Date Created Date of creation of the resource. 2018-10-30 Date Copyrighted Date of copyright. 2018 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Maynard, James, 1974- Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_150 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_150.mp3 SherInterview https://digital.lib.buffalo.edu/files/original/d5057be1186fa566d8b4ec1e9abc71d0.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/8395c307c594c949496b84a5c7dbf9fe.txt a42e9fd7029e00de422d54432fcac487 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource 1986 reading of "(As) on things which (headpiece) touches the Moslem" at Living Batch Bookstore, Albuquerque, New Mexico Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1986 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1986 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/m4a Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_158 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_158.mp3 SherInterview https://digital.lib.buffalo.edu/files/original/903f81ecf15506023787895a25e5a5b3.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/7d2e6eaac88531237d0e1d46c78aafc3.txt e6620c2e6bc8d02db5fc035149b295e9 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource 1986 reading of "For Bart" at Living Batch Bookstore, Albuquerque, New Mexico Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1986 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1986 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_159 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_159.mp3 SherInterview https://digital.lib.buffalo.edu/files/original/21854449c90436acf5b17f9e77eacbe3.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/38023f16503795e46ef6abcc974b4bc0.txt b387acb4d121b71d96477b076f2e33cb Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource 1986 reading of "The Lanyard" at Living Batch Bookstore, Albuquerque, New Mexico Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1986 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1986 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_160 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_160.mp3 Video Source Source of video. Streaming server, YouTube, etc. Streaming server Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 SherInterview https://digital.lib.buffalo.edu/files/original/6c35e30b76c731e591d9ea444dbb98cb.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/43baec5d7bfad263533c2442c07f0675.txt b56f8cc6fa636f22f0038eb484910ef0 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): introductory remarks Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_151 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_151-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/a8a02bad9189d6576fdf0f42cfaa42bd.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/5ee6aebd90cb01b3368b12ce8b8eef9b.pdf 02272f22ab68640992b0ea06213e79df PDF Text Text From another point of view the woman seems to be resting •Gail Sher �Trike • San Francisco •1982 �From another point of vie\N the \Noman seems to be resting �Naive or feelings of isolation and at the same time naive. The same woman only a feeling of sun now arrested on the floor near her chair. Rocking and making various gestures in concentrated posture. From another point of view the woman seems to be resting. Perhaps this resting is what brings the fields into play. Figures appear. The sky and the woman each unsurrounded. The sound (of no concern to anyone else) into which she feels drawn suddenly. This scene gives the impression of fields. Separated from fields by a porch. �Settles in watchful gesture. Gradual ability. Settles in place for reading and life of reading as insisted internal thing. Speaks about it softly. Volition as a kind of thought. Attributes of body (sun) and muscles of body. (Also light in marked relationship.) Somewhat confused sense or some boastfulness coupled with something else. �Time and also clouds. Texture of clouds and so forth in a continuous line or pattern. Landscape and trees. (Haze of trees.) Shoulders arms or occasional repetitive thought. �Now reads. Imagines herself in the dark room. Something recognized as dark. Shouts for the little girl. Presses forward to some extent. �Moments held clean and intact no\N appears as a \Nail. (Method and exposure to first thought.) The expression fixed. Points of softness absolutely seen by someone else. Seeing heavily or seeing effects of kno\Nn sedentary person. (Inclusive of her in an early period.) Provides a certain luminosity of detail. At the same time balance. �Suggestions in this vein. (Objects) existing in unheard sound. (Both color) and the boundaries of all objects hitherto mentioned. Trees but basically the house is the same. Reads with attention on trees shifts entering into balanced reading. Or woman lying reading. Paraphernalia of mind seen as objects coming to a complete rest. �Also as a child she had wanted to eat �Also as a child she had vvanted to eat. Without particular motive (to be) on her ovvn crossing the street on her ovvn or going through the door making an effort to buy food. �Always with amount of energy she could spend with that person (son) or even possibly some other people. Even simply listening. Not urged to but that that had already occurred. �Seen by the other people (during) the day or sometime during the course of the day (the driver) calls out something. To be phased by this. To appear calm but actually to imagine herself quarreling. �Intense expression in striving for something (intake) of food (inheritance) of something. Having asked for something to eat (in) one process to eat one (particular) part. �In bed for example (always) perpetuating (striving) in the midst of any room. Which (she) as a lonely person appreciated. Avenues and walking with such & such emotion (buses) where they seem needed. �Reversing her terminology and tendency to want something from him. (To) supply food here. (Not) to move or feel like moving. With others like her in the same mood (hiding) something received from her. Delicate relation to her (discerned) (quarter) of mind. �Children & events of the day enter her mind. Once while eating (in) quiet manner of saying something. Or being in a hurry to get somewhere. Arrangement of food at (moment) of giving it to her. �Even the lady's pressure next to her �Povverful inner lapse or undivulged sense. (Also) him in the capacity of boy. Pictures of him. Related in vvay of terrific scene (bed) or vvarm vvith hand in book of him. Through caring charged tone. Age & body as vvell as also this caring. Days later in place of children (to) see in others the possibility of her body. �Receptive position requiring this blessing. Short breaths of sun (minerals) in lap of her. Always eats (sings) walks near river humming & singing. �Focused on point of milling crovvd (assembly) of persons Cvvindovvs) doors & many people in them looking avvay. (Conversation) of vvoman in curious posture. COne) face (eventual) eloquence of her. Which moves in her. This abstraction Cvvhich) this pain vvas. �Even the lady's pressure next to her. (Roughness) of feet also some cleaning of the room. Slender girl or (old) purpose of united her. �With spread of her (sings) probing also words. Waits for bus. Borrows man's capacity (what) lay behind in pastime of several minutes. �Quantities of people among them (visualized) poised person (alert) posture of gratitude. Or in tovvards her. To utter it (to) please refurbish life compelling in this respect. Kneels before him (hovv) he felt alone. Fragrance of vvood (nails) appealing to her. �Travels in sphere of white or unhappy face . (Ignites) death response (her) in group of waking men. Defining it Cor) reads about rapture to break this pattern. To be awake like this if not disappointment to be aware of them redeeming themselves. �Perhaps there is no content paint or sun �Perhaps there is no content paint or sun. Wood or light. 1 ) Makes loving motion as of kissed one 2) Achieves resistance on a black surface . �Private inner weight. Conceives reality of strokes placed on the paper carefully. Somewhat revised circumstance (temper) of hand. �(Will) mesh in with only one passively assembled tone. 1 ) Elements of brown (tree) (justifiable) pitch 2) As a novelty or given content in the dress of a woman. �Concentrates on pattern vvith (repetitious) conception of her eating. Conception of her addressing someone. Percentage of vvords (invvard breathed vvords) along these lines. Joined by points though propelled in free-floating something (vvhich is) hovv color vvorks. �As within sleep something including him sleeping in the other room. Also the woman on the bed. Easily takes suggestion from the girl writing. 1 ) Whether from frightening circumstance 2) Short pause imposed from without 3) Repeats this constantly. �Completes act of eating (alone) tired & depressed before eating. 1 ) Only certain portions of this 2) This and religion (certain) rosaries. �A wedge or sound no one notices. Like a lot of red (in restful building) or drives up very solemn. Which turns into eating or ability of someone with talent. ��© copyright by Gail Sher 1982 Painting © copyright by Patty Arnold 1982 Published by Trike 277 23rd Avenue San Francisco. California 941 21 ISBN 0-917588-09-6 First edition of 400 copies Book design by Patty Arnold �� https://digital.lib.buffalo.edu/files/original/993b58ce5e01482aabf8e2084658e626.txt d5936a932b5378b9e04230af0538db26 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): Reading: "From another point of view the woman seems to be resting" Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_152 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_152-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/869016d59cb63c65379619dd77e1a9ad.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/ea902d4265aabbd0fb376aaeae16509d.txt 89894d01d4145f9c190846b0192e319b Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): Discussion 1 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_153 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_153-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/7ba806da636ba8e69d8ddccd90a8dcba.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/c64df39321f5007d0209c21c37bd342f.txt 9bbddc26919c9c731a1048f53e0cc14d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): First reading of: : "(As) on thing which (headpiece) touches the Moslem Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_154 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_154-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/c05a1152a89ac0803feccf3e56278047.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/6ae09cb65be49771f01bd6aa1294f136.txt 4f00674b86b74714f2ba4fb0a04024bd Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): Discussion 2 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_155 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_155-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/76e8630e0dc1c441b14eb301c3cd3f2e.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/995a3a3d69060a6af816aeea909d6324.txt 5ec8e8f4ebb5bdb06f76e3b91408850e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): Second reading of: : "(As) on thing which (headpiece) touches the Moslem Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_156 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_156-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/1ad045a1da14afd189cf05c60f1f770f.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/17545a39b81afce8b9a9ddbaeb5feffd.txt 5ce8d89cb10b689c8515b232a4a9dc96 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher reading at Niagara County Community College (1985): Discussion 3 Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1985 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1985 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_157 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Subject The topic of the resource Sher, Gail, 1942- Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_157-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/156a837e79e9ff84fdbac72a0394cbde.jpg f91b42616a4f700f7836870dca80ede5 https://digital.lib.buffalo.edu/files/original/017018404d0a1f9983aedcea0c17a02c.txt 4151e966855ad99cf16ecd7037d74a33 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Moving Image A series of visual representations that, when shown in succession, impart an impression of motion. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource 1999 interview with Connie Platt on KDTV about One continuous mistake Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date A point or period of time associated with an event in the lifecycle of the resource 1999 Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 1999 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource video/mp4 Type The nature or genre of the resource Video Identifier An unambiguous reference to the resource within a given context LIB-PC011_161 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Language A language of the resource eng Rights Information about rights held in and over the resource <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_161-cc Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/3e0dce2ec1aeb6e1a08685b4933e8709.jpg 8fa9a78dab61ce65af4438e3a8e6d1e8 https://digital.lib.buffalo.edu/files/original/15a74b69759a3769132367d884e8cebd.txt eac3fbaddb48e3525664a57bb0b3207a Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Gail Sher Collection Subject The topic of the resource Sher, Gail, 1942- Poetry -- United States Creator An entity primarily responsible for making the resource Sher, Gail, 1942- Identifier An unambiguous reference to the resource within a given context LIB-PC011 Sound A resource whose content is primarily intended to be rendered as audio. Duration Length of time involved (seconds, minutes, hours, days, class periods, etc.) 1:02:38 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource "The Four Noble Truths for Conscious & Creative Writers" Description An account of the resource Julia McCutchen, founder of the International Association of Conscious and Creative Writers interviews Gail Sher. "In this interview," writes Julia McCutchen, "Gail Sher will guide us through the framework of her Four Noble Truths for writers and lead us to understand how to: establish our writing environment, recognize our authentic writer's voice, troubleshoot obstacles that tend to trip us up, work with process as a key to unlocking our true potential, and cultivate and deepen our relationship with words, their inner silence and stillness." Publisher An entity responsible for making the resource available State University of New York at Buffalo. Poetry Collection. Date Created Date of creation of the resource. 2018-11-16 Date Copyrighted Date of copyright. 2018 Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. Poetry Collection. Format The file format, physical medium, or dimensions of the resource audio/mp3 Type The nature or genre of the resource Sound recording Identifier An unambiguous reference to the resource within a given context LIB-PC011_140 Is Part Of A related resource in which the described resource is physically or logically included. LIB-PC011 Subject The topic of the resource Sher, Gail, 1942- Rights Information about rights held in and over the resource Copyright Gail Sher and used with permission. Contact the <a href="http://library.buffalo.edu/pl/">Poetry Collection</a> for more information. <a href="https://rightsstatements.org/vocab/InC/1.0/">IN COPYRIGHT</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). Language A language of the resource eng Creator An entity primarily responsible for making the resource Sher, Gail, 1942-2026 Streaming Video Elements needed for streaming video for the VideoStream Plugin Video Filename Actual filename of the video on the video source server LIB-PC011_140.mp3 Video Type Encoding for the video; mp4, flv, mov, and so forth mp4 Video Source Source of video. Streaming server, YouTube, etc. Streaming server SherInterview https://digital.lib.buffalo.edu/files/original/da3a4858834527e0e8e73b2501d593f5.pdf d57d8580b37d59ec8600eac8e8cc0544 PDF Text Text �THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Volume 26. '\umhcr I DIRECTOR OF PUBLICATIONS Nancy Tobm EDITOR Nanette Trd::1l PI kolhg, R.. ART DIRECTOR Alan J k g1er ASSOCIATE ART DIRECTOR ~con Robert f rit ker STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john "'Jugl";;on, 'vice t'<r"de·" or ( hmcal \ffa1rs Dean EDITORIAL BOARD Dr Dr Dr Dr Dr ~lr Dr Dr Dr john A R.• hen Chs ma., liar >l<:l Brodv (,Jcn (Jresham '\cdr 1 Ha7nson james Ka~skt Harok L t ( har cs Pag~nelli Antui· cttc Pflc·s L~· her Rohmson Thomas RPsenthal Dr Dr 'iakda Dr Dr Dr :'>lr Dr Surr~r: Smgerman Stephen 'ipaulding '\elson Tc rr I dward \\"c-uke jerome )ates UlLrlO:l TEACHING HOSPITALS AND LIAISONS Ibtana \' ·\ \h:di ... a. Center Buffak• C.cner.>l Ho,pllal \lidwel Shaw Buffatc> \'A ~edicat Ccnte• ( h>ldrcn's lie spital of C:.. '·•lo K.:rrn Dryja-Swit'r\hl tnc Ccuntv ~Icc! .cal (enter .\fwv ,\'orthrrn \lercy HC'pitJI \Iillard fillmore llosp11als Dear Alumni and Supporters of the UBMedical School: P rogrammatJc mitt. a~ivcs often r~quirc an extended._Iead time before thetr values ~an be recognized and their opportumucs brought to frunwn Such IS the situation with the medical school's development of a centralized mformation system and computer assisted education <CAl). In the early 1980s, the school embarked on projects designed to meet ib operatwnalwmputer requirements and to become a leader m CAl. L ndcr the leadership of Dr Alan Reynard and Dr. john Loonsk, the gains hoped for have been rcahzed UB represents one of only a few medical schools that offers a required course m med1cal computmg to ib students and requires medical computer literacy for graduation. [hanks to Alan's and John's leadership we were prepared to computerize all medical student and resident credcntialing information within 18 months of implementation of New York State's new 405 Code requirements; LB IS no\\ considered a model for others to emulate. And we arc considered leaders at the forefront of CAl. I he foregoing developments and successes set the stage for even more exciting opportumues in tht commg years. During 1990 and the early part of 1991, the Graduate I:ducatton Consortium conducted a wnsultant study rcgardmg destrcd future directions for the school and the teaching hospitals. That report, conducted by a consultant staff from Coopers and Lybrand was completed and accepted by the Consortium in 1991. Soon after its acceptance, representatives of the Digital lqUipment Corporation learned of our progress and expressed an mtercst Ill using the Consortium as a model for developmg a truly community-wdc medical-educatton-health care communicatiOn system. Under Dr Thomas Riemenschneider's leadership, a planning program involvmg consortia! member~. D1g1tal, IBM. NY" EX and Siemens is now in place, and there is every reason to be opttm1stiL that UB and its consortia! members will become acttve participants in an adventure that can serve to move our efforts forward and to showcase Buffalo as a leader m these important areas It should enhance the quality of medical education and health care for years to come Both the Physician and I will keep you abreast of future dewlopmenls. '>mcercly, ~ (• 0J ~ 1"john i'.aughton, M.D . Vice Pres1drnr for Clinical Affairs Dean, School of Medicine and Biomedical Sciences I-rani< Sava Roswelll'a; k (anccr lnstitutt: juJ!Ih RICe "'''""of ( harit) llosptc 1l DrnniS \fcC arthv © I he ~tAte L ,.- ver,llv ol "Jew YJr'< "l Buffalo rhc Hu((.. :o Phvs.c <liWild BiomrdtC.II ~(ICII· liSt ts '?Ubltshcd quarterly hv t~c ''"" L mver>II\ cf "'ew Ycrk ll Bt:!' 1lo 'ic' c PI of Mcd ;ctnc and Biomedic~: ~cic,ces and the Office >I Puhhca•tn,s. It is sent 'rce of c'1Jrgl' tt" odumni, fac11 i 1v ... tuclcnts. rcsl· dePts "nl! !nerds fhc st~lf reserves ;.he rag; to edn 4lll c>pv 2.:-:d ~ubmiss..:;'l;:•;; J.c ccpted for ~L.~Iication Address quest .c·ns. {.,.)r;:T"' 1.cnts dnd sub,,-; 'i~lons to: l'ditl r. The Bu([ulo Phv<i.·can cmd Bilnnedical ')dtnt;st ...,t~uc l mver~;~v ol 'Jew Yo:k at Buffalo l nt\'crs··v •·ubh cat Lens, I ~t (rAts Hall BuffJio ...... wYcrk 14loO Send addrc" chan~c' t<>c rl1r lluJ]al·, Phy sloan antl Bwrm:dica! '\ocntisl. l tf. C P~ Ad<!. lion, H 15 Main S~rcct Buffalo. ~ew York 14!1 t Cover Illustration by Jay Lincoln Dear Fellow Alumni: D on't le.t the wmtcr doldrums get you down 1 The Alumm. Assouation is offering some warmmg and cheerful events. On january 18, 1992. we held the Senior Reception for our future alums. As in years past, It was greatly appreciated and enjoyed by the scmors alums and faculty The Chairpersons for the Reunion Classes arc busy making plans for an exctttng n:umon weekend in Buffalo on April 25. You will be heanng more from them during the commg weeks. \Ve have a lot to be proud of in our medtcal school and our strong and active Alumni Association This is due to the strong support from vou, our alums' ' If you have any questwns, please feel free to call me at my office. ':imcerely ~~· ~ Nedra]. Harrison, .\1.D., '77 �WIN T ER 1992 VOL. 26 , No . 1 ..... ........... . .. .. .......... . . . .. . .. . .... .. . . ..... . .. . ..... . . .. ...... . ......... . .. . .. . ...... . ... Research Hospital News Further Notes on 11 The Other Classroom" • The School of Medicine and Biomedical Sciences' dean,John Naughton, M.D. , looks at the advancement of the medical school's teaching hospital relationships. Journey to the Top of the M.D. Ladder • For women, UB researchers have developed a "smart pill" that knows where to go and what to do when it gets there. Page 3. according to some, it's a longer climb. ASpoonful of Humor • A West Coast pediatrician and University at Buffalo graduate prescribes it for his patients and peers alike. Medical School People Alumni Classnotes The neurologic problems of musicians and singers ore the subject of a lecture by neurologist Alan Lockwood, M.D. Page 2. Dean Naughton's further notes on "The Other Classroom." Page 6. * Millard Fillmore Hospitals opens its new podiatry clinic. Page 4. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . .. . . . . . . . . . ' ' I ' Success of new biotech drugs depends on prescreening patients Lecture focuses on problems of musicians and singers eurologic problems that tend to strike singers and musicians were the main topics of an evening of medicine and music held in early December at UB's Baird Recital Hall. The combination lecture and recital featured performances of various instruments, followed by a brief presentation on the injuries that typically are found in matching performers. University at Buffalo neurologist Alan Lockwood, M.D., internationally known for his research and clinical treatment of musicians and vocalists who incur neurologic problems as work-related disorders, discussed clinical case studies. Lockwood is a professor of neurology and nuclear medicine. Edward]. Fine, M.D., clinical associate professor of neurology, explained the roles of electromyography and electroneurography in the diagnosis of music-related neurologic problems. An estimated one-third of professional singers and musicians likely will expe- 8 BUFFALO PHYSICIAN rience some neurologic problem related to their work at some point during their careers. While a large percentage of these involve peripheral nerves, others may be traced to the central nervous system. Although surgery is indicated in a small percentage of the cases, a greater number can be treated effectively with physical or occupational therapy. "Although most people are aware of work-related disorders that can occur in various occupational groups, those among musicians and singers are not as well understood in the general population," Lockwood said. UB faculty who performed included Stephen Manes, chair of the department of music, piano; Ronald Richards, a lecturer in the department of music, oboe; Deborah Chung, professor of mechanical and aerospace engineering and Niagara Mohawk Chair of Materials Research, piano and voice, and graduate student Patti Cudd, percussion. The event was co-sponsored by the Buffalo Chapter of Sigma Xi and the UB departments of music and neurology.+ - A BY N D MARY BETH he success of expensive new biotech drugs that are nearing government approval will depend in large part on identifying the patients most likely to benefit from them, according to a UB professor of pharmacy. Speaking at the annual meeting of the American Association of Pharmaceutical Scientists in November, jerome ]. Schentag, who is also director of the Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital, referred to E5 and Centoxin, both costly new treatments for the often fatal gram negative sepsis infection, as cases in point. "The challenge with these new products is going to be proving that they work and communicating to physicians ~hich patients will clearly benefit from the treatment," he said. "If given indiscriminately, the cost to the health care system for the sepsis drug alone would approach $1 billion. When you're talking about $4,000 to $5,000 for a single dose, you need to pick your patients carefully." Each year, gram negative sepsis infection strikes 500,000 patients, most of whom are already SPINA BIOMEDICAL SCIENTIST WINTER 1 9 9 z �···· · · ·· ··· ····· · · · ····· ·· ······· ···· · · ··· · · · · · · · ···· ·· ·· ·· · ·· · · · ··· · · · · ··· ·· ·· ·· ·· · · · · · · · · ·~ \ . ;... . ill with cancer, heart or liver disease or who have just had major surgery. New treatments for sepsis block the action of endotoxin, the product of bacteria that causes most of the injury. In some cass, the new biotech treatment has completely cured patients. But other patients have seen little or no improvement following treatment. According to Schentag, this discrepancy in how the new drug affects patients is what makes vigorous prescreening of patients so necessary. + - B Y ELLEN geting drugs in the GI tract involve intubation. In contrast, the new targeted capsule is swallowed and its progress monitored by use of a tracking ··' GOLDBAUM Smart pHI" knows where to go after it's swallowed 11 "smart capsule" that allows researchers to precisely direct nearly any medication to a specific place in the gastrointestinal tract has been developed by scientists and engineers at the State University of New York at Buffalo and Millard Fillmore Hospitals. Described at a meeting of the American Association of Pharmaceutical Scientists in Washington, D.C. , the ingestible capsule and its microelectronic technology have important implications for treating patients who require repeated delivery of a drug, such as insulin, to a small area of the intestine where it can be absorbed. David T. D'Andrea, director of the Engineering and Devices Laboratory of Millard Fillmore Hospitals, is co-investigator on the project. Schentag, who also directs Millard's Clinical Pharmacokinetics Laboratory, explained that current methods of tar- BUFFALO PHYSICIAN device worn as part of a vest. The vest houses a computer monitor about the size of a Walkman. As the capsule, which contains a tiny radiotransmitter, passes through the GI tract, it sends out a continuous radio signal as the computer monitor system computes the position of the capsule and triggers release of the drug when it gets to a predetermined spot in the intestinal tract. Schentag noted that the technology would allow for the intact delivery of drugs such as insulin and some of the new biotech drugs, which are large proteins that are usually degraded by the acid in the stomach or the enzymes in the intestine. + -BY AND BI ELLEN O MEDI GOLDBAUM C AL S C .. UB surgeon performs world's first splenectomy by laparoscopy at BGH .. ,. "· \ ,, surgical procedure known as a laparoscopic splenectomy was performed for the first time on October 10 when a University at Buffalo surgeon removed the spleen of a 24-year-old woman at Buffalo General Hospital. Scott A. Tulman, M.D., clinical assistant professor of surgery, says the clinically experimental technique was made possible by the development of new tools for advanced laparoscopic surgery by U.S. Surgical Co. According to Tulman, the woman was suffering from hereditary spherocytosis, a congenital condition that causes severe, hemolytic anemia. The woman's gallbladder was also removed during the surgery, which lasted two and one-half hours. "Although the condition is rarely fatal, it is extremely debilitating and requires numerous blood transfusions or removal of the spleen, depending upon the severity of the condition in the individual patient," Tulman said. During the laparascopic splenectomy, small, half-inch punctures were made in the patient's abdomen and the recently developed laparoscopic instruments were inserted. The surgery was performed with no complications. + IENTIST WINTER �-- - - - - - - - -- - - ----------- - · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · ·· · · ·· · · [i] II MDiard Fillmore Hospitals podiatry clinic opens at Gates illard Fillmore Hospitals now offers specialized podiatric care in its newly opened Foot Clinic in its Gates Circle facility. The clinic offers routine podiatric services as well as preventive foot care for patients with diabetes and peripheral vascular disease, according to David M. Davidson, D.P.M., chief of the podiatry section at Millard Fillmore Hospitals. "In addition to meeting the community's growing need for podiatric services, the Foot Clinic helps contribute to the comprehensive, quality health care services at Millard Fillmore Hospitals," Davidson said. The Foot Clinic is staffed by American Board of Podiatric Surgery board certified podiatrists from the hospital's medical staff. + PET imaging center to bolster research and enhance patient care he opening of the new Positron Emission Tomography (PET) imaging facility at the Buffalo VA Medical Center marks completion of the first phase of a cooperative effort between the hospital and the University at Buffalo to bolster medical research and patient care in Western ew York. The center will be completed in 1993 with the opening of a cyclotron facility e BUFFAL O PHYSIC IAN that will manufacture radionuclides for use with the scanner. Work on the cyclotron facility, to be located in renovated space on UB's South Campus, began last summer. Until it is completed, materials used in scanning at the hospital will be provided by outside sources. Once the cyclotron is operating, underground pneumatic tubes connecting the hospital and Parker Hall will be used to transport radionuclides produced by the cyclotron facility for use with the PET scanner. Because of its unique ability to visualize and quantify complex physiological processes occurring in the human body, PET imaging has potential for important advances in the understanding and treatment of major ailments, including heart disease, stroke, cancer, epilepsy and A N 0 B IOMEDICAL S C Alzheimer's disease. The first one in Western New York, the PET scanner at the Buffalo VA Medical Center is one of only four in the state and one of two approved for use with patient care. While there are several dozen PET imaging centers in the U.S., the UB-VA center will have clinical and research capabilities shared by only a few PET imaging centers located at other major research institutions, according to john Naughton, M.D., UB vice president for clinical affairs and dean of the medical school. "This project will put the UB medical school at the very edge of a new frontier of diagnostic medicine," aughton said. While located at the Buffalo VA Medical Center, the PET scanner will be available to veterans and other patients throughout Western New York through a shared services agreement between the University at Buffalo and and VA Medical Center. The center is being funded through a $3.4 million federal grant from the Department of Veterans Affairs, with the balance of the $12 million cost of the center provided by UB, state grant support and private support. Funding includes a $1 million grant from the james H. Cummings Foundation in the form of a contribution to the University at Buffalo Fotmdation's "Pathways to Greatness Campaign." + - B Y IENTIST A R T H U R WINTER P A G 1 9 9 E 2 �First Stereotadic Radiation Therapy performed at Roswell Park Institute most effective for the treatment of target areas up to three cen56-year-old Tonawanda, New timeters in York, man became the first pamaximum ditient in Western New York to ameter. The be treated with Stereotactic Raprocedure diation Therapy of the Brain gives access to (SRTB) for a recurrent malig- deep-seated lesions which were formerly nant brain tumor. inoperable or could be reached only by The procedure, which uses sophisti- extensive surgery, according to West. cated digitized computer targeting, was "The precise, pinpoint accuracy of this performed by Kyu H. Shin, professor and procedure enables us to deliver a high chairman of the department of radiation dose of radiation in single or multiple medicine at UB's School of Medicine and doses to a well-defined, small intracraBiomedical Sciences and head of the de- nial area without delivering significant partment of radiation medicine at Roswell radiation to adjacent normal tissue," Shin and Charles R. West, M.D., research as- said. sociate professor of neurosurgery at UB SRTB requires a high degree of posiand head of the department of tional accuracy. CAT, MRI scans or neurosurgery at Roswell. Roswell Park angiographic studies are performed to Cancer Institute is one of 28 National determine the center and dimensions of Cancer Institute-designated Comprehen- the target and compute the isodose dissive Cancer Centers nationwide. tribution. Treatment is first simulated The patient, who was diagnosed with a to ensure accuracy. The procedure, highly malignant, very advanced which usually takes about one hour, is glioblastoma, had already undergone then performed using the photon beam surgery and conventional radiation which of the high energy linear accelerator. had failed, according to Shin. The suc"We couldn't be more pleased with cess of the new procedure, Shin said, will this first procedure," said West. "The not be known for several months until a dose of radiation was delivered to the repeat CAT scan is performed. "It takes tumor exactly as the computer had caltime to know," Shin explained. "The culated. The future for this therapy is mass is still there and there is no way of exciting and promising for patients. " + knowing whether it's dead or alive until we see no tumor on subsequent CAT scans. With highly malignant tumors , the response is somewhat quicker. " The noninvasive procedure, which can be performed on an outpatient basis, has been used in other centers to treat a variety of benign and malignant lesions, such as arterio-venous malformation , acoustic neuroma , pituitary adenoma, craniopharyngioma, single metastatic lesions and malignant brain tumors. It is BUFFAL O PHYSI C IAN BI O MEDICAL BGH and ECMC announce plans for computer services in a new ioint venture he Buffalo General Hospital and Erie County Medical Center have announced plans to join forces to develop and install a fully integrated computerized information system at the medical center. Under terms of the collaborative agreement , Buffalo General will provide ECMC with a variety of services, including the computer capability required to process ECMC data volumes and operational statistics; installation/systems development; staffing and services; training, and ongoing operational support as well as hardware, software, database and communications support. The ECMC system will be implemented in phases with the first "go live" date tentatively scheduled for early january. The final phase of the project is scheduled to be implemented in january 1994. Under the agreement, ECMC admissions, registration and patient accounting information will be stored in separate data banks at Buffalo General and transmitted to ECMC via a microwave connection. Hospital officials noted that it will be a controlled process to ensure total patient confidentiality between the two institutions. + SCIENTIST WINTER �The following is a continuation of Dean John Naughton's paper, "The Other Classroom," published in the Late Winter 1988-89 issue of Buffalo Physician and Biomedical Scientist • Copies of the earlier paper are available from the medical school. PHOTOS B 0 B BY WALl ON 0 I C A L �BY B U F F A L 0 P H Y 5 I C JOHN I A N A N 0 B I 0 NAUGHTON , M E 0 I C A L 5 C I E N T I S T W I N T M.D. E R 1 9 9 28 �~~ ·- ~---------~~~~-------~~-~------------ uring the Fall of 1988 a major retreat was held at the Buffalo General Hospital focused in its continuing relationships with the medical school. A number of perspectives were presented and positive communications developed considering existing and future relationships. My presentation concerning the development of cooperative arrangements through the formation of consortia, entitled "The Other Classroom," was printed in The Buffalo Physician and Biomedical Scientist. 1 A manuscript detailing the role ofUB's medical school in regional economic development is being published this winter in, Metropolitan Universities .2 This paper will expand on the earlier publication and present some more contemporary views abou t how the University at Biffalo and its affiliated institutions strengthened their relationships through cooperative planning and programmatic sharing. [urrent [onsortial ~trategies GRRDURTE HEDICRL DEHTRL EDUCRTIOH COHSORTIUH OF BUFFRLO The medical school and its teaching hospitals entered into their first consortium in 1983 to respond in an efficient and cohesive manner to the new guidelines promulgated by the Liaison Committee in Graduate Medical EducationJ A major leadership role was provided by Michael oe, M.D., senior vice president for professional affairs and medical director at Buffalo General Hospital; he has been an active leader throughout its development and evolution. This organization , the Graduate Medical Dental Education Consortium of Buffalo (GMDECB), governs all residency training programs in Western ew York. The organization's institutional members include the affiliated teaching hospitals, the schools of medicine and biomedical sciences and dental medicine, all residency training program directors and one resident representative from each program. The work is conducted through a series of committees, i.e., Administrative, Program Directors, Residents and Coordinating. Over the past eight years, the GMDECB has been developed as an alternative model for other medical schools and their affiliated institutions to consider when dealing with the need to change their approaches to managing graduate medical education (GME). The GMDECB is now positioned to deal institutionally with the many issues that 0 BUFFALO PHY SICIAN ono~~ue. m.~., t~e ~rfmf mrector for [ontinuin~ menical fnucation. ~rouinen t~e leaners~i~ for t~is im~ortant innouation. AND BI OMEDIC AL face the medical education and health delivery systems. For example, GMDECB responded rapidly to the new requirements imposed by ew York State imposing the credentialing of medical students and residents. The program directors worked cooperatively to develop the required programs and reporting mechanisms, and with support made available from the Information Service system under the leadership of Alan Reynard, Ph.D. , a computerized reporting system was operational systemwide on July 1, 1990. The total time between the announcement of the new requirements and implementation was about 18 months. Institutionally, GMDECB has moved forward to change the method of orienting new residents. The usual one- to three-day hospital orientation was replaced by a comprehensive week-long curriculum. Its course contents include the usual personnel issues; completion of the required history and physical examination at a single site; training and certification in advanced cardiac life support; learning and evaluation of bedside teaching skills and lectures and small group sessions dealing with medicolegal, record keeping and ethics. Glenda Donoghue, M.D. , theAPFME Director for Continuing Medical Education, provided the leadership for this important innovation. 4 A total of 125 individuals representing specialties in medicine, law, nursing, medical record librarians and hospital administration participate as faculty for this unique and SCIENTIST WIN TER 1992 �important function. The GMDECB responded to the initiatives of the YS Council on GMP·6 ·7 •8 by committing to a ratio of 50 percent distribution of resident positions to primary care (family medicine, internal medicine and pediatrics) by 1994; recruiting and retaining representation from minority and socially underrepresented representatives of at least 11 percent of the total pool , and evaluating and studying the strengths and weaknesses ofconsortia! governance. The Council's subcommittee in Consortia evaluated GMDECB's progress in 1989 and 1991 and reported to the Council that we were meeting its definition and criteria for an operational consortia. The GMDECB's most recent accomplishment was the pooling of resident salaries into a single organization. This has enabled the teaching hospitals to pay all residents across the system one equitable salary and common fringe benefit BUFFALO PHYSICIAN rates. The residents have a consortialwide annual dinner dance, and each receives a UB certificate upon graduation with all member institutions listed on it. These changes together with other attempts at standardization of the education programs are serving to confirm that GMDECB is indeed the "institution of record" for graduate medical education in Buffalo and Western ewYork. vices was formed in 1987. This organization, the Western New York Health Sciences Consortium (W YHSC), has a membership similar to thatof GMDECB. UJESTERH HEUJ YORK HEHLTH SCIENCES COHSORTIUH In addition there are those representatives from the business community and each board chairman of an affiliated hospital and the president ofUB. This organization is incorporated and is not a membership body as is GMDECB. A second consortium designed to emphasize the need to cooperate and to enhance the quality of health care ser- A N D BI OMEDICAL Above, Millard Fillmore i'-11!11111• Suburban Hospital's newborn nursery, now under the diredion of Children's Hospital's Division of Neonatalogy. Left, Buffalo General Hospital's designated Heart Transplant Center. SCIENTIST W I N T E R 1 9 9 20 �----- The formation ofWNYHSC was more difficult than was that of GMDECB because its focus affected more constituents. It originated at the institutional levels and was perceived as a "top-down" organization. The rapidity with which it formed and the breadth of the agenda caused a great deal of consternation for full-time and voluntary faculty alike. The approach taken to accomplish its --------------------------------~- constituents was high, and too little preparatory work was performed to decrease existing tensions and to facilitate the necessary work and leadership. evertheless, a number of significant and positive outcomes can be ascribed to W YHSC during the course of its short history. Among these were: (1) awarding of a Bone Marrow Transplant Center to Roswell Park Cancer Institute (RPCI); (2) completion of a clinical affiliation agreement and faculty contract between UB and the RPCI; (3) designation ofBGH as the Heart-Lung Transplant Center, (4) the formation of a single Division of Neonatology in Pediatrics to coordinate neonatal care at Children's Hospital of Buffalo (CHOB) , BGH, Sisters Hospital (SH) and Millard Fillmore Hospitals (MFH); (5) rationalization of an integrated psychiatry program; (6) securing of a shared agreement between the Buffalo VAMC and UB for a center in Positron Emission Tomography (PET)imaging, goals was to use task forces usually chaired by a UB clinical department chairman or a department's division chief. The composition of each task force included full-time and volunteer faculty, representatives of hospitals, the school and the business community. Most task forces proceeded to achieve their intended outcomes. Three others had more difficulty because tension among the Left, the VA Medical Center's new PET scanner will provide enhanced medical imaging for Western New York through a shared agreement between VAMC and the University ...____ _ --~-......-II!Ci::!!C;,;_:E::::::...::::::__ _ _~--_. at BuHalo. Above, Erie County Medical Center's designated Trauma-Burn Center. «<) BU F FA LO PHY S I CI AN A N 0 B IO MEDI C AL S C I E N T IS T WIN T ER 1992 �and (7) the designation of the regional Trauma-Burn Center at Erie County Medical Center (ECMC). lion dollars, and the scales of economy for BGH will be significant. UB's Health Sciences Library belongs to a regional health library consortium and services the Western New York region. The school has a major computerassisted educational capacity. lt is envisioned that these systems will be added to the other networking activities, thus bringing educational and informational services directly to the bedside and clinical settings in the years ahead. There is no doubt that Buffalo's willingness to enter into more and more cooperative planning has served to move the school and the community into a leadership role in these areas. IHFOJUtJlnOH HET\UORKIHG ll of the above activities serve to network the institutions around the mutual purposes which each shares. One of the beneficial byproducts has been the ability to develop a computer network which links the medical school with each department and each teaching hospital. This network has matured to the point that it is attracting national interest as a model which can be emulated in other regions of the country. Thomas Riemenschneider, M.D., associate vice president and associate dean for clinical affairs, is providing valuable and constructive leadership in this area. In 1990, theW YHSC received a consultant's report from Coopers and Lybrand which will serve as a blueprint to future planning and implementation of this network. Several commercial firms have indicated their interest in pursuing a partnership in moving this system forward since no comparable program with this potential exists in any other community in the United States at the present time. Since UB is also developing unique strategies for interactive computerized education under the leadershipof]ohn Loonsk, M.D., has a networked community-wide system in place and has an outstanding Health Sciences Library which serves medical students, residents, full-time and volunteer faculty and each hospital in Western ew York, the consortium is in a unique position to provide a model of delivery information to a broad range of constituencies in the region. Another example of cooperative planning is that Buffalo General Hospital and Erie County Medical Center (ECMC) are working collaboratively to establish a single computer mainframe for patient billing and medical record keeping. In this model the mainframe will be owned and operated by BGH and services will be purchased by ECMC. The potential savings to ECMC will total several mil- BUF FALO PHYSICIAN [urrent ~tatus ~iemensc~neiner. m.~ .. associ- ate uice presinent ann associate nean for clinical affairs. is prouining ualuaMe ann construehue leaners~ip to neuelop a computer networ~ lin~ing t~e menical sc~ool wit~ its teac~ing ~ospitals. A N 0 B IOMEDICAL While it is apparent that UB and its affiliated hospitals have taken steps to enhance cooperation and sharing, more needs to be accomplished to ensure quality medical education and patient care at a time when the health care system is undergoing rapid, sometimes unpredictable change. Since many constituencies must be represented in the decisionmaking process, yet some decisions must be made expediently, UB's former president, Steven B. Sample, recommended that the WNYHSC model be strengthened through a mechanism of increased centralized control with UB assuming a more authoritative role. This plan, the University ofBuffalo Health System, Inc. (UBHS), received considerable public discussion within UB and the State University of New York system, the New York State Department of Health and at each involved Buffalo institution. While considerable support for a strengthened consortia! model exists, it was clear that progressing toward a cooperative model in which each member enjoys a partnership role is preferred. To that end, UB's president, William Greiner, has offered an alternative plan, now identified as the University at Buffalo Affiliated Hospital, lnc. (UBAH). The affiliated hospital CEOs and the medical school leadership are engaged in developing a plan that SCIENTIST w I N T E R 1 9 9 2G �-- - - - · - - - - - - - - -- ----- ---------- - can be acceptable to SU Y, UB, hospital boards and the full-time and volunteer faculty. The tenets of common agreement and need are being developed; by late 1991 the process of muerging the two consortia into a single organization could begin. It appears that the medical education and health care communities which serve to form UB's other classroom, a "medical school without walls," are committed to increasing cooperative activity in an era of declining resources and changing patterns of rendering medical education and health care. If these institutions and constituencies continue on these vectors, then UB and its affiliates could provide important, necessary leadership for other sectors in New York State and the nation. [ondusions n important lesson learned from the various consortial experiences is that meeting the challenges that face our institutions requires the work of multiple constituencies coordinated by a responsible leadership group. The medical school and UB have an important, but not singular role in that process. Given the history of the medical school and its teaching hospitals, UB must be committed to achieving its major academic goals in an environment committed to taking advantage of diversity and through a philosophy of inclusion rather than exclusion. The GMDECB has served to demonstrate the value of cooperative management, planning and execution. WNYHSC served to demonstrate the need for institutional cooperation and sharing. Although the pressure to render decisions precisely and expeditiously will continue to occur, it appears that the cooperative, multiconstituent model will work more effectively than a strongly centralized, "top-down" organization. 1. Naughton,]. , The Other Classroom, The Buffalo Physician and Biomedical Scientist, Late Winter 1988-89. 2. Naughton, ]., "The Impact on Regional Health Care By A Medical School And Its Affiliated Teaching Institutions: A Potential Model For Other Academic Health Center," for publication in Metropolitan Universities late 1991. 4D BUFFALO PHYSICIAN 3. 1980-81 ACGME Guidelines, The Essentials of Accredited Residencies in Graduate Medical Education , Feb. 24, 1981. 4. Donoghue, G.D., Glieco, . Flint, L.M. , Naughton, ]. "A Core Curriculum for Entering Graduate Medicine Education Trainees" to be published in Teaching and Learning in Medicine later this year. 5. Report of the New York State Commission on Graduate Medical Education, Feb. First Reportofthe Council, Volume I, 1988. 7. ew York State Council on Graduate Medical Education, Second Annual Report, 1989. 8. ew York State Council on Graduate Medical Education, Third Annual Report, 1990. 9. Pristach , C. , Donoghue, G. , Sarkin, R., Wargula, C. , Doerr, R., Opila, D., Stern, M., Single, G. , "A Multidisciplinary Program To Improve The Teaching Skills Of Incoming Housestaff," Academic Medicine, 1991. 1986. 6. Council on Graduate Medical Education A N 0 B I OMEDICAL S C IENT I ST WIN T ER 1992 �The Burn Treatment Center at Erie County Medical Center, one of the significant achievements of the Western New York Health Sciences Consortium. 4. Report of the National Advisory Commission on Health Manpower, Washington, D.C.: Gov Printing Office, 1967. 5. Sickness and in Wealth, ewYork: Basic Books, 1989. 6. Caring for the Uninsured and Underinsured (several articles) , The journal of the American Medical Association, May 15, 1991 , Vol. 265 , No. 19, (pgs. 2491+ 2566). l. The New York State Council on Graduate Medical Education, First Annual Report, 1988. 2. Chapter on Consortia, ew York State Graduate Medical Education Councils' Third Annual Report, 1990 (In Press) . 3. Public Health Policy Forum, American Journal of Public Health, April 1991 , Vol. 81, o. 4 (pgs. 418-420). B UFFALO PHYSICIAN A N 0 BIOMEDICAL ECMC's designated Levell Trauma Center serves the eight county Western New York area. SCIENTIST W I N T E R 1 9 9 2 41) �- ---· - ---- -- ---·. .- - - --·----~~-- By Lois Baker When top administrators at the University of Iowa For women) Medical School met for a presentation on a new security system, the marketing representative turned to the group of distinguished profes- sionals, which included two longer climb women, and asked, "Why don't one of you girls come 0 41 B UFFALO P HYSICIAN up here and try this?" AND B IOMEDICAL S CIENTIST W INTE R 1992 �Mary Ann Bishara, M.D. medical establishment's upper echelons. Aschenbrener instead described her treatment throughout her career as a "day-today kind of minor assault," manifested in this instance by a boorish salesman's offthe cuff comment. The presence of Aschenbrener, Conley and a small number of other female physicians in the top ranks of the formerly all male medical establishment is a sign that women are breaking through societal barriers which in the past forced those inter- ne of the "girls" was neuropathologist Carol Aschenbrener, M.D ., the highest ranking women in academic medicine in the U.S. today. Aschenbrener, executive associate dean at the University of lowa Medical School, perhaps is lucky. She has not experienced the overt discrimination or sexual harassment, such as Stanford neurosurgeon Francis Conley, M.D., reported, during her climb into the BUFFAL O PHYSICIAN A N 0 81 0MEOIC,._L ested in healing the sick to become nurses, not doctors. But unlikejoshua fighting the battle of jerico, their assault on the medical status quo has not brought the walls of inequity tumbling down ; it has created only a small breach, leaving women physicians, after years of proving themselves accomplished, and often brilliant, still struggling for equal opportunity and respect in their profession. "l am troubled ," Aschenbrener said, SCIENTIST W I N T E R 1 9 9 2 4D �"by the persistence of subtle expressions, from men and women both, that indicate still an underlying belief that women are second class, and that yes, they can succeed, but their real place is in the home. I perceive this societal pressure as being more intense now, at least in the media ," she added, "than I did 20 years ago. " Statistics certainly do not paint a glowing picture: • A year ago there were three women deans in the nation's 127 medical schools. Today there is none. • A report published last fall by the American Medical Women's Association and the Feminist Majority Foundation showed that today women make up 36 percent of medical school students but hold only 2 percent of the department chairs. • In 1990, 20 percent of all medical school faculty were women - only a 7 percent increase in l3 years. "At that rate," the report stated, "women will not reach parity on medical school faculties until the year 2077. " Men also outnumber women in the higher faculty ranks. Statistics compiled by the Association of American Medical Colleges show that in 1991 nearly three times as many men than women were full professors. That gap can be attributed in part to women's later entry into the profession. But when the Association followed promotion records of full-time faculty first appointed in 1976, it found that by 1991 , more than twice as many men as women had been appointed full professor. Inequities follow through medical specialities - women are clustered in the lowest paying fields ; through wages- the American Medical Women's Association reports female physicians receive 62.8 cents for every dollar earned by their male counterparts; and through medical organizations- the American Medical Association finally put a women on its board in 1989. By many indications, male and female physicians in this country are not treated equally. The medical profession appears to feature a so-called glass ceiling that prevents women in substantial numbers from reaching the top. How could this situation persist in the enlightened 1990s? For Eileen McGrath, the answer is clear. "I think the only reason for a glass ceiling in any group would be discrimination, and I think discrimination exists because of ignorance." McGrath is executive director of the American Medical Women's Association. "It is clearly documented that a glass ceiling exists," she said, "particularly in academic, but in all aspects of medicine." Nancy E. Gary, M.D. 4D BUFFALO PHYSICIAN A N D BI O MEDI C AL iscrimination against women is partly deliberate, partly unconscious, she said. "Most of the injustices we see are probably the result of unconscious acceptance of values in which one group is privileged at the expense of another group , whether it's race or gender. But the effect is the same, so it is sort of immaterial. I've known very few intelligent men who could defend it logically. " Frances Conley at Stanford has become the standard bearer for women physicians who are frustrated by their treatment at the hands of male colleagues and the medical establishment. Conley's oped piece in the San Francisco Chronicle last june, following her resignation from Stanford Medical School's neurosurgery faculty, detailed years of indignities and sexual harassment, including male colleagues calling her "honey," running their hands up her leg in the operating room and commenting on her breasts. Her public statement shocked the campus and raised a furor in the national media. Conley eventually rescinded her resignation, electing to work within the medical school to bring about change. She continues to press for equal, dignified treatment for women at Stanford and elsewhere. ''I'm here as a conscience," Conley said. "To remind people every time they see my ugly mug that there's some unfinished business." Conley thinks wide spread bias against women exists in many occupations. "Our society has a mind-set," she said. "We've been taught ever since we were small children that women were not quite as good as men. The thing that is most depressing to me is the stereotypical response from institutions to women who make an issue of it. They get rid of them." As a tenured professor with a wellestablished reputation, Conley can't be "gotten rid of. " But she admits her future at Stanford Medical School is not bright. "Things are relatively hostile," she said. "What I did is not exactly an acceptable behavior pattern for women. My department will never forgive me I'm sure." Olgajonasson has not experienced the kind of sexual harassment Conley de- SCIENTIST WINTER 1 9 9 2 1 \ �scribes, but she believes it happened to Conley, and says similar things happen to women in medicine all the time. jonassonchairs the DepartmentofSurgery at Ohio State University College of Medicine, one of two women surgery department heads in the U.S., as of july 1991. She has held the position for four years. "I think it is just constantly part of daily living," jonasson said. "I don't believe women are given the credence that men get. We tend to be ignored, passed off." She has dealt with such treatment in the past by ignoring it, but for young women physicians today she has other advice. "In the past I would have said just swallow it and make do," she said. "I don't know that that is practical, possible or reasonable these days. We have to make it clear we won't put up with these things." "It is not possible as a woman to go through medical school without some discrimination," stated Paula Clayton, chair of the Department of Psychiatry at the University of Minnesota Medical School. Clayton, a specialist in mood disorders, is the only female currently heading a department of psychiatry in the U.S., although the field has been popular with women for some time. She describes her own experience with discrimination as "little things- more in whether you deserve the same office" but tells about the complaints of a friend, a top researcher at Yale. "She has had trouble getting promoted, so there must be some bias against promoting women." Not all women physicians agree that discrimination is a problem in medicine. Nancy Gary, a nephrologist, is former dean of Albany Medical School. She left that position 17 months ago to become senior medical advisor to the administrator of the federal Health Care Financing Administration. Gary said she does not think a maledominated medical establishment prevents women from advancing. She thinks women are underrepresented in the top ranks of medicine because they are latecomers to the profession. "It's a time-related aspect," Gary said. "Women have only been entering graduateschool in any significant numbers since the 1970s. Then you have to add three to BUFFALO PHYSICIAN Pat Duffner, M.D. seven years of training and getting started in the lower academic ranks. Only now do you have a significant number of women reaching the maturity in their profession to realize such opportunities as chair positions." If a glass ceiling exists, it is caused by personal choices, not by institutional discrimination, she feels. "I think there may be limitations on opportunities various people can achieve by virtue of their preparation, their willingness to take risks, their willingness to go on divergent paths to reach certain opportunities," Gary said. "So I think it is A N D BIOMEDICAL a very individualized pursuit of a career that determines whether there is a glass ceiling." Clayton agrees that the choices women make may contribute to their concentration in medicine's lower ranks. "I think we have to take some responsibility for not getting ourselves promoted, " Clayton said. "My experience as chairman, and even before becoming chairman, is you have to be a researcher to get promoted. I don't think women are as intense about their research as they should be. They tend to take care of people. They enjoy that role SCIENTIST WINTER 1 9 9 2 4D �-- - --~~~~~-- and it's instantly gratifying. things are good, you are not going to make to identify the unique barriers women face "The feedback in taking care of people it in academic medicine. in using the system, and find out how to is so much quicker than planning a re"You have to be comfortable with your- get leverage from women colleagues and search project, executing it, writing it up self," Duffner added. "I think if women sympathetic male colleagues." ·and getting it published, that we tend not would just relax to some extent and not Mentoring is indispensable for women to do those things," she said. fight it so hard, and feel comfortable in in medicine, Gary emphasized. "People Clayton speculated that women also their expertise, things would be better. are identified to move on because they've had their career shaped by someone in a may not be advancing as fast as they But that's easier said than done. " Clayton said that if women want to position to guide them and advise them. should because they are not as mobile as men . "There are many women associate advance they have to publish. "And not Then they need the contacts, so when an deans, but why those women aren't being just books," she emphasized. "It's easier opportunity becomes available, someone promoted, that's the disturbing question. to write a non-refereed book than to pub- thinks of them as a potential candidate. " Practical advice notwithstanding, mediSometimes it's tough to get promoted from lish in respected refereed journals. Women within. You have to be able to move. And also have to protect their time, so they can cine remains a demanding profession. For women may not be as flexible. I know of do the research necessary to publish, she many reasons the burden seems to be a woman whose husband greater for women. "I think one ought not told her when they got to have to be an exceedmarried: 'You can move once."' ingly strong person to On the other hand, succeed," Aschenbrener UB's School of Medicine and Biomedical Sciences women may simply be said, "but I think someranks 25th among the nation's 147 medical schools times with women that more particular about the in the number of -women in its student body. A study is the case. There are jobs they take. Jonassen conducted by the Association of American Medical Colleges in 1990 sho-wed that 41.5 percent of UB's still an awful lot of socisaid she has had several medical students -were female . etal factors that are baropportunities to be a canToday the percentage is even higher. This spring riers to women. They didate for a deanship, but 73 -women- 4& percent of the class- -will receive turned them down bestill have to do more medical degrees from UB. The follo-wing table cause the offers didn't work. They still have tracks female graduates for the past 10 years. come from the right place. responsibility for home and children." Clayton too said she has 50% ------------------------------------------;---Aschenbrener has been asked many times, but isn't interested in bethrived in a difficult ca40% ;---;---h ;---;---..... 7 coming dean. reer by following the ad14<-' "Being a dean is more vice of her grandfather - 30% 47 4,~ 4~ ~ ~ nurturing, and I don't - "Do whatever your want to take care of more task is as well as you can, 20% people," Clayton said. " ! and everything else will want to be involved with fall into place." To that 10% philosophy she adds psychiatry and research, some wisdom of her or something bigger than 0 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 dean ." own: develop strong values, stick to them and But statistics tell us that most women in medicine do not have said. "You can't be the token member of reflect on them often. Despite the difficulties women in medithese options. Many are strugglingjust to too many committees. You'll be asked to do that. You have to work the same kind cine face today, the future will be brighter, make it out of the lower ranks. What, then , should women physicians of hours that your peers work. If you have Aschenbrener predicts. "Things are definitely improving," she children, you have to have shared respondo to bring about change? said. "There are more male physicians in "You have to find an area you can excel sibilities." in and focus your interest," said Patricia McGrath, at the American Medical positions of power who are really making Duffner, chief of the medical staff at The Women's Association, said women need a great effort to help women along, who Children's Hospital of Buffalo. Duffner to learn how to use the system to their take delight in seeing women succeed. was one of the early specialists in pediatric advantage. "Doing a good job just isn't I've been very fortunate to have a number brain tumors. going to get you there. Women have to of very fine men assist me in ways I never "If you do good work in a focused area, look at the political mechanisms men use asked for and in ways I wasn't aware of. it's hard to be ignored," Duffner said. "If to get on committee, be appointed to And I've seen peopledoitforotherwomen. you do a lot of little things, even if the committee chairs, get visibility. They have That is very gratifying." + UB RANKED AMONG TOP FOR WOMEN GRAD~ ,,~ ;---- ~r- ~ 4D BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST WINTER 1 9 9 2 �WE~TERN NEW YORK WOMEN ~EE GAIN~ omen may be gaining power ancy ielsen, M.D., paved the way and influence in the medical for Western ew York's women physiprofession, if Western ew cians to be more involved in organized York is an indication. The medicine by becoming the first woman Erie County Medical Soci- president of the Erie County Medical Soety and the Eighth District ciety in 1989. ielsen is a specialist in Medical Society both are internal medicine and a clinical assistant headed by women. professor of microbiology at UB. She also Mary Ann Bishara, M.D., is associated with the Buffalo Medical was elected last May to represent physi- Group. cians in the eight Western New York "Once someone has been the first counties that make up the eighth district. woman to do anything, it's easier for othBefore that, Bishara was president of the ers coming behind," ielsen said. "I don't iagara County Medical Society for two have this load I carry around of blazing years. She is chief of anesthesia at Mount trails" - among her other accomplishSt. Mary's Hospital in Niagara Falls. Bishara said being a female has not hindered her advancement in her field. "I've always been accepted as an equal," she said. "I've never noticed any problems." As head of the eighth district, Bishara monitors problems that develop in the member counties, acts as liaison between the county societies and works with the state medical society. Amy Early, M.D., a specialist in oncology and a clinical associate professor in the Department of Medicine at UB, is -Amy Early, M.D. president of the county group. She practices with the Buffalo Medical Group. "If someone had told me 15 years ago I would be doing this," she said, "I wouldn't have believed them. " The local medical community is very receptive to women, Early said. " l think men for the most part have been very supportive. The two people who were most influential in my career have been men. They have gone out of their way to promote my career. " Early said the medical profession could be perceived by women as a large old boys network, which might make them reluctant to jump in. But that is changing, she said. "In medical organizations, men have gone out and recruited women. The American Medical Association is very interested in female members. " Amy Early, M.D. rrlf someone had told me 15 years ago I would be doing thisr I wouldnt have believed them.rr BUFFALO PHYSICIAN AND B I OMEDICAL ments, Nielsen was the first woman chief resident at Buffalo General Hospital. "But one thing I did do as president of the medical society was make sure young talented women physicians interested in the society had opportunities to sit on key committees. That's what it's all about. " Medical societies are still remarkably male dominated, ielsen said, but not necessarily because of conscious discrimination. "People in positions of power did not know there were women interested in being involved ," she said. "Once that barrier was broken, ina couple of years the executive board of our society was 50 percent female. That's how quickly it can change." Today, opportunities for women in medicine are wide open, in Nielsen's opinion. "Women have always gravitated toward specialities such as pediatrics, obstetrics/gynecology and psychiatry," she said. "But they are now going in to in temal medicine, family practice and the last bastion- surgery. The surgical ranks, even the traditionally male-dominated subspecialities such as colo-rectal and urology, have female residents. There has been enormous improvement compared to a few years ago. " + SCIENTIST WINTER 1 9 9 2 «> �BY ROBERT 5. WIEDER When Dr. Stu Silverstein is examining an undressed patient, he likes to save the balance test for last. ttAs they open their eyes, I tell them, 'You're fine- but somebody just stole your clothes.'" A Spoonful of Whensuturingminorlacerations. Humor he tries out standup comedy routines on his patients. ttThey can't walk out on me, and they don't dare heckle." Moretothepoint, theyusuallylaugh, and sail through the procedure before they know it. (We'll avoid any puns on ttkeeping them in stitches.") • EI!) BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST W INTER 1992 �BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST W I N T E R 9 9 2 �--------- --------------~-----~-- • aughter can play an important role in pain-control by distracting patients from pain and discomfort'," Univer_ _ _. . _ sity at Buffalo 1 graduate (1981) Silverstein says. In fact, as he wrote recently in California Physician, he believes that "in the appropriate doses and settings, humor can help in the healing process. It should be part of the plan." The role and application of humor in medicine has been widely discussed since publication of orman Cousins' "Anatomy Of An Illness" but Silverstein has taken it to heart as a practitioner, advocate, teacher - and comedian. A pediatrics resident at San Francisco's Children's Hospital, he is also a professional stand up comic, a regional winner of the 1990 Merit Comedy Competition. Physician-comedian may not be a traditional career combination like poet-musician or author-historian, but it has worked well for him , as a physician, a lecturer- he presents "Stand up Medicine Seminars" for physicians on the virtues and uses of humor in medicine -and an instructor, conducting workshops on comedy writing techniques for health care and other professionals. He also writes jokes tailored for medical personneL Silverstein represents an emerging school of thought whose principle hypothesis is that humor can be a beneficial tool for the healing arts in a variety of ways: ~ Humor can psychologically enhance the doctor-patient relationship and the efficacy of treatment; ~ Humor provides discernible physiological benefits to the patient in several clinical areas; ~ Humor is a mnemonic aid in giving instructions to patients and in imparting 0 BUFFAL O PHYSICIAN information to students and lecture audiences; ~ Humor can improve the outlook and productivity of medical staffs and, as an emotional release valve, help reduce stress overload among health professionals. Patient Morale And Cooperativeness Humor helps to alleviate the feelings of anxiety, apprehension and helplessness that patients experience in clinical and hospital settings. A laugh can ease tension and put a "serious" situation into perspective. Silverstein recalls one colleague who kidded patients as he handed them their dressing gowns by saying, "These quality designer gowns, if purchased from Macy's, would go for twice what we pay for them at the Men's Wearhouse, allowing us to pass the sav- A N 0 B IOMEDICAL ings on to you ... " Lightening the moment with obvious parody made it easier for patients to don this particularly grim and depersonalizinggarment, Silverstein notes. "Sharing a laugh also makes it easier for them to bring up their fears about more serious issues - such as the bill," he adds. Humor also works to "socialize the situation," by establishing the doctorpatient relationship in warmer, less formal terms. Given the current atmosphere of biotech medicine and industrialized health care, the healing process is probably more in need of humanizing than ever, and there is no more distinctively human activity than laughter. Nothing enhances a doctor-patient relationship, Silverstein suggests, like the ability to laugh together and kid one another. The end result, he feels, is SCIENTIST WINTER 1 9 9 2 �increasedpatientcomplianceandcooperation. To paraphrase Mary Poppins, "just a spoonful of silliness helps the me~~ci~~!~ ~~~e:~·, clinical treatment seems to be more effective when dispensed by someone the patient trusts, likes .and feels close to. .And almost mvanably, we are more mclmed to trust, like and feel close to persons who add laughtertoourlives. Humorthushelps establish a bond between previously unrelated individuals in circumstances where such a bond is most needed. As Victor Borge says, "A laugh is the closest distance between two people." A joke made at the expense of the clinical :ituation adds a "we're in this together camaradene to a settmg otherwise characterized by inequality and ~,:0~;:~:!:\',:"~~~n~~~;'.:~~~~~~:~:l BUFFALO PHYSICIAN Humor also works to "socialize the situation," by establishing the doctor-patient relationship in warmer, less formal terms. Given the current atmosphere of biotech medicine and industrialized health care, the healing proc e s s is p r 0 b a b l y m 0 r e d f h u man l.z l n nee 0 1• ng than ever and t h ere l•s n 0 m 0 r e dish 1 tl n c t l v e y u man a c ti vi ty than laughter. • 1 • AND • BIOMEDICAL SCIENTIST WINTER 1992 @) �Top 10 Oscarwinning movies if selected by the "Academy" of Pediatrics By Stu Silverstein, M.D. lQ I Indianna Jones and the Precipitous Delivery 9 8 7 6 Saturday ight Fever ... without Origin Dirty Harry in "Tell me that it's just the flu doctor and I'll blow your head clean off." Sophie's Choice ... Augmentin The Man Who Fell to Earth on Librium s ET makes a Child Protective Services referral 4 3 2 l Sally Field in "Not Without My ... Lawyer" King Kong Rules Out Sepsis Godzilla vs. Fecal Impaction Rosemary's Baby Gets a Psych Consult sphere, lending a note of easy familiarity to impersonal protocol. It leavens uneasiness with laughter. Humor can be a lighthearted acknowledgement of the loss of privacy and control that patients are subjected to by medical procedures. This isn't to suggest that practitioners incorporate handpuppets, novelty bow-ties or five minutes of bedpan gags into their exami- ~ BUFFALO PHYSI CIAN nations or instructions. It is to suggest deal" matters, especially when patient that the inclusion of banter, such as cooperation is essential. And when im"These jokes are free, but we do have a parting instructions for self-medication two-enema minimum," can bring a valu- and self-monitoring, a joke or two may able humanizing quality to an otherwise be an important mnemonic aid. A patient too disconcerted by the gravity of dreary medical context. the situation to remember specific proAfter all, underlying the increasing cedures might very well recall a joke corporate formality, esoteric technology and confusing protocol of modern medi- designed to remind him or her of those cine, the fundamental task of the healer procedures. For example, when prescribing mediremains to make the patient feel better. And few things accomplish this more cation that may impair the patient's motor immediately than the simple act oflaugh- functions, the warning "Don't operate any vehicle, machinery or sexual partter. ner over 300 pounds" - can engrave the PhysiologicalBenefits caveat into the patient's memory more Silverstein doesn't actually extol hu- deeply than a dry recitation of the stanmor as a clinical panacea, but if laughter dard precautions. Humor, in short, can were a pharmaceutical, he'd attract the put things in more engaging, and memoattention of the FDA. "For bedridden rable, terms. When it comes to delivering a progpatients, it can improve the circulation nosis, if the situation is not all that serialmost like an aerobic workout. It stimuhumor is the most immediate and ous, lates the diaphragm and can induce coughing, which is important to pneu- persuasive way to underscore that fact. monia-prone patients in stasis, and more Conversely, if the situation is serious, fun than a respiratory therapist. Muscle- humor can help soften the impact of that tension headaches often disappear after reality, can provide comic respite from laughing at comedy. Laughter can lower intense emotions and can be a vital tool blood pressure, improve digestion by for managing or minimizing the resultstimulating GI blood flow - important ant anxiety or despair. "At best, you'll when you're dealing with hospital food live a long and normal life. At worst, - and as a distraction from pain, can you'll have the satisfaction of making your health insurance salesman wish reduce the need for medications." he'd never met you ." Humor similarly helps to convey Instructional And boilerplate data and terminology to lisMnemonic Aid. teners during lectures, seminars and Humor can do wonders for doctorrounds, according to Silverstein, a vetpatient communication by getting the patient's attention, by helping to express eran of all three. "The professors, things in a more comprehensible way attendings and presenters who work and as a memory facilitator. Given that humor into their material are the ones the diagnosic interaction is often com- we usually remember best. They keep us plicated by the distraction of patient interested and attentive. ln fact, the apprehension, a lighthearted note can more serious the message, the more imalleviate patient misgivings, and thereby portant humor can be." make procedures and instructions less formidable. For instance, the declara- Stress Reduction For tion that, "We'll need samples of your Health Professionals stool, blood, semen and urine," can beMedicine's very intensity, Silverstein come far less stark and ominous an an- feels, makes humor a vital mechanism nouncement if followed by, "Gee, maybe for decreasing the stress inherent in its I should just take your underwear. " practice: "A sense of humor helps keep Humor can convert impersonal de- us from being swallowed up emotionmands made on the patient into "no big ally." The simple ability to joke about AND BI OMEDIC AL SCIENTIST WINTER 1 9 9 2 �- ---- - ---~~~ crisis situations, wo rkload pressures and bureaucratic frustrations can foresta ll burnout and discordant overreaction. Studies of hum or in non-medi cal workplaces show it boosts productivity, aids mental acuity and dimi nishes alienation , conflict and absenteeism. Most importantl y, it can make th e cl in ica l en- vironment less a source of dread and depression. There is, of course, so me antipathy among pro fessio nals toward compromising th e "serious business" of medicin e with "undignified" lightheartedness. But, Silverstein poi nts out, "Humor has always been part of our profes- ~ tu "Schrick Doc" Silverstein, M.D., a University at Buffalo grad (1981) , began doing comedy as a student here , back when medicine was still a gleam in his agenda. "I lived in Ellicot Complex, and I knew I'd need humor when they passed out Elavil along with the dorm keys. ln Ellicot, people would turn the sound down on the TV and have me do the dialogue. I did impressions of professors, Jimmy Carter, Menachem Begin, Mick Jagger. People said l should do comedy, so l went on at the Rathskeller in Squire Hall, which I think is now a dental school; somehow appropriate. I did mock press conferences, I did a lot of material about Buffalo- I was from Brooklyn and used to wonder what people meant by, 'Do you drive a kerr? '" Now a pediatrics resident and working comic, Silverstein has combined his two vocations into a flourishing enterprise, delivering what he calls Standup Medicine Seminars on "The Power of Humor in Medical Practice" to groups of medical professionals, often for Continuing Medical Education credits, and conducting workshops on comedy writing techniques for physicians wishing to integrate humor into their practices and presentations. His "seminar circuit" ranges from California to the east and midwest, and he has been featured in newspapers and magazines, and on ABC's World News Tonight. + e B UFFALO P HYSICIAN sional lives, and it's usually a welcome relief. " The "pro-humor" advocates might argue that it is precisely because medicine is both serious and a business that it stands to benefit fro m those humanizing, comforting and even tranquilizing qualities that "comic relief' so uniquely provides. + AND B IOMEDICAL S CIENTIST W INTER 1 9 9 2 6) �--- • ········································································ · ················· . I Buffalo Academy of Medicine presents Kart Haas OF MEDICINE , MUSIC AND THE HUMANTIES arl Haas, the radio host of the popular "Adventures in Good Music," must know that there always are doctors in the concert hall. And not just because he hears their beepers. Doctors are there because medicine and music have a common theme, which is healing. They are there too because to be effective physicians they must not shut themselves in a diagnostic world. "Medicine is life," Haas told an audience oflargely physicians who had come to his piano recital and lecture last October in UB's Katharine Cornell Theatre. "Medicine is life-healing," he said, expanding his theme. "So is music." Haas's appearance was the opening event in the Buffalo Academy of Medicine's Centennial Lecture Series, a series which this season is prescribing doses of the humanities. Haas' topic was "Medicine, Music and the Humanities." During the course of it he examined several of the great composers, and named a number of scientific and medical discoveries that were footnotes to his text of musical appreciation. "A musician is the poorer for going through life only as a musician," Haas said. "And physicians, too." The "kinship" of music and science, he said, is "creativity." "Medicine," he dared say, "is as much a matter of talent as music." Haas chose to begin his musical examination with Bach, the composer who lived from 1685 to 1750, whose music summed up the achievements of the baroque period in music, and who, as Haas fl) BUFFALO PHYSICIAN "Medicine is life. Medicine is life-healing. So is music. A musician is the poorer for going through life only as a musician. And physicians, too. The kinship of music and science is creativity. Medicine is as much a matter of talent as music." A N 0 BIOMEDICAL reminded, produced in addition to great contrapuntal works, 20 children. The piece he played by Bach was chosen for its "melodious beauty" rather than its intellectual rigor. The scientific achievement that Haas chose for his footnote to Bach was the first recorded attempt to measure the rate of the heartbeat- a very appropriate choice, for one of the notable characteristics of Bach's music is its strong and steady rhythmic pulse. During Bach's lifetime scientists were first envisioning a vaccine for smallpox. During the lifetime of Mozart they were discovering a way to fight dropsy. Mozart died mysteriously, perhaps as the result of an epidemic. He lived to be 35, and died 200 years ago. Since then, it might be argued, there has been more good medicine than good music. For Haas, Mozart represents a psychological advance in music. He played the D minor Fantasia by Mozart, in which he believes the composer bares his soul. "He wasn't a regular guy," Haas said, "and we can only understand him through his music." Haas remarked that each time he plays Mozart he discovers something new about the composer. And he suggested that a physician too should find something new each time he treats a patient. The other composers examined by Haas were Beethoven, Schumann, Gershwin and Debussy. Haas mentioned a few scientific discoveries during their lives. The vaccination against smallpox was discovered, and the stethoscope was invented, during the time of Beethoven, and penicillin was discovered during the lifetime of Gershwin. Beethoven was going deaf, and he was dejected, Haas said, when he wrote his last will in 1802. "Music was the refuge from all the tribulations that befell him," Haas said. He played the slow movement of the Pathetique Sonata, which SCIENTIST WINTER 1 9 9 2 �---- -- ..................... .. ......................................................... • • • • •••• • ~ I I Karl Haas presents uMedicine, Music and the Humanities" as the opening event of the Buffalo Academy of Medicine's Centennial lecture Series. romanticism: "There is no such thing as a creative mind working in a vacuum," Haas said. At the piano Haas did not venture beyond Gershwin, who died in 193 7 of a brain tumor. (He did, however, make passing praise of Leonard Bernstein and Aaron Copland, whom he called great, and he told especially of his admiration for Bernstein, who once impressed him at Tanglewood by being able to sing all the roles of Carmen during a class for conductors.) Haas played a piano blues by Gershwin, and he made it sound urgent. happens to be the theme he has used for his radio program, ever since it first aired in Detroit 32 years ago (one year for each of Beethoven's piano sonatas). Haas gave a heartfelt performance of an Arabesque for piano by Schumann, the great romantic composer who suffered from mental disorders. If you would understand Schumann, Haas suggested, you would best listen to the dual personality expressed in his music. Footnotes to Schumann were not scientific, but included fleeting references to other romantic artists, such as Delacroix, Hugo, Goethe and Schiller. They were all on to 8 U F F A L 0 PHYSICIAN ~ N 0 BIOMEDICAL The "vague chords" and impressionism of Debussy's Prelude from Pour le Piano concluded the musical part of the program, with wonderful washes of notes and harmonies. The harmonies of music do go far in making us whole, Haas suggested. At the close he told of a period of suffering in own life, when his sister was dying, and he found strength in the music of the slow movement of Beethoven's Emperor Concerto. It was for him a powerful example of the healing effect of musicof the composer as physician. + -BY SCIENTIST THOMAS W I N T E R PUTNAM I 9 9 2. $ �• ... . ............................ ... ............. .. .... . .......... . .............. .. ... ... . . . I SSOO,OOO grant received to estabfish supercomputing network for research Med school oHers unique medical computing course he practice of medicine, like nearly every other profession, has been revolutionized by computers. A dazzling array of computer programs is available to the physician at the touch of a keystroke, providing access to everything from full medical texts to electronic mail consultations with colleagues. Students at the School of Medicine and Biomedical Sciences are learning how to use this computer wizardry in a course unique to medical schools across the country. The course is distinctive in two ways: it is mandatory for students and it allows them to apply all the technical tools, interactively, to real-life cases. "What we're doing now is quite different from what most schools are doing," said john Loonsk, M.D. , director of academic computing. "There are some schools with electives in medical computing, and some schools that have mandatory computer literacy courses. But what we've been doing is requiring a course specifically oriented to the use of e BUFFALO PHYSICIAN computers in medicine." Each student is assigned a case to diagnose and treat using the full array of computer-based records and medical information systems that will be available in hospitals in the future. Students have access to the patient's computerized medical records and laboratory and drug reports, as well as computer images of X-rays or CAT scans. Students can use a medical expert system that helps interpret findings and make decisions; a data base of medical literature; full texts of reference books, clinical manuals and journal articles; the full Physicians' Desk Reference of drugs; a program that identifies interactions between food and drugs, and electronic mail for soliciting opinions from other physicians. Loonsk said the students respond well to the new technology. "The time spent on computers is definitely very beneficial," he said. Many come back to us and admit that they had to struggle some, but now that they're in a clinical setting and are seeing some of these tools at work, they're glad they had the experience." + - BY AND LOIS BI O BAKER MEDICAL S C he State University of New York at Buffalo has received a $500,000 grant to set up a supercomputing network that will place it at the vanguard of the emerging field of biomedical supercomputing. The funding comes as a $300,000 grant from the National Science Foundation and a $200,000 contribution from the University at Buffalo. The new system, which is 500 times faster than the current system, will allow faculty to intensify their work in two important research areas: biomedical imaging and the study of ion channels, tunnel-like structures that control the electrical behavior of cells. "Only a handful of medical schools have this kind of facility available for biomedical research," said Anthony L. Auerbach, professor of biophysics and director of the supercomputer project. "And I'm not aware of any other research university in the country having this level of research power available for ion channel studies." Knowledge of how ion channels work can provide new information on brain and muscle function and the causes of certain diseases. "This supercomputer will allow us to do experiments we could only dream of doing before," saidjoseph T. Spence, associate dean for research and graduate studies for the medical school. The supercomputer will support the work ofbiophysical sciences professor Frederick Sachs, physiology professor Donald S. Faber and Auerbach. + - BY IENTIST LOIS BAKER WINTER 1 9 9 2 �. .............. .. ........ . ............. . . . . . . . . . .... . ....... .. .. . ...... .. . . . . ......... ••••~• I UB's rural training track in famUy medicine accredited in rural areas, where the need for primary care physicians is great. The rural campus currently is staffed by two physicians and two resident physicians. It will eventually accommodate four physicians and resident physicians, plus a number of medical students who will rotate through the center. The practice will serve parts of two counties with a population of 21,000. Two private physicians, neither of whom offers prenatal care, currently practice in the area. By 1992, rural campus visits are expected to reach 18,000 per year. The Residency review Committee of the Accreditation Council on Medical Education has accredited similar programs at the University of Washington + and the University of ebraska. he rural training track in family medicine at UB has been accredited by the Residency Review Committee of the Accreditation Council on Medical Education, making it one of three universities in the country approved to train primary care physicians to be country doctors. The rural training program is part of a three-year program. Resident physicians spend the first year in Buffaloarea hospitals and clinics affiliated wit the medical school, and the remaining two years at UB's Rural Health Campus on the grounds of Cuba Memorial Hospital in Cuba, ew York. Cuba is a community of about 1,700 people 70 miles south of Buffalo in sparsely populated Allegany County. The resident physicians live and practice in the area, seeing patients at the rural campus and Cuba Memorial Hospital and Olean General Hospital, cosponsors of the project. "Residents tend to practice near the area where they did their training," said Thomas Rosenthal, M.D., clinical associate professor of family medicine and director of the project. "For the past 40 years, the American medical training system has focused on large urban institutions. " Rosenthal hopes exposing residents to a country practice will help reverse that trend and encourage them to settle BUFFALO PHYSICIAN - B Y LOIS B I This year's forum featured the work of 93 students, the largest field since the competition began. Projects ranged from a study of the effects of cocaine on the brain of a rat, to an analysis of heart disease risk factors in an old order Mennonite community. One student's research took him to Kenya, where he studied health and disease among the Rendille. Most participants conducted their research with the help of summer research fellowships, working at UB and other institutions. Forum particpants presented their research in poster form . UB faculty served as judges; each display was reviewed by three judges. More than 60 UB faculty took part in the judging. + AKER Research forum features wen of 93 medical students B medical students vyed for $500 prizes and the chance to take their research to a national competition during the 11th annual Medical Student Research Forum in early December. A N 0 BIOMEDICAL SC I Medical students present their research during the 11th annual Medical Student Research Farum. ENTIST W I NTER I 9 9 2 ED �rfi,iil".... ............ .... ..... ..... ................ ........................ .. ......... ... .... . ~ Fisher wins award for excellence in writing N adine Fisher, Ed.D. , a research scientist in rehabilitation medicine, recently received the 1990 Sidney Licht Award for Excellence in Scientific Writing from the American Congress of Rehabilitation Medicine. The award was presented in late October. Fisher received her doctorate last May ~ from the Department of Exercise Sci- ~ ence. Her research has been published v; Nadine Fisher, Ed.D. extensively in the Archives of Physical Medicine and Rehabilitation Medicine. Fisher received the award along with fellow authors professor David R. Pendergast, Ed. D., and professor emeriames H. Cosgriff, tus Evan C. Calkins, M.D. , for their Jr. , M.D. , was recarticle "Maximal Isometric Torque of ognized for his Knee Extension as a Function of Muscle contributions to Length in Subjects of Advancing Age ," trauma care at a published in the September 1990 issue dinner in November at + the Hyatt Regency Bufof Archives. falo. Nationally known trauma surgeon, James]. "Red" Duke, Jr. , M.D., delivered the keynote address on the effects of traumatic injuries and the ecoradley P. Fuhrman, M.D., was re- nomic factors of trauma care. Orgacently appointed chief of the divi- nized by the Medical Society of the sion of critical care at The County of Erie and co-sponsored by the Buffalo Medical Group and IndepenChildren's Hospital of Buffalo. Fuhrman, a UB medical school dent Health, the event was a fundraiser professor, is responsible for overseeing for Mercy Flight, Western ew York's clinical research and training programs emergency medical care helicopter serin the pediatric intensive care unit. He vice. Cosgriff, an assistant clinical professor will also participate in of surgery since 1962, has served as the modernization of director of Mercy Flight, chief of trauma the unit and impleservice at Sisters of Charity Hospital and ment new medical chairman of the New York State Commanagement promittee on Trauma. grams as well as build Duke, a Texas native, is a nationally a fellowship program. recognized authority on trauma care. Fuhrman was previously assistant director of the intensive care unit at Pitts- He established Houston's Hermann Hosburgh Children's Hospital. + pital Life Flight and help found the Cosgriff honored at Mercy Flight benefit J Fuhrman appointed chief of critical care at CHOB B BUFFALO PH Y SICIAN AND B I OMEDICAL American Trauma Society . A 1989 candidate for the position of Surgeon General of the United States , he was host of the PBS prog r a m Body watch . He currently serves as professor of surgery at the University of Texas Medical School at Houston. + Bettigole named Red Cross blood services director R ichard Bettigole, M.D., an associate professor of medicine and clinical associate professor of pathology , has been named medical director of the American Red Cross Blood Services Buffalo Region. Bettigole previously served as head of hematology laboratories, blood bank and clinical hematology at Erie County Medical Center. He is a graduate of Yale University and Columbia University Medical School. + John Naughton, M.D., right, dean of the medical school, receives an Award of Excellence at the 19th Annual Black Achievers Dinner held last October. SCIENTIST WINTER 1 9 9 2 �........................ . .. . ........................................ . ........ James Platt White Societr holds annua meeting embers of the james Platt White Society were honored at the society's sixth annual meeting held last October 18 at the Country Club of Buffalo. joseph T. Spence, Ph.D., associate dean for research and graduate studies, delivered a slide presentation on plans for the medical school's new biomedical sciences building. The dinner dance was held to honor society members, who have made annual contributions of $1,000 of more. The members of the james Platt White Society for 1991 are: Dr. Kenneth Alford Dr. William S. Andaloro Dr. Kenneth Z. Altshuler Dr. Amos Ar Drs. Kevin and Elizabeth Barlog Dr. jared Barlow Dr. Charles D. Bauer Dr. Richard A. Berkson Dr. Willard Bernhoft Dr. Russell W. Bessette Dr. Theodore Bistany Dr. Dennis L. Bordan Dr. and Mrs. Harold Brody Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. and Mrs. Irwin Burstein Dr. David W. Butsch Ms. janet F. Butsch Dr. john L. Butsch Dr. Evan Calkins Dr. icholas]. Capuana BUFFALO Dr. Dr. Dr. Dr. Dr. Dr. Dr. .fl l Michael E. Cohen and Mrs. joseph A. Chazan George H. Christ Daniel E. Curtin Roger S. Dayer Carlo E. DeSantis PeterS. D'Arrigo Dr. Edward Diao Dr. Thomas A. Donohue Drs. Thomas C. Doolittle and Leslie Doolittle Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Leon Farhi Dr. Daniel Fahey and Dr. Marie Runfola Dr. Donald M. Fisher Dr. Grant T. Fisher Dr. jack C. Fisher Dr. Richard R. Gacek Dr. Matthew A. Gajewski Dr. Kenneth L. Gayles Dr. john W. Gibbs, jr. Dr. Allen Goldfarb Dr. Seymour Grauer Dr. Harvey Greenberg Dr. Mala Gupta Dr. Thomas]. Guttuso Dr. Eugene Hanavan Mr. and Mrs. Edward Hansen Dr. and Mrs. Gerald Hardner Dr. Reid R. Heffner, Jr. Dr. Orvan W. Hess Dr. Takeshi Homma Dr. Bradley Hull Dr. Annabel M. Irons Dr. and Mrs. Kenneth L. jewel Dr. Charles Alexander joy Dr. Herbenjoyce Dr. Stephen T. joyce Dr. james R. Kanski Dr. Ivan W. Kuhl Dr. joseph L. Kunz Dr. Marvin Z. Kurian Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. and Mrs. Harold]. Levy Dr. Stanley Lewin Dr. jack Lippes PHYSICIAN A N 0 The James Platt White Society's sixth annual meeting was held in October. Dr. Dr. Dr. Dr. Dr. Don L. Maunz Robert C. McCormick William . Mcintosh Harry L. Metcalf Merrill L. Miller Dr. Eugene R. Mindell Dr. joseph F. Monte Dr. john D. Mountain Dr. Richard L. Munk Dr. Arthur Mruczek Dr. Dennis adler Dr. Richard]. agel Dr. Masao akandakari Dr. Richard B. Narins Dr. and Mrs. john Naughton Dr. David H. ichols Dr. john]. O'Connor Dr. Benjamin E. Obletz Dr. Yasuyo Ohta Dr. Elizabeth P. Olmsted Dr. Arthur Otis Dr. Donald N. Pachuta Dr. and Mrs. Robert]. Patterson Dr. and Mrs. joel Paull Dr. Deming L. Payne Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. james F. Phillips Dr. He rbert S. Pirson Dr. Dr. Dr. Dr. Dr. Dr. Ben Rappole Frederic D. Regan Albert C. Rekate Frank T. Riforgiato Alben G. Rowe Richard R. Romanowski BIOMEDICAL SCIENTIST Dr. and Mrs. Charles H. Rosenberg Miss Thelma Sanes Dr. Arthur]. Schaefer Dr. Robert . Schnitzler Dr. Roy E. Seibel Dr. joseph I. Schultz Dr. Elizabeth G. Serrage Dr. Edward Shanbrom Dr. and Mrs. Samuel Shatkin Dr. john B. Sheffer Miss Alice Simpson Dr. Richard A. Smith Dr. John E. Spoor Dr. William Sternfeld Dr. Gerald Sufrin Dr. Eugene M. Sullivan, Jr. Dr. Michael A. Sullivan Dr. Hiroshi Tazawa Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. W . William Tornow Dr. Anthony C. Trippi Dr. Ronald H. Usiak Dr. john P. Visco Dr. Barbara Von Schmidt Dr. Philip Wels Dr. Paul H. Wierzbieniec Dr. Gary]. Wilcox Dr. james S. Williams Dr. john R. Wright Dr. Hajima Yamabayashi Dr. Tetsuro Yokoyama Dr. Wende W . Young Dr. Franklin Zeplowitz Dr. and Mrs. David C. Ziegler WINTER 1992 ED �• ········ · · · · · ····· · ········ · ····· · ···· · ······ · ··· · ····················· ·· ······ · ········ ·· I 1 9 2 s 0 ROSARI E ROSSELL BENDER medical director of the Urgent Maryland. Theyhavefivedaughters (including five-year-old trip- '20 , of Ft. Lauderdale , Florida, is Care Department of the Western lets). JOHN published in 1991. 9 JOSEPH 3 R. 0 SAAB '34 , ANDERSON '67 , ew York Medical Park, was Board the author of Don't Say Goodbye 1 R . partment of Medicine at johns in 1989. Hopkins. 1 WALTER Z . SCHWEBEL '38 , is 9 7 0 s ROBERT P . GALE '70 , of Los Angeles, California, is a section from general practice and is living in Hamburg, New York editor of a new journal entitled Robert Gole, M.D. and is an instructor in the De- certified in emergency medicine s retired He is in private practice Cell Transplantation. JAMES A . SOLOMON '79 , is assistant clinical professor of dermatology and director of the International Centre for Applied Immunologic Principles at Tufts Medical School/Bay State Medical still active in pediatrics and is the Center. has MELVIN POHL '76 , has returned been appointed to the senior-acLive staff at the Memorial Hospital to Las Vegas as a family practitio- of Salem, New jersey (thisappoint- author of The Caregivers' jour- JANET M . WILLIAMS '88 , ment is only possible after 25 years ney, When you Love Someone With her husband john ]. Barbaccia of service to the hospital). Aids, published by Harpers. '88, announce the birth of their tired in 1982 and enjoys living in STEPHEN C . SCHE I BER '64 , ORESTES G . ROSABAL '77 , Jupiter, Florida for six months the executive vice-president of the who serves the Southern Medi- each year. liams is an attending in emer- American Board ofPsychiatry and cal Association as Councilor for gency medicine at Allegheny director of the Physically Handicapped Children's Program of Rennsselaer County, New York. 1 9 4 0 s A . ARTHUR GRABAU '45 , re- MYRON E . W ILLIAMS , JR . , '46 , tells us that he retired in july from Family Practice and Geriatrics. 1 9 5 0 s JOHN J . LAMAR , JR . , '63 , ner and addictionist. He is the 1 9 8 s 0 and daughter , Katherine Moore Barbaccia onjuly 17, 1991. Wil- Neurology, serves on the Edito- the State of Florida, attended their General Hospital; Barbaccia is rial Board of Academic Psychiatry 85th Annual Scientific Assembly chief resident in anesthesiology and is a member of the Board of in Atlanta , Georgia during at Mercy Hospital. Trustees for the Group for the November. Advancement of Psychiatry. JAN ICE DENISE W IL LI AMS '77 , OBITUARIES HENRY J . WISER '34 died in has a ROBERT M . TABACHNIKOFF private practice in neurology in '66 , was deployed inAugust1990, gynecology at the U.S. Naval Hos- Winter Park, Florida August 22 , Honolulu, Hawaii, and is doing while chief of the Obstetrics and pital in Patuxent River, Maryland. 1991. research in the epidemiology of stroke and Parkinson's Disease. Gynecology Departmental Keller Hospital, West Point, New York, R ICHARD F . BUSCH '78 , and served with the 46th Combat assistant clinical professor of sur- Harry 0. Westphal '58, of Palm Support Hospital in Saudi Arabia City, Florida, retiredjuly, 1991. until mid-Aprill99L gery (otolaryngology) at the University of California at San Di- JORDAN S . POPPER '56 , is an attending in obstetrics and ego, School of Medicine. 1 9 6 0 s MICHAEL I. WE I NTRAUB '66 , is His article "Intermaxillary Fixation THOMAS J . KAISER '43 died in May, 1991. diedjuly 15, 1991, at his home in JOHN WILLIAMS '43 , Cassadaga, New York, after a battle with cancer. com- co-edited a book with Arthur E. pleted the three-month Advanced Fass, M.D. ,onthecombinedmedi- with Intra Oral Cortical Bone Screws" was published in the Management Program at the cal disciplines of neurology and December 1991 issue of The july 11 , 1991 following a six- Harvard Business School in No- cardiology, Heart and Brain: In- Laryngoscope. year battle with lymphoma. vember, 1991. He is medical di- teractions of Cardiac and Neur·o- rector of Kaiser Permanente in logic Disease. Weintraub also co- KENNETH GLICK '78 , Orange County, California authored one of the book's chapters with Allan Rothman, M.D .. wife Sandy live in Baltimore, KENNETH E . BELL '61 , G BUFFALO PHYSICIAN A N 0 BIOMEDICAL HARVEY Z . KLEIN '57 , died on and his SCIENTIST WINTER 1 9 9 2 ��BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Winter 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. 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Changes in version imply substantive changes in content rather than differences in format. v26n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0af5ee947c7835ea9a73c57959b897fc.pdf 724995e8ef322632a43de73bd2a29914 PDF Text Text �THE BUFFALO PHYS I CIAN AND BIOM E DICAL SCIENTIST Dear Alumni and Supporters of the UB Medical School: Volume 26, Number 2 N DIRECTOR OF PUBLICATIONS NancyTobm EDITOR Nanelte Tramont Kolhg, R.N. ART DIRECTOR Alan J. Kegler ASSOCIATE AR T D I RECTOR Scolt Robert fricker CONTRIBUTING EDITOR Arthur Page STATE UN I VERS I TY OF NEW Y ORK A T BU F FALO SCHOOL O F M E D I CINE AND BI OM E DICA L SC I ENCES Or John Naughton, V1ce President for Clmical Affairs, Dean EDITOR I AL BOARD Or John A Richert, Chairman Or Harold Brody Or. Glen Gresham Or. Nedra Hamson Or. Jame> Kansk1 Mr. Harold Llll Or. Charles Paganelh Or. Luther Robmson Or. Thomas Rosenthal Or. Saleela Suresh Or Burton Singerman Or. Stephen Spauldmg Or Nelson Torre Mr Edward Wenzke Or. Jerome Yates ineteen ninety-two is off to a busy and difficult start. The good news is that the demolition project of the back-end of Harriman Hall is almost completed and construction of the new 110,000-square-foot research building should be underway by April1. Already one can sense the "campus-like" quality that will exist once these projects are completed. Indeed, UB will have a core medical-health-science campus of which we all can be proud. The bad news is that New York State's fiscal crisis will take yet another toll on the level of available state operating revenues. The reductions for 1992-93 will approximate $1.5 million and 25 full-time equivalents. The cumulative reductions since 1990 will total almost $3.5 million by March 31, 1993. lt is very fortunate that we experienced necessary growth and program development throughout the 1980s. O nly through the mechanisms of increased private giving, an expanded research program and the institution of the faculty practice p lan ar~ we able to cope wtth such large reductions in state funding. Even wtth these resources we w1ll be hard pressed to maintain the pace that 1s needed to be a med1cal school of top-rank. We are committed to do our best. Your help and support will be even more important in th_e months and years ahead. The faculty, students and 1 know you w1ll contmue to prov1de tt. We commit ourselves to maintain educational quality and to strive to keep your medical school among the leaders in the country. Sincerely, j ohn Naughton, M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences T E A C HIN G HOSPI T ALS AND LI AI S ON S Batavia VA Medical Center Buffalo General Hospital Michael Shaw Buffalo VA Medical Center Paula Pcdene ChHdren's llosp11al of Buffalo Karen Dryja-Swiersh1 Eric County Med1cal Center Mary Northen Mercy Hospital MHiard f'Himore llosp1ta!s Frank Sava Roswell Park Cancer Institute judith Rice S1sters of Chanty llospnal Dennis McCarthy © The State University of 1\ew York at Buffalo The Buffalo Physician and Bwmed1cal Scientist IS published quarterly by the State Umversity of New York at Buffalo School of Med1cinc and Biomedical Sciences and the Office of Pubhcauons. ll "sent, free of charge, to alumm, faculty, students, residents and fncnds. The staff reserves the right to ed11 all copy and submisSions accepted for publication. Address questions, commenlS and submissions to: Editor, The Buffalo Physician and Biomedical Scienllsl, Stale University of New York at Buffalo, Umversity Pubhcallons, 136 Crofts Hall, Buffalo, New York 14260 Send address changes 10: The Buffalo Physician and Biomedical Scientist, 146 CFS Addition, 3435 Main Street, Buffalo, New York l4214 Dear Fellow Alumni: W ith an exciting and informative Spring Clinical Day and Reunion Weekend just pa~t, I would hke to thank all of the board members who made ita reality. Dr. Mary Altce Kelly, as Program Cha1r, Dr. Margaret Parowski as Exhibits Chair and all of the others, made this event a big success. ' I would like to thank all the alumni who supported the many activities of the Association. You helped not only the medical school, but many medical students in their educational pursuits. We are a strong and healthy Alumni Association because you have shown that you care. Best wishes for a wonderful and healthy summer! Sincerely, J ~~·~ Nedra ]. Harrison, M.D., '77 �VOL . 26 , No . 2 .......... . . . .. . ........ .. .. . . . . . . . . ............. . . ... . . ....... . . ... . ... .. . . . SPR ING 1992 ..... . . . . ..... . . . ..... II Research IJ Hospital News IJ Perspective on Healing e A pictorial feature on UB's Smokers who quit smoking after bypass surgery were more interested in saving money than their lives, according to UB researchers. Page 3. Robert L. Brown History of Medicine Collection. DJ ASpoonful of Humor m Charting the Secrets of Life e As part of the Human Genome Project, researchers at Roswell Park Cancer Institute are unraveling the mysteries of our genes. ~~ It Hurts to Be Beautiful e Once nearly exclusively the UB researchers see a relationship between lower blood pressure and people with extensive social networks. Page 2. province of women, cosmetic surgery is fast becoming an equal opportunity operation as more and more men flock to surgeons than ever before. m m Medical School People • An early 1900s gas X-ray tube from UB's History of Medicine Collection. Page 6. EZJ Classnotes After a fouryear hiatus to do standup comedy, a physician returns to residency. Page 14. * C 0 V E R Apottery phrenology bust, ca. 1855, from the Robert L. Brown History of Medicine Collection. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · & ' " . North American Symptomatic Carotid Endarterectomy Trial to determine if patients with 30 to 69 percent narrowing of the arteries would also benefit from surgery. + National Eye Institute funds UB retina research VA study shows vascular surgery may help prevent strokes Department of Veterans Affairs cooperative study concludes that carotid endarterectomy surgery should be performed on patients who are at high risk for stroke. Linda Hershey, M.D., chief of neurology at the Buffalo VA Medical Center and UB associate professor of neurology, is one of the authors of the report published in December in the journal of the American Medical Association. "This validates the usefulness of surgery in high-grade stenosis, which can lead to strokes," Hershey saicJ. She added the study results showed that half of the patients who were randomly selected and treated with surgery and aspirin therapy had fewer strokes than those who were receivingaspi rin therapy alone. Thirteen patients from the Buffalo VA Medical Centerwereenrolled in the study that included 189 patients nationwide. The Buffalo study group will join the 8 BUFFALO PHYSICIAN alcolm A. Slaughter, Ph.D., UB associate professor ofbiophysical science and ophthalmology, has received a $143,000 grant from the National Eye Institute to continue research into how the retina functions. Specifically, he will study how neurons in the retina interact with one another. "There have been a lot of advances in eye research in recent years," Slaughter said, "but when it comes down to understanding the retina, we are just getting some real questions answered." Slaughter and his colleagues have been studying retinal function for nearly a decade. One of their discoveries revealed that the eye sees a light going on and a light going off in different parts of theretiM. + Study finds relationship between social contad and lower blood pressure UB study of social interaction and its relationship to blood pressure shows that people with extensive social networks have lower blood pressure than people with little social contact. And while connections with others in general were associated with lower blood pressure, certain aspects in particularthe number of siblings for women and household size and club participation for men - appeared to affect blood AND BIOMEDICAL pressure more than others. The study was conducted by researchers in the University at Buffalo's Department of Social and Preventive Medicine, headed by Maurizio Trevisan, M.D., using data from the 1960 Buffalo Blood Pressure Study. Results of the research were published in the ovember-December issue of Psychosomatic Medicine. To assess the effect of social interaction on blood pressure, researchers selected five categories of social encounters - household size, number of siblings, participation in social clubs and meetings, religious service attendance and maritalstatus-andcompared them with adjusted mean blood pressure levels for the 656 men and 753 women in the study group. Among women, the only category that showed a significant relationship to blood pressure was number of siblings. Those with six or more brothers and sisters had significantly lower blood pressure than those having five or less. Among men, significant correlations with blood pressure showed up only with size of household - the larger the better - and club participation - the more active the better. The researchers were surprised to find no significant relationship between blood pressure and church attendance since other research has shown an asso~iation between attendance at religious services and longer life, less hypertension and better health in at least some segments of the populations studied. + By SCIENTIST LOIS BAKER SPRING 1 9 9 2 �. ... ........ . .... . ........... .. ..... .. .... . ... . . . ......... . .... . ........ . ...... . . Money more important in motivation to stop smoking quit smoking and 13 had not. The smokers listed lack of will power, having nothing to do with their hands and nervousness as the most important rea+ sons for resuming their habits. mokers who quit smoking after bypass surgery considered saving money, not improving their health, the most important reason for kicking the habit, researchers in the University at Buffalo School of Nursing have discovered. And patients who returned to smoking did so within the first three months, they reported in an article in the Journal of Cardiopu l m onary RehabilitaLion. The survey of 46 people taken five years after surgery to determine the perceived benefits and barriers to stopping smoking showed that being more healthy wasn't even the second most important reason for remaining smoke-free. "Feeling better emotionally" (no smoker's guilt) held that position. one of the other potential benefitsfreer breathing, less coughing, feeling better physically- were listed often enough to be statistically significant. Further, the severity of their disease had no effect on p·atients' smoking behavior after the operation. Thestudytracked 197 patients who had coronary bypass surgery at Buffalo General Hospital in 1985. Of that group, 112 were smokers when they entered the hospital. All participated in post-operative programs to help them stop. The smokers' group was resurveyed after five years to find out how many were still smoking and why. Of the 46 who returned the survey, 33 had successfully BUFFAL O PHYSI C IAN By LOIS BAKER Roswell Pen to concUt Plme II breast aner study oswell Park Cancer Institute will conduct a Phase ll clinical trial of liposome-encapsulateddoxorubicin (TLC D-99) to treat women with advanced breast cancer who have not had prior chemotherapy. Doxorubicin is a widely used anticancer drug that has proven effective in treating solid tumors- carcinomas of the breast, lung and bladder-as well as lymphomas , leukemias and soft tissue sarcomas. Although effective, doxorubicin has been limited by the side effects it can cause, particularly damage to the heart, which may be irreversible and can be fatal. "Since the first chemotherapeutic agents were introduced," according to Ellis Levine, M.D. , assistant professor of medicine and the principal investigator of the study, "their inability to differentiate between malignant cells and healthy cells has resulted in potentially life-threatening side effects that have limited the dose that A N 0 BIOMEDICAL S C [I] could be safely given to patients." Encapsulating the chemotherapeutic agent could reduce its toxicity and target the drug to the tumor, according to Patrick j. Creaven, M.D., Ph.D. , associate research professor, who was among the investigators completing Phase l clinical trials of TLC D-99 in 1990. Those trials demonstrated that the toxicity of doxorubicin was reduced to a point where it may be possible to expand its use. When TLC D-99 is administered, its liposomal structures shields the body against many of the toxicities of the enclosed doxorubicin. lt is thought that TLC D-99 accumulates at the sites of tumors and avoids damaging tissue. The liposome breaks down after it reaches the targeted sites and releases the + doxorubicin. I IENTIST SPRING �lfZil · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · ~ BuHmo Genetd flies pm1 i1 study to cid stroke victins issue plasminogen activator, tPA, the clot-dissolving agent that provides hope [or many heart attack victims, is now being studied at The Buffalo General Hospital for its effectiveness in offering similar results for stroke patients. Buffalo General is one of l3 facilities nationwide involved in the study to determine if t-PA can increase recovery chances for stroke patients. The purpose of the study is to investigate whether t-PA can improve recovery by opening blocked arteries from strokes caused by a clot in an artery leading to the brain. "The use of agents like t-PA in acute stroke represents a new exciting chapter in stroke therapy," said Patrick Pullicino, M.D. , UB assistant professor of neurology and chief neurologist for the local 0 BUFFALO PHYSICIAN arm of the study. "Until now , there has been no effective therapy for a stroke. T -PA promises to be the first drug that will reduce the amount of brain damage caused by a stroke. " To be effective, t-PA must be administered within six hours of the onset of stroke symptoms. Pullicino emphasized doctors' attitudes about stroke, as well as those of the general public, would have to change if drugs like t-PA are to be useful. "The lack of treatment for stroke in the past has meant a pessimistic attitude and usually a long delay from the time of stroke onset to the time of arrival at the hospital. " The first BGH patients in the study, sponsored by the California pharmaceutical firm , Genentech, have experienced positive results [rom the drug. + clothing items to first-time pregnant teenagers who receive regular checkups through the Prenatal Care Assistance Program (PCAP) or are in Medicaid assistance in the Sisters Hospital Outpatient Program. PCAP provides free prenatal care to women who have no health insurance. The new program provides a "credit" each time the patient visits the prenatal clinic at Sisters for her scheduled checkup. After eight visits, she qualifies to receive a layette package that includes a variety of baby clothing items, receiving blankets and a specially designed diaper bag. + VA Medical Center one of 14 to receive HUMOR Proiect grant he Buffalo VA Medical Center has been awarded a grant to establish a Humor Resource Center within the medical center The grant, awarded by the HUMOR Project in Saratoga Springs, New York, was one of 14 awarded nationwide from a total of over 100 applicants. According to Michael Ackerman, R.N. , Ph.D. , director of the medical center's grant-writing team , "The Humor Resource Center is part of a larger project at the VA aimed at instilling a sense of humor into the health care setting. These are very difficult times for health care centers, and we feel that by providing an avenue for humor and creativity , there can only be one benefit and that is improved patient care." An integral part of the program is the isters Hospital has begun a pro- use of a hospital-wide humor cart, gram to offer incentives for first- dubbed "The Chuckle Wagon, " which time pregnant teenagers to seek will make a variety of items, including prenatal care. books, videotapes , toys, puzzles, etc., Called "New Beginnings," the available to patients throughout the program provides basic infant medical center. + Sisters Hospital program offers incentives for early prenatal care AND BIOMEDICAL SCIENTIST SPRING 1 9 9 2 �. .. . . . . . . . . . . . . ... . . .... . . . . . . .. . ... ..... . . . . .... . [1] CHOB purchases area's first fully computerized obstetric management system ultrafast CT scanner - an !matron can screen for coronary artery disease by detecting calcifications in the arteries associated with atherosclerotic plaques. Imatron scanners are ultrafast, taking images in one-tenth of a second as opposed to the two seconds required for conventional CT imaging. Because it is so fast, !matron scanning freezes the action of the heart's beat, resulting in clear, precise images that show calcifications. Images taken by traditional CT scanning can be blurry. Studies have shown that when I matron scans show no calcification , the patient is free of coronary artery disease. The presence of calcifications, however, may indicate the presence of CAD. According to Alan S. Brody, M.D., director of the CT Section of the Department of Radiology at Children's and he Children's Hospital of Buffalo has become the first area hospital to offer a fully computerized obstetrical management system in its labor and delivery suites. Purchased with proceeds from its 1990 and 1991 Golf Classic, the hospital's new system provides the staff with vital information on both the maternity patient and her ::~ -~-=-=-= . ./ '_...,.- ~- . .~....ro<t"·-··-:'' baby. From a central station, the system allows ll patients to be monitored at the same time on a single screen display, providing an instant overview of each patient in the system with immediate warning of critical conditions. The hospital, the region's designated high-risk maternity center with 5,000 deliveries annually, also purchased a new technologically advanced ultrasound for labor and delivery. Lawrence Romano, chairman of the '91 Golf Classic, notes "The new computerized monitoring system will enable the hospital to continue offering the highest quality care to maternity patients throughout Western New York. The Golf Committee is very proud of the business community's commitment and support of Children's Hospital. " + assistant professor of radiology at UB , "The Imatron has probably had the very best results in early evaluation of coronary artery disease than anything that's been tried previously. "The !matron scan is a screening test. If the Imatron shows that you have calcifications, it doesn 't always mean that you have coronary artery disease; but if the I matron shows no calcifications, you do not have CAD. In cases where no calcifications are present, an invasive angiogram should not be necessary. " Brody added, "Children's shares its technology and expertise with the community. We have an adult medicine department, and can cure adults as well as children ." In addition to being much faster than traditional CT scanning, !matron scanning uses a much lower dose of radiation. + ChUdren'sHospital becomes first in state to oHer ultrafast a scanning he Children's Hospital of Buffalo has become the only hospital in ew York State to offer ultrafast CT scanning. Research being conducted nationally indicates that use of an BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST SPRING �' ' The Robert L. Brown History of Medicine Collection Housed in UB's Health Sciences Library, the Robert l. Brown Robert l. Brown, M.D., medical school archivist and professor History of Medicine Collection offers an unrivaled perspective of medicine emeritus. The collection has grown, and continues into the evolution of the art and practice of modem medicine. to grow, in both scope and breadth with acquisitions and From its pre-Civil War lithotomy instruments to its assortdonations each year. ment of rare books dating back nearly half a millennium, the The instruments collection includes a range of dental tools, collection chronicles the progress of medicine stethoscopes, surgical kits, bloodletting devices, through the tools of its practitioners. One of ..-microscopes, lithotomy tools, obstetrical inonly three formal history of medicine collec- _,.__.,..~------- _:Struments, splints and early X-ray tubes. The tions among medical schools in New York State, oldest instrument - a Roman surgical clampthq:ollection at UB was formally established in dates back to the first century A.D. In 1985, 1972. Annette Cravens established the Edgar R. Before that, it existed as an aggregation of McGuire Historical Medical Instrument Fund donations to the medical school and volumes in honor of her father, a 1900 medical school acquired for the school's library from 1846. alumnus and chair of surgery from 1914 to his One of the first donations was the 1 ,070-voldeath in 1931. The fund supports the purchase ume private library ofUniversity founder james of historical medical instruments. Platt White, M.D. The medical school also Here, The Buffalo Physician and Biomedical acquired Roswell Park, M.D.'s entire 3,000Scientist presents a sampling of items from the volume collection when he died in 1914. Robert L. Brown History of Medicine CollecIn 1986, the collection was named after tion. 0 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST SPRING 1 9 9 2 �'A 19th century Staffordshire leech jar. cupping set and lancets. The practice of bloodletting reached a high point in the early 19th century . BUFFALO PHYSICIAN A N 0 * BIOMEDICAL SCIENTIST SPRING 1 9 9 2 0 �I' ,, I' II I. I~ I~ n II II I~ il !I II This Naval surgical kit . manufactured by w. and H . Hutchinson of Sheffield. contains a trephine. tooth keys and forceps. as well as an This Powell amputation and Lealand saw and "No. 1" stand surgical microscope. knives. Gift manufac- of Theodore tured in England in 1884. represents the height of microscope design and craftsmanship in the 19th century . Gift of William H . Merrilees. M.D. 0 * BUFFAL O PHYSI C IAN A N 0 B IO MEDI CAL SCI ENTIST SPRING 1 9 9 2 �I' r ,.,, II I, I~ II I! II II il II !I This un iden tified art ifact was made by Maw and Ca. of London . a med ical instrument manufactu r er. * •••• BUFFAL O PHY SICIAN A N D BI OMED I CAL SCIENTIST SPRING r 9 9 2 0 �I~ I' ,, I' BUFFALO II I, PHYSICIAN I~ A N 0 II BIOMEDICAL II II I~ SCIENTIST II II 5 F' R I N G !I 9 9 2 �I~ I' ,, I' II I, I~ II I~ II II William A set of Hunter' s lenses for the Anatomia Powell and I~ II II !I Lealand "No. Humani 1" stand Gravidi. microscope. originally * published in 1774. was donated by James Platt .. White. M.D. It is shown here with early 19th century obstetrical instruments. * This set of dental instruments with ivory handles (ca. 1850) is similar to a set made for the Great Exhibition of 1851. Gift of L .L . Mulcahy. Jr.. D .D.S. * B UFFALO PHYSICIAN A N 0 B IOMEDICAL SCIENTIST SPRING 1 9 9 2 (D �I' I' ,, I' II I. II II II I~ II !I II The staff of The Buffalo Phys1nan and Bwmedical Scientist gratefully acknowledges collecuon curator Lilli Sentz for her mvaluable help m producing this feature. 'A trephina- tion set (ca . 1760). 'A trephine was a circular saw used to remove a disc of bone Post mortem from the instruments skull. (ca. 1870). * This set was manufactured by Luer in Paris. * 41) B UFFALO PH YSICIAN A N 0 B IOMEDICAL S CIENTIST S PRING 1 9 9 2 �I, I' \J I~ IJ II II il II !I 'A homeo- pathic drug kit. Founded by Samuel Hahnemann in the early 19th century. homeopathy as a system of medicine was based on the doctrine that diseases can be cured by administering minute doses of a drug which in larger amounts cause the symptoms of the disease. * BUFFALO PHY SICIAN AND BI OMED I C AL SCIENTIST S PRI NG 1 9 9 2 G) �ASp I{}on't know how I got here, but I couldn't get up. I wa\, pinned to the asphalt of Market Street, my legs were moving but I w~sn't going anywhere. ThiswasMarket Street in San Francisco, so why was the Empire State Building looming in the horizon? It was all so strange. Vice President Dan Quayle was dressed in white culottes, playing the accordian. It was more than I could take. But as hard as I tried I couldn't get up. Suddenly I could hear the beeping of a dump truck backing up, heading right for me .. The beeping got louder and more piercing, and wouldn't stop. It was then that I woke up. I was in the Newborn Intensive Care Unit call room, my first night "on," after taking a four-year leave of absence to perform standup comedy. I glanced at my glow-in-the-dark watch (which retails for $295, according to my father. He picked it up for $39.95 and had the slashed sales slip to prove it). It was 7:15 a.m. I managed to sleep until 7:15 on my first night, on call? I thought, "not bad" until G) BUFFALO PHYSI CI AN o on f u I remember that I went to sleep at 6:45 a.m. Better call that number, see what's the problem. "Hello! This is Dr. Silver ... "MEC!!! OR3!!!" CLICK!! No good morning? MEC!!! What a great medical euphemism. Makes me glad I didn't become a plumber, which according to my father wasn't a "dignified job." You spend your life up to your elbows in ... 'mec!"' Fortunately I don't have to get dressed. I never intended to sleep. I just collapsed in my scrubs and shoes. So I just drag myself down the hall to OR 3, wearing what amounts to pajamas and slippers (no bathrobe, though). I'm still waiting for the day when someone will notice this and say, "Hey Stu, get out of those pajamas and put on some clothes. You're a doctor, for God's sake!" Of course before you enter the hallowed ground of the OR, you must cover your shoes with the "shoecovers." I must admit that I was never quite sure whether we do this to maintain sterile conditions or to protect our shoes from falling "mec." (Since surgeons and anesthesiologists wear these covers and their showercaps in the cafeteria, I've always assumed it was for the latter.) I must admit this was my first delivery alone in a long time and I am quite nervous, but just like in comedy one must "never let them see you sweat." At least there aren't any hecklers, but I AND B I OMEDICAL I of Humor still imagine the anesthesiologist yelling from behind the drape. "Hey Silverstein, YOU SUCK! " Where'd you get your medical license from? A raffle? Would you look at him intubate! I'm waiting for Alfred Hitchcock to walk through this scene!" Relieved that this probably won't happen in a medical setting (with the possible exception of quality assurance meetings) , I relax and enter the OR. I begin by casually checking out the equipment on the table as recommended by NAl.Scourseand realize that some things have indeed changed. The NBICU nurse who will serve as my assistant, informs me that we are no longer required to"' suck the meconium into our masks through a Krazy Strawlike apparatus. It is now done with wall suction. Finally we've entered the "safe mec" era in medicine. The delivery goes well. I'm tempted to say, "Thank you! Good night! Drive home safely and don't forget to tip your circulating nurses, they worked hard for you tonight." Luckily, I keep this one to myself. BackintheNursery, l(;~~a:;;Zf£{jjd it was the usual rounds: "This is hospital day 4 forT win A, who is now a five-cell morula, up from two cells yesterday, tolerating masked CPAP with good gases. Twin B SCIENT I ST SPRING 1 9 9 2 �© Stu Silverstein, M.D . .. is still a zygote and is dependent on hyperal. He took in l20cc/kilo/day, urine output 2 cc/kilo/hour and a surprising three runs batted in. " The day was relatively uneventful except when the post call intern desaturated into the '80s. Fortunately he came around with vigorous stimulation and some bagging. And so my final year of pediatric training was finally underway. Starting in the NBICU was my choice; I figured it was one of the tougher rotations, yet it was a "controlled environment," with a finite number of problems and finite number of solutions. On day one, I sounded like a veteran fielding questions from the nurses. "OK, just turn the ratedown,getagasandcall me with the results. Yea, just go up on the PIP and increase the rate and get a gas ... " Oh! "Sorry, didn't realize this was a bili baby. " Ina way,standupdid prepare me for this return appearance on theresidencystage. Here, too , we must p e r - BUFFA LO PHYSICIAN Perform procedures, perform on rounds, and, of course, perform for parents while examining their children to show that we take their concerns very seriously no matter how trivial they appear to us: "Yes, I realize that your son has had abdominal pain since birth, and I AM concerned, however, since your child is 35 years old, I'm going to refer him to a specialist. " I did, indeed, learn some lessons in the comedy world that would come in handy here. I realize that rounds aren't "ExConvict Night" at the local comedy club, and I won't be heckled by a cyanotic mouth breather with no neck. However, medicine does have its version of the heckler and heckling, i.e. , the attending and pimping. I learned in comedy that one must always be prepared for difficult situations in advance. We comedians do this by preparing what the unsuspecting audience perceives as "ad Jibs," i.e., if a couple in their sixties should walk out while I'm performing, I can't rely on luck. I must allow them to get within five feetoftheexit so everyone can see them and pause before saying, "Mom! Dad! You promised that THIS TIME you'd stay for the whole show! " Likewise the performer, I mean resident, must be prepared with "ad Jibs" for rounds. Standard comedian retorts like, "I like the haircut, didn't realize Supercuts AND BIOMEDICAL had a drive-thru window" probably won't work on rounds. Ad Jibs must be more subtle. For example, when discussing the incidence of various diseases, I bear in mind "LaCombe's Rule of Percentages" (Hospital Physician, 1971, 7(2);102), whichstates that the incidence of any disease is either 15 to 25 percent or 80 to 90 percent. Even if I'm wrong, I'll be right if I finish my answer with, "depending on the study. " There are many others, however, since I still have another six months to go and some of my attendings might be reading this, I will keep them to myself for now. And so I am the comedian returning to complete my medical training after starting and establishing my second career as a standup comedian. I couldn't have done it any other way. I feel the same toward comedy that William Carlos Williams felt toward poetry when asked how he reconciled such an unusual combination. They both require an understanding of what people are feeling and fearing in their lives. In both cases it is my job to relieve suffering, and in both medicine and comedy, timing is everything. And my time is up. Thank you! Good night! + Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California , lectures nationwide on the role of humor in medicine. SCIENTIST / SPRING 1 9 9 2 G) �~ m ~ 0 ~ > " Q • ••• • • • •• • ••• • • •• •• BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST SPRING 9 9 2 �Roswell Park research team unravels the human oenome Like a kaleidoscope, the Human Genome Project looks a little different to everyone _ who spends some time observing it. The view depends on the spin thats put on it. B ~ BUFFALO S c PHYSICIAN o AND t t BIOMEDICAL T h SCIENTIST o m SPRING a 1992 s 4D �o physicians and genetic counsel- genes that, when altered through mutation, can cause disease. The lab has identified, among others on Chromosome 11, the genes that cause aniridia, a form of blindness resulting from a complete or partial absence of the iris; Wilms' tumor; diabetes, and albinism. Teams working on other chromosomes have met with similar success; a recent breakthrough was the discovery, on Chromosome 7, of the gene that causes cystic fibrosis. The physical mapping is a tedious process of chemically breaking the DNA into manageable pieces of 300,000 to 400,000 base pairs, then assembling the information into a continuous strand of information - a seemingly endless string of permutations of A, T, G and C. But even success at this gargantuan task, Shows says, will be only the beginning of understanding how genes work; it won't mean that every genetic disease can immediately be eliminated. "It should not be construed that once we know this sequence, this is the prescription of life," he says. "This is just the first step in the long process of understanding the information in the genome. "How they function, how they are.controlled- all these are questions that have to be taken up." Because the Roswell Park lab has the computer capabilities to maintain the physical map, Shows said, biologists - about 200 a year - often write to ask for help in situating a gene they've extracted. The Roswell Park researchers can analyze a sample, match it against the DNA sequence they've stored in the computer database and tell the correspondent that the gene is situated, say, in position l3 on the short arm of Chromosome 11. And so another bit of the human genome code is penciled in. "Here's what I can picture," says Shows, whose enthusiasm for the project is prodigious: "Once we get the physical map and know what genes there are and know what the characteristics of genes are, all of this will be stored on computers. The time will come when biology will be done sitting at a terminal, instead of in the laboratory. "The amountofinformation is astounding. After all, this genome we have sitting here is the product of the universe." Decoding that information doesn'tcome cheaply. It now costs about $5 to pin down each nucleotide base pair; if that figure ors, the project is rich with promise for endinghumanmiseryfromawiderange ofgenetic diseases. To philosophers and medical ethicists, it~fraught with perilous implications for social policy. To pharmaceutical companies, it~ a potential bonanza ofgene therapies, a whole new industry of genes as drugs. The goal of the Human Genome Project, of nucleotide bases. The average chromohowever, is not complex: working in teams some contains 120 million base pairs; the in laboratories throughout the United entire human genome contains 3 billion. States, scientists are seeking to codify the The project, begun in 1990 and expected sequence of nucleotide "bases" that makes to cost U.S. taxpayers $3 billion by the end of up the genes in each of the 23 chromosome its 15-year life, has been compared to taking a pairs in the human body. census ofeveryone on Earth -and getting all The structure of the human genetic their addresses right. code was discovered by James Watson and About 2 percent of the total number of Francis Crick in 1953 when they deter- human genes have been mapped thus far. mined the configuration of the DNA (de"You could argue, why do this? " says oxyribonucleic acid) molecule that is the Thomas B. Shows, Ph.D., an adjunct profundamental molecular unit of life. The fessor at the University at Buffalo School of molecule is a double helix- shaped like a Medicine and Biomedical Sciences and diladder that is twisted. The sides of the rector of the genetics department at Roswell ladder are composed of a sugar-phosphate- Park Cancer Institute. "But to me, it's out sugar-phosphate polymer. The rungs are there to be understood. And what a thrill made up of the four nucleotide bases it will be to understand the human getwo purines, adenine and guanine, and two nome. " pyrimidines, cytosine and thymine. Each Shows' 20-person lab at Roswell Park is rung is formed by one purine and one involved in two aspects of genetic mappyrimidine; adenine always pairs with thy- ping. First is functional mapping - idenmine (A-T) , and guanine always pairs with tifying chromosome sites where diseasecytosine (G-C). Each side of the DNA related genes are located. He said the lab ladder is complementary to the other. has mapped about 400 genes- more than The D A (about six feet of it) is located any other group in the world. in the 46 chromosomes that are found in And then there's physical mapping, the the nucleus of every cell in the body. A primary goal of the Human Genome Project. gene is a chromosome segment that con- Working with a computer database, the tains specific genetic information, such as Roswell Park lab has concentrated its efeye color or the expression of certain dis- forts on the physical map of Chromosome eases. The 23 chromosome pairs are esti- l l, which is estimated to contain 2,500 mated to contain 100,000 genes and each genes. gene contains from 2,000 to 200,000 pairs Chromosome 11, Shows says, is rich in 4I) BUFFAL O PHYSICIAN AND BI O MEDICAL S C I E NT I ST SPRIN G 1 9 9 2 �•• •• doesn't fall to less than 50 cents per base health care and health insurance; the pair, the comprehensive project could be • • effect of genetic testing on parent-child doomed since the amount of money origirelationships . nally allocated is not enough to decode all "We're now moving into the area of of the nucleotides at the present $5 per insurance and insurability," Erbe says. "A base pair cost. The Department of lot of people are very concerned about Energy and the ational Inemployment. But other than the stitutes of Health, the major occasional horrible case there government sponsors of the hasn't been much in the way of project, are counting on developpre-employment screening yet." ments in robotics and other technologiShows, at Roswell Park Cancer cal improvements to make the process Institute, says the concerns about ethical cheaper before the money runs out. • • and social issues, although valid, are Cost considerations aren't the only • overestimated. aspect of the Human Genome Project that • "I get a lot of calls from ethicists and • philosophers who want to know what's has observers worrying. What about the ethical and social implications of this newgoing to happen once the genome is found knowledge? Like the design for a sequenced," he says. "They're all connuclear weapon, the genetic code is somecerned that there's going to be a real probthing that, once discovered, can never be lem quickly. We don't have a real problem unlearned. The world will have to live with quickly. We have a lot of work to do. its effects. "There will eventually be a blood test Writers of science fiction and newspawhere your entire genome is analyzed. It per "think pieces" have found much grist won't be soon , but it will happen. for speculation in the possibilities of the "There's no question that my insurance genome project: company could look at that and, if I had What will it mean for the insurance indussusceptibility to asbestos dust or whatever, try, they ask, when it becomes possible to they could decide I'm uninsurable. You bet identify an apparently healthy person as carrythat's a genetic issue," Shows says. ing the gene for a deadly disease? "But to me, the ethical issues are not as Who will have the right to study an important as the risk/benefit ratio of getindividual's genome? ting that physical map of the genome and Can potential criminals be identified discovering how to treat all those diseases. " through a simple blood test? What does the Human Genome Project Will D A testing create a "genetic mean for the practicing physician? Evenunderclass," shunned in their search for tually, it may make all the difference. In a jobs and health insurance? book by Leon Jaroff, "The ew Genetics: Richard W. Erbe, M.D., a UB medical they would abort a fetus if tests showed the The Human Genome Project and Its Imschool adjunct professor and director of baby would be born with CF. pact on the Practice of Medicine," molecuthe Division of Genetics at The Children's These parents' attitudes, they say in a lar biologist Leroy Hood is quoted as deHospital of Buffalo, knows the range of paper published in the May 1992 American scribing an exacting new world of doctorquestions that are being raised. For two journal of Human Genetics, may be indica- patient relations. After an analysis of a years he has chaired the study group that tive of those of parents faced with similar patient's genome, he says, "the computer reviews all grant applications for proposals choices about bearing children with other will give you a printout of the potential life to study social-policy issues of the Human disorders. history of that individual. ... You'll also get Genome Project. ElSI project proposals range widely in a printout that says, 'You should avoid The project has allocated a generous 3 subject and originate both individually and overexposure to the sun, change your diet percent of its budget to fund the study of jointly from theologians, scientists, actuar- at age 13, etc.' The focus of medicine, the ethical, legal and social implications ies, historians and philosophers- groups basically, will be on keeping people well, (ElSI) of its results. As a result, Erbe finds with little or no experience working with on making predictions about the difficulhis group in an unusual position: it has each other and often little or no knowledge ties people will run into and then avoiding more money to fund research projects than of each others' fields. The concerns they those problems by manipulating their diet, there are research projects to fund. raise are just as diverse: such issues as their environment or their immune sys"In certain respects, the many real is- religious implications of genetic knowl- tems, or applying molecular pharmacolsues are no different for genetics now than edge; professional standards for the use of ogy." Until then, we can only watch as the they've been all along," Erbe says. "But D A typing in police work; the history of now the public awareness is huge, because how people with genetic disorders have pieces of the human genome, one by one, only one in seven of the fertile couples said been stigmatized; the problem of access to fall neatly and inexorably into place. + •• • BUFFALO PHYSICIAN A N 0 BIOM E DI C AL SCI E • NTIST SPRING 1 9 9 2 4D �IN AN 1\I'I'EMPT TO LOOK TIIEIR BEST, MORE AND MORE MEN ARE UNDERGOING COSMETIC SURGERY THAN EVER BEFORE a> B UFFALO PHYSICIAN AND B IOMEDICAL S CIENTIST S PRING 199 2 �lastic surgery, the equal opportunity operation, has come of age. Once the exclusive domain of women, it is becoming more and more popular among men as they flock to surgeons in record numbers for chin implants, facelifts, eyelid tucks and liposuctions. And although women still account for 90 percent of plastic surgeries performed, the increasing numbers of men who seek cosmetic surgery prove that women no longer have an exclusive right to vanity. After 17 years in the business, Hanley M. Horwitz, M.D., has witnessed a change in the type of patients coming into his Williamsville office seeking cosmetic surgery. Ten years ago, he said, 2 percent of his practice was male. Today men represent 33 percent of his patients. What drives a man to seek cosmetic surgery? "A very strong ego to start with," said Horwitz, a 1969 graduate of the State University of ew York at Buffalo School ofMedicine and Biomedical Sciences. "And they can't be easily embarrassed. They also must have an overwhelming desire to have something corrected." Women also are important factors. "Wives are significant," Horwitz said, "very frequently young wives. Men feel it's good for the relationship." With society's intense focus on youth, there is no mistaking that this, too, plays an important role in their decision to seek cosmetic surgery. But that influence, according to Horwitz, is vastly overplayed. "That's one way to look at it," he said, but overshadowing this search for youth is simply the fact that people want to look their best. "Males age better than females," Horwitz said. "They don't get those little crow's feet and spiders all over their faces because their skin is thicker. And they don't get all the wrinkles on their upper lip." A man and woman walk into his office, both seeking a facelift. "Most of the time, they don't need it. Most of the time, they need something done with their eyelids" to achieve the results they want, Horwitz explained, adding that most men are well into their 50s, possibly their early 60s, before they need facelifts. Women, he said, usually need face-lifts 10 or 15 years earlier in life than men , usually in their late 40s. Buffalo surgeon and 1981 UB medical school graduate Bruce J. Cusenz, M.D. , has noticed that in men seeking cosmetic surgery, the aging process, regardless of the age, is more advanced. "Eyelids tend to hang more in men," he said. jack Fisher, M.D., a 1962 UB medical school graduate and professor of plastic surgery at the University of California, San Diego, estimates lO to 15 percent of his patients are male. "Many more men are coming in who feel fine , but look awful with folds and bags of skin." Not everyone who enters a plastic surgeon's office ends up having surgery. Most surgeons have extensive screening systems to weed out potential problem patients who have unrealistic expectations about how plastic surgery will change their lives. Horwitz schedules three office visits for his patients before performing surgery. "The first time I talk," he said. "The second time I listen. I have to flush the type of person he is out. If he can't come in three times before surgery, I won'tdo the surgery, even if l'm doing a doctor- someone I know well." Based on the initial sessions, a good portion of the problem patients are weeded out. "If they had expectations beyond what I could do, I won't even consider performing surgery," Horwitz said. For men , he said, a frequent request is a face-lift that will help them "to get their wife back or they want a job promotion," liON A MALE, YOU WANT TO LEAVE TH:E FEATURES ON TH:E HEAVIER SIDE. FULLNESS GIVES AN IMPRESSION OF AUTH:ORI1Y, AND YOU WANT TO LEAVE SOME WRINKLES." BUFFAL O PHYSICIAN A N 0 BI he added. Overall, the most frequent reason for turning someone away is an unreasonable demand, like obese people wanting liposuction to shed unwanted pounds. "They want to be skinny," Horwitz said, "and you can't do that" with an obese person through liposuction. Enhancing the diagnostic techniques of some cosmetic surgeons is computer imagery, where a patient can actually visualize what he or she will look like after the surgery is completed. But Horwitz calls this method unfair. "If you're showing it to the patients, you're potentially implying a result. You're also giving them unrealistic expec- OMEDICAL SCIENTIST SPRING , 9 9 2 ED �tations. If you're using it to analyze things for yourself and not showing it to the patient, you probably don't need it." Horwitz further explained his aversion to the method. "You can take away the bump on their nose with a computer picture, but it isn't the way a nose is going to look, because you'll have scar tissue and contracture. It's not going to look like that anyway," he said. Women on the whole don't experience as much dissatisfaction as men do after cosmetic surgery. Again , the selectivity of the surgeons comes into play, as those patients with underlying psychological quirks are more apt to be dissatisfied. As a rule, patient satisfaction with plastic surgery is quite high, with more than half of Horwitz's patients returning for more. Both McKissack and Horwitz themselves have had eyelid surgery and are pleased with the results. And both men said they would have it again. But gender is an important factor , as more women than men seek further surgery. "It's much more prevalent in women," Horwitz said. "They have their eyelids done; a year goes by and their face is sagging. It's not unrealistic that they would return for more. "Men get something done, and they're done," he said. The kinds of operations Horwitz performs on his men and Bruce J. Cusenz m BUFFA LO PHYSI CIAN A N 0 women patients are basically the same - rhytidectomies (face-lifts), rhytidectomies with liposuctions, rhinoplasties -but the techniques employed on men and women differ. "On a male, you want to leave the features on the heavier side," he said. "Fullness gives an impression of authority, and you want to leave some wrinkles. On a female you want more of a sculptured look, and you want to remove every wrinkle." Horwitz shares a philosophy held by many plastic surgeons: because of differences in skin thickness and texture, and due to the increased presence of hair follicles, cosmetic surgery on men can bring a worthwhile improvement. On women the results can be spectacular. According to PaulK. McKissack, M.D., a '56 graduate of the University at Buffalo medical school, men are not as good candidates for plastic surgery as women, especially when it comes to facial surgery. "Men's facial skin is a lot thicker than women's because it's hair-bearing," he said. "They also have a stormier course because they bleed more" due to the increased vascularity of the hair-bearing skin, he added, explaining that because of this, control of blood pressure is particularly important in surgery on men. "Women are easier to do," he said. "Their bones aren't [hard] like marble." Men also pose challenges when it comes to hair placement and concealing scars. For example, a face-lift on a male could cause his hairline to migrate behind his ear. To avoid this, hair follicles are destroyed in some cases. Doctors point out that on men it is much more difficult to conceal scars after surgery because they don't wear makeup. Nose surgery differs among men and women, too. "If you overdo it on a man, you can make him look effeminate," McKissack said. Surgeons also cite personality glitches as another source of complication in male cosmetic surgery. "Men are impatient," said james Wells, M.D., chairman of the public education committee for the American Society of Plastic and Reconstructive Surgeons. "And from that BIOMEDICAL S CIENTIST SPRING 1 9 9 2 �Hanley M. Horowitz and female patients. "Men come in just as tentative as the women, and they take a little more time beating around the bush. It takes them longer to open up," Cusenz said, "but once they get going ... " McKissock, who practices in the Los Angeles suburb of Torrance, California, has experienced a marked increase in face-lifts among his male patients. "It used to be considered a feminine operation," he said, "but especially here in Los Angeles, it's quite common." Some procedures, McKissack added, such as pectoral implants for men, are a very small and insignificant pan of plastic surgery. They appeal, he said, to "a certain type of man," such as the body-builder type. "I wouldn't even know who to send a patient to who wanted them . It's a stupid operation," McKissack said. It's a fly-by-night thing, and it will come and go along with a lot of other dumb things because they're a male fad ." "It's frivolous, " he said, "and for a plastic surgeon to call something frivolous .. . but this really is." + standpoint, they are more difficult to deal with than women. "Women are much more attuned to the length of time it takes to recover. Men think they are indispensable," he said. "Before they get out of the recovery area, they have a phone screwed into their ear. " Horwitz described his typical male candidate as a business executive with limited time. "They look at it like this: 'I want to buy a new car. I want to buy a new suit. I want to have my eyes done.' It's just one of many things." And before surgery, Horwitz, said, men are more demanding. "The male comes in and says: 'I have three days off and I want this done.' I say, 'But it isn't what you need.' If he still wants it done, I won't do it. "The female comes in and says: Just do anything you can; I want to look better."' When the surgery is completed, Horwitz added, "males are the most cooperative and the least demanding." By contrast, Cusenz sees few differences between his male BUFFAL O PH Y SICIAN AND B IO M E DI C AL S C IENTIST SPRING , 9 9 2 ED �• ························ · · · ······· · ··········· · ···················· · ······ · · · ·· · · · ········ ~ I UB medical school ranks high in terms of minority graduates years." Many of the programs for minority students - such as the Federal Health Centers Opportunity Program, the Minority High School Student Research Apprentice Program and the summer enrichment programs - have been funded by grants received by Wright. + nderrepresented minority students represent a higher percentage of graduates of the School of Medicine and Biomedical SciB Y M ARY B ETH S PINA ences than at medical schools at Medical students learn how to set up a private or other public universities in ew group practice at UB' s Prep for Practice program. York, according to a survey conducted dents some sort of benchmark from by the American Association of Medical which to make decisions about things Colleges. The medical school ranked like where to geographically set up a 16th in the survey of the 126 accredited practice or buy into one, what some of medical schools in the U.S. Cornell raduating medical residents the facility requirements are for differUniversity's medical school, ranked have rarely received sound ent kinds of practices and how best to ninth, was the only one in New York practical management training handle their own personnel," Richert ranked higher. in how to set up a private or added. The survey showed that students in The program attempted to give resigroup practice once they leave this group made up 12.2 percent of the their residencies. But a new dents further options concerning join704 students graduating from the school from 1986 to 1990. During the period, program at UB, called Prep for Practice, ing an HMO as well , he said. "For the University at Buffalo medical school is helping to change that, according to example, a doctor doesn't have to worry graduated 86 students in the john Richert, associate dean for alumni about getting malpractice insurance if underrepresented category, consisting of relations in the School of Medicine and he works for an HMO. He's already covered. And he receives a guaranteed African Americans, mainland Puerto Biomedical Sciences. salary. I think it's important for a young "We've long been wanting to do someRicans, American Indians and Mexican thing for graduating residents. It's really physician to understand these types of Americans. Maggie S. Wright, Ph.D., assistant long overdue," he explained. "This pro- things." Richert gave an example of how imdean of student affairs, attributed UB's gram touches on things that are never outstanding ranking to a number of fac- taught in medical school about what it portant geographic placement of a pracmeans to begin a practice. This program tice is by pointing out that if a young tors. is practical preparation for someone doctor chose to begin a general practice "For the past decade," she said, "we who's not going into academic medi- near the site of a military base, where have built and maintained a highly succine. " most of the people in the community cessful and comprehensive pipeline for Richert said that the program, which would already be cared for by the base early identification of talented minority students in Western New York and en- took place last November at UB and was doctors, the new practice would unrichment programs for middle and high sponsored by the Medical Alumni Asso- doubtedly fail. "These young doctors school students as well as undergraduate ciation, is designed to help graduating want to be able to make a living. I think and pre-med and accepted medical stu- residents make intelligent decisions this program teaches them and also takes about criteria such as malpractice insur- some of the pressure off by giving them dents." Wright noted that "faculty have par- ance, establishing a market for a prac- options." While practical knowledge was ticipated in summer minority research tice, banking and financing and risk manprograms at the school and have been agement. It was a single-day, eight-hour stressed during the program, Richert extremely enthusiastic and cooperative seminar. "We (Medical Alumni Asso- said that another purpose of the seminar in working with minority student en- ciation) were working in concert with was to present a myriad of possibilities richment programs and projects over the Syntax Laboratories. It gave the resi- to the residents from which they could Prep for Practice program helps residents set up new practices fl) BUF F AL O PHYSI C IAN A N 0 BI O MEDI C AL S C IENTIS T SPRIN G 1 9 9 2 �· ·· ···· · · ·· ····················· · · ·· · · ···· · ··················· · ········ · ········· · ···· · · · • make decisions based upon their own needs and wants. "Do you want to practice alone? Do you have the start-up costs involved in a solo practice7 Or is an HMO the best way to begin? And where do you want to live? These are all important questions, " he said. Ninety residents attended the inaugural seminar last fall and there was nothing but praise for the program, according to Richert. "It really was a smashing success. All of the evaluations were very positive. lthink that anybody who wants to go into some son of private, non-academic practice should be exposed to a program like this before leaving medical school. " + -BY MARK HAMMER UB to estabHsh nation's first comprehensive nuclear imaging training center he State University of New York at Buffalo will establish the first comprehensive training center for nuclear imaging in the United States, funded by a three-year grant from Siemens H.G. The grant is the result of two years of discussions between UB and Siemens. The training center, to be headquartered in the Department of uclear Medicine, will concentrate on positive emission tomography. "We're in the process of organizing a core curriculum to train everyone from the PET technician who assists the chemists, through all of the higher levels of science right up to a director of PET operations," said JosephA. Prezio , M.D. , UB chair of nuclear medicine. " o one is doing that anywhere in the United States. " Siemens needed a center that could train its people in depth in this new BUFFAL O PHYSICIAN field, Prezio said, and UB already had a well-regarded program in nuclear medicine and is establishing a major PET facility. The University , in conjunction with the Buffalo VA Medical Center, will be operating one of the most advanced PET imaging centers in the world by 1993. "The problem throughout the U.S. , and probably the world, is that training for PET has not been organized appropriately, or in enough depth , so that you can send someone to one site and have them come back seasoned and trained, " Prezio said. "Our goal from the beginning," he added , "in addition to establishing the PET imaging center for research and clinical use, was to set up a national educational program that would be unrivaled in the United States. " The center will be organized around four major training groups - technicians, radiochemists, nuclear physicists and physicians. Training of PET technicians will begin this spring. Other programs will accept enrollees as the curriculum is finalized. Training periods will vary from a month for technicians to two years for physicians being trained to interpret PET images. + B Y LOIS B AKER Ri(hard Safeer, right, distusses his poster with Murray Murphy at the Researth Forum. AND BIOMEDICAL Congratulations to the winners of the 11 th annual Student Research Forum irst Honors Winners Richard Safeer: The effect of the "Get Heart Smart" curriculum on middle school students. Diana Sanderson: Urine sorbitol excretion reflects blood glucose level in diabetes mellitus. Second Honors Winners Keung Lee: Characterization of a eDNA clone that encodes a Schistosoma mansoni antigen that may play a role in immunity. Harold Lilt: An integrated physician workstation: Digital patient records and the medical desktop. Atif Zafar: The temporal dynamics of scoliosis: Visualization of spinal geometry. Ann Comi: Copper toxicity and the distribution of copper in normal and Menkes lymphoblasts. Third Honors Winners Shane Ferguson: A controlled comparison of four different surfactant preparations in surfactant-deficient preterm lambs. Andrew Michel and Myron Glick: Cardiovascular risk factor analysis of an old order Mennonite community. Gina Marrero: Effect of combination photochemotherapy and hyperthermia vs. rotenone on human squamous carcinoma. Kristine Tenebruso: ~ Knowledge, attitudes ~I and practices of := women over age 50 regarding breast cancer screening and breast cancer screening practices. + SCIENTIST SF>RING I 9 9 2. ED �. . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . .. . . . [1] ' . American Board of Pediatrics and its sub-board of pediatric nephrology. He is a diplomate of the American Board of Medical Examiners and a member of the American Pediatric Society and the executive councils of the American Society of Pediatric Nephrology and the Eastern Society for Pediatric Research. + Children's Hospital appoints Alon Co_ppens to Department of Radiology T he Children's Hospital of Buffalo has appointed Alon Coppens, M.D. , to a fellowship in its Department of Radiology. Coppens received his medical degree from the State University of New York at Buffalo School of Medicine and Biomedical Sciences. He received his postgraduate medical training at Mary Imogene Bassett Hospital in Cooperstown, New York, and completed his residency in diagnostic radiology at the University of Arizona School of Medicine. + -BY . F Bruder Stapleton, M.D. , A. Conger Goodyear professor and chair of the Department of Pediatrics, has been appointed by the executive board of the American Academy of Pediatrics to the academy's Council on Pediatric Research. Stapleton is also pediatrician-in-chief at The Children's Hospital of Buffalo. The Council on Pediatric Research was established to provide a forum on pediatric research; its objectives include promoting pediatric research through the identification of major researchable questions, recognition of important completed pediatric research and the development of statements or other publications on pediatric research. Stapleton, a fellow of the American Academy of Pediatrics, is certified by the BUFFALO PHYSI C PAGE Raghavan appointed division hea~ at Roswell Park Cancer Institute D Stapleton ap~ointed to councU on peCiiatric research 6) ARTHUR IAN erek Raghavan , M.D. , Ph.D. , has been appointed professor of medicine at UB and chief of the divisions of solid tumor oncology and investigational therapeutics in the Department ofMedicine at Roswell Park Cancer Institute. Raghavan earned his medical degree from the University of Sydney, Australia, and his doctoral degree in experimental pathology from the University of London, England. He completed his residency in general medicine at the Royal Prince Alfred Hospital and served a medical oncology fellowship at the Royal Marsden Hospital, Ludwig Institute for Cancer Research, Surrey, England , and a research fellowship in medical and urologic oncology at the University of Minnesota. Prior to taking the position at Roswell, Raghavan served as senior medical oncologist as well as research director of the Urological Cancer Research Unit, Royal Prince Alfred Hospital, Sydney, Australia. Raghavan has published over 150 articles in peer-reviewed journals and presented over 100 papers at national and international meetings. He serves on the editorial board of the journals The Prostate, The Breast and The European journal of Cancer. + AND BI O MEDICAL Head of rehabilitation medicine named at BGH G ary S. Clark, M.D ., a UB associate professor of rehabilitation medicine , has been appointed head of the Department of Rehabilitation Medicine at Buffalo General Hospital. Clark earned his medical degree at jefferson Medical College, Philadelphia, through a five-year premedicaVmedical accelerated program with Pennsylvania State University. He is a diplomate of the American Board of Electrodiagnostic Medicine. Most recently, he served as medical director of Rehabilitation Services at Park Ridge Hospital, Rochester. A fellow of the American Academy of Physical Medicine and Rehabilitation, Clark is also a member of the board of trustees of the Association of Academic Physiatrists.+ Chddren'sHospital names attending physician in otolaryngology department T he Children's Hospital of Buffalo hasnamedMichaelP. Pizzuto, M.D. , to the Department of Otolaryngology as an attending physician. Pizzuto will manage all aspects of pediatric otolaryngology with special interest in pediatric airway and voice. After receiving his medical degree from the State University of New York Upstate Medical Center, Pizzuto completed a residency in otorhinolaryngology at the UB Graduate Medical!Dental Education Consortium. He completed a fellowship in pediatric otolaryngology at Children's Hospital of Michigan. Pizzuto is a member of the American Board of Otolaryngology, Head and Neck Surgery and the American Medical Association. + SCIENTIST SPRING 1992 �·········· · ················· ···· ·························· · ······························ • 1 9 3 0 Hospital (Co rnell University 5 Medical College). WILLARD G . FISCHER'36, fully re- SEBASTIAN CONT I '70 , cine on July 1, 1991, after 54 years. 9 4 0 9 ROBERT 8 J. 0 5 BRACO '80, an- nounces that he is beginning a tired from the practice of medi- 1 1 5 has a private practice in vascular sur- new practice in occupational and environmental medicine in gery in Sacramento, California, Appleton, Wisconsin. Braco re- and is an associate clinical pro- ceived his M.P.H. in 1990. fessor at the University of Cali- JOHN D . WHITE '40, is serving on fornia at Davis. R ICHARD A. SMI T H '81 , has the boards of the Older Americans Council and the AARP in ELLIOTT BRENDER '70 , is as- moved to Boston (Jamaica Plain), Massachusetts, to become an at- Tavernier, Florida. sistant clinical professor in sur- tending pathologist at the gery at the University of Califor- Faulkner Hospital. FRANK A. PFALZER '46 , has David H. Nichols '47 nia at Irvine, and chief of surgery been retired since july 1989. He 1 9 6 0 5 at Garden Grove Hospital, Gar- HOWARD WALDMAN '81 , den Grove, California. his wife,jan, announce the birth of t h eir daughter, Alanna and now lives at 2 Laurel Oak, Amelia Island, Florida, and spends sum- ROBERTA M . GILBERT ' 62 , mers in Western Falls Church, Virginia, informs RETA D . FLOYD'73, announces Denbrook,onSeptember9, 1991. us that her book, "Extraordinary the opening of her new office for Waldman is director of the car- Relationships, A New Way of the practice of psychiatry at 924 Buena Vista, Duarte, California diac catheterization lab at Salem ew York and Muskoka, Canada. DAVID H . NICHOLS '47 , has of accepted an appointment as Vis- Thinking About Human Connectedness," will be published in iting Professor of Obstetrics, Gy- June 1992. Hospital. 91010. D O U G LA S MELVIN R . PRATTER '73 , necology and Reproductive Biol- is AN D PLESKOW '82 , RANDI announce that ogy at Harvard University School JEFFREY of head of the division of pulmo- Rebecca Danielle, born on Sep- of Medicine and Head of the Di- Brewester, New York, writes, "1 vision of Gynecologic Pelvic Surgery at the Massachusetts Gen- have achieved no positions of prominence, written no notewor- nary and critical care at the Robert Wood johnson School of Medicine, Camden, ew Jersey. tember 10,1991, has joined her sisters Sara, 5, and Heather, 2 V2. eral Hospital. thy medical articles and am di- S. CARR ' 64 , vorced. 1 am very happy. " 1 9 5 0 5 JOHN J . BIRD ' 65 , ofWilmette, BERNARD H . SKLAR ' 56 , Fair Lawn, of ew Jersey, retired from active practice October 31, lllinois, is an associate professor of ophthalmology at orthwest- ern University. 1991. ROSS E . MCRONALD ' 66 , BEN CELNIKER ' 56 and his wife, Ilene, announce the birth of was medicine at Rutgers University. 1 9 7 0 his wife Debbie have five chil- Community Hospital of Shore University in Lattingtown, li na, School of Medicine. of directors of the American Lung of D E NNI S L. B O RDAN '70 , was elected vice president of the board of directors of the Ameri- Port Washington , New York, was recently named associate chair- can Diabetes Association , Western ew York Chapter. man of the department of surgery at North Shore University PHYSICIAN A N D orth New York. R ICHARD L . C OLLINS '83 , has recently been elected to the board Association of Western New DAVID M . K E NTON '79 , and their second child, Michael An5 is a vas- cular surgeon at Glen Cove's dren ages 15, 14, 13, 12 and 6. Neuberg is an associate professorof pediatrics in the division of pediatric hematology-oncology at the University of South Caro- his wife announce the birth of CHARLES F . O ' CONNO R ' 57 , BuFFALO and recently named director of sports their son,Jared Brandon, on November 17, 1991. G E RARD VI T A LE '82 , RON W . NEU BE R G '77 , drew, on September 3, 1991. Kenton is a practicing cardiologist in Deerfield Beach, Florida. BIOMEDICAL York. Collins also recently joined Buffalo Medical Group. R E NATA WAJ S MAN '83 , writes, "We have just returned to the USA after spending a year and a half in Israel. Ourfirstson, Oren Sharabi, was born in Israel in SCIENTIST SPRING 1 9 9 2 til �•• ........................................................................................ OBITUARIES July 1991. I am now joining a V I NCEN T J . FASANEL LO '86 , group in Cainsville, Florida, in and his wife Donna proudly an- gastroenterology." nounce the birth of their son, died December 26, 1991 in St. Vincent John , on February 3, Paul , Minnesota. ROBERT LASEK ' 84 , and COLETT E ( PRUEFE R ) LASEK '84 , announce the birth of their BRINA KESSEL RICHTER ' 25 , 1992. Fasanello is a psychiatrist with Westfall Associates in Roch- JOHN J . CONNELLY '42 , ester, January 3, 1992, in Buffalo , New ew York. first child, Christopher Ryan Lasek, on December 10, 1991. died York. SANFORD LEVY '86 , writes, "After travelling the world for GEORGE J . ALKER , JR. , ' 56 , LINDA PETERSON MANDANAS two years, I have settled back in former chair of the Department was recently inducted as a Buffalo and have joined the Cleve- of Radiology, died December 31, fellow of the American Academy land Hill Medical Group, prac- of Family Practice at the annual ticing internal medicine." '84 , AAFP meeting in Washington , ART H UR WE ISSMAN '86 , D.C. GRACIELA has 1991 , in his home in Williams- George J. Alker, Jr., 'S6, ville, New York , following a burgh as assistant professor of lengthy illness. He was 62. radiation oncology. Alker, who worked actively to joined a private practice in gen- promote passage of ( CONSTANTIN O) era]surgeryinBuffa]o, ewYork, State's mandatory seat belt law, writes, "jim with jonathan Reynhout '68. DESEMONE ' 85 , 1 9 9 0 HEIDI DEBLOCK s '90 , and her and I have recentl y moved to the Weissman 's Berkshire, Massachuseus, area, Zachary Arthur, was born on husband announce the birth of but more importantly, our daugh- April 12, 1991. Elizabeth Wende DeBlock on second child, February 2, 1992. ter, Marcela Grace, was born SepJOHN tember 8, 1991. " E. ZVIJAC '86 , com- pleted an orthopaedic surgery of residency at the University of Norfolk, Virginia, has started a Miami's jackson Memorial Hos- plastic and reconstructive sur- pital in june 1991. He is cur- gery fellowship at Eastern Vir- rently doing a one-year fellow- ginia Medical School. ship in sports medicine at the MICHAEL JON DENK '86 , American Sports Medicine InstiANDREW GIACOBBE '86 , of tute in Birmingham, Alabama. was honored by Governor Mario Cuomo two years ago for his service on the Governor's Coalition on Traffic Safety. Alkerwas chair of the Department of Radiology from 1981 until he retired in September 1991. During the same period, he served as director of the Department of Radiology at Erie County Medical Center, where he was a neuroradiologist from 1963 until his retirement. He was honored last year as Richmond, Virginia, writes, "My wife, Laura, and I became the proud parents of our new baby ROBERT F . CAFARELL '87 , writes, "I have combined an aca- daughter, Cristina Maria, on No- demic practice in anesthesiology vember 20, 1991." Giacobbe is at the University of Rochester's currently a plastic surgery fellow Strong Memorial Hospital with at the Medical College ofVirginia. ew York Physician of the Year by Erie County and ECMC. private practice at Rochester General. My wife, Brenda, and I are DEIDRE GREENE '86 , of Allen- town, Pennsylvania , writes, "My expecting our first child in March 1992." husband, Rob Dixon , and I are thrilled to write of the birth of RUS S ELL FUHRER ' 87 , mar- our second child, a daughter, ried Nancy in January and has Aurora, born August 8, 1991." joined the University of Pius- ti) BUFFALO PHYSICIAN A N 0 BtOMEOICAL SCIENTIST SPRING 1 9 9 2 ��BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1992 Subject The topic of the resource State University of New York at Buffalo. 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Research Perspective on Healing A Spoonful of Humor Charting the Secrets of Life It Hurts to Be Beautiful Medical School People Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n02 Extent The size or duration of the resource. 32 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/50c30866460c3a36ce2f7ab2fcff931f.pdf c5b96c6da6ebd5da36c8d5f2c9aaac4d PDF Text Text �THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST \c umc 2~ "" mhcr l r"'"'"'lld m the bst ts.sue of the P/1\~.n.:n that thl' propili>Cd nC\\ research bu1ldmg was DIRECTOR OF PUBUCATIONS "lancv T L .... EDITOR ""~ rue rr m >nt lolhg r.: "' ART DIRECTOR A An I &.cj:,' r r "kcr STATE; UNIV£RSITY OF NEW YORK AT BUFFALO <;chool of !'.lrd•<mr ~nd B•omrd~ral ~lfDCCS Dr 1.>!: 1 "'au~hton 'V ( hntc \I -'" f.'lr11r. Prt nt lor EDITORIAL BOARD Or J >h D D~ Dr Dr M• Dr D Dr D '\ R r, l h 'd ru BrH hu II rr I r r I) Ra , 1td ~ ol I" ~- ~ JplcR [' \ l \ _ J [l nn-n T1 >th) '' bnrl ~olen <r m !"'ot\\ 'tork C:.t..1tc o; buJgct Th(' offt tal grcundbreakmg a ma;L~r hLstoncal t:Bovent'i I ~6-)C.UCXISI('n<c \\.:sheldon 11.1ay.! IQQ1 Ihcfa~..tht) \\til pro' 1dc nC\\, st.:tc or th(' an rusK rC'K'".trch l.tbor.non('<; dcs1gned to be operated as a . non-d('panmcnt.Jih ilSSt ncd untl It \\Ill al,o serve to umte the Health as envtsioncd .Ls long ago ._, I CJ6l ""=--,....,....,.~,....;..-...., fhe buildmg wtll straddl(' the "p<:~e bel\\een the 'x.hool of Dental Medion(' and th· rnrd•tal o;chool'" Am mal f .1oim AdJmmng the wcc;t side of the lampu.:; \\ t'l beth(' clcgantllc.tlth C,Cicnce<> library and foster Hall, the dental c;lhool"s b.L>~c sctc.nlc fac1hty. On the ea.o.;t s1dc wtll be the med1ca: sdtool complex Hamm.m (Old Nonon) Hall wtll be rcnov.ard for the slhool c; .tdmmtstr.lllvc offu.:es later m th1s dcc.ade .md w:r.nt:ltcd to 1hc new fa~.1ht) When completed Hamman \\ill be bounded on each '>ide by qu.tdr.mgles, and h) 1')<)'), th(' campus w11l 1: \e ho•h pre• ntl' .md the l pacnv to conunuc lOntnhutmg toNe\\ York <.t.!le'" needs,., bH.mied~t~l n.'sl'"ar~h The £acuity and I appreciate L nt\t.T-.;ll\ admtnt ... tr.ttwn 'tl'~'r tl•est.:k slt..:Jcrshlpdnd the\\esteml\oew ,,..,, ........ , m d1d on ou~ bdmlf Thanks 'tmccn:l\', 0 ASSOCIATE ART DIRECTOR ''-C"h 1 l"''ltrt f and Supporters of the UB Medical School: 1 r. ~LJL-.~ a <I a 1.- '1 Jr.o 0• < nl.- P • ~ I Dr L uthc Rc ""' D• Th<' P r'lthal Dr ..,a t• .a ' u~• D <;trp r .,,,a ld n Dr <.'It\ T r X Dr )ncmc ~at John 'Iaughton. M.D. far ( lmu:al Afjatr~ Dca'l, <, h110l c( \ftd1une and BwmtdiCtJI ':lctrna•s \ ltC Prt~tdtnt rr TEACHING HOSPITALS AND LIAISONS ~· n u \ \ "tr , I ( cntr L' flak• t.cncr I It< i'' al M chad ~"-"" flu I' o \ \ \1rJ I ( c " ' ,,.,.u,emi, wheel comes round uga rr...ula l'cdtt ( 1;, Jrrn, lie< pi al <! u'i I< E nr ( o·ml\' \1cJ•c ( rntr• Marv ft.trlflttl \{<!<Y H<>Spll M1l arJ ~, I re llr>pll h t r.,rrk ~a>u f<os" rl J k l 1 rr Ins 11 1 juduh "" ~· tr•• d <t- ••II> II< p.t I Otnnt) \1 ( '' Burr.· \ddrcs~ t; t In "~m ol fl'c '' tr ·. "'w hrk c mmcr.· u d suh r ' em~ tr 1 ~ > rhr C.4J~' H1>~t1• and Btomt'dJ,al 5dmrw C.t.•, l mvcrsll) c£ Ill~ \ rk Bull• <' l , \CI>II) Pt:" Ull<'m I lt'lr,>fhll"' [_•, 1lo."'~ ~ 11, bnngmg wuh 11 u l'C\\ \1edtc.tl \lumm &ard of rm cnthus• ,u._ .tbout !>C'rvmg .h) our new pre< 1dcn• La'>t >car's Board under Hamson set the htghtst .,!a"ldards for us to emulate. In lQ92 1991 we will such pre\ wusl} "-UCl"l''i~£ul .1c uvmco; ,,., the ph~ stCtan c.trcer presentations to sophomon mcdKal sllld('nts, .md the onent.tuon scssrono; for freshman restdem doctor; \\ l pbn .mother )Jnuarv rcccpuon for c.cmor <;tudcnt<,, along Jar out of-tO\\ n rrccptiott- for alumm m oth::r c tlle<.. <.)ur C,pnng Chmcal Day promtses.t forum cl ...ontcmpon.tl)" medtc.tl cone em, mtxc:d \lo ith the pleasures old fnends Our I1tsrm1:m<.hed \1edKal Alumnu<> Award will he presented in '-",,,.,mh..dl:•n Yale Emcntu~ Profc-,.><>r Dr \!£red L,,m. <.urrc'lth \\c .1rc \\orkmg on some nt-v. tde.lS for the commg )car mdudmg.tn IPR<.) rmx k tnal '>t.lntnar and a M.tt< h Da\ <elcbration for scmor., \\ ( '' tll conunuc our ltat"><m \\ 1th the Mcchwl AdmissiOns ( ommlllrc to fL•IIO\\ our lf'J.'fiC.\ stud... nts In addiuon, \lof' f'xpcct to recogmze unsung hlll dl'>Cr"\'ll'J;alumm \lolth a ne\\ catcgorv of Alumm t\thtevement r\\\ards to be presented at a <:.pcctal spnng luncheon. We are seeking opponumucs to suppon and acknowledge our hardworkmg volunteer fawh~ \\care also cono;rdcnng a Medical Alumni Who's Who to help '>pread the \\ ord about our more promment da~mates fhc \car ahe.td prom o;cc; all the cxcuement and mnovauon together our far-flung medtcal school fam1ly. 1k '"""'·" <;end address change• w n.r llu[jalfiPh} siCtull and Bwmrdual ~nrnllsr. 14f\ ( f'> Addu'"" H\5 !l.tJm 'ltrru. Buffalo New Ycrk 14214 Don Copley, M.D., '70 D(JY\ oJ..d. P. ee, rtto, MD . �VOL26,No.3 5UMMER1992 II Research II Hospital News IJI Country Doctors C. K. Huang, diredor of the Healtll Sciences Library, re<eived the first John and Margaret Naughton Spe<ial Recognition Award at the meiKal school' s annual fCKulty meetilg. Page 22 Rural physicians see more patients, work longer hours and earn less money than their urban counterparts. So, why do they do it? Diane Zwirecki finds out. Dr. Muse In an age of scientific specialization, some physicians find inspiration and expression in the humanities. Mark Hammer examines the phenomenon. _..,m --.111 m ASpoonful of Humor Stu Silverstein, M.D., learns about political correctness. m MeaKal School * Buffalo Gueral Hospital sends badly needed meiKal suppttes to Third World nations. Poge 4. Aguide to pahtically corred medspeak. Page 18. The School of MeiKine and Biomedical S<iences graduates Its 146th dass. Page 25. �[1] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. Exercise no substitute for not smoking n a collaboranve effort to determine the connecuon between hfestyle habits and blood levels of htgh-density lipoprotein cholesterol, researchers at UB and the University of Naples have found that smokmg and intensive exercise affect HDL in the body, but with opposite results. Based on an analysis of the habits of797 men who participated m the Olivetu Heart Study in aples, Italy, they found that nonsmokers who paructpated in vtgorous sport acti\ity- at least four hours a week for nine months a year- expenenced an average lO percent increase m levels of HDL, the c;o-called Mgood cholesterol.M Smokers, however, showed no statisticall> relevant mcrease m HDL levels, no matter how hard the> exerciSed. Results of the study were recently published in Preventive Medicme. "From a prevention potnt of view, this clearly says that you cannot run and sttll do everything else you want, because physical activity will not be able to overcome other bad habits," satd Maurizio Tre\isan, M.D , intenm chair of the Umversit) at Buffalo Department ofSocial and Preventive Medicme and one of the pnnctpal authors of the StUd). It has been known for some time that smoking is an tmportant nsk factor for developtng heart diSeaSe and that smokers have lower levels of HDL tn their blood than non-smoker... Meanwhile, studies have shown that high-density lipoproteins help protect against heart disease and that vigorous f) BU~,ALO PHVStCIAN exercise mcreases HDL levels. ~It appears that smokmg and physical activity act on high-denSH) ltpoproteins by the same mechanism, but have opposite effects," Trevisan said. "Mostltkely, they affect a number of enzymes, primarily lipoprotein lipase, a key enzyme in HDL metabolism. Smoking may decrease its activity, while exercise may increase it." The Findings were part of a larger study of the effect of lifestyle habits on HDL levels. The UB-UniversityofNaplesstud) supported previous findmgs that smokmg and being overwetght decrease HDL levels. Moderate alcohol consumpuon and \igorottS, sustained exercise increase H D L while low and moderate levels of phystcal + activity have no effect. BY LOIS BAKER Internationa I rehabilitation assessment standard developed at UB he first international standard for measuring the effectiveness of medical rehabilitation, developed by a University at Buffalo research group, could launch international research in the field and lead to refonns in the way Medicare reimburses the multi-million dollar rehabilitation industry for its services. The Uniform Data System for Medical Rehabilitation was developed through a three-year, $330.000 grant from the , ationallnsutute for Disability and Rehabilitation Research. The keystone of the system, e11:plained Carl V. Granger, M.D., professor in the UB Department of Rehabilitation Medicine and one of its principal developers, is the functional independence measure, or FIM, an easy-to-use instrument that allows trained personnel to assign a numerical value to a patienl's ability to function based on the performance of 18 physical and mental tasks that are part of a typtcal daily routine. By assessing pattents throughout treatmem and after diSCharge, their progress, outcomes and cost of treatment can be measured. The method has been embraced enthusiastically: -.r More than 150,000 patients m 337 facilities in 47 states have been assessed since its introduction in 1987. ._;. FIM has been translated ~ into five languages. ~.;.. Twenty-five facilities in ~ Aust~alia and five in Canada arc ~ sendmg data to UB's Center for i ANI) BtO..-£DICAL, SCt&HTIST I lit lit 2 .. �·························································································· m r3 m Functional Assessment Research, with japan expected to come on-line next. .;. Seventy-five VA rehabilitation centers will jom the system shortly Data collected from participating facilities are fed into a spectally destgned database that generates reports for each facility to compare its performance with similar facilities regionally and nationally. In addition, UB has opened a new database to serve skilled nursing facilities, and another is being developed to process information from m-home therapy services. Researchers have also adapted and are currently tesung the assessment method for pediatnc application, calling it WeeFlM. + BY LOIS BAKER Muscle rehabilitation with non-aerobk exercise can improve aerobic fitness .. VB study that used persons with osteoarthritis of the knee as subjects has shown that strengthening weak knee muscles with nonaerobic exercise also improves cardtovascular fitness. adtne M. FISher, Ed. D.,and colleagues in the departments of rehabtlitative medicine and physiolog} tested the subjects' aerobic fitness before and after three months of ISOmetric and endurance knee f!exton and extenston exercises known as quantitauve progre$tve e.xerctSe rehabilitation. After the program, the participants gained 65 percent more aerobtc power and could walk faster and exercise longer than previously. The study showed that, for this populauon at least, muscle rehabilitation alone can improve aerobic fitness. The findings were reported recently + in Gerontologist. BY LOIS BAKER nme percent having it in at least one meal per week ._;. Those with a higher frequency of eatmg the fish tend to eat larger serving sizes at one meal. ._;. Blacks and Native Americans, along with anglers with fewer years of education and lower LOtal household income, reported the most frequent consumption of ~ fish from Lake Ontario. ~ ~There is still a large percentage of people S using thiS resource, despite the warnings,·· ~ said john E. Vena, Ph.D., principal invesugator and associate professor of social and prevenuve medicine at the Universll) at Buffalo. • • Funded by a grant from the Great Lakes Protection Fund, the study was based on questionnaires returned by 11.717 anglers bile more than 90 percent of who purchased fishing licenses in 16 upanglers in upstate ew York state counties from October 1990 to Febare aware of the state's health ruary 1991. For six counties that border Lake advisory warning that fish Ontario, more than 10 percent of the anin Lake Ontario are chemiglers reported consumption of fish from cally contaminated, most have not changed their fishing habits or Lake Ontario at least once a fish consumption, according to prelimi- week. Venahasbeenfunded nary results from the largest study ever conducted on the health impact of eating by the Great Lakes ftSh from the Great Lakes. The study of more than 11,000 anglers by UB researchers showed that less than half have changed their fiShing habits and only 20 percent have cut their consumption of Protection Fund fish from Lake Ontario, the most chemifor follow-up studies. incally contaminated of the Great Lakes. cluding those of birth outThe study also found that: comes m female anglers and wives of an._;. Sixty percent reported consummg about the same amount of ftSh from Lake glers, and a study that '.viii focus on 350 Ontario in the last year as m prevtous anglers in the responding group that will years, while 30 percent reported eating mvolve taking blood and hair samples to determine who much of the chemicals are less. + .._;. One-third reported consuming the being absorbed by their bodies. Eight out of 10 anglers 1gnore wam1ngs about Great Lakes fish fish in at least one meal per month, with B Y L OIS BAKER �s ······ · ···· · ··· · ······························ · ··············· · ··························· Buffalo General Hospital shi ppi~ bad~ needed medkal supplies overseas uffalo General Hospital has launched a project to ship badly needed medical supplies and equipment to hospitals in Guatemala and the Philippines. Known as the Overseas Medical Assistance PrOJCCt (OMAP), the program was orgamzed b) BGH surgeon F fero Sadeghian , M D , and NanC} E. \ltazuchowski, assiStant admmiStrator for professional affairs. ~While traveling in different pariS of the world, I found that so many countries are in dire need of the type of medtcal and surgical items that we discard," Sadeghian The St. Louise West Side Health Core Center, site of Sisters Hospital's new OB/ GYH cfini<. satd. As an example, the BGH surgeon explamed that once a package ofsutures is goal is to conunue sending these types of counsel. Mazuchowski said support for OMAP opened and parually used, New York State ttems, but also to provtde hosp1tals with larger equipment whtch is no longer in usc has come from several sources, including health department codes do not permit it here," she explained. the hospital's medical and dental staff to be resealed and used In addition to the two organiz- which donated money to cover shipping elsewhere. He noted ers, other BGH staff mvolved charges for medical and surgical that a disclatmer ac+ in OMAP include Lynne supplies. companies each package advising Blanchard, R.N., sterilization of the supplies, if appropriate. Linda Butterfass, R.N., Mal) Ann The OMAP commmee meetsquarterl) to evaluDannenhoffer, ate the proJect, explore Phann. D , Charles , \ ways to expand the Lakso. \thchael program and to \ ' F "oe. ~1 . 0.. prepare pack~ ~'~~.:;;.~....... 'vttchael H. ISters Hospital has opened an obages for shtp- ............_ • stetncs/gynecology clmic featurl ping. To date, mg a wtde range of women's health t threeshtpments · senices and a bilingual nursmg ~ have been sent - staff at 209 Niagara Srreet, Buffalo. to Roosevelt The clinic is located at the St. Louise Hospital, a Also on the West Side Health Care Center, one of the 2,000-bed facthty commtttee are Rtchard hospttal's satellite facilities. Moore and Susan Regan, in Guatemala, and "We serve women of all age categories several to St. Martin de who are providing pro bono with various needs, including teenagers, I Porres Charity Hospital in legal services in connection with menopausal women and geriatric pathe project. They represent Magavern tients," notes joyce D. Heath, M.S., comManila. "As we proceed with this project, our and Magavern, the hospital's general munity services coordinator. Sisters Hospital opens obIgyn servke on Buffalo's west side l . 0 8U,.P'AL0 PHYSICIAN AND BIOMI[O f CAL SC.I:HTIST 5U .... M£R 1882 .. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] The clmic 1s also a site for the SISters Hospital Prenatal Care AssiStance Program. The center's staff includes an obstetrician/gynecologist, a registered nurse. a nurse practitioner, a social worker, a nutritionist and a financial advocate. The clinic also serves chemtcally dependent and high-risk pregnant women. + ment of radiation medtcme at Roswell, "It takes less than lO minutes, seems to be more effective, offers greater patient safety and convenience and significantly reduces length of hospitalization. And the potential uses of this treatment seem to be limited only by our imaginations." Shin and his colleagues arc currently administering brachytherapy to patients with recurrent, inoperable lung cancer, particularly those who have failed to respond to conventional radiation therapy. Patients with tumor obstructions in the esophagus may also benefit from this treatment, Shin said, as well as pauents with prostate, breast, head and neck, cervical and endometrial cancers. + Sisters Hospital plans to open ambulatory care center in Amherst Roswell Park Cancer Institute first to offer high-dose brachytherapy igh-dose brachytherapy-a new. more efficient method of delivering radiation d1rectly to tumors - is now being offered to area cancer patients at Roswell Park Cancer Institute Brachytherap). m which a radioacuve pellet is attached to a thin, fieXlble catheter and placed directly on or near the tumor. has man) advantages over convenuonal radtauon therapy The procedure allows the dehvery of a very htgh dose of radiation that rema1ns essenually confined to the LUmor area, sparing the surrounding healthy tissue. In convenuonal radiation therapy. radiation IS delivered indirectly from outside the paucnt's body. According to Kyu Shin, M.D., chair of radiation oncology and head of the depart- he Amherst Planning Board has approved a Sisters Hospital plan to open a fullservice ambulatory care center on Harlem Road at Sheridan Drn•e in Amherst. The Sisters Amherst "" Health Center will occupy approximately 15,000squarefeetof a four-story, 40.000square-foot medical ' office building planned by Ftrst Amherst Development Group. The center will provide mammography, X-ray and CT scanning, laboratory and blood draw station and a full range of outpatient primary•care services. The hospital's Corporate Health Ser- vices division will also be a part of the Amherst complex. as well as a medical reference materials room and conference/ classroom areas for medical meetings and seminars. Ststers Hospital medical staff will also maintain offices for specialties including 08/GYN, cardiology, orthopedics, internal medicine and family practice at the center. "The building of the Sisters hospital ambulatory care center results from the hospttal's need to bring many of its outpauent senices closer to the consumer. Our location will pro,ide easy and quick access from all the northern suburbs,~ said Sr Angela Bontempo. president of Sisters Hospttal. The remainder of the space in the medical office butlding , ...;JJ be leased to physiCians and other health care specialists whose practices are compatible \\.ith the Sisters Hospital facility. The medical office building will be located direclly at the Harlem-Sheridan Drive exit of the Youngmann Memorial Highway. It is scheduled to open this fall. Artist's rendering of Sisters Hospital's planned ambulatory care center. + ���• "Most of these people are my patients, if not friends, then acq11aintances. I just enjoy the rural setting, the people and the attitude. " Rural phvsrcrans sec more patients, work longer hours and cam less money than their counterpart~ m maJOr cities. The\ are more sevcrd) affected b\ shonagesof con~ultants, nu~es, thcraprsts and social support agcnw:., So, why do they do it? And why do other doctors opt for an urban practice? For many, the choiCe b based on their upbnngmg. For others, lb srmply a lifeume dream come true. Ask farmh pracuuoncr Wallace alter wh) he chose a rural practice and he's at a loss to answer- verbally. Instead, he'll rm,te you to hop m hrsjeep and maneuver through the 35 acres oft and he and his ,,;fe Debra O\\ n m the lulls of Boston, 1\Je,-. York. From therr mountainside home which ha~ the look and atmosphere of a ski chalet they overlook a breathtak- 0 8U,P'AL0 PHYSICIAN ing scene of foliage and wildlife. from lheir living room, you can sec the renovated 170-year-old farmhouse a quarter of a mile mva) which houses their JOint practice. Debora and\\ allacc. one of the the first husband-and-\\ife teams to complete residenc> trainmg at the State UmvcNl\ of '\ew York at Buffalo. clear!)' arc dchghtcd "ith thetr choice ofa practtcc locauon. In Wallace's opinion, they ha,·c the best of both worlds, ,,;th ready accc..,., to care m Buffalo. where ~children·s Hospnal 1s a 17-min.ute \-1edE,·ac awa} \\ c're luck) here." In Boston, '\e"' '\ ork, and the ncrghboring hamlet ofPatchin, C\'CT} bod) knO\vs evef}rbody else and adults and children alike are on first-name bases. An hourlong visit for breakfast at a local restaurant AND BIOMEDICAL brings in at least a half-dozen guests who stop and chat ''ith the doctors. Referring to the restaurant's clientele, Wallace Salter notes that "most of these people are In) pauents. if not friends, then acquaintances. I just enjO) the rural seuing. the people and the attitude... If the Boston hills are off the beaten path, then the Salters' ex'J)Crience as resrdents m Point Barro". Alaska, was downright Siberian. Point Barrow is a town of 4,000 located 330 miles north of the Arctic (rrclc Its people are mega-miles from the nearest Cit). m geographic location as well as in mind-set. '-:otes Debra Salter, "The) still have their medicine women ... The) still do things like cupping (placing heat cups on the back) and burning to remove bad sprrits." Both Debra and Wallace spent time in Alaska caring for the resi- SCIENTIST SUMNI:fll I 8 8 2 �dents of Point SarrO\\ and se,·en outlying \'Hlages \\ithin a 300-mtle rad1us Wallace made two mps from Buffalo to Pomt BarrO\\, Debra. one, accompamed on her venture b\ the1ro:.onjcremy, who was two year.; old at the ume. The family lived at the 14-bed hospital where the doctors worked and Jeremy burned off toddler steam by running in the corridor.; (At 70 degrees belO\\ zero. planng outdoor.; was out of the quesuon ) Many of the Salters· pauents were Alaskan p1peline workers and their famJI1es. Complex cases had to be transferred to Anchorage. 700 miles and two-and-a-half hours away by jet. Wallace Salter recalls treating a head injury on a pipeline worker: he was a1rlifted to the scene of the injury and mformed by his pilot that he had 11 minutes to disembark. suture h1s pauent and return to the plane before fuel ran out (at 70 degrees below zero. the temperature IS too cold to restart the plane) I accomplished ll m 13 minutes and ....-e made it back safclv,'' he recalls. Home for mam a Point Barrow family was a tarpaper shack. and basic necessities such as indoor plumbing often simplv were not available "\\ e·d treat a chtld \Vith an ear mfecuon and recommend a humidifier and the qucsuon wasn't, 'Do you have a humidifier?' The question was, 'Do you have runmng water or electricity?"' says Debra Salter. 'They melt icebergs for fresh water," adds Wallace. Tuberculosis, syphilis, hepatitis and other infections ran rampant man area where a sanitation truck visited homes datlv to empty out waste. In sharp con~t to the1r Alaskan e.'.-penence and ultimate choice of a rural practice, the Salters both have experience m urban mechcine, ha-.ing worked in \'arious Buffalo hospital emergenC\ departments. For eight years. they res1ded in the inner cil) and are convmced that their urban medicine counterparts could •keep ~anhattan,just give me that coumn'Slde" "It wasn't neccssanh the pauents as much as ll .... as the hfcstvle," explams Debra. "I JUSt never had the mner-cily attitude. Part of the d1fference for me was my upbringmg. I was ra1sed on a 6,000acre cattle ranch m ew Mex1co. I was just much more used to rural-type living in the first place." �Recent studies show that two trends related to phys1c1ans choices of a practice location arc similarity to their 0\\11 home town and spousal preference. In the Salters' case. both these theories appl). and their decision to open a practice in a country scuing ,.,.as mutual To sa\ thev are happ)''"ith their choice of both profession and lifestyle c, an understatement Ther speak enthus1asucally about every aspect of it, even cham sa\\ season "We have things that walk mto our office that I would nner get 1fl '"as practicing in the city... says \\ allace. "Last fall ''as chain saw season. 'HO\\ do) ou get those annoying blood stains out of vour chain saw?'~ Catherine Weeden. \t D also !)C~ her share of chain saw injuries. <l'> well as farmingaccidentsandsimilar mediCal miShaps. Weeden completed her famll~ practice training at UB in june 1992 and became medical director of the Unt\'Cr'>ity's Rural Health Campus in Cuba, 70 miles south of Buffalo. The campus was funded b\ a 1988legislative grant from 'iew York State. sponsored by the state's Corrurus'>IOn on Rural Resources. Physicians began seemg patients at the campus, located on the grounds of 26-bed Cuba Memorial Hospital. mjuly 1991. In less than a vear. '>taffed by a medical director and t\\."0 re'>idents. the campus has handled 4,000 patient ,;sits Thomas Rosenthal. M.D.. director of the rural campus, comments that "we're where we'd normally be after a couple of years an urban site." ''I'm not sure why I chose a rural practice,'' says Weeden. "I've just always dreamed of being a small-town country doctor." In contrast to Debra Salter. Weeden's upbringing does not mirror her choice of a rural area in which to live and work. She grew up in suburban Orlando. Florida, and attended the University of Tampa College of 'vtedicine. Her link to :-.le" 'r ork's heartland is her husband. M1chael. a minister in Olean- at 15 miles away the nearest Cit\ to Cuba. She describes her patients as ~farmers and small busmessmen. Animal bites, rabies vaccinauons and farm-related accidents are common," she notes, as are injuries to boaters on nearby Cuba Lake. Recently, Weeden treated "horrible lacerations" on a gentleman whose face was caught in a barbedwire fence. "It's not really very glamorous," she says. "He was wrestling with his dog." like her peers from UB, Weeden spent the ftrSt m·oyearsofherres1dency training at the Deaconess Family Medicme Center, an inner-city subsidiary of The Buffalo General Hospital. She sees hkenesses, as well as stark differences, bet\veen her urban and rural pauent experiences. ..Actually, they're very similar populations in some ways," she notes. "Both are largely Medic- I II II 2 �aid patient~. The difference 1s that here, moreofthcmarC\\OrkmgMcdicatdpcople. The) work hard. but don't cam enough to get med1calmsurance. Referring to her adopted rural hfestyle, Weeden says, "It's been a pleasant surprise working here. More and more, I can't go anywhere without ~omeone knO\\ing my name." Access to mcd1cal tcchnoloro , circa 1992. is nota problem. "In th1sage,you're not a.., isolated as you u..,cd to be," she commenLs. One of her colleague:, m Cuba. Kimberle\ \tarkowsk1. \-1 D , echoes \\'ecdcn ~ op1mon Dbtance hasn t Jeopardized an) cases, note'> \-tarkowski. "In an emergenC). v. hen atrtransport becomes necessary, any tunc seems to long. But in all reality. it's reasonable." Born in the tin\ communit) of~ewfane. t\ew York, and raised 111 the nearby to\m oflockport, Markowski d1dn't thmk t\\ice about JOinmg her husband Geoffrev in family pracuce and movtng to a spre;d of land that measured "257 acres, at last count." When they're not treating animal bites or gunshot wounds, the Markowskis raise three daughte~. 14 head of cattle, fi"e rabbits and a dog. Their work represents "famih practice in itsenuret)," <>avs Kimberlev Markowski. "The best place for famth pracucc IS m a rural setting, where there s more of a need than there is in the cit\ In the Cll), there are specialists for e'wythmg. Specialists tend to cluster in the cll~ where thev can be reimbursed for thc1r ~pecialue:, .. Rural or urban. canng for people. building relationships and '>culpting a hfest\·le rooted m personal cxpcnence is what choosmga practice locauon ult1m.11ely comes down to. And for some of toda) \recent medical school graduates, mral medicine is the right choice. 8U,,-ALO .. HYSICIAN AND t's a long, long way from modem medicine to Point Barrow. Traveling to this Alaskan outpost 330 miles above the Arctic Circle, Drs. Debra and Wallace Salter may as well have entered a time warp. Traditional native medicine in Point Barrow borders on the prehistoric; for many an Eskimo, the first line of care is a medicine woman who uses techniques such as burning the skin's surface with coins or metal cups to ward off evil spirits that are believed to bring disease. "The people there equated their medicine woman with a witch doctor. She was very highly regarded ," says Debra Salter. The Salters spent several weeks during their residency training living in and working from a 14-bed Point Barrow hospital. " If the traditional means of treatment provided by the medicine woman didn't work, then they'd seek us out for care." In a procedure commonly known as cupping, Eskimo medicine women heat BIOMEDICAL metal objects and place them on the back. "Evil spirits are associated with illness. If they can get the evil spirit to leave the body, they believe the illness will go with it," Debra Salter explains. The Salters saw four or five cases a month, many of whom were children, brought to the hospital only after such traditional native techniques had failed to cure fevers, ear infections and similar childhood maladies. But not all the natives' medical problems were minor. "Some of the disease processes in children and in the population in general were similar to those you'd find in a third-world country ... advanced tuberculosis, hepatitis B... it was amazing," says Debra Salter. Amazing, perhaps. to the physician educated in a major American university. Buttothe Eskimo bred in Alaska's most remote geographic comer, it was a simple matter of respecting timehonored traditions passed down through the generations. One man's witchcraft is another man's cure. Perhaps it's just a matter of what you believe in. SCtaNTIST + S U M M £ R 1992 CD �I; In an age of specialization, n1any p/,ysicians find inspiration /ronz tlze arts. By Mark Hammer ver the last 50 years or so, American cuilure has come to celebrate s pectahzauon, not only in medtcme, law and academic pursuits, but in virtuallr every arena of human acuvity from mortgage banking to cosmetologr, ,..·here an electroly:.ist can seldom give r ou a good pedicure. In the field of medicine, specializauon is eptdemtc Where once the GP tripped up and d own the statrways of our hves, humming a tunc of his own creation, painting a hulc on thcstde, writing poetry, perhaps doing an autopsy now and then, there now gallops a he rd of otolaryngologists, orthopedists (and orthopedic surgeons), neurologists (and neurosurgeons) , urinary incontinologists, endometrial samplers, comeaologists and investigators into the structural relationships of dihydorpyridine-l)'Pe calciUm channel antagonists. Perhaps because we cast individualism in a sacred light, Americans denve great comfort from the label ~expert." After all, who do you want to sew up your aorta? One way for practitioners to augment the narrow focus of thetr scienufic pursuit is to explore a different creative realm entirely, giving free reign to the intuitive process in a relief from the sctentific. We know the dogmas and strictures that define the realm of the mcdtcal expert can accommodate the errant muse, and have often enough. The world of medicine has yielded great poets, authors and compos- ers. And sometimes, the arts have yielded a physician or two. Anton Chekov (1860-1904), the Russian playwnght who wrote such dramatic masterpieces as The Seagull and The Cherry Orchard, was a (sporadically) practicing physician who lived a life devoted to the arts. He wrote his first short stories as a medical student at Moscow University to help pay off family debts. Although his reputation as an artist far exceeds his work m medicme, Chekov's writing continually encounters and questions the human spirit and the motivations which produce the emotional and physical environments within which the Russian people lived at the tum of the century. His characters continually face a moral struggle in finding their true selves, only to find that the I II II 2 �8 U P' P' A L 0 A N 0 8 IO M COICAt.. I II II 2 G �tragic aspects of life are often comed1c as well. Another example of a man of medicine who devoted his life to the arts ts the American poet W1lham Carlos Williams (1883-1963) 'low v1ewed as a major contributor to American moderniSt artistic ach1evement, \o\lilliarrJS was a general practitioner m Paterson, '\ie,... jerse}. for most ofh1s adult hfe He spumed the large city of New York, both arusucally and medically, in favor of a small commumty where he did everything from setting broken arms and treating chronic headaches CD eu,,.ALO ,-HYatctAN to perfonrung emergency appendectonues and making house calls to deliver babies And yet Williams produced a bo<h of work that includes over 1,000 pages of poetry, se,·eral plays, collections of short stories and books of essar:. and an autobiography. An annual poet!) contest, open to medical students around the country, is sponsored by the Human values m Medtcine program at Northeastern Oh10 University's College ofMedtcmc in honor of Williams. Williams was presented with an honorary Doctor of laws degree by UB during AND BIOt-t£.DICAL its centennial celebration in October 1946 (sees1debaron Williams). His sponsor for that degree, then-Dtrector of Universit) Libranes Charles D. Abbou. sa1d at the ume that Williams had encountered and celebrated ordinal)· American life both wtth his wnung and his medical practice. ~He has been able to see, understand and to express the larger unities of American hfe," Abbou said. '·Like the Universit}. whose hundredth year we celebrate, he too began in medicine, kept faith with all that it demands and sought beyond to that large store of knowledge that fits SCICNTIST SUMME:llt 18St2 �man's mind to grasp the ends of thought." Williams was also a celebrated participant 10 the Niagara Fronuer Convocation in Buffalo m 1951, whtch explored the possibilities of Amenca m the Iauer half of the 20th century A large collection of lus papers is owned by the Universny as well. Williams and Cheko", and numerous others like the Enghsh poet, dramaust and physictan Thomas Campion (1567-1620) and the Austnan doctor and composer understand a great deal of disparate information. -1 believe that doctors think in a way that is amagonistic to poetry," he says. ~because phystctans are often mflextble m their thinking. 'My Simple premLSe IS doctors aren't trained broad!}· m the liberal arts. Their educauon IS generali}' very specialized. Poetic thought goes 360 degrees. And the process of poeuc th10kmg brirlgs the poet mto other mtellectual ar- the physician, or the poet, to encounter new prirlciples that become universal, according to Charles Bernsteirl, a prominent American poet who holds the David Gray chatr ofPoetry· and Lettersat UB. Bernstern has wnuen and edited over 20 books of poell) and essays on language. As a ghost wn ter for 15 years, Bernstein wrote monographs for physicians for medical education publications and abstracts about new experimental drugs and procedures for '~ grounding in science alone won 't make anyone a doctor. There also needs to be an understanding of the intuition that tells us what the whole individual is." Peter Lichtenthal (1867-1924), spent a great deal of their hves pursuing artistic beauty while adhering to their calling in medicine. One reason for tlus lies m the process of commumcauon that underlies much of what an arust does, accordmg to Wilham Coles, M.D., chatrman of the depanment of ophthalmology at lJB's School of Medtcine and Btomedical Sciences. Coles is an accomplished poet published wide!> 10 Buffalo and in magazines around the country - who holds Wilharns as a maJor mfluence on lus 0\\-'11 writing. He 1S also a Jazz mustctan who bills himself as "Doctor jazz," specializing in heritage jazz and blues on the banjo and vocals. "I started writing creatively after Igraduated from medical school. I went imo poetry because 1 was very interested m idea transfer as an educator as well as a public speaker," explained Coles, who has also taught Life Workshops m poetry at UB and won the Callenwold Poetry prize in Atlanta. "Poetry 1S appeal10g because tt is made up of very• concentrated and well thought out tdeas. It's what 1 call the process of poetry, and u centers on communicauon. My medical school trammg left out that kind of process-onented thinking. Let's admu It, most doctors are not very communicauve." The poeuc process brirlgs the poet into various areas of thought, according to Coles, who has also taught poetry·at Emory University in Atlanta, Georgta. And it is through that kind of intellectual diversity that the poet is invested with the ability to BUP'Fo\ LO .. HVSICIAN eas continually. Poetry is the new sensitivity forme, the seventh sense, if you will, that also allows me to reach people across a universal spectrum." An intense attention to detail is what makes creative photography and surgery· complementary, according to NanC} Stubbe. M.D., a clinical physician at UB's University Health Services and a facult} member at the medical school "Wllh photography, you need to spend a great amount of attenuon to set up a good stillhfe scene, for example. If the least thing is wrong, the picture is ruined," she explained. "In that respect, it's very simtlar to medicine, where a physician must be very conscious of detail in her work. And with both, you must devote yourself entirely to the task at hand." Another parallel between med1cine and photography is in the intricate observation essential for both, said Stubbe, who regularly enters her photographs of nature in local photo competitions and has had some of her work published in a local medical newsletter, Medical News. "As a physician, you're taught how to observe a patient very· carefully. whether before, during or after treatment. The same goes for photography. But being a photographer made me learn how to observe without someone speaking about symptoms. In that way, photography has made me a better clinical observer." Changing focus, using the mformation from one field to shed light or bring new intellectual possibility to another, allows AND B IOMEDICAL pharmaceutical companies. He also edIted the Canadian edition of Modern Medicme and wrote and edited over 20 books of poetry and essays on language. •J loved the precision of the medical nomenclature in that it was very specific. But thewritingl was asked to do was often relatively dry·. and most of it was recycled mformauon. And that writing.~ he explamed, "earned a sense of neutral descnpuon, which is the exact oppostte of m} poetry~ Bernstein said he began to notice that his medical writing began toaffectlusown wnting and thinking. He maintair!S that medical writing both altered and expanded his perception of language. ~I found that the medical terminology, the phrasing, staned to creep into my creative work. For example, I wrote a piece about 'dysraphism,' which means the congenital mis-seanung of body parts. And that description seems to have caught on regarding what my creative work does, in general. It's like bad stitching. I'm generalh fascmated by any descnption of abnormality" It IS the large spectrum of feeling that gives doctors-as-writers their field of exploration, accordmg to Richard Seltzer, M.D ,a retired professorofsurgeryatYale Umverstty's School of Medicine and author of six books of shon fiction and essays. His most recent work, Down From Troy, a memoir about lus boyhood in Troy, NewYork,duringtheDepression, is forthcoming this summer from William Morrow Publishers. "I've worked very SCtlNTtaT SUMMIE" t882 G) �hard to transfer the feeling of surgery mto my writtng. And there is a strong similarity between the two for me Both are techniques, crafts." he c;rud won a very simple level, you have a scalpel that draws bloodandapenthatdraw.. mk ln\vnung. you're suturing words together and \\'lth surge[}. you resutunng together the body. I want to report, m the most compelling language that! can use,the suuauon of the human bod)." 11 Tommy Dorsey, Benny Goodman, Glenn Miller, and we do a few modem tunes as well." he said. WThe number one reason why we do thiS is for the fun of it. It gtves us a chance to do somethmg outside of medicine that we all enjoy" \Vhile Schiller finds music to be an escape from the daily rigors and pressures of being a ph)'sictan, a way to enJO}' the com pan) of his colleagues. the technical aspects ofbeing a musician resonate much Washmgton for a year. ~A grounding in sctence alone won't make anyone a doctor There also needs to be an understandmg of the mtUttion that tells us what the whole individual is.·· She also points to the technical expertise associated with both fields as bemg a point of convergence, although she admtts that the basic discipline she gained from studying music for most of her life has made her a better physician. MThere 1S 0n a t'ery simple let•el, you lzat'e a scalpel that draws blood and a pen that draws ink. In writing, you're suturing words together and with surgery, you're suturing togetlter the body." Seltzer, who didn't begm wnting until the age of 40 (he's now 64), satd that once he became entranced with language, his abthty to sense and empathtze with his patients mcreased dramaucally. "In making myself mto a writer, I became a better doctor I saw that! \\.'as much more in tune with my pauents as human bemgs," he explamed. "Because with things like compassion and pll), some people have it naturally and others get it b~ enduring thetr own suffering. I found ll through wntmg In his forthcommg memOir, Seltzer writes of his boyhood and the stress of having parents who had very dtfferent career choices in mind for their son; his father was a doctor and his mother was a singer. "My father wanted me to be a physician and my mother wanted me to be an artist. I guess at 64. I've finally satisfied both of them," he laughed. And satisfacuon, whether personal or otherwise, 1S often mouvauon enough lO want to create provocau"e prose or a prisune photograph, or mterpret a !)'tiCal ballad by Benny Goodman. says Sheldon Schtller, M.D., an ophthalmologtSt from LoutSvtlle. Kentuck), and the onginator of WThe Doctor's Band," a popular 25piece dance band there. He plays the saxophone "I started ll over 25 years ago," he satd. WThtS band allows us to do something wewouldn'totherwisedo. lt'sareleasefor our own stress, kmd of group therapy for us. We're a dance band. We play a lot of music from the big band era, people Like 4D 8U,I'AL0 ~HYSICIAN deeper while offering a sense of commuruty not found in the medical profess1on according to Deborah Shuster, M. D , a graduate of UB's School of Med1cme and Biomedical Sciences m Ma) 1992, and a pathology resident at Stanford liniverstt} She is an accomplished \iOilSt who has played in orchestras m New York and Italy and has a master's degree m mus1c from the Cruvers1ty of Colorado "There is definitely too much speclaltzation in medicme. As a pathologist. rm outside the realm of patient care, but it doesn't have to be that wa)," she explained. "There seems to be no conversauon between the primary care doctors and myself. 1 don't like that at all." Shuster said she wants to be a part of a working community of physicians that is similar to the community she enjors when plaring in a symphony. "Being an artist, marbe I bring a vision of the whole individual to m) work m pathology. Because what finall} makes someone an anist is thatthe) begm to trUSt an innate sense of intulllon when performing or creating." she sa1d ~And medicine is defmuel> more of an art than a sc1ence, because there needs to be a lot of intuition mvolved on the part of the physician. And a pathologiSt can't exist without other physicians, and a musician, at least m my case, can't exist without the rest of the orchestra. Each IS one pan of the whole," said Shuster, who has played in the prestigiousSpolctto Opera in Italy and the Spokane Symphony in ANO BIOMCO!CAL a large amount of minute attention needed to function in both fields. With pathology. I may spend hours looking at one or two cells in hopes of getting a better sense of the whole cause of death," she said. "In mus1c, there is a tremendous amount of practice, sometimes several hours on one series of notes, m order to be able to play a beautiful piece of music." Bemg able to perceive one's singular function wilhin a whole structure, mustcall)' or medtcall), is essential to understanding the entire structure, according to Harold Utt, a French hom player and currently a student in the M.D./Ph.D. program at UB. "To find the value of what you're doing means that you must understand how what you're doing fits in with the whole. "It's the same in art as in medicine," he explained. "When looking at a medical problem, it's very important to identify the underlying causes. And similarly, in order to understand the one part you're playing m a symphony. you must understand the whole p1ece of music." He stressed that there needs to be a dichotomy between the technique and the art of medtcme. "To be a great anist, you must do more than play all of the right notes. You must transcend the ordinary." said Liu, who studied classical music with members of the Philadelphia Philharmonic when he was a teenager. "And it's the same m medicine. A doctor needs to have compassion and an intuition regarding his patients, which leads to a transcendent understanding of the human animal." + SCt&NTIS'T SU,..NEit llil82 ) J �LJ'm '') OS ] ]'IS and the UB connection J J ' he lJnivers1ty at Buffalo"s sored Williams for the honorary doctorsupport and recognition ate he received from VB m 1946 at ItS of William Carlos Williams, Centennial Celebration. M.D.'s work as a creative artist is It was also a dose connection to the made clear by the University's University that enabled Williams to take massive holdings of Williams' papers. part in The Niagara Frontier ConvocaOver 20,000 documentS in the Williams tion in December 1951, when for two collection are housed in the University's days, hundreds of scholars and intellecPoetry/Rare Books Collectuals from across America descended tion, inupon BuiTalo to probe ~The Outlook cluding letFor Mankind in the Next Half ters, manuCentury." scripts, Williams working w a s a draftS of postrong ems, notes critic of and other mas o m e terials. The maAmeriterials span more than 30 years of Williams' career as a writer-from the \Y';//;am 1920s to the Carlos \fT;//;ams' poem 1950s. Williams re- "Lear," u•riften on ltis ceived his medi- prescription pad- part cal degree in 1906 o/ UB's collection. from the University ofPennsylvania. After an internship can artists in New York and graduate study in the ~Expatn­ pediatrics in Leipzig, he returned to his ates," such as Ezra Pound and Ernest hometOY.'Il of Paterson, New jersey, in Hemingway - who left their counl910,determined to care for those m his try to go to Europe during the 1920s own community. Here was a man, as and 1930s. ln his speech at the Convowriter and physictan, who had a strong cation titled ~will the ArtS Thrive or sense of responsibility to community Degenerate During the Next FiftyYearsr and country. He would focus his cre- Williams lamented that American wntaU\'e and medical talentS m Paterson for ers had too often harkened back to Euthe durauon of htS hfe. rope for enlightenment and knowledge, lt was Williams' close relationship instead of focusing on Amencan mtelwith Charles Abbott, the former direc- lectual and artistic achievementS. ~Our first comers, while their bodies tor of Umversity Ubraries for the thenUniversity of Buffalo, which brought went forward into the wilderness, turned much of the material to Buffalo in the back in their minds to Europe,M said 1940s. And it was Abbott who spon- Williams. "After the first burst of BU,.,AL..O flHY81CIAH ANO BIOMIIOICAL affirmation at the time of the Revoluuon, and as wealth increased and the spiritual and Intellectual gradations between individuals became more and more apparent, the trend of mind back to Erope and the past grew in appeal." The second half of the twentieth century could prove to be the period during wh1ch the American artistic genius would shed itS dependency on past European associations and become disunct and smgular, said Williams. The ume, he said, was ~now~ for transformation, for creating a distinctly American literature. "Fifty years is a small space of time. It wdl be hard to say whether we have gone forward or shpped back during that ume, but the way tS dearly indicated. I do not thmk that we shall fail.M Withams' reputation as a wnter has grown steadily since ..... his death in 1963 when he was posthumously awarded the Pulitzer Prize in poetry for his Pictures from Brueghel, and Other Poems. His struggle to propose and define a literature that would reflect at once both the s1mple and complex themes played out m the Amen can experience has been recognized and applauded by a new generation of American writers and scholars. His attitude of looking to the future to defme people's relationships to thetr country and itS history continues to compel and challenge American writers to observe and defme their country's + heritage. - Mark Hammer 5CtCNTl8'f SUMN£11t 1882 G �A Spoonful Po of Humor ically rrect Medical Terms for the Last week I was informed by one of my colleagues that I can no longer use lhe words "woman~ or "female~ because lhey contained lhe words "man~ and "male," which implied a subservient status. From now on she insisted on being referred to as a "Gyno-American." I said, "That would be fine, Dr. Zimmerman ... er, Dr. ZimmerPERSON." Welcome to lhe "Politically Correct (PC)" world of the '90s. PC "newspeak" is no longer just the domain of college campuses and the West Coast. I must learn it, or risk being seen as a "phallocenoist impenahst." For example, someone who is "smelly and dirty" is now considered "hrgterucally challenged." Someone who IS lazy is actually "motivationally dispossessed." If 1t hasn't already happened, we will need to rethink and rephrase medical jargon so as not to offend patients and politically aware colleagues alike. With this in mmd, we are proud to present a primer on "politically correct medspeak." In using these updated terms, you will be looked upon as an enlightened man ("testosterone poisoned human") or woman C[) 8 U , P' A L0 fii'H Y S ICI AN ANO 8 10 tolli: OIC A L. 5 Ct CNT I ST SUM ... C:IIt 1$$2 �I 1 Stu Silverstein, M.D . ..,.. dead :> metabolically challenged ..,.. preemie :> gestationally challenged newborn After trying to resusCitate ~ir. Da\ 1dson for over one hour, we declared h1m "metabolicall) challenged" and called off the code. TillS IS a 27-\"eek ..gescacionall.> challenged newborn," born to a 27-year-old G2 P2 "Gyno-American." ..,.. drug abuser :> recreational pharmacologist ..,.. psychotic C> neurotransmitically challenged Sub-acute bacterial endocarditis is common among "recreational phannacologists." The murderer's lawyer tried to get him offby claiming he was temporarily "neurotransmitically challenged." ..,.. fungus C> Fungo-American (a fungus that resides in the United States) ..,.. sociopath C> ethically diverse Coccidioides is the "Fungo-American" that causes San joaquin Valley fever. Charles Manson's swatisha tattoo on his forehead is a manifestation of his "ethical diversity" ..,.. hernatopoeisis C> he!shematopoeisis Her retic. count was up, indicating that "shematopoeisis" \Vas not impaired "L\tetabolkall_~ Challenged" ..,.. lice infestation C> pedicular enhanced The presence of nits on his halT shafts sug- gested that he '~as ..pedicularly enhanced " (~womyn M) and a role model for future ..,.. male pattern baldness C> reverse Mohawk generauons. On the left are the pohucall} mcorrect terms. On the right, the latest politically correct replacement terms. We have also included a sentence to illustrate proper usage. I don't know wh.> men are so self-consoous A "reYerse Mohawk" malles a man looll so ..,.. amnesia C> memory-tested, Reagano-centrist recollection ..,.. morbid obesity C> verticulohorizontally enhanced His "Reagano-centrist recollective" abilities suggested a worll-up for organic brain syndrome. 1 suggested that he was dangerously sexy. ..,.. menses C> femses Fill in your own sentence, please. "verticulo-horizontally enhanced" and ought to go on a diet. ..,.. autism C> ce.rebro-centricindividual Dustin Hoffman's portrayal of a "cerebrocentricindl~idual~wasmagnificent in "Rain Man ... W. hope this guide is helpful. Bring 1t with you to your next QA meeting or when you give a talk at your next conference. We also welcome additional political corrections. Author's Note: After this guide went to press, I was mformed that the term ~poliu­ cally correct" is no longer politically correct Therefore, when you receive this arucle, please cross out all references to PC and replace them with "multiculturally assessed. I apologize to those offended by my use of the term ~politically correct." ..,.. boring C> REM sleep enhancer That lecture on the '"or k-upfor slwrt stature ("vertically challenged~) children was sure an "R£\4 sleep enhancer " M ..,.. cocaine addict C> cocainist As a "cocainist," he was at risll for becoming REF Tilt Ojjat1al Polatuall~ Corrtct DICUon<U) and Hand!AA>. Htnl") Burd and Chns!oph<r Ccrf motivationally dispossessed Vallard Booi<s ..,.. colicky newborn C> infant of choler Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California, lectures nationwide on the role of humor in medicine. No matter what we do, this kid will not stop crying. This "rnfant of choler" is driving me up the wall. 8U,,.ALO .. HYIICIAN " Recreational Pharmacologist" AHO BIOfro4110fCAL SC II HTIST SUMMEfl 1882. G> �-- n n ~ ~ '1he sky's the hmit" for UB and Roswell Park's 1 new radiation oncology department -- hen Kyu Shin, M.D., talks about 1nedicinc as his mission, lle stresses that he was "taught to be a good physician, not a just a good clinician." Th£ distinction, he says, is an imp01tant one. "Sometimes, tlte human factor is ~issing." For l.he chatrman of l.he deparLment of radiation oncology at a large medical school and maJOr cancer center, l.he disuncuon could eastly get lost in the technology. Not so for Shm. '" I regard medtcine as my mission not as my JOb," he says. "I like to use my expertise to help l.hcse unfortunate cancer patients. "A good physician looks after patients. It's not just 'nine to live' and then drop it. lt's important. That's why I chose to specialize. I always feel if there's a need I will be there." Shin, who was recruned by UB and Roswell Park Cancer Institute last year to estabhsh a radtauon oncology program, has filled such needs before - creatmg preeminent radiation oncology departments at such presugtous msutullons as the Cleveland Clinic and Lhe Tom Baker Cancer Center m Calgary . Alberta, Canada. He auns to do the same Lhmg for UB. Roswell and the other consortium hospitals - and is well on l.he way, having already introduced several innovauve treatments and applied for residency program accreditation. "This is really an exciting lime," Shin says. "So many positive things are happening here. This is exactly what Dr. (Tho- uons. Buffalo people always go elsewhere to learn Now, they are coming here." Part of Shin's efforts at establishing the radiation oncology program at UB includes building a residency program. "We began l.he recruionent process for a deparLment chair for radiation oncology as far back as 1987," saysjohn Naughton, M.D.. vice president for clinical affairs and dean of the medical school. The department is new to UB, established after the faculty council researched the program. "Radiation oncology is seen nationally as a separate residency program," Naughton explained. "Our policy is if a program has independent status, we consider establishing a deparunent. Obviously, wil.h Roswell Park here, we should take advantage of that." Shm and his deparunent are now drafting curriculums for Lhe three-year residency program, scheduled to begin in 1993. The consortium program will also train two post-graduate fellows. A clinical traineeship was established last fall. The department already provides major traming for Erie Community College's two-year radiation therapy technician program, and works with both medical and tugh school students during the summer. mas) Tomasi (director of RPCI) and the entire institute are trying to do - make Roswell a leader on an international level. ~we can achieve that by having quality programs, and we can actueve quality programs from a quality staff supported by clinical research, patient care and education. And that is exactly what we have here.~ Shin doesn't conceal his enthustasm, and it has spread throughout Roswell's revitalized radiation oncology deparLmenL. Since he arrived a year ago the department has tripled the number of patients it treats each day. last year, l.he radiaoon oncology department logged 16,525 pauent visits. The treatments offered are often the ~last resort" for some, proffered only after ol.her treatments have proven ineffective. One recent success, Shin notes, IS total electron skin radiation. ~Treating the entire skin only IS a techUndergraduate medical teaching (as a nical nighonare,~ Shin explatns. But with third-year student selective) has already Roswell's new low-dose, computer-con- begun. "We intend to go into first and trolled, after-loadmg system - the only fourth year selectives as we expand our one in Western NewYork-Shinand hiS staffing,~ Shin said. colleagues recently treated a patient from Roswell's radiation oncology departSyracuse with mycosis fungoides whose ment has three divisions-clinical, medi"lesions are now completely gone. One of cal physics and radiobiology. "We have the doctors from Syracuse came to team been able to recruit many new staff to the technique," Shin relates, adding "we implement many new programs," Shin have an obligation to teach other institu- says proudly. "The most important role "RGOOD PHYSICmn LOOHS RfTfR PRTifnTS. IT'S nOT JUST \nlflf TO fiVf' RnD THfn DROP IT. IT'S lfnPOfURnT.. �the University has played has been to allow us to recruit a first class staff." One of the most exciting new developments in the depanment is tts computer netv,rork system, scheduled to go on-line this fall. The program, which wHI be a first in New York and probably m the U.S., Shin says, will completely automate all patient record-keeping m the department - from the time patients are referred, through thetr treatment and to follow-up back to the referring physicians. The system will enable physicians to see patients, dictate findings to the computer and send the results to the referring physicians by fax automatically. "just imagine the dynamics of the referring doctors getting their mforrnation the same day," Shin marvels. "Iu s a dream come true." He envisions the system will eventually be hnked wuh the Umverstty's and other area hospttals' systems Another mnovauon Shm has brought to VB and Roswell tS stereotactic radiotherapy-"a prectSton bramsurgel') without a knife and without bleedmg," Shin explains. The procedure, which uses sophisticated digitized computer targeting and planning, "destroys the part of the brain already destroyed by the tumor without any significant side effects," Shin says. The noninvasive procedure, which can be performed on an outpatient basis, is used to treat a variety of benign and malignant lesions, including glioblastoma, arterio-venous malformations, acoustic neuroma, pituitary adenoma, craniopharyngioma, smgle metastatic malignant tumors and solitary. base-of-the-skull metastatic lesions. Most effective for the treatment of target areas up to three centimeters in maximum diameter, the procedure giVes access to deep-seated lesions which were formerly inoperable or reachable only by extensive surgery. Although many centers in New York State are gearing up to do the procedure, Roswell Park is the only one currently performing it. Shin is characteristically already looking ahead. "We're now looking one step further," he says, "using MR1 spectroscopic technology research to find out exactly what happens metabolically when 8U,.P'AL0 ~HY81CIAN "IRfGMO mfOICinf HS mY miSSIOn -noT HS mY JOB. IUHf TO USf mY fXPffiTISf TO ~flP T~fSf UnfORTUnHTf CHnCfR PHTifnTS.N Kyw Shill, M.D. patients are treated by means of megavoltage radiation therap} How does the tumor disappear? Can we predict the radiation response by monitonng the exact metabolic changes? For the first time ever," Shin says, "we may be able to explain why radiation works." Preliminary research, he adds, has already begun. Shin has a great deal of pride in his department, in the University and in Roswell Park Cancer 1nstitute. He is also AND BIONEDIC:At.. grateful for the support he has garnered from each. and mindful the accomplishments realized belong to the multidisciplinary environment that fosters innovation and quality patient care and education. "We are building a very nice department as a group and a family. And that is possible because of Dr. Tomasi and Dr. Naughton. This is an exciting time. The + sky is the limit." SCt&NTIST SU""'WII." 1882 fJ) �University at Buffalo med students win •• I1Cifiotd research awards hree Umversny at BufTalo medical students have won top national research awards. Arlene Lobo, a second-year student, was named a Howard Hughes Med•callnsutute Research Scholar at the National Institutes of Health from the Howard Hughes Medical Institute in Bethesda, Maryland Yvette Vinson and Andrea Williams, also both second-year students, were selected as fellows in Lhe Fellowship Pro- -=-,._..gram in Academic Medicme sponsored b} Bristol-Meyers Squibb Company and The Commonwealth Fund. The fellowships carry$6,000awards. Vinson received hers for her "lnvestigauon of Haemopllilus ducreyi" (memored by Michael A. Apicella, M.D., professor of med1cme and microbiology); Williams received hers for her "Nasopharyngeal colonizauon m otitis prone and non-otHIS prone children" (mentored by Howard Faden, \1.D., professor of pediatncs and co-director of the divisiOnofinfectiousd~SCaseS). + Alums rjve back with generous endowments oscph A. Chazan, M.D., '60,and hiS wife, Helen, have made a pledge to the ~hool of Medicine and Biomedical Sciences' Pathways to Greatness Campa1gn. Their g1ft will be used to endow the Dr. and Mrs. joseph A. Chazan Scholarsh1p Fund es- fl) 8U,,-A 1..0 ~HVS ICI AN tablished in 1985 to provide full tUition scholarships. Chazan is the 1991-92 national chairman ofUB'sAnnual Fund Drive He LS also a member of the medical school's Advisory Board. Paul K. Bin ch, M.D.;43, chmcal associate professor emeritus of gynecology and obstetrics, has made a gift of$1 00,000 to the medical school to endow the Paul Binch, M.D., Endowment Fund. The fund will provide general suppon for research, visiting speakers, equipment and scholarships in the field of reproducuve endocrinolog} . + C. K. Huang honored at annual medical school faculty meeting ix faculty members, e1ght r~1dem physicians and the director ofUB's Health Sciences Library were honored june 3 at the annual faculty meeting of the School of Medicine and Biomedical Sciences. C. K. Huang, director of the UB Health Sciences Library, received the first john and Margaret Naughton Special Recognition Award. Naughton, vice president of clinical affairs and dean of the med1cal school, and his wife established the award to recognize significant comnbuuons to the advancement of the medical sc hool by a staff person or member of the community. Huang, library director smce 1970, IS credited \\ith bringing nauonal recogmtion to the library for its mnovauons and SCT\'!ce. He is a fellow of the Upstate and Ontario Chapter of the Medical Ubral"} Association and a distinguished member of the Academy of Health Informauon Professionals. Robert A. Klocke, M.D., professor of medicine and physiology, rece1ved the AND B IO MCO IC AL ~ Stockton K1mball Award for excellence in academic achievement. The award recognizes contributions to research, teaching and service. Klocke, chief of UB's Pulmonary (. K. Huang Division, is also editor of American Review of Respiratory Diseases. He Vl-'ill deliver the Stockton Kimball lecture at next year's annual meeting. Milford C. Maloney . M 0 Robert A. Kladte, M.D. clinical professor of medicine, received the fourth annual Robert S. Berkson Memorial Award in theArtofMedicinc. The award recognizes excellence in patient care and teaching by volunteer faculty. Robert J. Ge11<o, D.D.S. Robert]. Genco, DDS., Ph D., distinguished professor and chair of oral biology in the School of Dental Medicine, was the first person outside the medical school to receive the Deans A\\ard for outstanding leadership and academic excellence. While noting Genco's numerous contributions to the health sciences at the univerSity, the dean lauded him in particular for assuming the mterim chair of the medical school's Department of Microbiolog} wh1le mainLaining his demal school responsibilities. Louis A. and Ruth Siegel Teaching Awards were presented in four categories: ' Q Q 2 �• pre-clinical, for basic sciences teaching; clinical, for in-hospital instruction; volumeer, for unpaid faculty, and house staff, for resident physicians. Winners were selected from nearly 200 faculry nominated by students. The recipients were: .,;. Alan Lessc, M.D., assistant professor of pharmacology and therapeutics, pre-clinical category. Lesse also won this award in 1990. -.r Fred Luchette, M.D., assistant professor of surgery, clinical category. Luchette also won this award in 1990. -.r Steven lana, M.D., clirucal assistant professor of pedtatncs, volunteer category. -.r Alon Coppens, M D., radiology; Kathylynn Pietak, M.D., med1cme; Ramanathapur Natesha, M.D., surgery; Bruce Solomon, D.O., neurology; Mattheos Falagas, M.D., medicine; Siddhartha Shah, M.D., medicine; Edgardo Salvador, M.D., medicine, and Dawn Hrab, M.D., med1cme, all received house staff awards. + B Y LOIS BA Thomas F. Frawley, M.D., "44, chairman of Graduate Med1cal Education. St John's Mercy Medical Center, Emeritus Professor of \fedicine. St. Louis University School of Medicine, St. Louts, Missouri, and national chairman of the UB medical school's 1991-92 Annual Fund, "''as inadvertently omiued from the list of members of the James Piau White Society in the Winter 1992 cd1tion of Buffalo Physician and Biomedical Scirnlisl. + KER Match Day 1992: most UB med students get their top choice atch Day - that nail-biting time when fourth-year medical students learn where they will spend the next three years as resident physicians- was overwhelmingly successful this year for UB's medical students as 84 percent of them received one of the1r top three choices. Sixry-eight percent of the 141 students who participated received the1r topch01ce. 10 percent received their second choice and 9 percent received their third cho1ce Eight percent were unmatched. In addition, six military matches were made Although a majority of the students (56 percem) will venture out of state for the•r residency training, a full 25 percent of UB's medical students will remain in Buffalo and take their training at the Graduate Medical Dental Education Consortium of Buffalo. + �[1] . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . ..... . .. . . . . . . ~ I Medical school alunri feted at receptions in Florida cnl Indiana he University at Buffalo's medical school recently honored its graduatesatalumnieventsheld in Florida and Indiana. Florida alumni were feted at two separate receptions in February. William Boardman, M.D., '44, and Barry Weiss, M.D., '67, hosted a reception in Tampa at the Westwood Hyatt whtle Thomas Rodenberg M D , '51 , and his wife, joan, hosted East Coast alumni at the Tower Club in Ft Lauderdale. Alumni from various classes attended, mcluding Thomas Bumbalo. MD . '31 , and hiS wife, Ednh Bumbalo's grandson, Thomas Bumbalo,jr., tS a member of the medical school's Class of 1992. Also in February, George Ellis, M.D., '45, hosted a luncheon at the Radisson Plaza Hotel in Indianapolis, Indiana. Thomas Riemenschneider, M.D., M.B.A. , associate vice president for clinical affairs and associate dean of the mcd1cal school , discussed the Western New York Health Sciences Consortium and the lnformaoon Network System that will soon lmk the medical school with its affiliate hospitals and rural health care sites. On hand at the events in Florida was john Naughton, M.D., dean of the medical school , who spoke about the many new developmentsand II programs currently underway at UB. 1 aughton told the groups about the construction of the new biomedical research complex to be completed in 1993 and the Western New York Health Sciences Consortium and its Information Network System. He also talked about the continued recruitment of some of New York State's most talented students and UB's unique uclassroom without walls" clinical training setting. + Medical school begins department chai' secl'ches earchesare underway for the cha1rs of two clinical departments and one basic sc1ence department m the School of Medicine and BIOmedical Sciences. Department heads are expected to be chosen toward the end of the summer for the departments of anesthesiology, radiology and biochemistry, accord- mg to john Naughton, vice president for clinical affairs and dean of the medical school. ~we have outstanding candidates for all posts," a ughton said, adding that UB has been able to attract well-recognized academics of national prominence vying for the positions. In addition, search committees have been formed to chose the city-wide head of cardiOvascular surgery and the director of the Dent Neurologic Institute. aughton said several prominent prospects are in the running for the cardiovascular post, wh1ch is expected to be filled by the fall. The post at the Dent will be filled next summer. + UB med student selected for Ameriam Meclcal Student Association felowslip hristopher Wood, a second-year medical student at UB, has been selected to participate in the American Medical Student Association Foundation's Washington Health Policy Fellowship Program (WHPFP). Wood isoneoflS medi cal students chosen for th1s summer's fellowship fromapoolof74cand!dates. The fellowship is associated with thiS summer's American College of Prevenuve Medicine. In its founh year, the Washington Health Policy Fellowship Program IS designed to introduce promising medical student leaders to the health policy process, current topics in health policy and their role as advocates. The program combines an orientation and weekly seminar <;f'ries with a field placement experience.+ �[I] ( 0 M M E N ( E M E N T I 9 2 he School of Medicme and Biomedical Sciences graduated Its 146th class during ceremonies held in May. Here, fnends and families celebrate with the graduates as they receive their degrees. The Class of 1992 includes 150 students- 146 who earned medical degrees and four who earned combmed M.DJ + Ph.D.s. 8U,.,.ALO .. HVSICIAN AND BIOMEDICAL SCtC:NTIST 5UMM£R 1 g g 2 0 �Alunri meet il Apri for Spri1g Ciicm Day cnl Reurion Weel(end he School of Medicme and Biomedical Sciences held tts Spnng Chmcal Day and Reunion Weekend on Apnl 25. The events, which included a day-long seminar and cocktail receptions, were well-received, as evidenced by thts photo montage. BU e BU,,.A\.0 PHYS ICI AN AND B IO MCOI C Al.. SCICHTIST SUMMER 1992 �A N A N 0 BIOMEDICAL SCIENTIST $ U M M E R 1 Sl Sl 2 El) �CLASS OF 1942 ~ First row, left to right: George L Eckhert, Richard Mnauo, Vincent Cotroneo, Howard Frederickson ~ Second row: Urban L Throm, Richard Ament, Boris Marmolya, Charles A. Baudo, Ivan Bunnell, J. Walter Knapp ~ Third row: Richard Jones, Kent L Brown, Francis Clifford, Vincent Parlante CLASS OF 1947 ~ First row, left to right: Frecleridt Whiting, Wilrtom S. Edgecomb, Robert M. Jaeger, Hans F. Kipping ~ Second row, Robert Ehrenreidt, Wil~am C. Baker, Wilrtam M. Bukowsk~ Arthur J. S<haefer, Ridlard J. Kenr.ne ~ Third row: Ferdinand Paor.n~ Robert J. Dean. Russell J. Sacco, John B. Sheffer, Carl J. Nicosia, HenryS. Gardner, Daniel R. Curtin. James F. Stagg, Peter J. Jurtan, Elbert Hubbard CLASS ~ OF 1952 First row, left to right: Colin C. Madead, Eugene Sigman. Kenneth Altshuler, Barbara G. Coriey, Burtoa Stulberg, Donald F. Doha ~ Second row: John J. Banas, Aaroa Simpson. Robert A. Baumler, Alvin J. Brown ~ Third row: Roy J. Thu111. Kurt J. WegDer, Oliver J. Steiner, Vidor Panaro ~ Fourth row: James N. Schmitt, Bernie P. Davis, Bruce F. Connell. Alfred Lmarus ~ Fifth row: Donald J. Spredter, Eugene W. Loeser, Wilbur S. Schwartz, John Y. Rllllchoff, Travers Robbins, Ralph M. Obler, Neal W. Fuhr �··········································································· · ···················· ~all • CLASS OF 1957 ..,. First row, left to right: Btn Celnilter, Robert B. Sussmcm, Sol Messinger, Arthur L Btdt, Ross Marltello, Frank J. Chafel ..,. Se<ond row: Herbert Metsch, Robert Carpenter, Donald R. Hauler, Sherman Woldmon, Joseph I. Schultz ..,. Third row: Paul Archambeau, Edward Welsenheimer, Bronson Berghorn, Charles F. O' Connor, Richard F. ~iller CLASS OF 1962 ..,. First row, left to right: Charles G. Adams, Ronald Dozoretz, Joseph P. Amenia, Josepla R. Gerbas~ Paul J. LorH ..,. Se<ond row: Robert G. Ney, Morton E. Wei<hsel. David E. Carlson, Phitlp D. Morey, George R. Tzetto, Sebastian FasaneUo ..,. Third row: Seth A. Resni<off, Owen G. Bossman, Alan L Pohl, Morlt Peter Heilbrun, Morton P. Klein, Melvin J. Steinhart, Joseph A. Cimino, Roberto J. Gnbert, Anthony Morkella, Robert Goldstein, Harold Brody ..,. fourth row: Jack C. fisher, Philip Weisinger, Gerald Patterson, Martin F. Abbert, Oscar Oberkircher CLASS OF 1967 ..,. First row, left to r¥rt: Jonathan ~ J. Brian Sheedy ..,. Second row: David C. Stephens, Barry M. fpstein, Barry M. ~ Thomas P. Sheehan, vn&c.n Burie9l, Lon C. Ouem:Jer, John P. Kely, Docdd l Mler ..,. T1Wd row: David FugcrnoHo, Jacob Kritemc~~~, Arthur C~ Ronald Josephson, John B. Keiser, Robert M. Benson, Douglas M. Sirlti1, Trevor Robinson, David R. Dantzker, James Gicrirone, Ridtard Judelsohn, Thomas Augustine, Robert J. Brown, George S. StilT .... Fourth row: F11111kln H. Splm, Arthur C. Sosis, David L Larson, Norman Berltowih, Anthony l.oGallo, Cart W. Ehmann, IInKe Etmger, Alan R. Salmnan, Rocco C. Vetwto, Thomas O'Comor, Douglas Gerstein, Arnold Z. Gold, John J. Teanor, Midtoel !'haps �CLASS OF 1972 ..,.. First row, left to right: Martin T. Hoffman, Steven J. Rosansky, George E. Lundgren. Ywginia F. Howley, lon M. Frankfort, Robert fmhorn ..,. Se<ond row: George Kotlewsk~ Ridlard S. Goldman. Martin Brecher, Edwin A. Salsitz, Richard A. Savage, Stephen J. levine, Murray A. Morphy CLASS OF 1977 ..,.. First row, left to right: AntoineHe Wozniak, Chem1 A. Thorpe, HelenS. fmdlay, Nedra J. Harrison. Undo L Benjamin ..,. Second row: Albert Sddisserman. Carl J. Schmi«, Thomas H. Botsford, Alan S. Kuritzky, Dirk H. Dugan. Richard P. Newman. Joseph Byleby~ Reginald B. Stdes, Eugene A. Paul CLASS OF 1982 .... frst row, left to r9rt: Men CJtuns. waam Schedrter, £Jon Healy, Pilip Steget~~C~~~n. tmo RIDnowitz, Bet+nin Confesso, Y~rginio Keane, Joseph P. leberer, Ancho Abati-Scon, Debbie L K~ fhabetla Bartog, Nancy Peters, Susan fasd!beck. Richard A. WoH, David I. Kuru, Joseph F. Gioia, Gen*l F. Ylfale ..,.. Second row: Jessial Roc:kwel, Robert ~ Stephen Donovan, Robert C. Thomas, Potridl T. Hurley ..,.. T1n row: Michele Leon, An«ew R. Hordes, Robert P. Dudek ..,. Fourth row: Marcia McAvoy, Gerold A. Hinter, Joseph Gelonnini ..,. fifth row: Mary ASce Kely, Kevil J. Bartog, Joseph T. Wayne ..,. Sixth row: Eliot Chartash, David Weldon, Michael A. Cesar, Ivan A. Bcalmwel, fmotlay Geemg �CLASS OF 1987 ..,. ftrst row, left to right: Camille Buonocore, Marina Cotto, Patrick Shaughnessy, Jennifer Cadiz, Bonnie Orzech-Mixon, Kevin Quinlivan ..,. Second row: BrU<e Mac:KeUcr, John O' Brien, Thomas Smith, Michael Rudnidt. JiB Koehler, Timothy Bukowski, Douglas Katz TWs sigaecl origillal of a po&tical Dr. &ush finally arrives YE:.S, I BELIE.\/~ IT IS A Rt.ct.SSION... c.tooa, •Dr. Bnh finaly arrives," donated to tlte medical school by Plllitzer Prizewinning Buffalo News cartooftist Tom Toles, was won by Robert Reisman 'S6 in a siletlt auctiall held d.ring spn.g Oilical Day. �• 1 ·························································································· - I 9 3 0 cology at the Umvef!>ll}' of Pillsburgh C.Chool of Medic me. 5 MAURICE B . FURLONG '35, of jame:.town, New \ork mforms us that hts book, How To Gtt rour Baby To 5/tep, ha!> JUSt been published. A VROM M . GREENBERG '36, of Tucson, Arizona. was named Phystctan of the Year by the Ptma County Medtcal Society. Hts hfe story. "Reflections of an Old Curmudgeon.~ was featured m the Februarv pubhcauon of the Societ\ . 1 9 4 0 5 W . WILLIAM TORNOW '4 6 , IS pre:.tdent of the Hobart Club of Buffalo and mus1c eduor of a weekly newspaper, "The Southtowns CitiZen." Tornow tS an assistant chnical profes.sor of medicine (pcdtatrics) at the Umversity at Buffalo School of 'vi edtcine and B10medtcal Sciences. 1 9 5 0 5 ROBERT E . PLOSS '5 1 , writes, "Iam ahve and well after the Oakland firestorm of October 20. 1991, that burned m~ home to the ground along \\ith 3,000other!>. I w1ll rebutld." ANTHONY P SANTOMAURO '56. was elected a delegate from the State ~ledtcal SoCiety to the house of delegate!> of the Amencan Medical As<,ocmuon A past pres•dent of the ~1edtcal Soctety of the County ofEne. he current!\ serves as a representative from Western ew York on the Council of the Mcdtcal SoCiety of the wntes, "After two \·ear!> of pcdiatnc residency at The Chtldren's llospttal of Buffalo, I transferred to a surgery residenc> at the Eastern Yirgmia Graduate School of "v1edtcme m Norfolk. Vtrgmta Presently I am a second year resident insurgef). I have JUSt matched for a plasuc surgerv restdenc} at the Pennsylvania State Umver!>llY beginmng in 1993. JOHN S . AKER '88, John S. Alter '88 State of '\ew York. He is a member of the board of directors of the .\.1edtcal Uability .\.1utual Insurance Company and IS a member of the State ~1edtcal Soctety'sState Legl!>lanon Commmee. He tS also an officer of the E•ghth OtStnct Branch "v1ed•cal Society which comprises the eight Western New York counues. 1 9 7 0 5 H UGH A . SAMPSON 75, was recently promoted to professor of pedtatrics at Johns Hopk•ns Universll) He is co-editor of the new JOUrnal, Pedimric Allerg> and lmmunolog>. and co-editor of a book. Food A/lug>. published by Black\\ell in 1991. 1 9 8 0 5 ARLENE ROSE CURRY '82, and her husband.john Hntes, are the proud parentS of a baby gtrl, Alyssa Rose, born Januaf) 20, 1992 CHERYL A . KUBISTY '86, tSan J!>ststant professor of medtcine in the Center for Clinical Pharma- A N 0 B tO M NARINDER SHALLA '88.15 now chtef restdent of mternal medicine at '\ew York Umver!>ll}'. He and hts wtfe. \1arva KaltSh. announce the bmh of a daughter. Son) a Shalla, on june 30. 1991. CLIFTON WOODFORD '88 , vmtes, "I've been in San Otego for two years takmg care of dtvers and submarmer<,. We (my wire Kelly and three chtldren) wtll be here ror tWO more years while I complete m\ medtcme restdency at the San Otego 'laval Hospttal " RusseU Van Coeveriag II, ' 77 OBITUARIES ROY E . REED '32, died sudden)} or a heart attack on Februaf}' 2. 1992. MELBOURNE LENT '4 3 , dted Apnl 11. 1992. after suffenng a heart attack. JOSEPH A . VALVO '4 3 , died on March 13. 1992. in Pinehurst, North Carolina. R OY S WARTOUT Ill '4 5 , died of cancer onjanuaf)' 1, 1992, m Temple City. California. RUSSELL VAN COEVERING II , 1 9 9 0 5 MATTHEW J . CYWINSKI '91 , '77. rued unexpectedh on May 2, 1992 rnamed Bonme Zmuda on Februaf} 29, 1992. He tS a general surgef)' hou!>C offtcer at Hen'} Ford Hospual. Dearborn , \11chtgan. Call for nominations Don·t forget to cumplete and matl the attached postcard for OtStmgUtshed Medical Alumnus/a Award. Nominations will be accepted unul March I, 1993. C:OICAL SCtlrHTtiT 1 9 g 2 �I : �Buffalo, NY Permit No. 311 1773 HEALTH SCIEf.tCES SERIALS DEPT ABBOTT HA-L CAMPUS f·A:L 4 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Summer 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n03-1992-Summer Table Of Contents A list of subunits of the resource. Research Hospital News Country Doctors Dr. Muse A Spoonful of Humor Medical School Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/59a8520632c63aba138f00cb7eaf3b1c.pdf 0a12fc59c7855326d69a10762f093f6d PDF Text Text �BUFFALO PHYS I C I AN Volume 26, Number 4 EDITOR Nanette Tramont Kollig, R. N ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIR E CTOR Scott Robert Fricker STATE UNIVERSITY O F NEW YORK AT BUFFALO SCHOOL OF M E DIC I NE AND B I OMED I CAL SC I ENCES Dr. John aughton, Vice President for Clinical Affairs, Dean ED I TOR I AL BOARD Dr. J ohn A. Rtchert, Chairman Mr Ric hard de Asia Dr Martm Brecher Dr Harold Brody Dr. Rtchard L. Colhns Dr. Donald P. Copley Dr. Alan J Dnnnan Dr. Ttmothy Gabryel Dr. Glen Gresham Dr. Charles Massa ro Dr. Charles Paganelh Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Su resh Dr Bradley T Truax Dr. Ste phen Spauldmg Dr Jerome Yates TEACHING HOSPITALS AND LIAISONS Batavia VA Medtcal Center Buffalo General Hospttal Michael Shaw Buffalo VA Medical Center Paula Pedene Children's Hospttal of Buffalo Ene County Medical Center Mercy Hospital Millard Fillmore Hospitals Frank Sava Roswell Park Cancer Institute judith Rice Sisters of Charity Hospital Dennis McCarthy © The State Umversity of New York at Buffalo Buffalo Phvsicwn is pubhshed quarterly by the State UmversnyofNew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge , to alumni , faculty , students, reSidents and friends . The staff reserves the nght to edit all copy and submissions accepted for publication . Address questions, comments and submissiOns to: Edttor, Buffalo Phystcian, State University of New York at Buffalo, University Publications, 136 Crofts Hall , Buffalo, New York 14260 Send address changes to: Buffalo Physician, 146 CFSAddition , 3435 Mam Street , Buffalo, New York 14214 Dear Alumni and Supporters of the UB Medical School: T he medical school and its teaching hospitals together with the faculty have made a major commitment to promote the education and training of an increased number of generalists for Internal Medicine, Family Medicine and Pediatrics. Throughout the past year, significant changes and accomplishments have been made in the governance of the graduate medical education programs and a mandatory two-month long clerkship has been initiated in comprehensive ambulatory care education. Through the recently funded Reimbursement Demonstration Project, six coordinated projects in primary care were funded together with a major project in geriatrics and minority recruitment and retention. These changes have positioned the medical school to address needed reform in undergraduate medical education. While some changes are already planned, UB has applied for a major grant for the training of generalists from the Robert Wood johnson Foundation. The school was visited by an external review committee in july, and we hope to be membered among the 18 awardees when the Foundation announces its choices in mid-November. The next challenge will be to compete successfully to be one of the l2 schools funded for a period of five years commencing in mid-1994. These two initiatives are accompanied by another complementary award. Dr. Thomas Rosenthal of the Department of Family Medicine was a successful winner of a major five-year grant from Health Resources and Services Administration to study the ways in which to develop and promote primary care in rural areas. I hope you are pleased by the commitment to this needed part of medical education and care that UB has made. We will keep you posted on the school's progress in this important area in the years ahead. Sincerely, john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni: T his is the ~ear of Professor William Greiner's inauguration as the thirteenth president of the Umversny , an ausptc~ous event for those of us who support the continued growth and ~ttahty of our medtcal school. Prestdent Greiner has long been a friend of . the_ bwmedtcal soences and has been conststently vigorous in his support of our objectives. For example, Prestdent Gremer and Dean john Naughton recently announced a target of 50 percent pnmary care phystctans by the graduating class of 1995, thus placing us m the vanguard of Amencan medical schools in meeting our country's health care needs. Your Alumni Association has presented the Distinguished Medical Alumnus Award to Dr. Alfred Evans, Yale Emeritus Professor of Epidemiology and UB Class of 194 3. We have also met our Rochester alumni at the Richardson Canal House for an informal renewal of friendships. Support for our current medical residents has continued wtth another "Prep for Practice" seminar. Our Community Physician t. for series on career choices has reached many students p · c1· · 1D d . repara wns Spnng . t_mca ay an Reunion Weekend are well underway toward · n a hvely program abou t phystctan . . . . performance and competence . 0 ur c1ass reumo to organize spring reun d 1 ·ft chatrmen. have been workmg dthgently · 0 n d. 1 . . mners an c ass gt s. We cenamly have reason for pnde m our school and its successful alumni/ae! Yours truly, Don Copley, M.D., '70 �V 0 A 2 L u T u 6 N o 9 N 4 9 2 Research Hospital News The Graying of Medicine e Changing the practice of medicine to meet the challenges of a burgeoning elderly population. Rehabilitation Comes of Age e UB's new Center helps an aging population reclaim its lost abilities. UB' s new SS million demonstrotion project to eose the primary care shortage could become a model for the nation. Page 26. Conquering Ojos del Salado • UB's William Carl, D.D.S., on his mountain-climbing adventure in the Andes. UB medical students wm soon see patients who aren't really sick at all. Page 28. , Medical School People Alumni Classnotes *[limning t~e secono· ~ig~est eleuation int~e Western ~emisp~ere. Harold Brody steps down as chair of anatomical sciences after over two decades. Page 30. ~age 1~. �m ····················· ··········· • • ••••••• 0 •••••• 0. 0. 0 •••• 0 ••••••• • 0 •• • •••• •• 0 ••• • • • • 0 •••• 0 UB-NASA experiments yield unexpected results n experiments with potentially far-reaching ramifications for the U.S. space program, University at Buffalo scientists have found that the human body regulates the cardiovascular system in a totally unexpected manner in the weightless environment of space and takes at least a week to return to normal functioning after even short flights. The cardiovascular research, conducted on NASA's first Spacelab Life Sciences Mission last june, showed that astronauts could not perform some routine tasks at their full capacity for the first days after returning to Earth. And in what the researchers term the most surprising finding of the study, results showed that in space, the human body uses a previously unobserved mechanism to regulate the cardiovascular system. David R. Pendergast, Ed. D., professor of physiology and one of the investigators, presented the findings at a special two-day meeting on cardiovascular response to exercise sponsored by the American Heart Association in Chicago injune. The experiment, funded by a $2.3 million grant from ASA, was developed by Leon E. Farhi, UB distinguished professor of physiology. It was one of three studies on the mission focusing on astronauts' cardiovascular function in zero gravity and under normal gravitational forces once they return to Earth - the first comprehensive human cardiovascular experiments conducted in space. B u a a p "These results will change the way ASA isthinkingabouthumansurvivalinspace," Pendergast said. " ASA had thought man could adapt readily to problems of space flight. This research shows that some functions remain compromised to some extent for at least seven days after a short flight. "This was only a nine-day flight," Pendergast added. "On a much longer flight, the effects could be much more pronounced, or last considerably longer." The project was designed to determine how the heart and lungs perform during weightlessness, and after adjusting to that environment, how they function when resubjected to Earth's gravity or a stronger gravitational force. This knowledge is important, Pendergast . explamed because the success of future ' . depen d on the travelers' space travel Will . . . norma lly during travel ab1hty to funcuon . as well as when they reach their destma· anotherplanet tion-beitaspacestauon, or Earth. , mechanisms and neural "Our bo d ys d reflexes are esi·gned to control blood h y 5 c a A pressure at 1-G ," Pender-gast said. "One of the major concerns regarding the body's adaptation to space flight is that the adjustments the cardiovascular system makes during flight to maintain blood pressure in weightlessness may compromise its ability to readjust to gravity upon return." UB researchers, using equipment engineered by UB technicians Richard A. Morin (U.S. . ret.), Christopher G. Eisenhardt and Claude Miller, took readings of three astronauts' cardiac output, oxygen consumption, mean blood pressure and heart rate five times during the six months before the flight. They calculated stroke volume, total peripheral resistance and the amount of oxygen extracted from the blood. The astronauts conducted the same experiments during the nine-day space flight, and UB researchers took readings again on the first seven days after the astronauts returned, as well as on the 45th post-flight day. Cardiac output was expected to increase initially in space, and then drop to normal in the weightless environment, as it does in experiments conducted on Earth under simulated weightlessness. During space flight, however, cardiac output went up and stayed up. When cardiac output increases, the body u u m n 9 9 2 �··· · ······· · ····· ··· · ·· ·· · ··· ·· ········ · · · ············ ···· · · ·· · ······ · ······ ·· ········· · ·· • 1'3 .~ .. attempts to maintain blood pressure; previous experiments had suggested the body reduces the amount of plasma in the blood to regain cardiovascular balance, freeing up water from the plasma and eliminating it in the urine. But because cardiac output did not come down in space and blood pressure remained stable, the researchers speculated a previously unobserved adjustment mechanism was apparently at work. And, in fact, calculation of the other cardiovascular variables showed that in space, the body had maintained blood pressure through hyperperfusion- engorging organs and tissues with blood. "This type of regulation of blood pressure was completely unexpected ," Pendergast said. "The system's failure to reduce cardiac output and its ability to accept the hyperperfusion are hard to reconcile using current physiological thinking." The researchers now theorize that this phenomenon is at the crux of the cardiovascular difficulties astro- B u reentering gravity. It will be the central focus of their research on future space flights. Post-flight data showed the ability of astronauts to perform work was severely limited immediately after leaving the weightless state and reentering gravity. "On the day they returned, the cardiovascular system was very compromised," Pendergast said. "Stroke volume was low, heart rate was high. The system was trying to compensate for the stress of gravity, but it couldn't. "By post-flight day one, the astronauts were able to perform exercise, but the body was not stable. They could do 30 minutes of exercise but the body was stressed. They couldn't have done more." The astronauts' ability to respond to stress remained compromised for seven days. 5 c o n A u "This is a significant problem that needs to be corrected if we are serious about longer space flights," Pendergast said. "Some more creative thinking has to come into play." All readings were back to normal by the 45th day. Pendergast praised the astronauts for their skill in conducting the experiments under demanding conditions. 'The crew did a phenomenal job getting data," he said. "It's an incredible testament to what humans can do." UB researchers have already begun training more astronauts to perform the same experiments on a Space Shuttle mission tentatively scheduled for next summer. + - u m n B Y L OIS 9 9 B AKER 2 0 �• ································· Area's first ECMO opens at Children's Hospital . . . . . . . . . . . . . . . . . .. . mained on ECMO for six days and finished recovering in the hospital until he was able to go home several weeks later. As many as one in every 4,000 to 5,000 newborns could benefit from the treatment, according to Robin Steinhorn, M.D., director of the ECMO Center. "With the establishment of an ECMO Center here at Children's we're taking on the challenge of caring for these desperately ill babies. We hope to be a resource for the local community as well as the entire state," Steinhorn said. + he Children's Hospital of Buffalo has opened the area's first extra corporeal membrane oxygenation (ECMO) service. Open since late june, the ECMO Center is one of only two in the state (the other is at Columbia Presbyterian Medical Center in ew York City). The state-of-the-art heart-lung machine, used for infants and children with lifethreatening lung or heart failure, completely takes over heart and lung function, enabling the patient's heart and lungs to rest and recuperate on their own. Housed in its pediatric intensive care unit, Children's ECMO service is manS Senator Alfonse M. D'Amato · · aged by an interdisciplinary team consistrecently announcedthattheSening of an ECMO physician, coordinator, ate VAIHUD!lndependent Agen. . tions Subcommlttechnician, pediatric surgeons, attending cies Appropna tee has approved his request for physicians and pediatric intensive care . to renovate The nurses. The unit's first patient, a newborn $2 m1.11 wn . . of Buffalo's Regional 1 with sepsis, was placed on ECMO within Children's Hosplta . his first 18 hours of life. The infant re- Pediatric Intensive Care Umt. . . .. . . . . . . .. . . . . .. . . . . . . . . . . "Children's Hospital is a national leader of health care for our children, providing cutting-edge scientific discoveries and stateof-the-art medical treatments for seriously ill and injured children, regardless of their ability to pay," said D'Amato. "Our children deserve the very best health care available. These funds will ensure that the badly needed renovation of the PICU will go forward without delay to provide for the health care needs of the community's families." Work on the $8.7 million renovation is scheduled to begin next year, pending approval by the State Department ofHealth's Office of Health Systems Management and the completion of additional fundraising efforts. The project includes expanded space for each PICU bed, expanded isolation rooms, enhanced nurses' and physicians' stations, an on-site satellite pharmacy and laboratory and enhanced storage and ad+ ministrative space. $8.7 mORon renovations proceed at Children's B a 0 p y s a n A u m n 9 9 2 �· ·· · ····· ······ · · · · ··· · ··· · · ·· .· ···· ·· · · ··· · ···· ···· ··· ···· ··· ··· · · ·· · ··· · ··· ··· ········ · · · • Legislature authorizes funding for RPCI maior modernization proied tion of a pedestrian walkway system to unite the campus; replacement and modernization of inpatient beds; correction of life safety , health code and infrastructure deficiencies , and restoration of structured parking. he New York State Legislature last March passed legislation that would authorize bonding for a major modernization ofBuffalo's Roswell Park Cancer (RPCI) Institute. Thomas B. Tomasi, Ph.D., M.D., RPCI president, said he felt tremendous "relief, elation and gratitude" as he watched ew York State Governor Mario M. Cuomo sign the bill which would appropriate $241.5 million to rebuild the nation's oldest cancer center. "Relief," he said, "because we had won a long hard fight. Elation because we had taken a giant step toward accomplishing what we had set out to do. And gratitude to the many individuals whose response to "it can't be done" was always "it will be done." Roswell Park's current campus comprises 19 buildings with approximately one million square feet on 25 acres. The major modernization program calls for the construction of a new diagnostic and treatment center for radiation therapy, diagnostic imaging, nuclear medicine and surgery with its related post-anesthesia care unit and central sterile supply. Construction of the center will begin next year, with completion scheduled for early 1996. A new vivarium - which would centralize disparate animal facilities presently spread over five buildings on campus and two off campus - will be completed in 1995. The plan also calls for the construction of a new laboratory building and renovation of other laboratory space to remediate obsolete mechanical and electrical systems and to provide additional space to meet the needs of the institute's basic science programs. Other priorities include the construe- B 0 0 p h The legisla- Artist's rendering of Roswell Park Cancer Institute's major modernization. tive bill passed in March, which is the final legisla- delays in renovations required to repair tive approval required before the project its deteriorating infrastructure, correct can commence, also authorizes the estab- code deficiencies, support competitive lishment of a Roswell Park Practice Plan to programs and facilitate recruitment, were enable the institute to add 30 new physi- chipping away at the institute's oncecians over the next few years without solid reputation as a major national canincreasing state funding. It will also pro- cer center. vide opportunities to develop joint venCuomo made a commitment to reverse tures with other health care facilities , in- these trends and pledged in 1989 and cluded Roswell-owned and operated fa- again in 1991 to do "whatever it would cilities outside the Buffalo area. take" to modernize the Institute. Funding for the project, which took The major modernization formally beyears to obtain, began in 1984, when gan in 1989 when a team of architects, Cuomo appointed a Blue Ribbon Com- planners, engineers and market and fimittee to assess conditions at RoswelL nancial analysts headed by Bohm • BBJ The committee stressed the national im- was selected to conduct the planning portance of the institute's scientific and project. An interagency core committee clinical programs, but underscored the of key management from the Institute, critical need for capital improvements to the Department of Health, Office of Genthe physical plant it found fundamentally eral Services and the Dormitory Authorinefficient and dehumanizing. ity was established to review and approve In the past, Roswell Park- part of the the plan in progress. ew York State Department of Health The combined direct and indirect ecosince 1911 - received approximately 45 nomic impact of Roswell's major modpercent of its funding from the state. ernization program on Western New York Today, the institute receives less than 30 is estimated at $511 million, with over percent from ew York State. That, plus 5,000 new jobs expected to be created. + y a n A u m n 9 2 �0 B u f f a l a P h y sl cIa n A u t u m n 1 9 9 2 �A ~ C T A N E M 0 N D s the baby boomers age, a demographic tidal wave will reshape the structure and culture of medical care for the elderly Already, physicians are learning to care for an older populationsome of whom are astonishingly able while others are remarkably frail- that is relatively new on the planet. Human life expectancy at birth has virtually doubled since the mid-19th century from 40 years to near 80. In fact, since 1900, the number of Americans 65 years and older has grown tenfold, from 3.1 million to 31 million today By the year 2040,68 million people will be older than 65, an estimated 22.2 percent of the U.S. population at that time, as compared with 12.5 percent now. L B L U a 5 T 0 R p A h T 0 s N c ~ 5 a n Y A l AHA 5 m 9 N EY 2 �ere, more than 15 percent of the community is 65 years and older, A preview of the medical community's competitive grant process. The program emphasizes clinical trainresponse to the nation's aging population maybefoundinWestem ewYork. Here, ing, aughton says, because, "The most more than 15 percent of the community is effective part of our education is the in for65 years and older, approximating the ratio that will prevail in the country as a whole in another 15 years. Responding to the needs of this community, the University at Buffalo School of Medicine and Biomedical Sciences is taking a leadership role in training physicians to respond to the needs of older patients. This year the medical school initiated a three-year trial program, the Indirect Medical Education (I ME) Demonstration Project, through which the region's consortium of six teaching hospitals pools Graduate Medical Education (GME) payments from area medical insurers and redirects these funds to train more residents in geriatric care. Funds are also set aside to train residents in primary care and to recruit and retain more minority residents - a strategy recently cited in Hospitals, as a national model for promoting primary care and reshaping graduate medical education. "We're using this as as tim ulus to move us institutionally mal methodologies and patient demonto help in these missions, " says john P. strations. Changes in the curriculum reNaughton, M.D., vice president for clinical affairs and dean of the School of Medi- lated to the medical problems of an aging cine and Biomedical Sciences. During the population will occur as the faculty develnext three years, the IME will provide ops interests and integrates them into the between $4 million and $5 million for curriculum." Already, Susan H. Schwartz, M.D., diresident training in geriatric and primary care, disbursing funds through an internal rector of UB's third-year medicine clerk- 0 B u a 0 p h s c a ship and assistant head of medicine at Buffalo General Hospital, has altered the medicine rotation to include outpatient exposure to the elderly this year for the first time. "Compared to their current exposure, this will change medical students' attitudes tremendously," Schwartz says. "The in-hospital exposure to the elderly is an unfortunate one. For students on inhospitalrotation, the elderly are the people who are in the hospital to die. They [the patients] are at their worst in an acute setting, away from home, where they're disoriented. It can be very frustrating for students to deal with. " Next year, Schwartz says, four of the 11 weeks of the medicine rotation will beat outpatient sites such as nursing homes and day care centers for the elderly. "It's important for medical students to see older patients in outpatient settings where they're walking, talking older people who may have assorted medical problems but are still functioning," she says. "They will see being elderly does not mean being completely infirm, and that there is a reward, clearly, for dealing with the elderly. It's both an emotional reward of just interacting with older people, and it's also the reward that you can make people better, that there are curable or chronic illnesses you can modify if not totally cure. , The geriatric initiatives funded through the IME Demonstration Project also reflect the progress of physicians' understanding of the needs of the elderly - u m n 9 �approximating the ratio that will prevail in the country as a whole in another 15 years. emphasizing preventive and chronic medical care, outpatient care for ambulatory older patients and interdisciplinary geriatric teams. Until recently, many physicians assumed that increased physical frailty was inevitable as aging progresses. A more current approach, often referred to as "successful aging," in reference to the landmark article in Science, "Human Aging, Unusual and Successful" byjohn W. Rowe and Robert L. Kahn, is gaining credence as research indicates that a healthy lifestyle and prevention of conditions such as heart disease and osteoporosis that are often present in an older population lead to increased longevity and a higher quality of life in later years. john Feather, Ph.D., director of the Western ew York Geriatric Education Center, which serves as a regional resource for geriatric education, observes, "If you think of aging as an inevitable degenerative process, then what's the point of trying to help people? You should just try to make them as comfortable as possible. However, if the frailties associated with old age are really disease-specific, then you should aggressively treat disease at any age. The truth probably falls somewhere in the middle; even if you solve every disease, that person isn't going to live forever. " june I. Chang, M.D. , who coordinates the education and training programs in UB's Division of Geriatrics/Gerontology, concurs. "A middle ground might be described as progressive aging, making people as healthy as long as possible, but accepting that some physical changes are going to occur." These philosophic approaches to medi- 8 0 0 p h cal care of the elderly have real consequences, she says. For example, though there is some senescence in aging, Chang says, people shouldn't forget important things like their child's name or someone who is a close friend. She observes, 'Tve had patients with memory loss say there's nothing sume that some surgical procedures or aggressive treatments would not be appropriate; but in many of these instances, treatment might extend life by another 10 to 15 years. Typically, students may not be aware of the importance rehabilitative therapy or assistive devices could have in improving the quality of life for older patients, she says. And they often Number of c ertl·r·led Geriatricians aren't aware of how changes re40,000 lated to aging affect which medications should be prescribed. Even practicing physicians have ....---.~ 30,000 a tendency to misdiagnose the symptoms of older patients, frequently failing to diagnose the treat_ ____, 20, 000 able medical problems that affect the health of older persons, Chang says. Medicine's approach to older patients will clearly receive more and more attention in the decades to come due to the sheer numbers of patients living to their "golden years. " T. Franklin Williams, M.D., the immediate past director of the ational Institute that on Aging and a professor of medicine at can be the University of Rochester, says, "Bedone, that's cause of the rapidly increasing numbers of normal with ag- older people in our society and especially ing. But this symptom really should be the very old, there's no question but that looked into. It could be a problem with the predominant amount of medical pracmedication, depression, a stroke or tice in essentially every field will be with Alzheimer's disease. Likewise, sleeping olderpatients-orthopedics,generalsurproblems that patients typically attribute gery, urology, family practice, internal to age could be symptoms of congestive medicine and cardiology, and so on, heart failure which gets worse at night, through every medical specialty. depression, improper medication or uri"The team approach is the key direcnary problems." tion for geriatrics, and specifically for the Chang works closely with medical stu- most complicated patients," Williams dents to address common misconceptions says. "That's true because the most comabout older patients. She says medical mon situation is a relatively older patient students frequently have a mistaken im- who may have two or three different morpression that people in their 70s or 80s bid medical complications, and may have don't have long life expectancies, and as- depression, dementia, plus social prob- Jo,ooo 5 c 0 A u m n 2 0 �related to care of the elderly with practicfor Graduate Medical Education. lems and functional losses as a result. "These two settings will expose resiing physicians and medical educators in "This is not only recognized in acavirtually every specialty. dents to the practices and principals of demic circles, but many community hosChang concurs. "Our goal for geriatpitals recognize that they need geriatricall y geriatrics with an emphasis on continuity specialized physicians, or geriatricians, on of care for elderly patients. These are real rics in general should not be training experiences in alternative settings away geriatric physicians, but to accept a role staff. They also recognize that in order to be known in a community as the right from acute care facilities, " says David W. as teacher and distributor of information place to come if you're a frail older person Bentley, M.D., head of UB's Division of to our colleagues. " Part of this mission, Geriatrics/Gerontology and the project she adds, is to convince medical stuwith complicated problems, you've got to director for the Geriatric IME Demonstra- dents that care for the elderly is chalbe well-staffed." lenging. An integral element in the develPopulation in Millions, 65 "Attitudes are changing," opment of needed geriatric experand older 10 she says, "but they're changing tise at UB's affiliated teaching hospitals, the Indirect Medical Education very slowly." Demonstration Project this year proIn the absence of a single 60 vides $130,000 in funding from the university-affiliated teaching = seven-hospital consortium for two hospital - which elsewhere t-_ - ____ , new interdisciplinary team initiatives have been criticized as being -~ overrun by medical specialists to train UB residents in geriatric ~~£40 and isolated from their commucare: nities- six of the teaching hos• Beginning in October, 1993, a 30 pitals affiliated with the UB medinew, mobile geriatric assessment team will treat older persons who cal school produced the bluelive in the community at ambu20 print for this first three-year latory care sites at area hospitals. phase of the IME DemonstraThe team, composed of a geri- 19--~:::-:--k::: J0 tion Project. atrician , nurse practitioner and 90 2000 ~ k:: Based on the project's ansocial worker experienced in the care of 201 0 0 ticipated success, UB medical older persons, will provide consultauons 'n::AI{ 2030 ~ school was asked to make a 20 40 presentation to the U.S. Congressional as requested by;residents and their intertion Project. nist-preceptors. Resident training will be ationwide, the demand for geriatric- Commission on Health Care Financing. aughton and senior staff associate provided through these consultations, as trained physicians has already outpaced ancy Gleico represented UB at the hearwell as through team conferences and supply. The Alliance for Aging Research recently asserted that the U.S. , which now ings that explored ways to change the seminars for approximately 40 residents during the first year. has 4,084 physicians certified in geriat- direction of graduate medical education • A new Geriatric Evaluation and Manage- rics, falls far short of the 20,000 needed to for which the federal government spends ment Unit, located at the VA Medical deliver medical care to the nation's 30 $5 billion a year. "We're ahead of where the country Center, will provide rehabilitative assessmillion persons over 65. This Washingment and care for frail elderly patients. ton-basednon-profitorganizationprojects should be going," aughton says, adding Theinterdisciplinarymembersofthis unit that by the year 2030, when there will be that for UB and other medical schools will also provide consultations to the VA more than 65 million Americans over 65, "One of the challenges for physicians wili MedicalCenter'sacutehospitalunits,adult more than 36,000 geriatricians will be be to coordinate medical care with specialday health care program and the geriatric needed. ists from the allied health professions. However, it will not be possible to keep Another challenge will be to integrate care ambulatory clinic. This program is expected to train approximately 20 Departpace with this projected demand. Instead, and prevention. ment of Medicine residents next year in a Bentley, who is also director of UB's "As the reemphasis on developing more proposed, required geriatric module rec- Multidisciplinary Center on Aging, sug- generalists occurs, and we turn around ommended by the Accreditation Council gests that geriatricians should share data our specialty model, it can be done. " + - - so ~~[/ B a 0 p y 5 c a I )..) n A u m 9 9 2 �lRf~li~G l H[ flDfRl~ arion Z. Goldstein, M.D., receives equate severity to require treatment, and nearly two calls a week from nearly 63 percent of this group receive no women who are concerned about treatment. Among persons over 65 living the quality of medical care pro- in institutions, an estimated 65 percent of vided to their elderly mothers. older persons require mental health serOften, the calls come as a com- vices, yet 91 percent of them receive no plaint, says Goldstein, director of the UB treatment. medical school's division of geriatrics. "The Team care is well suited to older paprimary care physician has just relegated whatever symptom is presented as just 'old age' or 'confusion."' A board certified psychiatrist with added qualification in geriatric psychiatry, Goldstein describes the common scenario: "The physician sent the elderly and their families away, saying you're just getting confused, getting old- without making distinctions between what is treatable and what is related to getting old. The stereotyping is horrendous. It's a matter of perceiving treatable, potentially reversible conditions as normal when they could be treated." She notes, for example, that if the symptom is memory loss, physicians need to conduct a differential diagnosis of the nature of the memory loss to identify how severe it is, whether it's something the person needs to adapt to, whether it's progressive or whether the anxiety and depression associated with it are treatable. A complicating factor: older patients are also often reluctant to acknowledge mental health problems, she adds. "They often are unaware of treatable mental health issues or attach a great deal of stigma to it. There's a great deal of fear of the mental health field by this elderly group. They're afraid their independence will be taken away." Depression is by far the most common complaint among an older population. Other typical mental health problems among older persons include dementia, anxiety, paranoia and alcohol abuse. In fact, research indicates that 7.8 percent of adults over 65living in the community have psychological disorders of ad- 1111111• B a 0 p h y s c a ll. u RIG Hl tients, Goldstein observes. "We need to address the specific needs of each individual much more adequately than we have so far. Our whole society needs to do something about the fragmentation of care. Hopefully the next generation will find it much more easy to seek out and find services they need. " + u m 2 �p ~ H J y B E s 0 T 0 c 5 5 a y B a p R h y s N E T A c R E B 0 a n T w A A L M m n N 0 N 0 9 D 9 2 �ul G. Bulger, 68, was reading a report at work one day, rubbing his eyes, when suddenly a giant black blotch covered the right side of the paper. When he looked up, the dark spot remained in his right field of vision. Alarmed, the former president of Buffalo State College had an assistant rush him to his ophthalmologist. There he learned that the condition in his right eye, age-related macular degeneration, would soon affect his left eye as well. Two years later, in 1988, while relaxing with his family at a wilderness summer cottage near Albany, the prognosis came true. �hough laser treatment in his left eye preserved some peripheral vision , Bulger was now legally blind. His ophthalmologist told him nothing more could be done to restore his vision , and sent him on his way. Bulger, frightened by his loss of vision , soon resigned from his position as interim director of the Buffalo & Erie County Historical Society. He became increasingly irritable, dependent on others, and subject to depression. Anticipating the needs of a growing population of elderly disabled persons like Bulger, a group of clinical and research faculty at the University at Buffalo recently founded a rehabilitation , research and infom1ation center for me elderly known as the Rehabilitative Engineering Center on Assistive Technology and Environmental Interventions for Older Persons with Disabilities. The center is the first of 18 national rehabilitative engineering centers to focus exclusively on ilie needs of the aging. It officially opened in September 1991 wiili the initiation of a fiveyear, $2.5 million grant from the Department of Education's ationa! Institute on Disability and Rehabilitation Research. An additional $2.5 million in matching funds were provided by UB and oilier sources for the center. William C. Mann , Ph.D. , director of the center known informally as the REC on Aging, says, "We have a unique service orientation. The ultimate goal of the center is to improve me quality of life by helping people maintain independence in the face of the aging process. While the physician is more typically involved with disease and medical treatment, we are addressing issues of long-term disability, and providing solutions ilirough assistive devices and environmental interventions." Referred by his physician shortly after the REC on Aging received funding in 1991 , Bulger visited the center for a full diagnostic review. The age-related macular degeneration that he suffers from occurs among an estimated 17 percent of Americans who are 60 years and older, and 30 percent of those 75 and older. Specialists identified two devices that would be of use to Bulger: a portable reading device and a computer with voice playback software. Though he remembers his early days ofblindness as, "A low spot that was pretty rough on me, and on other people around me, especially mywife,"Bulgersays. "With these devices, there is a tremendous elevation of the psyche. I have relatively few days of depression anymore." The REC also helped Bulger apply for financial support for me new devices, and provided six weeks of instruction on the devices. Bulger hopes to establish a consulting business, and is already using a desktop device that enlarges print for reading and writing that the Blind Association of Westem New York helped him obtain in 1989. Emmett Turner used the center's services to obtain a wheelchair specially molded to his body. Turner was 58 years old when he fell down a flight of steel stairs on ilie ship he was working on and broke his back. The former construction firm owner and port authority foreman couldn't sit for long periods of time in his first wheelchair and found it painful to ride over bumps.' In ilie new wheelchair, Turner can sit " nstead ofpatients who need treatment, older persons should be viewed as consumers who B u a a p h 5 c a n m 9 9 2 �process, accidents, developmental disabilities or disease. Among the medical conditions typically associated with aging that predispose to disability are arthritis, Alzheimer's, osteoporosis, cancer, heart disease, the inability to regain balance and neurologic diseases such as Parkinson's. Another REC client, john See!, a 71year-old information systems specialist who became legally blind from macular degeneration in 1988 now uses a voice-activated, specialized software package for a new computer that the center helped him obtain and learn to use. See! says if he had known of the center when he was first diagnosed, "It would have made all the difference in the world." Using this equipment, See! works from his home as a computerized maintenance, inventory and purchasing specialist for area corporations. He works for the income, and also because, "I would have just dried up and blown away if I didn't have something to keep me active." One of the RECs goals is to bridge the divide between geriatric specialists and rehabilitative engineers. "The technology people are not focusing on aging, and the aging people are not focusing in on rehabilitative technology and the applications of assistive technology and environmental interventions," says Mann, a licensed occupational therapist. "Perhaps we can bring them together." The center's cross-disciplinary team includes UB faculty in the School of Medicine and Biomedical Sciences, the School of Engineering, the School of Architecture and Planning, the Department of Communicative Disorders and Sciences, the School of Health Related Professions' Department of Occupational Therapy and specialists from UB's teaching hospitals and numerous state and local service agencies. In conjunction with their research efforts, these varied specialists provide wideranging, individualized client services that for nearly l2 hours, and is comfortable riding over uneven surfaces. "I go more places, and stay longer," he says. "It makes me feel a lot better." The medical community is on the front lines as the aging of America takes its financial and emotional toll. Currently, one in five Americans is older than age 55, as compared to one in 10 in 1910. By the year 2050, Census Bureau projections indicate this ratio will be one in three. Physicians are accustomed to providing medical solutions to health problems. However, as the nation's elderly population grows, the medical community is becoming increasingly aware of the need for non-medical approaches to improving the quality of life for older patients, many of whom face disability or loss of function to one degree or another as they age. While advancing age isn't always accompanied by disability, there is a strong relationship between age and disability or the need for assistance with the basic activities of daily life. A U.S. Census survey of non-institutionalized people conducted in the mid1980s found that 9.3 percent of persons 65 to 69 years old needed assistance with one or more activities such as dressing, eating, personal hygiene, housework, keeping track of finances or getting around outside the home. This rate rises steadily with age to 10.9 percent of persons 70 to 75, 18.9 percent of persons 75 to 79, 23.6 percent of persons 80 to 85 and 45.4 percent of those 85 years and over. These rates were significantly higher among persons living in an institutional setting. The research and service activities of the REC on Aging focus on restoring a measure of independence to those older persons whose limitations to mobility, speech, vision, hearing, strength, coordination or mental acuity are caused by normal changes associated with the aging B a a p h y c a n �he ultimate goal of the center is to improve the quality of life by helping people include in-depth assessments of each client's functional abilities, limitations and goals; identification of technologies that meet clients' needs, and assistance coordinating third-party payments for purchasing and training on new devices. The center also features a full-scale interior design testing center where changes in the layout of a home or office are tested before expensive modifications are made. lt also boasts computer and device laboratories where clients choose devices that will be most useful. The research component of the REC focuses primarily on persons 60 years and older. Interviews with about 600 of the center's clients will be used to identify which assistive devices on the market are most u eful for older persons, whether new devices should be created to meet their needs and how to make their living and work space more functional. Based on this input, the REC on Aging B u 0 0 p will design devices that are not currently commercially available to disabled older persons. Items the REC has already invented include a "smart" microwave oven that reads cooking instructions off bar codes and a motorized wheelchair testing platform to which a conventional wheelchair is attached, providing a cost-effective means to evaluate different models of motorized wheelchairs. The survey will also be used to identify and meet the needs of the older disabled person's family members and professional care givers. Survey respondents will be interviewed over regular intervals during the the REC's five-year education department grant, enabling the center to evaluate the long-term effectiveness of its services and the usefulness ofspecific assistive devices and modifications in living and work space. In keeping with a national trend to- h y 5 c o n ward patient empowerment, joseph P. Lane, an associate director of the center, observes that, "Instead of patients who need treatment, older persons should be viewed as consumers who need information to make rational choices. They have a role to play in decision-making. " Glen E. Gresham, M.D., chairman of rehabilitative medicine at UB and medical director at Erie County Medical Center, shares this perspective. just as internists consult with a surgeon if they think a patient needs an operation, he recommends that physicians with older patients with disabilities should consult with rehabilitative and geriatric specialists as well as the REC on Aging. "If physicians have patients who have functional problems that are limiting their lives, they shouldn't just say, 'You have to live with it,"' says Gresham. "The focus should be to help people stay functioning and independent as long as possible." + m n 9 2 �maintain independence in the face of the aging process. to mobility, vision, speech and hearing to read, write, control their environment and communicate in person and over the phone. * Inspection of home and work settings, full-scale testing of recommended modifications such as the enlargement of doorways or installation of hand rails. * Assistance coordinating funding from state agencies, insurance companies and employers. (The REC on Aging's fee-based services are covered by many insurance plans.) And for service providers and care givers for older persons with disabilities, the center provides: *Training and informational seminars for rehabilitative engineers, occupational therapists and institutional care givers for the elderly. * Presentations to residents of nursing homes and self-help groups for the disabled. * Presentations to advocacy groups for the aging, hospitals and church groups aimed at attracting clients who may regain independence with the center's assistance. For more general information, contact information coordinator Thomas Burford, Ph.D., and forreferrals for services contact Peggy Strassheim, social worker, at (716) 831-3141. + he University at Buffalo's new Rehabilitative Engineering Center on Aging offers wide-ranging services. For the medical community, the REC on Aging provides: * A center to which patients may be referred for evaluation and assistance. * Information about the effectiveness of more than 20,000 assistive devices and modifications to home and work settings. *Training for rehabilitation medicine residents, participants in UB's geriatrics/gerontology fellowship program, nurses, counselors, social workers, engineers, occupational and physical therapists and speecManguage pathologists. Because the REC on Aging shares the facilities of the University at Buffalo's Center for Therapeutic Applications of Technology, the following services are available to disabled persons of all ages: * Free information and referrals. * In-depth evaluation of needs and abilities, including identification of helpful devices and environmental modifications and installation and training on new assistive devices. * Custom modification of wheelchairs. * Computer facilities where clients may sample hardware and software designed to help people with significant limitations B 0 0 p 5 c o n A u m 9 2 �• • '' • n the centennial a iversary of the founding of th Sch l of Dental Medicine and the 25 year since graduated from it, Ros ell Park Cancer Institutes William Carl, D.D.S., climbs Ojos del Salado, the second-highest eleva. in the Western Hemisphere. This is his story. xl &Photos By illlam Carl D.D.S. �• �he world looks warm and pleasant through the windows of the Restaurant Miramare in Caldera, Chile. In the harbor, pelicans dive for fish. Small boats sway gently in the water. Beyond the bay, small houses, painted white and green, with flat roofs, cling like aphids to the desert slopes. The sun warms my back and face and drives the last of the lingering cold out of my body. Forty-eight hours ago, I stood on the crater rim of Ojos del Salado and shivered in the summit wind and fog. But now the Atacama Desert and its high plains and mountains are memories of an adventure into a great and unique wilderness. The Atacama Desert in northern Chile is one of the driest deserts in the world. It begins along the Pacific coast as gentle, sandy slopes and terminates inland in snow and ice-covered mountains of more than 20,000 feet high. No rivers flow through this desert; no rain wets the parched earth. The merciless sun during the day, the ever blowing wind and the bitter cold of night, have reduced all life to a minimum. What does grow in that desert of sand plains, saline lagoons and dry salt basins hugs the sterile earth firmly as tufts of coarse yellow grass. B a 0 p y 5 c a n u m n 9 2 ��THE CLIMBERS ENJOYING A BATH IN THE LAGUNA VERDE HOT SPRINGS AT 15.000 FEET . he creatures that inhabit this barren, desolate region reflect its colors in their feathers or furs. The few Oamingos on the shores of the saline lagoons don't have the bright pink shades of their African relatives. The furs of the occasional guanacos blend in with the maize of the salt flat grass, and the small lizards here and there scurry like fleeting shadows over the gray and brown sand. But then there are the rare humans wearing bright blue and red Goretex clothing in this endless wilderness: miners and adventurers searching to fulfill their ambitions and explore where few have tread before. What brought me to this end of the world? Once a year I feel the urge to get away from it all, leave civilization behind and test myself against the adversities of nature. I had climbed Kilimanjaro, Aconcagua, Cotopaxi and Chimborazo. But all of these mountains had the marks of tourism on them. Probably half a million people had climbed Kilimanjaro by the time I did. On Aconcagua - the highest mountain in the Western Hemisphere - the base camps were cramped with climbers from around the world and littered with garbage. Cotopaxi and Chimborazo were covered with snow and ice. That made them a little le s attractive to the average amateur climber. This time I was looking for something different. When I contacted Greg Wilson, B u 0 0 p my guide from Aconcagua, he immediatelysent mea list ofout-of-the-wayplaces. I picked Ojos because at 22,000 feet, it is the second-highest mountain in the Westem Hemisphere. Fewer than 150 people have climbed it. Climbers like those credentials. Besides, in 1992, the School of Dental Medicine in Buffalo celebrates its 100th birthday. I promised Dean Feagans to take the banner of the school to the top. There were four of us, all veterans of many mountains, waiting anxiously in Miami in March for the flight to Santiago, Chile: Peter Spatt, an internist from Colorado; Thomas Sieben, a pharmacist from Connecticut; David Hersey, a psychiatrist from Michigan, and me, a dentist from Buffalo. We had a specialist for any potential physical and emotional problems. In addition, there was Greg Wilson, our guide from Idaho who had recently climbed Mt. Everest and met Fernando and Missal, our Chilean drivers and part-time guides. From Copiap6, we headed north-east into the plains and canyons of the Atacama desert with two, four-wheel drive vehicles, leaving civilization behind. Life on land seemed to die. Clouds of dust and endless sand flats and dunes surrounded us. On the eastern horizon, rugged mountains met the blue sky in sharp silhouettes. The sun was only a few inches above the far horizon as we reached the first saline lagoon. The few flamingos munching in the shallow water took off as soon as we approached the shore. By now we were 12,000 feet high and the cold crept in y 5 c 0 closer as the sun dipped. That first night was a restless one; I never sleep well at high altitudes. The heat already made the air shimmer over the salt flat as I opened the tent flap the next morning. In the east, the three crosses - snow-capped mountains of about 21,000 feet altitude - suddenly loomed on the horizon. The Argentinean border was not far away. We camped for three days at 14,000 feet altitude to acclimatize to the altitude and then moved up to 17,000 feet. The best insurance against altitude sickness and pulmonary edema is gradual adaptation. Because the mountain air is cold and dry, hydration is crucial. Our high camp was at 19,000 feet, immediately at the foot of Ojos del Salado. Everything around oozed barrenness and isolation. On one side was the mighty massif of Ojos; on the other and below stretched the magnificent Atacama Desert with its canyons, driedout riverbeds and endless chains of snow- , W ILLI AM C ARL . D .D .S .. DESCE N D ING F ROM HIGH CAMP A T 19 .000 FEET . u m n 9 9 2 �capped mountains. We had been at high altitude for more than a week and I was anxious to get to the top after a few hours of rest at high camp. But Greg decided to allow for another rest day before our ascent. Finally, March 21st arrived - the first day of autumn in the Southern Hemisphere and the day we made our first attempt for the summit. We had packed ropes, crampons, provisions, water bottles and extra clothes the evening before. The anticipation was palpable. At 4 a.m., there was something different about Ojos. The top had an ominous white cap with a tail pointing toward the east. The cloud lingered at first on the summit ridge and then enlarged. Still, in the silvery moonlight, we continued in countless switchbacks up the scree slope until we reached the lower edge of the glacier at 20,000 feet. With the rising sun came the first gusts of wind carrying crystals of ice and snow. Above, the mountain top melted into B 0 0 p dense, fast-drifting clouds. Reluctantly, we turned back to the refugio hut. Cold and miserable, we sat around and cursed the weather. "You pay for the summit in the currency of toil," Greg philosophized. But in this weather, you couldn't even see the summit, let alone toil for it. All day the wind rattled the hut and snow showers alternated with moments c 0 A u of brilliant sunshine. When night came, no silvery moonlight illuminated the slopes of Ojos; its head remained in the clouds and our dreams of the summit began to evaporate. But weather in the mountains is unpredictable. I fell asleep in the small hours of the night and dreamed I flew a small airplane from mountain range to mountain range. It was 4 a.m. again when Greg called, "The top is clear, the wind has died." We rolled out of our sleeping bags and in the narrow space between the bunks fum bled around for our climbing gear. At this altitude, any exertion, like putting on boots and gaiters, is torture. At 5 a.m. we started to retrace our steps up the mountain. By the time the sun was well up we had reached the level of the glacier where we had to cross it. We strapped on crampons and roped up. The surface broke in large slabs, the snow underneath the ice sheet was soft and deep, up to the knees. Lifting your legs for each step out of a hole just to advance another 10 or l2 inches is agony at this altitude. Soon I measured my progress in half-boot lengths. "Breathe harder," I heard someone yell from above. I tried to answer, but no sound came out of my mouth, only a cloud of vapor that warmed my face momentarily. I concentrated on pressure breathing; breathe in deeply and let the air out with an explosive burst. The slope ahead looked steeper than anything I had ever climbed before. I conjured up the image of the little airplane that took me so effortlessly to the mountain tops in my dream and struggled on. The pain in my legs and the continuous gasping for air eventually gave way to my renewed deter- u m n 9 9 2 �summit of Ojos del Salado. To climb it, some technical know-how with ropes, jumars and descenders was required. I did not have that skill; besides, being scared of heights, I did not want to dangle from a rope at that altitude. Twenty-two thousand feet is respectable. The descent was long and slow, almost as tiring as the ascent. We met the sun again at the upper edge of the snow field and I had a picture taken with the centennial banner of the School of Dental Medicine. We had climbed and descended from 5 a.m. to 5 p.m.- a full day's work. I squeezed a few drops of water out of my frozen bottle and then dropped into my sleeping bag. I left summit jubilation for thenextdayand the long trek back through the desert. Climbing a mountain like Ojos is more than just physical toil - you have to be prepared for conditions that are not on an ordinary day's schedule. One thing is cleanliness. If you are obsessed with it, forget an adventure like this. I didn't wash my hands, let alone the rest of me, for two weeks. There is sand everywhere - in your clothes, in your sleeping bag and between your teeth. The toilet is the far side of a designated big boulder. It offers privacy, plenty of sand and lots of ventilation. You have to bring your own toilet paper and shovel. ights can be difficult on high mountains. You wake up out of a half sleep and your tongue sticks to the roof of your mination. Mini-breaks, while I waited for the slack of the rope ahead of me to pick up, sometimes allowed me to catch two or three breaths before the next step. That was sheer luxury. he steady deep breathing, the exertion and the dry air of the high mountains made my tongue and throat raw and painful. A short break, only a short break to get a drink of water, kept racing through my head. We reached the end of the snow field by early afternoon. Willpower and physical strength shriveled down to two and three breaths for each step of progress for the last few hundred vertical feet to the crater. We struggled up the ridge toward this almost imaginary point, so close to the eye, yet so far for the tired and aching muscles and oxygen-starved lungs. And then suddenly the ground leveled and we were there, on top of our world. I knew from other summits that there would be no magic insight into man and nature, no voice from heaven at that moment. My only thought was: I have to climb no more. The sun was by now behind the clouds and fog rolled in. From the rim, the depression of the crater stretched beyond the rocky elevation that was the actual mouth. You fumble around for your water bottle that's not frozen and squeeze out a few drops. And then you have to visit the far side of the boulder. At first you think about not getting up and going out into the cold for a while, but then nature demands action. You crawl back into your sleeping bag and a little while later it starts all over again. Some nights I had to get up five or six times. That's the price of hydration on high mountains. Physical fitness is essential for climbing. For a couple of months before I left for Chile, I toted heavy loads up and down Omphelius and Pfamer Roads in the Boston Hills, collecting curious looks from people in passing cars. But Ojos del Salado is different from the Boston Hills. As you struggle higher and higher, your back- THE UNIVERSITY OF ATACAMA·s .. REFUGio·· HUT AT 17.000 FEET . B u a a p y 5 c a A u m 9 2 �The memories of the cold, the wind, the sand and the toil faded as the snow-covered peak of Oj os vanished on the horizon. But the memory and the glory of having made it to the top always linger for a long time. And since this was our centennial year at the School ofDental Medicine in Buffalo and a quarter of a century since I graduated from that school, the summit of Ojos was a particularly memorable experience for me. But this was really more than just a mountain climb. It was an adventure into pack feels as if it weighs a ton and the straps cut mercilessly into your shoulders. Every muscle aches; your lungs never seem to get enough oxygen. You want to get to the top, butgravitywants you down. It becomes a balancing act. And then you begin to wonder what you are doing here. If you have any quit in you, the mountain will find it. When you set one foot in front of the other for hours and hours, you need something to occupy your mind. I wrote a few acid letters to people I didn't like. I counted from one to 100 in three languages, then did the multiplication tables and recited poems I had learned in school many years ago. I always knew they would come in handy some time. We left the mountain in high spirits. B a 0 p y a n the unknown. Even Greg had not been to this part of the Andes before. For a directional guide he used an article someone had written a few years ago for a magazine. That's the kind of stuff great adventures + are made of. m n 9 9 2 �• ················································· ··· ················· · ·························· . ' Proied aims to ease shortage of primary care physicians MODEL PROGRAM ESTABLISHED AROUND CONSORTIUM $5 million demonstration project that could become a model for easing the nations current and projected shortage of primary care physicians is being initiated by the School of Medicine and Biomedical Sciences, six of its affiliated teaching hospitals, theNew York State Department of Health, Jour private health insurance payers and Medicaid. The unique project is organized around UBs Graduate Medical Dental Education Consortium ofBuffalo (GMDECB). "The Reimbursement Demonstration Project represents a major cooperative effort on the part of our teaching institutions and graduate medical education directors to respond to known problems that face medical education, the medical profession and health care," said john aughton, M.D., vice president for clinical affairs and dean of the medical school. aughton, who chairs the GMDECB, will direct the three-year project, which also could pave the way for the more efficient use of graduate medical education dollars paid to hospitals. The project will also address ew York State's press- B u 0 0 ing need for more physicians to care for its growing elderly population as well as increase its pool of minority physicians. "We will strive to increase our commitment to the educational preparation of more generalists, and to attract increased numbers of underrepresented graduates from minority and socio-economically disadvantaged populations," augh ton said. "This effort shows the importance of cooperation by a number of diverse constituencies, each of which is involved in graduate medical education in some way," he noted. "Each has a responsibility to provide the innovative leadership this p h y 5 c a n project represents," he added. William R. Greiner, UB president, said, "The project is a clear and exciting example of the way in which we at UB and we in Western ew York can lead in a time when extraordinary new steps and unprecedented collaborations are called for. "It's a network of partnerships within our academic community; it's a way to address critical needs here at home, as well as a model for efforts throughout ew York State and across the nation. It will serve as a template for all of us here at UB, too, as we focus our attention on developing such experiments and leadership throughout our university's endeavors," Greiner noted. Eight new health care initiatives - to begin this fall - form the centerpiece of the project, for which $1.13 million is budgeted for start-up. Funding for the remaining two years is set at $1.7 million and 2.27 million. The funding is provided by the six hospitals through reimbursement from the insurance payers. The hospitals, which currently are reimbursed directly for their indirect medical education costs, will receive increased reimbursement rates and contribute a portion of these reimbursements into a pool to support the eight initiatives. A primary goal of the demonstration project is to increase the number of residents enrolled in the primary care specialties to 50 percent of the GMDECB's total by 1994. Currently, 35 percent of the Consortium's residents are enrolled in family practice, pediatrics or internal medicine. A Primary Care Resource Center, to be located in Beck Hall on the South Campus, will house five health care initiatives aimed at making primary care medicine - historically not as attractive professionally or economically- more appealing to medical students. ationally, less than 20 percent of medical school graduates enter primary care - down from 50 percent in m n 9 2 �without walls"- is fairly atypical of most of the nation's medical schools, which generally run their own medical centers. The Graduate Medical Dental ten have longer ....~~~~~~~~~~~~~~. .r1~~~~"~~~~~~~~ Education Conand less predictsortium of Bufable hours. falo came into The Reimformal existbursement ence in 1983 Demonstration when the mediProject's prical school and its mary care initiateaching hospitives would seek tals entered into to increase the its first consorGMDECB'scadre tium. Consisting of primary care of all affiliated residents by: teaching hospi4 Recruiting tals, the Schools medical students of Medicine and into primary care Biomedical Sciresidencies ence and Den4 Developing tal Medicine, all community sites residency trainwhere medical ing program diresidents can rectors and one practice resident from 4 Developing a each program, medical school the Consortium curriculum track governs all resiaimed at training dency training primary care leadprograms ers through a se4 Designing a ries of comprogram to immittees. prove the teachThe unique ing of primary program has care faculty, and, ~ emphasized 0 4 Developing re~ cooperation search opportuni~ rather than ties and fund recompetition search fellowamong its ships in primary teaching hospicare. tals , many of Other aims of the which were once consentation in its residency programs is 9 demonstration project insidered competing institutions. + clude incorporating geriatrics and the care percent. UB's medical school teaching hospital of patients with chronic conditions into - BY NANETTE TRAMONT KOLLIG model itself- labeled a "medical center residency training as well as reaching and 1963. Primary care physicians currently earn about one-third to one-half the salary their specialist colleagues do. And primary care physicians of- maintaining an 11 percent minority representation in residency programs. UB's current minority repre- �• ..................... . ......... . ................... . ... . .... . ...... . ... . .. . .............. . ... . .. . I Ador'' patients to be used to test competency of medical students 11 B medical students \ soon will be , \ I \ I I seeing pa~, \ I \ f tients ' ' '• '' w h 0 ... won't besickatall. The patients will be faking - to test how compassionate, caring and competent medical students are. UB is joining Albany Medical College, the State University of ew York Health Sciences Center at Syracuse and the nursing program at Regents College in a pilot program to uses tandardized patients - healthy people trained to portray the symptoms and characteristics of real patients - to test medical students' skills. The project is funded by a two-year, $200,000 grant from thejosiah Macy,jr. Foundation. To carry it out, the schools have formed the Upstate ew York Clinical Competency Center, one of six such groups funded by the foundation nationwide, for a total of $1.5 million. Using standardized patients allows examiners to compare and rate performances of students as they diagnose and treat the same patients. Students know when they are being tested with standardized patients, but the encounters take place under true-to-life conditions. "Many of us in medical education have become increasingly concerned about the use of standardized pencil and paper tests I .. .. . as the primary, and at times, only measure of physician competence," said Dennis adler, M.D, associate dean and head of medical education at the UB medical school. "This grant will allow us to start developing tools to assess a much broader spectrum of attributes and skills a physician .. should have. Knowledge, critical thinking, f \ I \ sensitivity, social skills and the ability to communicate are just some of the many components of competence we hope to address in this new interactive manner." The program will begin in January 1993. By the end of the two-year grant period, all fourth-year students in the three medical schools will be required to pass this new performance-based examination by working with eight standardized patients. Albany Medical College will set up the patient training program during the first year of the grant. The program will ex- -- pand to the other campuses during the second year. The ational Board of Medical Examiners is expected to add a clinical skills exam to its licensing process in 1995. + BY LOIS BAKER Knight named chair of Anesthesiology Department au! R. Knight, M.D., professor in Department of Anesthesiology at the University of Michigan Medical Center, .. has been named chair and •• - - - professor of the medical , \ ' ' .. school's Department of Anesthesiology. A University of Michigan faculty member since 1977, Knight also served as assistant and associate professor in the department of anesthesiology and an assistant research scientist in the department of epidemiology there. Before going to the University ofMichigan, he completed a residency in the departments of anesthesiology and surgery at the Milton S. Hershey Medical Center in Pennsylvania. Knight did graduate fellowship training in the department of microbiology at the Pennsylvania State College of Medicine. Knight has authored numerous journal articles and has delivered many presentations. He is a reviewer for thejournal Anesthesiology. + - BY MARK POLLIO �· · ·· ·· ·· · ······ ·· ··· · ······· ·· ·· · ·· · ·· ·· ····· · ··· · ····· ·· ······· · ········· ·· · ·· ··· ·· ··· ·· ·· ·· ··· • · ~ I I UB app6es for maior Robert Wood Johnson Foundation grant he University at Buffalo School ofMedicine and Biomedical Sciences has applied for one of 18 Robert Wood johnson Foundation planning grants aimed at increasing the number of medical school graduates entering generalist physician residency programs and practicing generalist physicians. Under project director john aughton, M.D., vice president for clinical affairs and dean of the medical school, UB's proposal uses its unique Consortium teaching hospital structure to improve the quality and numbers of primary care physicians it produces by effecting long-term changes in recruitment, training and support of the generalist physician. The planning grant is for one and onehalf years. + ers to receive the award in 1992. Robert Adams of the IH's Cancer Training Branch said career development UB researcher studying diet and cancer Bnk wins NIH award o L Freudenheim, Ph.D., assistant professor of social and preventive medicine, has received a $325 ,000 Research Career Development Award from the National Institutes of Health to support her research during the next five years. Freudenheim is one of eight research- B a a p grants are awarded to promising young investigators who have established themselves in their fields. Freudenheim has published articles in professional journals on her research into diet and osteoporosis and diet and cancer. Her work over the duration of the grant will involve further investigations into the effects of diet on breast and endometrial cancers, as well as a study of diet in Italy and its relation to cardiovascular disease and cancer. A University at Buffalo faculty member since 1988, she received a bachelor's degree in human nutrition from the University of Michigan, master's degrees in nutritional sciences and epidemiology from the University of Wisconsin at Madison and a doctorate in nutritional sciences from the University of Wisconsin . + B Jo L Freudenheim, Ph.D s c a }l. u u m Y n LOIS 9 B 9 AKER 2 �Harold Brody steps down as chair of anatomical sciences When the war was over, Brody was assigned to a VA-type hospital on Staten Island, where he worked in the OR until he was discharged. From there, he returned to his hometown of Cleveland and entered Western Reserve University "while it was still pure," Brody jokes about WILL REMAIN ACTIVE IN MEDICAL SCHOOL TEACHING what is now Case Western Reserve University- to study biology. "While I was there," he says, "with my ot only is UB's Harold Brody tor, but Haynes told me that unless I knew probably the only chair of any the anatomy, I wouldn't be a help to him experience with the medical unit and all the studying - I had kind of fallen in love department of anatomical sci- ... and told me to leave the room. ences who was kicked out of an "From then on," Brody said, "I memo- with anatomy. I wanted to do something operating room for not knowing rized Gray's Anatomy at night until1 a.m. with it, so I finally decided to go fora Ph.D. anatomy, but he readily re- I would know what the [surgical] cases in anatomy," which he received from the counts the incident and fondly recalls it. would be the next day so I studied the University of Minnesota in 1953. In 1950, Brody went to the University In fact, he says, it is the catalyst that anatomy the night before." Haynes was began his passion for anatomy and led to pleased. "He had kind of expected it," of North Dakota to head the teaching program in neuroanatomy for 40 firsthis still-ongoing distinguished career as a Brody recalls. "Gradually, I became more and more year medical students. teacher and researcher in the field . While there, his reputation as a reknowledgeable. And I never got kicked Here is what happened. searcher and instructor spread, and with Itwas 1944and Brody was in the Army out of an OR again. " Brody eventually became so knowl- only one neurosurgeon in the state at that medical corps. His outfit was stationed in Southern England at one of a cluster of five edgeableand proficient that Haynes would time (and no neurologists) , he served as a general hospitals set up there in anticipa- assist him. "I did a couple of craniotomies source for general practitioners on infortion of the French invasion. Brody and for shrapnel in the brainandaboutadozen mation on the nervous system. "There was so much to learn," hereseven others had been working as surgical nerve repairs," he remembers. members, adding that he had a couple job technicians and were trained to assist in offersone from Buffalo after a "hallway and perform the closure of wounds, apinterview by Dr. 0 . P. jones" at a conferplying casts, passing instruments, etc. "At ence in Galveston. least from a mechanical point of view," "And so we came here," he says. Brody says, "the enlisted men could close That was in 1954, and Brody and his wounds as well as the surgeons." wife, Anne, had a one-year-old son, David, It was about the time the Allies broke now an attorney in Buffalo. Their second through in ormandy and the surgical son, Evan, who just completed his Ph.D. suites of the general hospital were busy, in exercise physiology, was born in 1957 handling as many as 50 cases a day. while Brody was in his first year as a "We were joined by a neurosurgeon medical student. A year earlier, Stockton from the University of Illinois - Walter Kimball, the dean of the medical school at Haynes. He was put in charge of developthe time, had asked Brody to consider ing a neurosurgical unit. " obtaining a medical degree. Haynes chose Brody as his assistant. Brody managed to complete his degree "The first time I scrubbed with him was five years- all the while teaching gross in for a sciatic nerve repair. He asked me if I anatomy and neuroanatomy and doing could describe the anatomy of the sciatic research. "I would teach when I had to nerve," Brody recalls. teach and attend class when I could." ''I'd never been expected to do anyChairman of UB's department of anathing but tie a knot fast and hold a retrac- "With my experience with the medical unit and all the studying- I kind of fell in love with anatomy. I wanted to do something with it." B u a 0 p h 5 c a n A u u m 9 9 2 �······ ·· ················· · ·············· · · · ······ · ······ · ·· · · · ·· · ······· · ····· · ··· · ······· ··· · · ·• · ~ I tomical sciences since 1971, Brody was marked by his ability to take it in new one of the first people john aughton, directions in response to the burgeoning M.D., vice president for clinical affairs and knowledge and changing aspects the field dean of the medical school, met when he has taken. "Anatomy was almost exclusively teaching, rather than research," visited Buffalo in 1974. "He was very warm, gracious and sen- Naughton recalls. "Brody recruited a fine sitive," Naughton says, adding that Brody's faculty- good researchers as well as fine tenure as chairman of the department was teachers. He has been a stalwart supporter B u 0 0 p h s c 0 A I of the University and the medical school as he continued his own scholarly interests. "He is well regarded as a teacher and committed to the needs of his students. His sense of humor and warmth have served him well. His students feel very good about the education they get in m n 9 9 2 �• · ··· ···· · ··················· ··· ········ ·· · ····· · ·· ·· · ·· ···· ···· ··· · ····· ·· ··· ·· · · ·· ·· · ···· ·· · ··· . ' n anatomy, you have a " very different and unique relationship with your students. You don't see them just in lecture. The faculty struggles through with them. You come to know your students much better over a dissecting table." determine whether there is an optimum number of cells necessary for activity to take place." With widely published journal articles and book chapters, Brody, former editorin-chief of the journal of Gerontology, is an editor of eurobiology of Aging and an editorial board member of five other journals. President of the Gerontological Society of America and a founding member of the ational Advisory Council of the ational Institute on Aging, he continues to be active in professional and community organizations, as well as on several medical school committees. He is also spearheading the development of an anatomy museum "where everything will be on display for the students to use. " Brody, who was aided by Dr. Chester Glomski, professor and vice chairman of anatomy during his tenure, sees more changes ahead- not the least of which is, he hopes, another name change that better anatomy, and," aughton adds, "it is not an easy set of courses to teach." Indeed, Brody's--relationship with his students has, in many ways, been shaped by the very nature of the anatomical sciences courses. "In anatomy," Brody says, "you have a verydifferentand unique relationship with your students. You don't see them just in lecture. The faculty struggles through with them. You come to know your students much better over a dissecting table and at the microscope." Brody's major research interest has been in studies of normal aging in the human central nervous system. He is presently working on the effects of aging and alcohol on the cerebellum, a study in which Dr. Roberta Pentney, interim chairman of anatomy, is the principal investigator. "I have always been interested in cell numbers," he says. "Ultimately, my interest is in trying to B u 0 0 p h y c o n reflects the scope of the activity the department engages in. "One of the first things I encouraged the department to do when I became chair was to change its name. We were responsible for teaching and research in several subjects; I got tired of people saying, 'Oh, you only have one course.' We had not only gross anatomy, but neuroanatomy, histology and embryology. "We've been the anatomical sciences since then." Brody has worked to change the department's name to "anatomy and cell biology" to reflect the additional focus of neurobiology, cell biology, reproductive biology, hematology and functional morphology. The change, suggested by Dr. Barry Eckert, associate professor of anatomy, and approved by the medical school, is stalled at higher levels, but Brody is hopeful it will move forward soon. + -BY NANETTE u m TRAMONT n KOLLIG 9 2 �....... . ... . ........... . ....... . ............. . ... . ....................... . .. . . . . . .... . ....... . . 1973 graduate appointed U of Connecticut Health Center interim chief eslie Cutler, who received his Ph.D. in pathology from the School of Medicine and Biomedical Sciences in 1973, has been named interim vice president and provost for health affairs and executive director of the Farmington facility , including john Dempsey Hospital, for the University of Connecticut Health Center. Cutler joined the University of Connecticut School of Dental Medicine's department of oral biology in 1973 and has been associate vice president and associate provost for health affairs since 1991. He previously served as associate vice president for administration and research. He is currently a professor of pathology in the School of Medicine and a professor of oral diagnosis in the School of Dental Medicine. Cutler is also on the attending + staff of john Dempsey Hospital. Cosgriff elected vice president of New York State medical society state delegate to the American Medical Association. He is a past president of the Medical Society of the County of Erie. An attending surgeon and chief of trauma services at Sisters of Charity Hospital, he has been active in numerous medical organizations locally and at the state and national levels. He is a fellow of the American College of Surgeons, a fellow of the American Association for the Surgery of Trauma, a member of the American College of Emergency Physicians, a founding member of the ew York State Society of Surgeons and a member of the Buffalo Surgical Society of which he is a past president. Cosgriff serves on the state medical society's professional medical liability insurance and defense board. He is also a member of the American Medical Association. A diplomate of the ational Board of Medical Examiners and the American Board of Surgery, Cosgriff was recently honored at a benefit dinner for Mercy Flight. He was recognized for his contributions and dedicated service toward the improvement of trauma care services in Western ew York. Cosgriff has served on the board of directors of Mercy Flight and is a past director of the American College of Surgeon's Advanced Trauma Life Support courses for ew York State. + New officers elected to M111ard Fillmore Hospitals ames H. Cosgriff, Jr., M.D., a UB clinical assistant professor of surgery, has been elected vice president of the Medical Society of the State of ew York. The election took place at the society's 186th annual meeting held in ew York City. Cosgriff had been serving as the state medical society's treasurer. He also served as assistant treasurer and is currently a B u a 0 p h ndrasj. Vari, M.D. , was recently elected as president of the medical staff for Millard Fillmore Hospitals. Vari, a clinical assistant professor of medicine, will serve a two-year term. y s c a A ll l Other newly elected officers include Thomas S. Cumbo, M.D., clinical assistant professor of medicine, president-elect; Thomas A. Lombardo, M.D., clinical instructor oforthopaedics, secretary; Sanford R. Hoffman, M.D., clinical assistant professor of otolaryngology, treasurer, and Robert M. Barone, M.D., clinical assistant professor ofsurgery, immediate past president. Each will serve a two-year term. + Taheri develops FDAapproved device to treat hardening of the arteries he Food and Drug Administration recently approved a new device to assist in the treatment of femoral artery occlusion. Called the Taheri valvulotome, the device was developed by Syde A. Taheri, M.D., clinical assistant professors of surgery at the University at Buffalo and a thoracic and vascular surgeon at Millard Fillmore Hospitals. One of the common treatments for symptomatic femoral artery occlusion is vein bypass surgery. The Taheri valvulotome allows surgeons to remove the valves inside the vein used to bypass the patient's femoral artery. The device also permits simultaneous measurement of the blood pressure through the bypassing vein, Taheri explained. "In addition to removing valves and measuring blood pressure, the Taheri valvulotome also allows for detection of any abnormal communication between the artery and vein, and can effectively locate valves inside the vein," said Taheri, who spent two years developing the instrument. He has performed more than 25 procedures using the new technique, all at Millard Fillmore Hospital. + �•[21 ·································································· · ··············· ············· · . UB researcher to head awision of prosthetic materials at Sisters nne E. Meyer, Ph.D., has be n named head of the division of prosthetic materials of the Head and Neck Center in the department ofotolaryngology/head and neck surgery at Sisters Hospital. Recently appointed research assistant professor in the School of Medicine and Biomedical Sciences, Meyer is renowned for her research in surface science. She received her undergraduate degree from the State University of New York at Potsdam and earned her Ph.D. in surface science, prosthetics, at Lund University, Sweden. She formerly served as section head of the surface science section at Calspan Advanced Technology Center. Meyer is also principal research scientist for UB's Industry/University Cooperative Research Center for Biosurfaces, as well as a graduate faculty member in the School of Dental Medicine's oral sciences program and a research assistant professor in the department of biophysical sci+ ences in the medical school. ology, will serve a two-year term as vice president. Pieroni is a professor of pediatrics at UB and has been with Children's since 1976. Ehsan Afshani, M.D. , director of education for radiology and a clinical associate professor of radiology and pediatrics, will serve a one-year term as secretary/ + treasurer. Sisters Hospital names chainnan of obstetricsI gynecology department Alumni named department heads at St. Joseph ruce]. Cusenz, M.D., has been appointed director of the plastic and reconstructive section of the department of surgery at St. joseph Hospital in Cheektowaga. A 1981 graduate of the School of Medicine and Biomedical Sciences, Cusenz is an adjunct assistant professor of surgery and dermatology at the University. Heisamember of the American Society of Plastic and Reconstructive Surgeons of Upstate ew York and the Buffalo Plastic Surgery Society. Gerald V. Schwartz, M.D. , has been named chairman of the department of radiology at the hospital. Schwartz, a 1961 graduate of the School of Medicine and Biomedical Sciences, has been a staff radiologist at St. joseph since 1968. Board certified by the American College of Radiology, he is a member of the Buffalo Radiologic Society. + ichael Ray, M.D., has been appointed chairman of the department of obstetrics/gynecology at Sisters Hospital. Ray had been acting chairman of the department since 1991 and vice chairman since 1986. He is director of the hospital's antepartum fetal testing laboratory. A clinical associate professor in gynecology and obstetrics, Ray is a graduate of Georgetown University and earned his medical degree from the School of Medicine and Biomedical Sciences at UB in 1965. He completed a fellowship in perinatal medicine at the University of Southern California and has done extensive post-graduate work specializing in obstetrical ultrasound and antepartum fetal testing. ormal]. Sfeir, M.D. , clinical asRay is a diplomat of the American Board of sistant professor of medicine, has ames E. Allen, M.D., a professor of Obstetrics and Gynecology, a member of the been installed as president of the surgery at UB's School of Medicine American College ofObstetricians and Gynemedical staff at Sisters Hospital. and Biomedical Sciences, has been cologists, the Erie County and ew York State Also installed were Paul Burstein, elected president of the medical staff medical societies, the Buffalo Gynecological M.D., clinical assistant professor and Obstetrical Society, the American Instiof The Children's Hospital of Buftute ofUltrasound in Medicine and the Ameriof gynecology and obstetrics, presidentfalo. Allen, acting head of Children's Hospital's Department of Pediatric Sur- can College of Physician Executives. ln addi- elect; Daniel Castellani, M.D., clinical ingery and an attending surgeon there for 27 tion, he is a site visitor for the ew York State structor in neurology, secretary, and EdDepartrnentofHealth/ACOG District II Com- ward Bartels, M.D., clinical instructor in years, will serve a two-year term. Daniel R. Pieroni, M.D., chief of cardi- mittee to Reduce Cesarean Section Rate. + gynecology and obstetrics, treasurer. + Medical staH officers elected at Children's Hospital of Buffalo B 0 Sisters Hosp_ital installs medical staH officers 0 p h 5 c 0 A u u m n 9 2 I �.. ... . . . ......... ............ . .. .... . .. ..... ........ .. ... ..... ........ ..... ................. . . [I] CLASS OF 1 953 "Can't believe it's 40 years! See you in May." M ICH A EL A . S ULLIVAN, M .D., CHAIRPERSON CLASS OF 1943 MARCH "Don't miss our 50th Year Reunion. Lookingforward to seeing you." D UNCAN K . M ACLEOD , M . D ., co-CHAIRPERSON CLASS OF 1 943 D E CEMBER "Please circle the weekend of May 1, 1993. Plan to celebrate our 50th graduation anniversary. Hope to see you there." MORRIS UNHER, M . D ., "Half a century - our 50th Reunion! A special time for all of us. We want to see you. Please try to make a special effort to attend." R ICHARD J. CO-CHAIRPERSON "]oinusforthecelebration!" IVAN L . BUNNELL, M . D ., CO-CHAIRPERSON CLASS OF 1948 "Don't miss our 45th. We need you to make it a success. Please come. We can promise a happy time. " HAROLD L. GRAFF, M .D. , CO-CHAIRPERSON "Two-thirds of us made it to the last reunion. Hopingfor 100 percent attendance at our Spring Reunion!" DANIEL J. FAHEY, M . D ., CO-CHAIRPERSON BUCKLEY, M . D ., co-CHAIRPERSON IN MEMORY Long-time Reunion Co-Chairperson of the March Class of 1943, William H. Georgi, M.D. , died last July after a long illness. CLASS OF 1958 "Our 35th Reunion will take place on May 1,1993. Mark your calendar, reserve the date; great plans are underway! We look forward to seeing you." M ICHAEL T . GENCO. M . D ., CO-CHAIRPERSON I ALFRED M . STEIN , M . D ., CO-CHAIRPERSON s 0 0 p c 0 m n 9 9 2 �• ··························· ·· ··································································· CLASS OF 1973 CLASS OF "It's hard to believe that 20 yeras have elapsed since we graduated. Now that we're all settled and 'huge successes,' let's get reacquainted at Spring Clinical Day this coming May." 1988 "May 1st- Our Five Year Reunion. Don't miss out on the fun for everyone!" FRANK A . LUZI , M .D ., CoCHAIRPERSON LORI GUTTUSO-LUZI , M.D. , CO-CHAIRPERSON MICHAEL A . SANSONE, M . D ., CHAIRPERSON CLASS OF 1963 1 968 CLASS OF "Put the routine aside for a weekend. Come back and enjoy the warm companionship and memories of your classmates and friends at our 30th Reunion. " "It's hard to believe that it's been25 years since we went our separate ways. We really would like to see a tremendous turnout on May 1,1993. Come together and relive some of the special times we all shared. Please try to join us and make this a truly memorable time for all of us." ANTHONY M . FOTI , M.D. , CO-CHAIRPERSON "Each reunion has been rewardingtoall who attended. Let's make our 30th the best yet! Reserve the weekend of May 1, 1963 and renew our friendships. Makeourday!" THOMAS J . CUMBO, M . D ., CO-CHAIRPERSON "We are lookingforward to seeing you for our Silver Anniversary!" JOHN R . FANELLI , M .D ., CO-CHAIRPERSON ROBERT A. MILCH , M .D ., CO-CHAIRPERSON CLASS OF 1983 "Let's get together and renew our friendships at our lOth year reunion." RICHARD L. COLLINS , M .D ., CO-CHAIRPERSON "/ am really lookingforward to getting together with those we have lost touch with. I hope you all make it!" JAMES G . CORASANTI , CLASS OF 1978 M .D ., CO-CHAIRPERSON "Medicine's changed a lot in the past 15 years. Let's get togetherfor Spring Clinical Day and see how much we've all changed. Looking forward to seeing all ofyou in May of'93!" STUART L. DORFMAN , M .D ., CHAIRPERSON a u a a p s a n u m 9 2 �································································································r a a • 172 19 Connecticut ••••...•••••••••.• 123 District of Columbia •••.•••• 19 he 4,924 graduates ofUB's School ofMeclicine Delaware ........................ 9 and Biomedical Sciences are scattered far and Florida ......................... 270 wide across the United States. Georgia •.•••••••••••••••••••.••• SS Here, Buffalo Physician lists its medical Hawaii .......................... IS school graduates state-by-state and in the Dis- Iowa ............................... 6 trict of Columbia and Puerto Rico. The ll Idaho .............................. ] alumni listed in the "Other" category represent physi- Illinois ........................... 63 cians in Canada, England, Africa and other countries. Indiana .......................... 22 Alaska ••••••••••••.••••••••.••••••• 2 Arizona ......................... 84 Kansas ............................ 8 Alabama ........................ I 0 California ••.••••.••••.••••••.. S02 Kentucky ....................... 20 Arkansas ••.••••.••••.•••••••••••• 4 Colorado ........................ 48 Louisiana ...........•••••••••••• 17 Mapping our medical alumni s a a p h y s a n A Massachusetts .•..••••••••• 172 Maryland ..................... 16S Maine ............................ 36 Michigan ........................ 6S Minnesota ••..••••••••.•••••••• 3S Missouri ••.•••••••••••••••••••.• 20 Mississippi ••••...••••••••••••••• 3 Montana .......................... ] North Carolina ••••••••••••••• 66 North Dakota ••••••••••••••••••• S Nebraska ......................... 3 Nevada ••••••••••••••••••••••••. 22 New Hampshire •••.••••••••• 26 New Jersey •••••••••.••••••• 119 New Mexico •••..••••••.•••••• 18 New York •••.••••••••.•••• 2,06S Ohio ............................ l36 Oklahoma •••••••••••••••••••••• II Oregon .......................... l2 Pennsylvania •••••..•••••••• 239 Puerto Rico •••.•••••••••••••••••• S u m 9 ~5 Rhode Island •.••••••••.••••••• 33 South Carolina •••.••••••••••• 29 South Dakota •••••••••••••••••• 1 Tennessee ••••••••••••••••••••• 19 Texas ............................ 91 Utah ••••••••••••••••••.•••••••••• 11 Virginia ••••••••••••••••••••••• II 0 Vermont ••••.•••.••••••••••••••• 13 Washington ••••.•••••••.•••••• SO Wisconsin •••••••••••••••••••••• 27 West Virginia ••••.••••••••••• II Wyoming •••••••••••••••••••••••• 4 Other ............................ 11 9 9 2 �• ............................ . ............. . . . ............................. . . . .. . .... . . .... I niversary with a cruise from IRA L . SALOM '77 , Venice to the Black ea and the june 1992, I received a Master of Mediterranean. " Science in Management from the writes, "In s Wagner Graduate School of Public Service, ew York University. an- I had been enrolled in the Ad- nounces his retirement after 30 vanced Management Program for 1 9 5 JOSEPH 5 . 0 DAVID '53 , years in practice at Children's Clinicians, a W. K. Kellogg Foun- Hospital in Orange, California, dation-sponsored program in where he served as chief of sur- health care policy and manage- gery and chief of staff. He now ment studies." resides in Sun Valley, Idaho. John Ambrusko '37 1 9 6 s 0 1 Harry L. Metcalf '60, 9 8 s 0 MICHAEL D . RUDN ICK '87 , of ew York, was fellows named by the College's completed a fellowship in Adoles- Board of Chancellors during their cent Health in 1991 and was ap- elected president of the American annual meeting held in Septem- pointed director of the Westside cepted an appointment as surgi- Academy of Family Physicians ber in Phoenix, Arizona. cal consultant for the Qualitative Foundation. HARRY L . MET CALF '60, 1 9 3 s 0 JOHN AMBRUSKO '37 , Williamsville, has ac- Assurance Program at Manatee Memorial Hospital in Bradenton, Florida. ROB E RT BARRYS. 5HULTZ '68, J O RDO N '65 , chairman of dermatology at The Ambrusko served as University of Texas Medical medical executive director of the School at Houston, was elected Manatee County Public Health chairman of the National Advi- Department from 1977 to 1990. ofWest Reading, Pennsylvania, has been elected president of the Urological Association of Pennsylvania . Shultz is chief executive officer of Genito-Urinary Associations, Ltd. sory Board for the National Insti- The Doctor john Ambrusko Public Health Complex is named in tute of Arthritis, Musculoskeletal his honor. From 1950 to 1977, Amrusko served as chief of surgery and chief consultant in surgery at Kenmore Mercy Hospital , Kenmore, E. Teen Clinic of Denver's Health ew York. 1 9 7 s 0 and Skin Diseases. Jordon also THO MAS serves on various commiuees and '71 , boards of such professional orga- profes or of pediatrics and ap- G E RALD DISESSA was recently promoted to and Hospital System. His wife, Ann Smith-Rudnick '87, is in private family practice. JOHN CLAUDE KRUSZ '83, is on the executive board of the orth Texas Multiple Sclerosis Society and has served as chairman of the Professional Advisory Commillee for three years. He has a private practice in neurology in Dallas. nizations as the ociety for Inves- pointed division chief of pediatric tigative Dermatology and the cardiology at the University of American Academy of Dermatol- Tennessee College of Medicine, writes, "Marc Levine '83 and I are DEBORAPH L. FELDHEIM '84 , FRANK T . RIFORGIATO '39 , ogy. He is also chief of dermatol- Memphis, Tennessee. DiSessa is celebrating our eighth wedding retired in january. He informs us ogy at Hermann Hospital and a medical director of the cardiac anniversary and have been living that he is the last of the Italian- consultant to The University of catheterization laboratory and the in the Washington, D.C., area. American physicians on Buffalo's West Side, saying, "there are none left." Texa M. D. Anderson Cancer Center and St. Luke's Episcopal non-invasive laboratory at LeBonheur Children's Medical and psychoanalysis in private Hospital. Center. We are both practicing psychiatry practice and are expecting our second child in October." 1 9 4 C HAR L ES J . S MITH '66 , ofBay s 0 Shore, ew York, has been named of West Palm Beach, Florida, writes, WILLIAM J . FOLLE TTE '42 , a fellow of the American College of Radiology. Smith, selected for "My wife, Della (Walters) , and I celebrated our 50th wedding an- 6 u a 0 is now chairman of the section of general Z I NA surgery at Scripps Memorial Hospital, La jolla, California. writes, "After five years in Iowa (where we had a DANA P . LAU N E R '73 , ( DM YTRIJUK) HAJ - DUCZO K '84 , his contributions to the field of son, Alex, born in May, 1989), radiology, was one of 144 new we're back in Buffalo. I am the p 5 a n u m n 9 2 �··· · ···· · ··· ·· ··················· · ··· · ··········· · ·· · ·············· · ·· · ·············· · ····• • ' new director of echocardiography MICHAELJ . 8ARTISS '87 ,com- 1991. Bhayana is currently a third retired in 1986 from X-Ray Associates, a private practice in iagara Falls. He practiced radiology at at Buffalo General Hospital and pleted a fellowship in pediatric year resident at Francis Scott Key was recently inducted as a fellow ophthalmology at Wills Eye Hos- Hospital. of the American College of Cardi- pital, Philadelphia, Pennsylvania, ology in Dallas in last March." I Children's Hospital and Sisters and has joined a private practice in Rochester, New York. ANDREW FR IEDMAN '85 , OBITUARIES Hospital in Buffalo and DeGraff CARL A. STETTENBENZ '35, Memorial Hospital in Kenmore. of Snyder, ew York, died in Feb- He is survived by his wife, the writes, "My wife, Susan, and I JOHN J . O'BR IEN '87 , has have two children: jacob, 3, and started a plastic and reconstruc- William, l. I started a hand fel- tive surgery fellowship in Hous- PAUL V. DOWNEY '36, died lowship at the University of Pitts- ton, Texas,aftercompletingagen- july 20, 1992, in his Kenmore WILLIAM H. GEORGI '43 , died burgh july 1, 1992." eral surgery residency in Buffalo. home after a long illness. in july after a long illness. AMY (MILLER) O 'DONNELL THOMAS P . SMITH , JR . '87 , '85 , writes, ''I'm moving back to announces the birth of Sean Buffalo from the University of Patrick on june 5, 1992. He is Michigan with my husband jack welcomed by his sister Megan, 7, and two children, Sara and jef- and brother, Tommy, 3 1/2. former Mary Agnew Cain, a son ruary, 1992. and six daughters. He Help us find your classmates frey, and will be on the staff in endocrinology at VA Medical Center. I hope to get back in touch with my classmates in Buffalo. " R ICHARD SCARFONE '87 , I rl writes, "Karen and I have recently veryone likes to read about relocated to Philadelphia and are expecting our first child in Octo- LISA BECHTEL '86 , writes, "Un- ber. In May, I was awarded the expectedly, I'm back in Las Vegas, Society for Pediatric Research's coordinating HIV ambulatory care Fellow's Research Award for the at the University Medical Center. study of the use of corticosteroids Most importantly, my spouse and to treat moderate to severe asthma I have two wonderful daughters, in the emergency room setting. " what their fmmer colleagues r JJ Scarfone is an associate professor Mariah and Rose. " Medicine at St. Christopher's Hos- accepted a position as chief of the pital for Children. classmates are doing. division of internal medicine and assistant director of the residency HOWARD CHANG '89 , informs program at Mt. Sinai Hospital in us that he has moved to Los Ange- Cleveland , Ohio. Pamies has a les with his new wife, Dawn, and faculty appointment with Case will be beginning a fellowship in Western Reserve Medical School. pulmonary/critical care medicine at UCLA Medical Center. If you orthopaedics in the department of orthopaedic surgery at the George Washington Medical Center. B u a 0 1 9 9 0 know. just use the attached post card s and we'll print the infonnation as RANJ AN BHAYANA '90, ofPerry Hall, Maryland, announces the soon as we can. birth of a daughter, Monisha Maria Bhayana, born November 27, p h know where they are and what they're doing - please let us JOHN K. STARR '86 , has been appointed assistant professor of Buffalo Physician better by telling us what you and your of Pediatric Emergency Room RUBENS J . PAM IES '86 , has Help us make are doing. 0 n u m n 9 9 2 �A Spoonful of Humor © Stu Silverstein, M.D . Top 10 things overheard in the OR afternational health care reform ') OK, let's close. Wait a minute ( , where's my watch? !J ] Do you have health insurance? I Look, I've got 6.02 X 10 23 more J cases. I'll be out of here in 36 -1 hours. Let's do lunch. I' There aren'tsupposed to be two ~J of these. (\ Insert tab A into slot B. u '( Oh my God, what's that? () Aren't there supposed to be two of these? U Yes doctor. I'll take a table near U • the w indow. l('U r) I've got a plane to catch in 15 minutes, let's get started. Sw Silverstein, M.D., president of Standup Medicine Seminars of San francisco , Californ ia, lecwres nationwide on the role of humor in medicine. B u 0 0 p h s c 0 u m 9 2 ��BUFFALO PHYSICIAN STATE' UNIVERSITY OF Non-Profit Org. U.S. Postage 3435 PAID AIN STREET BU FALO NEW YORK 1421"1 Buffalo NY Permit No. 311 �( l ~ ~ - ~ 0 . , f ij~IUfR~Il~ ~l 8ijff~l0 ~(HOfrl Of · ffifDI(I~f ~~D BIOffifDI(~l ~(lf~(f~ l 9 9 B u f f a t o P h y s I c l a n A u t u m n 1 9 9 2 EJ) �The Class of! 996. h learning, study and gro . train them and make th their four years at UB's . Biomedical Sciences, relationships · ~nd build c ~-------- ,---------~~~~~--~~--~ , ·to the medical school a cquire knowledge that · ~nd . contribute t~ their · lere; Buffalo Phy$ician 96 ·and wishes the.m well ·h e. medical school. tD B u f f a I o P h y s I c I a n A u t u m n 1 9 9 2 �. Jo.Attne Arnold tI Oneil Bains ( A · Sa"raJ. Ballow John Barrett Natthew Bartels 0 Susan Behr Gina Brescia · Kimberly Bonisch · Paul B.;ms Christine Bopp Tiffany Boquard Ronald Bremer John Butsch Russell Canfield· Katherine Catallo f 9. 6 �.( ' ff ~ l A Patricia Cawley Ricl~ard Cl~arles BasJ Cherpelis Melanie Christian Joseph Chruscicki Thomas Cimalo Stephen Cook Tim~thy Cotter Holly Crorriwell David D'Souza .o f r • .l 9 9 Josepl~ DcJames Bradley Davis · Allen Davis ~lanny DeLucca Rob DeHuro 6 B u a 0 p 5 c a n A u u m 9 9 2 �( l A Andrew Drnytrijuk Kathleen Dyson Richard Edwards Simone Elvey ~ -~ o,\lichacl Endl Joshua Fischer Gina Flores Scoll Flugman James Foit Brian Fortman Thomas Gennosa Patti Hamernik Chen Han Hccghan Hart f 6 �{ l . ~ Steven Heintz Jason Ilo Jean Ilsia9 . Tl10mas Hughes Babak Jahan-Parwar Rajiv J~in ,\lark Jajkowski Paul ]ee Erik Jensen Clara Kim Anthony Langome Matthias Lee ]ilmes Ida . 0 f 1 9 9. · Dionne K"rr Timot hy Jorden 6 B u a a p 5 c a A u m 9 9 �' ( ~\ a _ ~ '1k: l i_-_:_ __ J '} J Michael Leonard. Kwok Li Kristen Lukasik Beth MacDonald Dominic Lpomc Cheng' Lo Jiadc Lu ~lichael ~lanka Dori Marshall 1 l .. f l 1 1 9 Christopl1cr Mascia Paul Nab: Peter HcQuiller William ~Icdwid Kimberly Metz 9 6 �(. l· A· Alex ~loinpoint Davicl l\l.ilJcr ~ _Pinaki Hukbcrji Sluini Hukkarnala Dwayne Narayan Nncnna Okcrckc Nayomi Omura Hik~ Oslempowski John Patli • Oscar Piedad Frederick Piwko . ~- 0 f . . Sltarnantha 1 Tcsarajal1 I l 9 9 John Pana""iolopoulos Pa_ras Pandya 6 B a 0 p 5 c a u u m n 9 9 2 �( l John Pulvino Kavitha Ram Eileen Reilly Brian Riegel 0 Mary Rykert Starlecn Schaffer Kristen Schenk David Schmitz f 1 9 Rudolph Schrot Otto Schucckler Douglas Schultz . Karin Selva Lisa Shutt .9 6 �( Jo~athan Sirkin" lnclrani Sinha Sun~ Son Karen Snell Patrick Stein ) 0 f Kristin Stievater ~1ichael Stoner Tova Stram Maxine Szumigala Renate Treadway Millicent Trevett Susan Szimonisz" Julie Szumigala l 9 Meryl Tucker LisaWalk 6 B u a 0 p 5 c a u u m n 9 9 2 �( l .A Jim Wa'xm'onskv 111 c Kee Wee Byron Willis ol Naa'mi Weinstein 1h t HaryWilsch I; uf ~ I ~ 1 ~ .o . Emily Wong' Joseph Wittmann 'l 1 1 \1 ' \'a!, Buf'1Jo l ..t_r ·' · ,I!) I · Mark Zambron Clmck Yates ·.. Jennifer Wrazen 1t em 1 L \\ R;. I C R t .Jt f 1, t} lH[ f.OUOWI~G HUD[~H fROffi lH[ (lAH Of 1996 W[R[ ~OJ PHOJOGRAPHfD.· .Peter Augustino~: Christopher Jayne: ~ ·. Eileen KJlackey: Cozzette Lyons:' I.. Deborah ;\lann: ;l Thomas ;\lead: ::Andrew Stirling: I' " Davi~ Zinkin · Daniel Zorich 'n Bufhl· l 1 'Pil()lOS. ·::-r 10 TO l; 9 9 �qHI Uf R~ ll ~ Al Bq.f f Al 0 ~ ( H00l . o·f ffi f DI ( I Hf AHD BI 0 ffi f DHAl ~ ( I f.H( f ~ l. ~ au ffo t oP h y s I c I an ll.utu m n t 9 9 2 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n04-1992-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News The Graying of Medicine Rehabilitation Comes of Age Conquering Ojos del Salado Medical School People Alumni Classnotes A Spoonful of Humor Class of 1996 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n04 Extent The size or duration of the resource. 56 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/e7c663ad05ea016a079396c1be013372.pdf 898cc1e3821d4eef7f43acda9552b44b PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1993 Problem Patients 8 'A Thorny Issue �THE BUFFALO PHYSICIAN AND BIOMED I CAL SCIENT I ST \olume 27 -.;umber I DIRECTOR OF PUBLICAT IONS (A CT ING) Dr Carole Smith Petro EDITOR -.;anelte Tramont Kolhg. R.:\ ART D I RECTOR ~Ian J Kegler ASSOCIATE ART DIRECTOR Scott Fricker STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john -.;aughton \ice President for Chntcal Affa'"· Dran EDITORIAL BOARD Dr john ·\ Richert Chairman \lr Richard de Asia Dr \!arlin Brecher Dr Harold Brad\ Dr. RIChard L Colhns Dr. Donald P Copley Dr. Alan j . Dnnnan Dr. Ttmoth,· Gabryel Dr. Glen Gresham Dr. james Kanskt Dr. Charles \lassaro Dr. Charles Paganelli Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr Bradlev T. Truax Dr Steph~n Spauldmg Dr jerome Yates TEACHING HOSPITALS AND LIAISONS Bata\la \A \ledtcal Center Buffalo General Hospital \fichacl Shah Buffalo\',\ \led teal Center Paula Prdmr Children's Hospital of Buffalo Ene Count\ \lediCal Center \lerC\· Hospital \hllard Fillmore Hospitals franl1 Sam Roswell Park Cancer Institute Sisters of Charity Hospttal Dmnis .\ lcCartln 'c The State Lnt,·erstty of""' York at Buffalo Buffalo PlnSICian IS published quarterly b' the State Lni,·ersity of -.;ew York at Buffalo School of \ledtcme and BIOmediCal Sctences and the Office of Publications. It IS sent free of charge, toalumnt, faculty, students, reSidents and fnends. The staff resen-cs the nghtto edtt all copy and subm1ssion~ accepted for pubhcauon \ddrcss quesuono; , comments and submiSSions to · Editor. Buffalo Physician. State Lni,·ersitv of "\c,, York at Buffalo, C~i\'CrSll\ Publications. 136 Crofts Hall, Buffa!~ , "o;ew York 1-+260 Send address changes to: Dear Alumni and Friends, D r. Elizabeth Olmstead, an alumna, class of '39, has established a significant endowment designed to support the school's educational efforts m the area of medical informatics. The endowment principal of$1.5 million will generate an annual income to support the continued development of computer-assisted learning for medical students and to deliver ongoing educational information to residents, faculty and practicing physicians in Western New York. We believe this is the first such endowment of its kind in the United States. Dr. Olmstead has been a loyal, dedicated volunteer faculty member of the school for man} years. She established this important gift to memorialize the memory of her late husband, Dr. Ira Ross, who was an engineer at Calspan and who served as its administrative leader from 1958 until his retirement in 1969. The medical school is committed to expanding Its role in this important area as part of its commitment to keeping all of its constituencies involved in ongoing, life-long learning. Under the capable leadership of Dr. John Loonsk, UB is on the cutting edge of this Important educational technology. Thanks to Dr. Olmstead, this program will be enriched and we will all benefit from her generosity and kindness. On behalf of the administration, faculty and alumni, I am pleased to express our heartfelt gratitude to Dr. Olmstead. Sincerely, J ohn aughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni: W e're all excited about a high profile idea that should put your Alumm AssoCiation in the spotlight again. We have begun accepting contributions to a $1 million Alumni Scholars Fund to support worthy medical school applicants. This is a way to consolidate our class gifts so we can all pull together for a highly visible objective. Dean Naughton has expressed his full support for this major endowment fund that will accumulate principal over a five-year cycle so that each class has a chance to participate. The admissions department will assist us in picking two or three students each year. The awards will be presented at our Spring Clinical Day reception. We intend to follow our Alumni Scholars through the school year and keep you informed of their progress. Another major innovation for 1993 will be our new Alumm Achievement Awards, to be presented to a select group ofUB medical alumni who, although perhaps not universally famous, have nevertheless made their mark in a particular area of medical endeavor such as research, teachmg, technical innovation, private practice, community service and school administration. We are soliciting nominations from all over the country including both rural and urban locales. These Achievement Awards will be presented at our Spring Clinical Day luncheon. We are also sponsoring a Visiting Alumni Lecture Program to encourage the return of qualified alumni to lecture to peers, residents and students. We will contribute an honorarium to defray travel expenses. We also plan informal receptions to allo"" the lecturers a chance to meet old and new friends. Yours truly, Buffalo Plnsician. 146 CF~ \ddnion, 3435 \lamStreet , Buffalo, :\c" York 14214 Don Copley, M. D., '70 �- 0 ...........r - :;,r- w N 2 ~ ., _ N 0 1 f 3 ' 7/. I T( E R 9 9 Hospital News I Problem'Patients e T:Pe experts sa managing them takes a :mu self- Xami ation as patient-exami ati9n. Taking the Stand e As the need for medical experts In courtrooms grows, and in the absence o( stand,ardiz-ed pro(essional guidelines-, testifying in court can be a contro ers~al practtce. ASpoonful of Humor Medi,al s,hool People Alumni NCI' s Breast Cancer Prevention Trial still open to area women. Poge 2. Classnotes fflillarn ann ~r~lin forge joint seruice agreement. New findings on electric blanket use and breast cancer. Page 2. rage~- �l~l .................................................................................... Overall, electric blanket use did not increase the risk of breast cancer, the study found. But there was a slightly elevated, although not statistically significant, risk associated with sleeping with the blanket on all night throughout the season, suggesting the need for further study. Vena continues to investigate the risks of electric blanket use among premenopausal women. Electric blankets do not increase breast cancer risk urling up under an electric blanket ward off winter's chill may not pose an increased cancer risk , according to UB researchers. john Vena, Ph.D., and colleagues in the Department of Social and Preventive Medicine have shown that using an electric blanket does not increase the risk of breast cancer in post-menopausal women, the population group most likely to develop the disease. The study was published in the Americanjournal of Epidemiology. The breast cancer investigation compared electric blanket use over 10 years in 382 post-menopausal women with the disease and 439 with no known cancer. Scientists have hypothesized that chronic exposure to electromagnetic fields , such as those produced by electric blankets, increase breast cancer risk by suppressing the normal nighttime rise in the level of . the hormone melatonin. Melatonin regulates the hormone prolactin , known to influence breast cell growth. to 6 u a 0 BY LOIS The study is designed to determine whether the drug tamoxifen is effective in preventing breast cancer in women at a high risk of developing it. Tamoxifen has been used for 20 years to treat patients with advanced breast cancer. Since 1985, it has also been recommended as an adjuvant therapy for early-stage breast cancer. "With the latest statistics showing that one in eight women will develop breast cancer at some time in her lifetime, the BAKER Breast cancer study open to WNY area women he Breast Cancer Prevention Trial announced last April by the ational Cancer Institute's ational Surgical Adjuvant Breast and Bowel Project is still accepting women in Western New York. p y 5 c a n w e 9 9 3 �... . .... . ................................................................. . .............. tamoxifen study could potentially mean the reversal of this frightening trend and the saving of thousands of women's lives," said Stephen Edge, M.D., chief of breast surgery at Roswell Park Cancer Institute's Breast Center. The study will involve 16,000 women who will be randomly assigned to either tamoxifen or a placebo. Women 60 years and older are eligible to participate in the study based on age alone. Women aged 35 to 59 arc eligible to participate if they have an increased risk for developing breast cancer based on certain factors. Western ew York women interested in participating in the study or obtaining further information should contact Roswell Park Cancer Institute at845-7667. opinion turned up first on the list. \ ommunities trying to attract family physicians may get better results if they woo the doctors' spouses rather than the doctors themselves, a UB researcher has found. ln a survey designed to determine the factors that influence a doctor's decision concerning where to practice, the spouse's u 0 0 p Personal income , on the other hand, ranked lOth . Results of the survey cond uctcd by Thomas Rosenthal , M.D. , associate professor of family medicine, were reported in the journal of the American Board of Family Spouse's opinion means most in practice location B ' ' h Practice. Family practice is one of the most heavily recruited specialties due to existing and projected shortages of primary care physicians, a diminishing number of medical school graduates entering these fields and a high turnover rate among those who do. To better understand why a family physician selects one community over an- y c a w .[! other , Rosenthal surveyed physicians who graduated from family practice residencies between 1970 and 1989. Data were analyzed collectively, as well a by year of graduation , community size and in-state versus out-of-state location. The survey asked respondents to rank 24 factors known to influence a physician's decision about where to practice. Spouse's opinion was rated "most important" or "important" by 86 percent, with little change across year of graduation, community size or other variables. "Public policies and medical school experiences can have an impact on physician specialty and distribution ," Rosenthal said , "but the ability of an individual community to attract physicians will rely on how well it can confront problems and take action." The next three factors receiving the highest percentage of importance were hospital-related - hospital consultants (73 percent), hospital services (71 percent) and colleague interaction (70 percent). umber five on the list was afterhours coverage with 70 percent. Other factors rated important or most important by a majority of doctors were: quality of schools (67 percent), proximity to hospital (6J percent), family health and education need (60 percent), personal income (59 percent), employment for spouse (56 percent) and cultural opportunities (53 percent). BY e LOIS BAKER 9 9 0 �a ··························································· · ······· · ··············· · · · ··· the hospital's ties with the School of Medicine and Biomedical Sciences, and forging an agreement that made Millard Fillmore Hospitals one of the medical school's major teaching affiliates, with 16 residency programs based there. jennings was also instrumental in establishing in 1987 the Western ew York Health Sciences Consortium - an association of representatives from the medical school and its affiliated teaching hospitals, business and government designed to emphasize the need for cooperation and enhance the quality ofhealth care in Westem ewYork. "One of the most rewarding aspects of my experience in Buffalo," jennings said, "has been working with the University at Buffalo School of Medicine and Biomedical Sciences in the formation of the Western ew York Health Sciences Consortium. "One of the best secrets in Western ew York is the quiet but measurable leadership of Dr. john Naughton. He has in this tenure taken the University's medical school to the top quartile of all U.S. medical schools. In several key areas of measurement, the UB medical school is clearly within the top lOin thecountry,"jennings said. "This achievement is directly related to Dean aughton's commitment to excellence and perseverance," he added. Under jennings' stewardship, Millard Fillmore Hospitals established five primary care sites in medically underserved areas, established its successful Sleep Disorders and Hand Center specialty services, forged an agreement between its 3,342-birth Suburban Hospital maternity service and The Children's Hospital of Buffalo for neonatal coverage, established its $4.5 million Baird MS research center and developed the nation's largest freestanding ambulatory care center. The hospital also recently broke ground for a $60-million expansion and renovation project. The project, one of the Jennings leaves Mnlard post for Chicago ChUdren's an R. jennings, president and chief executive officerofMillard Fillmore Hospitals for the last 10 years, was recently named president and chief executive officer of the Chicago Children's Memorial Medical Center. He took over his new post january 15, 1993. "Having securely positioned Millard Fillmore Hospitals to meet the health care needs of this community for many generations, the climate was appropriate to accept the position at the Chicago Children's Memorial Medical Center, considered the 'crown jewel' of the U.S. child advocacy movement," jennings said. "During my nine years as president of Millard Fillmore, we have achieved every strategic objective charted. Millard Fillmore Hospitals has become one of the leading health care facilities in ew York State," he said. "The numerous successes achieved by Millard Fillmore during these nine years could not have been accomplished without the cooperation and dedication of the hospitals' board of directors, medical and nursing staffs, administration, employees and volunteers," jennings added. jennings took over as president ofMillard Fillmore Hospitals in 1983. The twohospital system had, at the time, lost $20 million over the previous l3 years. With several additions to a newly built administrative team, jennings turned Millard's finances around, with it emerging as the only major teaching hospital in the state to have maintained a positive bottom line for the past eight consecutive years. jennings is credited with strengthening 0 B u a 0 p 5 c a largest in its history, includes the addition of 43 beds to Millard Fillmore Suburban Hospital and major renovations to both the Gates Circle and Suburban facilities. The Chicago Children's Memorial Medical Center, founded in 1882 for poor children and affiliated with orthwestem University Medical School, is a multicorporate entity with its 265-bed facility as its centerpiece. A national search to find a new presidentand chief executive officer for Millard Fillmore Hospitals is already underway. New surgery chief named at VA Medical Center illiam Lynn Weaver, M.D., has been appointed clinical associate professor of surgery and chief of surgery at Buffalo VA Medical Center. A native ofKnoxville, Tennessee, Weaver graduated from Howard University in Washington, D.C. , with a degree in pharmacy. He attended Me harry Medical College in ashville and completed his internship, residency and nine years in the Army. "I think this is a tremendous challenge because of the history of the surgical department of this VA and all it stands for ," Weaver said. "The important name that the Buffalo VA and University at Buffalo medical school have developed in the national medical community gives me the opportunity to work with some of the brightest minds in the country," he added. Weaver hopes to increase the visibility of the surgery department by highlighting some of its past accomplishments, including its leading role in the development of cardiovascular technology. w e 9 �.... . ................................................ Sisters Hospital announces change in leadership isters of Charity Hospital has announced that Sister Angela Bontempo, hospital president and chief executive officer, is leaving Sisters Hospital for other duties within her religious order, the Daughters of Charity of St. Vincent De Paul. With the change in Sister Bontempo's status effective in October, a search process for a new chief executive officer is now underway under the direction of the regional office of the Daughters of Charity National Health System. "Being missioned is part of life in our religious community," Sister Bontempo said. "I've been at Sisters Hospital for six years and that's probably about an average stay for sisters in our order. But whether it's six, 16 or 60, moving on is never easy," Sister Bontempo said. "I will carry Buffalo and its people in my heart, always. Like so many others who have come to this beautiful area, Buffalo has captured me and I'll always be a Buffalo booster." Sister Bontempo took over Sisters Hospital in December 1986. "When I came here," she said, "the hospital needed major work. We had an old facility that begged for attention and was dangerously close to slipping into financial disaster. " Sister Bontempo brought in a new administrative team and the hospital has finished every year of her tenure with a positive bottom line while its fund balance has doubled. Among her accomplishments have been the establishment of new women's services, satellite primary care and chemical B u a 0 p ························· ···········a In 1990, Gov. Mario Cuomo named Sister Bontempo to the ew York State Pubic Health Council. She was also named to the Board of Trustees of the Western ew York Public Broadcasting Association. dependency centers and the hospital's $42 million modernization project, slated for completion in 1994. The project includes a new emergency department, family care center, operating rooms, intensive and ----- I Mnlard and BryUn announce ioint service agreement illard Fillmore Hospitals and Brylin Hospitals recently announced the establishment ofa formal medical ser- vices exchange agreement and the appointment of a jointly recruited physician to head Millard's psychiatry department and serve as associate medical director at BryLin. The agreement provides psychiatric consultation services for all emergency room and inpatients at Millard's Gates Circle and Suburban facilities and inservice educational programs for the nursing and support staffs. It also will foster a more coordinated care effort for inpatients at Brylin who need acute medical care and treatment. Under th e agreement, Ellen S. Dickinson, M.D., clinical assistant professor of psychiatry, was named chairperson of Millard's psychiatry department and associate medical director at BryLin. Board certified in psychiatry and neurology, Dickinson was an assistant professor of psychiatry at Albert Einstein College ofMedicine, Yeshiva University, ew York. She also served as the unit chief of psychiatry at North Central Bronx Hospital in ew York. coronary care units, head and neck center, urology and ambulatory care areas as well as a new entrance way and lobby. Sister Bontempo was the first woman to serve on the board of directors of M&:T Bank and currently sits on the board of the bank's parent company, First Empire State Corporation. In 1987, she received the Clifton C. Thorne Award for outstanding achievement in health care and human services. She received the 1989 Brotherhood! Sisterhood Award in health care by the National Conference of Christians and jews. 5 c a w n e 9 0 �~ 1 \ L 0 L B u 5 T R a A T 0 0 N p h 5 B y w H a T n N w E y 5 H e E R M A 9 9 N �B Y S C 0 T T T H 0 M A S Problem Patients Every physician has themhere's how he patient, a some doctors woman, came to Suzanne K.W. Anderson, M.D., with a complaint beyond the l<en of any diagnostician. deal "I feel with "I just feel so empty." empty inside," she said. them. Then she came again. And again. Soon, the patient was seeing Anderson every couple of days. "She really glommed onto me," says Anderson, now a family phy~ician and a clinical assistant professor of family medicine at the UB medical school. "She told me I was the only doctor who would ever tal<e care of her, who would ever love her." Buff a loP h y s i c ion WIn I e r 19 9 3 0 �Anderson tried to set limits- and the young woman turned violent. She cut herself with razor blades, showing the doctor her scars as punishment for her "rejection. " She invented a wild story about being kidnapped and raped, saying the rapist had carved an obscenity into her abdomen. The word was there, all right, but it was the woman's own knife that had done the carving. "Over time we did manage to establish some limits and got her into counseling," Anderson says. "And she actually ended up having astable relationship with a man after a couple of years." Problem solved. But for physicians struggling to treat difficult patients, rarely is the solution so neat. From dependent, fawning persons to the hostile and delusional , problem patients are a continual source of frustration for the caring doctor. Treating them means negotiating a fine line between empathy and effectiveness. And, perhaps most difficult to acknowledge, problem patients can point up a physician's own subconscious prejudices and shortcomings. "In a way, every patient is potentially a problem patient," Anderson says. "If their problems aren't treated respectfully, they can be a problem." "Compassionate objectivity" is how Jamie Shiffner defines that line between getting too involved with a patient and staying too distant. Too close, he says, and the physician can get caught up in the patient's emotions and stresses. Too far , and it's impossible to treat a patient with the empathy essential to proper diagnosis. Shiffner, a psychologist with a doctoral degree, teaches a Behavioral Sciences Seminar in the medical school's Department of Family Medicine. As part of that seminar, he delivers an annual lecture on problem patients- who they are and how to cope with them. There are no easy answers; the lecture consists of a series of video clips of patients, followed by students' discussion 0 B u a a hysician A might have no problem with a patient Physician B finds highly annoying- a difference that's rooted in the doctor's own subconscious. "There are certain kinds of personalities that we have trouble with, just because they remind us of people we've had bad experiences with in our own lives. You can use your own response as a diagnostic tool." of how they might handle the situation. One thing he has discovered, Shiffner says, is that "Know thyselr' is the first rule for dealing with problem patients. "Rather than being focused outwardly, pay attention to yourself," he says. "Know when you need to excuse yourself and get a cup of coffee, then come back. ... Give yourself time and space. Often it feels like, 'I've got to do this now, in my office, this second.' But there are very few things other than a code that you have to do right people who are excessively concerned about why I'm prescribing this drug, and does it have side effects. I also have a problem with excessively dependent people, and I can use my own annoyance as a signal that this is a dependent person. You can use your own response as a diagnostic tool." One place where problem patients congregate is hospital emergency departments. Close to the street, often serving as primary care providers for people without a regular physician, ERs play host every day to a wide-ranging drama of human misery. "There are hundreds of different reasons that people have stress that may ultimately result in a visit to the emergency department," says Steve Lakomy, M.D., who practices in three Western ew York ERs - at St. joseph and Sisters hospitals and the Erie County Medical Center-and is a clinical assistant professor of emergency medicine at UB . "There now. " Anderson notes that Physician A might have no problem with a patient whom Physician B finds highly annoying - a difference, she says, that's roo ted in the doctor's own subconscious. "There are certain kinds of personalities that we have trouble with,just because they remind us of people we've had bad experiences wi th in ou r own lives," she says. "I tend to have a problem wi th people who challenge authority a lot - p y s c a w n e 9 �are people who come to the emergency department because they're depressed and have a physical manifestation. Or they have a lot of stress at home or on the job, and they come in with an ulcer or high blood pressure. "There are people who just have emotional insecurity and can't deal with their problems; they don't have the coping mechanisms. It's a very wide range of people, and a wide range of problems. We kind of lump all these people together as hypochondriacs, when in fact there are all sorts of reasons. " One problem endemic to emergency rooms is the drug-seeking person. 'Tve had a patient come in and complain of a crushing chest pain, and gave him morphine for what could have been heart attack pain," Lakomy says. "It turned out he was faking it. "Or you have people from out of town who present with pain and say they need Demerol. But most area little more tactful. They have a whole list of drugs they can't take because (they say) they have an allergic reaction. Basically, it narrows down to one or two narcotics that they can take. "Sometimes they walk out of the department when they realize you're not just going to give them medication. "Butl always try to err on the side of the patient. l would rather be fooled several times, and actually give narcotics to a patient who's not being honest, than send somebody home in pain." Then there are the characters - not too sick, not too crazy,just enough of both - who keep life in the ER interesting. Lakomy tells of one patient, an asthmatic man in his late 40s, who sometimes shows up every day for two weeks with an exacerbation of his condition. While he's being treated, he regales the staff with his intentions to marry famous exMouseketeer Annette Funicello - who, of course, knows nothing of the sort. But he has this plan, see ... The patient has refused psychiatric counseling, Lakomy says, "but he's still a very functional individual." B a 0 p " here~ a reporting system for doctors - if we commit a violation or have a lawsuit against us, it gets recorded and gets reported to the physician registry. But patients who have seen doctors multiple times or who have had multiple surgeries, and never had any positive findings - we don't know about those patients. We become their victims." Anxiety, in all its forms, surfaces again and again as an underlying cause of patients' problem behaviors. Anderson, the family physician, tells of a recent patient who imagined that his head was Ooating up to the ceiling, and that electric shocks were shooting from his head to his toes and out his anns. Such symptoms, she noted , don't correlate with any known organic illness. So she spent some time talking with the patient. lt turned out that he had recently emigrated from Cuba, had a big family to support, had no job and no health insurance. "The symptoms were all related to this tremendous anxiety he had," Anderson says. "The thing is, he had been to an internist who had put him through a whole lot of tests, and spent a lot of his personal money, without result. " ln such cases, she says, "it's really a challenge to get them to see they don't have a physical illness. You have to bring this on very slowly and carefully, not too abruptly. "Often, just the awareness (that the symptoms are anxiety-related) makes the symptoms disappear or become a nonconcern to the patient." a n w Dentists, especially, find fear and anxiety epidemic among their patients- often stemming from fear of the dentist himself. The effects can be crippling. SanfordL. Nusbaum, D.D.S. ,a l960graduate of the UB dental school, tells of one patient. "Open, please," Nusbaum said to the patient, who would not. "We talked about it. l said, 'Can you open7' '"Yes.' "'Do you want me to examine you and see what the problem is?' '"Yes.' '"Well , open.' '"I can't."' 'Tve seen patients that, when you start explaining to them what has to be done, they'll pass out just listening to it. There's all this psychological, emotional baggage they're carrying with them that makes it a problem.'' Despite the time pressures on every physician, Howard Lippes, M.D. , '77, a clinical assistant professor of medicine at B, says the doctor's time is what fearful patients need most. "If you can possibly spend the time to e 0 �ot all problem patients are in the wrong. There are " many problem patients who ought to be problem patients, because they're not given the information that the patient should be receiving." [I i I I II B II "If you can't find something physically patient on, you're almost acknowledging wrong with them, they're almost angry at the wrongs of the prior physician." you . And they'll go to another doctor. All this is moot, he says, if the patient is "There's a reporting system for doctors not physically ill. Abandonment is rarely - if we commit a violation or have a charged, he says, "but physicians worry lawsuit against us, it gets recorded and anyway." gets reported to the physician registry. But Also , Albert notes, "Not all problem patients who have seen doctors multiple patients are in the wrong. There are many times or who have had multiple admis- problem patients who ought to be probsions and multiple surgeries, and never lem patients, because they're not given the had any positive findings - we don't information that the patient should be know about those patients. We become receiving. " their victims. " And just because a patient presents sympCan a physician who finds a patient toms that have grown in the mind, endocriunbearable sever their professional rela- nologist Lippes notes that doesn't mean he tionship? The answer is yes, but the isn't sick in body anyway. He tells of a patient legalities can be dicey. he saw while an intern- "an elderly woman UB Law School Professor Lee A. Albert, who complained of chest pain on a daily a specialist in medical-related legal issues, basis. All the physicians who took care of her says ending a doctor-patient relationship were rather exasperated; her pains were atis legally risky when the patient is ill and tributed to depression. has nowhere else to go. "But one day she explained that her "A doctor may not deny services to that chest pain was really due to a heart attack. patient without being sure the patient has And it really was. The attending physician access to a substitute physician," Albert told me, 'Even the crocks get sick somesays. "If she does refuse services after a times.' The lesson being that even the patient-physician relationship is estab- hypochondriacal patients can get real illlished, without reasonable assurance that nesses. You really have to be tuned in." a substitute physician is available, that's Despite the frustrations , Campagna and called abandonment, and it's tortious con- other physicians say dealing with problem duct. The patient can sue for damages. " patients is just part of the territory in a But,Aibertsays, "reasonable assurance" human science like medicine. "If you is a gray area. "It's often not very easy to conquer the challenge and ultimately find a substitute. When you go to a new things turn out well for them , it's a victory doctor, he asks whom you've been treated and it's a wonderful feeling," she says. by and what happened. There's a kind of "But sometimes the pain of getting there is collegiality that says if you do take that more than you want to bear." sit down and explain to the patient what it is you're doing or what it is you think the patient has, you're most of the way there," Lippes says. "The more suspicious and anxious the person is, the more time it takes." But the physician can talk until he's three shades of blue, and he won't talk some patients into doing what's best for themselves. on-compliance, or nonadherence, is one of the thorniest issues confronting physicians with a sincere interest in their patients' well-being. Ida M. Campagna, M.D ., '79, apracticing OB/GYN who is a clinical assistant professor in UB medical school's Department of Gynecology and Obstetrics, cites the case of a young patient she has now: pregnant, diabetic, but who refuses to take insulin. "We're going to try to do some outreach to this girl," Campagna says. "Get on the horn, call her, see if we can convince her how serious this is. A lot of things can happen with this baby. You have to pull at the heartstrings of the mother and say, This is what's best for your baby.' "Sometimes you have to do what your mother did, which is to administer an oldfashioned dose of guilt." Campagna also says she is troubled by "doctor-shopping," where patients go to one physician after another in search of a diagnosis that fits their own idea of what's wrong. "There are people who are really delusional about their ailments," she says. u a 0 p h y 5 a n w e 9 3 �'A roster of difficult patients Jamie Shiffner, a psychologist with a doctoral degree who teaches a Behavioral Sciences Seminar in the UB medical school's Department of Family Medicine, delivers an annual lecture on problem patients- who they are and how to cope with them. Shiffner has summarized the range of problem patients - a range as broad as humanity itself - into a dozen categories. They're a laundry list of the people who can ruin a physician's day. Perhaps you've encountered: Overly dependent people who have trouble making decisions . "They're the ones who call up at 3 in the morning and say, Tve got a runny nose, do you think I should take an antihistamine?'" Shiffner says. Seductive patients, both those who approach a physician sexually and patients who wheedle and flatter the physician in order to obtain narcotics. Aggressive patients. "Some get B 0 0 p h downright nasty," Shiffner says. Threatening people, who know what they want- for the doctor to sign disability papers, for example - and threaten force to get it. Suicidal or self-mutilating patients. Antisocial personalities, whose problem behaviors include lying, cheating and stealing. One antisocial patient is the one who never pays his bill. Patients who withhold necessary information, out of distrust or shyness. "Sometimes," Shiffner says, "people expect that doctors should be magical, and figure out what's going on without any information." Those with psychotic delusions. Arguing logic with them gets the physician nowhere. Passive-aggressive persons - tho e who say yes but mean no. Into this category fall all those patients who say they'll take their medication , lose weight, whatever, but don't follow up. People who are disgusting for some reason. Their appearance may just pro- y s a n w voke strong emotion in the physician -or they may not have showered in weeks. "They can be lovely people," Shiffnersays, "but it's really hard if you can't sit there without passing out from the aroma." Extremely attractive people. "Feelings don't just go away because you're a doctor," Shiffner says. And finally, patients suffering from a borderline personality disorder, generally people who have been abused as children. These patients, Shiffner says, are both dependent and standoffish - a contradictory set of behaviors difficult to resolve. In addition, Shiffner mentions a seemingly innocuous behavior that can turn into a problem: the patient who's exceedingly nice. "Maybe they talk and talk," he says; "maybe it's hard to deliver difficult news to them. What if you have to talk to them about their drinking too much? That can be as difficult as the person who comes in and yells at you." n e 9 9 3 ��BY ANDREW DANZO he said he raped her. He said she consented. The physical evidence couldn't say who was telling the truth. Thats where Raphael S. Good, M.D., came in. "My testimony was that the way she described the event, rape was not possible - or at least entry was not possible," recalled the University at Buffalo medical school graduate. "That was the bottom line. " He never said in so many words that William Kennedy Smiths accuser was lying, but Good gave the jury in West Palm Beach, Florida, reason to doubt her. And in December 1991 , thefourwomenandtwomen found Smith innocent. I)hysicians (L' I ILLUSTRATION Buff a loP h y sic JJ( rt BY ian Witnt sscs TED w PITTS i n t e r 1 9 9 3 �Lastly, taking the stand isn't always fun. "It's very intimidating to be a witness," said Brian S. joseph, M.D., a psychiatrist who graduated from the UB medical school in 1968. "You're playing by different rules, and while they're always respectful, they don't always treat you like you know everything." But the American College of Physicians maintains testifying in court is part and parcel of a higher calling. In its 1990 statement, which accompanies guidelines for medical expert witnesses, the college said: "Physicians, as members of society and as professionals, have a duty to testify in court as expert witnesses . . .. Nonpartisan and scientifically valid expert testimony not only assists the deliberations in a particular case, but also can establish for the record applicable standards of care." Some physicians say an occasional court date can be a gratifying teaching experience that helps keep them sharp. Others say there are personal rewards, especially in medical malpractice cases where they can help weed out incompetents or come to the aid of a wrongfully accused colleague. And, while it's not for everyone, cross- be to get more physicians into the courtroom. "Small numbers of physicians should not spend disproportionate amounts of time testifying; rather, more physicians should try to be available to serve as experts as a component of their professional activities," the American College ofPhysicians proclaimed in a 1990 statement. How can practitioners obliger "They might make it known to their local medical societies," said Lois Snyder, ].D., manager of health and medical-legal policy development for the college. "Some societies are becoming interested in pulling together an information bank of people who could be experts." But, she added, "I don't know who is doing this with regularity. " Physicians have plenty of reasons for avoiding the courts. Many cite the time it takes from their already busy schedules. And things can get messy if arrangements with the lawyer aren't spelled out. In Buffalo, so many disputes over issues like fees and canceled court dates have arisen that the county medical society has been working with the local bar association to develop a model witness agreement for members. ood is among the large number of physicians who go into the courtroom as expert witnesses. Many more serve as experts in cases that never reach court, either because the cases are settled beforehand or because the physicians convince the lawyers that there really isn't a case. Many lawyers say their need for medical experts has grown, and with that growth has come controversy. Court rules for the use of medical experts are vague, and professional guidelines vary among different medical organizations. Some physicians turn up so frequently on the witness stand that they have little or no time to actually practice. Some of their colleagues refer to them as "hired guns," the medical equivalent of the ambulancechasing lawyer. The best way to reduce the reliance on experts with questionable expertise may "THE PEOPLE WHO TESTIFY FREQUENTLY, MANY OF US THINK OF THEM AS WHOREs.•• Rapna I(, t>d \1 D. B a a p h c a n w e 9 l �"YOU'RE PLAYING BY DIFFERENT RULES, AND WHILE THEY'RE ALWAYS RESPECTFUL,THEY DON'T ALWAYS TREAT YOU LIKE YOU KNOW EVERYTHING." -Bnanjoseplt, M.D. examination can be as invigorating as a good game of tennis. "Listen," said Good. "I don't do anything I don't enjoy. I've been around too long." Good, a member of the UB medical school's Class of 1948, said he was brought into the William Kennedy Smith case by defense attorneys seeking a rape expert. Board certified in OB-GY and psychiatry, both of which he teaches as a clinical professor at the University ofMiami medical school, Good helped establish one of the nation's first rape-treatment centers in Miami in the early 1970s. He also is coauthor of a book chapter on rape. But Good's testimony ended up centering on the physiology of sexual response, and for that he was also qualified as a former vice president of the American Association of Sex Educators, Counselors and Therapists, and as the organizer of a human sexuality course at the University of Miami. He also maintains a psychiatric practice in Miami. Before trial, he reviewed voluminous records, including the depositions, police statements and polygraph tests of Patricia Bowman, the woman who accused Smith. "I would guess the stack was close to two B u 0 0 p h feet high ," Good said. On the witness stand, he said, he was given a hypothetical situation mirroring the alleged circumstances- that the rape occurred even though the victim was fighting off the attacker, the victim was not sexually aroused and the attacker had only a partial erection. Good said it didn't add up. Under cross-examination, he said, the prosecuting attorney kept hammering away at the fact that there was semen in the woman's vagina, so there had to have been intercourse. "I kept saying that under the conditions described, she could not have had intercourse," Good said. "The prosecutor said intercourse did occur. 1 said, 'Well, there must be some discrepancy."' The physician said he enjoyed verbally dueling with the assistant prosecutor who questioned him. "She tried to downplay my clinical experience, saying 1 was busy reviewing journals and giving talks around the country, implying I was not clinically involved with patients," Good said. "1answered by saying, 'Yes, it's true I am a very busy doctor.' She was very frustrated. " For all his cool, Good had been on a y a w witness stand only twice before. Once he testified about behavioral responses to pornography in an obscenity trial, and another time about marital relationships in a case involving an abortion law's spousal-notification clause. Like many medical experts, Good has worked with attorneys much more frequentlyoutside the courtroom. He said he is often called upon to review records in medical malpractice and personal injury cases, but the cases are usually settled or dropped before court, based on his conclusions. Good emphasized, however, that it's only a sideline. "The people who testify frequently, many of us think of them as whores," he said. "It's not an unusual experience, the same people are testifying all the time. I'm not sure they are dishonest, but they may see things a little differently." Few formal restrictions, however, govern the use of expert medical witnesses. "Generally, the relevant guidelines are the federal rules that govern court proceedings, and they are very broad about who can testify," said the American College of Physicians' Snyder. "Physicians sometimes see that as a problem." e �Various medical organizations have their own guidelines. The American Association of eurological Surgeons, for instance, says members who testify should be practicing surgeons or those who "can demonstrate enough familiarity with present practices as warrant designation as an expert." The American College of Physicians suggests that witnesses "should be actively involved in the clinical practice of the specialty or the subject matter of the case for three of the previous five years at the time of the testimony." The Medical Society of the State of ew York says witnesses should be practicing in the specialty at issue, but if they are already retired, it shouldn't be for more than five years. Not only do guidelines vary, but there are also gaps. For example, one pediatrician wrote in a letter to the journal Pediatrics last year that he would like better criteria for testifying in medical malprac- "YOU CAN'T SURVIVE FOR VERY LONG AS AN EXPERT WITNESS IF YOU'RE A HIRED GUN, BECAUSE YOU'D BE EXPOSED." They don't teach "Expert Testimony" in medical school. Yet some believe more physicians should lend their expertise to the legal system as a matter of professional duty Here are some tips for those who get involved: GET IT IN WRITING Many physicians become expert witnesses on the basis of little more than a phone conversation. That's a mistake, because there is ample room for misunderstanding. The Medical Society of Erie County and the Erie County Bar Association have been working on a model document to use in drafting expert witness agreements. For more information on the model, contact the medical society at (716) 8521810. WHAT To CHARGE A general rule of thumb is, charge whatever the value of the time taken from your practice. B u a 0 p Keep in mind, the American College of Physicians and others consider it unethical for experts to take a fee contingent on the case's outcome. One physician, however, has proposed an interesting twist on the contingency fee. In a letter in the May 20, 1992, journal of the American Medical Association ,]. Terrence Coyle, M.D. , a physician who practices at the Eye Clinic ofBellevue, Washington, writes that when he is asked to review a medical malpractice case and finds no merit to it, he asks no payment as long as the case is dropped. That, he writes, "has saved several physicians unnecessary stress from unfounded malpractice suits." h s a w PRACTICE WHAT YOU PREACH One of the top criteria for a medical expert is clinical experience in the subject. The American College of Physicians, for instance, suggests active clinical practice for three of the previous five years. Consult your state medical society and your specialty organization -there's a good chance they also have guidelines. And once you take the stand: DON' T SPECULATE ln the William Kennedy Smith rape trial, Raphael S. Good, M.D. , testified that sexual intercourse could not have occurred under the circumstances de- e 9 9 3 �Lice cases. lt is unclear how many different professional guidelines have been issued. Only late last year did the American Medical Association survey specialty societies to get a handle on the patchwork of rules. ln the meantime, the classified pages of law journals are filled with ads for medical experts seeking work. One ad in a recent issue of the National Law joumal states: "Neurologist. On faculty of prestigious university. Head injury and other expertise. " The ad lists a Boston-area telephone number. There are also services that provide medical experts. ln another National Law ]oumal ad, the Medsearch etwork lnc. offers "Prompt initial case assessment$495" for medical malpractice attorneys. Medsearch advertises that "Our expert panel consists of 15,000 board certified medical specialists nationwide" who provide reports, depositions and testimony. scribed by the accuser. Good says the prosecuting attorney kept asking how that could be, since physical evidence showed that intercourse had occurred. "The prosecutor would have liked me to say she (the woman) must have been lying. Butthat's a trap. Once you say that, they ask you how do you know someone is lying," Good recounts. "When they asked how do you explain it, l said, 'Hey, there's some discrepancy."' \ ATTITUDE IS EVERYTHING "You can't be arrogant and you must understand where you are," advises Franklin Zcplowitz, M.D. "Many times they (lawyers) get after physicians that come into the courtroom with a hostile B u 0 0 p manner." A past president of the UB medical school alumni association (Class of'58), Zeplowitz is a Buffalo surgeon who has testified in the past as an expert and now testifies regularly as the treating physician when his patients pursue personal injury cases. BE CLEAR "lt's not unlike giving a lecture to a class, to the extent they can understand what you're saying," says psychiatrist Brian S. joseph, M.D., '68. "You'vegota lay jury," addsZeplowitz. "You've got to answer questions at their level so they can understand what you're talking about." s o n w o one suggests that such witnesses will say anything for a price. But some question the expertise of physicians who spend more time in court than at the bedside. Others point out that in court, it's not always what you say but how you say it, and some experts might be more willing than others to tailor the way they answer questions. Good said a close friend of his is an attorney who handles personal injury cases. Years ago the lawyer had Good review a worker's compensation case. "I told him my opinion," Good recalled. "He thought I could say ita different way. I did not feell could say it another way." The two have remained friends, but the lawyer has never again sought Good's medical expertise. Many attorneys, however, say the only thing they want from an expert is an honest, unslanted assessment. Lawyers are becoming more thorough in research- COACHING Lawyers won't tell you what to say (at least they shouldn't). But they may want you to emphasize some things and downplay others. The best way to deal with the gray areas is to stick to your notes. "You just bring the facts out as you see them," says Zeplowitz. DON ' T BE FOOLED Advises joseph: "When you go to court and the opposing attorney says, 'Good morning, doctor,' it's important to know he doesn't mean it. " - n A N 0 e R E W 0 9 A N Z 0 9 �-----------------~--~- ••H .. "OFTEN YOU ARE CONTACTED BY ATTORNEYS BY VIRTUE OF THE PAPERS YOU HAVE WRITTEN." -]ach Fisher, M.D. ing the history of their opponent's expert witnesses, and they will seize on anything that helps them paint the witness as a hired gun. A lawyer can raise questions in jurors' minds about a psychiatrist who always finds criminal defendants insane or an obstetrician who always testifies for malpractice plaintiffs but never for defendants. "You can't survive for very long as an expert witness if you're a hired gun, because you'd be exposed," said Charles P. Ewing, J.D. and Ph.D. , a UB professor of law and psychology who has testified as a forensic psychologist. "You want someone who is rigorous and fair," said Gregory Stamm, j.D., a Buffalo-area attorney who frequently represents physicians before government agencies and sometimes represents medical malpractice plaintiffs. "If you have a doctor who's willing to testify about gynecology one day and psychology the next day and internal medicine the next day, he's going to be exposed, so you haven't done yourself any favors hiring him," said Stamm, a 1971 UB law school graduate. Lawyers usually can find experts without resorting to the full-time professionals. B a 0 "Often you are contacted by attorneys by virtue of the papers you have written," said jack C. Fisher, M.D., head of the division of plastic surgery at the University of California, San Diego, Medical Center. Fisher, a 1962 UB medicalschoolgraduate, served as chairman of a Plastic Surgery Educational Foundation committee on silicone implants in the late 1980s. He later wrote about the issue in the New England journal of Medicine. ow he is working with several attorneys defending physicians against silicone breast implant lawsuits. "So when you put a summary of an issue in the New Englandjoumal of Medicine, there are a lot more eyes on that summary than just the subscribers to the journal," Fisher said. In cases involving quality of care, Stamm said lawyers first look for experts within the community who can address local standards. "If you're representing the physician, it's very easy to find someone," he said. It's much harder to find local experts willing to testify for plaintiffs against physicians, he added. lf no local physicians will testify, Stamm said a lawyer will look to nearby communities. "What you're looking for is an p y a n expert who at least practices in the same state as the defendant," he said. After a while, attorneys develop their own lists of experts who are willing to testify, though they try to avoid using the same ones over and over. Lawyers will occasionally give a colleague the name of one of their own experts as a professional favor. In the William Kennedy Smith case, Good said defense lawyers first enlisted a friend of his, a pathologist, in their search for a rape expert. The pathologist called around the country, unaware that his friend had a reputation in the field. "People said, 'Hey, there's somebody there in Miami,"' Good recalled. In the end, Good said, he felt his testimony carried a lot of weight with the jury. But, he added, "There were many other aspects of the case that resulted in the not guilty verdict, l'm sure." And Stamm noted that as important as experts are, they usually don't make or break a case by themselves. "Good cases will tend to win regardless of experts and bad cases will tend to lose regardless of experts," he said. "I've had jurors tell me they didn't listen to the experts." w e 9 9 �A Spoonful of Humor © Stu Silverstein, M.D . hou hts on avisit to our nation's ca ital Before addressing the physicians of the D.C. Medical Society, l got to see the happenings of Washington first hand. l was welcomed to the D.C. area by all of the soon-to-be-unemployed Republicans at the exit ramp holding their "Will forge passports for food" signs. After living the past few years in California and growing accustomed to its casual ew Age attire, like tie-dyed lab coats, l was overwhelmed by the sea of blue and gray suits - more than I saw during the entire 15 days of the PBS series on the Civil War. Aides say they are concerned with how Bush will adjust to just sitting around with no defined job or agenda doing nothing during the next few months. Cmonhe's been doing that for the past four years. Bush is getting ready to move out. Barbara is out house-hunting for a nice place in George's hometown ... just as soon as they figure out which state it is in. Secretary of State james Baker, who has always bolstered his career by associating with winners,justsigned on as the mascot of the '49ers (sorry, Bills fans!). The Democrats are taking over the city, and with President-elect Clinton's drive for ethics in government, startingjanuary 20th you could easily get pulled over for driving under the influence of a lobbyist. ow, Arkansas "chic" is in. (An oxymoron, like congressional ethics.) l caught an early sign of this when I saw a young civil servant drive by in a Chevy pickup with a wine rack on the back. Clinton says he will involve Americans from all sectors of society in his administration. He's considering giving Gennifer Flowers a position . .. as First Bimbo. Bill and Hillary's daughter, Chelsea, is back at school. Her principal said she will 6 u a 0 p be treated "just like any other student" ... ow that the Church of England is yeah, any student who has the bomb squad allowing female priests, l guess it's only a matter of time before we start seeing male opening her Cheese Doodles! AI Gore will supposedly have a more nuns at the airport. active role than he did at their first press And, of course, baseball player Steve conference where he looked like a cadaver Howe, who was thrown out ofbaseball18 on line at the ATM machine. times for using drugs, just signed with the Yankees. A spokesman for the We now have two women senaYankees said that despite his probtors from California. they were introduced to the Q~[~t\ !ems and difficulties, "gram for senate floor, Senator Bob gram" he's still one of the best PackwoodlMMEDIpitchers in baseball. ATELY Seems like someone forgot to tell Bill Clinton that he won the election because he's still on the campaign trail. Responding to the death of Superman, he claimed it could have been avoided if Bush had implemented humane health care reform . The election year brought some interesting issues to the ballot. ln Northern California there was the controversial "Doctor-Assisted Suicide" Bill and in Southern California, the "Police-Assisted Suicide" Bill. But most of all , we are probably going to face some kind of government-mandated health care reform , leaving a lot of doubt and uncertainty in the medical community. Many wish we could just run things involveour way. In this spirit, I would like to leave ment! To get some relief from politics, last you with the Top 10 Current Movies- if week l watched the Frank Sinatra and the AMA were in charge of Hollywood. Michael jackson specials back-to-back. l Malcolm XXY soon realized that they actually do have a In House Alone 2 lot in common - they both grab their A Broviac Runs Through lL crotches and are willing to have their Beauty and the Plastic Surgeon noses broken to further their careers! Th e Last of the Meconiwm Back home, I discovered that the City Bram Stol?er's Dracula's lnservice of San Francisco is now being sued by on Exchange Transfusions Tampa Bay because they didn't get the Of Murine and Men Giants. Several local law firms are going to Informed Consenting Adults donate $3 million worth of legal services, A La Leche League of Their Own which works out to about three hours of Three Ninjas On Rounds work. s a n w n e �a ································································································ "For his many scholarly contributions in genetics in general and to medical genetics in particular and for his many personal contributions through generations and generations of geneticists, young physicians and others, we honor today Victor A. McKusick with the bestowing of the D.W. Harrington Award. " McKusick was founding president of The Human Genome Organisation from 1988 to 1990 and a founding member of the American Board of Medical Genetics. "Through his writings, courses, conferences and his personal example through his relentless activities, he has organized and called attention to important genetic disorders that result from alterations in fundamental biological processes. He has been a major contributor to making possible the more recent applications of powerful molecular genetic technique to the human disorders," Erbe said. Editor-in-chief of Medicine and founding editor of Genomics, McKusick talked about the international effort to map and sequence the human genome. "Thegoalofthe human genome project is to locate all of these genes, to identify them and to discover upon which chromosome they are situated and where on that chromosome, and to determine the full sequence of nucleotides from one end of genome to the other," McKusick explained. "There was an influential editorial in Science in March of 1986 suggesting that the way to solve the problems of cancer is to complete the sequence of the human genome," he said in regard to the significance of the study of the genome. The ational Academy of Science committee recommended that a special project was warranted and that it should have add-on funding so there would be no "robbing of Peter to pay Paul." Estimates of funding necessary to complete the project approximate $200 billion The Human Genome Proiect: unraveling its implications VICTOR MCKUSICK DELIVERS HARRINGTON LECTURE he ~ddcning gap bt.>t~H.'etl Hhat ph_';si( ians kno1-v h(nv to diagnose and H· hat thn hnov~. haw to tnat ""'ill he inten~ified b1r the luto""' ledg£ gleaned front tlu I Iuntan (,enome Ptoject. ptedic ted 1enowned geneticist\ idot A. tvkKusic h. ~1.IJ., '>c. D., cL~ he delhCJrd the 1992 I).\\. Ilanington I ccttoe. "I he llunu.ut C1enonte PJV)CCt: Bachgnntnd, ~tat us, Ptosp£ cts and bnplic ations. ·· members , quickly and unanimously, reached a decision to give the award today to Victor A. McKusick." Erbe, who is director of the Division of Genetics at The Children's Hospital in Buffalo, chairs the study group that reviews all grant applications for proposals to study social and policy issues of the Human Genome Project. The massive project to codify the sequence of nucleotide bases that makes up the genes in each of the 23 chromosome pairs in the human body has allocated a generous 3 percent of its budget to fund the study of the ethical, legal and social implications of its results. Erbe lauded McKusick by saying, "Dr. McKusick is a name really synonymous with clinical genetics and ... a major figure in American medicine. McKusick referred to subjecting D A to study as the diagnostic biopsy of the gene- an approach that will be increasingly used to identify specific neoplasms and their dispositions. But the knowledge that comes from this study raises "ethical and social issues" such as privacy and confidentiality that are being given a great deal of attention, he said. And although some may try to make connections between the genome's "constitution" and issues such as criminality, McKusick said many of these associations will be "spurious." Richard Erbe M.D., UB professor of pediatrics and medicine and chair of the Harrington Lecture selection committee, introduced McKusick, saying that although few geneticists have been chosen for the Harrington award, "the committee B 0 0 p h 5 c o n w n e 9 9 3 �·········· · ··································································· ·· ················ a · I (m 1988 dollars). I Also codtfted ts a growing hst of dtseases anatomy. He explained that while three categories of genetic disorders ~~-~t~r' /,I feet. The first of these diseases, McKusick related, was Huntington's disease , which was f mapped on the short arm o Chro~'1.~~~., mosome 4 in 1983. "This type of mapping is useful because once one knows where the gene is on the chromosome, one can hope to design a diagnostic test," McKusick explained. Of the 2 million plus genes in the human genome - 2,600 have been mapped. The genes for diseases such as cystic fibrosis , one form of Alzheimer's and Duchenne muscular dystrophy have been identified. McKusick said genes express disease ·: · f> . B a a p h s a n w A graduate of Tufts University and johns Hopkins' School ofMedicine where he received his M.D. in 1946, McKusick is a professor of medical genetics at The johns Hopkins University. - s v c A R R 1E A . L 1a E R A N T E e 9 �a ·············································· Dean Naughton receives Distinguished Service Award from Sickle Cell Disease Association School of Medicine and Biomedical Sciences, the School of Social Work and the Institute for CBO Education and Training. ohn P. Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences received a Distinguished Service Award along with the medical school from the iagara Frontier Association for Sickle Cell Disease at its twenty-fifth Anniversary Dinner held last September. Naughton was cited for "his notable contributions to, and support of, the agency's unique health service to promote and ensure the well-being of the sickle cell affected and at-risk populations ofWestern New York from 1981 to 1992." During that time, a ugh ton provided a quality of material assistance that substantially contributed to the association's survival, according to the citation he received. He was also lauded for his active involvement in the creation of the Sickle Cell Center of Western ew York at The Children's Hospital of Buffalo, as well as his "always available advice and counsel on programs and problems." The University was cited for "its invaluable contributions to, and support of, the agency's unique community service work." Individual units of the University that provided singular contributions were also cited. They include: the Student ational Medical Association, the Black Student Union, the Equal Opportunity Program, the Office of Urban Affairs, the B a a ........ . ................. . ........... . .. . ........ idly growing field of medical information into its curriculum, according to John aughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. "Ira was a visionary - always looking two decades ahead," Olmsted, his wife of 39 years, said. "With medical informatics the wave of the future, this chair, one of the first of its kind in the country, represents an appropriate tribute to him." The use of medical informatics is not far off for UB's teaching hospitals, which are working with the medical school to develop an Information Systems etwork to link health care facilities and physicians in Western ew York. The network will provide a national and international prototype for medical education and health care delivery, according to Thomas A. Riemenschneider, M.D. , chair of the Western ew York Health Sciences Consortium Information Systems Council and associate vice president for clinical affairs and associate dean of the medical school. "The new Information Systems Network will place Western ew York on the cutting edge of this medical technology. The Ross chair in Medical Informatics adds significantly to that impetus," said Dr. Riemenschneider. Medical informatics chair to be estabhshed with gift in honor of Ira Ross ne of the nation's first professorships in medical informatics has been established at the School ofMedicine and Biomedical Sciences through a $1.5 million gift in honor of the late Ira G. Ross by his widow Elizabeth Pierce Olmsted Ross, M.D., '39. Olmsted is a practicing ophthalmologist and UB clinical professor of ophthalmology. The endowed chair will be known as the Ira G. and Elizabeth Olmsted Ross Chair in Medical Informatics. Ross, a distinguished aeronautical engineer, former president of Cornell Aeronautical Laboratories (later known as Calspan) and a dedicated Buffalo community leader, died january 3, 1991. The chair in medical informatics will help the medical school integrate the rap- p h y s c a Correction Our sincerest apologies to Robert A. Klocke, M.D., for printing a photograph of Francis Klocke, M.D., (instead of Robert) in an article about the medical school's annual faculty meeting in the Summer 1992 issue. Robert Klocke, a professor of medicine and physiology and chief of the pulmonary division, received the Stockton Kimball Award for excellence in academic achievement. w n e 9 9 �····· ········ ············· ············· ·· ···· ··········· ········ ····························· ·· ·[ ! ] Lore honored for oncologic surgery contributions project progress reports, Fish received the 1985 Outstanding Teacher Award and the 1987 Francis V. Hanavan Outstanding Teacher Award from the SchoolofHealth Related Professions. In 1985 , 1987 and 1988 he received the Faculty Recognition Award from the University's physical therapy program. Fish is a member of the American Physical Therapy Association, a manuscript reviewer for Physical Therapy and Physical Therapy Practice and a member of the MedicaVProfessional Advisory Committee of the Visiting Nurses Association of Western New York ohn M. Lore , Jr. , M.D., professor and former chair of the Department of Otolaryngology, has received the Presidential Award of the American Society for Head and Neck Surgery, for "his leadership in raising the quality and measurement of fellowship training in Head and eck Oncology ... " He is also the recipient of a Special Recognition Award from The Society of Head and eck Surgeons for his "untiring service as chairman of the joint council for approval of advanced training in head and neck oncologic surgery." Lore, the author of An Atlas of Head and Nech Surgery, is a senior member of the Commission on Cancer and a fellow of the American College of Surgeons. He holds dual certification by the American Board of Otolaryngology and the American Board of Surgery. Bissonette re-elected head of UCPA of WNY board aymond P. Bissonette, Ph.D. , associate professor of family medicine at UB, has been re-elected president of the board of directors of the United Cerebral Palsy Association ofWestern ew York. Also re-elected to the board was Kathryn A. Sawner as vice president, executive assistant in the Office of the President and G. Alan Stull, dean ofHealth Related Professions at the University at Buffalo. The UCPA of W Y volunteer board of directors governs the policies and procedures of the agency which provides a comprehensive range of services locally to 1,200 adults and children with disabilities. Fish wUI head physical therapy/exercise science ale R. Fish, associate professor of physical therapy and exercise science, has been named to a threeyear term as chair of the Department of Physical Therapy and Exercise Science in the School of Health Related Professions. Fish has been a UB faculty member since 1974. He is also a clinical assistant professor in the Department of Anatomical Sciences. Author or co-author of numerous abstracts, book chapters,journal articles and B 0 0 p h y s o n w Roswell doctors named 11 best" cancer specio6sts ive physicians from UB and Roswell Park Cancer Institute were selected as among the 419 "best cancer specialists in the United States" in a survey conducted by Good Househeeping magazine. The results were published in the magazine's October 1992 issue. Over 350 department heads and section chiefs at 110 major hospitals and comprehensive cancer centers nationwide were asked to name doctors they considered "outstanding" in treating the most prevalent cancers. Cited by their peers were Roswell Park surgeon and research associate professor of surgery Harold Douglass, Jr. , M.D., for gastrointestinal cancer; surgeon and clinical professor of surgery Constantine Karakousis, M.D. , for melanoma; surgeon and clinical professor of gynecology and obstetrics M. Steven Piver, M.D. , for gynecologic cancer; medical oncologist/hematologist, chairman of Roswell's Department of Medicine and professor of medicine Clara D. Bloomfield, M.D. , for leukemia, and medical oncologist/hematologist and professor of medicine Geoffrey P. Herzig, M.D. GYN and OB managers nome local editor oni Canazzi has been named editor in chief of AMGO News - the newsletter of the Association of Managers of Gynecology and Obstetrics. Canazzi is a senior staff assistant in the Department of Gynecology and Obstetrics at The Children's Hospital of Buffalo. e 9 3 �~ - · ····· ······· ······ ············ · ··············· ·· ··· · ·· · ·········· · ··· · ················· · ······ Q Evans receives Distinguished Medical Alumnus Award cation that l got at the University at Buffalo and that my father got." He said he would have liked the award to have been given to his late father, a graduate of UB's medical school and professor of anesthesiology, whom he described as a "pioneer" who established the first anesthesia training program in the country. After graduating from UB medical school in 1943, Evans interned at Philadelphia University Hospitals, Philadelphia and Goldwater Hospital in New York City. He then served two tours of duty in the U.S. Army- the first as a post-World War 11 public health officer in japan and the second as chief of the Hepatitis Research Center in Munich, Germany. Evans was appointed deputy chief of preventive medicine and consultant in epidemiology to the Army Surgeon General after his discharge from the Army. In 1987, he received the john R. Seal Award from the Society of Medical Consultants to Armed Forces, that organization's highest tribute. In 1977, Evans, who majored in English as an undergraduate at the University of Michigan, received the Best Book award from the American Medical Writers Association for his textbook Viral Infections of Humans. The book is currently in its third printing. Evans has published more than 200 articles in professional journals and spent his 43-year career studying the relationship of viruses to cancer and other chronic diseases, focusing his interests on infectious mononucleosis and the Epstein-Barr virus. About80 people attended the dinnerto see Evans receive his award, a specially designed crystal bison, from Donald Copley M.D., president of the Medical Alumni Association. LAUDS HIS LATE FATHER IN ACCEPTING AWARD lfredS. Evans M.D., '43, consultant to ASA's Manned Space Program and an infectious diseases expert, received the School of Medicine and Biomedical Sciences' 1992 Distinguished Medical Alumnus Award on September 24 at a dinner in his honor at the Buffalo Club. "I am very proud to be the recipient of this distinguished award," Evans said. "You have a very distinguished group of medical alumni. I am happy to be among them. I am happy to be a member who has been trained by this fine medical school." Evans,john Rodman Paul professor of epidemiology at Yale University for 20 years, was professor and chair of the Department of Preventative Medicine at the University ofWisconsin until he retired in 1988. A fellow and past president of the American College of Epidemiology and past president of the American Epidemiology Society, Evans served as editor in chief of the Yale journal of Biology and Medicine for three years. On accepting his award, Evans said, "I appreciate very much the wonderful edu- - BY CARRIE A . LIBERANTE Alfred S. Evans, M.D., '43, (center) receives the 1992 Distinguished Medical Alumnus Aword, a specially designed crystal bison, from Donald P. Copley, M.D., '70 (left) and Dean John Naughton, M.D. B u a 0 p h y 5 c a n w e 9 9 3 �....................................................... . . . . . . . Annual James Platt White meeting held he james Piau White Societyof the School ofMedicine and Biomedical Sciences held its seventh annual meeting October 23. The event included a talk by joseph Prezio, Chairman of the Department of uclear Medicine, on the introduction of the medical school's new Positron Emission Tomography Center as well as a tour of the facility and the new cyclotron. A reception and dinner dance were held later that evening at The Saturn Club. The event honors members of the society, who make annual contributions of $1,000 or more to the medical school. The membersofthejames Piau White Society for 1992 are: Dr. Kenneth Z. Altshuler Dr. Richard Ament Dr. WilliamS. Andaloro Dr. jared S. Barlow Dr. Horace L. Banaglia Dr. Charles A. Bauda Dr. Barry Benisch Dr. Richard A. Berkson Dr. Willard Bcrnhoft Dr. Paul K. Birtch Dr. Theodore S. Bistany Dr. Dennis L. Bordan Dr. Willard H. Boardman Dr. Martin Brecher Dr. Harold Brody Dr. james B. Bronk Dr. Robert L. Brown Dr. Melvin M. Brothman Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. Thomas S. Bumbalo Dr. William M. Burleigh Dr. David W. Butsch Ms. Janel F. Butsch Dr. john L. Butsch Mr. David N. Campbell Dr. Nicholas j. Capuana Dr. Ben Celniker Dr. and Mrs. joseph A. Chazan Dr. Michael E. Cohen Dr. Donald P. Copley Dr. Daniel E. Curtin Dr. Edward Diao Dr. PeterS. D'Arrigo Dr. Richard Daffner Dr. RogerS. Dayer Dr. Alfred H. Dobrak Dr. Stuart L. Dorfman Dr. Sterling M. Doubrava B u a a Dr. Ronald I. Dozorctz Dr. Patricia K. Duffner Dr. Kenneth H. Eckhen Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Alfred S. Evans Dr. john A. Feldenzer Dr. Donald M. Fisher Dr. jack C. Fisher Dr. Eugene S. Flamm Dr. Thomas F. Frawley Dr. Richard Gacek Dr. Man A. Gajewski Dr. Penny A. Gardner Dr. Robert A. G1anfagna Dr. john W. Gibbs Dr. Mala Gupta Dr. Thomas Gunuso Dr. Theodore R. Hall Dr. Eugene Hanavan,jr. Mr. Edward Hansen Mrs. Edythe T. Harris Dr. Re1d R. Heffner,jr. Dr. Orvan W. Hess Dr. Williamj. Hewell Dr. joseph M. Hill Dr. Annabel M. Irons Dr. Stephen joyce Dr. james R. Kanski,jr. Dr. john P. Kelly Dr. Richard j. Ken line Dr. Kenneth Kim Dr. Hans F. Kipping Dr. Arthur C. Klein Mrs. jean L. Klein Dr. Monon P. Klein Dr. jacobS. Kriteman Dr. joseph L. Kunz Dr. Marvin Z. Kurian Dr. Gordon R. Lang Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. Harold Levy Dr. Stanley B. Lewin Dr. jack Lippes Dr. Hing-Har Lo Dr. Gary H. Lyman Mrs. GraceS. Mabie Dr. Michael M. Madden Dr. Milford C. Maloney Dr. Boris L. Marmolya Dr. Don L. Maunz Dr. Robert C. McCormick Dr. Harry Metcalf Dr. Merrill L. M1ller Dr. Eugene R. Mindcll Dr. joseph F. Monte Dr. john D. Mounlam Dr. Arthur W. Mruczek, Sr. Dr. Richard L. Munk Dr. Richard j. Nagel Dr. Masao akandari Dr. Richard B. Narins Dr. and Mrs. john a ugh ton Dr. Robert ey Dr. john D. orlund Dr. Timolh)' T. Nostrant Dr. Ralph M. Obler Dr. Benpmin E. Obletz Dr. john j. O'Connor Dr. Thomas P. O'Connor Dr. Yasuyo Ohta Dr. Carrie P. Ogorek Dr. Elizabeth P. Olmsted p h y s . . . . . . ... . . ...... n w .. . . . . [!] Mrs. Rose Marie L. Wong Dr. john Wright Dr. HaJIIlla Yamabarashi Dr. Gregory [. Young Dr. Wende W. Young Dr. Syedc r. Zafar Dr. franklin Zeplowuz Dr. and Mr;. David C. Z1egler Dr. Dean E. Orman Dr. johnS. Parker Dr. Gerald E. Pancrson Dr. and Mrs. Robenj. Pallcrson Dr. Clayton A. Primer Dr. Victor L. Pellicano Dr. james F. Phillips Mr. R. Willis Post Dr. Linda Rabinowitz Dr. Ben Rappole Dr. Alben C. Rekate Dr. Frank T. RiforgialO Dr. Charles Riggio Dr. Richard R. Romanowski Dr. Charles Rosenberg Dr. Alben G. Rowe Dr. Eric j. Russell Miss Thelma Sanes Dr. DavidS. Schreiber Dr. joseph I. Schultz Dr. Roy E. Seibel Dr. Elizabeth Serrage Dr. Arthur j. Schaefer Dr. Robert N. Schnitzler Dr. Edward Shanbrom Dr. john B. Sheffer Miss Alice Simpson Dr. john [. Spoor Dr. William C. Sternfeld Dr. Eugene M. Sullivan, Jr. Dr. Michael A. Sulivan Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. Edward A. Toriello Dr. Anthony C. Trippi Mrs. johnnie Vinson Mrs. Yvelle Vinson Dr. john P. Visco Dr. Barbara Von Schmidt Dr. Franklin Waters Dr. Harold j. Weinstein Dr. Virginia Weldon Dr. Philip B. Wels Dr. and Mrs. llarold F. Wherley Dr. james j. While, j r. Dr. Gary j. Wilcox Dr. james S. Williams Dr. Richard G. Williams a . . . 1993 Spring Clinical Day and Reunion Weekend Set Mark your calendars and make plans to attend the 56th Annual Spring Clinical Day and Reunion Weekend. The program features cocktai I receptions for reunion classes on Friday, Apri130, and james S. Todd, M.D., executive vice president of theAMA, speaking on "The ame of the Game," and Reunion Dinners on Saturday, May l. e 9 9 �[!!····························· Brown pub6shes history of area medicine rom the natural medicine of the native Americans to the hightech practices of 20th centu!}'_ surgeons, KentL. Brown, M.D.y '42 , has chronicled the extensive history of medicine in the Westfield, ew York area. His recently released book , A Medical History of Westfield, New Yorh, not only recounts the history of nearly 100 doctors who practiced medicine in the area , but captures the striking evolution in the art of caring for the sick over the last two centuries. Brown's history , illustrated with the drawings of jane E. Nelson, is a record of those who tended the ill from the early 1800s when the Westfield area - then called Cross Roads - was first settled. The history begins with Westfield's first physicians and continues to the present. The book features an ex tensive on the Civil War brings to life the {). horror of that conflict. Not only has Brown captured the history of medicine in the Westfield area, but his chapters on what he believes was the first autopsy in Westfield, Prohibition Days, the !lu pandemic, the Lydia Warner atrocity and many other topics offer a unique microcosmic look at the growth of the medical profession in America. Brown practiced medicine for 38 years in Cleveland before retiring to his native Westfield. An assistant clinical professor of surgery at Case Western Reserve University Medical School, he has written and lectured extensively on medical-legal problems. He is the author of Medical Problems and the Law and The Medical Witness , as well as several scientific papers. subject index to help readers pinpoint specific people and topics. A detailed chapter on the remedies and practices of the native Americans includes a fascinating discussion on natural cures. Brown also includes intriguing chapters on root and herb doctors and homeopaths. A chapter z a z w w z < ~ Brown's Medical History of Westfield, New York is illustrated with the drawings of Jane E. Nelson. B 0 0 p y 5 c 0 n w e 9 9 �································· · ······························································[ ! ] Phrnp B. Wels, M.D. '41, named chair of UB CouncH hilip B. Wels, M.D., '41, has been appointed chair of the University at Buffalo Council by Governor Mario M. Cuomo. Wels, a clinical professor of surgery at UB and distinguished alumnus, has served on the council since 1980 and last year was named its vice chairman. He succeeds M. Robert Koren, who was chairman from 1981 until his death last March. "Dr. Wels has been a part of our university community for more than half a century. He knows UB inside and out, and has a great deal of insight into the university's relationship with the Western ew York community," said B President William R. Greiner. Wels holds a bachelor's, master's and medical degree from UB. A founder of UB's fencing team , Wels was a member of the United States Olympic fencing team in 1936 and served as coach of the UB team from 1938 to 1940. He was a member of the UB Athletic Council and an original inductee into the UB Athletic Hall of Fame in 1965. He received the Distinguished Alumnus Award in 1979 and the Samuel P. Capen Award in 1981. A trustee of the University from 1972to 1976, he has been a trustee emeritus since 1979. Wels, a founder of the UB fendng team and its coach from 1938 to 1940, was a member of the U.S. Olympic fencing team in 1936. ciated with Hospice Buffalo - and the hospice concept- since its inception in Buffalo in the mid-1970s. Acting as its first medical director on a voluntary basis, Milch was pan of the group of health care and commLtnity leaders that first introduced the concept to the area and focused the attention of an international American Cancer Society conference held here on it. Milch also worked to educate health care professionals as well as the community at large about the benefits of hospice to both patients and their families. Milch served as medical director of the Palliative Care Unit at Buffalo General Hospital, and has been a staunch advocate for Hospice Buffalo. On the national level , he has acted as co-founder of Milch appointed full-time medical director of Hospice Buffalo oben A. Milch , M.D., '68, has joined the medical staff of Hospice Buffalo as its full-time medical director. Milch , a clinical assistant professor of surgery, has been asso- B u 0 0 p y 0 w Children's Hospice International and is a member of that organization's scientific advisory board. In 1988, he was given the prestigious British Ambassador's Award for his service to dying children and their families. Medical Alumni Association estab&shes Achievement Awards he Medical Alumni Association announces the creation of Alumni Achievement Awards to honorthose physicians who have demonstrated uncommon dedication in research, teaching, technical innovation, private practice, community ervice and school administration. The newly created awards will be presented annually at the Spring Clinical Day luncheon . e �B l · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · b::J division of laparoscopic surgery, a retired psychiatrist writes, "In three international photo salons sponsored by the Photographic Society of America, my stereo slides won awards. Because most of my photographs are close-ups, I do not use a stereo camera; I use two 35mm single lens reflex cameras whose shutters are synchronized electronically. The electronic flash units that I use are also synchronized at speeds up to 1/50,000 of a second. lam over80 years old, so l find it easier to set up my photo equipment on our backyard patio than to travel to some out-of-the-way place to get unusual pictures. At present, l have a Diamond Star in PSA Competitions. owl am accumulating credits for the next PSA Stereo Division Award, Master Stereographer l." further development of the resi- BERNARD S . STELL '36 , ARTHUR J . SCHAE FER '47 , was a member of the faculty for dency training programs and enhancement of research activities. He is an avid sailor and serves as the Fleet Surgeon of the Knickerbocker Yacht Club in Port Washington, New York. ELLIOTT BRENDER '70 , ~ 11. Elliott Brender '70 American College of Surgeons. sor of surgery at the University of retired from active family prac- California at Irvine and chief of tice. He has been promoted to surgery at Garden Grove Hospi- clinical assistant professor at the ROY M . OSWAKS '71 , lege of Medicine and Dentistry. cal College of Hampton Roads. of KENNETH P . SUN '89 , informs us that he and his wife are Insurance expecting their fifth child. He is pital Center, Company DONALD SCH ERTZMAN '82 , and lntracorp. vania, had his fourth textbook, Clinical Radiology: The Essentials, published byWilliams&:Wilkins, ovember 1992. minutes south of jerusalem, Israel on a West Bank settlement. BURTON L. HERZ '67 , died May 9, 1987. lem. JOHN K . CU S ICK '57 , Schertzman's address is: orthern judean Desert, Israel. com- pleted three years in adult psy- been appointed Director of Sur- chiatry at Massachusetts General. gery at New Rochelle Hospital He is currently finishing a two- Medical Center. Herz is respon- chiatry at Massachusetts General. administration of the department 5 His wife is at 5080 Lemon Bay Drive, Venice, Florida 34293. ER IC ARNOU '91 , died in Ari- automobile accident. ued growth and expansion of the h children. zona on November 5, 1992, in an of surgery, including the contin- p Talbott Recovery Center. He is survived by his wife Pat and six year fellowship in children's psy- sible for the overall direction and a died August 27, 1992. Prior to his death he spent six months at the ROY J . BOORADY '87 , has RAY MONDW. M ITCH ELL'44 , He practices anesthesiology at Bikur Cholim Hospital, jerusaMaalie Amos #109, ptosis and acquired involutional a ew York. practicing family medicine 30 in September. Schaefer lectured B is currently an anesthesiology resident at St. Luke's Roosevelt Hos- Hospital in Lexington, Kentucky Association. is currently a pediat- for Health Care Compare and the Southwestern Division of Cigna a professor of radiologic sciences at the Medical College of Pennsyl- Minnesota, has been elected treasurer of the Minnesota Medical LYN '88 , ton, Texas. come the orthopaedic consultant presented by the Center for Advanced Eye Surgery at Humana ERI C K REE S E R '56 , ofBagley, M ICHELLE V . ANDERSON - rics emergency fellow in Hous- ew Mexico, has be- RICHARD H . DAFFNER '67 , ptosis." jor 'project.'" appointed assistant professor of the Sixth Biannual Multispecialty for the correction of congenital was clinical surgery at the Eastern Virginia Medical School of the Medi- Oculoplastic Surgery Symposium on "Levator aponeurotic surgery writes, "I am continuing as an urgent care physician in Miller now two-years-old and is my ma- ew jersey Col- BERT A. LIES JR . '64 , T I NA MARIE GARDNER '87 , Place, New York. My son jake is tal. Robert Wood johnson School of Santa Fe, Roy J. Boorady '87 He is an assistant clinical profes- BERNARD H . SKLAR '56, Medicine of the re- cently became a fellow of the c a n w n e 9 9 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/d780fd2a03a80c9fed4f5662cb58735f.pdf 3aa09c9c1329e25bce74f2157eff2cd7 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1993 . '• B~~a~·se of it, 7,367 .Americans will die this year. �Dear Alumni and Supporters of the UB Medical School, BUFFALO PHYSICIAN \ olume ~7 1\ -be- T DIRECTOR OF PUBLICATIONS (ACTING! )- C m 'e ~m1th Pet o he facultv of the Department of Social and PreYentn·e \ledKme and Gynecolog) and Obstetri~s are pursuing the possihilit\· of bemg designated a \'anguard Center for the EDITOR -..anette Tramo;- r_, g, R ART DIRECTOR \!an ] Kegler ASSOCIATE ART DIRECTOR Soa R f rich. STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES 1 John "\~mg',~ );--. \ L ~: Prcslc ~nt fc r Climcal -\ffz s, D.· Jlt EDITORIAL BOARD )r )0hn \ Rich t C r• ..,.." • Wvmen s Health Initiati,·e Clinical Trial sponsored b' the :\atioroal Institutes of Health. This m1tiat1Ye ''as approYed by Congress and is designed to eYaluate the health status vf women and the effect of a selected number of interYentions important to the health of women. Dr. \laurizio Tre\isan and Dr. \lyrosla\\ Hreshchyshyn haw proYided excellent leadership for this important multidisciplinaf\ effort TwentY-four organi::ations are being site-Yisited and it is expected that 15 wtll recciYe the designation of a Vanguard Center UB 1s wn excited about th1s possibdn' because clinical trials arc an important component of our research portfoho, and thts trial in particular, serws to complement our other inil!al!Yes re:.ned to pnman health care, health promotion and d1sease preHntion The staff of the Buffalo Physic tan and 1 keep you abreast of our progress in this Important area ''ill Sincere!~, ~~- R charc de Asia Dr \lo t - r ec ·or !.)r HOl old Bn""~d\ D• R charL Lolhns !), Donald P (.>:>lev '"lr I !an J Dnnnan L>1 fi -"'C'l \ ual-rvc Dr Glen ( res',J-, ]a -es Kd. 1s"'i john ;'>.aughton, ~!.D. \'ice Prcstdcnt for Cli111cal 4.ffairs Dean, Sdwol of \fcdiCIIIL cwd Bio111cdical Sciences L)r harles \lassar ..l ( harles Poganelh L utrc Rc bnson T cmas Rcse ·hal "" Ia ~Lrc ,r Bra<llrv fP'lX s, phen Snaul<ung jerome\ •• .:s !)r ( ): ): ), · 11 ::Jr Dr Dr Dear Fellow Alumni, TEACHING HOSPITALS AND LIAISONS Bato\ ia \ \ \le~ ul (enter Buffa'o C.e •er~. • >Sf nal ~\fh. harl '\rlt n. Buffo o \ \ \le~ c II ( enter t .<lo Pcd'"' C hildren s Ho;m 1! vf Buffale> E'IC c uUnt\ V,Jical ( e ·t.r Me C\ tms;1u,tl Mill. d FIll more t. "rlt.IIs Fr..,"11l '\a\· RC'..,we \ .... k (ancer ns.Hute SISt"rs of C harm • "• nal Dcnn.s \~. ( arriJ, c: fhl ~tJte a· >1 "IIo l m,·cro;;it\ ,. '\._w \ )f c. ,{Ja'o P11, s •• In 1s pu~l sh d quanerh "' t .. State l mvers v < f ew \ ork a• f ff 1lc Sc ..lol of \teL c~ne ., d Dl~:ncc... c 11 '>lllnccs '" c. ·~e '-'f:- c~ vi Pubu... lt c ns. I • ) ~nt free vic Jtg". 1o::~ .,...ni, 1'li uh} 't .:tc --s. r,si<.~nts anc. fnends. frc stalfr~srrve<t e r ght t· e~ .allccp' 11 Jnc Sl. b ni<;.c;Jo 1!...t. hcai.IOn. S lCCe 'ted f H \ddr>ss <JU stions, wmments and submis'i<.."- ~ ~o F c! tor b.IJJ.l'~ Pin s.(.UHl State l nivercoih of t\,;.c'' ' ' k Jt BuffJIJ l nners;t. Pu.>i"cc...:io""'"' ~6\.. oftsHall,b1 J Jlu "C\\ \ 1: k l4l6ll Send address changes to: BuJ ,• PII) '" an 14f ( FS \J<.htwn. l h \1ain~t eet Puffalo,"'cw\or' 1+21+ Cover llluslrolion by Ted Pitts T he excitement mounts as we approach the focal pomt of our -\lumni war- our 56th annual Spring Clinical Day on \lay 1, 1993 at the Buffalo \Iamott. \\'e are expLcting ~arucularly good att.endance this ,·ear for our C\-cle of class reumons going back o\'er )0 years. As) ou h.n e come to expect, we w11l also be presentmg another proYocatl\ e and challengmg cducauonal program that this Year is entitled "Doctor Watchers." This program will highlight the Yarious agencies that monitor physiuan performance and suggest \\a\·s to aYoid unwarranted scrutin). Our energetic ch:urpcrson, Dr. \largaret Paroski, has obtained commitments from an outstanding group of knowledgeable speakers. From Rochester comes Dr. Charles\ acanti, who is presentlY ser\'lng as Chairman of the '\Je\\ York State Board of Professwnal Conduct. Another speaker wlll be '\Janq ' iclsen, \\ell-known Buffalo internist and currenth the Regional ~led !Cal Coordinator of the Office of Professional Conduct. Other local speakers will include Dr Ross Hewitt from the AIDS ser\'lce at Erie Count\ \ledical Center and Dr. \lichael Horan clinical mstructor in pediatrics at The Children's Hospital of Buffalo Our d,stinguished Stockton Kimball lecturer thisyearwill he the American Medical -\ssociation's Dr James Todd, talking about "The '-Jame of the Gaml" As alwaYs, thts program carries four hours of Category 1 C\IE credit. Be sure to look a gam this year at the full Yaricty of Spring Clinical Day poster displavs summari::ing much of the current medical research being done at the UniYersity. \\ e are also Yen· pleased this year to be presentmg for the first time a group of Alumm Achie\·ement Awards at the afternoon luncheon honoring alumni who haYe made outstandmg contnbutions in partJCular fields of medical endeaYor or communit) sCf\"lce And don't forget our popular fridav night reception April 30th at the Center 'or Tomorrow thM th1s year wdl recognize our Reunion Chamnen as thev present for the first time our \lumni Scholarship awards to desen·ing medical students. This Year"s Spring Clinical Da\ \\ill certain I) be memorable and I urge you all to attend. 'I ours truh, Don Caple). \I D .. '70 �0 L p 2 R N G 9 9 3 IJ Research IJ Hospital News II Cluster lllnessese UB med student wins American Public Health Association award. Page 22. Sorting through one of the most vexing phenomena in medicine. m The Waiting Game e Despite advances in transplant technology, one-fourth of the people waiting for organs will die because of a shortage of donors. Leaving them laughing using humor in talks and presentations. Page 25. m Medical School ASpoonful of Humor , Alumni Classnotes ~tanoaro antibiotic therap~ for ear infections calleo ineffectiue. rage ~. New Roswell Park testing helps ensure safety of donated tissue. Page 20. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · IJ ' / . girls, he points out, and bottle feeding blood flow, " said Alan Lockwood, M.D., appears to be associated with increased UB professor of neurology and nuclear medicine and director of PET operaotitis media with effusion. In addition, the earlier in life children tions at the Buffalo VA. "This will octors know that ear infections in develop ear infections, the greater their expand the capability for existing and children rise as the temperature falls. risk of suffering recurring infections future PET system," he added. + But what they don't know, says a UB throughout childhood. Other factors such researcher and physician, is how to as family history, allergic conditions and a effectively treat the condition, de- mother's cigarette smoking might increase spite decades of antibiotic use. the risk of otitis media. 'The very fact that otitis media ... in the The standard treatment for ear infecantibiotic era, has emerged as a disease of tions is successive doses of antibiotics, an overwhelming, epidemiologic importance, approach that has resulted in increasing he National Cancer Institute has awarded five multi-year grants totalmust indicate that the treatment of this populations of resistant bacteria, Bernstein ling$1,566,723, to UB-Roswell Park condition has been somewhat of a fail- notes. + BY LOIS BAKER Cancer Institute researchers. ure," saidjoel M. Bernstein, M.D., clinical Richard Bankert, an associate reassistant professor of otolaryngology and search professor from Roswell's depediatrics. Otitis media accounts for more pediatpartment of molecular immunology, received a fourric visits to doctors' offices than any other year, $572,764 infectious disease and is the most common cause of hearing loss in children, grant to assess he Buffalo VA Medical Center will Epstein-Barr ViBernstein writes in Hospital Formulary. receive more than $I50,000 to de- rus (EBV) vacciSome children have ear infections more velop software for its new Positron nation strategies than others- a result, he says, of characEmission Tomography (PET) scan- to determine their teristics or conditions that seem to predisner through a grant developed un- ability to induce pose certain children to the condition. der a cooperative research and de- immunity in laboBoys tend to be more susceptible than velopment agreement ratory mice from between the VA and SieEBV-induced disseminated lymphopromens Medical Systems. liferation. The three-year reBonnie B. Asch, Ph.D., an assistant research project, formed search professor from Roswell's experiunder the auspices of the mental pathology department, received a four-year, $421,795 grant to investigate federal Technology Transfer Act, will allow mammary cell markers in different stages the development of two of progression to malignancy. Carleton C. Stewart, Ph.D., a UB renew software modulesone to compute blood search assistant professor, received a fourflow and one to describe year, $239,499 grant to conduct a multiparameter flow cytometric analysis of metabolism in the brain solid tumors. Stewart, from Roswell's flow using mathematical cytometry facility, also received a threemodeling of biochemiyear, $158,574 grant to study the role of cal reactions. flow cytometryin molecularphenotyping. "Right now there is Thomas S. Mang, Ph.D., a research assono software in our computer system that enciate professor from Roswell's radiation ables a user to measure medicine department, received a three- Standard antibiotic treatment for ear infections labeled ineiTective NCI awards $1.5 million in grant money to UB-Roswell researchers VAMC receives cooperative grant to develop new PET software B a 0 p a n 5 p g 9 �····························································· · ·········· ·· ··············· · m ·~!lj '·' ~~"· '· , . women and 239 Italian women with relation to 16 symptoms during three phases- premenstrual (defined as the week before menstruation), menstrual and the remainder. Results showed that omen from different cultures, livAmerican and Italian ing vastly different lives, experiwomen experienced ence many of the same menstrual nearly the same amount and premenstrual symptoms, a of symptoms overall, State University of New York at while Bahrainian women Buffalo researcher has found. reported fewer symptoms. The study is the first large-scale, popuWomen's experiences lation-based comparison of menstrual across cultures were most cycle distress across cultures. similar during the men"Margaret Mead suggested cramps are strual phase, and least trans-cultural symptoms," said Lisa A. similar during the remainder phase. Monagle, Ph.D., clinical assistant profesSymptoms reported during the premensor of social and preventive medicine and strual phase were revealing, Monaglesaid, lead investigator in the research. "Our because they show that the condition study confirms this, and also suggests that known as premenstrual syndrome (PMS) other symptoms, such as water retention, is not, as some people have suggested, a emotional distress and decreased activity, media-created phenomenon. Premenare experienced trans-culturally as well." strual symptoms common to all three The study compares the experiences of cultures were fatigue, anxiety and cramps. 179 American women, 172 Bahrainian Generally, Monagle found as many differences as similarities between cultures in the prevalence ofindividualsymptoms, but found consistent symptom groups + across all three cultures. . ' . year, $174,091 grant to investigate the use of photodynamic therapy in the treatment of pancreatic cancer. + Menstrual symptoms experienced across cultures,UB study shows BY LOIS BAKER Tacrine found to reduce some early Alzheimer'ssymptoms UB researcher is one of six authors of a study published in the ovember 11, 1992 issue of the journal of theAmericanMedicalAssociation that shows the drug tacrine is effective in reducing some of the symptoms of early Alzheimer's disease. Linda A. Hershey, M.D., associate pro- B u a a p s c a n s p fessor of neurology and chiefof the Buffalo VA's neurology service, performed the study at the Buffalo VA Medical Center with Kerry Donnelly, Ph.D., assistant professor of psychology, and Karen Burch, R.N., clinical nurse specialist. The 20 patients in the Buffalo component of the study were among 468 Alzheimer's patients at 23 outpatient centers nationwide enrolled in the trial. The study involved men and women over 50 who were mildly to moderately impaired due to probable Alzheimer's disease, but otherwise in good health. During the 12-week trial, patients received either a placebo or a daily dose of tacrine. Tacrine-treated patients showed significantly more improvement in memory and language than those receiving a placebo. Physicians and caregivers also noted greater improvement in behavior in the tacrine-treated patients than those on placebo. Patients taking tacrine should be closely monitored for side effects, including liver toxicity, nausea and vomiting, diarrhea, abdominal pain, dyspepsia and rash, Hershey cautioned. + BY n LO 9 I S BAKER 9 9 0 �----- Deaconess establishes area'sfirst pediatrtc long-term care unit v a 0 - couraged to participate in formulating care plans, as appropriate. The 21 pediatric S F beds are being filledinstages,withoccupancyofthefirst two-thirds already completed and the last third anticipated by June. Jan Valencourt, R. ., is the unit coordinator. + he only long-term pediatric care unlt m upstate ew York opened late last year at The Deaconess Center, a division of The Buffalo General Hospital. The 21-bed unit will care for children with congenital defects, specialized medical problems and head trauma. It is the seventh such facility in ew York State. The pediatric unit is the final link in an $8 million renovation and construction project at Deaconess that began in 1989. An earlierphaseoftheprojectadded 38 geriatric beds to the facility, which now has 200 geriatric skilled nursing beds, 21 adult long-term care head trauma beds and the pediatric unit. "A serious shortage of skilled nursing beds for children in the state prompted Buffalo General to develop this specialized unit," said Marilyn ]. Gibbin, BGH vice president for long-term care. "Because of this scarcity, we anticipate referrals from local agencies, as well as downstate and out-ofstate," she added. Gibbin noted that The Children's Hospital of Buffalo served as an early catalyst for the project and trained the unit's nursing staff. Linda A. Kam, M.D., medical director for the new unit, has privileges at both hospitals. In addition to physicians and nurses, the unit's multidisciplinary team includes social workers, audiologists, leisure time activities and educational personnel, nutritional services staff and occupational, speech and respiratory therapists. Families, and the children themselves, are en- B -- sliding glass door to allow for both continuousobservationandquietprivacywhen desired. Each patient room also has a large window to allow for ample natural lighting." The new ICU connects directly to Sisters' new surgical unit, slated to open in March. A new on-call physician room adjacent to the unit has also been added. The renovated units feature time-elapse clocks in patient rooms and nursing stations to facilitate code and drug administration record-keeping, air mattresses with pumps, scales mounted directly onto the beds and hemodialysis hookups at each bed. + Edge appointed chief of Roswell Park breast surgery division tephen B. Edge, M.D., has been appointed head of the Division of Breast Surgery, Department of Surgica I Oncology, at Roswell Park Cancer Institute. Before assuming his position at Roswell last summer, Edge served as assistant professor of surgery at the University of Virginia at Charlottesville since 1986. He is a graduate of Case Western Reserve University Medical School and completed his internship and residency in general surgery at the University Hospitals of Cleveland. He served a threeyear fellowship in surgicaloncologyatthe ationa! Cancer Institute, Surgery Branch. Edge is a principal investigator with the a- Sisters of Chanty Hospital opens renovated critical care units s part of its $42 million renovation project, Sisters Hospital has opened its newly modernized 16-bed intensive care and eight-bed coronary care units. "Both new critical care units offer patients and staff a much larger area," said Sister Mary Kelley, vice president for asset management. " ursing observation stations with recessed lighting and large counter areas overlook generous patient care rooms. Each patient room has a p y s a 5 p g 9 9 3 �. . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .[1] 0 0 p h 111: II!Otlill~ Tue M :'l], Dec 15 l'.l'lZ ................ ... . ,.. _ ......,.,,..... ?& •• _ ?1.8 .. ?1.1_ ,."' .... 18, ';0 1?. 8 17.8_ fS + :~:~- s_ '"··12 .5_ u.8_ s_ ,. ..... ... ..."·'.. """ "'·' ,,. -tZ r• tteftt. 1.11 • ll"ltb't Wed 11 .51 . ...... 1993 , ,8_ BtUi_ 88. 5_ :n.s 39.5_ Jf>.5_ JS. O "'·' ~:1 ..... 2:1.8_ 21 . 8 ' Dlt:rTI:Jil:t .' A topographic corneal scan, showing (at right) an essentially normal eye with mild astigmatism and (at left) an eye with keratoconus (pre-corneal transplant). assigned to a certain power range to produce a color-coded contour map of the cornea. One of the main diagnostic advantages of the new analyzer, Reidy said, is its ability to confirm the presence of certain conditions that previously could only be speculated, such as early corneal abnormalities. Special software added to the $30,000 analyzer allows operators to produce computerized spheric or aspheric contact lens fittings for difficult-to-fit patients. Millard's Eye Department, which has been doing five to 10 exams a week since it obtained the analyzer about a year ago, takes referrals from eye care professionals throughout Western New York, Reidy added. + illard Fillmore Hospitals' Gates Circle facility has become the only facility in Western New York to offer topographic corneal scans using newly developed computerized technology. The hospital's corneal analyzer uses concentric rings of light focused on the cornea to map its shape. Used to determine the presence of certain corneal conditions such as keratoconus, astigmatism and post-corneal transplant torsion, as well as for contact lens fittings and preradial keratotomy mapping, the analyzer uses video technology to capture the rings of light reflected off the cornea and then digitizes the image to produce a full-color print out, according to James]. Reidy, M.D. , assistant professor of ophthalmology and director of the cornea service at Erie County Medical Center. A mathematical formula translates the distance between the individual rings and transforms those distances into corneal power. "The rings are traced by computer, as well as each space between each of the 15 rings along 270 different meridians, and translated into the corneal curvature," Reidy said. The results, he added, are u r.ueon. 050 Millard oiTers first topographic corneal scans in WNY area B .. .,._"' .·-·-_ tiona! Surgical Adjuvant Breast and Bowel Project- a group of cancer researchers that receives support from the ational Cancer Institute. A leader in breast cancer research, the group was a dominant force behind the widespread use of less extensive surgical procedures for breast cancer. A fellow of the American College of Surgeons, Edge is also a member of the American Society of Clinical Oncology, the American Federation of Clinical Research and the Southeastern Surgical Congress. + - B Y N ANETTE T RAMONT KOLLIG Buffalo General Hospital names new head of orthopaedic surgery enneth A. Krackow, M.D. , an orthopaedic surgeon who specializes in hip and knee replacements, has been named head of the Department of Orthopaedic Surgery at The Buffalo General Hospital. Krackow, also named professor of orthopaedic surgery at the University at Buffalo, succeeds Edward H. Simmons, y 5 c 0 n s p M.D. , who had served as head of BGH's orthopaedic surgery department since 1983 before retiring from the position late last year. He remains an active member of the orthopaedic surgery staff. Immediately prior to accepting his new position at BGH, Krackow was a professor, full-time faculty, Department of Orthopaedic Surgery at Johns Hopkins University Medical School. He was also a member of the active orthopaedic surgery staff at Good Samaritan Hospital, Children's Hospital and Union Memorial Hospital, all in Baltimore. Krackow has authored numerous journal articles for peer and non-peer review publications, written four books and chapters for many others. His 1990 book, The Technique of Total Knee Arthroplasty, is used by most of the nation's orthopaedic surgery residents. A member of the American Orthopaedic Association, he is also a diplomate of the ational Board of Medical Examiners, a member of the American Academy of Orthopaedic Surgery, the Orthopaedic Research Society, the Knee Society and the American Medical Association. He is board certified by the American Board of Orthopaedic Surgery. + n g 9 3 0 �() B a 0 p 5 c 0 5 p g 9 3 �Buffo Ia Phy sIcIanS p rl n g 19 9 3 0 �- ~ - --- -- , a British sur~Oil co es across a b~arre ildlioo tumor ilien tindS at ·t stri es wi in a o- e a e It Belt." Since the childhood diabetes cases a decade ago in Poland, researchers have found other outbreaks, and the World Health Organization now hopes that further study can identify environmental agents at work in the disease. But cluster investigations aren't easy, and for every one that adds to medical understanding, many, many more raise unanswered questions, hit dead ends or simply prove to be matters of coincidence. "The cluster phenomenon is very difficult to evaluate," said Alfred S. Evans, M.D. , a 1943 graduate of the UB medical school, winner of the school's 1992 Distinguished Medical Alumnus Award and Yale University professor emeritus of epidemiology. In the UB incident, there were 15 Hodgkin's disease cases among 5,708 faculty, staff and students who once used a building at 4230 Ridge lea Road in Amherst. The New York State health department labeled it a true cluster, noting that the cases occurred at more than four times the national rate. But it also found that the people with Hodgkin's had a number of demographic and medical char- ln midwest Poland, physicians notice an upsurge in childhood diabetes so striking that it looks for all the world like a communicable epidemic. In a building once used by the University at Buffalo, worried faculty and staff members tally the number of Hodgkin's disease cases among their colleagues, then call in the state Department of Health. Clusters of chronic disease are among the most vexing phenomena in medicine. Communicable diseases are by definition subject to outbreaks. But tumors? Multiple sclerosis? What is the small-town pediatrician to make of the third patient this month to be diagnosed with childhood leukemia? Chronic disease clusters are rare, but hardly unheard of. And in some cases, they can yield significant medical insights. After dogged field study, some good hunches and a little luck, the strange jaw tumors noticed in Africa by Denis P. Burkitt, M.D. , in the late 1950s contributed not only to the discovery of the Epstein-Barr virus, but also to theories on relationships between the virus , immunodepression and cancer. 0 B a 0 e Lvmp oma 7 ......... p y c a acteristics closely associated with the disease. ln essence, investigators said the cluster was one of risk factors and probably would have occurred if the same group of people came together anywhere. Unusual? Yes. Reason for alarm? o. ot everyone is satisfied. "I think it was kind of a pat on the head, you know, 'Don't worry,"' said Joel S. Rose, who once worked at 4 230 Ridge lea. "I have colleagues who worked in that building, and I'm concerned about their welfare. " The public in general has grown more concerned about clusters in recent years. Hardly a day goes by at many large public health agencies without a call from someone who's noticed that there's an awful lot of cancer in the neighborhood lately. Many in public health think people have every right to be concerned, and government has been devoting more resources to cluster investigations. But physicians and policymakersstillgrapple with how much to spend in light of other needs. "It's a very important question because the past experience has been that they (cluster investigations) tend to be 5 p g 9 3 �unrewarding," said Curtis Mettlin, Ph.D. , UB research associate professor and director of cancer control and epidemiology at Roswell Park Cancer Institute in Buffalo. "There have been very few instances where a cluster aha lysis has led to disease prevention or control. More often they end up unexplained. There are some cases historically, though, which turned out to be so rewarding. " Cluster investigations are nothing new to medicine. In fact, since john Snow noticed 139 years ago that a London cholera outbreak was concentrated suspiciouslyarounda public-water pump, clusters have been at the heart of epidemiology. And just as that case contributed to the understanding of infectious disease, researchers have long hoped cluster investigations could shed light on diseases like cancer. As far back as the late 19th century there was a cancer-cluster study in Buffalo; a map from it remains on display in the Roswell Park library, Mettlin said. Over the last two decades, cluster cases have jumped from the medical journals to newspapers and television. After the ational Cancer Institute showed with maps in the 1970s that clusters were present in the Northeast, the ew jersey Turnpike would forever be known as "Cancer Alley." In 1978, the ew York State health department found that people living next to iagara Falls' Love Canal appeared to be at heightened risk for miscarriages and birth defects and sent panic through the community when it recommended pregnant women and children under two years leave the area directly adjacent to the site. Residents subsequently did their own health surveys, and under the glare of network television lights successfully pushed for evacuation of the wider neighborhood. john E. Vena, Ph.D. , associate professor in the UB medical school's Department of Social and Preventive Medicine, began his epidemiological work at Love Canal. "It made people aware that there are problems out there that aren't figments of their imagination," he said. B u a 0 p h ." he anyone gets ow e reason or it;' saidK llyAnnBarixa 1v1. ., w o ~tu 1e Ri eLea ortheNew "Yc r S De arttnen Environme~ta a w11e ge s.o many c~ . . e enVIrol)ment 1S 1n e news lot. Rather an thin itS n act Of Go , 1 e ip .e old a, s, ey In .It '' I 5 a s p g 9 3 0 �cause, and the exposures are often high. In neighborhoods, however, the number of cases tends to be relatively small, people move in and out and exposure levels are much lower. "We feel people do have a right to know what's going on in their communities," said Philip C. asca, Ph.D. , director of the New York State health department's Bureau of Cancer Epidemiology. "But I will say this up front- it's very difficult with these methodologies to pinpoint an exposure. " With a five-decade-old cancer registry and cluster investigation units dating to the 1970s, New York is considered one of the leaders in the field. But efforts have been growing nationally.In 1989 the Centers for Disease Control and Prevention, the Association of State and Territorial Health Officials and the Agency for Toxic Substances and Disease Registry held a two-day conference on clusters. They followed up with a set of guidelines for health agencies, published in the CDC's july 27, 1990, Morbidity and Mortality Weekly Report supplement. According to the guidelines, clusters that might yield important findings share several characteristics: "Usually such a cluster has a definable health outcome, either new or rare; a potential exposure or agent is suspected, along with a connection between the exposure and the health event; the situation is highly unusual, and statistical testing confirms the investigator's impression; and the short-term public health impact is immediate and self-evident. " Few clusters make the grade. "More clusters are due to a chance occurrence of rare events, what I've heard some people call the 'expected unexpected,"' said Ward Cates, M.D., M.P.H. , director of training in the CDC's Epidemiology Program Office. "just by chance alone, these things are going to occur." Some initial cluster reports come from Frequently it is related to the environment, or at least to where people live. Many chronic diseases do follow geographic patterns. Multiple sclerosis is more common in temperate climes. So is Hodgkin's disease. But why? Is it something in the air? Better diagnosis and reporting of cases? Or something else? Burkitt found that his jaw tumors occurred only below a certain altitude, later realizing that temperature was the critical factor. He also found correlations with rainfall. Then someone suggested he compare his maps of tumor incidence with maps of intense malaria cases. Bingo. Eventually Burkitt came to believe that the Epstein-Barr virus, in the presence of immunodepression brought on by longterm malaria, could cause "Burkitt's lymphoma." Today, the relatively frequent clustering of diseases like multiple sclerosis and Hodgkin's have bolstered theories that viral agents are at work there, too. In many cluster cases, pollution is also a suspect. Animal tests have linked anumber of chemicals to cancer. And some studies have found a correlation between high cancer rates and proximity to chemical plants, hazardous waste sites or ground water contamination. "There's no question that clusters could occur with an appropriate exposure," Evans said. Proving it is another matter. To document an environmental connection to a cluster, he said investigators should show a relationship between incidence and the duration of and proximity to the suspected cause. They should also study a large, comparable area that is free of the suspected cause. All in all, he said, it's a daunting task. In occupational cases, particularly industrial ones, investigators can at least document how long a person has worked and been exposed to a suspected disease B u 0 0 p s c 0 n physicians, but the vast bulk are made by the general public. In New York State last year, the health department's Bureau of Cancer Epidemiology received 328 phone inquiries. "We've always sworn that right around Christmas time, when people get together at parties, we tend to get a lot," said Nasca, who earned his Ph.D. in epidemiology from UB's Department of Social and Preventive Medicine. Of the hundreds of cluster reports annually, asca said about three-quarters go no further than the initial call. The department has an ombudsman to handle the reports, many of which involve a variety of cancers. After asking some questions, the ombudsman is usually able to tell the caller that there's nothing unusual going on. "Lay people have the idea that no matterwhat the disease is, it must all be caused by the same thing," said Brix. "We have to do health education and explain to people that first of all, cancer is very common, unfortunately. One-third of Americans will get cancer at some point in their lives and one-fourth will die of cancer." If there does seem to be something unusual, the department will check its cancer registry, and that often resolves the issue. For instance, asca said, a report of four brain tumors on one block will raise eyebrows, but on checking the registry investigators may find that the tumors all metastasized from different sites, greatly reducing the likelihood of a true cluster. If the registry confirms the report and sometimes it reveals even more cases -the department calculates whether the number of cases really are more than would be expected. Nasca said investigators work with local citizens and health officials to draw boundaries for the study area, taking local concerns and scientific needs into consideration. "If it looks like nothing is going on, we write up a long report as well as a simpler 5 p g 9 �executive summary," he said. The reports go to local health officials and concerned citizens. When a study confirms there are more cases that expected, investigators interview the patients, asking about medical history as well as lifestyle, occupation and where else they have lived. In eight cases last year the department went at least as far as checking whether the observed cases were more than expected, and as of early this yearthere were 19 other such studies under way. "In some cases we have confirmed some excess," asca said. "The real problem is trying to confirm some etiology." Given that, resource allocation is one of the biggest issues facing cluster investigators. asca feels that as long as clusterinvestigation units carefully target their studies and help educate the public in cases that don't merit investigation, their cost is well worth it. But he notes that the state is also working on cancer research, intervention and prevention. "I would not want to see cluster investigations draw staff from those other important areas," he said. + B 0 0 p y 5 c 0 5 p n g 9 9 �- --- ---~- - ~----- ' I Questions still remain I B y a 0 N 0 R E W 0 A N Z 0 relations aspects of their task as well as the and indicators of pre-existing immunological problems, also risk factors. And scientific issues. At Ridge Lea, things got off to a bad several had family members with start. The investigation officially began in Hodgkin's. All were at risk for the disease 1989, but after two years little had hap- before ever setting foot in the building. pened. Two people with Hodgkin's died "We don't think there's anything in without being interviewed by the health that building that would make it unfit for department, Hastrup said. And people human occupancy," Brix said. "These who had used the building were not alerted people had a very high prevalence ofknown to seek early treatment if they had risk factors associated with Hodgkin's disease. I'll be honest, I was surprised at how Hodgkin's symptoms. After a letter from 50 faculty, staff and well they fit the pattern. " students and some pressure from the adHastrup doesn't buy it. 1f you had a ministration, the health department as- group with an unusually high rate ofbreast signed Brix to the case in 1991. cancer, she asks, would you be satisfied She documented 15 Hodgkin's cases simply to know that the victims were among the 5,708 faculty, staff and stu- women? She said the cluster can't be exdents who used the building the most plained by risk factors without knowing while it was part ofUB's temporary Amherst how common those factors were among campus from 1969 to 1986. The incidence everyone who used 4230 Ridge Lea. "I don't think the health department's was more than four times the rate for the nation as a whole and more than three explanation is sufficient," she said. "What they're basically asking us to do times the rate for upstate New York, where Hodgkin's is more prevalent than it is is a 45-minute interview on over 5,000 people," responded Brix. "It's an enornationally. The health department tested the build- mous use of state resources, and there's no ing for chemicals, ionizing radiation and scientific reason for it whatsoever. " Clifford B. Wilson, UB associate vice magnetic fields. It found nothing unusual. But, Brix said, she did find something president for student affairs, said he acunusual among the people with Hodgkin's. cepts Brix's conclusion. He said he would They were of higher than average socio- rest easier if there were something more economic status, which previous studies concrete than risk factors to explain the have found to be common in people with cluster. But, he added, ''I'm not sure what + the disease. Many had had mononucleosis more one does. " Overtheyears,janicel. Hastrup, Ph.D., sensed that something was wrong. In talking with other UB faculty, staff and students who used the temporary building at 4230 Ridge Lea Road in Amherst, Hastrup heard about four with Hodgkin's disease. It seemed like a lot. Then, in 1989, there were two more cases. Hastrup, an associate professor of psychology, called the ew York State Department of Health. Last summer the health department confirmed that there indeed had been a Hodgkin's disease cluster at 4230 Ridge Lea. But it said the cluster had more to do with the backgrounds of those who were sick than with the building they shared. UB accepts the findings. Hastrup and several others who used the building don't. "It's better to say you don't know than to say you've explained it when you haven't," she said. "We did a very thorough investigation both on the health side and the environmental side," countered Kelley Ann Brix, M.D. , of the health department's Bureau of Environmental and Occupational Epidemiology. Cluster investigations frequently fail to satisfy the people who requested them. Cover-up charges are so common that guidelines published by the Centers for Disease Control and Prevention suggest investigators be sensitive to the public B A p 5 a s p 9 9 �B u f f a l a P h y s I c I a n 5 p r 1 n g 1 9 9 3 6) �y I B I 5 c i r D u 0 s t 5 p n i a n g e 0 9 s �z r w y b T e e c i p d i k t s t It will be a deadly one for 7,3&7 of the 29,4&9 Americans waiting for organ transplants. B u a 0 p y s c a �odern medicine has come a long wa~ Docto~ but in this day of xe- nograft transplants from baboons and microscopic cookie cutters for replacing human corneas) a frustrating dichotomy exists. Under its end-stage renal disease program, the federal government spends $3.5 billion a year to treat patients who could be taken off dialysis if donor kidneys could be found. And, the average ICU patient awaiting a liver transplant runs up costs of between $1 ,000 and $2,000 a day. The donor shortage, according to kidney transplant surgeon Sidney Anthone, M.D., needs to be addressed from both an educational and a legislative point of view. Anthone chairs an ad hoc committee for the United etwork of Organ Sharing (U OS) - made up of the country's 75 regional organ sharing centers and their computer networks- which has among its goals the integration of the organ donation process into medical school curriculums. "Curriculums are crammed already," notes Anthone, professor of surgery at UB. "But a curriculum has been written by U OS for nurses, medical students and neurosurgeons. It is now a matter of putting it into the schools and promoting it, having somebody who will go around and stampede for it." Indeed, the organ procurement movement needs a P.R. boost. It's a life-anddeath matter for the 22,415 Americans who, as of]anuary 1993, were waiting for Tremendous diagnostic, surgical and treatment advances have brought organ transplantation into a new era. But the single biggest obstacle to hope for the nearly 30,000 Americans awaiting organ transplants is a shortage of healthy individuals willing to make the vital choice to donate such organs when they or their loved ones die. In the laboratory, enhanced tissue preservation media and immunosuppressive drugs are developed. Dramatic methodologies for accurately matching donor and recipient cells are devised. Twenty-first century surgical instruments and techniques are mastered. But in hospital intensive care and hemodialysis units, the number of patients whose survival depends on new organs swells by 5 percent each year. All the milestones and medical advances in the world simply don't work without organ donors. Transplant surgeons and organ procurement officials agree that despite required request laws and similar recentlyenacted measures, a critical donor shortage remains. The average wait for a kidney transplant increased from 126 days in 1988 to more than a year in 1991. Some potential kidney recipients wait more than five years for the right donor to surface. B u 0 0 p s 0 s donor kidneys, the 2,321 awaiting liver transplants and the 2,686 who needed new hearts. Add to these statistics 127 patients in need of a pancreas, 775 who needed joint kidney/pancreas procedures, 964 awaiting lung transplants and 181 who needed heart/lung procedures. The numbers are sobering, even more so when one considers that 25 percent of these patients will not live to realize a second chance at life. "The waiting lists are so long because individuals are being diagnosed more rapidly with end-stage organ disease," according to Elizabeth A. Me amara, R.N. , M.S.N. , director of procurement at The Upstate ew York Transplant Services, Inc. "More patients are coming in sicker and being diagnosed quicker. "Individuals waiting for heart, lung, liver and heart/lung transplants usually end up becoming very ill before their transplant. Sometimes, they're too ill to undergo the surgery," she adds. jacob Bergsland, M.D., assistant professor of surgery at UB, is a cardiac transplant surgeon affiliated with the Buffalo Heart Surgical Associates. He echoes Anthone's concerns about the donor shortage and elaborates on an added wrinkle for patients awaiting hearts instead of kidneys. p n 9 9 9 3 ' �; "The nature of the .. problem for cardiac patients is that, unlike dialysis for kidney patients, we don't really haveaback-upsystem, except for mechanical devices which are not perfected. Our patients tend to die within one or two years unless they're transplanted. Also, each donor has only one heart, versus two kidneys," says Bergsland. While Bergsland sees a "stagnation" in the number of potential heart donors, he adds that "the number on the waiting list slowly goes up, though it is limited due to the nature of heart disease." Further contributing to the problem, according to the cardiacsurgeon, has been the recent explosion in the number of heart transplant centers nationwide. Of the approximately 2,000 cardiac transplants perfomedannually, about 75 percent are done in the United States. As of December 1987, there were 114 heart transplant centers in the country, according to U OS. By 1988, the year the first ew York State-certified center was established at The Buffalo General Hospital, this number had grown to 135. Today, there are 158 cardiac transplant centers. "There are too many centers," emphasizes Bergsland. "Fifteen hundred transplants ... is not enough [per center] to keep people in shape to perform these operations. Also, the cost goes up with B 0 0 p fewer numbers, and it's more difficult to answer key scientific questions. For a successful clinical study, you need more patients per center. It is society's responsibility to make sure this is handled properly. Transplant centers can't be used for advertising or prestige purposes." The cloud hanging over progress in transplantation does, however, have a silver lining. Several of them, in fact, as illustrated by recent technological breakthroughs in such areas as tissue matching, surgical procedures, tissue and bone preservation and immunosuppressive y s c 0 5 p agents to battle organ rejection. Kathleen Polanski, a Buffalo-area school bus driver, was diagnosed with systemic Iu pus erythematosus at the age of 16. Within six years, her disease had caused kidney damage so severe that dialysis was the only answer. Standing in the way of a successful transplant was the fact that her lupus produced various antibodies that reacted not only with potential donor tissue, but with her own as well. Three times, positive crossmatches between Polanski and potential donors ruled out transplant surgery. Crossmatch procedures to manually and visually measure antibodyreactivity failed to distinguish between antibodies related to the patient's lupus and · those which could have caused rejection of a donor organ. The answer to this dilemma and an increasing number of perplexing cases-lies in flow cytometry, a process of tissue matching that uses laser beams to measure the light properties of various types of tissue cells. Only 12 facilities nationwide are accredited by the American Society for Histocompatibility and Immunogenetics to use flow cytometry as a predictive index in transplantation. One is at Buffalo's Erie County Medical Center and directed by Thomas C. Shanahan, Ph.D., associate professor of microbiology at UB. In addition to lupus patients in need of n 9 9 �ecause it offers this heightened degree of sensitivity in detecting immune responses and helps eliminate some candidates from unfair exclusion from organ transplants) flow cytometry is a giant step in addressing the organ donor shortage. techniques for pancreas implantation as the most promising area of development in his field. Utilizing a process known as the bladder drainage technique, in which the duodenum is anastomosed to the bladder, surgeons are now able to implant the pancreas along with a section of the duodenum. This has resulted in reduced rates of post-operative complications and improved chances of detecting early organ rejection. Kidney/pancreas transplants, performed routinely for only the past five years, are vital to approximately 4,000 Americans each year, most of whom have been diabetic since their youth. Breakthroughs in surgical technology have led to new promise for patients who need cornea transplants, as well. Transplant surgeon james]. Reidy, M.D., cites the example of the surgical microscope and the trephine blade, the latter of which is now used in 75 percent of cornea transplant cases. "The trephine blade is basically a hightech cookie cutter," explains Reidy, assistant professor of ophthalmology at UB. "It looks like a small, round cutter with a razor-blade edge, and it cuts a circular transplants, flow cytometry is effective in cases ofindividuals who take certain drugs, such as hydralazine for hypertension and procainamide for heart disease, which produce antibodies similar to those lupus patients produce. "Old methods [of tissue matching] couldn't distinguish between harmful and non-harmful antibodies. Therefore, some patients were unfairly excluded," explains Shanahan. "In some cases, patients' antibodies may react against tissue, but this may not rule out a transplant. These patients may produce antibodies which mimic rejection." Because it offers this heightened degree of sensitivity in detecting immune responses and helps eliminate some candidates from unfair exclusion from organ transplants, flow cytometry is a giant step forward in addressing the organ donor shortage. In Polanski's case, it allowed her surgeons to perform a successful kidney transplant in 1989. Rabie Stephan, M.D. , a transplant surgeon and clinical assistant instructor who is working to establish a kidney/pancreas center based at UB, sees new surgical B u a 0 p 5 c a n 5 hole in the cornea. It is used to cut out damaged corneas and replace them with donor corneas, which are sewn in with stitches one-third the diameter of a human hair. " The story of a patient who literally has a brighter outlook on life as the result of these amazing instruments is perhaps their best testimonial. Marilyn Foit, a suburban Buffalo woman in her mid-40s who is working toward a masters degree in special education, literally couldn't see to read the blackboard before Reidy transplanted her left cornea in 1987. Five years later, she underwent a transplant in her right eye. She had suffered since her childhood from keratoconus, a cornea disease that causes progressive astigmatism and had rendered her legally blind. Following the success of her first transplant, Foit returned to school. "I started school 20 years ago and I've finally been able to return," she says triumphantly. A year after the first transplant, when her cornea had sufficiently healed, Foit was fitted with a standard contact lens to replace the cumbersome, uncomfortable p n g 9 �"The donor situalens she had been tion is pretty good in forced to wear to corBuffalo," says Edward rect her vision. "I H. Simmons, M.D., UB looked in the mirror professor of orthopedic and started laughing surgery. "Thesupplyis and said to the techniapproaching the decian, 'I've aged 20 mand, within reason. years!' I could finally Once bone is tested, culsee! It was the same tured and frozen, it can What this country needs is more of a "can-do" attitude about feeling l had when getbe kept indefinitely. " tingglasses at age nine. organ and tissue donations. Misconceptions such as these are Bone allografts are typiAll of a sudden, life cally either frozen or a big part of the reason why nearly 30,000 Americans can only became easier," she freeze-dried, depending recalls. wait - and hope for a second chance at life: on whether or not the Fait's right eye is accompanying cartilage still healing; in her left MYTH: ''I'm too old to be a donor. " must be preserved. eye, she enjoys 20/20 FACT: Organ and tissue donors range in age from newborn to 70 Bone grafting is vision with a standard years. probably the oldest contact lens. form of transplantation, MYTH: "My loved one's body will be disfigured. " Compared to the according to Simmons. FACT: Skilled surgeons harvest organs and tissues in such a way that dire shortage of organs He notes that autothe body is in no way visually marred by the surgery. such as kidneys and genous spine fusion hearts, donor corneas MYTH: "He never signed a donor card, so we can't agree to give up his procedures were perare relatively easy to organs." formed in the United find. Because tissue FACT: Signing a donor card is important, but not necessary. ext of States as early as 1911. matching generally is kin have the final say regarding organ and tissue donation. "When bone graftnot required because ing was first being done, the cornea is avascuMYTH: "It's against my religion. " all grafts were autoglar and corneas may FACT: Today, every major U.S. religion supports the concept of organ enous, and a patient's be preserved for up to and tissue donation. own bone continues to two weeks after harbe the gold standard vesting, a generous MYTH: "Organ donation is expensive." against which all others number of eligible FACT: A donor bears no financial responsibility for the costs related are judged," notes Euto transplant surgery. -Diane Zwirecki donors exists. Each gene R. Mindell, M.D. , year, 40,000 corneas professor of orthoare transplanted in the plant patients is the fact that, although 10 paedics and director of UB's division of United States. "Corneas may be harvested up to six to 20 percent of patients suffer rejection orthopaedic oncology. "However, 20 to hours after death," Reidy says. He sees the episodes, 90 percent of these can be treated 30 years ago , it was discovered that the development of specialized preservation with topical eye drops that are not only sites from which grafts were taken somemedia as a milestone and describes this effective but inexpensive. The drops cost times had residual disease symptoms. And, media as "similar to that used by scientists between $5 and $30 for a month's supply there were situations oflarge defect where - compared, for instance, to immuno- much bone was needed. Then, surgeons to grow cells outside the body." Unlike organs that derive their nutri- suppressive agents for renal patients that began to use bone allografts. " Allografts are common in cases oflimb tion from the body's blood supply, cor- may cost in excess of$100 for 100 tablets. cancer, severe trauma and total joint failSupply and demand come close to a neas derive oxygen from the atmosphere balance for patients who need bone graft ure. "In order to save a tumorous limb, and glucose from inside the eye itself. It is this difference in makeup that makes this procedures to treat cancer, trauma, failed surgeons dissect 10 to l2 inches of that joints or similar orthopaedic problems, limb and fill the defect with cadaverous type of preservation possible. bone," explains Mindel!. "If a total hip or Also working in favor of cornea trans- according to UB surgeons in this field. Organ Donations ~e~un~ln~ t~e m~t~s B a a p s c a n 5 p g 9 �knee which has been in place for 10 to 15 years fails, reconstruction is done to avoid a shortened leg after joint removal. The use of allografts in these cases is increasingly common." Fresh-frozen grafts are necessary in cases where cartilage as well as bone must be preserved to ensure a successful transplant. lf cartilage is not needed, freezedried bone is sufficient. Approximately 25 bone banks nationwide provide both large bone and bone/ cartilage allografts. In Buffalo, Mindell performs a bone graft every one to two weeks, includingseverallimb-sparing procedures each year. Transplant surgeons in various disciplines agree that improved immunosuppressive agents, several of which have become available only during the past few years, have led to great strides in the success of organ transplantation procedures. Kidney recipients usually rely on one of three kinds of immunosuppressants: cyclosporine, steroids or imuran. A new weapon in the arsenal is known as OKT3 . "OKT3 is directed against cytotoxic lymphocytes, as opposed to other immunosuppressive agents which are non-specific to the lymphocytes that cause rejection," says Anthone. In the realm of cardiac transplants, a new drug known as FK 506 bears some similarity to cyclosporine, according to Bergsland, who notes "most patients have some type of rejection, usually during the early phases following a transplant." A single donor can help as many as 200 people in need of new organs and tissue. Technological history is made over and over via the introduction of new equipment, new drugs, new talent and new techniques. But for those who are waiting, the numbers and the scientific breakthroughs often don't add up to a healthy, hopeful future. Unless more people are willing to donate organs and promote the concept of organ donation, the waiting game for many potential organ and tissue recipients will be lost. + B a a p h y s a 5 p 9 9 9 3 �Roswell Park uses PCR diagnosis to help ensure the safety of potential organ donations n a first-of-its-kind agreement in New York State designed to ensure that transplanted organs and tissues are HIV-free, Roswell Park Cancer Institute has recently been commissioned by Upstate New York Transplant Services (U YTS) to perform polymerase chain reaction (PCR) diagnosis on all potential donor specimens. "Concerns about undisclosed HIV infection were underscored earher this year in reports published in the New England journal of Medicine and the journal Lancet, which documented cases of HIV -infected individuals who had tested negative on serological examination and who were inadvertently used as tissue or organ donors," according to Steven]. Greenberg, M.D., UB assistant professor of neurology and chairman of the Roswell's neurology department. Greenberg, who came to UB two years ago from the National Institutes ofHealth, says that with PCR testing, "basically, we can ask, 'Is there a retrovirus present?' Unfortunately, if an individual is HIVinfected, it can take up to six weeks before an antibody level can be detected by normal serological techniques. This is a more sensitive test which can be done rapidly with a turnaround time of only about eight hours." Steven J. Greenberg, M.D., in his lab at Buffalo's Roswell Park Cancer Center. B u 0 0 p h Greenberg attributes the relatively recent capability to test potential donor tissues and organs not on the PCR technique itself- which already existed and, in fact, is routinely used in forensic science to type blood products and semen - but rather, on "a rather ingenious application of existing methodologies and an existing understanding of how molecular engineers put things together. "What has helped to automate the process and make it more widespread," he adds, "have been the more recent developments. The technology had to play catch up. " Greenberg credited the development of the automated DNA thermal cyclerwhich runs the PCR based on a software program the investigator downloads and the cloning and production-scale availability of a thermal-stable polymerase enzyme. Consisting of three separate reactions "repeated ad nauseum ," according to Greenberg, PCR "allows one to take a needle in a haystackandamplifyit to make a haystack full of needles." The "haystack full of needles" is the amplified genetic material- be it virus, bacteria, fungus or protozoa- of whatever the investigators are testing for. In the first step of the reaction, performed at high temperatures , duplex strands of DNA are melted apart. The second - or annealing step - "allows primers to anneal with either strand of the DNA to , therefore, frame the genetic tar- 5 a n 5 p get of interest," according to Greenberg. The final step is the polymerization step, in which DNA is synthesized for the ends of both primers, using DNA as a template. The reaction doubles the amount of existing material, which then is synthesized exponentially. The amount of material- of "haystacks full of needles" depends on the amount of cycles the reaction is programmed for. For 30 cycles, for instance, the material- synthesized exponentially - is multiplied by one billion. "There are two main reasons for using this," Greenberg explains. "It is excruciatingly sensitive, and independent of a host immune response. " That independence from the host immune response will help eliminate the "window of vulnerability" between the time a person is actually infected and his immune response is activated that often exists in the screening process for donor organs and tissues. According to Eugene R. Mindel!, M.D. , director of UB's division of orthopaedic oncology, "the number-one question I hear from patients is 'will I get AIDS from my allograft?"' And though the safety of this and other transplant procedures has greatly increased, the AIDS question continues to permeate all aspects of medicine - transplantation being no exception. Answering this query can only help to enhance the overall success rate of organ and tissue donation. + - N AN ET TE TRAM O N T 9 9 9 K O LLIG �I - • ---------------- ·· ·· ··· ····· ····· ··· ··········· ······· ·· ····· ·· · ········ · ·· ······ ······ ······ · ············ ······ ~ I lie health professionals. Mahoney wrote his doctoral dissertation on temporal mortalitypattemsamong the Seneca Nation oflndians, the first such study to have been done wi.th the Senecas. The study compares the mortality rates among specific age groups within the Seneca Nation to the mortality rates of other New York State residents in the same age groups. The research found unusually high mortality rates among the Senecas, especially due to cancer. The study has lead to a refinement and refocusing of the Seneca ation's public health programs, pinpointing specific areas, such as cancer, which wi.ll receive Med student winsAmerican PublicHealth research award artin C. Mahoney, Ph.D. , has won the 1992JayS. DrotmanMemorial Award from the American Public Health Association for his work in public health. Mahoney, a member of the class ofl995, received the award and presented his research at the APHA's annual meeting last ovember in Washington, D.C. The award, established in 1979 by Peter Drotman in memory of his late brother, recognizes promising young pub- B a 0 p y a n 5 more attention and further research. Mahoney earned his master's and doctoral degrees from UB. He has been a research scientist with the New York State Department of Health Bureau of Cancer Epidemiology and director of the bureau's Cancer Surveillance Program. He is a founder and member of the steering committee of the ational Cancer Institute's Network for Cancer Control Research in American Indian and Alaska ative Populations, and has initiated a survey of state public health agencies' sponsorships of cancer prevention and control services for Native Americans. + p n g 9 9 �Donald Rennie,M.D, senior UB counselor and vice presideni dies onaldW. Rennie,M.D.,67, a former UB vice president and vice provost, died December 28, 1992, in Myrtle Beach, South Carolina, while on vacation. A senior counselor to UB President William R. Greiner, Rennie had served as a faculty member in the department of physiology at the medical school for 34 years. He was named vice president for research in 1980 and assumed the additional responsibilities of vice provost for research from 1990 until last December, when he was named a senior counselor in the areas of research and sponsored programs, a position of cabinet rank. Greiner described Rennie as "a wonderful, sensitive and wise person; a man who all of us really admired. Don was our senior counselor for the last 10 years, someone Steve Sample and I wanted at the table for his wisdom." Rennie joined the UB faculty as an assistant professor of physiology in 1958. He was promoted to associate professor in 1962 and named a professor in 1966. Rennie was a visiting professor at Laboratorio di Fisiologia at the University of Milan, Italy, from 1966 to 1967. In 1968, Rennie assumed the responsibilities of associate chairman of the UB physiology department, was named acting chairman in 1971 and served as department chairman from 1973 to 1980. While serving as a vice president and vice provost, Rennie continued to teach physiology. Rennie received his medical degree and a master's degree in physiology from the University e u 0 0 p h of Oregon School of Medicine. He did a postdoctoral fellowship there as well as at Harvard Medical School. A member of the editorial boards of the American journal of Physiology and journal of Applied Physiology, Rennie had served on the Porter Fellowship Committee of the American Physiological Society, Test Committee for Physiology of the ational Board of Medical Examiners and as an ex-officio member of the Educational Committee of the American Physiological Society. Donations in his memory can be made to the Donald W. Rennie Memorial Fund, in care of the University at Buffalo Foundation, and sent to the Department of Physiology, University at Buffalo, 122 Sherman Hall, Buffalo, NY 14214. + B Y ARTHUR PAGE needed for optimal function. A member of the American Institute of Nutrition, the American Association of Cancer Research and the American Heart Association's Basic Science Council, Spence joined the UB faculty in 1980. He was appointed associate dean in 1988 and held a joint appointment as research asso+ ciate professor of nutrition. Above, about 50 physicians attended the second annual "Prep for Practice," held last October. Below, about 200 students, staff and alumni attended this year's senior reception at the Marine Midland (enter. Spence leaves UB to head USDA research center in Maryland oseph T. Spence, Ph.D., former associate dean for research and graduate studies, has become the new director of the U.S. Department ofAgriculture's Beltsville, Maryland, Human utrition Research Center. Below, faculty and staff view the exhibits entered in the 12th annual Medical Student Research Forum. ter - one of five nutrition research centers operated by the USDA's Agriculture Research Service. He oversees nutrition studies ranging from how many calories are burned in today's lifestyle to how much of the ultra-trace elements chromium and selenium are y s c 0 s p n 9 9 �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ll 1/ ~iJ ~ I UB wins Robert Wood Johnson Foundation planning grant B's School of Medicine and Biomedical Sciences has received a $150,000 grant from the Robert Woodjohnson Foundation to plan new ways to select and train students to become primary care physicians. UB is one of 18 medical schools, selected from 83 applicants, participating in the first phase of the foundation's Generalist Physician Initiative to increase the number of pediatricians, general internists and family practice specialists. As a recipient of a planning grant, UB is in a strong position to secure a $2.5 million implementation grant from the foundation. "UB's medical school and teaching hospital system are honored to be numbered among the 18 recipients of a Robert Wood johnson Generalist Physicians Grant," said B a a others about their use. joseph L. lzzo, Jr. , M.D., professor of medicine and pharmacology and program director, said specialists with a knowledge of drugs and drug interactions are in critically short supply. "The shortage of clinical pharmacologists is occurring at a time when the number of new drugs under development and the need for drug-related education are at an all-time high," lzzo said. The program - one of four nationwide - is expected to grant two or three fellowships for the first year. The fellowships are aimed primarily at physicians who would choose clinical pharmacology as a subspecialty, but qualified doctoral candidates also will be considered, lzzo said. The UB program offers two avenues of entry: a two-year certification program following a residency or other postdoctoral training, or a unique four-year program combining a residency in internal medicine with a clinical pharmacology + fellowship. john P. aughton, M.D., vice president for clinical affairs, dean of the medical school and director of the project. "The faculty is committed to developing an outstanding educational experience to help correct a major manpower deficiency in American health care. This grant will help develop throughout our region those programs necessary to encourage future medical students to become generalist physicians." The medical school launched its own primary care initiative in graduate medical education last September, unveiling a $5 million demonstration project involving six Buffalo teaching hospitals, Medicaid and four private health care insurers. The Robert Wood johnson initiative aims to reach students even earlier, starting at the high school, undergraduate and medical school levels. One project involves working with the 14 area hospitals to identify promising high school students to work during the summer with community physicians. Projects are also underway to increase the emphasis on primary care in the medical school curriculum and add more out-ofhospital teaching sites. The Robert Wood johnson Foundation, headquartered in Princeton, ew Jersey, is the nation's largest philanthropic organization dedicated to improving health + care in the United States. B Y L o 5 B Y LOIS B AKER BAKER UB receives clinical pharmacology grant to launch pilot program he University at Buffalo has received a $3 million grant from the U.S. Food and Drug Administration to establish a pilot program in clinical pharmacology aimed at relieving the shortage of specialists trained to develop and test new drugs and teach p s c a 5 p n 9 9 �A Spoonful of Humor © Stu Silverstein, M.D . Leaving them laughing Think back to the last conference you attended. That first lecturer, he watss~t~h~e;::::;::;::;:;;::;::::=; obel Laureate from ew Zealand .. you came to hear. His CV is recited in a British accent by the chairman of neurology (who was raised in Brooklyn) . This world-renowned speaker approaches the podium and begins to speak. You become intrigued by the stain on his jacket and obsessed with the phone bill you forgot to pay, or did you pay it ... or didn't you? The lights go out, the slides go up. You close your eyes for "just a second" because of the lead in your eyelids. It's now 11:30; the lecture ended 45 minutes ago. All you remember is his bowtie and your drool-covered collar. What went wrong? Why do some people grab the audience's attention from the start? Chances are they use humor in the form of appropriate, wellplaced jokes, anecdotes and asides. But most people claim they can't use humor in their talks for a number of reasons. Theoneihearmostis, ''I'm not funny ," or, "Ican'tcomeupwithmaterial." While it's true most people are not naturally funny, most don't know how to ice skate erence becomes naturally either (including members of How do you the Buffalo Sabres), but it is something make a small fortune in medical practice? that can be learned. And coming up with Start with a large one. the material is not as hard as you think. The same can be done with anecdotes. One of the easiest ways is to "switch" an Here is a switched joke to a medical theme. old joke and replace the details with mediAt the circus, a strongman takes a lemon cal references. The result is a new joke that and squeezes it. At first, the juice dribbles is essentially original. Comedy writers did out quickly, then slows down until not a this during the past four years, when Pol- single drop comes out. The ringmaster ish jokes were switched to Dan Quayle offers $200 to anyone who can squeeze jokes. Andbytheway, virtually all "ortho- even one more drop from the lemon. Two paedic" jokes are restructured Polish jokes. pumped-up bouncer types step up and Suppose you want to comment on the squeeze until they're red in the face. otheconomic hard times of medical practice ing comes out. "Does anyone else wish to today. Followingisanexampleofaswitched try," says the ringmaster. joke. The originalis from jewish Humor by A frail-looking man steps forward. The joseph Telushkin (Morrow 1992). crowd begins to snicker. He picks up the How do you make a small fortune in lemon, squeezes it and a cup ofjuice pours Israel? Come up with a large one ... with out. Stunned, the ringmaster asks, "Who B a 0 p y 5 c a n s p are you? What do you do? " "Arnold Mills, Blue Cross claims department. " If you were using this joke to begin a talk on collecting from third party payers, you could add, "Billing and collecting from third party payers is difficult and sometimes you have to be a little like Arnold Mills to make it in practice. Making it in medical practice in the '90s is what I'll talk about today. " When using a "funny story," it's best not to begin by saying, "Here's a joke." It's better to say, ''I'd like to start with a story." The joke you start with should relate to your topic. Following is a joke derived from old jokes and how to use this to lead into a serious talk. A young man walks into an internist's office, rushes up to the receptionist's desk and says, "I understand my father has owed you for an office visit for three years now. " The receptionist replies, "Yes, have you come to settle the account? " "No," says the man. "I've come to get health care on the same plan he has. " "The cost of health care- and paying for it - are uppermost on the minds of most Americans. Today, I'd like to discuss ways we can make it more affordable ... " Here's another joke with a medical theme. In hospitals in heaven, internists order the fluids , orthopods set the fractures, psychiatrists do the talking, gynecologists do the pelvics. In hospitals in hell, orthopods order the fluids , gynecologists set the fractures, internists do the talking, psychiatrists do the pelvics. If you look at every joke as an opportunity to come up with a funnier one with a better theme, you will soon have more jokes than you know what to do with. + References: A Funny Thing Happened on th e Way to th e Boardroom, Michaellapoce (Wiley 1988) Us ing Hum or f or Eff ecti ve Business Spealling, Ge ne Perrell (Sterling 1989) Stu Silverstein , M.D., president of Standup Medicine Seminars of San Francisco , California , lectures nationwide on humor in medicine. g 9 �Gianturco named chair of St Joseph department of surgery ichael]. Gianturco, M.D., a 1955 graduate of the School of Medicine and Biomedical Sciences, has been appointed Chairman of the St.Joseph Hospital Department of Surgery. A board certified general surgeon, Gianturco has been on staff at St. Joseph Hospital for 29 years and is currently medical staff president. He is a member of the Buffalo Surgical Society, Western New York Vascular Society, Baccelli Medical Club, Erie County Medical Society, ew York State Medical Society and American + Medical Association. Michael J. Gianturco, M.D.,'SS, in his Amherst restaurant, Michael's Plum. Wels, a clinical professor of surgery at UB and distinguished alumnus, was recently appointed chair of the University at Buffalo Council by Governor Mario M. Cuomo. Chairman of the department of surgery at Millard Fillmore Hospitals from 1987 until1989, Wels completed his residency in surgery at the former E.]. Meyer Memorial Hospital, Buffalo, New York. He received the Distinguished Alumnus Award in 1979 and the Samuel P. Capen Award in 1981. A trustee of the University from 1972 to 1976, he has been a trustee emeritus since 1979. Hess, director of the Perinatal Monitoring Program at Yale- ew Haven Hospital (Y NH), Yale University School of Medicine, completed his residency in surgery, gynecology and obstetrics at New Haven Hospital, ew Haven, Conn ecticut. He is also co-director of the Y HH Fetal Heart Institute and Fetal Cardio-Vascular Center. Hess is a diplomate of the ational Board of the American Medical Association, past-president and a member of the Connecticut State Medical Society, a fellow of the Ameri- Alumni Association announces first Achievement Award winners our UB physicians will receive the first annual Alumni Achievement Awards - one of them posthumously- at this year's Spring Clinical Day luncheon. The awards, which recognize a select group of UB medical alumni who have made their mark in a particular area of medical endeavor, will be given to Philip Wels, M.D., '41; Orvan Hess, M.D., '31; Kenneth Altshuler, M.D., '52, and posthumously to 0. P. Jones, M.D. ,'56. In establishing the awards, the Alumni Association wants to laud alumni who have distinguished themselves in areas such as research, teaching, technical innovation, private practice, community service and school administration, according to Donald P. Copley, M.D., '70, Alumni Association president. In each case this year, he added, the recipients have made outstanding contributions in one or more fields. B 0 0 p c o n 5 can Board of Obstetrics and Gynecology and the American College of Surgeons and a fellow of the American College of Obstetrics and Gynecology and pastchairman of that organization's Committee on Anesthesia and Analgesia. Altshuler, professor and chairman of the department of psychiatry at the University of Texas Southwestern Medical Center, completed residencies in psychiatry at the Bronx Veterans Administration Hospital, Bronx, New York, and the ew York Psychiatric Institute. A fellow of the American Association for the Advancement of Science, the American College of Psychoanalysts and the American College of Psychiatrists, Altshuler is also a member of the American Medical Association and a life fellow of the American Psychiatric Association. 0. P. Jones, UB professor emeritus of anatomyandassistantmedicalschooldean who died in 1989, was recognized as one of the world's experts on the morphology of red blood cells. He also received the Distinguished Research Award from the Buffalo Chapter of Sigma Chi for pioneer- p 9 9 �ing the use of advanced microscopic techniques in hematology. The awards will be given prior to the Stockton Kimball lecture on Saturday, + May l. Alumni Association establishes scholarship endowment fund o help further the medical school's goal to seek students of all means, the Medical Alumni Association has announced it is establishing an Alumni Scholars Endowment Fund out of donations received from reunion classes at Spring Clinical Day and Reunion Weekend. "This year's donations will be pooled together in one fund," explained Alumni Association President Donald P. Copley, M.D., '70. A goal of $1 million, to be collected over five years, has been set, Copley added; the interest would be used to fund 10 scholarship awards one made for each of the 10 reunion classes. "The size of the award would likely be $1,000 per year for four years," Copley said. "There would be 40 such awards at any one time- and we hope to continue them indefinitely," he added. The first awards will be given April30 at the Reunion Class Cocktail Receptions + held at the Center for Tommorow. Spring Clinical Day and Reunion Weekend set for April30, May 1 he Medical Alumni Assocation has set Saturday, May 1 for the 56th annual Spring Clinical Day. Mark your calendars and plan to attend! jamesS. Todd, M.D., executive vice president of the American Medical Association will deliver the keynote address, "The Name of the Game." Reunion classes of 1943, 1948, 1953, 1958,1963,1968,1973,1978, 1983and 1988 will meet for Cocktail Receptions on Friday, April 30, at UB's Center for Tomorrow, and on Saturday, May 1 for Reunion Dinners. Those classes will be vying for the Best Attendance Trophy, won last year by the Class of 1952. + 1992 Reunion Class Donations New med school alumni directory to be published in June 1994 Donations from last year's Reunion Classes totaled nearly $80,000. Following is a summary of the gifts. he Bernard C. Harris Publishing Company, Inc., will produce a new medical alumni directory. Scheduled for publication in june 1994, the directory will contain facts on over 5,200 medical school graduates, including their current names, addresses and telephone numbers as well as academic and career information. The Harris Company will begin mailing questionnaires to alumni in the near future; if you prefer not to be listed in the directory, please contact the Alumni Affairs Office in writing as soon as possible. + Class Year .. #in Class .. #of Dooors ...... Total Gifts 1942 .........41 ........... 18 ................. $8,077.13 1947 ......... 52 ........... 12 ................. $5,850.00 1952 ......... 54 ........... 26 ............... SI 0,225.25 1957 ......... 61 ........... 22 ................ $ 5,925.00 1962 ......... 66 ........... 19 ............... $13,875.00 1967 ......... 92 ........... 42 ............... S14,525.00 1972 ......... 117 ......... 31 ................ $ 9,425.00 1977 ......... 134 ......... II ................ $ 3,925.00 1982 ......... 138 ......... 18 ................ $ 4,625.00 s 1987 ········· 144 ......... 27 ................ 2,050.00 B u 0 0 p h y o n 5 p James S. Todd, M.D. AMA executive to deliver Spring Clinical Day keynote address ames S. Todd, M.D., executive vice president of the American Medical Association, will deliver the keynote address for this year's Spring Clinical Day lecture. A general surgeon from Ridgewood, New jersey, Todd joined the AMA in 1985. Before that, he was a member of the organization's board of trustees as well as a commissioner to the joint Commission on Accreditation of Hospitals. Todd graduated cum laude from Harvard Medical School and interned and served his residency at Columbia Presbyterian Medical Center. A diplomate of the American Board of Surgery and a fellow of the American College of Surgeons, he has been a director of the Institute of Society, Ethics, and the Life Sciences (Hastings Center) and has published numerous articles dealing with health care and professional liability. On May 1, he will talk about 'The Name of the Game" at Spring Clinical + Day. 9 9 3 �• ·························································································· I 1 9 3 s 0 won the APA's Newsletter of the Year in 1992. CARLJ . STREICHER '35 , is enjoying retirement in Lake Havasu City, Arizona. He plays golf five times a week and has a new home built on a golf course. BERNARDS . STELL '36 , a retired psychiatrist writes, "In three international photo salons sponsored by the Photographic Society of America, my stereo slides won awards. Because most of my photographs are close-ups, ARTHUR J . tion of the various mal positions of the eyelids. tronic flash units that I use are also synchronized at speeds up to DONALD practice in thoracic and cardiovascular surgery in Cincinnati, 1 9 5 s 0 F. DOHN '52 , reports that he is busy with coastal cruising (sailboat) , camping and travel after retiring from the practice of neurosurgery in july 1991. EDWARD W. HOHENSEE '54 , retired in June from the have a Diamond Star in PSA Competitions. ow I am accumulat- ogy. After a total hip replacement private practice of ophthalmol- HILLIARD 1 9 4 s 0 THEODOREW . KOSS '4 1 , writes, "I am comfortably retired nearCenterhillLake,Tennessee. " GILBERT B . TYBRING '45 ,edits the Wisconsin Psychia- trist, the Wisconsin Psychiatric Association's newsletter, which B a ' 58 , book co-authored with his wife, Jane Westberg, Ph.D., Collaborative Clinical Education: The Foun- died December 1, 1992. A tuberculosis researcher after his graduation from medical school, he did private practice in Buffalo for nearly half a century, retiring in the early 1980s. dation of Effective Health Care, published by Stringer Publishing Company in 1992. Jason is currently executive director of the died October 3, 1992. Slocum Center for Instructional Support (a non-profit educational service) system. Heleft Texas in 1952 and in September, he reports that he is enjoying retirement and visiting and clinical professor of family medicine at the UniversityofColo- his eight offspring. rado School of Medicine. ERNEST H . MEESE '54 , retired three years ago after 50 years of practice and is keeping busy sculpting and writing books. JASON announced the release of a new Stereographer I. " IRVING PERLSTEIN '39 , OBITUARIES CLYDE W . GEORGE '29 , Ohio. some out-of-the-way place to get unusual pictures. At present, I ing credits for the next PSA Stereo Division Award, Master Hilliard Jason '58 Ernest H. Meese '54 physiology and surgical correc- I do not use a stereo camera; I use two 35 mm single lens reflex cameras whose shutters are synchronized electronically. The elec- 1/SO,OOOofasecond. Iamover80 years old, so I find it easier to set up my photo equipment on our backyard patio than to travel to SCHAEFER '4 7 , a UB clinical associate professor, attended the Advisory Board meetings of the American Society of Ophthalmic, Plastic and Reconstructive Surgery and the American Academy of Ophthalmology, in Dallas, Texas, as a member of a team of physicians who gave a lecture on the patho- 1 was presented the 1993 Swords- 9 6 s 0 HARVEY C . SLOCUM '32 , was the first professor of anesthesiology in the University of Texas spent approximately 10 years in military service at Walter Reed Army Medical Center. Upon retirement from military service, he returned to the University of Texas; in 1979 he was named Professor Emeritus. man Award given by the American Cancer Society at the Annual Beverly Hills, California, writes, Swordsman Ball on January 16, "My associate in practice and I 1993. This prestigious award recognizes his outstanding service and leadership in the field of can- have scheduled 17 radiology technology courses for mammography EDMUND M . TEDEROUS techs around the country. " '43 , died December 19, 1992. SAAR PORRATH '61 , of cer for the past 30 years. He has beenontheBoardofTrusteesof the Ohio Division of the Ameri- STEPHEN can Cancer Society since 1979 and served as the Board's president in 1990. Meese has a private 0 p y 5 E . RICHARDJ . MILAZZ0 '42 , died October 26, 1992. LANGER GEORGE BISGEIER '50 , '67 , of Berkeley, California, has recently been named medical director of the Wellness International etwork. died of a brain tumor on ovember 5, 1992. DANIEL A . RAKOWSKI '60 , died December 8, 1992. c a 5 p g 9 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO Non-Profit Org. U.S. Postage 3435 MAIN STREET PAID BUFFALO NEW YORK 14214 Buffalo, NY Permit No. 311 ADDRESS CORRECTION REQUESTED .. .. •' • . .. .• .. ;.. . ... . ... .~ .· . .. .. .. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. 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You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/5100bb6f7d6df56d3ae4d288f1f6f4c0.pdf 6d18a66fe9ae26c576d782d37b48e9bd PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1993 �Dear Friends, BUFFALO PHYSICIAN Volume 27, Number 3 ASSOC I ATE V ICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole mtth Petro D IRECTOR OF PUBLICATIONS Timothy J. Conro) EDITOR anette Tramont Kollig, R.N. ART D IRECTOR Alan J. Kegler ASSOC IATE ART D l RECTOR Scott Fricker PRODUCT ION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND B IOMEDICAL SCIENCES Dr john Naughton, Vice Prestdent for Chmcal Affans, Dean EDITORIAL BOARD Dr. john A Rtchert, Chatnnan Dr. Martm Brecher Dr Harold Brody Dr. Rtchard L. Collins Dr. Alan j. Dnnnan Dr Timothy Gabryel Dr james Kanskt Dr Charles Massaro Dr. Charles Paganelh Dr Robert E. Retsman Dr Thomas Rosenthal Dr Stephen Spauldmg Dr Bradley T Truax TEACHING HOSP ITALS AND LIAISONS Batavia VA Medtcal Center Arlene Kelly Buffalo General Hospttal Mtchacl Shaw Buffalo VA Medtcal Center Chtldren's Hospttal of Buffalo Ene County Medtcal Center Mercy Hospttal Mtllard Fillmore Hospttals Franl1 Sava Roswell Park Cancer Institute Ststers of Chanty Hospnal Dennis McCarthy ©The State Umversity ofr\ew York at Buffalo Buffalo Phys1c1an IS published quarterly b)' the State Umverstty of f\,;ew York at Buffalo School of Med1cmc and BiomediCal SCiences and the Orfice of Publications. It is sent, free of charge, to alumni, faculty , students, resadents and fnends. The staff reserves the right to edit all copy and submissaons accepted for publication. Address quesuons , comments and I n july, a very concrete example of the benefits of Buffalo's consortia! efforts will be realized. The University, its Health Sciences Schools, the Health Sciences Library, and seven of the eight teaching hospitals will upgrade the availability of reference materials for students, residents and physicians who are based in or who use these faClhlles. This project will be jointly funded by UB and the hospitals and will bring the total MEDline reference system plus other biological reference systems directly to each hospital. In addition, a large number of actual text materials and graphics can be transmitted to the end-users or consumers. Because it is a joint venture of all of these partners, common equipment will be used across the educational system and the costs of adding to existing computer information capacities, while not insignificant, are much less than if developed in another manner. The services will improve education and information availability at all levels - undergraduate, graduate and continuing medical education. My office is grateful for the leadership provided by individuals such as john Hammond,john Loonsk and jerry Wilson, to name just a few of the many people involved, and for the cooperative input among the many units of UB and the teaching hospital system, which helped make this important project a reality. Literally everyone involved in medical and health education in all these institutions will benefit directly from this effort. At this time, l would like to take this opportunity to announce that Buffalo Physician magazine will begin accepting advertisements in our next issue. We are pleased to be able to offer our readers this additional benefit of informing them of various services and products that might be useful to them. Sincerely, john Naughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, T he Medical Alumni Association had a most successful1992-1993 year. Congratulations and sincere thanks to Don Copley, who guided the organization with wisdom, tact and boundless energy. The basic goals were met- addressing many of the needs of the medical students, alumni and medical school. In addition, the Medical Alumni Board, under Don's leadership, established new alumni recognition awards, first presented at the 1993 Spring Clinical Day, and a new medical school scholarship fund, which should serve as an acceptable and appropriate conduit for reunion class contributions to the medical school. Spring Clinical Day, as usual, was educationally enlightening and socially, a warm pleasurable event particularly for those celebrating five-year reunions. We are indebted to Margaret Paroski, Class of 1980, for her direction and organization of this superb program. With the help of an enthusiastic, dedicated Medical Alumni Governing Board, I hope to continue to support the standards set by my predecessors. I hope you will continue to support the Medical Alumni Association which provides very special services, particularly to the medical students. Best regards, submtss10ns 10 Editor , Buffalo Physician, Stale Umversity o[New York at Buffalo, Umversity Publications, 136 Crofts Hall, Buffalo, ew York 14260 Send address changes to: Buffalo Physician, 146 CFS Add1t1on , 3435 Mam Street, Buffalo, l'ew York 14214 Robert E. Reisman, M. D., '56 �v 5 2 L 0 u M M N 7 E R 3 0 9 9 3 II Research II Hospital News He captured my heart in a way that patients aren't D supposed to." • Doctors affect patients every 11 Health care reform it's no joke. Page 42. day. But sometimes, patients profoundly affect their physicians. IIJ Managed Care e Containing health care costs or physicians' autonomy? EJ Medical School ~~ Graduate Education Social and Preventive Medicine's Maurizio Trevisan studies dietary habits. Page 22. IJ Alumni IIJ ASpoonful of Humor m Classnotes *managing rnanageo care. rage lt Med student Andrea Williams wins National Medical Fellowships award. Page 33. �11 ............................................ . ..... . ......... ... .... . ............ . ......... § " ~ ~ • :t u Skin cancer is the target of NIH's $5 million grant to Roswell Park Cancer Institute. Roswell gets $5 million NIH grant to study photodynamic therapy esearchers at Roswell Park Cancer Institute have received a $5 million grant from the ational Institutes of Health to conduct in-depth clinical and basic science studies of photodynamic therapy and skin cancer. Pioneered at RPCI in the 1970s by chemist Thomas Dougherty, Ph.D., photodynamic therapy (PDT) has been shown in clinical trials conducted in the United States and abroad to shrink or eradicate certain solid tumors, especially those of the bladder, breast, brain, lung and head and neck. PDT has also become an option for thousands ofcancer patients for whom surgery is not possible or who cannot tolerate additional chemotherapy and radiation. A large percentage ofPDT "cures" have been skin cancer patients. "An epidemic of 600,000 new cases of skin cancer are reported in the United States each year," said Allan R. Oseroff, M.D., chief of Roswell's Department of B u 0 0 p Dermatology and principal investigator of the IH study. "For large skin tumors, especially those appearing on the face, surgical removal may result in extensive reconstruction and in some cases, disfigurement. Chemotherapy and radiation may have a cumulative toxic effect." PDT virtually eliminates the drawbacks associated with more conventional treatments, without toppling the cure rates. Over the next five years, the Roswell researchers will assess the effectiveness of PDT against the most common type of skin cancer and scrutinize the mechanisms and dynamics of PDT as they explore strategies to perfect the treatment. + Selenium-enriched garlic is just one of the "designer foods" being tested as a cancer preventative by Clement Ip, Ph.D., a breast cancer researcher in Roswell Park Cancer Institute's Division of Breast Surgery. These days, Ip's laboratory smells like an Italian restaurant. In one recent study, Ip discovered that garlic- enriched by the anticancer agent selenium - protected animals against breast tumors. Selenium - a non-metallic element that resembles sulfur - has been Ip's major research interest for the last 15 years. "My studies and those of others, have shown that selenium protects against breast cancer. My goal has been to find the best ways to incorporate sufficient quantities of selenium safely into foods. " His choice of garlic is a natural, since the vegetable is abundantly rich in sulfur and has moderate anticancer activity. "Plants convert inorganic selenium in soil to organic selenium analogs of naturally occurring sulfur compounds," Ip said. "By substituting sulfur with selenium, we had hoped to produce more powerful anticancer agents in garlic." Ip compared garlic grown in seleniumenriched soil to garlic grown in normal soil. The selenium-enriched garlic was far superior to regular garlic in suppressing breast cancer in experimental rats treated with a carcinogen to induce breast tumors. "Designer foods"being tested as cancer preventatives at RPCI picures may call it the "stinking rose," but garlic by any other name will still carry that heady aroma potent enough to keep vampires, and perhaps even a disease or two, at bay. h s c o n s Garlic by any other name will still carry that heady aroma. u m m e 9 9 3 �m ····· · ·· · ··· · ································ ··· · · ·· ·· ··· ·· · · ··· ·· ··········· · ····· ·· ····· • .. . ' "Our research shows that by incorporating selenium into a plant that is already rich in sulfur, the potential for cancer protection is significantly enhanced," lp said. + Agrowing population of children may be at risk for long-term school problems. Half of veiY premature infants need special education services alf of extremely premature infants who survive into childhood may need special education services when they enter kindergarten. Another 15 percent are on the verge of needing special help, a study conducted by UB researchers has found. And children whose families had limited resources were seven times more likely to need help than those in more affluent households. Being non-white or male each increased the risk two and onehalf times. The study, headed by Michael E. Msall, M.D., associate professor of pediatrics and rehabilitation medicine, was published in the American journal of Diseases of Children. The research constitutes one of the first school-readiness studies of children born extremely prematurely during the 1980s and treated with calf-lung surfactant extract to prevent respiratory distress syn- B u a 0 p h The study, headed by Carl V. Granger, M.D. , professor of rehabilitation medicine, appeared in the journal Stroke. Granger speculated that older patients may be discharged from rehabilitation earlier because they reach a plateau sooner or because other medical problems may limit their ability to participate vigorously in rehabilitation. He also raised the possibility of a bias against older patients on the part ofyounger care providers, who may speed up discharge because they feel older patients + have less potential to benefit. drome. The treatment has dramatically increased the survival rates of extremely low birth weight infants. With more children surviving prematurely, especially those weighing under three pounds, Msall said, researchers have speculated there is a growing population of children at risk for long-term physical problems and school difficulty. Msall and his research team set out to assess the kindergarten readiness of children who survived extremely premature births to determine factors that identify children who might need extra help. The cohort of 149 children born at 23 to 28 weeks gestation were between four and five years old at the time of the study. Of the 149 children, 35 percent were observed to be ready for regular public school kindergarten. Fifteen percent were considered at risk of requiring special education resources, 4 2 percent were classified as requiring modified classrooms and 9 percent as needing extensive rehabilitative therapies and special education resources. Low socioeconomic status was the most significant predictor of the need for special education help among the children studied, followed by being non-white or male. + B Y L OIS BA ' ' KER Older stroke patients fare worse than younger ones,UB study finds lder stroke patients don't recover as well as younger ones and spend less time in rehabilitation than do the younger patients, according to a UB study of the rehabilitation history of 7,905 stroke patients. 5 c a 5 u Other health problems may limit the recovery of older stroke patients. m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . [1 '' ' "' . aspirin bind to the same receptor in the platelet. "But aspirin can't produce its effects if ibuprofen is already there," Gengo said. "If both drugs are taken together, the patient will get the temporary effect of the ibuprofen, rather than the permanent effect of the aspirin. " The researchers are now expanding their study to include older subjects taking both aspirin and ibuprofen for several + weeks. - B Y ELLEN G OLDBAUM Ibuprofen and aspirin don't mix. UB team uses DNA to recreate key Ibuprofen may diminish aspirtn's proteins to prevent tooth decay beneficial eftects on platelets B scientists have used recombinant eople who take aspirin regularly to prevent stroke and heart attack may need to be careful about how- and especially when - they take ibuprofen, according to a UB study. Published in the journal of Clinical Phannacology, the study demonstrated that in healthy, young volunteers who took a single dose of ibuprofen and then took an aspirin an hour later, the ibuprofen markedly shortened the duration of aspirin's effect on blood platelets. But the ibuprofen did not have the same effect on blood platelets if taken after the aspirin. "Both ibuprofen and aspirin inhibit platelet activity," said Terence Fullerton, Pharm. D., UB clinical instructor of pharmacy and director of the study conducted at Millard Fillmore Hospital. "But aspirin does so irreversibly for the life of a platelet - about seven to 10 days - while ibuprofen does so for only four or five hours." According to Francis M. Gengo, Pharm. D., UB associate professor of pharmacy, director of neuropharmacology at Millard Fillmore and co-director of the study, the working hypothesis is that ibuprofen and 0 B u a 0 p called mucins, that lubricate the mouth and tooth surfaces, minimize the abrasion of enamel and provide a moisture-rich environment that discourages the proliferation of harmful bacteria and fungi. Histatin possesses antifungal and antibacterial properties, Levine said, attacking the outer membrane of fungi or bacteria. While Levine said the mechanism of cystatin is not yet clear, it also possesses antibacterial and antiviral properties and halts the proliferation of microorganisms. Both proteins can help prevent the decay of tooth enamel, as well as infections that eat away at soft tissue and bone. Although future mou thrinses and toothpastes containing these proteins will not replace chemical antibacterial drugs, which, in tandem with the body's immune system, attack colonies of several types of microorganisms, "they'll be important in preventing or fighting the growth of these + microorganisms," Levine said. D A techniques to recreate key proteins in human saliva that help fight bacteria, possibly paving the way for over-the-counter products that - B Y would help prevent tooth decay. "Inexpensive products containing these salivary proteins will be used in toothpastes, mouthrinses and oral sprays by the turn of the century," predicted Michael j . Levine, D.D.S. , UB professor of periodontics. The two proteins in saliva recreated by the UB team - cystatin and histatin - inhibit the reproduction of microbes or interfere with their activity, which contributes to oral diseases. The team also is working to recreate two glycoproteins, Using DNA to fight tooth de<ay. h 5 c a 5 m MARY BETH S PINA ,z ~ " m e 9 9 3 �. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . ... . . ... . . . . [1] Tucker appointed director of WNY Regional Poison Control Center r effrey R. Tucker, M.D., has been appointed medical director of theWestem ew York Regional Poison Control Center at The Children's Hospital of Buffalo. Tucker is a staff member at CHOB in its emergency medicine department and has been the associatedirector for the Poison Control Center. Tucker's responsibilities include providing medical advice to the poison specialists at the Center and educating residents and medical students about toxicology. Tucker is currently involved in several research projects, including a study of Albuterol- the medicine commonly used to relieve wheezing in children. Tucker graduated from Boston University School of Medicine and completed his residency at Boston City Hospital. He completed fellowship training in pediatric emergency medicine in Brown University's program at Rhode Island Hospital. + radiation over a 40- to 60-hour time period. Radiation from the pellets remains essentially confined to the tumor area, sparing the surrounding healthy tissue. Roswell Park's first patient to receive low-dose radiation using the new remote afterloading system was diagnosed with stage IlA cervical cancer. She had been treated with conventional external radiation prior to this treatment. Conventional intracavitary brachy~ therapy- the use of which was pioneered "'~ for gynecological cancers at Roswell to achieve the highest cure rate in the country following hysterectomy- carries with it certain risks for those treating the paLast year's record loss exceeded $29 million. tient. "Any persons having contact with the patient during treatment are exposed to be the most difficult in recent years, the - although briefly - to the radiation report said. The overall operating loss of source," said Kyu Shin, M.D., chairman of $7.9 million was posted in 1989; that loss the Department of Radiation Medicine. grew by 68 percent to $13.3 million in "The risk," he added, "is minimal, almost 1990 and increased by 30 percent to $17.3 inconsequential, but our new method million in 1991. eliminates any potential risk of exposure." The current loss of $29 million repreA computer-controlled robotic system sents an increase of 68 percent over the loads and unloads the radiation sources. previous year. Proposed ew York State "Before a person enters the patient's room, budget cuts for 1993 would mean an addi- the robot will remove the radiation imtional revenue loss of$41.4 million, while plant and place it into a vault. When the proposed Medicare cuts would result in a visitor leaves the room , the radiation further revenue loss of over $20 million to sources are replaced in the patient." Western New York hospitals. Combined Shin and his colleagues are currently with the 1992 operating loss, the pro- using the new procedure on patients with posed Medicare and Medicaid cuts could gynecologic cancers. account for a collective loss of$93 million For more information on brachytherapy in 1993. + or to refer a patient, call Roswell Park Cancer Institute's Department of Radiation Medicine at 845-3172. + Western New York hospitals post record-high operating loss for '92 RPCI oiTers computer-controlled estern ew York Hospital Asso- low-dose radiation therapy ciation member hospitals posted a record-high operating loss of $29,023,000 for 1992, resulting in 759layoffs in 1992, according to a report by the Western ew York Hospital Association. The financial performance of Western ew York's hospitals has been declining over the past four years, and 1992 appears B u a 0 p h oswell Park Cancer Institute is now offering computer-controlled lowdose brachytherapy - a safer, more efficient way to deliver low-dose radiation directly to tumors. The procedure uses robotics to implant radioactive pellets directly on or near the tumor to deliver low doses of y s c a 5 z ..: Asafer way to deliver low-dose radiation. m m e 9 3 0 �. .. ................ . . . ..................... . ........................ . ........ . ... . ........ psychiatric beds at BGH to 107, including 4 7 in the main hospital building and 60 in the hospital's Community Mental Health Center (CMHC). Buffalo General now operates 74 2 beds. Philip C. oe, assistant vice president and CMHC administrator, said the hospital has also opened two new specialty units, one for senior adults and the other for mentally ill chemical abuse patients. Each unit contains 20 beds. "Putting the 22 psychiatric beds in the tower will help maintain a close affiliation with medical units in the hospital," oe said. Additional multidisciplinary staff have been hired, including nurses, social workers and occupational and recreational therapists. Opening of the new units completes the final phase of a project begun in 1989. The first phase, a lO-bed medical psychiatric acute care unit, was completed in 1990; the second phase, a 15-bed affective disor+ ders unit, was opened in 1991. Sisters Hospital opens new lobby and 10-unit surgical department isters of Charity Hospital is heading for the three-quarter mark of its 28month, $42 million modernization project with the opening of its new operating rooms and lobby. The new 10-suite surgical department, which opened in March, is located on the hospital's fifth floor next to its recently opened intensive care unit. "It's quite an exciting change from the old area, which was built in 1948," said Gino Pazzaglini, executive vice president at Sisters. "The new space provides us with a modern, efficient area which will allow our surgeons and nurses to offer the best and safest possible care to our surgical patients." The new rooms are larger and equipped with the latest in surgical support systems. The new lobby, with its heavy emphasis on glass architecture and natural lighting, features stained glass artwork, high ceilings and banners carrying pastoral themes of hope, peace and joy. "From the beginning we felt the lobby should be seen as a special place to greet the general public, a place where they will be made to feel comfortable and at ease," + Pazzaglini said. 0 B a 0 Van Vorst named new Millard Fillmore Hospitals president Sisters Hospital nears <ampletion of its $4 2 million modernization proje<t. BGH opens 22 psychiatric beds to complete $1.6 million project he Buffalo General Hospital has completed the final phase of a $1.6 million project with the opening of 22 psychiatric beds in its medicaVsurgical tower. The new beds increase the total of p h y 5 a n S illard Fillmore Hospitals' ChairmanoftheBoard, Edward T. Hunt, announced that Charles B. Van Vorst has been appointed the new hospital president and chief executive officer. He succeeds jan R. jennings, who was recently named president and chief executive officer of the Chicago Children's Memorial Medical Center. VanVorst most recently held the position of president and chief executive officer of the Santa Rosa Health Care Corporation of San Antonio, Texas. The corporation is a regional, notfor-profitmulti-hospi- u m m e 9 3 �. . . . . . . . . . . . . . ... . . . . . . ...... . ... . ... . . . . . . . . . . . .... [1] tal system consisting of seven hospitals with 1,166 licensed beds. During his tenure at Santa Rosa, Van Vorst's accomplishments included the development of a new long-range strategic plan and the implementation of a total quality management structure. "We are extremely pleased that Mr. Van Vorst will be leading our hospitals and look forward to his contributions toward the continued success of our health care delivery system," Hunt said. "While his philosophies are very similar to those of the hospitals' board, we anticipate that he will add a new dimension which can only serve to further enhance the level of care we currently provide," he added. Prior to his position at Santa Rosa, Van Vorstspent l l yearsaspresidentandchief executive officer of The Carle Foundation in Urbana, Illinois, a not-for-profit health care-related holding company that owns and manages a number of health care entities including two hospitals, a nursing home and retirement center. Additionally, he held the position of vice president for operations for Methodist Hospital of Indiana for seven years. "I look forward to the opportunity to continue the momentum set forth by Mr. jennings and lead Millard Fillmore Hospitals to even greater heights and national prominence," VanVorst said. + MFH' s Hertel-Elmwood Internal Medicine Center. diagnostic services. Thomas Small, M.D., has been appointed medical director of the center. The center will operate under a preventive medicine philosophy, administering immunizations and vaccinations and providing information on health maintenance. A major goal of the center is to avoid major health problems in its patients through + early and ongoing intervention. New technique for liquid breathing discovered by UB research team simplified technique for liquid breathing discovered by a team ofUB researchers could significantly improve treatment of premature infants, children and adults with lung diseases. It could also help cut this country's annual $5 billion price tag for treating adult respiratory distress syndrome. Bradley P. Fuhrman, M.D., UB professor ofpediatrics and the team's chiefinvestigator, has pioneered an inexpensive way to enable the body to "breathe" perfluorocarbon. The technique is known as perfluorocarbon-associated gas exchange, or PAGE. Liquid ventilation shows great promise for treating premature babies with hyaline membrane disease and other patients with adult respiratory syndrome. Widespread testing of liquid breathing in humans has been impossible in the past, Fuhrman said, because a suitable, high-purity, me- he medically underserved community of Black Rock/Riverside is the location of a new primary care center run by Millard Fillmore Hospitals in conjunction with UB's School of Medicine and Biomedical Sciences. The Hertel-Elmwood Internal Medicine Center offers patients 16 years and older convenient access to medical care and a 0 p + ~ns. B MFH opens primary care center in medically underserved community 6 dicinal grade of perfluorocarbon did not exist and the procedure required special equipment. Fuhrman's technique uses a standard respirator, rather than a specially designed liquid ventilator. In PAGE , the perfluorocarbon remains in the lung while the respirator delivers breaths of oxygen. In standard liquid ventilation , perfluorocarbon is cycled into and out of the lungs using a specially designed liquid ventilator, which oxygenates the liquid and purges it of carbon dioxide. When his liquid ventilator broke down in the midst of research on piglets, Fuhrman decided to hook up an animal with a perfluorocarbon-filled lung to a standard respirator. "When I saw it worked," Fuhrman said, "I was exhilarated." PAGE is significantly less expensive than other methods of liquid ventilation since it uses readily available equipment. It is also kinder to damaged lungs because it is effective at lower pressure and may allow the use of lower oxygen concentra- y s c a n 5 m Y LOIS B AKER re nhalation halation Liquid breathing technique holds great promise for treating children and adults with lung disease. m e 9 9 3 0 �"He captu my heart in a way that patients aren t SUptxJSed to." • 1 tors affect patients every day. But sometimes, patients profoundly affect their physicians. Here are their stories. 0 Buffalo Ph y sl c I a n summer 1993 �Illustrations by Glyn B u a a p h y s c a s Sweeney 5 u m m e 9 3 0 �11 -rII remember my patientstheir grace, dignity and humor and triumph over adversity. Their stories are legion and what we have to do is train ourselves to listen and see. They're all out there and each has a moral of its own." -r- __e ,s - ... and they couldn't come to visit him. He was all by himself. "So the nurses and physicians who took care of him became his parents. "The barriers of how I was going to deal with this little boy were quickly broken. He captured my heart in a way that patients aren't supposed to. "He always wanted people to stay with him and although he was in a lot of pain, he rarely, if ever, cried. "We were constantly trying to figure out ways to try to relieve Rodney's pain. We tried everything. "We used to just carry him around. He always wanted to be carried, so we would just take turns carrying him. "Once he wanted to know why I had to leave- I remember this very vividly. "He finally died and we all cried together about his death. "That child made a very big impression on me. He was always upbeat, always happy to see you and always asking to go on a trip around the ward. And he could always con one of us into carrying him around. "He's probably the first patient who I knew intimately who died. And I did grieve for him. I have lost other patients, and I think I remember the names of all of them - a little bit of you dies with them each time- but this boy taught me there are ways you can comfort patients and make their time more meaningful." probably the first patient vvho I k.ne\v intimately Bob Milch, M.D., '68, was talking about his patients who have changed him. "You know what the definition of a minor procedure is?" he asked. "It's a procedure that's done on someone else. "Stories not memorable to the physician are to the patient. That's what it's all about - minor procedures and memorable stories." The physician-patient relationship is a complex one -and by its very nature, one in which it is the patient whose life is most affected. But sometimes, it is the physician who is changed by a patient who shows remarkable courage, or humor, or strength, or spirit, or pure force of will in the face of illness and adversity. And different patients affect their physicians in different ways- changing the way they see or practice medicine, or changing the way they see themselves. These are the patients whose stories are chronicled here. \vho died. And I did grieve for him. I have lost other patients, and I think I remember the names of all of them - a little bit of you dies \vith them each tin1e -but this boy taught n'1e there are vvays you can Virginia Weldon, M.D., '62, con1fort patients and make their vice president for public pol icy at Monsanto. "He was a little boy about two. I was an intern atjohns Hopkins Hospital. He had a neuroblastoma and it had metastasized to his orbits and his face had become deformed. "I knew I was going to be on the service he was on and i was worried about how I was going to take care of this little boy. "His parents lived in rural Maryland B u a 0 p Donald P. Copley, M.D., '70, past president ofUB's Medical Alumni Board of Directors. "I first saw KathyFreerin May ofl989. The last time I saw her was April 13. She was a young teacher who had had an extremely bad heart attack in May of '89. I never thought she'd leave the hospital, let alone go back to teaching. We did an echocardiogram on her which showed an ejection fraction of 15 percent, which is about as low as I've ever seen in anyone time more rneaningfu l. " h y s c a n S u m m e 9 3 �who's alive. "She had a prolonged hospitalization -at least 10 days - and I sent her home with trepidation. Her echo was slightly improved when she went home but still very bad. "We did a stress test, at least we tried, and she did poorly - she couldn't walk very far at all. "She had been a busy, active teacher, with no prior medical findings - no smoking, a family history of coronary disease, but not remarkably bad. "But she may be the type that goes with blood clots rather than atherosclerosis. We did an angiogram just before she went home and found a single occluded artery. My best guess is she had an atherosclerotic plaque that produced a clot that closed the vessel rather abruptly. "She went home and went into a rehab program that lasted a long time- at least six months. She started slowly and we weren't optimistic. "I had thought she was close to dying in the hospital - maybe a 50-50 risk - and I had told her husband things were grim. "But she is a very positive, jocular, bubbly person. In fact, she's been accused of being kind of cavalier- cracking jokes about dying early. People who don't know her accuse her of being flip. "She has what I would call an extreme form of an optimistic attitude. Whenever I would describe to her the possible outcomes, she would focus on the positive. She always passed over the negative. "And that's the way she was in rehab, too. She was very helpful to the other patients. She was even ready to get on with her life, without going back to work, which was always very important to her. And she was always very well-liked by the kidsshe taught middle school- and also very highly regarded by her peers. "She is very energetic- a Type A, an intense coronary factor- but with none of the hostility you associate with Type As. B u a 0 p "It was a full year before she could consider going back to work full time. And her echo is not normal now, it still shows the scar clearly. Her ejection fraction is doubled what it was when she was in the hospital and she still has a rather dilated heart. But she's found ways to cope with the disability." one had ever done exercise testing after a John aughton, M .D., vicepresident for clinical affairs and dean of UB's School ofMedicine and Biomedical Sciences. "I had one patient, Mr. Douglas Cordon, during my residency and fellowship training at the University of Oklahoma, who was the first to undergo exercise testing and training after a heart attack. It was because of him that we [Bruno Balke, Francis agle, Michael Lategola and aughton] developed a strategy for exercise testing and physical reconditioning for cardiac patients. "In 1964, Mr. Cordon indicated to me he wanted to get into some physical activity after his heart attack. He was 54 at the time. Two months earlier he had wanted to enter a physical therapy program- he had high blood pressure-and was one of a group of healthy volunteers we were studying. So we had the data on him before his MI. And so two weeks post-MI we first did an exercise test and measured the loss. We put him on a training program. He had a higher capacity after the training program. His work capacity increased. "He lived another 15 years after that and always kept fit. " o one had ever done exercise testing after a heart attack. We had him walking on a treadmill, and as we got more comfortable with him, we increased to 50 patients. It's an example of how you make a change by studying one individual patient, and then adding groups of patients. "My efforts grew from studying Mr. Cordon well to the development of group programs for heart attack patients and heart attack. vVe had him \·valking on a treadmilt and as vve got n1ore comfortable \ vith him , \veincreased to 50 patients. It's an exan1ple ofho\v you make a change by studying one individual patient, and then adding groups of patients." y s c a n 5 m m e 9 9 3 �then to the development , implementation and completion of the ational Exercise and Heart Disease Project. ln essence, he because l don't think she looks at it as changed my whole world. " terminal. "She faces the future with a realistic, yet Roseanne Berger, M.D., associ- optimistic point of view. She's very calm ate dean for graduate medical education. and brave and even at times when she is "Her name is Frieda Bair, and l remem- uncomfortable or in the hospital. ber her for a number of reasons. She is an "l have to feel her attitude is certainly accomplished poet. She is an elegant, ar- contributing in a lot of ways to the way she ticulate, very attractive elderly woman is coping with a very serious illness . who has a terminal disease ... rather, Even when she is in the hospital, she cancer ... l don't want to say terminal, has the ability to reach out to other B u a 0 p h y s c a n 5 people e v e n though she has a very good reason to be introspective and self-centered. But despite all that she's interested in and concerned with other people. Whenever l see her, before l even have a chance to say a word, she asks me how I am. And it's not just me- she's like that with other people. "She's always been an observer of life. She has these inspirations, or muses ... "l first saw her about two years ago. She was diagnosed with cancer [pancreatic] that first visit. But her illness is only a small part of this woman - her creativity and u m m e 9 9 3 �11 -relegance are central to her. "She has always been a teacher, formally, and she has allowed me to share her story with fourth-year medical students, so her case has been examined in detail by several seminars of medical students and she has been more than willing to allow me to do that- and has always been very gracious about allowing them to examine her and ask her about what she was feeling and what was happening with her life. "Her poetry has given me an insight into this person. She writes about very tangible things that people can relate to easily, like home. And she has a lovely little poem about red mittens ... the Buffalo Blizzard ... pollution ... and this one that I use for the medical students. "She is very much at peace with herself, and has that calm and confidence that comes from having led a full life. She is at ease and peaceful with what is happening. She is ready to accept death if it happens, but she's not just going to give up. She wants to live every day as well as she can." Ji first sa\v her about t\vo years ago. She \vas diagnosed \ vith cancer [pancreatic] that first "risit. But her illness is Robert Milch, M.D., '68, medical director of Hospice Buffalo. "There are so many patients in my line of work who are recollected for different reasons. And it's good that we try to recollect as many as possible - each of them is part of the fabric of us. "I remember a patient with cancer of the pancreas who was referred to us after discharge from one of our teaching hospitals. His wife was given a prescription for demerol and syringes to inject him with. "And we were told that he was a 'troubled patient' because at the height of one of his pain episodes, he bent the siderails ofa bed. We got him offinjectables to a more appropriate medication and he lived a comfortable and pain-free life for the remainder of his five months. "His gratitude was matched only by ours. "I remember seeing patients who point B a 0 p out just how fallible all the things we learned in medical school are regarding the use of pain medication. "I remembera39-year-old woman with cancer of the pancreas. As her disease progressed, she would take four grams of morphine every four hours. Do you know what the normal dose is? "We brought her into the hospital and gave her an epidural of morphine of just four milligrams. And all her pain disappeared. "We had to actually convince her to take small amounts of morphine to prevent withdrawal. "All the things we learned about addiction and dosing are not always applicable. "I remember a young man of 28 who was dying of Hodgkin's. Every day I came in to see him he was wearing a different t-shirt- whether it was U2, Jefferson Airplane, The Who - he always had some t -shirt from a rock group. As he got thinner and thinner, one day he was wearing one that said 'Hoots and the Geraltones.' So I said, 'Who are these guys?' "And he said, 'We got you!' He was Hoots and his wife was Geraldine and they just had one made up because they finally ran out. "I remember a man who was 50 and dying of cancer of the thyroid. When he and his wife had gotten married they had been very poor together for a long time. By dint of hard work, their marriage had worked out successfully - their children were healthy, they had sacrificed a lot in their early years. "The one thing she had wanted, but never had got, was a pair of diamond earrings. He was going to die before their next anniversary, and did, in fact, die about six months before. "But on the day before that anniversary, he had delivered to her a pair of diamond earrings." + only a small part of this \voman - her creativity and elegance are central to her. " y s c 0 5 u m m e 9 9 3 �By 0 Andrew an z o There was a time when organized medicine didn't think much of managed care. In fact, it tried desperately to stamp out, or at least contain, the health maintenance organizations that were spreadingfrom the west coast. Managed care won. 4D a u f f a I a P h y s I c I a n 5 u m m e r 1 9 9 3 ��ne in five insuredAmericans now belongs to an HMO . At least half the nation's physicians are believed to be affiliated with HMOs and related entities, and the majority at some point encounter utilization review, part of managed care's widening spectrum. The American Medical Association last year went so far as to acknowledge the "legitimacy" of HMOs. ow, organized medicine is even getting into the game- the Medical Society of the State of ew York is forming a statewide physician network to compete on the managed care field as early as this year. Health care reform will only accelerate the trend. While details remain to be hammered out in Congress, the Clinton administration's reform plan relies heavily on managed care to deliver health services. In New York State, Gov. Mario Cuomo is also pushing a reform initiative emphasizing managed care principles. Once the dust settles, several trends are obvious: greater demand for primary-care physicians, the backbone of managed care plans; a continued erosion of the solo practice as more physicians are pushed into groups, and further diminution of the ~~FOR THE autonomy physicians have traditionally enjoyed. "For the individual physician, I think it's a very disquieting time," said UB School ofMedicine and Biomedical Sciences Dean john aughton,M.D. "We'vehadthroughout the history of medicine in the United States the fee-for-service system and the solo practice. Clearly the forces are to encourage physicians to practice more in groups than in the past." In 1980, 4 7 percent of ew York State physicians were in solo practice. By 1988, the latest year for which figures were available, the percentage had dropped to 41 percent overall and to only 27 percent of doctors under 40 years old. Only 2 percent of New York doctors listed HMOs as their primary practice in 1988. But many more are affiliated with non-staff HMOs and similar plans, the fastest-growing segment of the managed care sector. o one knows exactly how many, but nationally it's estimated to be at least half of practicing physicians. "In some communities, every doctor is involved," said Kathryn Allen, executive director of the New York State HMO Council. And HMOs are scooping up more and more patients. During the 1980s, national HMO enrollment nearly quadrupled to 40 million. In ew York State it tripled and now stands at about 3.5 million. Health care reforms are expected to drive the numbers up dramatically, though ew York State Health Commissioner Mark Chassin, M.D., said that if federal rules permit, he favors a flexible approach based on the needs and resources of different regions of the state. " etworksandhealthplansandHMOs are part of the solution, but forcing consumers into one of the health plans, forcing physicians and hospitals into one of the health plans is not what we want to do," he said. However reforms play out, there will be greater emphasis on primary care physicians. "It can't be successful unless there is a larger pool of generalists available," said UB's Naughton. About one-third of the approximately 56,700 practicing doctors in New York are in primary care. It's the same proportion nationally, and the exact opposite of the generalist-specialist ratio in most other nations. Since managed care programs rely on primary care physicians to coordinate and control patient treatment, it's estimated that at least half of all physicians should practice the primary care specialties to make the programs work effectively. In ew York's inner cities and rural areas, there aren't enough physicians now, said Richard Kirsch, chairman of the ew York State Health Care Campaign, a coalition of groups pushing reform. "The INDIVIDUAL PHYSICIAN, I THINK IT'S A VERY DISQUIETING TIME." 6 u 0 Dean John Naughton, M.D. 0 p h s c 0 5 u m m e 9 9 3 �said aughton. Last year UB, in consultation with its consortium of teaching hospitals, set a goal of getting half its residents into primary care by 1995. However, aughton noted, even if all the nation's residency programs went to the 50 percent goal, the proportion of practicing generalists wouldn't reach 50 percent until the year 2035. In the meantime, some specialists might find themselves in the same boat as the laid-off factory worker. "People for the first time in recent months have been talking about the issue of retraining," said Edward Salsberg, director of the ew York State Department of Health's Bureau of Health Resources Development. "If you have a large supply of specialists and managed care comes into place and the use of specialists is decreased, then the demand and need for specialists should be dropping. In a specialist-rich state like New York, there's the question of what they will do. " Psychiatrists are already feeling the managed care crunch. Faced with premium complaints from employers, the Blue Cross and Blue Shield HMO in Buffalo , Community Blue, last year hired an outside health management company to oversee its mental health-substance abuse benefits. The company revised Community Blue's provider list, cutting the number of psychiatrists from 99 to 31. lt also reduced the number of Ph.D. psychologists from 141 to 93. The number of master's-level psychologists, social workers, psychiatric nurses and addiction counselors rose from 94 to 166. "They cover a broader range and there is not as heavy a concentration of psychiatrists," said Lynn Sidare, Community Blue spokeswoman. "We felt there were other specialties in mental health that could provide good, effective treatment." She said anyone who was seeing a psychiatrist removed from the list was given a grace period to wrap up treatment main thing New York needs to be doing is building up its capacity to provide primary care to its citizens," he said. Cuomo's initiative acknowledges that -proposing incentives to steer more medical students to primary care and financial help to open primary care practices. "l think we're a school that has been looking at the problem for quite some time, " B a 0 p h 5 c a n 5 m m e 9 9 3 �and make the switch. "The medical community obviously thinks this is very wrong," said H. John Rubinstein, M.D., president of the Medical Society of the County of Erie and a 1966 UB medical graduate. The society protested to the state, which ruled that Community Blue was within its rights. The tate, in fact, did the same thing last year with its own insurance plan, farming out management ofmental healthsubstance abuse benefits for 395,000 state and local government employees. "On an annualized basis, the program has saved us $30 million," said Priscilla Feinberg of the governor's Office of Employee Relations. any physicians are frustrated and angry, feeling that while the profession bears some responsibility, they've been made the scapegoat for a health care system that is far too expensive and far too inequitable. They agree that some kind of change is needed, but worry about the details. "My fear is we'll be left with even more administration and more micromanagement than we have now," said Amy P. Early, M.D., an associate clinical professor in UB's oncology division. The Medical Society of the State of ew York is hoping to maintain more control for physicians by taking a lesson from the labor movement and organizing, not as a union, but as a network of doctors who can negotiate from a position of strength in the expanding world of managed care. "Like it or not, the pressures faced by private practicing physicians in their efforts to compete effectively in the health care arena will be overwhelming and many physicians will lose the struggle to main- a u a 0 p tain their private practices," ancy H. Nielsen, M.D., SU Ytrusteeand the plan's coordinator, wrote in a report to the medical society's house of delegates this year. "When these challenges are added to the growing problems of a crushing bureaucracy and significantly decreased payments, it is evident that for the physicians of ew York State, 'business as usual' is no longer possible." The MSSNY Physician Network would provide medical services for insurers, employers and HMOs, with the state medical society negotiating statewide contracts and local medical societies handling local contracts. The network, which would have its own utilization review and quality assurance programs, would require an unspecified financial commitment from members. "It is clear that if these initiatives are uniformly implemented, physicians will gain immeasurably in their ability to compete effectively in the future managed care market," ielsen wrote. The medical society is also fonning a second network to compete in New York's Medicaid Managed Care Program, which seeks to get half the state Medicaid population into managed care by 1996. By and large, physicians have come to accept HMOs and managed care arrangements as part of the health care landscape. Early, an oncologist with the Buffalo Medical Group, said she has had occasional problems getting HMO approval for specialized cancer treatments in facilities outside the area. But overall, she feels she has a good relationship with her group's HMOs. "If I, as the primary doctor, have a problem or recognize that my patient has a special need, I can call someone," she said. "I may not always get approval, but I have a line of communication open." The real hassles, she said, are with the long-distance utilization reviewers. "For me to call an 800 number to someone in Indiana whose credentials I don't have a s c a S clue about to seek hospital admission for my desperately ill patient is ludicrous," she said. Chassin, who was most recently senior vice president of a utilization review company before becoming New York's health commissioner, agreed that there is both good and bad under the managed care umbrella. "In its best incarnation it can be a very effective way to maintain quality or improve quality at the same time costs are being controlled," he said. "But it's not always implemented that way. In other implementations it is micromanagement and throwing obstacles in the way of physicians trying to provide quality care for their patients." Chassin favors a flexible approach to reform in ew York, one that allows a variety of arrangements for health care delivery and compensation. He wants the state's rate-setting power expanded to physicians so there will be more uniformity and fewer inequities, like Medicaid reimbursements that discourage doctors from serving poor neighborhoods. But he would like different cities and regions to use the payment system that works best for them, whether it be salary, capitation or fee-for-service. "We want to have a statewide approach that encourages diversity," he said. John Rodat, an Albany health care consultant who has served in a variety of state positions, said perhaps the biggest trick in reform will be finding a way to accommodate the organizational impulses of the reformers and the independent nature of medicine. "The knowledge and skills and temperament and perspective that good physicians can and should have are ones which cause them to focus totally on the individual patient and not to see the organizational context around them," Rodat said. "These are not folks in gray flannel suits, and they should not be." u m m e 9 9 3 �But those traits, he said, have made the medical community slow to deal with restructuring, to see it as someone else's problem. "My very strong fear is that those who are going to impose reform, because they've B y nan age when care is "managed" and physicians are "providers," everyone complains about the bureaucracy. But to Robert A. Milch, M.D., it was something a little more unsettling. It was the feeling that medicine was surrendering its humanity to a cold ethic of efficiency. He wanted out. Unlike many frustrated physicians, the 1968 UB medical graduate didn't retire early. But he did give up his surgical practice to become medical director of Hospice Buffalo on january l. He's much happier now. "What I found was, I think, a microcosm of the best that medicine has to offer, which is humane, appropriate, cost-effective care," Milch said. It's unclear how many physicians are fed up and making a change. "At this point it's still primarily anecdotal," said Edward Salsberg, director of the ew York State Department of Health's Bureau of Health Resources Development. In 1990, the latest year for which figures were available, only 52,722 of ew York's 70,080 licensed physicians were active in patient care, but B u a 0 p h make things worse for many folks .... To do it right, it seems to me we have to have some kind of common language for solving the problem." Will that happen? "I think it's possible," he said. + grown impatient and the public has grown impatient, have a completely different set of perspectives," he added. "Even though they also may be perfectly wellintentioned, it is my great fear that their organizational perspectives are going to A N D R E D W A N Z 0 to specialized treatment. "What a terrible word," Rodat said. "What's terrible about it is that it is, in fact, descriptive of what the role is.. .. This is somebody whose primary role is to decide whether or not you go on, and if so, what price you pay. Wait a minute! " For Milch it was seemingly small things that added up. Like the surgery schedules that left residents little time to interact with patients, to gain some understanding of their hopes and fears before the anesthesiologist arrived. "This system conspires against humanity in the name of perceived efficiency," he said. He blames insurance companies. But he also blames medicine itself. "You've got to recognize truth when it's staring you in the eye," he said. "We have so many problems with health care delivery. So many of them are societal and the practitioner is the convenient whipping boy. But so mu.c h of the criticism is well-deserved. We have abdicated so many of our responsibilities. We have closed our eyes to questionable practices. Once you lose your deserved stance of moral rectitude, you can't be surprised when those who you should be serving tum on you." + the proportion doesn't seem notably different from past years, Salsberg said. Still, everyone seems to know someone who couldn't take it anymore. "I have seen some people who have just gotten out of practice and taken administrative jobs because the bureaucratic morass has gotten so bad," said H. john Rubinstein, president of the Erie County medical society. "I think it's fair to say that practicing medicine is probably not as much fun as it once was, when there wasn't a lot of regulation," said john aughton, M.D., UB medical school dean. "I think most physicians are very well motivated and committed to providing good care and dedicated to the needs of patients. But the emphasis on more external review and documentation of what we do, those are hard habits to take on. It does create a climate of distrust between physicians and patients, and vice versa. " john Rodat, a health care consultant in Albany, thinks the lexicon of contemporary health care tells a lot about it. Take, for instance, "gatekeeper," the term managed care plans use for primary care physicians, who control their patients' access s c a n S u m m e 9 9 �• ········· · ··················· · · ····· · ·· ··············· ·· ·· ·· ····· · ·· · ··· · · · ····· ·· ·· · · ··· ···· ··· ~ I tiative. "In addition to benefiting women living in Western ew York," he said, "this program will accelerate the role of the school's Department of Social and Preventive Medicine in epidemiology, preventive medicine and community medicine. Italso will complement the medical school's efforts to train a larger number of primary care providers." The UB Women's Health Initiative will be headquartered in Farber Hall on the UB South Campus. A 24-hour hot line will be established later this summer to answer questions about the study and to take the names of women who wish to participate. Trevisan said he is convinced that one of the major reasons UB was selected to participate in the study is because the UB selected as vanguard center for national Women's Health Initiative Maurizio Trevisan, M.D ., chair of sohe University at Buffalo has been selected to be a lead research center cial and preventive medicine, is UB's primary investigator. in the $635 million Women's Health "This is a wonderful occasion for UB Initiative- the largest clinical trial and Western ew York," Trevisan said. ever undertaken in the United States. "This was a very tough competition and UB will aetas one of 16 vanguard clinical centers; its share of the project will UB fared very well. " john P. aughton, UB vice president total about $11 million over 12 years. The Women's Health Initiative is being for clinical affairs and dean of the medical undertaken to learn how to reduce the risk school, said, "UB is very pleased to be of coronary heart disease , breast and among the institutions selected to be vancolo rectal cancers and osteoporosis in older guard centers in the Women's Health Iniwomen. Approximately 160 ,000 postmenopausal women between the ages of 50 and 79 will be recruited by the 45 research centers throughout the country participating in the study. A pproxi rna tel y 3,500 women will be recruited from Western ewYork. As a vanguard center, UB will help design the study and establish operating procedures that other centers will follow . Clinical trials are expected to begin at the vanguard centers this fall. The remaining 39 clinical centers are expected to be anJean Wactawski-Wende, M.D., dinical assistant prafessar of Gynecology and Obstetrics, and Maurizio Trevisan, M.D., chair of nounced this fall. Social and Preventive Medicine, at a news conference announcing UB' s vanguard center designation. B a a p h y 5 c a n 5 u m m e �··········································································· ··············· · ····· • ·· ~ I entire community supports the effort. Ph.D. , and Terry Pechacek, Ph.D., all from "We were able to offer a package not the UB Department of Social and Prevenmany institutions could match," he said. tive Medicine. "This effort involved the departments of Also participating are Myroslaw gynecology and obstetrics, medicine and Hreshchyshyn, M.D., chair, and jean medical technology. We had the support Wactawski-Wende, M.D., from the Deof the deans of the medical school and the partment of Gynecology and Obstetrics; School of Health Related Professions and Robert Kohn, M.D., Susan Graham, M.D., the UB provost. We had the support of the June Chang, M.D. and Paresh Dandona, medical community, the political commu- M.D., from the Department of Medicine, nity, the health-care providers and civic and Donald Armstrong, Ed. D., chair of the and religious organizations. Department of Medical Technology. + "This is a very complex study, involvB Y LOIS B AKER ing recruiting volunteers, retaining them and arranging for reimbursement," Trevisan said. "Because everyone was behind us, we were able to address all of these issues." The study itself will be conducted in two parts - clinical and observational. he United State's first comprehenThe clinical component will involve three sive training center for nuclear iminvestigations: aging has been established • A test of the effectiveness of hormone at the Univerreplacement therapy in reducing the risk sity at Buffalo, of coronary heart disease, osteoporosis funded by a and endometrial cancer. • A study of the effect of a low-fat diet $450,000, three-year on the risk of cardiovascular disease and grant from Siemens H.G. breast and colorectal cancer. The grant is the re• An investigation of the effectiveness of calcium and vitamin D supplements in sult of two years of reducing osteoporosis, colorectal cancer, discussions between UB and Siemens, an blood pressure and breast cancer. The trials will begin in August or Sep- international contember in Western New York. The obser- glomerate headquarvational study will follow about 2,200 tered in Germany and a women from 12 to 17 years of age to try to major supplier of determine physiological and lifestyle fac- nuclear imaging equiptors that can affect the health of women. ment worldwide. Under the grant, Participants in this phase initially will give detailed medical histories and then will be the training center- to be headquartered contacted every three years to update their in the medical school's department of nuclear medicine- will concentrate on information. Co-principal investigator on the study positron emission tomography (PET). "We're in the process of organizing a is james Marshall, Ph.D., UB professor of core curriculum to train everyone from social and preventive medicine. Otherinvestigatorsarejo Freudenheim, the PET technician who assists the chemPh.D.; Alma Blake, Ph.D.; Diane Hayes, ists, through all of the higher levels of science right up to a director of PET operations," said joseph A. Prezio, M.D., UB chair of nuclear medicine. " o one is doing that anywhere in the United States. " Siemens needed a center that could train its people in depth in this new field, Prezio said, and UB already had a wellregarded program in nuclear medicine and is establishing a major PET facility in conjunction with the Buffalo VA Medical Center. The new facility will be one of the most advanced PET imaging centers in the world. 'The problem throughout the U.S. and, probably the world, is that training for PET has not been organized appropriately, or in enough depth, so that you can send someone to one site and have them come back seasoned and trained," Prezio said. "Siemens liked what we were doing here. They were looking for someone willing to put the effort into it. "Our goal from the beginning," he added, "in addition UB establishes comprehensive nuclear imaging training center B u 0 0 p y s c 0 S u I valed in the United States," Preziostated. The center will be organized around four major training groups -technicians, radiochemists, nuclear physicists and physicians, according to Prezio. Training of PET technicians began this spring. Other programs will accept enrollees when curriculums are finalized. Training periods will vary from a month for technicians to two years for physicians being trained to + interpret PET images. B m m Y e LOIS B 9 AKER 9 3 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Maurizio Trevisan is poised to expand SPM's role in both scope and breadth he first thing that struck Maurizio Trevisan, M.D. about this country after he came here from his native aples, Italy, was Americans' penchant for eating large breakfasts with meat every day. "My parents used to have a cup of coffee- maybe toast and jelly- but no meat," he recalls. ow, the chair ofUB's Department of Social and Preventive Medicine (SPM) is putting that observation - and many more about the American lifestyle - to work, studying dietary habits with an eye toward reducing the incidence of the number one and two killers of Americans, cardiovascular disease and cancer. Trevisan believes that the key to changing the bad habits that contribute to the deaths of over 1.2 million Americans each year is "to focus more on societal problems. The largest impact will come not so much from focusing on the individual, but by influencing the market for foodby lowering fat, eating leaner meats. "And the market," he notes, "has responded to consumer demand. The largest impact will be the change in labeling," soon to be phased in by the Food and Drug Administration. "Increased awareness has created a change in consumer awareness that has resulted in producers changing their packaging." Trevisan, who originally came to this country in 1979 to study at orthwestern University, talks about his former boss in Chicago, a leading authority on diet and heart disease. "He shows slides of two meat cows - one from years ago and one from now. There is a huge difference in B a 0 p the sizes. And now the one that wins the competitions is leaner. People used to look for the steak with all the marbling. ow they're looking for the leaner meat. "We tend to consume what's available," he notes, adding, "I was lucky enough to grow up in a place where you didn't use butter on your bread and you didn't eat meat every day. We would only eat meat once a week. "Lunch was the major meal, and always with pasta. I'm still not used to a cold lunch," even after eight years. In 1982, Trevisan returned to the University of aples, where he obtained his medical degree, before coming to UB as an assistant professor in 1985. He notes that since he's lived in the United States, "dietary habits have changed tremendously," resulting in decreased incidence since 1970 in heart disease and stroke. "And they're still changing for the better." And that is his ultimate goal, of course - to be able to influence peoples' habits and lifestyles to improve the quality of their lives. To that end, Trevisan and Social and Preventive Medicine are carrying on the work of Saxon Graham, emeritus professor and former chair of the department. Graham and his groundbreaking work in epidemiology and diet and disease were key to Trevisan's decision to come to UB. He was, at the time, being wooed by two other institutions. "One of the reasons I came here," he recalls, "was I fell in love with Saxon Graham. I thought he had tremendous vision for the department. 'Td like to continue what Saxon started. I want to maintain and continue to strengthen the department in the field of diet and chronic disease. And I'd like to expand it and continue to include environmental and occupational research. " Another ofTrevisan's goals is to make SPM more clinical. "My background," he explains, "is in internal medicine. Trevisan moved closer to this goal last March when UB was named a vanguard center in the ationalinstitutes' ofHealth landmark Women's Health Initiative. UB, under the auspices of SPM, along with the Departments of Obstetrics and Gynecology and Medicine, will look at a number of factors affecting women's health. Among those to be investigated in the observational study that will look at over 100,000 postmenopausal women are diet, physical activity, smoking, estrogen replacement therapy, alcohol use and psychosocial factors, including social networks, personality, depression and role satisfaction. "At some time, I'd like to expand our definition of Social and Preventive Medicine by being more closely in contact with the community I don't want to be an Ivory Tower scientist. We need to participate more and be more aware of the needs of the community" h y 5 c a n 5 m m e 9 �········· · ··· · ·············· · ················· · · · ············ · ·············· · ··············· · ···• · ~ I I ) J Maurizio Trevisan, M.D. UB will also participate in the initiative's clinical trials to determine whether ERT for postmenopausal women is ultimately beneficial or not. [See the previous story in this section for more information on the Women's Health Initiative.] Trevisan acknowledges the chairs of the other departments involved for their support and involvement in obtaining the prestigious IH designation, as well as that of john Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. "The IH people said, 'It's the first time we've ever seen a dean so involved.' If we 8 a 0 p h his department is relatively small, it is thriving under the medical school's primary care recruitment and women's health initiatives and poised to enjoy an even larger role in the future. "At some time, I'd like to expand our definition of Social and Preventive Medicine by being more closely in contact with the community. The medical school has a responsibility for the health of its community. "I don't want to be an Ivory Tower scientist. We need to participate more and be more aware of the needs of the community." + make it, it's a great end to the efforts of many people involved," Trevisan said, referring to one of the IH's last site visits before awarding the vanguard clinical center designation to UB. Naughton has similar praise for Trevisan. "Maurizio is a very broad thinker. He is committed to epidemiologic and clinical research, and is a good leader of the faculty. His strong leadership, particularly in the area of primary care and interaction with other departments, make us fortunate to have him here." Trevisan officially took over SPM on january l after serving as interim chair after Saxon Graham retired. And although y 5 a n S u - m BY N ANETTE TRAMONT m e KOLLIG �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Suraj A. Acharya Family Practice, UniversityofCalifornia-San Diego Medical Center, San Diego, California Match Day '93 aresounding success for UB'sgraduating medical students Shabi na Ahmad Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York atch Day went well for UB's medical students this year- with 84 percent of the graduating seniors accepted into one of their top three residency program choices. Dennis Nadler, M.D., associate deanfor curricular and academic affairs, said that this year saw 63 percent of UB's medical students accepted by their first choice of residency programs, 11 percent by their second choice and 10 percent by their third choice. In the highly competitive surgical specialties, 10 of 11 UB students who applied were accepted. "The usual match in these specialties is 50 percent," Nadler said. "So to get 10 out of 11 is excellent." Nearly one-third of the students will remain in Buffalo to continue their training- an increase of7 percent over last year. Twenty percent will go to other New York State programs, while about half were matched with out-ofFollowing is a list of the medical school's Class of '93 matches. u 0 0 ancy A. Allen Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Jewel D. Alleyne Surgery, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew York Matthew E. Alter Surgery, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew Yorlz Pavan Anand Anesthesiology, Albany Medical Center, Albany, ew York Gregory A. Andrews Obstetrics/Gynecology, Sisters ofCharity Hospital, Buffalo, ew York Michael]. Aronica Med!Peds, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew York Behnam Asgharian Surgery (Prelim), University of Louisville, Louisville, KentucJzy Hisla A. Bates Intemal Medicine (Primary), Yale-New Haven Hospital, ew Haven, Connecticut Ophthalmology, Yale University, ew Haven, Connecticut Andrew J. Bauer Pediatrics, Madigan Army Medical Center, Tacoma, Washington Elyssa A. Blissenbach Intemal Medicine, Medical University of South Carolina, Charleston, South Carolina John S. Brebbia Surgery, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York state residency programs. B Elizabeth A. Allen Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York p h s c 0 5 Jon M. Bruce Surgery, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York m m e 9 9 �................................................ .... ............................ . . . . ... . . . . . . . . .•. ·. ' ~ ' ' AnneM. Comi Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Thomas A. Coppola Internal Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, New York Andrew C. Corsello Internal Medicine, Strong Memorial Hospital, Rochester, New York Vanessa L. Crothers Obstetrics/Gynecology, Ohio State University Hospitals, Columbus, Ohio Joan C. Davis Obstetrics/Gynecology, Baystate Medical Center, Springfield, Massachusetts Michael L. DuBartell Family Practice, Middlesex Hospital, Middletown, Connecticut Karen M. Duguid Obstetrics/Gynecology, Strong Memorial Hospital, Rochester, ew York John A. Dzik Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Congratulations abound as over 60 percent of the class members are accepted into their top choice. Tricia L. Eisenstein Surgery (Prelim), Mt. Sinai Hospital, New York, ew York Julene 0. Evansmurage Obstetrics/Gynecology, Maimonides Medical Center, ew York, New York Lisa A. Cardamone Surgery (Prelim), University at Buffalo Graduate ALL PHOTOS BY SIM ON TONG Thomas G. Burke Internal Medicine (Prelim), St. joseph Hospital, Denver, Colorado Emergency Medicine, Denver General Hospital, Denver, Colorado Craig]. Burrows Family Practice, St. Vincent Health Center, Erie, Pennsylvania Heather R. Campbell Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Jean M. Cange Family Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Rodney Capiro Obstetrics/Gynecology, Harlem Hospital, ew York, New York B a 0 p h MedicaVDental Consortium, Buffalo, ew York Orthopaedic Surgery, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Gil M. Farkash Obstetrics/Gynecology, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Richard M. Chemelli Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Paul Favorito Surgery (Prelim), UniversityofMinnesota Hospital and Clinic, Minneapolis, Minnesota Elaine H. Cheon Obstetrics/Gynecology, Strong Memorial Hospital, Rochester, ew Yorl1 Ilana L. Feinerman Otolaryngology, Tufts ew England Medical Center, Boston, Massachusetts William F. Chlosta Surgery, St. Mary's Hospital, Waterbury , Michael S. Ferguson Emergency Medicine, University of Massachusetts Coordinated Programs, Worcester, Massachusetts Connecticut Josephine Cho Internal Medicine (Prelim), Staten Island University Hospital, New York, New York Radiology - Diagnostic, Einstein Affiliated Hospital, ew York, New York David M. Fisher Surgery, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York David K. Frey Psychiatry, SUNY Health Science Center at Syracuse, Syracuse, ew York Judine C. Coggins Obstetrics/Gynecology, Sisters ofCharity Hospital, Buffalo, ew York 5 c a n s m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Allen Friedland Med!Peds, University of Cincinnati Hospital, Cincinnati, Ohio Timothy D. Haley Surgery, Medical College of Pennsylvania, Philadelphia, Pennsylvania Wallace E. Johnson Internal Medicine, Strong Memorial Hospital, Rochester, ew York Myron L. Glick Family Practice, Lancaster General Hospital, Lancaster, Pennsylvania John D. Hall Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Saidat T. Kashimawo Psychiatry, Beth Israel Medical Center, New Yorh, ew Yorh Charles R. Gray Psycl1iatry, Thomas jefferson Philadelphia, Pennsylvania Hospital , Betty B. Gregoire Psychiatry, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York Kathleen T. Grimm Med!Peds, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, New York B u 0 0 p Richard E. Hall Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Honora M. Heffner Patholog,, University of Minnesota Hospital and Clinic, Minneapolis, Minnesota James M. lsemia Internal Medicine, Healtheast Teaching Hospital, Allen10wn, Pennsylvania h y 5 c 0 n 5 Robin M. Kass Internal Medicine (Prelim), Faulhner Hospital, Boswn, Massachuseus eurology, Columbia University, New York, ew York Lisa F. Keicher Pediatrics, Hershey, Pennsylvania State, Hershey, Pennsylvania Kevin J. Kelleher Family Practice, Franklin Square Hospital, Baltimore, Maryland m m e �· ········ ··· ···················· ·· ······· ············· · ···· ····· · ······· ········· ········· ······• · · ~ I I Theodore J. Kolias Internal Medicine, Hershey, Pennsylvania State, Hershey, Pennsylvania Joseph M. Kowalski Surge1y (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, New York Paul M. Kozlowski Surgery (Prelim), Strong Memorial Hospital, Rochester, New Yorlz Urology, Strong Memorial Hospital ofthe University of Rochester, Rochester, ew York UB' s graduating medical students getting the good news: 84 percent were accepted into one of their top three choices for residency programs in this year's Match Day. Brian J. Krabak Internal Medicine (Prelim), Sinai Hospital, Baltimore, Maryland Physical Medicine and Rehabilitation, New England Medical Center, Boston, Massachusetts Jonathan R. Kemp Internal Medicine (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, ew York Ophthalmology, Louisiana State University Eye Center, ew Orleans, Louisiana J . Christopher Kuhn Pediatrics, University at Buffalo Graduate MedicaU Dental Consortium, Buffalo, New Yorlz Cathy Kim Surgery (Prelim), Barnes Hospital, St. Louis, Missouri Urology, Washington University, St. Louis, Missouri Tracy]. Lathrop Internal Medicine (Prelim), Einstein Affiliated Hospitals, New York, ew Yorlz Elizabeth H. Kim Internal Medicine (Preli m), St. Vincent's Hospital, ew Yorlz, ew York Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts David]. Lee Transitional Year, Presbyterian/St. Luke's Medical Center, Denver, Colorado Anesthesiology, Dartmouth-Hitchcoclz, Lebanon, New Hampshire Jeffrey 5. Kingsbury Surgery (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, ew York Kewjung Lee Family Practice, orthwestern University/St. joseph Hospital, Chicago, Illinois Ricardo A. Knight Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, Pennsylvania B u 0 0 p s c 0 n 5 Charles H. Lieu Internal Medicine, Barnes Hospital, St. Louis, Missouri m m e 9 9 3 �• ··············································· .................... .... .... ...... .......... ..... An ebullient Jon Brute reteives tongratulations from his tolleagues. Jeffrey R. Parnell Internal Medicine (Primary), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew Yorh Ophthalmology, University of California-Los Angeles, Los Angeles, California Vikram . Patel Surgery (Prelim), McGaw Medical Center, orthwestern University, Chicago, Illinois Otolaryngology, orthwestern University, Chicago, Illinois Francis R. Pallerson Orthopaedic Surgery, SUNY Health Science Center at Syracuse, Syracuse, ew York Kristen L. Paulus Internal Medicine, Georgetown University Hospital, Washington, D.C. Randall J. Loftus uclear Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Andrew C. Michel Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania Karen M. Maier Family Practice, Harrisburg Hospital, Harrisburg, Pennsylvania Rogena L. Miller Pediatrics, Emory University School of Medicine, Atlanta, Georgia James K. Mantone Orthopaedic Surgery, Grace Hospital, Detroit, Michigan David A. Milling Internal Medicine, University at Buffalo Graduate MedicaVDental Consortittm, Buffalo, ew York Gina M. Marrero Pediatrics, Yale- ew Haven Hospital, ew Haven, Connecticut Lomelle B. Mills Internal Medicine, George Washington University, Washington, D.C. Bruce B. Marshall Emergency Medicine, Carolinas Medical Center, Charlotte, orth Carolina Daniel]. Mollin Internal Medicine, University of orth Carolina, Chapel Hill, orth Carolina Christina L. Master Pediatrics, Children's Hospital , Philadelphia, Pennsylvania Michael]. a ugh ton Internal Medicine, Barnes Hospital, St. Louis, Edward F. Math Internal Medicine (Prelim), University of California-Irvine, Irvine, California Radiology-Diagnostic, Duke University Medical Center, Durham, orth Carolina Jennifer A. ordby Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York Fiona A. McConnell Pediatrics, University of Colorado, School of Medicine, Denver, Colorado Kevin C. McMahon Family Practice, St. Vincent Health Center, Erie, Pennsylvania Claudia F. Michalek Psychiatry, University at Buffalo Graduate MedicaV Dental Cons01iium, Buffalo, ew York B u 0 0 p Missouri Katherine A. O'Donnell Surgery, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York Sanjay R. Ogra Internal Medicine (Primary), University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew Yorh William E. Ottowitz Internal Medicine (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York h y s 0 n s Laura]. Pierce Med!Peds, Strong Memorial Hospital, Rochester, ew York James D. Pile Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew Yorh Michael D. Rabice Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Arlene E. Ricardo Surgery, University of Texas Medical School, Houston, Texas Gloria Richards Internal Medicine C., Georgia Baptist Medical Center, Atlanta, Georgia Marcus R. Romanowski Surgery (Prelim), University at Buffalo Graduate MedicaVDental Consortium, Buffalo, New Yorh Orthopaedic Surgery, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Leon Ronen Family Practice, aval Hospital Charleston, Charleston, South Carolina Paul B. Rosenthal Family Practice, UniversityofCalifornia-San Diego Medical Center, San Diego, California Mark A. Runfola Surgery, Good Samaritan Regional Medical Center, Phoenix, Arizona Richard S. Safeer Family Practice, Franklin Square Hospital Center, Baltimore, Maryland u m m e 9 9 �······························································· ···· ·········· ··· ········· ·· ····· • ·· · ~ I Diane M. Sanfilippo Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Frank M. Scappaticci Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Eric]. Schneider Family Practice, University of VirginiaCharlottesville, Charlottesville, Virginia Jeffrey A. Senall Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan Jeffrey Seymour Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Peter U. Shen Internal Medicine, The York, ew York 1 ew Yorh Hospital, ew Andrew L. Sherman Physical Medicine and Rehabilitation, University of Washington Affiliated Hospitals, Seattle, Washington Julie M. Sicilia Transitional Year, Mary Imogene Bassett Hospital, Cooperstown, New York Patricia Sticca Pediatrics, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, 1 ew York Michel E. Wild Obstetrics/Gynecology, ew Yorh Downtown Hospital, ew Yorh, ew Yorh Michael F. Sweeney Obstetrics/Gynecology, Akron City Hospital, Akron, Ohio Kelly A. Wood Internal Medicine, Barnes Hospital, St. Louis, Missouri Brian Szymanski Physical Medicine and Rehabilitation, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Thomas]. Yacovella Medicine C, University of Minnesota Hospital and avy + Clinic, Minneapolis, Minnesota aval Heather Campbell phones home. Courtenay C. Watt Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania Samiris Sostre Psychiatry, Einstein Affiliated Hospitals, ew York, ew York Michelle A. Webb Internal Medicine, Medical College of Virginia, Richmond, Virginia Anthony M. Spina Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York h Edward R. Stephenson Surgery, Hershey, Pennsylvania State, Philadelphia, Pennsylvania Christopher R. White Internal Medicine (Prelim), Sisters of Charity Hospital, Buffalo, New Yorl1 Radiology-Diagnostic, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Anil K. Vaidian Internal Medicine, Montefiore Medical Center, Bronx, ew York Michael K Soeder Med!Peds, Baystate Medical Center, Springfield, Massachusetts p Thomas C. Wheatley Pediatrics, University Hospital of Cleveland, Cleveland, Ohio Mary C. Totten Otolaryngology, Loyola University, Chicago, Illinois Christina A. Smith Psychiatry, University Health CenterofPittsburgh, Pittsburgh, Pennsylvania 0 Judy A. Wesolowski Obstetrics/Gynecology, SU Y Health Science Center at Syracuse, Syracuse, ew Yorh Kristine L. Tenebruso Internal Medicine (Primary), Rhode Island Hospital, Providence, Rhode Island Gail H. Smallen Pediatrics, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York a icho\as A. Stathopoulos Internal Medicine (Prelim), St. Mary's Hospital, Rochester, ew York Ophthalmology, Pennsylvania State University, Hershey, Pennsylvania Guy A. Taylor Internal Medicine (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Anesthesiology, Presbyterian Hospital, New York, New Yorh Alissa M. Shulman Surgery, University of Texas Medical School, Houston, Texas u Jonathan I. Weinstein Pediatrics, Children's Hospital National Medical Center, Washington, D.C. Robert W . Tahara Family Medicine, United States Hospital, jacksonville, Florida Mansour V. Shirbacheh Surgery, assau County Medical Center, East Meadow, ew York e Christopher D. Sprowl Family Practice, St. joseph Hospital, Denver, Colorado Irwin C. Steinberg Obstetrics/Gynecology, Winthrop Universi ty Hospital, Mineola, New York Paul D. Seeman Family Practice, United States avy aval Hospital, jacksonville, Florida y I s a 5 u m m e 9 9 �- - ········· ··· · ······· ········· ····· ··· ··· ·· ······· ······· . . .. . .. ... .. .. . ... ..... ......... ... • Maria New, M.D~ thanks her patients as she delivers 1993 D. WHarrington Lecture common symptom of the disorder) aggravated by stress. In her study of this disorder, ew identified its "nonclassical" form- a late onset hyperplasia in which the patient acquires the symptoms of the disease after HLA-TYPING LED TO DISCOVERY OF NONCLASSICAL birth, rather than in utero. ew became FORM OF CONGENITAL ADRENAL HYPERPLASIA aware of this form using HLA-typing to identify carriers in a specific family. Up to this point in herresearch, HLA-typing had en owned pediatric endocrinologist and then a male until adulthood, when the predicted every outcome in her patients. Maria I. ew, M.D., delivered the victim fell in love with and tried to marry "It was all fine until we hit this family, " 1993 D. W. Harrington Lecture, a maid. "The maid was dismayed and ran where ew noted that the deficiency wasn't away," when the unfortunate patient pro"Congenital Adrenal Hyperplasia: being passed on the way it was predicted From the Laboratory to the Bed- duced a birth certificate that was for a baby to . girl rather than a boy. Although it was ' ~ side," recounting her research on "We were very disappointed in the believed "he died of a broken heart," in the nonclassical form of the disorder. nonconcordance of the HLA prediction." Alexander Brownie, Ph.D., UB profes- fact, she said, he died of salt-wasting (a ew discovered one particular family sor and research professor in pathology, member - a male with a mild deficiency introduced ew, chair of pediatrics at on one of the sixth chromosome pair and Cornell Medical College. A friend of ew's a major deficiency on the other. She defor over 20 years, Brownie described her scribed the man's son "like no patient I dedication to the field of pediatric endohave ever seen," noting that the son should crinology, recounting how she always have had the deficiency at birth but in fact wanted to have a positive impact on childid not, nor did his sister who had the dren suffering from endocrine disorders. same HLA gene type. ew thanked many for their help in her Symptoms of the nonclassical form inresearch , but she made a special point to clude infertility and rapid growth. One of 100 thank her patients, "some of whom I have the most common symptoms is frontal followed from the time they were born hair loss. Treatment can help eliminate until they were parents." many of these symptoms. Pediatrician-in-chief and director of Statistics show that the severe classical the pediatric metabolism clinic at The disorder occurs in one in 14 ,554live births, ew York Hospital, ew has concenalthough there are some geographic variatrated her studies on the 21-hydroxylase tions; Alaska's Yupik Eskimos show the deficiency, which along with the 11-hyhighest frequency of the classical form. droxylase defect, is one of the most comew described how she "never exmon forms. The deficiency causes an inpected what I got" when she tested the creased secretion from the adrenal gland genetic axiom that mild disorders occur of cortisol precursors and androgens, remore frequent than severe ones. She said sulting in masculinization of the female she expected the frequency of the mild external genitalia during intrauterine life. deficiency of congenital adrenal First described in 1854, the disorder hyperplasia to be somewhere around one can lead to female infants being sexually in 13,000 live births, and was shocked misassigned at birth, as well as precocious when she realized it was much higher. A sexual maturation in boys. New told the 11 test on Eastern Europeanjewsshowed the story of that case, in which an Italian frequency to be one in 27 and a test on patient- raised as a female until age four, Hispanics in New York showed a fre- ~I Overall, the frequency average of congenital adrenal hyperplasia is one in who shows symptoms, while one in seven is a carrier, making it the most common autosomal recessive defect. New called for universal testing, but lamented the fact that only states have mandated it thus Jar. a a a p s c a n 5 u m m e 9 �quency of one in 40. Overall the frequency average of congenital adrenal hyperplasia is one in 100 who shows symptoms, while one in seven is a carrier, making it "the most common autosomal recessive defect. " ew called for universal testing, but lamented the fact that only 11 states have mandated it thus far. Treatment begins in the womb as fetal cells are Hl.A-typed. "When you get a diagnosis by amniocentesis, it's already too late," ew said. Dexamethasone is used to treat the fetus at risk even before the gender has been determined. If it is later found the fetus is a male, treatment is ended; females are treated until term. ew said treatment can lead to recovered fertility and the lessening of other symptoms "without causing complications. "It's still a very experimental procedure," explained ew, "but I am very respectful of human life." The author of more than 400 research papers on abnormalities of the adrenal gland, New is immediate past presidentof the Endocrine Society. In 1988, she received the society's Robert H. Williams Distinguished leadership Award in Endocrinology. She has received the New YorkAcademyofMedicineMedalofAward and the Due Case award from the Office of the Governor of ew York. She was elected a fellow of the American Academy of Arts and Sciences in 1991. The Harrington lecture is sponsored by the School of Medicine and Biomedical Sciences. As Harrington visiting professor, ew spent two days meeting with faculty and medical students in hospital grand rounds, at clinics and in informal discussion groups. The D. W. Harrington lecture Fund was established in 1886 by Devillo White Harrington, M.D. , an 1861 graduate of the UB medical school and a professor of genito-urinary and venereal diseases from 1886 to 1905. + r' Maria New, M.D. B s 0 0 p h y s c 0 5 u m m Y e M ARK P 9 OLLIO �• ································································································ ~ I The aim of both initiatives is to provide cooperative patient care networks for diverse specialty services to residents of the West Side close to their homes as well as to develop cost-effective access to University-affiliated tertiary care services to medically underserved communities. Prenatal services will be provided at the Buffalo Columbus' Family Care Center by clinical faculty of the department of gynecology and obstetrics. Women receiving prenatal care at the Buffalo Columbus facility will be referred primarily to CHOB for deliveries, as well as for any specialized pregnancy-related care. Additionally, women seen for gynecological services at the Family Care Center will be referred to either Children's or Erie County Medical Center. The agreement was forged through the joint efforts of john P. BlFFALO COL.lMIUS HOSPITAL UB-Columbus agreement provides cooperative patient-care services for West Side residents. UB-Columbus Hospital linkage to provide prenatal care services new agreement to enhance access to women's health and AIDS services to residents of Buffalo's West Side community has been inked between the School of Medicine and Biomedical Sciences, The Children's Hospital of Buffalo, Erie County Medical Center and the Buffalo Columbus Hospital. The agreement, which establishes a primary-tertiary care network to provide comprehensive women's services, includes provisions for delivering early prenatal care to an area with some of New York State's highest infant mortality rates. The agreement also provides for the training of local medical and nursing staff by specialists ofECMCS AIDS program to administer routine primary medical and specialized ambulatory care to AIDS and HIVpositive patients. B u 0 0 p president for clinical affairs and dean of the medical school, and the hospitals. At a press conference and luncheon announcing its es- II h c 0 UB oiTers GRATEFUL MED through National Library of Medicine grant B's Health Sciences Library has been awarded a 15-month outreach contract to promote library services to 75,000 health care professionals throughout Western and Central ew York. The library will do this through its Western New York Outreach Program, which began in August1992 and will run through this October, funded by a $159,699 ational Library of Medicine (NLM) contract awarded through the ew York Academy of Medicine. The program will introduce its audience to GRATEFUL MED, a software package that offers desktop access to biomedical information and will link unaffiliated health professionals to library services. Cynthia Bertuca, head of information dissemination services for the Health Sciences Library, said the program currently targets more than 10,000 pharmacists and dentists in a 25-county area. The counties involved are the eight counties ofWestern ew York, plus Steuben, Livingston, Mon- GRATEFUL MED reaches out. 5 tablishment, Naughton was lauded by Columbus Hospital board members for his community service and efforts on behalf + of Buffalo's West Side. 5 u m m e 9 3 �. .. . . . .. ... ..... .... . .. .... . . . .... . .... ... ...... .... ......... . . ..... . ... . ..... ... . . . . .. .... ••• ••~ ••• • I roe, Ontario, Wayne, Cayuga, Yates, Seneca, Schuyler, Chemung, Tompkins, + Cortland and Tioga. New plan turns private practices into formal classrooms in WNY the memory of the associate professor of medicine at New York University School of Medicine who served as a member of MF's board from 195 2 until his death in 1979. + The Graef Memorial Scholarship was established by the ational Medical Fellowships (NMF) board of directors and endowed through a gift from the Irving Graef Medical Fund. The award honors our doctors' offices, an inner-city health clinic and an HMO in Western ew York are becoming the nation's first private medical practices to function as formal training sites for medical students and resident physicians studying to become primary care physicians. The program is called the Community Action Practice (CAP) project, a cooperativeventure of the Graduate Medical Dental Education Consortium ofBuffalo. CAP is part of a $5 million primary care initiative unveiled by the Consortium last fall , designed to increase the number of resident physicians training in primary care from 35 to 50 percent by 1994. The new program will allow aspiring doctors to study primary care medicine where it is practiced- in doctors' private offices and walk-in clinics rather than in hospitals, the traditional training ground for all fields of medicine. Computer software and hardware will also be provided on-site as part of the new program. + UB medical student wins Irving Graef Memorial National Medical Fellowships scholar award ndrea Williams, a University at Buffalo medical student, has been chosen as the 1992-93 Irving Graef Memorial Scholar. As the Graef Scholar, Williams will receive $2,000 during her senior year. B u a 0 p h Andrea Williams 5 a n 5 I m m e 9 �. . . . . • ••••••••••••••••• •••••••••• . . . . .... . . . . . . . . . . . . . . . .. . . . UB'sOffice of Graduate Medical Education is key to excellence in Consortium residency training oseanne Berger, M.D., UB's new associate dean for graduate medical education has her capable hands full. Her office - the Office of Graduate Medical Education and House Staff Affairs - is charged with overseeing not only the education of over 700 resident physicians, but the many functions associated with coordinating their education through the school's Graduate Medical Dental Education Consortium of Buffalo (GMDECB). Founded 10 years ago in an effort to respond to new guidelines issued by the Liaison Committee on Graduate Medical Education, the GMDECB consists of the School of Dental Medicine, the School of Medicine and Biomedical Sciences and its nine affiliated teaching hospitals, all residency training program directors and one resident from each program. Before her office was established last October, Berger says "graduate medical education was spread among the hospitals, with some residents sent to multiple hospitals without any coordination between them. One resident may have gotten a salary from one hospital and rotated to three hospitals and his or her colleague might have received a different salary from another hospital and essentially do the same thing. And benefits were a problem, too." In addition, Berger adds, the accrediting body for graduate medical education "required an institution of record to hold responsible for ensuring the quality of the programs. In Buffalo, we had eight hospitals - and who was responsible for the quality? "That function is now focused out of this office." B a 0 p Roseanne Berger, M.D. The office also serves as a clearinghouse for Consortium residency program directors to learn about accreditation information and other issues affectinggraduate medical education. "For example," Berger explains, "the impact health care reform being anticipated from Washington will have on graduate medical education- that type of effort comes out of this office." Issues common to all residency programs are coordinated through the medical school's graduate medical education department. "Because there are multiple residency programs, there are certain issues common to all programs that are managed more efficiently if coordinated through one office," Berger says, and cites the Consortium's one-week residency program orientation as an example. 'The residents learn about communication skills, teaching skills, issues in medicine such as advanced directives, documentation, medical records, and also receive training in life support and advanced life support- all issues common y s c a n s .................................... to all programs and important for the new house staff to know. " As the medical school's chief liaison to the Consortium, Berger's office is poised to take an even broader role, given the current climate of health care reform that is likely to touch not only practicing physicians, but both graduate and undergraduate medical education as well. That climate, Berger notes, will probably result in striking changes in the way physicians- particularly resident physicians- are trained in this country. And UB and its Consortium- having committed to achieving 50 percent of its residency positions in primary care "are on the forefront of change because we are a Consortium and in the future graduate medical education will look toward developing more. We are the oldest and we are looked at as a model for the nation, having worked collaboratively with the hospitals. " The 50 percent primary care residency goal is only one objective of a three-year ew York State Department of Health demonstration project Berger's office also has responsibility for. That demonstration project is aimed at easing the nation's current and projected shortage of primary care physicians. "We've made a commitment to make changes in graduate medical education in exchange for more favorable reimbursement rates. This is a key reason why this office was established," Berger said. "We have to demonstrate we're making the changes we've committed to making. And these are exactly the kind of changes the government and health care planners feel need to be made in this country in terms of health care delivery and medical education. "We have a leg up on things because we've already committed to making these kinds of changes." + - BY m NANETTE m e TRAMONT KOLLIG 9 9 3 �. .... . ... . ....................... ... ...... .... ........ ... ...................... . ............... II lell Listing of Consortium residency programs demonstrates expanded specialty scope as well as focus on primary care he Graduate Medical Dental Education Consortium of Buffalo is responsible for the education of over 700 resident physicians. Following is a listing of the programs the Consortium runs, including the affiliated hospitals, program directors and number of positions in each program. ALLERGY AND IMMUNOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Program Director Dr. Mark Ballow umber of Positions - 4 ANESTHESIOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Richard Ament Number of Positions - 52 VA Medical Center Program Director Dr. Clara Bloomfield E DOCRINOLOGY AND METABOLISM Hospital Erie County Medical Center Program Director Dr. Stephen Spaulding EPHROLOGY Hospital Erie County Medical Center Program Director Dr. Rocco Venuto GASTROENTEROLOGY Hospital Erie County Medical Center Program Director Dr. Milton M. Weiser INTERNAL MEDICINE PROGRAM A Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center VA Medical Center Program Director Dr. Robert Scheig Number of Positions- 156 (iJicludi,gfellowships ) Programs CARDIOVASCUlAR DISEASE Hospital Erie County Medical Center Program Director Dr. Avery K. Ellis PULMONARY DISEASES Hospital Erie County Medical Center Program Director Dr. Alan R. Saltzman HEMATOLOGY-MEDICI E Hospital Erie County Medical Center Program Director Dr. Gerald Logue RHEUMATOLOGY Hospital Erie County Medical Center Program Director Dr. Floyd A. Green INFECTIOUS DISEASES Hospital Erie County Medical Center Program Director Dr. Timothy Murphy INTERNAL MEDICINEPROGRAM B MEDICAL ONCOLOGY Hospitals Buffalo General Hospital Roswell Park Cancer Institute Hospital Millard Fillmore Hospitals Program Director Dr. joseph lzzo umber of Positions- 3 7 DERMATOLOGY Hospitals Buffalo General Hospital The Children's Hospi tal of Buffalo Erie County Medical Center Roswell Park Cancer Institute VA Medical Center Program Director Dr. Stephanie Pincus umber of Positions- 10 FAMILY PRACTICE Hospitals Buffalo General Hospital Cuba Memorial Hospital Erie County Medical Center Millard Fillmore Hospitals Olean General Hospital Program Director Dr. Daniel Morelli umber of Positions - 52 B a a p h y s c a n 5 m m e 9 9 �• ••••••••••• I VA Medical Center Program Director Dr. George Simpson Number of Positions - PSYCHIATRY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center VA Medical Center Program Director Dr. Seung-Kyoon Park Number of Positions - 26 12 PATHOLOGYANATOMICAL CLINICAL Hospitals Buffalo General Hospital Erie County Medical Center Roswell Park Cancer lnslllute VA Medical Center Program Director Dr. Reid Heffner umber of Positions - 19 CHILD PSYCHIATRY PEDIATRICS NEUROLOGICAL SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Program Director Dr. L. Nick Hopkm Number of Positions - 7 NEUROLOGY Hospitals The Children's Hospnal of Buffalo Buffalo General Hospnal Erie County Medical Center Millard Fillmore Hospnals VA Medical Center Program Director Dr. Michael Cohen Number of Positions- 16 CHILD NEUROLOGY Hospitals The Children's Ho pnal of Buffalo Erie County Medical Center VA Medical Center Program Director Dr. Michael Cohen NUCLEAR MEDICINE Hospitals Buffalo General Hospnal Mercy Hospital Roswell Park Cancer lnslllute VA Medical Center Program Director Dr. joseph Prez10 umber of Positions - 6 Program Director Dr. Myroslaw Hreshchyshyn umber of Positions - 40 OPHTHALMOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center VA Medical Center Program Director Dr. William Coles umber of Positions - 12 ORTHOPAEDIC SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital VA Medical Center Program Director Dr. Lawrence Bone umber of Positions - 16 Programs HA D SURGERY Hospitals Millard Fillmore Hospitals Erie County Medical Center Program Director Dr. Clayton Peimer umber of Po it ions 3 PEDIATRIC ORTHOPAEDICS Hospital The Children's Hospital of Buffalo Program Director Dr. Robert Gillespie umber of Positions- 1 GYNECOLOGY AND OBSTETRICS Hospitals Buffalo General Hospnal The Children's Hospnal of Buffalo Erie County Medical Center Millard Fillmore Hospitals Roswell Park Cancer Institute 6 u a OTOLARYNGOLOGY Hospitals The Children's Hospital of Buffalo Ene County Medical Center SISters of Charity Hospital 0 p h y 5 Hospitals The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Roswell Park Cancer lnslllute Program Director Dr. Gerald Daigler Number of Positions - 71 (includi ngfellowships) Programs EO ATAUPERJ ATAL MEDICI E Hospital The Children's Hospital ofBuffalo Program Director Dr. Frederick Morin PEDIATRIC EPHROLOGY Hospital The Children's Hospital ofBuffalo Program Director Dr. Leonard Feld PEDIATRIC HEMATOLOGYONCOLOGY Hospitals The Children's Hospital ofBuffalo Roswell Park Cancer Institute Program Director Dr. Martin Brecher PEDIATRIC ENDOCRINOLOGY Hospital The Children's Hospital ofBuffalo Program Director Dr. Margaret MacGillivray PHYSICAL MEDICINE AND REHABILITATION Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital Sisters of Charity Hospital VA Medical Center Program Director Dr. Kyu Ha Lee Number of Positions - 13 a n 5 u m Hospitals The Children's Hospital of Buffalo Western New York Children's Psychiatric Center Program Director Dr. David Kaye umber of Positions - 6 RADIOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Millard Fillmore Hospitals VA Medical Center Program Director Dr. Angelo De!Balso umber of Positions- 18 Programs PEDIATRIC RADIOLOGY Hospital The Children's Hospital of Buffalo Program Director Dr. jerald Kuhn SOCIAL AND PREVENTIVE MEDICINE Hospitals Buffalo General Hospital Program Director Dr. Michael oe Number of Positions - 7 SURGERY Hospitals Buffalo General Hospital Erie County Medical Center Millard Fillmore Hospitals VA Medical Center Program Director Dr. Eddie Hoover Number of Positions - 72 Programs COLO AND RECTAL SURGERY Hospital Buffalo General Hospital Program Director Dr. Bertram Portin umber of Positions - 1 PEDIATRIC SURGERY Hospital The Children's Hospital of Buffalo m e 9 9 �··············· ····························•··· Bl I Program Director Dr. james Allen Number of Positions - 2 Erie Count)' Medical Center VA Medical Center Program Director Dr. joseph Margarone Number of Positions - 8 VASCUlAR SURGERY Hospitals Buffalo General Hospital Millard Fillmore Hospitals VA Medical Center Number of Positions - 2 PEDODO TICS Hospital The Children's Hospital of Buffalo Program Director Dr. joseph Bernat umber of Positions- 4 THORACIC SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Eddie Hoover umber of Positions - 4 UROLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Gerald Sufrin umber of Positions - 9 AFFILIATED PROGRAMS MERCY HOSPITAL Program Internal Medicine Program Director Dr. Thomas Raab umber of Positions - 23 NIAGARA FALLS MEMORIAL HOSPITAL Program Family Practice Program Director Dr. M. Oyster umber of Positions - 12 Program Gynecology and Obstetrics Program Director Dr. Michael Ray umber of Positions- 8 SISTERS OF CHARITY HOSPITAL Program Internal Medicine Program Director Dr. elson Torre Number of Positions- 20 DENTAL PROGRAMS GENERALPRACTICE DE TISTRY Hospital Buffalo General Hospital Program Director Dr. Alan Drinnan umber of Positions - 6 GENERALPRACTICE DE TISTRY Hospital Erie County Medical Center Program Director Dr. Stuart Fischman umber of Positions - 6 GENERALPRACTICEDE TISTRY Hospital VA Medical Center Program Director Dr. Gene lnneo Number of Positions- 5 GE ERALPRACTICEDENTISTRY Hospital Millard Fillmore Hospital Program Director Dr. Sanford usbaum umber of Positions - 3 ORAL AND MAXILLOFACIAL SURGERY Hospitals Buffalo General Hospital B 0 0 • p h y 5 c 0 s m m e 9 9 I �"The Name of the Game" in health care reform today is reasonable change JAMES TODD , M .D. , GIVES STOCKTON KIMBALL LECTURE s he spoke in sports analogies and anecdotes,] ames Todd, M.D.'s message was clear: any change in the American health care system will have to be "slow and reasonable. " Executive vice president of the American Medical Association, Todd delivered the Stockton Kimball Memorial Lecture- "The arne of the Game" - at this year's Spring Clinical Day, held May 1. Margaret Paroski, M.D. , '80, assistant professor of neurology and Spring Clinical Day chairperson, introduced Todd to an audience of about 300. "If you read Time or Newsweek , I don't need to introduce you to Dr. Todd, because every time you hear anything about Hillary Clinton dealing with theAMA,you'llsee Dr. Todd's name." Todd explained how he sees health care as a game, with "rules, regulations, goals, winners and losers. Meanwhile, we and our patients are out on the playing court, fighting our way to a goal that sometimes seems only we continue to see. But unlike any other endeavor, there are also some rules, in this case called antitrust, that prevent doctors from working out their own team game plan. " Todd called UB "a grand example of how you can coordinate the education of students, the needs of the community and become a very cooperative activity to teach and advance the art and science of medicine." He lauded Stockton Kimball by saying, "Dr. Kimball was noted for many different achievements: for his knowledge of tropical disease, for his dedication to improving the physical facilities of your campus, for his concern for the people and commuB u 0 0 p nity of ew York State. "His involvement, his brand of humanitarianism, his genuine caring, personify the characteristics, the kind of personal concern which draws us all when we think about going to medical school." Todd said he saw a connection between Kimball's work and the theme of this year's Spring Clinical Day lecture, noting that in 1950 Kimball chaired a special AMA committee to study medical training in times of war and crisis called the joint Committee on Medical Educa- y s c 0 s tion at the Time of National Emergency. "How appropriate that is. And how very germane that is to my being with you this afternoon. Because if there was ever a time of national emergency in health care, we're facing it today. " The crisis is so compelling, Todd said, that "Mrs. Clinton has assembled a committee of 500 to find a solution. I'm not telling you it's a professional emergency -although it is that- nor is it a patient emergency- but it is that, too. The state of health care in this country is a national emergency-one that touches every single citizen of the United States," Todd said. "It touches the 87 percent for whom the current system has essentially been working pretty well. And it especially touches the 3 7 million people who are denied access to the system because of insurance regulations, loss of jobs or a dozen other quirks and loopholes. "These have rendered the basics of health care out of reach for too many for too long. And it is not a secret to anyone anymore that the present system is unsustainable. " either patients nor doctors can stand too much more of our present system. " Todd explained how he thought that the "future in the medical sciences will be limited only by our imaginations. Indeed, if the Clinton administration does the job that all of America hopes they'll do, I think we will have a lot to look forward to as far as returning to the goals that motivated us as physicians. " Todd warned of the dangers of mixing politics and medicine. "If Clinton and Clinton get stuck in the thicket m m e 9 �of political and practical miscalculations, we will all suffer-especially our patients. "The stakes are even higher than our own professional standing. And the name of the game I am talking about is patient care. Rules are being written even as we speak," Todd said. "Well, I'm no slam-dunker myself, but I do know this: there's not a coach in the world who doesn't try to improve on player performance." Todd noted that various strategies for rescuing the American health care system have already been proposed, adding that the AMA was one of the first organizations to put forth a plan. "We put a plan on the table known as Health Access America. It is the American way to reform the health care system. It seeks to bring to patients an essential set of benefits, universal access, cost containment, equity - while at the same time working to bring doctors relief from regulations." Todd believes the key to reforming the health care system is "not just change, but reasonable change. "Responsible change is the winning strategy. Today, patients are sent into a system so wrapped up in red tape they can hardly maneuver. Doctors half the time are playing with one hand tied behind our backs. We are coming under scrutiny that seeks to punish and not to educate, sending us racing full-tilt into the shelter of defensive medicine, so we don't get sued or worse," Todd said. ''I'm sure all of you would welcome a world in which you could follow your best clinical judgment and return the profession to the ability to discipline itself." But change will not occur, Todd said, unless "we show restraint in our behavior in what's going on around us. We have to focus on responsibility to our nation. We cannot afford to think of medicine as a spectator sport. We have to have active participation." + BY B u CARRIE a Calls for membership in the James Platt White Society went out from medical ~chool ~lumni during a special membership drive held last April. From left are: Albert G. Rowe, M.D., 61; R1chard R. Romanowski, M.D., '58; Michael A. Sansone, M.D., '85; Angelo M. DeiBalso, M.D., '78; Lawr~nce E. Mervine, assistant dean and senior development officer with the University at Buffalo Foundation; Arthur W. Mruczek, Sr., M.D., '73, and Elizabeth P. Olmsted, M.D., '39. Frawley '44 receives prestigious Alfred Stengel Memorial award homas F. Frawley, M.D., '44, has been awarded the 1993 Alfred Stengel Memorial Award. The American College of Physicians award, established in 1947, is given to a Master of the College who has exhibited "unusual loyalty and exceptional contributions to the aims and purposes of the College as well as outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research." Frawley, the 1989 recipient of UB's Distinguished Medical Alumnus Award, is a professor emeritus and chairman of the Department of Graduate Medical Education of St.john's Mercy Medical Center, St. Louis, Missouri. A governor of the American College of Physicians, he served as that group's president from 1981 to 1982. Frawley , who has been active on research and evaluation committees of the ationallnstitutes ofHealth, the ational Academy of Sciences and the American Medical Association, received his award in March at the American College of Physicians' Convocation held in + Washington, D.C. LIBERANTE 0 p h y 5 c a 5 m m e 9 9 3 �hkhert Kenneth Eckhert M.D~ Sr~ lauded by Niagara Lutheran Home he iagara Lutheran Home Foundation presented Dr. Kenneth Eckert, M.D., '35, with its 1993 Humanitarian Award at a special dinner in his honor last April. Eckhert, a lifelong Buffalo resident, played a key role in the establishment of the Health Service Agency- the first of its kind in Buffalo and the first to receive federal funding. Eckhen served as president of that agency, which was a forerunner of today's Health Systems Agency. Eckhert and his long-time friend, the Reverend Dr. Ralph Loew, were instrumental in the establishment of Trinity Tower, a senior citizen residence developed in conjunction with Holy Trinity Lutheran Church. Eckhert is a member of the board of trustees of the Niagara Lutheran Home Foundation and currently serves on a number of boards and medically related associations. He served as chiefof surgery, chief of staff and president of the executive committee of the fomer Deaconess Hospital. + B u 0 0 p American Academy of Family Physicians honors UB physician Harrts Directory begins survey of UB medical school alumni arlos Roberto jaen, M.D., '89, UB assistant professor of family medicine, was one of eight physicians honored recently by the American Academy of Family Physicians for their contributions to medicine and public health. Jaen received the Academy's McNeil Clinical Research Award for his work, "Symptoms Associated with Middle Ear Effusion in Children: A Basis for Quantifying Clinical]udgment." jaen came to the University at Buffalo in October 1992 after completing a fellowship and residency in family practice at University Hospitals of Cleveland, affiliated with Case Western Reserve University. He holds a doctorate in epidemiology and a medical degree from the UB School of Medicineand Biomedical Sciences. He completed his undergraduate and master's degree work at iagara University. jaen's research on tobacco dependence and bladder and colorectal cancer has been published in various scientific journals. + Carlos Roberto Jaen, M.D. s preparation for publishing an extensive medical school alumni directory, the Harris Company will begin sending questionnaires to all alumni with current addresses. Please be sure to complete and return your directory questionnaire as soon as possible to help make the School of Medicine and Biomedical Sciences' new directory as complete as possible. Alumni who fail to return their questionnaires may be inadvertently omitted from the directory. + y 5 c o n s m m e 9 9 3 �A Spoonful of Humor © Stu Silverstein, M.D. Health Care Reform It's No Joke • • • Stu Sil\'erswn, M.D., prrs1drnl of Slandup Med1c1ne Unless You Make It One Srm1nars of San Franmco, Califorma, lee lures nal!onw1de on humor in medicine In the previous issue of Buffalo Physician we talked about the technique of revamping old jokes with medical themes for appropriate use when addressing medical audiences. Here are a few jokes and anecdotes about an issue that seems to be appearing everywhere- in the news, on these pages, in our nation~ capital, and maybe even in our practices-the managed care movement in health care reform. • Recently, I was sitting in the doctors' lounge, reading the AMA ews and Buffalo Physician. I spotted a friend reading a government report on health care reform. I asked him why he was wasting his time reading that crap. He looked at the AMA News I was reading and said, "What are you reading about in there? How medicine is changing for the worse- managed care is placing unrealistic restrictions on us, our incomes will be going down, we won't be able to practice the way we used to. "You read that and get all depressed. I read this and find out we're all millionaires, play golf on Wednesdays and will continue to get rich despite health care reform." • I'm not sure ifl feel so good about two lawyers revamping the health care system in this country. Do you get the feeling that after four years in office we're going to get a bill for 35,000 hours for Hillary's services? B a a p h ''Asking the government for advice on how to run health care is like asking Sylvester Stallone for acting lessons.'' • Asking the governmentforadviceonhow to run health care is like asking Sylvester Stallone for acting lessons. • Hillary Clinton reminds me of someone who takes your watch off to tell you what time it is. • I told my son that I wanted him to be a partner in my practice, but it seems the government will beat him to it. • When I played hockey in high school, I spent most of the time sitting on the bench. In the last game of the season, we were down by one goal with one minute to go and no time outs left. The coach called my name to send me in. I turned around to get my instructions and he said, "We're out of time outs and can't stop the clock. Go in there and get hurt. " As a doctor facing health care reform, I feel as if I'm reliving that experience. + 5 c a n 5 u m m e 9 9 �• . ........... ... ... ..... . .................... ... .. . . .. . .. . ......... . ......... . ......... medical practice, and clinical re- governor to the American College search ." Frawley served as presi- of Surgeons for North Carolina. dent of the College from 1981to EUGENE A . PAUL '77 , writes, 1982. "My time is divided between a 1 9 6 0 full-time position as chief of the 5 medical clinic at Harlem Hospital ROBERTA GILBERT '62 , in- and a private general internal forms us that the first printing of medicine practice in Jamaica, ew her new book, Extraordinary Re- York. " lationships: A ew Way of Thinking About Human Interaction, sold out; the publisher is already be- ORESETES G . ROSABAL '77 , Southern Medical Association's ginning the second printing. Bernard S. Stell 1 9 3 State Councilor for Florida, reScientific Assembly of the Asso- laboratory dire ctor at Coastal 0 5 BERNARD 5 . STELL '36, of cently attended the 86th Annual Mi(hael Rowland CALVIN MARANTZ '65 , is now ROBERT B . KROOPNICK '72 , Communities Hospital in Santa Ana, California. Sun City, Arizona, has received was elected to fellowship in the Rosabal, a specialist in orthopaedic American College of Physicians. and traumatic surgery, is in private practice in Hialeah, Florida. the Diamond Star Award in the DONALD J . WALDOWSKI '65 , Kroopnick is board certified in Stereo Division of The Photo- has a solo private pediatric prac- internal medicine with additional graphic Society of America. tice at850 West High Street, Lima, qualifications in geriatric medi- Ohio. cine. pediatrics in Troy, ew York. " 1 9 4 0 5 THOMAS F . FRAWLEY '44 , DOUGLAS H . MOFFAT '79 , recently assumed the position of chief of medicine at Buffalo Psy- WALTER Z. SCHWEBEL '83 , writes, "I am still in the practice of ciation held in San Antonio, Texas. ANTHONY B . SERFUSTINI '66 , RETA D. FLOYD'73,announces chiatric Center. is chairman of the department of the opening of a new office at 924 orthopaedic surgery at the Uni- Buena Vista, Suite 204, Duarte, versity Medical Center in Las Ve- California 91010. Outside of work, EDWARD ROCKWOOD '80 , gas, evada. Floyd is active in her church where practices ophthalmology at Cleve- she is a Sunday school teacher. land Clinic Foundation. He and 1 9 8 0 5 chairman of graduate medical JOHN E . SPOOR '66 , writes, "I She also is active in the Pasadena! education at St. John's Mercy his wife Joan (former Millard have been named the editor of the Altadena chapter of Links - Medical Center and emeritus pro- Fillmore Medical Education sec- Section on Rural Emergency Medi- women's civic organization. Floyd fessor of medicine at St. Louis cine Newsletter- ACEP." lives in Altadena with her hus- University School of Medicine, was the 1993 recipient of the Alfred Stengel Memorial Award presented by the American College of Physicians. The award is given periodically to a Master of the College who has exhibited "unusual loyalty and exceptional con- a DANIEL P . SCHAEFER '81 , a band and two children. 1 9 7 0 retary) have three daughters. UB clinical assistant professor, 5 ELLIOTT SCHULMAN '74, has RONALD H . BLUM '70 , has been appointed deputy director of the Kaplan Comprehensive Cancer Center at New York University Medical Center. been elected a fellow of the Ameri- attended the American Society of Ophthalmic and Plastic Recon- can College of Physicians. In ad- structive Surgery meeting in Dal- dition to lecturing extensively on las, Texas. A member of the Edu- headaches, he is co-director of the cation Committee, he assisted in Comprehensive Headache Cen- giving written and oral examina- tributions to the aims and pur- BRUCE M . PRENNER '70 , was ter at the Germantown Hospital tions to the candidates for mem- poses of the College as well as in Philadelphia, Pennsylvania. bership in the society. outstanding influences in main- invited to present clinical research on asthma before the European taining and advancing the best standards of medical education, Respiratory Society in Vienna , Austria, in August. MICHAEL ROWLAND '75 , of Pinehurst, orth Carolina, was elected to a three-year term as B 0 0 p h 5 c 0 n s u m m e �····· · ················· ··· ··························· ·· ················· · ·················• II • DEIRDRE GREENE '86 , Elliott Schulman writes, JEFFREY WASSERMAN '82 , writes, "Vickie and I now reside in doing pediatrics. My husband, Rob Dixon, and I now have two kids - Patrick,3, andAurora, 16 Rochester, ew York, with our two sons, Robb, age 6, and Steven, age 4. After my residency in anes- months." thesiology, I spent one year as an MICHAEL S . academic anesthesiologist at the University of Rochester's Strong MILLER '86 , writes, "I am an assistant profes- Memorial Hospital. I am now in sor of psychiatry and a full-time faculty member of the University private practice at Rochester General Hospital." of Texas Health Science Center at San Antonio. My wife, Pamela, MARGARET and I have two beautiful children writes, "I completed my pediatric - Laura L. Post Matthew, age 3, and Jeffrey, D . JENKINS a senior fellow in the Robert TINA GARDNER '87 , ROSLYN '86 , R. ROMANOWSKI sion of hematology/oncology and Washington, will receive her MPH in Epidemiology in June 1993. Harvard Medical School instructor, received a five-year Clinical SARAH MURRAY WHITE '85 , Investigator Development Award (CIDA) totaling $385,000 from the National Heart, Lung and writes, "I have recently joined an Washington, D.C., where I practice rehabilitation medicine and perform electrodiagnosis. We are at the Washington Hospital Center. My husband, Bill, son Cameron, two and one-half years old and I live in Annapolis, Maryland. I recently spoke with Gretchen Pankow '87, who will be doing an endocrine fellowship at Massachusetts General (unless she changes her mind)." KARIN E . CHOYS '86 , writes, ''I'm a practicing pediatrician with the Kaiser Permanente HMO in the Hartford, Connecticut area. I am also happily divorced and enjoying 'flying solo!"' address is St. Regis Mohawk Tribe Health Services, do Community Building, Hogansburg, ew York. LAURA L. POST '87 , SHAUGHNESSY '86 , writes, "I have moved back to Boston with my partner, Rick, and combine private practice, mental health center work and a teaching appointment at Harvard Medical School and McLean Hospital." RAY 800RADY '87, has been medical director of Operation Concern, a lesbian/gay community mental health and services agency in San Francisco. She is active in research on lesbian mental health in addition to having a prolific writing career in women's music and culture. Post and her partner, Judith Avery, R.N.C. , have two sons and one grandchild, Karen, who is 18 months Blood Institute to investigate the erythropoietin receptor - how red blood cells are produced. JAM E S writes, "I have moved to northern ew York and am working for the Mohawks. It's beautiful up here! " Her new a staff physician in the divi- Wood Johnson Clinical Scholars Program at the University of orthopaedic surgery group in old. currently chief of the psychiatry clinic at Massachusetts General Hospital, completed four years in youth psychiatry and will finish a two-year STEPH E N C . SORENSON '87 , informs us that he completed an emergency medicine residency in Louisville, Kentucky, and is pres- fellowship in psychiatry in June. He has accepted a two-year staff position at Harvard. Boorady re- ently in private practice. He marriedJudith Bellville on September 19, 1992, in Louisville. cently attended an international A . MOREY '88, residency at Rainbow Babies and Children's Hospital, Cleveland. After a much-needed hiking trip in New Zealand, I'm beginning a fellowship in adolescent and young adult medicine at the Children's Hospital in Boston." is now director of clinical and regulatory organogenesis in CamM ICHAE L SABOLI NSK I '88 , bridge, Massachusetts. PAUL SHIELDS '88, u a 0 p h y 5 c has a pri- vate practice in internal medicine in Naples, Florida. In October he joined the aples Medical Center, specializing in internal medicine. CHARLES S . P . J E N KI NS '89 , of Chapel Hill, North Carolina, informs us, "Got married. Doing well. Will be hearing the pitterpatteroflittle feet soon. Seeya'll." KENN ETH P . SUN '89 , is cur- rently an anesthesiology resident at St. Luke's Roosevelt Hospital Center, ew York. TRAC I TROUP '89 , has joined the department of family practice convention in Paris. e '87 , "Still in Allentown, Pennsylvania, age 17 months." LAURACINNIE I a 5 m m e 9 9 �• .. . . . . . ................................................................................... I at Group Health , Inc.'s St. Paul Medical &: Dental Center, in St. Paul , Minnesota. 1 9 9 0 ELI Z ABETH CONROY 5 '92 , and her husband jeff, announce the birth of their son, Dylan Reid, on january 8, 1993. She is currently in a dermatology residency at the Cleveland Clinic Foundation . OBITUARIES RUTHERFORD FORD 5 . RUTHER · '41 , died in Dillon Beach, California, ovember 27, 1992, after a long illness. Rutherford was chief of staff and founder of Marin General Hospital in 1955; founder of Marin Organ Bank and Marin County Heart Association. He was the author of over 100 scientific and medical papers. L L OYD M. LEHRER '79 , died February 22, 1993, due to the effects of Behcet's Syndrome. In Beginning with our Autumn 1993 issue, our readers will hove the opportunity to learn more about products and services of interest to them. We ore happy to provide advertisers the opportunity to shore their product information with our unique readership who number more than 10,000. For additional information, please contact our Advertising Manager. addition to his private practice in Houston , he served as an assistant clinical instructor of medicine at Baylor College of Medicine , chair- • man of the department of medicine at Bellaire General Hospital and chairman for public education for the American Cancer So- University ot Buffalo Publications Deportment ciety, where he was honored for his work by the State of Texas. He 136 Crofts Hall is survived by his wife, Susan, and his sons, Benjamin and Michael , Buffalo, New York 14260 of whom he was so proud. Phone: (716) 645-2626 FAX: (716) 645-2313 B a a p h s a n s m m e 9 9 3 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1993 Subject The topic of the resource State University of New York at Buffalo. 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Research Hospital News "He captured my heart in a way that patients aren't supposed to." Managed Care Medical School Graduate Education Alumni A Spoonful of Humor Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v27n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/4268a956ed09e8732e83b20afff9bf8c.pdf f8f9e2c3529adfe0820340d25c3b8491 PDF Text Text Biomedical Sciences, Autumn 1993 �BUFFALO PHYSICIAN Volume 27, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy J Conroy EDITOR anette Tramont Kollig, R.N. ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIRECTOR Scoll Fncker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr John A. Richert, Chairman Dr Martin Brecher Dr. Harold Brody Dr Richard L. Collins Dr. AlanJ. Drinnan Dr. Timothy Gabryel Dr. James Kanski Dr. Charles Massaro Dr Charles Paganelli Dr Robert E. Retsman Dr Thomas Rosenthal Dr Stephen Spauldmg Dr Bradley T Truax Dear Friends, T wo major milestones are reported in this issue of Buffalo Physician. The first relates to the dedication of the Center for Positron Emission Tomography that occurred m mid-May. That dedication served to culminate several years of effort between the Department of Veterans Affairs and UB with the installation of the area's first PET camera. The Buffalo VAMC and the Cummings Foundation were included in the activities. The latter provided a $1 million grant that served to ensure the success of the project. Dr. Joseph Prezio provided exemplary leadership for this project and organized an outstanding scientific symposium. The second event was the celebration of the lOth anniversary of the Graduate Medical Dental Education Consortium of Buffalo (GMDECB). The organization has become the institution for governance of graduate medical education in Western ew York and it is membered by ll participating institutions- the medical and dental schools and nine affiliated teaching hospitals. The GMDECB has been instrumental in providing stronger training programs and in developing new direction and new emphasis for graduate medical education. The organization has committed to achieve a 50 percent distribution of trainees to the primary care specialties of family medicine, internal medicine and pediatrics over the next few years. It has also become a model that might serve to provide some guidance to national health care leaders as new initiatives in health care reform develop. Dr. Michael oe, executive vice president and medical director at The Buffalo General Hospital and program director of the preventive medicine training program, in particular, has provided extraordinary leadership to the GMDECB effort. Sincerely, John aughton, M.D. Vice President for Clinical Affairs TEACHING HOSPITALS AND LIAISONS Batavia VA Medical Center Arlene Kelly The Buffalo General Hospaal Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Fran I• Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy ~ The State University of ew York at Buffalo Buffalo Physician IS published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It 1ssent, free of charge, to alumm, faculty, students, residents and friends. The staff reserves the nght to edit all copy and submissions accepted for publication. Address questions, comments and submissions to : Editor, Buffalo Physician, State University of ewYork at Buffalo, Umversity Pubhcauons, 136 Crofts Hall, Buffalo, New York 14260 Send address changes to: Buffalo Physician, 146 CFS Addition, 3435 Mam Street, Buffalo, New York 14214 Dear Fellow Alumni, T he beginning of anew academic year brings another cycle of activities for the Medical Alumm AssocJatwn, with the goal of enriching the experiences of medical students, house officers and alumni. We have greeted the incoming house staff and will shortly sponsor another one-day session on "Prep for Practice," a practical practice management introduction (recognizing the current uncertainties of future practice). We have welcomed the entering freshman medical class and during the academic year will continue our support for a variety of student projects. In particular, the Alumm Association will continue to organize three sessions, with presentations by community physicians devoted to differing types of medical practice. In September, the annual award honoring an outstanding alumnus was presented to Dr. William Balistreri, Class of 1970. Dr. Balistreri is professor of pediatrics and medicine at the University of Cincinnati College of Medicine and is an internationally recognized pediatric hepatologist. We are especially pleased that Dr. Balistreri participated in the teaching program at Children's Hospital; his participation provided a wonderful opportunity for our medical students, house officers and faculty to benefit from his presence. Alumni receptions have been planned in neighboring Rochester and at several national medical meetings. Local alumni again will be guests at our annual reception. Your support for these most worthwhile activities is needed and appreciated. .,,,,,.,,d,, ~ (aver: The photograph of Dr. Joseph Prez10 was created by Collignot0arosz LTD. Robert E. Reisman, M.D. '5 6 �V 0 u A 2 L T u N 7 M N o 9 4 9 3 H OCT 1993 IJ Research IJ Hospital News IJ The Center for Positron Emission Tomography e "Then and Now" heralds the Sesquicentennial. Page 29. Dedicated to patient care, research and education. m 10 Years of Cooperation over Competition e The Graduate Medical Dental Education Consortium of Buffalo celebrates a decade of progress. m m m m m Alumni Graduate Education Medical School Classnotes ASpoonful of Humor 11 Shake and Bake." Page 3. * [~il~ren' s ~ospital ~egins ~W uaccine trials. ~agel. 11 ln Sickness and in Health." Page 28. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ' .... ' Study subjects must have well-documented HIV infection but no symptoms of HIV disease other than swollen lymph glands or a mildly swollen liver or spleen. Subjects also cannot have received any anti-retroviral or immune-regulating drugs within one month before their entry into the study. The Centers for Disease Control and Prevention estimates 10,000 children in the U .5. are infected with HIV. By the end of the decade, the World Health Organization projects 10 million children will be infected worldwide. For more information about trial sites or eligibility for enrollment, call the AID Clinical Trials Information Service at 1800-TRIALSA, or call the PACT program + at Children's Hospital at 878-7908. Children'sHospital selected for experimental HIV vaccine trials he Parents and Children's Together (PACT) program at The Children's Hospital of Buffalo is one of 12 sites nationwide coordinating the ationallnstitutes' of Health first trial of experimental HlV vaccines for children. "This trial is the first step in developing a vaccine thatmaypreventordelaydisease progression in children with HIV," notes Cynthia zelc Kelly, M.D., director of the pediatric AIDS program at Children's. The study, which will compare the safety of three experimental vaccines in 90 children, will enroll children between the ages of one month and 12 years. At least half of the children in the nationwide trial will be two years of age or younger to enable a comparison of the immune responses of the younger and older participants. Tying cholesterol testing to being overweight may miss many at risk Children's Hospital will help (Oordinate HIV va((ine trials. B u 0 0 p electing patients for cholesterol testing merely because they are overweight is a poor practice and may cause primary care physicians to miss many high-risk people, a University at Buffalo study has found. Neither weight nor body mass index is associated with high cholesterol levels, suggesting that screening should be offered without regard to weight, the study by Barbara A. Majeroni,M.D., UBclinical assistant professor of family medicine, determined. The study was reported in The journal of Family Practice. Majeroni reviewed the charts of 604 patients selected randomly from her group practice; 196 of the patients had had their cholesterol levels determined. Results showed a trend toward less screening of people with a low y 5 c 0 A Neither weight nor body mass index is assodated with high (holesterol, the study found. body mass index and more screening of persons with a higher body mass index. But the overweight people were no more likely to have high cholesterol levels than + patients who weren't overweight. BY LOIS BAKER Nitric oxide treatment used for persistent pulmonary hypertension esearch at The Children's Hospital of Buffalo with nitric oxide ( 0) may pave the way for breakthroughs in the treatment of persistent pulmonary hypertension in newborns. " itric oxide research and therapy may be the biggest step yet in the treatment of persistent pulmonary hypertension," said Frederick Morin, M.D., UB associate professor of pediatrics and division chief of neonatology at Children's Hospital. Treatment with 0 selectively dilates the vessels to the lungs-increasing blood u m 9 3 �............... .. ......... . ........... .. ................................... ........ m m ~~ ' flow to the lungs and oxygen in the blood within minutes - to stabilize the newborn. Preliminary indications show that 0 treatment may be a much less expensive and less risky treatment than extracorporeal membrane oxygenation - a fairly new treatment form itself. itric oxide treatment is being conducted on a trial basis for persistent pulmonary hypertension at Children's Hospital and four other medical centers across + the country. New software will allow rapid solution of complex molecules cientists who design new drugs will soon have at their disposal an extremely fast software package that solves complex molecular structures on a workstation, sometimes in minutes or hours. The new software, called "Shake and Bake," was developed by researchers at the University at Buffalo and the Medical Foundation ofBuffalo, and has developed from basic research to viable product in less than one year. Led by obel Laureate Herbert Hauptman, the research team invited researchers doing rational drug design and other work involving complex molecular structures to sign up for an initial test phase of the package during the summer. General distribution is scheduled for the fall. "'Shake and Bake' will solve structures that no one's been able to solve,'' said Russ Miller, Ph.D., UB computer science professor and a member of the research team. The software is the first that can routinely solve structures of up to 300 to 400 atoms if high-quality X-ray data are available. The user-friendly, menu-driven package has taken only hours or days to solve B u a 0 p h Bake" can solve complex molecular structures in minutes or hours. very complicated structures, including structures that previously took more than a decade to solve using other methods, and others that had previously been unsolved. Two versions of the software are available: one that runs on aU IX workstation and one on a massively parallel Thinking Machines CM-5 supercomputer. + - B Y ELLEN G OLDBAUM Method for synthesizing promising new cancer treatment developed niversity at Buffalo scientists have removed a major obstacle to the synthesis of an extremely promising cancer treatment that would inhibit uncontrolled cell division. A paper that describes the new approach to synthesizing potential protein kinase inhibitors, which is orders of magnitude faster than previous ones, was published in the May issue of The journal of Biological Chemistry. s c a '' "This will allow scientists to survey a much wider range of candidate inhibitors in a much shorter amount of time, including compounds that were just not synthetically accessible before," said David Lawrence, Ph.D., UB associate professor of chemistry, who led the research team. Protein kinase inhibitors, which inhibit the formation of the enzyme kinase that signals cells to divide, are generally recognized as potentially "a very novel family of chemotherapeutic agents," Lawrence said. Synthesizing such compounds in the lab, however, has been a difficult hurdle for scientists to overcome. Because of this, the UB scientists focused on developing protein kinase substrates rather than inhibitors. Both substances bind to their target enzymes substrates temporarily and inhibitors permanently - to inactivate the enzyme. Lawrence explained that focusing on substrates enabled the team to rapidly determine the types of chemical structures the enzyme would recognize. Lawrence said that both substrates and inhibitors must contain a specific amino acid within a peptide- a string of amino acids - that is recognized by the target enzyme, to be effective. He added it was generally accepted that the key amino acid had to be contained within the string, rather than on the end because this was observed in natural proteins. "Because the critical component is often very chemically sensitive, the process of attaching other amino acids to it often triggers unwanted chemical reactions which can ruin the critical compound,'; Lawrence said. In what he described as "an act of desperation," the UB team attached the key component at the very end of the chain of amino acids. "To our amazement, we found that such compounds served as extremely efficient substrates for enzymes,'' he said. + - BY u m ELLEN GOLDBAUM 9 3 0 �[ll . . . ............. .. ......... . . . ..... . .. . .............. . ....... . ....... . .... . able, as well. The program is closely affiliated with Roswell Park Cancer Institute and The Children's Hospital of Buffalo as well as other area health care facilities that offer pediatric services. It is one of only a few pediatric z hospice programs in 3 ~ the country that main§ tains swing beds in an ~ acute care hospital. Hospice Buffalo begins its home-based, comprehensive pediatric service. For more information or patient referral, call838-4438, Ext. 219. + . Comprehensive pediatric service established by Hospice Buffalo ECMC achieves lowest trauma mortality in New York State ECMC had 3,386 trauma admissions over the past 18 months with a total mortality rate under 2 percent- the lowest mortality rate in the state for a regional trauma center. For treatment of adolescents 10 to 15 years old admitted for trauma, the hospital achieved a 0 percent mortality rate. " o one component of the trauma system, whether it be police, fire, medical care or pre-hospital community care, can exist separately," said ECMC administrator Thomas Faith. "The truly regional and comprehensive nature of theW estern ew York Trauma System is a model that everyone who is associated with it can be proud of." + Buffalo General'sLancaster Alcoholism Clinic extends hours ospice Buffalo has established "The Carousel Program for Children and Families," a comprehensive pediatrie County Medical Center's Regional he Buffalo General Hospital's ric service for children and adolesTrauma Center has the lowest reLancaster outpatient alcoholism cents with life-threatening illnesses gional mortality statistics in the state, clinic has extended its hours of opand their families. and with the exception of the region eration. The interdisciplinary home-based prothat encompasses ew York City Alcoholism Outpatient Services, gram provides coordinated, comprehenand Long Island, the most trauma 11 West Main Street, Lancaster, is sive care under the direction of the child's patients. open from 9 a.m. to 8 p.m., Monday physician, according to Eva Rubinstein, According to statistics compiled by the through Thursday, and from 9 a.m. to 5 R. . , J.D., director of pediatrics for Hosew York State Department of Health, p.m. on Friday. pice Buffalo. Caregivers work closely with Services include Robert Milch, M.D., Hospice medical di- ~ assessment to derector, other area physicians, nurses and ~ termine if an alcoallied health care professionals to meet the * hol or drug probphysical, psycho-social and emotional ~ lem exists; indineeds of children and their families. Chilvidual, group and dren are not required to give up curative family counseling; therapy or have a limited prognosis to be education and readmitted into the program. lapse intervention The Carousel Program offers homecounseling, as well based pediatric skilled nurses, medical as services for adult social workers, child life specialists, art children ofalcoholspecialists, music therapists, speech theraics. pists, occupational therapists, pastoral For more inforcaregivers, volunteers, bereavement counmation, call 681selors, dietitians and home health aides. 4957. + High-tech home care services are avail- ECMC's Trauma Center mortality rate was less than 2 percent. 0 B a a p h 5 c a u m n 9 �. . . . . . . . . . . . . ... . ... . . . . . . . . . . .... .. . . . .. . . . ... . . .. [1] I . Buffalo General opens East Side adult ambulatmy care program Amsterdam named director of laboratory medicine at ECMC aniel Amsterdam, Ph.D., professor of microbiology and associate professor of medicine, has been appointed director of the department oflaboratorymedicineat Erie County Medical Center. Previously, he was director of clinical microbiolgy and im..... munology there. Amsterdam earned his doctorate ,.,,;)!'• .. .. ·.'...:·' from ewYorkUni"'~ versity. Before joiningECMC,heheaded the human cell biology program at the euroscience Center of the Kingsbrook jewish Medical Center and was on the faculties of Long Island University and the Mount Sinai School of Medicine. Amsterdam is a member of the American Association for the Advancement of Science, the American Association of Pathologists, the American Society for Cell Biology, the American Society for Microbiology and a fellow of the American Academy of Microbiology, the American Association for the Advancement of Science and the Infectious Diseases Society of America. + Children'sHospital appoints new director of pediatric surgery ~ ,. ~ ichard Azizkhan, M.D., has been appointed surgeon-in-chief and director of the department of pediatric surgery at The Children's Hospital of Buffalo and professor of surgery and pediatrics at the School of Medicine and Biomedical Sciences. Azizkhan was formerly associate professor of surgery and chief of pediatric surgery at the University of orth Carolina at Chapel Hill School of Medicine. He earned his medical degree from the Milton S. Hershey Center of Pennsylvania State University College of Medicine and completed a residency in general surgery at the University of Virginia Medical Center. Azizkhan did his pediatric surgical training at johns Hopkins University. Board certified by the American Board of Surgery in general surgery, pediatric surgery and surgical critical care, Azizkhan is a member of the American College of B u a 0 p h ~ ~-'!fl'~ 0 y 5 ' [IJ Surgeons, the American Pediatric Surgical Association, the Association for Academic Surgery, the Society of University Surgeons, the American Association for Surgery of Trauma, the American Medical Association and the American Academy of Pediatrics. + he Buffalo General Hospital has opened an adult primary care center on Buffalo's East Side. The 1490 jefferson Health Services at 1490 jefferson Avenue will offer general medical care, health screenings, podiatry care, nutritional counseling, health education and wellness programs and social work counseling for people who require referrals to social and human service agencies. The new facility includes five examination rooms on the first l1oor of the 1490 Enterprises Community Center, where it is housed. All private insurance as well as Medicaid and Medicare are accepted. + • c a A Chairman of pathology appointed at Roswell Park Cancer Institute ohn]. Brooks, M.D., has been appointed chairman of the department of pathology at Roswell Park Cancer Institute and professor and vice chairman of the department of pathology at UB. A graduate of jefferson Medical College, Thomas jefferson University, Philadelphia, Brooks completed his residency in pathology at the Hospital of the University of _Pennsylvania School of Medicine, where he was chief resident and assistant instructor of pathology. He was associate director of the section of surgical pathology, director of the immunohistochemistry laboratory and professor of pathology and laboratory medicine at the Hospital and School of Medicine at the University ofPennsylvania, Philadelphia. In 1987, he served as a visiting professor with honorary clinical status at the Royal Marsden Hospital and Institute for Cancer Research, London and Surrey, England. Brooks also has subspecialty training in hematopathology, soft tissue pathology, immunohistochemistry, in situ hybridization and the ultrastructure, cytogenetics and growth of soft tissue tumors. The author of more than 100 original scientific papers and 50 scientific abstracts, editorials, reviews, book chapters and letters, Brooks holds editorial positions on the journals Surgical Pathology, Modem Pathology and Applied Immunohistopathology. He is a reviewer for the journals Cancer, Ameri- can journal of Pathology, Cancer Research and the European journal of Cancer Research and Clinical Oncology. + u m n 9 9 3 0 �. Cooperative efforts between UB and the Department of Veterans Affairs become a reality O au tfa I a Ph y sl c 1 an A u t u m n 1 9 9 3 �On May 14, 1993, the University at Buffalo joined a select group not awarded its $3.4 million federal funding package until1988. "We didn't get it in the first round, but we did in the second," of nuclear medicine centers of excellence when it formally dedicated its $12 million Center for Positron Emission aughton says of the VA grants awarded on an annual basis. The Tomography- one of the most advanced in the country and grant was one of only four high-technology projects the federal one of the few with clinical, research and educational applicabody awarded that fiscal year. But with minimum PET startup costs estimated at between tions. The multidisciplinary center, which integrates medical spe$7 and $10 million, the federal grant was only a start for UB's cialties and subspecialties within its three functions , has been ambitious project. the result of collaborative efforts between the federal and state Funding ultimately came from diverse sources: $1.6 million governments and private foundations and corporations since its from UB itself, 6 million from ew York State, $1 million from the james H. Cummings Foundation in the form of a contribuinception. Indeed, even physically, the center consists of two distinct entities- UB's Parker Hall, the site of the cyclotron, and tion to the University at Buffalo Foundation's "Pathways to Greatness Campaign" and the VA award. the Buffalo VA Medical Center, 3,000 feet across the street, PET technology is considered one of the most advanced in where the PET scanner itself is housed - connected by an underground pneumatic tube system. medical imaging, distilled from a number of scientific disciThe center's origins date back to the mid-1980s, \l ucE sMA plines. It enables the visualization and quantification VI 11 LL . . . when congressional legislation made it possible c:, \\\ Q(J.f of complex physwlogiCal processes on a chemifor certain grants to be used to fund both ...,~'\ -+')'/'l cal level. The technology uses short-lived Department ofVeterans Affairs facilities and ,$'• ~ physiologically compatible positron-emitthe communities they serve to develop and ~ ~.,., ting radionuclides synthesized into phar~ maceutical drugs that are administered share scarce medical resources. The UB- ~ VA PET center accepts both veterans and : ~ to patients and read by a scanner. The non-veterans. ~ ~ infonnation the scanner reads is then "The VA was instrumental in the de- "' ~ fed into a computer to produce three%! velopment of this technology," says john ~ ~ dimensional images of physiological proaughton, M.D., vice president for clini- ~ cesses. cal affairs and dean ofUB's School ofMedi- ~ ~ PET technology uses radioactive nu?' cine and Biomedical Sciences. "There are ,; c, elides of elements commonly found in the several PETS in the country located in VAs. " body, such as oxygen, nitrogen and carbon, The PET center now serves four to six patients that are administered to the patient. Because they each week. "A fair number of those referrals are from are physiologically compatible, the PET radionuclides Rochester," aughton says. actually follow true physiological and metabolic processes, Cooperation between the different entities that comprise rather than mimic biological pathways as other nuclear mediUB's PET center has been the byword from the start of the cine imaging technology tracers do. PET imaging produces images of the functioning of the body, project. augh ton praised the joint relationship between the univerrather than its structure, as more traditional forms of medical sity and the Buffalo VAMC in both the ownership and manageimaging technology- CT scanning, for instance- do. The technology, which can afford physicians a cellular view ment of the PET facility. "The cooperative venture allows the VA to do something it of biochemical processes, shows promise in a number of disciplines and applications, among them, cardiology, neurology, couldn't do itself and the SU Y system to do something it couldn't do by itself," says Alan Lockwood, M.D. , director of psychiatry and oncology. The key to UB's successful PET center, according to aughton, PET center operations for the VA and UB professor of neurology and nuclear medicine. "This is a very rich intellectual environwas "developing the cyclotron"- the specially designed electromagnetic device that accelerates charged particles or ionized ment for something like this to take place in. UB is the flagship atoms to very high velocities. The high-speed particles then institution of the SU Y system and the Buffalo VA Medical collide into targets - physiologic elements- to produce the Center is one of the major VA hospitals in the country." radionuclides. "There was no space at the VA for the cyclotron," aughton says of the arrangement. "So we used a bay in Parker Hall to UB's cyclotron is one of the more advanced in the country. Manufactured by the Belgian firm , Ion Beams Application, it is house it. "Parker Hall not only houses the cyclotron now, but it serves the largest and most powerful of its type manufactured today. as a base for the nuclear medicine department. The arrangement From its specially designed bay in Parker Hall, it manufactures has enabled us to centralize that department. " radionuclides that are converted to radiopharmaceuticals by the UB entered the competition for PET grants in 1987, but was chemistry function of the nuclear medicine department in $ B u a 0 p s c a m n 9 9 8 �Parker and then transported via pneumatic tubes to the PET scanner suite at the VA. It takes the radio pharmaceuticals- many with a half-life of slightly more than two minutes, according to Lockwood- 80 to 90 seconds to travel the 3,000-foot distance. The scanner portion of the center has been in operation since October 1991; before UB's cyclotron went on-line during the summer, the center purchased radionuclides from Hamilton, Ontario, a ugh ton says. ow, the university is in a position to supply some of the "longer" short-lived radionuclides to other PET centers, he adds. UB's PET center is the only one within a 150-mile radius; it is one of only four in the state and one of two approved for use in patient care. PET technology has been in existence since the mid-1970s, according to joseph Prezio, M.D., chair of UB's department of nuclear medicine, director of the PET center and one of the driving forces behind the university's entree into PET technology. "But it was so technically poor and cumbersome and atrociously expensive, no one could get involved except for a few well-financed research centers," he explains. "As the equipment matured," he continues, "the cost, though still prohibitive, got a little better. "And," he explains, "there were clinical reasons to continue." Those clinical reasons include hopes for improved treatment outcomes and better understanding of a number of diseases and conditions, including epilepsy, coronary artery disease, schizophrenia, Alzheimer's disease, Parkinsonism, brain tumors and cancer. PET imaging in cardiology detects coronary artery disease earlier and with greater sensitivity than more traditional diagnostic procedures, often precluding the need for cardiac catheterization and other procedures that involve patient risk. At the VA Medical Center, patients with ischemic coronary artery diseases- about 100 so far- are scanned to determine whether an area of the heart with poor blood flow is still alive and capable of benefiting from certain treatments or dead and not capable, Lockwood says. "Current tests available primarily measure flow . We help sort out the difference between low-flow live muscle and low-flow An underground pneumatic tube connects the cyclotron boy in Porker Hall to the PET scanner suite at the Buffalo VA Medical Center. The tube system provides high-speed transfer of rodiophormoceuticols for use in medical imaging. The rodiophormoceuticols- some with a half-life of just over two minutes - travel the 3,000-foot route in 80 to 90 seconds. PET Scanner Suite Buffalo VA Medical Center 0 B u c 0 p h y s c n A u m 9 9 3 �dead muscle to determine the best candidates for bypass or angioplasty and to avoid expensive and risky procedures," he adds. The technology is revolutionizing the way patients are chosen for angioplasty and coronary bypass surgery or medical treatment. The technology is also revolutionizing oncology treatment decisions-enablingphysicians to evaluate the effectiveness of chemotherapy within a matter of days rather than months. At the VA, it is also being used to successfully pinpoint the site of electrical outbursts in the brains of epileptics as part of presurgical evaluations to determine whether seizures emanate from a single spot in the brain. "Around half the patients are seizure-free after surgery," Lockwood says. "And a substantial portion of the other half get substantial improvement. lt makes an enormous positive impact on the patient's life. " And although there are no clinical applications in psychiatry yet, UB's center already has garnered research awards with strong clinical applications, among them , grants to look at brain injury after minimal trauma and study brain pattern abnormalities after severe liver disease. The minimal brain trauma study, Lockwood says, involves collaborative work between the VA and UB's departments of psychiatry, neurology, internal medicine, nuclear medicine and emergency medicine at Erie County Medical Center. Lockwood says the PET center is beginning clinical studies of patients with colorectal cancer to detect recurrences. Other research involves collaborations with the university's linguistics department to try to determine which areas of the brain are involved with specific functions of speech. In addition to its clinical and research applications, UB's PET center is the first comprehensive training center for PET imaging in the United States, thanks to a three-year, $450,000 grant from Siemens H. G. , a major supplier of nuclear imaging equipment. The center is equipped to train the range of personnel needed to operate a fully functioning PET center - from the technicians who assist the chemists to the physicians who specialize in nuclear medicine. It is organized around four Winspear Ave. ~I Cyclotron Facility Porker Hall University at Buffalo South Com us I. B 0 0 p h y s c Buffalo VA Medical Center Parker Hall .,; > < University at Buffalo South Campus >- ~ ·;:; = 0 A u m n 3 0 �J~~~~~ ~r~li~. m.L ~~~~~~ ~~~~rtm~~t ~f ~~~ ~~r m~~~~~~~ w~ ~~~~r~~~~ r~ ~ major training groups: technicians, radiochemists, nuclear physicists and physicians. "The problem throughout the U.S. and, probably the world," Prezio says, "is that training for PET has not been organized appropriately, or in enough depth, so that you can end someone to one site and have them come back seasoned and trained. Siemens liked what we were doing here. They were looking for someone willing to put the effort into it. "Our goal from the beginning, in addition to establishing the PET imaging center for research and clinical use, was to set up a national educational program that would be unrivaled in the United States." In addition to that Siemens grant, the Buffalo VA Medical Center will receive more than $150,000 from the corporation to develop computer software for the PET scanner. Two new software modules will be developed: one, with both research and clinical care applications, will compute blood flow; the other will describe metabolism in the brain using mathematical modeling of biochemical reactions. "Right now there is no software in our computer system that enables a user to measure blood flow ," says Lockwood. 'This will expand the capability for existing and future PET systems," he adds. The grant was developed through a Cooperative Research and Development Agreement. The agreement, which falls under the auspices of the federal Technology Transfer Act of 1986, allows both federal and private corporations to work together to develop new technology.It is only the second time in VA history such an agreement has been reached. "This is an example of a new trend in funding of medical research where there's cooperation between public and private sectors," Lockwood says. "This will be an increasingly important aspect to funding future research of all types. " On the downside, "PET studies are expensive [currently running over $2,000 per procedure] and not generally covered by health insurance in this country. In Buffalo, however," aughton says, "payment arrangements are made on a case-bycase basis. Many of the area's major third-party payers have negotiated rates to cover the studies." To ensure coverage, Lockwood says that patients at the PET center are carefully screened to meet certain criteria. "We study patients only with specific indications for the procedure, rather than as an open-ended diagnostic procedure. "This is a very deliberate step we've taken because of our commiunent to provide cost-effective services to the public," he notes. "We request reimbursements only for procedures judged likely to be cost-effective. And because of this, we've had good relationships with insurers in this area. "After all, insurance companies will want to pay $2,400 for a study if it will save them $40,000 down the road." And although neither Medicaid nor Medicare reimburse for PET scans, national efforts are underway to change that. + B u a 0 p h y PET center dedication culminates two decades of planning and development for the future oe Prezio, M.D.'s singular vision of making the University at Buffalo a major force in nuclear imaging became a reality on May 14, 1993, when the University formally dedicated its Center for Positron Emission Tomography (PET) that is one of the most advanced in the country. It was a vision that began in the mid-1960s and took root two decades later when congressional legislation made it possible to award grants that would aid both federal Veterans Affairs hospitals and the local communities they served. And it was a vision that Prezio -as both chairman since 1985 and professor of nuclear medicine - is largely responsible for nurturing. According to john Naughton, M.D. , vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences, Prezio has helped build a department "always strong in the research arena and with a fine clinical presence." Prezio came to UB first as an internal medicine resident in 1959 and then as a clinical assistant professor and assistant director for medical education at Mercy Hospital in 1964. Over the next nearly 30 years he has served the university, he has seen both the department of nuclear medicine and the specialty itself grow and expand at the undergraduate and graduate levels as well as in its clinical and research functions. Prezio's love of nuclear medicine and the city in which he's realized his dream began rather circuitously with a rotating internship in internal medicine at Mercy Hospital. The Georgetown University Medical School cum laude graduate's strong interest in endocrinology- he eventually completed both a clinical and research fellowship in the field at Georgetown - developed into an even stronger interest in nuclear medicine as Prezio used radioactive iodine to treat thyroid patients. c a m n 9 �programs filled by international medical school graduates is about 60. Since 1985, UB's national graduate enrollment average has been greater than 90 percent. Part of what makes UB's nuclear medicine residency programs so attractive is that some combine nuclear medicine with another specialty- such as internal medicine and radiology- to allow graduates to get both boards in a shorter period of time than they would if they completed two separate residencies. "The programs are so successful," Prezio says, "that we're now offering a five-year program with the PET and neurology and psychiatry. That's five years versus six or seven years. And both the job market potential and academic career potential are outstanding. "We're the only university in the country offering the combined programs- except for a smaller, not-as-mature program at the University of orth Carolina." Prezio has also focused on major educational programs to increase community awareness and extend the university's concerns about the quality of nuclear medicine. "We want to expand our educational services beyond Western New York to become a national training site- not only for conventional nuclear medicine, but especially for PET training. "We've just completed a training program for endocrinologists to familiarize themselves with radiation safety techniques in their practice. We want to expand on that. " The PET center figures heavily in Prezio's plans for the future- he wants to establish it as a major research center, and is well on the way to accomplishing that goal already with the acquisition of grants to use PET technology to look at brain injury after minimal trauma and brain pattern abnormalities with severe liver disease. Prezio also wants to develop and enhance the department's attractiveness to industry. "I want to use the PET center and department as a resource and evaluation site for new drugs. " Taward this end, Prezio is recruiting an expert in nuclear pharmacokinetics. Prezio's final goal- at least for the present- is to further expand the multidisciplinary approach the department of nuclear medicine has taken in the past 10 years. "We want to continue to work closely with neurology and psychiatry to assist in research where PET technology can be applied. We want to bring all these research activities into this department. " Prezio credits Michael Cohen, M.D. and Murray Morphy, M.D. -chairs of neurology and psychiatry respectivelyfor spearheading the effort and for the successes they have already achieved. "They took a 'what's good for everybody' attitude rather than 'what's good for me' attitude and they deserve a lot of credit. + "We led the way in these jawboning techniques,'' he says. "That's how it all started," he relates. In fact , Prezio merged those interests when he started the clinical radioisotope program at the South Buffalo hospital nearly three decades ago. At that time, nuclear medicine was in its infancy- its first identification as a specialty, in fact, was in the late 1950sbefore the technology revolution that saw its knowledge base expand almost exponentially. "As the field became more complex, with the development of new imaging technology and new radiopharmaceuticals, it came into its own," Prezio said. "The idea to start a separate specialty," he adds, "was born in Buffalo, with Dr. Merrill Beader at Roswell Park Cancer Institute. He worked feverishly and with considerable aplomb to establish a forn1al residency program in 1971. It was the first in the country. In 1972 the boards were offered for the first time. " In 1972, nuclear medicine's technology consisted pretty much of a "scanner device and early scintillation gamma camera,'' according to Prezio. Applications consisted of lung, bone, thyroid and brain- the cardiac applications that are a mainstay today had not yet become a reality. And at the time, both the technology and its applications were directed at in1aging. "The direction today,'' Prezio explains, "is not just imaging, but the functional analysis of actual biochemical processes. "The next step is the cellular processes. We can look at these with the PET." And with UB's sophisticated new PET center- one of the few in the country with the capacity for both patient care and research- the department of nuclear medicine is positioned to become a national leader in both. Under Prezio's stewardship, the department has accomplished several goals. "The major thing," Prezio says, "is the centralization of the department from Diefendorf Annex. " Its recent consolidation to Parker Hall "is the first time in its history that it is totally centralized in one place. "All major educational activities for training medical students, technicians, nuclear medicine residents , are all here in Parker Hall. "Our grand rounds," he adds, "draw 90 people. They are always very well attended. We draw physicians and technicians from Rochester, Hamilton- the whole Western ew York area. It [the centralization and resulting consolidation] is an outstanding success. "And psychologically, it's better," he says, noting "neutral territory. " Making the nuclear medicine programs more attractive to American graduates has been another accomplishment. ationally, the percentage of nuclear medicine residency NANETTE B u a 0 p h y 5 a n u TRAMONT m KOLLI 9 9 3 G �.. B a 0 p a u m 9 9 �The Consortium's structure emphasizes the goal of improving educational quality, not meddling in the member hospitals' operations, and giving the members on equal voice in decisions. B u f f a l o P h ys icI an A u t u m n 1 9 9 3 �c 0 0 p ITED BY COMMO E R A NECESSITY, THE UNIVER- SITY AT BUFFALO MEDICAL SCHOOL A D ITS TEACH I G HOSPITALS ARE Fl A WELL AS CELEBRATE THE lOTH AI ATIO AL RECOG DI G STRE GTH lTJO AS THEY JVERSARY OF THEIR I STITUTIONAL ALLIANCE. Through the Graduate Medical Dental tion of American Medical Colleges. "People are coming and looking at Education Consortium of Buffalo, the assortment of residency programs scattered what we're doing with the Consortium," among area hospitals has been brought said William D. Pike, president of the under an organizational umbrella, giving Western ew York Hospital Association. the university greater control over gradu- "It is unique and something we should be ate medical education without threaten- proud of." aughton is ing hospital auclearly proud of the tonomy. The arrangeconsortium he was ment has fostered instrumental in greater cooperation at "If I had to describe it in forming 10 years a time of increasingly ago. "We're probstrained finances, and a word, I'd say ably the most soit has taken on some phisticated and of the thornier policy 'consensusbuilding .' I complex consorquestions in health tium that exists in care, such as the need would say no one has lost the country," he to tum out more prisaid. "I don't know mary care physicians. "There have been that we necessarily any autonomy." a lot of positive are the model, but outcomes ," john we are a model." Richard Braun, vice aughton , M.D. , asSitting back in sociate vice president shirt-sleeves behind president of finance and for clinical services his wide desk, and dean of the mediaughton recalled chief financial officer of cal school, said simthat it wasn't always ply. easy. Some resiAnd witl1 the nadencyprograms had The Buffalo General tion bracing for major to be reorganized, upheavals in health with responsibilHospital care and medical eduities and resources cation, the Consorshifted among diftium is also being ferent hospitals. viewed as a model. And, he notes, bu"When people talk about GME con- reaucratic turf battles haven't been comsortia, they all talk about Buffalo," said pletely relegated to history. joyce Kelly, Ph.D., associate vice presi"It'll lead to some testiness from time to dent for clinical services with the Associa- time," he said. "It'll lead to some issues. T 0 N But it works out." In fact, Naughton said, he was surprised there weren't more problems in bringing the university's teaching hospitals together. "Amazingly enough, given the magnitude of it, the difficulties were relatively modest," he said. "The main difficulties were in visualizing the needs and in bringing everybody into it so they filled their proper roles. " The goals behind the Consortium are better education for residents and better coordination among the participating institutions. "Most university medical centers are single centers that report back to one university," said Richard Braun, vice president of finance and chief financial officer of The Buffalo General Hospital. "What we have is a consortium of eight hospitals that divvy up the teaching." The idea for the Consortium came in the early 1980s when the Accreditation Council for Graduate Medical Education issued new guidelines requiring greater institutional management of residency programs. At the time there was little coordination between the Buffalo programs, with some controlled by the university and some by the hospitals - The Buffalo General Hospital, The Children's Hospital ofBuffalo, Millard Fillmore Hospitals, Erie County Medical Center, Sisters of Charity Hospital, Buffalo VA Medical Center, Mercy Hospital and Roswell Park Cancer Institute. UB was not the only medical school in the nation without its own medical center. But even among schools relying on community hospitals, the UB-affiliated residency programs were notably scattered, said Michael F. oe, M.D. ,BGH executive vice president and medical director. "We did not have the university or a university hospital identified as the sponsor of the programs," recalled oe, who worked with Naughton to forn1 the Consortium. "We had multiple hospitals identified as the sponsor of individual programs." . C 0 0 P E R A T I 0 N ti �.. oe described the situation as "fragmentation to the extreme." In some cases, he said, program directors found themselvesjuggling the conflicting interests of several hospitals involved in the same program. "The hospitals each had their own house staff, their own payroll and benefit package for the residents. There was no uniformityeveninthatarea," headded. " ordid we have any common operating policies that applied across the entire system." David M. Crossland, M.D. , chairman of the Consortium's residents committee, agreed. "There was no organization. They competed with one another and didn't trust one another," he said of the hospitals. "Residency programs were as good or as bad as the institution had them be." Said aughton: "We had had prior to that time a fair amount of problems with the various accrediting bodies." When the new ACGMErulescamealong, "We had to respond," aughton said. One of the first signs that the Consortium would workcameearlyon, during seemingly mundane discussions about designing a letterhead for Consortium stationery. "There was always a little tension in the communityaboutownershipoftheseresidencies," aughton recalled. "The question was, having made that bigjump, how would we identify ourselves." The dean said he was sure the hospitals would balk at putting the medical school's name anywhere prominent. He was happily mistaken. "It was pretty clear that the hospital directors thought the university should have the lead in it," he said. aughton credits several factors for the Consortium's success, including its design as a voluntary membership organization rather than a formal entity like a corporation. The structure emphasized the goal of improving educational quality, not meddling in the member hospitals' operations, and giving the members an equal voice in decisions. "We weren't merging anything," aughton said. "Ev- ery institution was going to maintain its integrity." oe agreed. "I think our success in establishment, as well as in the continued operation of the [organizational] model we decided upon, was first of all that it was a fully participatory governance process," he said. "You still have the individual tension, obviously," Naughton said. "But the decisions are made collaboratively, not by any single institution." Members meet regularly and lines of communication are kept open. The Consortium has three committees: administration, which includes deans, hospital �heads and hospital medical directors; program directors, which includes university department heads as well as the directors of each residency program, and residents, composed of elected representatives from each program. In addition, each committee elects a representative to sit on the other two C 0 0 committees. "All of our dealings are public within the organization," oe said. Program directors retain responsibility over the residencies, and medical school graduates still apply to individual residencies rather than the Consortium. But the Consortium is the sponsoring institution, and application forms and many other PER facets of the programs are now standardized. "What we did was to externalize the governance of all those programs from all those hospitals to a central body," oe said. Buffalo General CFO Braun said that while the Consortium's course is clearly set by aughton and the chief executive officers of the member hospitals, its decisions are group efforts. "If I had to describe it in a word, I'd say 'consensusbuilding,"' he said. "I would say no one has lost any autonomy. " Consortium members point to a number of achievements, including: • Centralized record-keeping Resident records were previously kept by the individual teaching hospitals. Bringing them under one roof is more efficient and has saved money, aughton said. • Resident salaries In the past, residents received different salaries and benefits depending on which program and hospital they were in. "Before there were different arrangements between hospitals ," aughton said. Even residents in the same program could receive different salaries if the program was spread over more than one hospital, oe said. Consortium members spent a number of years working on the problem. Along the way they encountered complications caused by the fact that some member hospitals- the VA and Erie County Medical Center - are run by government, oe said. "There were also union issues," he added. Two years ago the Consortium finally succeeded in forming two independent corporations to administer compensation packages for medical and dental residents. The corporations pool funds from the member hospitals and have eliminated most of the variations in resident salaries and benefits. • Orientation There is now a single week-long orientation program for residents, which in- AT I 0 l N ! �eludes training in bedside manner and certification in advanced life support. • Grievance procedure The establishment of a Consortium procedure for appealing disciplinary actions has been a major stride for residents, according to Crossland. "We've got much better due process in place now," he said. • Program reviews The Consortium itself reviews residency programs for potential accreditation problems before the ACGME arrives for its triennial checkup. "They do just as good a job as the outside body," said M. Luther Musselman, M.D., director of medical education at Millard Fillmore Hospitals. any of the Consortium's initiatives, such as pooling salaries and creating a combined orientation program, represent efficiency gains, said Diane Linskey-Hauser, executive director of the New York State Council on Graduate Medical Education. "There are lots of economic reasons for doing this," she said. Crossland said the Consortium also has worked to improve residency programs. Residents traditionally have been burdened with heavy workloads that cut into their time for study and research, he said, adding, "That's beginning to change and I'm impressed that they're serious about it." But some feel the Consortium's greatest achievement has been its willingness to tackle wider medical issues, such as the need for more primary care physicians. "It's really seeking to address some of these broader policy goals, well beyond these day-to-day operational issues," said Kelly. The emphasis on turning out more primary care physicians has become one of the Consortium's top priorities. It has set a goal of increasing the proportion of 13,000 residents, more than any other residents in primary care specialties to half state and nearly double the number in the total number of residents, and it has California. Buffalo itself has slightly more also pledged to cap the resident popula- residents than does all of Kansas. Buffalo's is neither the only nor the first tion at 750 medical and 32 dental, roughly teaching hospital consortium in the nathe present number. "That probably would be much more tion. The Association of American Medidifficult without some sort of consortia! cal Colleges tried to find out more about them this year by sending questionnaires effort," Braun said. Any proposal to start a new residency to about 400 teaching hospitals, accordprogram in a field outside primary care is ing to Kelly. The survey identified about met with heated debate at Consortium 40 different consortia around the country, though Kelly said meetings, he added. there are more, exMembers of the plaining that the Consortium are survey's purpose was presently involved to learn about the orin a demonstration "We're probably the most not to ganizations, project aimed at count them. boosting the numsophisticated and complex "Our preliminary ber of residents in findings suggest that the primary care spefor the most part the consortium that exists in cialties, the number consortia outside New of minority physiYork State do not share cians and the numthe country. of producing the goal ber of physicians in more generalist phyunderserved geoI don't know that w e sicians, more minorgraphic areas. ity physicians and Because of its efnecessarily ore more physicians servforts, the Buffalo ing underserved arConsortium is ateas," Kelly said. the model, but tracting national atThose other contention. "There are a sortia are geared more lot of organizations we ore a model." toward issues like resithat are interested in dent recruitment and trying to reform John Naughton, M.D., coordinating benefits, medical education," she said. "Buffalo is said Kelly. "Right vice president fo r clinical way ahead of everynowit'skindofheatbodyelse," she added. ing up because as The Buffalo Conaffairs and dean of the folks are thinking of sortium has taken its medical reform , cue on the broader they're also thinking School of Medicine and social issues from the ofmedical education state, which has been reform." Biomedical Sciences advocating greater use ew York State of consortia to implays a unique role prove medical trainin graduate medical ing since the report of education because the state Commission it has more than L �c 0 0 p E R A on Graduate Medical care, underserved Education in 1986. populations and miThe Commission's nority recruitment. "We did not hove the work led to creation Another consorof the state Council tium has been on Graduate Medical university or o university formed around AlEducation, which has bany Medical Colcontinued to push the lege and Albany hospital identified as the consortium idea. Medical Center, but "The advantages while its plan was apsponsor of the [residency] would be that it alproved by the state lows the opportunity Council on GME programs. We hod multiple for regional planning three years ago, the and looking at sociorganization has hospitals identified as the etal needs rather than been hampered by fiwhat the department nancial problems of medicine needs in and it continues to sponsor of individual tenns ofstaffing," said exist mostly on paLinskey-Hauser. per. programs. It was In its Fourth AnAs time goes on, nual Report, the Counhowever, and there fragmentation to the cil states: "Through is more pressure for consortia, medical changes in medical extreme. In some cases, schools, their affilieducation and the ated hospitals, and health care system, other teaching sites there will be more program directors found can jointly define the need for consortia. educational needs of "The point is that themselves juggling the residents and coordimedical schools and nate the development their teaching hospiconflicting interests of of core curricula, tals are going to have placement of resito network better," several hospitals involved dents and allocation said aughton. of educational re"A lot of coordisources in a way that nation is going to be in the some program." is both efficient and required among the responsive to the medical schools and Mi(hael F. Noe, M.D., needs of society." the affiliated hospiSo far , the only tals," agreed Linskeyexecutive vice president other operating conHauser. "Right now, sortium in the tate is Buffalo is a very clear and medical director of The one organized by model for how conew York Medical sortia might be modCollege and nine afeled." Buffalo General Hospital filiated hospitals in Kelly said there the late 1980s. In adhave been consortia dition to fostering around since the quality education, that consortium's goals 1960s and '70s, but now "they are being also include more emphasis on primary created at an increasing rate." C 0 0 PER T I 0 "The most common model for consortia is not the way it operates in Buffalo," she added. Most consortia now follow the "integrated program" model, Kelly said. These consortia are typically corporations set up to take over the residency programs. The member institutions give up their right to sponsor programs, and instead, the corporation becomes the sponsor. Kelly pointed to McGaw Medical Center at the orthwestern University School of Medicine. Contrary to what the name implies, McGraw Medical Center is not itself a hospital, but a consortium covering several member hospitals. Buffalo's consortium is an "independent" model, a less rigidly structured umbrella organization that lets member institutions retain a significant role in the residency programs. "There is no dominant hospital," said Musselman. "That's probably the biggest difference between Buffalo and other consortia." elly said that neither structure is particularly better suited than the other to pursue the widersocietalgoals for which consortia will be needed, but the Buffalo model makes it easier to get hospitals together in the first place. "It means you can maintain your independence," she said. One manifestation of that independence is in internal medicine, which is split into two programs within the Consortium. "Program A," with about 140 positions, is based at Buffalo General Hospital, Erie County Medical Center and the Buffalo VA Medical Center. The smaller "Program B," with about 40 slots, is based at Millard Fillmore. Even though Millard Fillmore was a Consortium member, it was reluctant to give up its own internal medicine pro- AT I 0 N �gram. "We didn't think it was good for residents to have two months in five different hospitals," Musselman said. "They finally agreed with us and allowed us to keep our program." Crossland said the Consortium's voluntary nature can be a disadvantage, limiting its ability to make changes. "It takes a lot of time and persuasion," he said. In general, however, the Consortium has fostered greater cooperation among its members. "I think we generally feel now that in a sense we have equal input into a decisionmaking process, that the unilateral decision-making that is sometimes not in the best interest of the educational objectives isnolongeraproblem," said oe. "Weare equal participants in a planning process that helps us assure the stability of our educational relationships. There is no question that sometimes decisions that are made don't go the way of one or more hospitals, but on balance I think everyone would agree the procedures set up have brought more advantages than disadvantages, more wins than losses." The primary care demonstration project i one of the more notable examples of cooperation through the Consortium. Under the project- initiated by the Consortium and the medical school, six of the 1 Consortium hospitals, the ew York State Department of Health, four private insurers and Medicaid- the hospitals involved pool about 15 percent of the indirect medical education reimbursements they receive from the government and insurers. The reimbursements are meant to help , compensate the hospitals for the costs of their teaching programs, and the 15 percent they are pooling is money that would otherwise have gone into the hospitals' general budgets, Braun said. The Consortium redistributes the pooled funds , which amounted to about 750,000 last year, to the hospitals for use in primary care training and other programs consistent with the demonstration c 0 project's goals. The Consortium also makes it easier for member institutions to respond to changes, as they did several years ago with a new state requirement involving resident credentialing. The Consortium brought the proper people together to establish a credentialing process, which now includes a system for forwarding records from one hospital to the next as residents rotate, aughton said. Crossland said that from the perspective of the residents themselves, the Consortium has been a "mixed bag." He said it has helped by making salaries and benefits more unifom1, but he adds quickly �c c o E 1 v c c that salaries should be higher. "Overall in the ortheast, we're in the lower 25 percent," he said. l n general, however,Crossland said he is pleased with the Consortium's goals and believes its members are making a good faith effort to improve educational programs. But he said he worries that financial problem could be an obstacle. "The hospitals, I can't overemphasize how much pressure they're under," he said. Last year wasn't a good one for the Consortium's hospitals. "ln total, the six hospitals that reported unaudited numbers showed a substantial loss, $8 million, I think," Braun said. "It's indicative of the environment and the problems we read about in the papers every day. It has nothing to do in a direct sense with the Consortium, but it influences people's ability to participate and the needs that they have." Braun said it hasn't kept the consortium from undertaking any new programs so far, but, "It's a consideration every time we sit around the table and talk about what new and innovative programs can be tried." Crossland said the hospitals are hampered by low reimbursement rates for graduate education. "Some of the reimbursement is going to have to be improved," he said. aughton agrees that the financial situation is serious. But he remains optimistic about the Consortium . "I think the threat is less if we continue to share resources as we do," he said. "l think the Consortium is a pretty good response to the economic climate." + f c c C 0 0 0 0 p E A R T I 0 "There is no dominant hospital. That's probably the biggest difference between Buffalo and other consortia." PER Luther Musselman, M.D., director of medical education for Millard Fillmore Hospitals AT I 0 N �-PAYING OFF FOR THE FUTURE, TOO Y ears ago, hospitals in Buffalo and less serious now," said Andrew J. Rudnick, president ''There's always been a little bit of disquiet elsewhere tended to look on other of the local business group called the Greater Buffalo Partnership. about it," he added. Now work is underway to form a new organi- health care institutions as rivals. They were motivated more by their own selfinterest than by what was best for the region. While the Graduate Medical Dental Education The business community pushed for creation of zation to replace the WNYHSC with a consortium the WNYHSC because it was concerned that local more directly under the control of the university hospitals were duplicating services and spreading and local medical community. The new consortium Consortium of Buffalo didn't set out to solve that some specialties too thinly over multiple institutions. would include the GMDECB, which would continue problem directly, it did help set the stage for anew As a result, there were inefficiencies and some pa- to operate without significant changes. After several years of the WNYHSC, Rudnick way of thinking and a new era of cooperation. tients were traveling to other cities for treatment they said, cooperative efforts have become institution"It helped to provide the mechanism for an should have been able to get in Buffalo. Through the WNYHSC, UB and the area hospitals alized and business leaders no longer feel a need evaluation," said medical school Dean John Naughton, M.D. now engage in more joint planning. Among other to be involved in the process. "We're not academic "Getting the parties to the table served as a things, Naughton and others credit the Consortium medical people," he said. ''We're not clinicians. springboard toward dealing with alarger agenda," with bringing a Trauma-Burn Center to Erie County We're not researchers. Ultimately it's got to be agreed Michael F. Noe, M.D., executive vice president and medical director at The Buffalo General Hospital. "Out of that, in 1987, the Western New Medical Center, a Heart-lung Transplant Center to turned over to them." In addition to encouraging cooperation, the The Buffalo General Hospital and a Bone Marrow Transplant Center to Roswell Park Cancer Institute. new consortium will also focus on issues such as York Health Sciences Consortium was formed." Forming the WNYHSC proved more difficult than new information systems and closer collaboration The Health Sciences Consortium took the the GMDECB because medical people were uneasy betweentheuniversityandcommunityphysicians, GMDECB concept one step further, going beyond with the central role played by the business commu- Noe said. the focus on training to look at the broader issue nity. "It was a little bit more controversial because it of providing quality care at low cost. was threatening to physicians and faculty as well," will be in place by the end of the year. Traditional hospital rivalries "seem to be far Naughton said. Naughton said he hopes the new consortium -A NDREW + DANZO �., ~·· ·· ······· ·· · · ··· · ······· · ··· · ················· · ····· · ······ ··· ··· · ·· ·· ·· · · · ············· · · · ··· Spring Clinical Day and Reunion Weekend '93 successfully staged his year's Spring Clinical Day and Reunion Weekend, held on April 30 and May 1, marked a time to reminisce, renew friendships and review health care practices today. lt was, as always, a rousing + success. From left to right- First row: Ronald E. Martin, Victor Guarneri, Richard]. Buckley, r. , Gertrude Swarthout Second row: Walter R. Peterson, Kenneth Bone, Alfred S. Evans, Duncan K. Macleod, Eugene M. Farber, athan P. egel From left to right- First row: Thomas Grayson, Morris Unher, Anthony Marano Second row: Thomas Heineman, B. joseph Galdys, Marvin Bloom, Harold Feldman, jane Freiberg, George Heus, William Keenan, Paul Wolfgruber, Ivan Bunnell, Ralph Behling, Edward Crohn, Richard jones Third row: Louis Ciola, Edward Tracy, Charles Tanner,john Ninfo From left to right- First row: Harold Graff, Daniel Fahey, Vernon Lubs Second row: Edward Heckman, Raphael Good, Myron Gordon , Daniel Miller, Robert Hall CLASS OF B a 0 p y 5 c a n A u 1948 u m 9 9 3 �CLASS OF 1 953 From left to right- First row: David Batt, jacob Shammash, Richard agel, joseph Ruh, Marvin Wadler, Donald Ehrenreich, Thomas Geoghegan Second row: Herbert Constantine, john Strachan, Reinhold Ullrich, james Coleman, Molly Seidenberg Panner, Thomas Comerford, Howard Smith, john Volunan, Milford Maloney, james Orr, Ronald Garvey Third row: Harley Lindquist, Curtis johnson, Stanley Cohen, Donald Rachow, john Handel, Bertram Portin, Raymond Smith, Michael Sullivan, Sander Fogel, Herbert Simpkins,john Fenger CLASS OF 1 958 From left to right- First row: Melvin Brothman, Richard Rahner, Thomas Cummiskey, Richard Wasson Second row: Richard Romanowski , John Armenia, Marie Leyden Kunz , Lucien Potenza, Michael Mazza,joseph Bellanti, jason Reder Third row: William Glazier,john Float, Michael Genco, Carl Contino, Donald Ginsberg, jacques Lipson , Domonic Falsetti, Robert Dickson, Bernice Comfort, Ronald Batt, Franklin Zeplowitz, Franklyn Campagna, Joseph Zizzi, Samuel Shatkin, Alfred Stein, Eugene Friedberg, Leo Kane, Richard Boyle, Robert Perez, Gerard Guerinot Fourth row:David Koretz, Morton Spivack, William Deverell, Gary Cohen, Gaspare Alfano , Reinhardt Wende,John Giardino, Elroy Anderson CLASS OF 1963 8 u a a p h c a A u m 9 3 �CLASS OF 1 968 i From left to right- First row: john hields, Gary Karch, jeffrey Stoff Second row: Bruce Gesson, Katherine Dowling Schlaerth, Barbara Blase Sayres, Sara Gerstman Sirkin, Thomas Cumbo, Ronald Friedman, Morris Stambler, Leonard Argentine Third row: Lawrence Baker, Gerald Daigler, Robert Baltimore, Albert Biglan, Robert White, Lesbia Fernandez Smith, Robert Rodner, john chlaerth, Geoffrey Clark, Elias Rosenblatt, Harold Kulman Fourth row: Bruce Rabin, jonathan Reynhout, Brianjoseph, Lawrence Dobmeier, julian Karelitz,john Bivona, Robert Rosen,julian Offsay, Robert Milch, Paul Murphy, Robert Dickman, William Clack From left to right- First row: David Breen, Frederic Buchwald, Robert Lamantia, Lynda Young, Sharon Kuritsky, Paul Kuritsky, Thomas Wasser, William Ackerman Second row: Frederick Beck, Michael Haberman, john Klimas, Michael Sansone, Charles McAllister, Arthur Mruczek Third row: jacob Rozbruch, john Przylucki, Dana Launer, Daniel McMahon, Andre Raszynski, Charles Wiles, Raymond Dattwyler, Arnold Scherz, Demetrius Ellis, Thomas Dwyer CLASS OF 1973 From left to right- First row: Michael Blume, Ronald Somogyi, Elizabeth Doherty,judith Baron-Stone, Richard Elman Second row: Stuart Dorfman, Kenneth Glick, Matthew O'Brien, Stephen Gawronski Third row: teven Kaplan, Paul Wopperer, Stewart Altmayer B u a 0 p h s c a " u m 9 9 3 �CLASS OF 1 983 From left to right - First row: Robert Smolinski, eal Smith, Richard Collins Second row: Melinda Cameron, Mary Lee, Suzzanne Tanbakuchi, Deborah Korwin, Younghee Limb, Gwen ichols, Andrea Manyon-Wild, Patricia Flanagan Third row: Ephraim Back, Kenneth Zimmerman, James Koness, Daniel Murak, Robert Rosen,jonathan Graff, Gregory Zuccaro, Borys Loza, Michael Chaskes, Kenneth Roth, Victor Chehebar, Therese Giglia , Peter Accetta Fourth row: Ross Greenberg, Lonny Behar, Robert Stall, Carl Grant, James Corasanti, Galvin Anderson, William Hanavan, Kevin Ferentz, Mark Schwager Fifth row: Charles iles, icholas Aquino, Frank Mezzadri, Frederick McAdam, James Wild, Mark Venditti, Allen Rosen SPRING CLINICAL DAY From left to right - First row: Judith Hays, Lisa Benson-Guterman, Stephanie Christenson, Ellen Adler-Weinberg, Janet Williams-Barbaccia, Norah Lincoff, Ann Marie Levine, Margaret Morey Second row: Kathleen O'Leary, Robert Mennella, Paul Shields, Helen HessCappuccino, Lori Guttuso-Luzi,John Barbaccia, Constance Greene-Klocke, Lisette D'Eon , Ralph Pothel, Thomas Bellomo Third row: Charles Everett, Lisa Guttuso-Klenk, Stephen Hughes, Andrew Cappuccino, Wayne Waz , Frank Luzi, Dawn Hrab, Mark Klocke Winners of the class with the highest percentage of attendees pose for a picture. The AMA's Dr. James Todd lectures on health care reform. Orvan Hess '31, wins an Alumni Achievement award. B u c 0 p y s a n A u m n 9 �~·· · ········································· · ············· · ·· · ··················· · ············ · · lEI Kathleen A. Lillis, M.D. Lillis '87,appointed attending physician in emergency medicine athleen A. Lillis, M.D. , '87, was recently appointed attending physician to the division of emergency medicine at The Children's Hospital of Buffalo. Her responsibilities include supervising resident and medical student teaching in addition to overseeing all incoming patients. Lillis is also medical director of the stabilization and transport team, as well as a child abuse and toxicology consultant for the hospital and medical director of Mercy Flight. + Frawley establishes endowment for residency research fellowship homas F. Frawley, M.D., '44, chairman of Graduate Medical Education at St. John's Medical Center and Emeritus Professor of Medicine at St. Louis University School ofMedicine, has established a charitable remainder unitrust through a gift of securities valued at $50,000 to the University at Buffalo. The unitrust will establish the Thomas F. Frawley, M.D. Residency Research Fellowship in the School of Medicine and Biomedical Sciences. The endowment will B a a p provide a stipend for a resident to perform r search for one year before deciding to follow primarily a medical re earch career or elect to go into clinical practice. Frawley received the Distinguished Medical Alumnus Award in 1989 and served as chairman of the medical school's annual fund drive in 1992. He served as president of the American College of Physicians from 1981 to 1982 and recently was the 1993 recipient of the Alfred Stengel Memorial Award presented to a Master of the College who has exhibited "unusual loyalty and exceptional contributions to the aims and purposes of the College as well as outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research." + Two annual awards endowed for graduating medical students enjamin E. Obletz, M.D. , '32, retired Buffalo surgeon, and his wife, Lila, have established the Dr. Benjamin and Lila Obletz Fund to support a prize in orthopaedic surgery to be awarded annually to a graduating senior. Obletz received both his undergraduate and medical degrees from the University at Buffalo and has served as a clinical professor of orthopaedic surgery from 1956 until the present. Mrs. june Alker has endowed a fund in memory of her husband, George]. Alker, M.D., '56, chairman of the department of radiology at UB from 1985 to 1991. The fund will provide an annual award at commencement to an outstanding student in the area of neuroradiology. Dr. Alker, who died December 31, 1991, was born in Budapest, Hungary, and immigrated to the United States in 1949 as a refugee. He was director of radiology at y 5 c a n A Erie County Medical Center and a member of the American Society of euroradiology. + Lillian Ney'64,named diplomate of medical management board illian Vitanza ey, M.D., '64, vice president for medical affairs and medical director ofW.C.A. Hospital in jamestown, ew York, has been designated a diplomate of the American Board of Medical Management, the national certifying agency for physician executives. ey, who has been with W.C.A. Hospital for 19 years, is board certified in internal medicine and cardiovascular disease. She is a fellow with the American College of Physicians, the American College of Cardiology and the Council of Clinical Cardiology of the American Heart Association. She is also a member of the American College of Physician Executives. + Reisman '56,named master in American College of Physicians obert Reisman, M.D. , '56, has been named a master in the AmericanCollege of Physicians. Reisman, UB clinical professor of pediatrics, is currently President of the Medical Alumni Association. + u m 9 3 �··· · ···· ······ ·· ···· · · ·· · ··· ····· · ·· · ·· · ····· ···· ··· ··· ·· ·· · ·· · ··· · · ·········· ·· ·········· ·· ····· · 1 ·. . II I • I Innovative palliative care training program begins at Hospice Buffalo or the first time, fellows from the Graduate Medical Dental Education Consortium of Buffalo are receiving training in palliative care at Hospice Buffalo. The eight-week rotation, under the auspices ofUB and the ational Institutes of Health Summer Program, emphasizes attitude, knowledge and skill. Under the leadership of Robert Milch, M.D ., medical director of Hospice Buffalo, the fellows examine the interdisciplinary approach of palliative care and how the therapeutic process involves more than diagnosing and attempting to revert advanced disease. Emphasis is placed on interventions as they relate to the patient's needs , desires and beliefs, and assuring patients have as much control as possible over decisions that affect them. The fellows are also involved in discussions on the ethical aspects of caregiving, including euthanasia , resuscitation , paternalism, aggressive versus palliative interventional therapy, incompetent patients, fairness in the health care system and strategies for resolving ethical issues. The curriculum covers common symptoms in patients with advanced chronic disease along with suggestions of appropriate techniques to combat them. Elements of grief reactions and preventive techniques for adverse reactions are also addressed. The rotation identifies various organizational arrangements for the delivery of palliative care and their relationship to the health care system, including community resources available to patients with advanced illnesses and their families . The fellows rotate through each clinical discipline of hospice care, examine methods used in nursing homes and accompany counselors on social work and bereavement visits. + B 0 0 p h The training follows an interdisciplinary approa(h to palliative (Ore that re(o.gnizes the therapeuti( pro(ess involves more than diagnosing and attempting to revert advan(ed d1sease. Pediatrtc fellow receives research award from national association elawati Yuwono , M.D., a fellow in the division of pediatric gastroenterology/nutrition at The Children's Hospital of Buffalo has received a Glaxo Fellow award for her abstract, the "Role of Promoter and Suppressor Genes During Adnomidis Polyp Development in Familial Polyposis Coli." Yuwono presented her data at the annual meeting of the American Gastroenterological + Association. "Membership in the consortium strenothens and improves the quality of b Memorial's family practice residency program through increased coordination with the State University of ew York at Buffalo's medical and dental schools and other area teaching hospitals," Memorial president Timothy]. Finan said. "Our participation will cement an effective working relationship and improve communication to the benefit of our resident physicians, the hospital and the community. " + Niagara Falls Memortal Medical Center joins Buffalo Consortium iagara Falls Memorial Medical Center has joined the Graduate Medical Dental Education Consortium of Buffalo to strengthen and enhance its family practice residency program. y c 0 n Resident training at Niagara Falls Memorial Medi(al Center will be enhan(ed. m n 9 9 �• ················· · ··· · ······························· ·· ·········· · ···················· · ··· · ····· ~ I "In Sickness and in Health" chronicles the plight of Alzheimer's disease victims he Western ew York Chapter of Alzheimer's Disease and Related Disorders Association has found an unusual way to raise money for its support services and promote awareness of the disease. lt has hired Buffalo Ensemble Theatre, a downtown professional company, to produce In Sickness and in Health, a new play about a family struggling to cope with the advancement of the disease. The play, by Donna Marie Vaughan, will be presented ovember 4, 5, 6 and 7 at Lancaster Opera House. All proceeds will benefit the local chapter. In Sickness and In Health, which is expected to receive national coverage, opens with Cecilia, a mother of four now in her late 50s, rummaging for her mislaid checkbook, which her husband, Emmet, eventually finds in the icebox. As the play progresses, Cecilia's condition steadily deteriorates, and Emmet alternates between shielding the severity of the disease from the children and visitors and grappling with the temptation to give his wife up to professional care. "Losing a person so gradually is more painful than death," said Marion Goldstein, M.D. , UB principal investigator of psychiatry who sits on the Alzheimer's Disease Association's Board ofDirectors. ''I've known a lot of people [who have] run away from it. But living to the fullest with a partial mind is something we should all know and share in - it enriches us." In Siclmess and In Health throws an unusual and sensitive spotlight on the other victims of the disease that afflicts four million Americans: their families. lt is the hope of the Alzheimer's Disease s u a 0 p Association's Western ew York chapter that the play will heighten awareness of both the severity of the disease and of the day-to-day struggles of the husbands, wives, children and friends- "caregivers" -who also live with it. "Donna came to us with the script in 1991 and consulted with our education director," said Sharon Ross, the chapter's executive director. "We've been looking for ways to produce it ever since. "What we're excited about is the opportunity for an innovative way of entertaining and educating people about Alzheimer's through the medium of theatre. " Ross said that she would be bringing the actors into contact with Alzheimer's sufferers so that they could stud) the symptoms o the disease. The local Alzheimer's Disease Association is one of 215 chapters working to alleviate the burden of the disease on victims and their families. Western New York's Chapter is armed by 100 volunteers who serve Allegany, Chautauqua, Erie, Genesee, iagara, Orleans and Wyoming counties. h s 0 A The support groups reflect a national web of interest and research that provides assistance for both those suffering from the disease and the next of kin who must continue to provide care as the disease takes its confusing and frequently devastating toll on daily life. The Western ew York Chapter's newsletter, for example, carries the advice, "You never win an argument with an Alzheimer's patient," from the Association's San Francisco chapter; the Greater Washington chapter offers tips "On Hiding Things." The association has also developed a program called "Safe Return," which helps locate patients who have wandered off alone (59 percent of sufferers are afflicted with what can be life-threatening wandering, and 70 percent of patients surveyed indicated wandering was a frightening factor in their lives.) The program, the impetus for which was the death of a wandering Buffalo patient in October of last year, enrolls patients in a national database and issues identity tags and brace- u m 9 9 3 �······ ··· ········ ·· ··· · ·· ·· · · ····· · · · ········ · ····· ·· ····················· ·· ··· ·· ············ r g l§JJ lets for a small fee. It also trains those who may not have had contact with the disease - and especially police and emergency crew members - in recognizing and responding to its symptoms. Information on Alzheimer's Association Western ew York support groups and its "Safe Return" program may be obtained by calling (716) 873-1335 or 1800-273-6737; information on purchasing tickets for In Siclmess and In Health may be obtained by calling (716) 8731335 or (716) 855-2225 . + - B Y R O B ERT W AT ERH OU SE PranikoiT elected asecretary of Amertcan Urological Association "Then and Now"will chronicle 150 years of medical school history evin Pranikoff, M.D., associate professor and vice chair of urology, has been elected secretary of the Northeastern Section of the American Urological Association for a five-year term. As secretary to the association, Pranikoff will coordinate its affairs as well as sit on its executive committee. He is the first urologist from the Buffalo area to be elected to the position. + n 1996, the University at Buffalo- and its founding School of Medicine and Biomedical Sciences- will celebrate 150 years of service. Beginning with its next issue, Buffalo Physician will commemorate the Sesquicentennial with the inauguration of o special series called "Then and Now," which will look at various aspects of what the medical school was like over the post 150 years. The series will toke both o historical perspective and o personal one with articles about what life was like for early medical students, clinicol "firsts," personol "firsts" and the history of the affiliated hospitals. In addition, Buffalo Physicianwill excerpt articles from The Buffalo Medical Journal, first published in 1845, and keep its readers abreast of the various events and exhibits scheduled to celebrate the Sesquicentennial. Stapleton appointed chair of pediattic nephrology sub-board Bruder Stapleton, M.D. , A. Conger Goodyear professor and chair of the Department of Pediatrics, has been named chair of the sub-board of pediatric nephrology of the Ameri1can Board of Pediatrics for 1993. The six-member board is responsible for certifying pediatric kidney specialists in the United States. Pediatrician-in-chief at The Children's B u a 0 p h Examiners, a member of the American Pediatric Society and sits on the executive councils of the Eastern Society for Pediatric Research and the American Society of Pediat+ ric Nephrology. Hospital ofBuffalo, Stapleton recently was named assistant secretary general of the International Pediatric ephrology Association. A fellow of the American Academy of Pediatrics, he is certified by the American Board of Pediatrics and its sub-board of pediatric nephrology. He is also a diplomate of the American Board of Medical y 5 a n A m n 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Two UB professors elected to Amertcan Pediatric Society aniel Green, M.D., and Bradley Fuhrman, M.D., UB professors of pediatrics, have been elected to the American Pediatric ociety for outstanding contributions to the field of pediatrics. Green, professor of pediatrics in the division of hematology/oncology, is chief of the oncology section in the department of pediatrics at Roswell Park Cancer Institute. He is also a member of the Scientific Committee of the International Society of Pediatric Oncology and the Society of Pediatric Research. Fuhrman heads the divisions of critical care medicine at The Children's Hospital of Buffalo and in the department of pediatrics at the medical school. He is a member of theNorthwestPecliatricSociety, the American Academy ofPediatrics and the Society of + Critical Care Medicine. Congratulations abounded as the S(hool of Medidne and Biomedkal Sden(es' Class of 199 3 attended its (Ommen(e· ment (eremonies in May. editorial board of thejoumal of Urology. Mark Ballow, M.D., professor of pediatrics and chief of the division of allergy/ immunology at The Children's Hospital of Buffalo, has been appointed to the editorial board of the ]oumal of Clinical Immunology. Donald Opila, M.D. , clinical assistant professor of medicine, received the "Young Internist of the Year" award from the American Society of Internal Medicine at + their recent national meeting. chair of medicine and microbiology and chief of the division of infectious diseases at UB untillastjanuary. The vaccine was judged the most promising invention among 40 entrants selected from more than 300 inventions receiving patents in 1992 in Western ew York. If it proves effective in humans, the vaccine will be a major medical breakthrough in the treatment of ear infections. The vaccine may also be effective against + lung infections in adults. B UB researcher Murphy named Inventor of the Year for 1992 wo researchers who developed a vaccine with the potential to provide immunity against middle ear infections were selected iagara Frontier Inventor of the Year for 1992 by the Technical ocieties Council of the iagara Frontier and the iagara Frontier Patent Law Association. Timothy Murphy, M.D. , UB professor of medicine and microbiology and director of its microbial pathogenesis graduate group, and Michael Apicella, M.D., professor and chair of the department of microbiology at the University of Iowa College of Medicine, were honored for their work. Apicella was professor and Bradley Fuhrman, M.D. UB physicians honored by award and journal board appointments hree UB physicians have been honored for their expertise in their repective fields. Gerald Sufrin, M D., professor and chairman of the department of urology, has been appointed to the B u a 0 p c a A Y LOIS B AKER Life Technologies donates labware for use in cell culture research abware valued at $45,000 for use in cell culture research recently was donated to the medical school b y GIBCO Life Technologies, Inc. Life Technologies, headquartered in Niagara Falls, ew York, develops, manufactures and sells molecular biology products and cell culture products under the BRL and GIBCO brand + names. u u m 9 3 �··························································································• II . - ' 1 9 4 0 director of the Delhi and Stam- structive pelvic surgery. George A. Gentner '41, of Phoe- '85, is presently a fellow in neonatology at the SU Y HSC. ford offices of the Mary Imogene nix, Arizona writes, "I have been retired for several years now and enjoy coastal cruising on a sailboat off southern California." John E. Shields '68, is medical particularly in the field of recon- s I Raymond Moffitt '48, retired in Bassett Hospital of Cooperstown, 1989 as chief emeritus of gastroenterologyatSt.Joseph's Hospital New York. Jeffrey G. Straus '84, writes, "I am a contributing author to the text Ophthalmic Anesthesia (Slack, in Providence, Rhode Island. He Sogba K. Bosu '69, is a pediatri- Inc., 1993); thechapterisonStraus William D. Loeser '45, of Young- now enjoys golf and working part- cian/neonatologist with the Retrobulbar stown, Ohio, closed his practice time elderly in Southern California Permanente nique, U.S. Patent#4,759,746." arragansett, Rhode Island, and Medical Group, Orange County, in 1989; he is currently medical director of a preferred provider with the California, assistant chief of pediatrics and director ofNicu-Kaiser Sarasota, Florida. organization. 1 9 5 0 Hospital, Anaheim, and chairman s Robert A. Benninger '50, of Cape of the pediatrics department, West Coral, Florida, informs us that he Anaheim Medical Center. Allyn, are expecting a second child in September. Paula Rothman '85, has joined a 1 9 7 0 s orthopaedic surgery and is cur- Maxine Hayes '73, is assistant rently helping to build a church. secretary of health for Washington State. She is president elect for tice in Birmingham, Alabama. Michael]. Bartiss '87, has joined the Carolina Eye Associates in the Association of Maternal Child Southern Pines/Pinehurst, of radiology at the Medical Col- Health Programs. Hayes received her MPH from Harvard Univer- Carolina, as a pediatric ophthal- lege ofWisconsin, has been elected sity School of Public Health in to the board of trustees of the American Board ofRadiology. His 1977. James E. Youker '54, professor and chairman of the department six-yearterm beganJuly l. Youker practices at the Milwaukee County 1 Medical Complex and Froedtert Memorial Lutheran Hospital, ichols '47, chief of where he specializes in chest radi- gynecologic pelvic surgery at Mas- ology, cardiac radiology and sachusetts General Hospital, was mammography. David H. Kevin M. Miller '85, ofWoodland Hills, California, and his wife, reproductive endocrinology prac- sold his airplane but still has a sailing sloop. He retired from David H. Ni(hols eedle and Tech- 1 9 6 0 mologist. MarkS. Courey '87, has joined the faculty of Vanderbilt Univer- 9 8 0 s sity, ashville, Tennessee, after completing a fellowship in voice George C. Geraci '80, is now board disorders and care of the profes- certified in medical management, sional voice. emergency medicine and family named Outstanding Surgeon of the Year at the annual meeting of orth s practice. Geraci is medical direc- Robert H. Goldklang'87, received tor of primary and urgent care for Capital Health System in Harris- a Clinical Research Award from burg, Pennsylvania. Health in 1992 and was selected the Glaxo Institute of Digestive to receive a renewal of the grant in the Society of Gynecologic Sur- Alan L. Pohl '62, informs us that Andrew M. Knoll '84, having suc- 1993. Goldklang is a junior fac- geons, held in PhoenLx. his son, Andrew, graduated from cessfully delayed his residency ulty member in the department of internal medicine at the Univer- ichols, formerly a professor and chair- the University ofWisconsin Medi- until the enactment of Section man of obstetrics and gynecology cal School and is a radiology resi- 405, is completing his final year of sity of California at San Diego at Brown University, is currently a dent at Michael Reese Hospital in training as chief resident in inter- School of Medicine/San Diego VA visiting professor at Harvard Medi- Chicago. nal medicine at the SUNY HSC in Medical Center. Currently, he is a cal School and Massachusetts Syracuse. He has accepted a posi- General Hospital. He is known for William M. Burleigh '67, of tion as attending physician in the his innovative surgical contribu- Rancho Mirage, California, in- Emergency Department at St. tions to the health care of women, forms us his daughter, Jennifer, Joseph's Medical Center in Syra- was born March 11, 1992. cuse. His wife, Maritza Alvarado 6 u 0 0 p y 0 n m trainee member of the American Gastroenterological Association and a member of the American College of Physicians. �• ····························· ······ ········ ··· · ········ ·· ································· . ' Deborah Shalder '87, writes, "I won a fir t place in watercolor at the annual exhibit of the American Physician AnA ociation held in San Antonio, ovember 1992." joseph Aferzon '89, announces the birth ofRacheljessicaAferzon onjanuary 11 , 1993. Aferzon is a third year neurosurgery resident at Hartford Hospital, University Stephanie is now Child Care Director at the YMCA." Scott Svitek '90, is chief resident in pediatrics at Long Island jew- of Connecticut. Ronald A. Alberico '90, was picked as one of the 40 best sec- ish Hospital. Debra M. Omiatek '89, is currently employed as clinical director at the Tuscarora Indian Health Center. ond-year radiology residents in the country. He has two children: Zachary Ryan, two, and Karissa icole, 11 months. Matthew]. Phillips '91, and his wife, Toula, announce the birth of Stuart Varon '89, has been appointed chief resident of child and Ronald Palazzo and Ellis Gomez Palazzo '90, announce "our new Richard G. Bennett '92, is cur- adolescent psychiatry at the West- addition, Ana-Maria Elaina, was psychiatry at Case Western Re- born September 17, 1992. Both of serve University Hospitals in Cleveland, Ohio. David]. Pochatko '88, completed an orthopaedic surgery re idency injune and began a foot and ankle fellowship at Emory Univer ity. Pochatko plans on practicing in us completed family practice residencies in june." very helpful bigsisterjanee.Janee was three years old in February. theirson,JamesMatthew,onApril 7, 1993. Buffalo. Helen Cappuccino '88, a general surgeon, and Andrew Cappuccino '88, an orthopaedic surgeon, proudly announce the birth of their fourth child, Nicholas An- em Psychiatric Institute and Clinic of the University of Pittsburgh, Pennsylvania, for 1993-1994. rently in the residency program in thony. 1 9 9 0 Ranjan Bhayana '90, announces the birth of his second daughter, Brittney Paulina, on March 4, 1993. Bhayana has relocated to the Buffalo area. Daniel F. Klee '90, began a cardiology residency at Good Samaritan Hospital in Phoenix in july. Pierre]. Moeser '90, of Chesterfield, Missouri, writes, "I will be in the citizen ambassador program rheumatology delegation to Russia and the Czech Republic in October 1993." Anna Kristina E. Hart Anna Kri tina E. Hart '89, writes, "I am still on active duty in the navy as a flight surgeon, currently in Pensacola, Florida. In earlyJune I'll be transferred to Whidbey Is- land, Washington , for one additional year before resuming re idency." B a William F. Balistreri '70, has been named the recipient of the Distinguished Medical Alumnus Award for 1993. 5 Ronald Alberico '90, is chief resident in radiology at Long Island 0 BIT U ARIES Evelyn Heath Jacobsen '24, died April 12, 1993, after a long illness. She worked for almost 50 years at The Children's Hospital of Buffalo, both full-time and part-time, until her retirement at age 70. The jacobsen Ambulatory Care Center at Children's Hospital was named for her and her husband, the late A. Wilmotjacobsen, M.D. Arthur C. Hassenfratz '28, died December 13, 1992. Hassenfratz was in private practice in Buffalo for 52 years. Rutherford S. Gilfallan '41, died in Dillon Beach, California, ovember 27, 1992, after a long illness. jewish Hospital. john F. Perry'S!, died December 25,1992, in Gilroy, California. William Palmer, Jr., '90, writes, James M. Garvey '55, died of emphysema at his home in Olean, "My wife, Stephanie, and I an- New York, March 8, 1993. nounce the birth of our second daughter, jilian, on October 11, 1992. She joins her proud and a p y 5 james]. Freeman '74, of Medford, New York, died of a heart attack April 18, 1993. Dr. Freeman worked for the assau County Health Department. a n A u u m n 9 9 �A Spoonful of Humor © Stu Silverstein , M.D . Future Perfect? THE TIMES THEY ARE A 'CHANGIN FOR HEALTH CARE eligious friends of mine tell me that we are living in the Messianic Era. With the scores of changes occurring recently, I remain open to this possibility, for these are indeed strange times. It's either that, or virtual reality scientists are playing a clever trick on all of us. Recently, we have seen the almost unthinkable - the death of Superman, and over the summer Charlie Brown finally hit that elusive home run after years ~f striking out. A colleague of mine just informed me that john Bradshawemperor of the dysfunctional family, admiral of the good ship healthy functioning- is getting a divorce (which sort of begs the question, "who gets custody of his inner child?"). The changes are particularly frightening for those of us in health care. And if all these changes aren't enough, we are facing the specter of two lawyers determining the economics of health care for the coming century -one lawyer who spent $200 at~~=-~~Z airport for a haircut and one, it seems, who spent 2 at the supercut drive-thru window. I am waiting for Hillary to actually bill us for 35,064 hours of service in 1996. Indeed, I am hoping that she doesn't expand the concept to "drive-thru" short-stay surgery to cut down on health care costs. When I decided to become a pediatrician, I did so despite warnings that I Would end up standing at the entrance to U.S. l 0 l holding a "Will do LPs for food" sign to make ends meet and pay off my student loans. At times I've thought about it, but resisted the temptation (primarily because there is barely room with all those unem~loyed lawyers holding up signs expresstug their willingness to litigate for the same). ow it seems that those who decried my going into primary care - my colleagues who chose careers in radiology and dermatology Will soon find that the real prestige will rest with those of us who chose primary care. According to Hillary Rodham Clinton, we're going to be the darlings of the new health care plan they're generating. At last I'll never again be asked to sit at the kiddie table during staff meetings, or play miniature golf to match my miniature salary. The possibilities are excitmg. We could soon see orthopaedists ordering "total" malleus, incus and stapes replacements to treat chronic otitis media, or perhaps general surgeons performing below-the-cochlea amputations for the same ... call it the van Gogh procedure- CPT code number 9990. Pathologists will prove what most of us suspected all along -that they know it all and this time they won't arrive when it is too late. Yet, this is perhaps what is awaiting us under the "managed competition" now being proposed by the Clinton administratio::,n~.-~~"" Managed competition is one of those oxymorons we've seen over the years, like "military intelligence," "government help" and "Super Bowl champion Buffalo Bills." What is managed competition anyway? I envision patients comparison-shopping from city to city, and hospitals setting up cubicles like those seen at car dealers. "OK Mr. Goodname. We'll throw in the epidural and the appendectomy, but the vasectomy will take me below cost - might have to call in a urologist, or even a plumber if you're willing to pay the difference. Let me check with my manager first!" President Clinton has promised us universal health coverage with acceptable quality, but he didn't mention that he will be using virtual reality technology to do it. This may not be such a bad idea, and actually may be the way to obtain not only universal health care coverage, but universal satisfac' tion in life-disgruntled postal workers could express their dissatisfaction while firingvirtualreality guns, Ross Perot could fulfill his megalomaniacal fantasies and actually become CEO of the country if not the universe in the privacy of his own home while leaving the rest of us alone. And maybe through the wonders of virtual reality technology, we can even see the unthinkable- the Bills winning a Super Bowl. Well, some things even in these times remain virtually + unrealistic. Stu Silve~tem, M.D., president of Stoooup Medicine Semino~ of Son fmocill:o, Colifom~. lectures nationwide on humor rn medi<ine. �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO Non-Profit Org. U.S. Postage 3435 MAIN STREET PA ID BUFFALO NEW YORK 14214 Buffalo, NY Perm it No. 311 ADDRESS CORRECTION REQUESTED The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physician than all other available insurers combined. Additionally, MLMIC has the large t and most experienced professional liability claim department in the country, the largest risk management department of any ew York tate professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., ew York, NY 10016 250 Harrison St., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 ' 1993 ~l edical Uability Mutual Insurance Company �I C s AND s B•OME... 0 9 1 F S C f [ N c.; E.G 9 7 I N L. �\ ~ 9 s > 0 1/J Ul EACH YEAR, THE UNIVERSITY AT BUFFALO'S SCHOOL OF IOMEDICAL SCIEN MEDICAL STU RS, THEY WILJ ES ADMITS ENTS. IN THE REALIZE THEIR :Y: WILL ENRICH FULFILLING YEARS OF THEIR LIVES. �s s J. Pablo Abonia I Jared Barlow ...,t h ' I II n \t:r [[!"1 9 > I l 1 Gonzalo Bearman Kathleen Batt tf B d • Angela Camasto l. orndl l n crs1t Timothy Braatz rf 1'1 l 1 \) Jeffrey Cassidy \, R Sandra Block Cassann Blake u t 9 Jean Bae Jason Andrus n ornu B 1 • Drew Barzman ri\ l ... F Mana! Abu Hegazy !u vc 0 c f, I B Edward Chan Alexander Chen ,, \u tf.mul 2 13'""' 111 lo llopk n' l lr 1 1\l Kristen Chimileski r tv R ,! c ter r;,, ,. �A \.. 0 5 5 F 1 9 9 > Joseph Chow l Catherine Costello Adrienne Deyo I FI II R Gregory DiFrancesco Bt f I Jacqueline Dombrowski \; !1 f I -., F Thomas Elmer. Jr. Eric Finkelstein 1 B 1 falo Ronika Dua Morris Elevado ~ <{ u rll I) r c otr , I Peter Ercolino otrc I J rrc 111 II ~ t Randy Fagin Bt f d' Michael Filicl! B ,tf ( n cr 1t t 1-{L I' B !. " David Fries ,, R k ' James Gaul Jennifer Geiger l IIV 3 t 1\ b!. </ f ) lk �A \.. 1 F 1 • : 9 9 > Carrie Greenberg Clarisa Gracia Kathleen Gillan Jennifer Gennuso l 0 5 5 II l B Matthew Gutierrez Rachna Gupta Taj Hadee Paul Guttuso 1 v b Pamela Haefner Sabrina Hammett I ::-l 't B, B I ) t B 1 1- l Bn 1 F F 4 1 n 't 1 Jennifer Hensen Scott Helsley Orlando Hayle Thomas Hansen Eric Hanauer , 11 Donald Higgs '! on l I t r 'o, �A \.. s s II \1r 1 r lie 9 9 > Claudia Jaramillo l Jeannie Kao 1 Brian Karaszewski ~ I 'I p I ll 1 l Michael Kane I Loren Kane F Dana Jandzinski Angela-Ayanna James Wen Hsu I 0 Peter Kim Asra Khan Paul Kerner Regina Kim r 1 , c F Gregg Kissel r B 1 Benjamin Koenig l Suchitra Koneru 1 I 5 Armond LaPine �\.. J 1 Frank Lee A s s 0 F f 9 9 > Janice Lee Jeffrey LeGrett Sandra Leni Timothy Liesching Joseph Lopes Andre Lopez Alexander Marcus Paul Mason Janine McAssey Lisa Mendonza Daniel Metrick B Kenneth Levey ! \ J Andrew Luisi. Jr. l. r H J I Angela Mclellan Peter McNeela 6 �A 1\ s 0 PI 1 I Manny Ng Christopher Occhino 9 9 > r David Novak David Nielsen 1 I 1 rf l E b Gregory Nagel F Jonathan Morgan Stephen Milback Jennifer Meyer l s B f I '-' t I I Tracey O'Connor I, Molly Parietti lesley Orman th II r Gina Parlato Emmanuella Paul Alka Patel 1 0 r ~ t 8 Philip Piasecki l I t a fl faio 1 " 7 f11 �A \.. Christopher Pieczonka 0 5 5 loll l 1.." c F 'IU '" l !. JU Noah Sabin t Btf ) 9 > Christine Pluviose 1\l l'\\'1 Pamela Paczan Rath Jennifer Ragi 1.. omclll n t\l It <1 r-it li., B· m,J, /[ n'", ' I'Nll"!il) Psy.f r "~IT Vitaly Raykhman 9 F I Bobbie Pustelny Aisha Prim ' V. Chowdry Pinnamaneni l I B I David Pilati P. I F Christian Rocholl Sd 11"1 I p, B /,1 1 "l ) fiiLJ ex, I t l n , h tgh.l nt 1 f or :htt 1 l , v r 1lv t ,/. ,.,.,, Thomas Schenk Tami Seaman Craig Senzon 1.. l (. \f rL] l 11 \ Nit b''"" 8 t "FU James Runfola Paul Rosen v I'd pm:. 1 >r1l \( k �5 0 5 F f \.. lily Snyder Monica Simons Jimmy Sim 9 9 > Gavin Somersel ! Noelle Stevens lisa Sufrin Gary Styn, Jr. Sarah Storm l l 0 lie l I Paniti Sukumvanich Jennifer Sussal Nicole Symons Matthew Taberski l It Evan Taragano ) I fl p Andrea Torsone ! 9 B' B '"' Usha Vaidyanathan Andrea Walter �A \.. ~..-r ( Ill th .. F f I H P .. 1 "/c.l l 1 1 P t:f Il 1 Carolyn Young Louise Zador 1/ \u' h .. • H I I .. ' ' I 1 l jf, Denise Woodall orPdll 1 cr 1t ~,.n, fulo p l f Lt111 9 Danielle Woodall William Wind Dayo Wilson f Lf "/l 9 > Joseph Wandass 1 0 5 5 0 by SimonTon~ . Pholo~raph,- of metli..:al instmments by Robert \Y' a! ion. J l\1 ... ,.. \ 9 f ;, l ~ Photo~raph,- of ,-tmlenb lL 11 u 1/) Ul d. > ..) 9 > �UN IV E R ~, f T BUFF-ALO L A s s 0 F 9 ENCE"S 9 7 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1993 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1993-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. 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You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f36d4d89e97460e54f336abca2038b2d.pdf d32ef53a42634df70763d2048e2a4b00 PDF Text Text I I I State' Unive!sity, of New York at . Buffal~ School of Medicine and Biomedi~al Sciences, Spri.ng 199.4 �BUFFALO PHYSICIAN Volume 28, Number 2 ASSOC IATE VICE PRES I DENT FOR UN IVERS ITY ADVANCEMENT Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j Conroy EDITOR Nanette Tramont Kollig, R.N. ART DIRECTOR Alan j Kegler ASSOCIATE ART DIRECTOR Scott Fricker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDIC I NE AND B IOMED ICAL SCIENCES Dr john Kaughton , Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. john A. Rtchert, Chairman Dr. Martm Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Alan j. Dnnnan Dr. Timothy Gabryel Dr. james Kanski Dr. Charles Massaro Dr. Charles Paganelli Dr. Robert E. Reisman Dr. Thomas Rosenthal Dr. Stephen Spaulding Dr. Bradley T Truax Dear Friends, C hanges in medical education and health care are occurring at breakneck speed! UB's medical school and its affiliated teaching hospitals fortunately began developing a strategy for coping with the anticipated adaptations in the mid-l980s. Some of the required efforts were made possible through the development of a demonstration project that served to modify the priorities and directions of the graduate medical education programs. This has been largely accomplished through the Graduate Medical Dental Education Consortium of Buffalo. In the late 1980s, the school's faculty agreed to pilot a comprehensive two-month ambulatory clerkship in the fourth year. During the past two years, the Curriculum Committee has begun its re-evaluation of course offerings to ensure that future graduates will be properly prepared for national health care reform. This effort has been enhanced by the planning grant received from the Robert Wood Johnson Foundation and the school has submitted its final proposal to the foundation in the hope that UB will be among the l2 finalists to receive its support over the course of the next five years. These funds will be directed to assist the faculty in making the required changes in curriculum offerings and to assist in the adaptations in educational technique and support that must be forthcoming. Already, some significant changes are occurring. For example, beginning this fall, a formal clerkship will be offered in family medicine; the departments of medicine and surgery will modify their clerkships so that each department will offer new one-month courses in the fourth year. The Curriculum Committee, faculty and students have initiated their evaluation of years one and two, and obviously new innovations and designs should be forthcoming for these academic calendars in the years ahead. We hope to be able to position the school and its affiliates so they can respond positively to the changes that lie ahead and to maintain our commitment to excellence in teaching, research and patient care. Sincerely, John aughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS Batavia VA Medical Center Arlene Kelly The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Frank Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy «:>The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications . It is sent, free of charge, to alumni , faculty , students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: Editor, Buffalo Physician, State University of New York at Buffalo, University Publications, 136 Crofts Hall, Buffalo , New York 14260 Dear Fellow Alumni, T he 57th Annual Spring Clinical Day, the traditional highlight of the Medical Alumni Association's activities, will take place on April30 at the Buffalo Marriott Hotel. The general reception for all Reunion Classes will be held on Friday evening, April 29, at the Center for Tomorrow. The five-year class reunion chairs have planned their Saturday evening receptions, a unique and ever more meaningful time to renew "old" close acquaintances and rehash unforgettable memories. This year, we have a most exciting and innovative program, addressing current and future issues in medical education- a subject that should be interesting and appealing to all attendees. The complete program can be found on the Alumni Section pages of this issue. The morning presentations set the basis for the Stockton Kimball Lecture, which will be presented by Jerome P. Kassirer, M.D., '57 , editor of The New England journal of Medicine, and a premier medical teacher and educator. His topic will be "Clinical Reasoning: Teaching it and Learning it. " As a personal note, I thank Dr. Kassirer for accepting this invitation. He is a past recipient of our Distinguished Alumnus Award and holds one of the most prestigious positions in American medicine. Thi• •hou\d b• '" ou~<anding w"~ Send address thanges to: Buffalo Physician, 147 CFS Addition , 3435 Main Street, Buffalo, New York 14214 Robert E. Reisman, M.D., '56 �v 5 2 L 0 p R 8 N N G 2 0 9 9 4 ~n tne [ouef: Five of the six new Consortium hospital CEOs. From left, Robert V. Stanek, Charles Van Vorst, Lynn Brown, Joseph Ruffolo and Paul Candino. Research Hospital News Leading Buffalo's Changing Health Care Scene e Six Dr. Roswell Park performs surgery. From The Pictorial History of the Medical School collection. Page 25. of the nine affiliated teaching hospitals have new CEOs. What will the changes mean? Changing the Face of Medical Education e The School of Medicine and Biomedical Sciences is moving steadily toward a new way of teaching that stresses analysis over memorization and patient interaction over crowded lectures. Medical School Alumni ASpoonful of Humor Graduate Education Classnotes Going home. Page 34. Alum Jack Coyne blends two callings. Page 30. �.... . .. . . .. . .. . .. . .. .. .. . . . ... . . ... . .. . ..... . . .. ... ... . .. ... . .. .. . . ...... ... .. . . ... .. . .. . . .' . UB research continues on NASA's Spacelab Life Sciences 2mission B research done on the first Spacelab Life Sciences mission that showed the body regulates the cardiovascular system in a novel way, continued on last October's Spacelab life Sciences 2 mission with three more astronauts over a longer period of time. The research was designed by a team of scientists headed by leon E. Farhi, M.D., distinguished professor of physiology. Results from the first mission showed that during space flight the cardiovascular system adjusts vascular tone to maintain blood pressure in the face of elevated cardiac output. "This type of regulation ofblood pressure was completely unexpected, " Far hi says. "The system's failure to reduce cardiac output surprised us." Earthbound research in simulated weightlessness has shown that when gravity is eliminated, the heart pumps more blood initially, but the body eventually reduces total blood volume by eliminating blood plasma through urine to maintain normal blood pressure. Astronauts on the Spacelab missions used special equipment designed by UB technicians to determine how the heart and lungs perform in and adapt to the weightless environment of space during exercise and at rest and how that adaptation affects the astronauts' readjustment to gravity. Results from the initial study found that astronauts did not regain normal cardiovascular balance and could not perform the experiment's exercises fully for at least seven days. UB researchers speculate that even five more days of weightlessness in space could cause more pronounced and longer-lasting effects on the heart and lungs. The experiment was one of three studies conducted during the mission that focused on the astronauts' cardiovascular functioning in zero gravity. Astronauts David Wolf, M.D. , Shannon lucid, Ph.D., and Martin Fettman, Ph.D. , trained for more thana year a tUB and the johnson Space Center in Houston to learn how to conduct the experimets in the confines of the Space Shuttle Columbia. - B y L 0 I 5 B A K E R Highest sepsis mortality rates found from respiratory infections lderly patients who develop sepsis from respiratory infections while hospitalized have higher mortality rates than patients who develop sepsis from all other infection groups , according to a study by UB's Center for Pharmacoepidemiology Research. Sepsis is the most common cause of death in intensive care units, according to Thaddeus H. Grasela , Pharm. D., assistant professor of pharmacy and director of the Center. Grasela was the principal investigator on the I, 758-patient study that revealed mortality rates that varied widely depending on the source of the sepsis infection. Patients with sepsis acquired from respiratory tract infections had the highest mortality rate at 59.3 percent. The lowest mortality rate was reported in patients who developed sepsis from a community-acquired urinary tract infection. Mortality rates for patients who acquired sepsis from other infections were: • 46.4 percent for hospital-acquired urinary tract infections. • 45 .8 percent for patients with abdominal infections. • 36.7 percent for patients with skin infections. • 35 .9 percent for gram-negative bacteremia inclusive of all sources. • 28.3 percent for respiratory tract infections acquired in a nursing home. • 24.6 percent for urinary tract infections acquired in a nursing home . The multi-center study followed patients receiving antibiotics for suspected or documented cases of gram negative infections that can lead to sepsis from the beginning of their treatment until their discharge from the hospital or death. + - B Y E LLEN G OLD B AUM Liposomes curb taxol's toxicity sing liposomes to deliver taxol has allowed researchers to control resistant tumor growth in animals with doses of the drug that would be lethal if delivered traditionally. UB and Roswell Park Cancer Institute scientists reported in the December 15, I993 issue of Cancer Research that the liposome delivery system may overcome some of the major obstacles to the more effective use of taxol in fighting cancer. "Taxol has two problems," said Robert Straubinger, Ph.D., assistant professor of pharmaceutics and lead author of the study, "The drug itself is toxic and �·············· · ············································· · · · ······················ · ····~ the solvent in which it is administered is also toxic." Straubinger's experiments showed that the use of liposomes to deliver taxol allowed it to be administered rapidly and in doses between two and seven times larger than those the animals would have been able to tolerate as free drug. "We're quite encouraged, " said Straubinger. "By encapsulating taxol in liposomes, we have caused a marked decrease in toxicity and increased the drug's potency. "Right now," he added, "patients who take taxol have to be treated heavily with antihistamines and steroids. That controls the side effects, but some of these supplementary drugs may interfere with the same systems that transport or metabolize taxol within the body." Liposomes, he explained, although they are essentially fat-soluble, are also very stable in water and thus provide a way to dissolve fat-soluble drugs such as taxol in the body. "Liposomes are particles with an oily core, and a fat-soluble drug like taxol tends to stay with them," Straubinger said. "As a result, we have reduced the massive wave of free drug that causes some of the side effects." The UB researchers compared the conventional delivery of taxol against taxol in liposomes in animals with colon cancer, even though the drug has not shown to be effective in controlling colon cancer growth. "We were able to see control of tumor growth in animals given multiple injections of liposomes containing 40 milligrams of taxol per kilogram of body weight," Straubinger said. "If you gave that amount as free drug, it would have killed the animals. But in liposomes, it didn't. It just controlled the tumors nicely." - B B Y ELLEN a GOLDBAUM 0 p UB'sDrug Surveillance Network tracks drug reactions nationwide he University at Buffalo's Drug Surveillance Network (DS ) is the only network of hospital pharmacists in the U.S. designed to rapidly track and share information about how patients react to drugs. Established by UB's Center for Pharmacoepidemiology Research with grants from pharmaceutical companies, and supported with a grant from the Food and Drug Administration, the DS includes more than 1,100 clinical pharmacists in 522 acute-care hospitals. "We have the unique ability to get a peek at what goes on in hospitals across the country," said Thaddeus H. Grasela, Pharm. D., director of the center and assistant professor of pharmacy. The network places Grasela virtually at the bedside of patients in hospitals from ~ :• -• The network of hospital pharmacists tracks and shares information about adverse drug reactions. 5 c a n s p Miami, Florida, to Anchorage, Alaska. Currently, clinical pharmacists from six UB teaching hospitals- Mercy Hospital, The Children's Hospital of Buffalo, Erie County Medical Center, Roswell Park Cancer Institute, The Buffalo General Hospital and Millard Fillmore Suburban Hospital- participate in the network. According to Grasela, one or two cases of adverse effects from a drug over a period of months or years in a single hospital may not attract concern. By combining information from hundreds of hospitals, however, the DSN provides a much faster way to spot problems with specific pharmaceuticals. - BY ELLEN GOLDBAUM UB scientists awarded $1.5 million in Veterans Affairs grant funding our UB researchers at the Buffalo VA Medical Center have received Department of Veterans Affairs grants totaling $1.5 million. John Canty, M.D., associate professor of medicine , received $606,600 to explore how nitric oxide affects coronary artery blood flow in conditions of underperfusion. Alan Lesse, M.D., assistant professor of medicine and pharmacology, received $174,100 to explore how changes in a surface protein on Haemophilus influenzae affect its virulence. Jeffrey Mador, M.D., assistant professor of medicine, received $175,600 to investigate the causes of respiratory fatigue. Timothy Murphy, M.D., professor of medicine and microbiology, received $533,700 to explore the causes of exacerbations of chronic obstructive pulmonary disease. He will also establish a Chronic Bronchitis Study Clinic to follow patients before, during and after exacerbations. n g 9 9 4 �~ -··· · ··· · · · ···· · ·· ·· · · ·· · · · ···· · ···· · ······ · ··· ···· ········ · ··· · ·· · ········· · · · ···· · ···· · · ~ Holmlund treats about 60 patients in Western ew York. The treatment, done on an outpatient basis, involves injecting the toxin directly into the overactive muscle , Holmlund says. The toxin, he explains, blocks the nerve impulse to effectively relax the muscle. "The nice thing about it," he notes, "is that we can grade the weakness" to tailor the response to each patient. The effects ofbotulinum toxin are transient, lasting several months - about three each in laryngeal dysphonia and spasmodic torticollis treatments and about six months for blepharospasms , Holmlund adds. "It has been a truly wonderful experience to help patients with disorders we previously could not help. We can finally do something positive for them," he says. In addition to facilities in Albany, Rochester and New York City, the treatment is only available at about 20 to 30 centers nationwide, Holmlund says. vices there. She holds a master's degree in health systems administration from the University ofLouisville in Kentucky, as well as both bachelor's and master's wo new CEOs have been ap- degrees in English from orth Texas pointed at University at Buffalo State University in Denton, Texas, and a medical school affiliated teaching bachelor's degree in nursing from Spalding hospitals. College in Louisville, Kentucky. Joseph A. Ruffolo has been appointed president and chief executive officer of The Children's Hospital of Buffalo and Evelynn G. Brown has been appointed as the new vice president and chief executive officer for hysicians at Millard Fillmore Millard Fillmore Suburban Hospital. Health System's Dent Neurologic (For more changes at the teaching hospiGroup are one of only four groups tals, see the cover story on Page 6.) in New York State using botuliRuffolo previously served as vice presinum toxin to treat patients with dent of corporate finance for Millard dystonias. Fillmore Hospitals, where he was reTomas Holmlund, M.D. , assistantprosponsible for financial leadership of fessor of neurology and an attending Millard and its affiliated health care subat the Dent, has been using physician sidiaries, including corporate restructuring, medical staff development, merg- botulinum toxin successfully in patients ers and acquisitions, programmatic de- with blepharospasms , spasmodic velopment and expansion as well as torticollis and laryngeal dysphonia since 1991. fiscal operations. New CEOs appointed to head two UB affiliated teaching hospitals Dent physicians use botulinum toxin successfully for dystonias Ruffolo was credited with playing a significant role in Millard's financial turnaround. The organization had lost over $20 million in operations over 13 years before Ruffolo joined it in 1984 and enjoyed operating surpluses in nine consecutive years after that. Brown most recently held the position of senior vice president and senior administrator for Eastern Maine Medical Center in Bangor, Maine. She also served as senior vice president for corporate services at North Colorado Medical Center, Inc., in Greeley, Colorado as well as director of professional and technical services and director of nursing and patient care ser- B a Mercy Hospital'striplehead nuclear camera is first in WNY area ercy Hospital of Buffalo has recently acquired Western New York's first triple-head nuclear imaging camera. The new camera provides superior quality images in shorter scan times and offers enhanced computer capabilities to address difficult processing demands. Compared to single-head, conventional nuclear medicine cameras, Botulinum toxin, injeded diredly into the muscle, blocks the nerve impulse. the triple-head is more effi- 0 p h y 5 c a n s p n g 9 9 4 �·· ······· · · ·· · · ·· ···· ··· ···· · ·· · · · ··· ·· ·· · · ······ ········ ···· · · · · · ··· ·· · ···· · ·· ······ ·· ·· · a cient, acquires three times the amount of information in the same amount of time and offers superior image resolution. "The recent acquisition of the triple-head camera will allow Mercy Hospital to provide our patients with the latest in nuclear medicine imaging techniques, " said Fazalur C. Rehman, M.B.B.S., clinical associate professor and chairman of Mercy's department of nuclear medicine. The flexibility of the triple-head camera allows it to handle all types of planar and SPECT studies as well. Suburban completes Suburban's new additions will add approximatelylOO,OOO square feet of space to the ISO,OOO-square-foot facility. phase one of its $60 will feature a dedicated X-ray room , two cystography rooms and an exam code room and 20 exam rooms when room . An additional six ambulatory surmillion modernization project illard Fillmore Suburban Hospital has completed the first phase of its $60 million modernization project, which broke ground in September 1992, with the opening of its orth and East additions. The new additions, which add approximately 100,000 square feet to the 150,000-square-foot facility, house a 20bed critical care unit, a 32-bed medicalsurgical unit, expanded emergency and radiology departments , new cardiology and respiratory therapy services and a new medical library, medical records and medical staff lounge. Suburban's new emergency department - with 50 percent more space than its busy 30,000-plus-visit ER - B a 0 p h renovation of the original, adjacent ER space is complete. The 151-bed hospital's radiology department, now doubled in size, accommodates nuclear medicine, fluoroscopy and the addition of angiography. The department features two dedicated mammography units, two ultrasound rooms and two SPECT cameras. The 20-bed critical care unit, with 10 each CCU and ICU beds, consolidates the hospital's four intensive care beds, four coronary care beds, a satellite pharmacy and a satellite laboratory. The new 32-bed medical-surgical unit includes 16-patient telemetry capabilities. The new construction also adds an additional OR room to Suburban's four , and three more recovery beds to its original six. The OR suite also features s c a s p gery beds have also been added to Suburban's original six. "The expansion and renovation project will help Suburban Hospital to meet the health care needs of Williamsville, Amherst, Clarence and surrounding communities well into the future . This also provides our physicians, nurses and other medical professionals with state-of-the-art facilities to care for their patients," said Lynn G. Brown, vice president and chief executive officer of Millard Fillmore Suburban Hospital. Renovation work continues on the original building, constructed in 1974. The $60 million project is the most extensive modernization project in Millard Fillmore Health System's 121-year history. n g 9 4 0 �--------------------------------------------------------------------. B y 5 0 C T T T H 0 M A S LEADING ' NOTHING IS CERTAIN BUT CHANGE- ESPECIALLY, IT SEEMS, IN HEALTH CARE. IN THESE TIMES OF SHIFTING POLITICAL SANDS AND AN EXPLOSION OF KNOWLEDGE ABOUT THE HUMAN BODY AND ITS SYSTEMS, THE EDUCATION OF FUTURE PHYSICIANS IS NEVER STATIC. THAT'S TRUE, TOO, OF THE INSTITUTIONS WHERE THOSE FUTURE PHYSICIANS PUT INTO PRACTICE THEIR RIGOROUS EDUCATION. SIX OF THE NINE HOSPITALS THAT ARE PART OF THE GRADUATE MEDICAL DENTAL EDUCATION CONSORTIUM OF BUFFALO - THE TRAINING GROUND FOR ABOUT 700 MEDICAL RESIDENTS - HAVE NEW CHI EF EXECUTIVE OFFICERS, ALL WITHIN THE PAST 15 MONTHS. P H 0 T 0 S E' v M A K R D ~ L L A s --------------------------------------------------------------------. 0 B u a 0 p h y 5 c a n 5 p g 9 9 4 �·-------------------------------------------------------------------~ • -- B a 0 p h y 5 c a n s p g 9 4 0 �e're living in an era where both medical education and health care will change considerably," said John P. Naughton, M.D., vice president for clinical affairs and dean of the University at Buffalo School ofMedicine and Biomedical Sciences. "The people coming in new will bring some new ideas, and if those ideas are worth testing, we'll probably test them.I think they'll contribute to positive change." The new CEOs have come to Buffalo from areas as diverse as Virginia and Indiana, Texas and Maine. Their backgrounds as businesspeople and health care administrators provide a wealth of experience that becomes a further resource for the education consortium. "It's something of an added learning curve for them," Dean Naughton said. "After all , they came here primarily to manage their hospitals, and now they find out that they have to work with each other. .. . It's been a learning process in the past six months, but I think it's been going very well. " Buffalo Physician caught up with these six newly appointed chief executives to ask about medical education, running a hospital and the unique demands that New York State places on the challenge of providing medical care. To a person, they were enthusiastic about the consortium's work in training medical residents. And they see more change ahead as the hospitals and the school - cope with a new era in health care. sity hospital , but that structure may turn out to be a long-term positive. The key to it is how well we work together. There's a tremendous give-and-take. ''I'm extremely supportive of the affiliation and want to continue to strengthen it. It's a real opportunity for practicing physicians, hospitals and the university to continue to come together in a cooperative way." VanVorst sees Millard Fillmore as a hospital system in a good position to adapt to the trend toward decentralized and outpatient care. "We need to continue to position Millard as an integrated delivery system," he said. "If you want to cling to the anchor of the past, this is a very troubling time. If you see it as a bridge into transforming our industry into even more of a positive force for society, it's a very exciting time. It's white-knuckle at times, but you just have to have faith that it will all come out appropriately." with sparking a dramatic turnaround in Buffalo's second-largest hospital system. Under his leadership , the formerly money-losing system ran consistently in the black. In addition, jennings formalized the hospitals' relationship with the university and many of the residency programs it operates. He left Buffalo last year to become president of the Children's Memorial Medical Center in Chicago. VanVorst came to Millard Fillmore in May from San Antonio, Texas, where he headed the multi-hospital Santa Rosa Health Care Corp. At Santa Rosa , he developed a long-range strategic plan and a quality management plan. His previous positions included president and CEO of the Carle Foundation, in Illinois, a not-for-profit health care holding company with hospitals and other facilities, and vice president of operations at Methodist Hospital of Indiana. Van Vorst has received the World Health Organization Fellowship and was appointed to the National Advisory Council on Public Health Training. His master's of business administration in health care administration is from George Washington University, in Washington, D.C. "New York is a much more regulated state" than hts previous locations, Van Vorst said. "It has unique nuances in terms of how health care is delivered." And the medical school's relationship with its consortium of hospitals, he said, also is unusual in American health care. "What is exciting and, frankly, I think is avant-garde about Buffalo, is the fact that there is a pluralistic approach many hospitals working with the university, a joining together of community resources. I think it may be a structure that's ahead of its time. "It starts from a level of collaboration and coordination that we have to do, because there is no (single) univer- Charles B. Van Vorst is the new president and chief executive officer of the Millard Fillmore Health System, which comprises the 443-bed Gates Circle and 151-bed Millard Fillmore Suburban hospitals. His predecessor,] an] ennings, served for a decade starting in 1983. Active in the community, Jennings is credited Lynn G. Brown joined Millard Fillmore Suburban Hospital on Nov. 3 as vice president and chief executive officer. She succeeds Albert L. Fritz, whose two years at the Amherst hospital ended when he returned to his hometown Baltimore to establish a health care consulting firm. During Fritz's tenure, the suburban hospital embarked on a major expansion necessitated by its burgeoning business in delivering babies as well as increased services, patient visits and occupancy that consistently approaches 100 percent. Millard Fillmore Suburban handles more than 3,000 obstetrical cases each year, reflecting its location in the youthful and populous Town of Amherst. Fritz redefined the hospital's approach to providing a "quality life experience" to couples at the birth of -------------------------------------------------------------------0 B u 0 0 p y s 0 s p g 9 4 �-------------------------------------------------------------------· B a 0 p y s c a 5 p g 9 9 4 �------------------------ --------------------------------------------- practice residency programs are the core of Millard Fillmore Suburban's role in the consortium, Brown said. The coordination of several teaching hospitals , she said, "certainly adds a layer of complexity. On the other hand , I believe there is tremendous value for a hospital to be affiliated with the medical school. It kind of forces everybody to stay on the cutting edge. "If you're there teaching residents and have residents in the building, it says that everybody there has to stay on their toes. It's a very positive growth experience, and really sets the stage for people to stay current in the field. " Brown said Eastern Maine Medical Center has affiliations with Tufts University, for the teaching of pediatric medicine, and the University of New England, an osteopathic program. "It's a very similar situation here ," she said. "Obviously, the more residencies you have, the more complicated it gets. "It's verymucha balancing act, too, " their children, instituting a wider spectrum of before- and after-delivery educational classes for new parents. Lynn G. Brown comes to the hospital from Eastern Maine Medical Center in Bangor, Maine, where she was senior vice president and senior administrator. During four years there, she implemented a total quality management program , brought 17 patient response teams on line and established a management development program. Previously, Brown worked for eight years at North Colorado Medical Center in Greeley, Colorado, serving as senior vice president for corporate services as well as director of professional and technical services and director of nursing and patient care services. Her master's degree in health systems administration is from the University of Louisville, Kentucky. She also holds a bachelor's degree in nursing from Spalding College in Louisville. Obstetrics/gynecology and family she said. "When you commit to being a teaching hospital, it is more work. A lot of times it would be faster to just do (some procedure) yourself rather than teaching someone. But it's really the questions, the answers and the interaction that helps us to grow. The patient, in the long run , will benefit because they are the recipient of having a well-attuned medical staff." Recognizing the hospital's "very attractive" suburban location, Brown says, "We're all looking toward becoming a more integrated health care system. As health care changes and evolves, a lot more emphasis is being placed on primary care. Family practice and obstetrics are both generally regarded as primary care practices. "We have a very strong focus on the health care of the future . Basically, we're a full-service community hospital. We want to look at more preventive medicine and the community's health in general. " -------------------------------------------------------------------- · B 0 0 p y 5 c 0 n s p n g 9 9 4 �-- --------------------------- ---------------------------------------- last October ,Joseph A. Ruffolo simply altered his daily commute. He had served as vice president of corporate finance at Millard Fillmore Hospitals since 1984. His predecessor at Children's, john P. Davanzo, saw the hospital come increasingly to handle high-risk deliveries; it also dominates the Buffalo market in pediatrics. During his two years at the helm of the West Side hospital, he grappled with a decrease in Children's patient load attributed to the population shift to the suburbs and severe competition for the obstetric market from other hospitals - most notably, Sisters and Millard Suburban. The resulting financial problems forced the layoffs of about 60 employees in 1992. At Millard Fillmore, Ruffolo played a significant role in that system's return to profitability. He also worked with the medical school to establish a Department of Rehabilitative Medicine. His previous health care administration experience includes positions at Sheehan Emergency Hospital and iagara Falls Memorial Medical Center. In 1990 he won the Cain, Shattuck Co. Award, a prestigious national award that provides the winner a fellowship in corporate financial management at Harvard University. Now, Children's financial picture has improved, and Ruffolo says the hospital's 125 residents in all specialties of pediatric medicine are keeping physicians up on the latest methods of caring for the tiniest of patients. "What (the consortium) enables us to do is to really stay on the cutting edge of new technologies and treatment modalities," he said. "Participating in these teaching programs allows you to develop protocols that can monitor behaviors much more effectively than if you were trying to do that using When he became president and chief community hospital physicians. " executive officer of Children's Hospital Ruffolo says he wants Children's Hos- regulated health care environment challenging. Here, "providers operate under a much more regulated environment," Maher said. "The options on what you can strategically do tend to be much more limited." He also cited the difficulties an administrator faces in a state that tightly regulates the fees hospitals can charge. "It's created a system where hospitals have a difficult time maintaining financial solvency," he said. "It makes it much more difficult for hospitals to have the capital to restructure and retool for the future. " About the medical school consortium, though, the new CEO is nothing but positive. "For a hospital like Sisters, it really opens up a lot of avenues for being able to work with the university," he said. "If you think about hospitals that are outside the opportunities a consortium provides, they're not able to access the educational resources that we're able to access. The consortium, for us, provides that opportunity, that avenue to benefit from resources that, without the consortium, frankly, we wouldn't have. " Sisters has about 48 residents in such programs as internal medicine, obstetrics/gynecology, otolaryngology and family practice. The Main Street hospital's future , Maher said, will be "very much involved in trying to not simply take care of the patients that arrive at our front door, but rather reaching out to the community and enhancing the health status of the community. It's something we can't do by ourselves, but only by working collaborativelywith other providers. " john]. Maher, Sisters Hospital president and chief executive officer, last April became the first lay president in the hospital's 145-year history. The hospital, part of the Daughters of Charity ational Health System, had been administered for the six years before that by Sister Angela Bontempo. Taking office at a time when the hospital needed renovation and was facing pressing financial problems, Sister Bontempo helped increase the hospital foundation's assets to more than $3 million, and directed the establishment of new women's services, chemical dependency centers and satellite primary care offices throughout Buffalo. She also was the force behind the hospital's $42 million modernization project. Sister Bontempo left to take on other duties in her religious order, the Daughters of Charity of St. Vincent de Paul. Maher previously was executive vice president of the St. Vincent Hospital and Health Care Center, in Indianapolis, also a part of the Daughters of Charity hospital system. There he was responsible for day-to-day operations at the hospital's three acute-care facilities, a regional referral center, a smaller community hospital and a mental health facility. He also managed a $100 million construction program and helped institute a program in which nurses and other staff members play a more active role in defining their care units - a program that cut costs, increased satisfaction among patients, physicians and staff and improved patient outcomes. Prior to his six years in Indianapolis, Maher worked in health care administration in Tacoma, Washington; Richmond, Virginia; and Chicago. He has master's degrees in business and in hospital administration from Ohio State University. He, too, finds NewYorkState's highly - ••••••••••••••••••••••••••••••••••••• B u a 0 p ., y s c 1 1 1 --------------------------------~ I a n s p n g 9 9 4 �--------------------------------------------------------------------· ficulties occasioned by stiff competition, fewer admissions and an increase in the average length of time patients stayed in the hospital. Mercy's financial picture improved after 81 positions were eliminated late in 1991. In Virginia, Stanek was responsible for all hospital operations, including finance and marketing. His previous experience included serving as executive vice president and chief operating officer of Good Samaritan Hospital, in Pottsville, Pennsylvania. His master's in business administration and administrative management is from St. joseph's University, in Philadelphia. His original training was in pharmacy, at the Philadelphia College of Pharmacy and Science, and in chemistry, at East Stroudsburg University, East Stroudsburg, Pennsylvania. Stanek says Eastern Virginia Medical School worked with DePaul Medical Center in much the same way the UB Medical School works with the hospitals in its teaching consortium. "It really is a major medical school," he said of UB. "The residents have the ability to experi~nce different environments. They pital to reach out to the community, "moving toward ambulatory settings so that residents have more exposure to ambulatory medicine. And we are beginning to develop more outreach initiatives in preventive medicine." Ruffolo says Children's seeks to encourage residents to choose primary care as a specialization, recognizing that primary care is increasingly essential to an integrated health care system. "I want to build Children's Hospital as more of a regional and statewide tertiary center for cardiovascular, thoracic and neurosurgery, hematology and oncology," he said. MERCY HOSPITAL Robert V. Stanek comes to Buffalo from orfolk, Virginia, where he was executive vice president and chief operating officer at DePaul Medical Center. He succeeds Sister Sheila Marie Walsh, who had been administrator of the South Buffalo hospital since 1976. Sister Walsh, like many local hospital executives, struggled with financial dif- also have exposure to not only full-time faculty members, but also with volunteer and part-time faculty members (at the hospitals). There's a richness and diversity there, and that's a major advantage that this type of consortium approach brings to the table." About34 residents, Stanek said, serve in the internal medicine, physical medicine and pediatrics programs at Mercy Hospital. ew York, he agreed, is a unique environment for the health care administrator. "It's driven to a large degree by this being a very regulated state health care environment. In Virginia it was very deregulated. Here, reimbursement rates are very regulated by the State of New York; in Virginia, it's much more a competitive situation, similar to the Clinton managed care environment. "I find the hospital providers in Buffalo to be very collaborative in nature, and I find that very helpful. The level of collaboration can help achieve a better quality of care for the people we serve. It becomes more cost-effective over time." In South Buffalo, Stanek said, "our -------------------------------------------------------------------- ~ B a 0 p h s c a n s p n g 9 9 4 �~ -------------------------------------------------------------------~ overall direction is to make sure that we are meeting the needs of the community. We try to make a commitment to servicing employees, patients, physicians-- we look at all of those as people whose needs we are challenged to meet." He points to gall bladder surgery as an example of how new technology is radically changing the way hospitals do business. "A few years back, you'd be in the hospital10 days to two weeks. Now it's laparoscopic; patients stay for a day or two. "We're watching the transition from care being provided in an inpatient setting evolving to outpatient settings. It's less expensive that way. "And there's a very strong evolution in the health care environment to really deal very heavily with preventive medicine rather than just the traditional delivery of health care. We want to develop an integrated, seamless delivery system. We want you to have the ability to get into the system and have your health care needs met." Wyoming County Community Hospital , where as CEO he guided the 102bed hospital to its first years in the black since its founding. Hired in 1990 - a year in which the hospital lost $2.3 million- he led it to profitable years in 1991, 1992 and 1993, with no financial assistance from the county. At ECMC, Candino said, his mission will be to bring the medical center into similar financial stability, while at the same time developing long-range plans for the way it delivers health care. "I think that ECMC and all the consortium hospitals have to begin looking at the overall delivery system and the health care community in the Buffalo and Western ew York area, " Candino said. "It's difficult to do, because there are all sorts of pressures on hospitals right now- reimbursement pressures, health care reform pressures. "It would be very easy for the CEO to continually focus on what's going on within the internal operations of the hospital he's in charge of, but if that's all the CEO does, then the overall world will change, and where the medical center fits into that will be up to someone other than the CEO. He has to make decisions for what makes sense for the community. "I think we have to work together and start making some decisions , not only what makes sense for our particular hospital, but what makes sense for the community." The appointment of ECMC's new chief executive officer was fraught with political controversy as the hospital's board rejected County Executive Dennis Gorski's candidate. The board has the sole authority to hire the county hospital's chief executive officer, but since the county executive appoints 10 of the board's l3 members, Gorski had argued he should have a voice in the selection process. With the selection process narrowed to three candidates, Gorski had sup- Paul Candino began work on February 14 as chief executive officer of the Erie County Medical Center, succeeding George H. McCoy, who had led the Grider Street facility since 1986. McCoy resigned effective April 1 to take a position with the government of St. Croix, in the U.S. Virgin Islands. As chief executive officer of St. Croix Hospital, he will oversee the rebuilding of the hospital, severely damaged by Hurricane Hugo in 1989. During his tenure, ECMC was named a regional center for the care of trauma, burns and AIDS. McCoy also is credited with buttressing the hospital's troubled cardiovascular surgery service and finances as it entered the 1990s. Nevertheless, it remains beset by financial and political troubles. Candino comes to ECMC from the ported Sushil C. Sharma, head of Buffalo's Columbus Hospital, over the other two, one from Washington, D.C., and one from Ohio . The board rejected Sharma, saying his experience at the helm of tiny Columbus Hospital didn't qualify him to lead giant ECMC. That decision set off a firestorm of protest, as supporters of Sharma pointed to his exemplary record at Columbus and his strong credentials. Candino maintains a firmer financial footing for ECMC will ease some of its political pressures. "We have to gain, as an institution, any efficiencies we can gain," he said. "Once we do that, a lot happens and a lot of opportunities will be presented. All of a sudden government is not as interested in the day-to-day operations of the medical center. As long as government is footing the bill in terms of a large subsidy, then they're going to want to have a say. That's their job. They're elected to serve the taxpayers' interests. "But once we can get beyond that, once we can generate a gain or a breakeven situation without a county subsidy, then we'll be able to look at the long-term picture of delivery of health care in the Western New York area , and work in more of a collegial environment with the other hospitals, work toward some mutual goals." OfECMC's part in graduate medical education, Candino said that's "a part of our overall mission. "In addition to providing high-quality care at the lowest cost possible, it's also a medical center that has the responsibility to provide teaching and research for the overall good of medicine," he said. "Somebody has to supply physicians to the community, especially the Western ew York community and especially primary care physicians, in the future. And somebody has to do the research and look into cures for the future. "I look at it as a challenge. " + -·------------------------------------------------------------------B u 0 0 p y s c o n 5 p n g 9 4 �HANGING FACE THE OF ED I CAL DUCATION UB'S REVAMPED CURRICULUM WITH THE BY BLENDS BEST ANDREW OF THE THE BEST OF THE OLD NEW DANZO It used to be fairly cut and dried. Two years of basic science. Two years of clinical experience. Then the M.D. Those days are over. The UB School of Medicine and Biomedical Sciences is moving steadily toward a new way of teaching -one that stresses analysis over memorization and patient interaction over crowded lectures. Proponents hope it will bring the art and science of medicine into more meaningful focus, providing future physicians with cutting-edge computer skills while re-emphasizing the people skills of old-fashioned doctoring. Many changes are being implemented or planned, but the central ones involve a problem-solving emphasis in basic science courses, earlier introduction to clinical skills, the creation of a clerkship in family medicine and a shift to ambulatory settings for other clerkships. B a a p 5 c a n s p g 9 9 4 �PHOTOS BY ROBERT basic science faculty, which he described as "excellent." "It's a difficult line we're walking here," said Loonsk, a 1986 UB medical school graduate. "By no means are we trying to imply that what they're doing is not superior." The proposals not only would make changes in the way the basic sciences are taught, but they would also establish a closer link to the clinical training that is the core of the second two years. "One of the ideas put forward is to focus the curriculum in the first two years around clinical education and experiences," said Dennis A. Nadler, M.D., associate dean for curricular and academic affairs. adler declined to predict the final outcome. He did say, however, that the ideas under discussion would "drastically" change the way medicine is taught at UB. Bone said it would be a "significantly" different education than the one he received when he attended the medical school more than 20 years ago. "We had no clinical correlation," said Bone, who graduated in 1973. "We had no interdisciplinary approach and we didn't see patients , except for an occasional visit with a preceptor, until the third year." The new proposals include an earlier introduction to clinical courses and improvements to the first-year preceptorship program. "The experiences the students had with the preceptor program vary, and that's a concern," said Loonsk, explaining that some students haven't had enough contact with their preceptor. One idea is to have students follow a single patient or family all the way through medical school. "That's a difficult one," Loonsk admitted. Nadler said the second-year family medicine course might The new approach is not so much a single effort as a group of ideas that have evolved independently in recent years. But many of those ideas are now coalescing under the umbrella of the medical school's primary care initiative. "The reason is that the forces of health care reform and national need are such that we don't need larger numbers of specialists, we need larger numbers of generalist physicians," said dean and vice president for clinical affairs john aughton, M.D. The medical school hopes to be chosen by the Robert Wood johnson Foundation in late spring for a $3 million grant to help implement the changes. If it wins the grant, and administration officials are optimistic, the funds could speed the changes, though no one has yet put a precise timetable on them. Naughton said UB isn't the only school making such efforts, but it's at the forefront. "We've moved a little faster than certainly most of the eastern schools have," he said. UB already has made some of the changes. It has started moving medical clerkships, for instance, from hospital bedsides to ambulatory settings, such as physician offices and clinics. It also has introduced a family medicine clerkship for third-year students. And some basic science classes have begun introducing problem-solving and clinical-correlation approaches. "The whole idea of medical school is to become a doctor and take care of patients," said Lawrence Bone, M.D., cochairman of the school's Curriculum Committee. "That's what we're trying to do , make doctors." Many of the changes that are still in the proposal stage focus on the first two years, where students traditionally have been immersed in basic sciences. john Loonsk, M.D. , the other Curriculum Committee cochairman, said that while the changes are significant, they are meant simply as improvements, not criticism of UB's B a 0 p s c WA LI ON 0 5 p g 9 9 4 �CHANGING THE FACE OF u a 0 p h 5 EDUCATION techniques almost to the exclusion of traditional didactic teaching. UB doesn't intend to go that far. "We hope to strive for a balance ," he said. "We believe both are important teaching tools , and we hope to achieve a balance. " Rosenthal said the techniques already have been introduced as a "clinical correlations " component in some courses, particularly microbiology and biochemistry. The teaching often is done in a team , with a clinical faculty member on hand to present the case, say, of a patient who has walked into a doctor's office with fever and chills. What might have been a purely scientific discourse on bacteria is transformed into a give-and-take exercise. Instead of- or in addition to - simply listening to a lecture, the students find themselves pondering the patient's chest X-ray. "What we hope to do is give the student the opportunity to recognize the relevance of what's being taught and give them the discipline to ask their own questions ," Rosenthal said. The teaching techniques would most likely take final shape around an "interdisciplinary medicine" course, a twoyear track that would integrate related aspects of basic science courses now taught separately. Among the many details still to be resolved are just which course components to move , and where. Rosenthal said there is no single model for what UB wants to do with its curriculum, but medical school officials have been exchanging ideas for several years with representatives of five other schools, including Harvard. "This has been an evolutionary process that comes into focus in 1994 with the Robert Wood johnson Initiative," he said. be expanded into the first year , using many of the same sites, as well as some additional ones, now used in the second-year preceptorships. Students might spend one or two half-days a week at the same site, following patients and seeing how a generalist practices, Nadler said. The second-year clinical introduction course also might be shifted to teach first-year students interviewing and diagnostic skills , said Thomas Rosenthal , M.D. , project director of the Robert Wood ] ohnson Generalist Initiative. Ideally, said Rosenthal, "by the time they hit the third year, they have some of these basic clinical skills developed and are able to take better advantage of the clinical experiences." While clinical experience would be accelerated and expanded under the proposals, the approach to teaching basic sciences also is in for some revision. Nadler said the catch-all phrase for the change is "self-directed learning," a central element of Harvard's New Pathway program. Essentially, it makes the student a more active participant. "The traditional curriculum at this school is a very didactic one," Nadler said. "Students go to lectures and laboratories and are taught." Self-directed learning is based on two techniques , casebased and problem-based teaching, which are similar. In problem-based teaching, basic science students are presented with a question that relates to a common medical problem, such as diabetes or cerebral palsy. The students break up into groups, decide what they must do, research the issue, discuss it, then present their findings . It's similar to a seminar. In case-based teaching, the process is about the same, but instead of being presented with an abstract problem, students are faced with a patient case. Nadler said Harvard's New Pathway program uses the B MEDICAL c a s p n g 9 9 4 �CHANGING THE FACE OF MEDICAL EDUCATION find the1r own UB was one of 18 medical schools that received answers rather Robert Wood johnson grants several years ago to than be told . search for ways of turning out more primary care Smith, who physicians. attends many Rosenthal said that the original Robert Wood Curriculum johnson grant of $150,000 expires in May. If UB is Committee among the l2 medical schools that win new $3 meetings but is million grants from the foundation~ , U~B~w~ou~ld!!h!av~e:._~~~~~.J._L___ 1w~..,.; not a member, "the resources to accomplish said the combiin a couple years what would nation of stu(otherwise) take us a much dent-based longer time ." learning and earlier clinical It would also elevate UB's exposure should give stunational stature, dents a greater appreciation not only among for what medicine is all schools emphaabout. "The students will sizing primary perceive from early in their care, but among careers the relevance of what those breaking they're learning to medical new ground in care," he said. "Some stumedical curricudents always understood lum innovation. why they were learning what While the package of prothey were learning. Other posed changes has come unstudents did not. " der the primary care umpart of the apA key brella, there's a broader raproach is research, not the tionale as well. scientific laboratory kind, "What is being proposed but the sort that's traditionwill be good for all doctors ," ally done in libraries. Exsaid Cedric Smith, M.D ., a cept now it's done more readily by computer and it's often professor in the department of pharmacology and therapeureferred to as "accessing information." tics . Bone sees it in terms of fostering a "lifelong pursuit of "There are many reasons ," said Nadler. "But maybe the knowledge. most important reason is we have discovered that students "As a physician, you don't stop learning the day you who know how to think, how to solve problems and access graduate from medical school," he said. "It's the obligation of information are more effective physicians than the ones who the school of medicine to help students develop those skills just memorize." ... in this day and age , the use of computers as a tool as well Murray Ettinger, Ph.D. and distinguished teaching proas an instrument for learning is very important." fessor of biochemistry, agreed. Already, vast amounts of information are available in "One goal is to try to give students a chance to learn more computer data bases, many of which can be tapped through on their own and to tie things together more on their own," said Ettinger, a member of the Curriculum Committee. "Up the HUBNET system operated by the medical school and its consortium hospitals. And electronic medical records will to now, a lot of medical school education in this school and most schools is an awful lot like undergraduate education, become more common, replacing traditional written records . "The electronic medical record is going to have terrific where people just go to lectures and take exams." The new curriculum may be more like traditional graduramifications in patient care," said Loonsk, who is the medical school's director of medical computing. ate education, where students are expected to conduct their Some proponents envision storing a patient's full medical own research , then present their findings and argue their history, right down to the X-rays , in computer data bases conclusions in seminar discussions. In short, students would B u a 0 p y 5 c a n 5 p g 9 9 4 �CHANGING T HE FACE OF from which the information can be easily retrieved and transferred. That could also have tremendous implications for clinical researchers, who currently must go to hospital record rooms and wade through stacks of patient charts. UB has been trying to familiarize medical students with computers and make them aware of the machines' potential since 1986, Loonsk said. It is one of the few schools that require computer training, though that's done now as a component of biophysics in the second year. One of the curriculum proposals now under discussion would create a first year, first semester course devoted to medical computing. "Actually, here at Buffalo, we're way ahead of the game compared to many schools because of the HUB NET system," said Loonsk. Through HUBNET, students and faculty can get into data bases like MEDLINE, where they will find information pertinent to both clinical care and research. Many of the data bases contain complete articles, and even textbooks are available on-line. "One of the problems with medicine for a long time was that it was becoming increasingly specialized, partly because there is so much information, it was difficult for the generalist physician to stay current in all these areas," Loonsk noted. Not any longer. "The implication to medical school," added Loonsk, "is that we should teach people how to access the information well." Specialists, of course, will always be needed. And physicians will always have to carry a lot around in their heads. But with medical knowledge expanding daily, some medical educators have come to the conclusion that it's better to stress thinking over memorization, because physicians who are well-versed in the principles can now more readily look up the detailed information they need for a specific case. And B u a 0 p h y 5 M EDICAL E DUCATION that information will be more current than something they learned years ago. "In the past we taught students much more to memorize," said Susan Schwartz, M.D., a Curriculum Committeemember. "Butit'simpossible to define anymore a body of knowledge they should have by the time they leave medical school." With problem-solving and research skills, she said, "they can become experts." The 25-member Curriculum Committee has been discussing many of the changes for several years and is just beginning to take the broad themes to the faculty at large. Before implementation, proposals must be approved by the Faculty Council, then go to course coordinators for more detailed development. Loonsk said they probably would not take effect until the 1995-96 academic year, at the earliest. Some significant related changes already have occurred, however. The biggest is the family medicine clerkship for third-year students. A major part of the Robert Wood johnson Generalist Initiative, it was approved by the Faculty Council in 1993 and will be instituted with the 1994-95 academic year. At the same time, the traditional clerkships are shifting away from hospitals toward ambulatory settings. "In medicine, the big change that we introduced over the past year was a four-week block of ambulatory medicine," said Schwartz, who is clerkship director for medicine. There are related goals. As medicine in general has shifted toward more ambulatory care, the educational experience for students in hospitals has narrowed. They've been meeting only the sickest patients, limiting their bedside interactions with patient and physician alike. c a n s p n g 9 9 4 �CHANGING THE FACE OF u a 0 p 5 c EDUCATION solution, she added , means that many students will take part two of their boards in senior year before finishing the full medicine and surgery clerkships. "That may be a problem," she said. The shift to ambulatory settings also has some students worried. "It's not a concern on my part, but for the students I think it seems a lot more intensive in the hospital setting, and they need to be reassured that they're learning as much in the ambulatory setting," Schwartz said. When the first group of students in the new ambulatory medicine rotation took their exam last fall, they did as well as previous groups, she noted . The ambulatory emphasis also means lining up new training sites and more community-based volunteer faculty . "That type of educational experience is basically one-onone," said Rosenthal. "It does represent a challenge to the departments of pediatrics and medicine to develop that volunteer faculty. " Other challenges lie ahead. For one thing, curriculum planners must decide which components of basic science courses should be integrated into the new interdisciplinary and problem-based approaches, and which should be left separate. There is consensus on the concepts - "We're trying to teach the science basic to medicine, rather than teaching basic science," said adler- but the devil is in the details. Also, some faculty members are uneasy with the uncertainty of the whole situation and the implication that the old ways were a failure . Naughton said that while UB is at the forefront of medical curriculum innovation, "most medical schools are going to make these same kinds of changes in the next few years ." "It will require a lot of faculty cooperation," he added. It is possible the new teaching approaches could take time from faculty who already are stretched between classes and their own research. Then again, the approaches could be easier to teach, since they delegate more of the responsibility for learning to the students. Either way, things are changing. "It will put a lot more stress on the primary care facultythey'll have to participate in courses they never thought about participating in before," said Rosenthal. "It will put the basic science faculty in a position where they'll have to interact more with clinical faculty ... it'll require change on both our parts, and change is stress." Ettinger agreed that faculty will be affected. "It's a different kind of teaching," he said. But, he added , "I think it may be less painful than people think." "The student wasn't getting a chance to do their own personal history and physical the way they were supposed to," said Schwartz. In a doctor's office or a clinic, Rosenthal said, students encounter patients "who present earlier in the disease process and with a condition that is not acutely life-threatening. So your diagnostic work-up is done not only at a different pace, but it's done with a different approach." Besides encouraging more students to choose primary care, he added, it will give future specialists more exposure to generalist physicians, which can only help interactions between the two groups. As faculty members ponder curriculum, some administrators have been thinking about the admissions side of things . adler said there have been efforts to identify demographic characteristics of medical school applicants most likely to choose primary care careers. "There is some literature on the subject, though it's pretty scarce," he said. "There is a sense that people from rural backgrounds are more likely to choose generalist medicine and return to rural areas ." But Thomas]. Guttuso, M.D., assistant dean for admissions, said the effort is limited. "We're looking for those people who have the personal qualities that we think will make them become outstanding practicing physicians," he said. "If it fits primary care, fine. But it doesn't have to be primary care." Meanwhile, said Guttuso , the number of applicants has increased from a low of about 2,250 in 1988 and 1989 to about 3 ,600 for the 1994-95 class. "There's definitely been an increase in the number of people applying who don't have pure scientific backgrounds," he said. "But still, the vast majority of the pool is scientifically oriented." While there is a sense of enthusiasm about all the changes, a lot of dust is still to settle. "These things come at a price, and they don't come easily," said Naughton, noting that introduction of the new family medicine clerkship resulted in scaled back third-year clerkships for medicine and surgery. The family medicine clerkship will be seven weeks, while medicine and surgery are being reduced to eight weeks from the previous 11 weeks. To compensate, students will take four weeks of a new Medicine 2 and Surgery 2 in the fourth year . "I was not happy about it," said Schwartz. "Not at all." She said planners considered a "screw everyone" solution that would have cut a week off all clerkships, but that would have disrupted the system of teaming students up with residents and interns on four-week rotations . "It was really a fierce battle for a year," Schwartz said. The B MEDICAL a 5 p n g 9 9 4 �a ············ · ··· · ·············· · · · ···· · ········· · ·· ·· ···· · · ·· · · · ··· ····· · ······ ·· · · · · · · · $7.5 million establishes new center ENTERPRISE WILL CONCENTRATE ON DEVELOPING AND MANUFACTURING REHABILITATIVE ASSISTIVE DEVICES he University at Buffalo has re- ogy Evaluation and Transfer "expands Assistive Technology and project direcceived a five-year, $7.5 million significantly the capabilities of the Cen- tor of the new initiative. The co-direcgrant from the National Institute ter for Assistive Technology, already a tors of the project are William C. Mann, on Disabilities and Rehabilitation visible leader in the field. professor and chair of the UB DepartResearch to establish the first na"It promises to increase our collabo- ment of Occupational Therapy and ditional center for advancing new ration with consumer-based agencies rector of the Center for Assistive Techassistive devices from the inventor's and private businesses in the commu- nology, and Kenneth ]. Ottenbacher, workshop to the manufacturer's assem- nity and nationally. It offers a promising professor of occupational therapy and new model of cooperation between uni- associate dean of the School of Health bly line. The Rehabilitation Engineering Re- versity, business and public interests." Related Professions. search Center on Technology EvaluaThe new center will help close the Five to 10 devices per year- items tion and Transfer is a collaboration be- - supply-demand gap in assistive devices that likely would not reach the public tween the Independent Living Center of existing nationwide, notes joseph Lane, otherwise - are expected to become Western New York, an agency that as- associate director of the Center for available to people with disabilities as a sists people with disabilities; result of the center's work. the Western New York Tech"We plan to bring into the nology Development Center, marketplace products that Inc. (TDC), a corporation that will make a difference in helps create, expand and dipeople's lives," Lane adds. versify technology-related "We hope to reach the inbusiness in Western New ventor working in the family York; and UB's Center for garage, as well as the estabAssistive Technology, a lished designer. multidisciplinary group that "Really helpful products provides research, education often never see the light of and service in the field of day because many designers assistive technology. and inventors don't have reThe center, which began sources to develop their ideas operating last fall, screens and make them marketable, prototypes for new assistive Above, Steve Bauer, director of research and development for the center, and don't know how to link works on an electronic data acquisition system. Below, Dale Johnson, design devices from across the up with the manufacturer," engineer associate, works on a powered mobility simulator. United States, selects those he said. "On the other hand, with the most market potential, evalumanufacturers often lack knowledge ates and refines them and establishes about consumer needs and product repartnerships with commercial firms to quirements. Our new center will promanufacture and market the products. vide the resources and become that missG. Alan Stull, dean of the UB School ing link." of Health Related Professions, in which Lane notes that the "military research the Center for Assistive Technology is and development of the past decade housed, says the Rehabilitation Engigenerated a wealth of new technologies neering Research Center on Techno!that are pending declassification. They B u 0 0 p s c o n 5 p n g 9 9 4 J } �············································ ····· ················ ·· ·········· · ·········· a · ~ I hold great promise for assistive technology applications. "The facilities now at UB, along with resources in Toronto, Rochester, Pittsburgh and Cleveland, make this region uniquely positioned to become the national center for research and manufacturing in assistive technology. We are definitely the leading region in the field." The Center for Assistive Technology currently houses the national Rehabilitation Engineering Research Center on Aging, which develops and evaluates assistive devices for disabled older adults. The Center for Assistive Technology also encompasses the Developmental Disabilities Assistive Technology Institute, which designs and produces lowdemand assistive products; Project LINK, a national clearinghouse that connects consumers who need assistive products with appropriate device manufacturers; Rehabilitation Technology Services, which designs and builds customized seating and positioning devices, plus a wide array of services for people with sensory, physical and cognitive impairments. The new center uses a five-stage evaluation process to ensure resources are expended on products with market value. Prototypes are analyzed by technical, user and marketing groups at each stage, and are either withdrawn or advanced, depending on the results of the collaborative evaluations. Organizers expect the center to be self-sufficient within five years, generating future operating funds through a percentage of the revenues from sales of devices licensed to manufacturers, partial ownership of some patents and fees for services charged to some inventors and corporations. A new not-for-profit company will eventually take over the center's technology evaluation and transfer functions. B a 0 p h I Above, Johnson welding in a lab at the center. The UB Center for Assistive Technology will continue new device research and development as well as grant procurement to fund the manufacture of "orphan" products- devices that would substantially enhance the lives of those who could use them, but that have little y 5 c a n 5 p commercial value to manufacturers. A 10-member board of directors with representatives from national consumer associations, private corporations, research centers and technology-transfer agencies oversees the work of the new center. - B v n L g 0 I 8 5 9 A 9 K 4 E R �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 l I UB begins joint study of addiction that 75 to 90 percent of the alcoholic population never enter an alcohol treatment program," Blane explains. "Thus, UB JOINS WITH RESEARCH INSTITUTE ON ADDICTIONS there is a strong need for populationbased studies like the ones we will conTO ESTABLISH ALCOHOL RESEARCH CENTER duct." RIA will conduct a study of why he School of Medicine and BioThe grant will create approximately some alcoholics seek treatment while others do not, and why some alcoholics medical Sciences and the Buffalo- 30 new jobs. "This is the first NIAAA Alcohol Re- appear to recover without treatment. based Research Institute on AdTrevisan notes the grant offers a dictions (RIA) have received a joint search Center dedicated to studying the $8 million grant from the National clinical and medical epidemiology of unique opportunity for alcohol researchInstitute on Alcohol Abuse and alcoholism. The new center adds an ers and clinical epidemiologists to work Alcoholism to establish the nation's first important, substantive direction to al- together to conduct research into Center for the Clinical and Medical Epi- cohol research in this country," Blane alcohol's relationship to chronic dissays. "These studies will significantly ease. demiology of Alcohol. "The study concentrating on coroHoward T. Blane, Ph.D., RIA direc- expand our knowledge of the natural tor, will direct the new center and Marcia history of alcoholism and the relation- nary heart disease will look in detail at Russell, Ph.D., RIA senior research sci- ship between alcohol use and health drinking patterns- not just the amount, but the way people consume alcohol entist, will serve as scientific director. disorders. "Most of what we know about alco- as possible risk factors," he adds. "We Maurizio Trevisan, M.D., chair of social and preventive medicine, will direct re- holism is based on studies of alcoholics will also look at the interaction between in treatment, but it has been estimated alcohol and other nutritional factors." search conducted at UB. The UB study on alcohol and The grant will fund three major ~!l!!fJ~IF~~;;;~II!I'I-,~Itll!!~ lung cancer will be the first to conresearch studies and one pilot protrol for possible confounders such as gram that will run concurrently over the next five years. The renutritional status and passive smoking - a particularly important facsearch programs will study the epitor to consider, Trevisan notes, since demiology oftreated and untreated alcoholism, the epidemiology of a great deal of alcohol is consumed alcohol and coronary heart disease in smoky bars. and the epidemiology of alcohol Other UB researchers involved in and lung cancer. The pilot prothe project includejo Freudenheim, gram will involve the development Ph .D.; james Marshall, Ph.D .; of a computer-based geographic inManavela M. Desu, Ph.D.; jeffrey S. formation system on alcohol conSchwartz, M.D.; Donald Armstrong, Ph.D.; Elisa V. Bandera, M.D.; Terry sumption to serve as a basis for Pechacek, Ph.D.;johnE. Vena, Ph.D.; further epidemiological study. The Lucy Campbell, Ph.D., and Paula grant also provides funds for a naMuti, M.D. tional conference on alcohol epiAdditional RIA researchers indemiology to be held in its fourth year and the establishment ofa blood cludeGerardj. Connors, Ph.D.; Kenand specimen bank that will allow neth E. Leonard, Ph.D., and Michael ~ ~ future researchers to explore the role R. Frone, Ph.D. ~ j of genetic markers and individual RIA is a research institute affiliated ~ susceptibility and to assess the interwith the New York State Office of u action between alcohol consump- The NIAAA Alcohol Research Center will be the first to study Alcoholism and Substance Abuse Sertion and these markers. vices. the clinical and medical epidemiology of alcoholism. B u a 0 p h s c a s p n 9 9 9 4 �···-·--·-·--·---·-------------·----------------·-·---------- ----··----·-·-·············· a · ~ I 1993 is strongest yeM ever for school's James Platt White Society he James Platt White Society capped its strongest membership drive ever last October with a special reception at the Park Country Club. Membership in the organization, which recognizes donors to the School ofMedicine and Biomedical Sciences of $1,000 or more, rose to more than 180 alumni, faculty and friends. Organized in 1986 on the medical school's 140th anniversary, theJames Platt White Society is a distinguished leadership organization based on the values and principles of James Platt White, M.D., one of the founders and a former dean of the medical school and a pioneer in the field of obstetrics. White's vision, intellectual vigor and moral courage represent the qualities of the society's membership and leaders. Gifts to the medical school by members of the society have helped fund biomedical and clinical research, provide scholarships, purchase stateof-the-art laboratory equipment and maintain innovative programming. Members of theJames Platt White Society for 1993 include: Dr. Bruce Abramowitz Dr. Kenneth Alford B a 0 Dr. Kenneth Z. Altshuler Dr. Richard Ament Dr. William S. Andaloro Drs. Kevin and Elizabeth Barlog Dr. jared C. Barlow Dr. Ronald E. Batt Dr. Ralph T. Behling Dr. David A. Berkson Dr. Richard A. Berkson Dr. and Mrs. Willard H. Bernhoft Dr. Theodore Bistany Dr. john C. Bivona, Jr. Dr. Willard H. Boardman Dr. Martin Brecher Dr. and Mrs. Harold Brody Dr. Melvin M. Brothman Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. Ivan L. Bunnell Dr. David W. Butsch Ms. janet F. Butsch Dr. john L. Butsch Mr. David N. Campbell Dr. icholas]. Capuana Dr. Peter A. Casagrande (deceased) Dr. and Mrs. Norman Chassin Dr. and Mrs. joseph A. Chazan Dr. Michael E. Cohen Dr. Robert]. Collins Dr. Donald P. Copley Dr. and Mrs. William R. Cromwell Dr. Daniel E. Curtin Dr. Richard Daffner Dr. Peter S. D'Arrigo Dr. Roger S. Dayer Mrs. Carlo E. DeSantis Dr. Edward Diao Dr. Stuart L. Dorfman Dr. Sterling M. Doubrava Dr. Ronald I. Dozoretz Dr. George L. Druger Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Alfred S. Evans Dr. john A. Feldenzer Dr. Donald M. Fisher Dr. jack C. Fisher Dr. john W . Float Dr. Thomas F. Frawley Dr. Vincent]. Fuselli Dr. Richard R. Gacek Dr. B. joseph Galdys Dr. Ronald F. Garvey Dr. john W . Gibbs Dr. Gerard Guerinot Dr. Thomas]. Guttuso Dr. Ralph R. Hallac Dr. joseph V. Hammel Mrs. Gilda L. Hansen Dr. Reid R. Heffner, Jr. Dr. Orvan W. Hess Dr. William J. Hewett Dr. joseph M. Hill p y 5 c Dr. Fredric Hirsh Dr. john M. Hodson Dr. Robert M. jaeger Dr. Kenneth L. jewel Dr. Stephen T. joyce Dr. james R. Kanski, Jr. Dr. julian R. Karelitz Dr. john P. Kelly Dr. Kenneth Kim Dr. and Mrs. Paul S. Kruger Dr. Marie Leyden Kunz Dr. and Mrs. Marvin Z. Kurlan Dr. Francis]. La Luna Dr. RobertS. LaMantia Dr. Gordon R. Lang Dr. Andre D. Lascari Dr. Dana P. Launer Dr. Won Yub Lee Dr. Sanford Leff Dr. Eugene V. Leslie Dr. Laurence M. Lesser Dr. Paul A. Lessler Dr. and Mrs. Harold]. Levy Dr. jack Lippes Dr. Hing-Har Lo Dr. Thomas A. Lombardo, Jr. Mrs. GraceS. Mabie Dr. Milford S. Maloney Dr. David L. Marchetti Dr. Don L. Maunz Dr. Michael A. Mazza Dr. Margaret McAloon Dr. Charles]. McAllister Dr. Margaret P. McDonnell Dr. Harry L. Metcalf Dr. Francis C. Mezzadri Dr. Merrill L. Miller Dr. Eugene R. Mindel! Dr. joseph F. Monte Dr. john D. Mountain Dr. Arthur W. Mruczek, Sr. Dr. Richard L. Munk Dr. Richard]. Nagel Dr. Masao Nakandakari Dr. Richard B. Narins Dr. john Naughton Drs. Robert and Lillian Ney Dr. Charles R. Niles Dr. john D. Norlund Dr. Benjamin E. Obletz Dr. Patrick L. O'Connor Dr. Thomas P. O'Connor Dr. Carrie P. Ogorek Dr. Yasuyo Ohta Dr. Elizabeth Olmsted Drs. Dean and Donna Orman Dr. johnS. Parker Dr. and Mrs. Robert]. Patterson Dr. orman L. Paul Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. james F. Phillips Dr. Daniel A. Pietro Mr. R. Willis Post Dr. Richard A. Rahner a s p I Dr. Bert W. Rappole Dr. Albert C. Rekate Dr. Frank R. Riforgiato Dr. Charles j . Riggio Dr. Richard R. Romanowski Dr. and Mrs. Charles H. Rosenberg Drs. Robert Smolinski and Claudia Fosket Dr. Albert G. Rowe Dr. jacob D. Rozbruch Dr. Eric]. Russell Miss Thelma Sanes Dr. Michael A. Sansone Dr. Robert N. Schnitzler Dr. David S. Schreiber Dr. joseph I. Schultz Dr. Roy E. Seibel Dr. Molly Seidenberg Dr. Elizabeth G. Serrage Dr. john B. Sheffer Dr. john E. Shields Dr. Timothy S. Sievenpiper Dr. Roger M. Simon Miss Alice Simpson Dr. Arthur C. Sgalia, Jr. Dr. Raymond M. Smith, Jr. Dr. Morton Spivak Dr. john E. Spoor Dr. john]. Squadrito Dr. Richard J . Sternberg Dr. William Sternfeld Dr. Eugene M. Sullivan Dr. Michael A. Sullivan Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. john P. Visco Dr. Franklin E. Waters The estate of Mrs. Pauline E. Watson Dr. and Mrs. Arnold Wax Dr. and Mrs. Harold F. Wherley Dr. james]. White, Jr. Dr. Gary]. Wilcox Dr. james S. Williams Dr. Richard G. Williams Dr. and Mrs. Marvin Winer Dr. john R. Wright Dr. Gregory E. Young Dr. Wende W . Logan-Young Dr. Syeda F. Zafar Dr. Franklin Zeplowitz Dr. and Mrs. David C. Ziegler Editor's Note: While every effort is made to ensure the accuracy of this listing, omissions and misprints may occur. This report lists all members between October 24, 1992 and October 22, 1993. If you have any questions, comments or concerns, please call Michael E. Benzin, Acting Director of Annual Giving, at (716) 645-3312. Thank you. 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ~ I Sesquicentennial committee begins events planning MEDICAL SCHOOL FOUNDING ALMOST 150 YEARS AGO MARKS UNIVERSITY AT BUFFALO'S BEGINNING ith a little more than two years before the University at Buffalo and its School of Medicine and Biomedical Sciences celebrate the 150th anniversary of its founding, the History of the Medical School Committee is already busy planning celebrations and events to commemorate the historic occasion. Composed of representatives from both the medical school and the university at large, the committee meets monthly as a whole; its task forces focus on specific aspects of the Sesquicentennial Celebration. In the planning stages are a symposium series, the medical school's annual Spring Clinical Day, various medical school and community-wide exhibits featuring medical school memorabilia, a special sesquicentennial logo and the Annual Meeting of the American Association for the History of Medicine, scheduled from May 8 to May 12, 1996. The group is also working on anumber of special publications, including A Medical History in Buffalo 1846-1996: Collected Essays, A Pictorial History of the Medical School, Selected Writings of Austin Flint and an alumni directory. Douglas Bacon, M.D. SCHOOL OF MEDICINE a 0 E y 8 Committee members include: Harold Brody, Ph.D., M.D., Co-chair Professor, Department of Anatomical Sciences Ronald E. Batt, M.D., Co-chair Clinical Associate Professor, Department of Gynecology-Obstetrics joyce Vana, Ph.D., Secretary Clinical Assistant Professor, Social and Preventive Medicine B Assistant Professor, Department of Anesthesiology James Bono, Ph.D. Assistant Professor, Department of History Ivan Bunnell, M.D. Clinical Professor Emeritus, Department of Medicine Leon Farhi, M.D. Distinguished Professor, Department of Physiology Shonnie Finnegan University Archivist David Gerber, Ph.D. Professor, Department of History Nanette Tramont Kollig Editor, Buffalo Physician Richard Lee, M.D. UNIVERSITY AT BUFFALO 4 A 6 R S 9 9 6 Professor of Medicine, Pediatrics and Obstetrics john Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Carole Smith Petro, Ph.D. Associate Vice President for University Advancement Office of the Vice President for University Advancement and Development jack Richert, Ph.D. Associate Dean for Alumni Affairs Mildred Sanes Lilli Sentz Curator, History of Medicine Collection Library of Anatomy and Cell Biology Dedicated -John Naughton, M.D., vice president of clinical affairs and dean of the School of Medicine and Biomedical Sciences, speaks at the dedication of the school's anatomy and cell biology library last October. At left, Irene DeSantis, widow of Carlo DeSantis, Clarice Bernhoft and Dr. Willard Bernhoft, after whom the library is dedicated, look on. p 5 c a n s p g 9 9 • �............................................................ . . · · · · ··· · · · · · · · ·a Medical school memorabilia sought for pictorial history o celebrate the l50th anniversary ofits founding, the medical school will publish a pictorial history. Already being compiled, the history will feature articles and memorabilia about the school, its students and the historical events that have made it what it is. Connie Oswald Stofko, former Buffalo Physician editor, who will edit and compile the publication, asks for help from anyone who might have a contribution to it: "We need pictures, lots and lots of pictures, to make our pictorial history shine. We're looking for anything visual: photos, paintings, drawings, commencement programs, award certificates, perhaps even an antique that we could photograph. We need pictures from every time period , but we expect we'll have the hardest time finding things from the 1800s. Don't send any original! We'd hate for an heirloom to get lost in the mail. Describe to us what you have, or perhaps photocopy it. Please include the names of people in the picture, the date, wh ere it was taken and any other information you have. If you can't identify the picture, maybe we can help. Send the information about your picture to: Connie Oswald Stofko Editor, Pictorial History of the Medical School History of Medicine Collection Health Sciences Library South Campus 3435 Main Street Buffalo, New York 14214 Please remember to include your name, address and telephone number so we can contact you . B u a 0 p h Items already from the Pictorial History of Medicine Collection, to be published for the Sesquicentennial Celebration in 1996. Above, Dr. Roswell Park performing surgery, circa 1898. At left, the University of Buffalo's 1894 football team. Pictu re guidelines: Photographs: Any size, color and shape is fine. We can have a print made from a slide. Photos from programs and other publications could be copied. Photos from old newspapers might work. Paintings, drawings: Oil paintings, charcoal sketches, pen and ink drawings, pastels and other artwork are all possibilities. Maybe you have artwork 5 c a n 5 p of an old building or a sketch of a piece of equipment or the readout of some pioneering piece of equipment. Other: Look for programs from lectures, commencements or other ceremonies; award certificates; pins or buttons, or perhaps early items used in your field. Thanks, but we don't need yearbooks. We've got those." g 9 9 4 �THEN-NOW Anesthesiology at the University at Butfalo: FROM ITS ROOTS IN 1913 TO TODAY , US'S DEPARTMENT OF ANESTHESIOLOGY HAS MADE NOTEWORTHY CONTRIBUTIONS TO THE SPECIALTY was a pivotal year in the history of medicine both locally and nationally. On May l l , 1846 the University of Buffalo School of Medicine was founded. Almost five months later, on October 14, 1846, William Thomas Green Morton used the vapors of sulfuric ether to anesthetize Gilbert Abbott for the removal of a jaw tumor in the first public demonstration of surgical anesthesia. One hundred forty-eight years later, Paul R. Knight, Ill , M.D. , Ph.D., chairman ofUB's Department of Anesthesiology, oversees a branch of the medical school with more than 80 faculty members. The anesthesiology department supports 52 residents and fellows in six clinical sites scattered across the Buffalo metropolitan area, administers anesthetics , cares for patients with pain and manages critical care. Its anesthesiologists actively investigate problems in basic science and clinical and historical research, as well as give lectures in basic science and clinical demonstrations for the medical students. The Department of Anesthesiology has not always been so substantial. It originally was part of the Department of Surgery; its first appointment, John Henry Evans , was nominated in 1913 by the world renowned surgeon, Roswell Park, as an assistant in anesthetics. Over the next 40 years, Evans would bring anesthesiology in Western New York and the University of Buffalo to international prominence as he developed the country's first department and residency B a a training program . While remaining in active clinical practice all his professionallife, Evans also published 29 papers over the length of his career in the leading journals of his day . John Henry Evans was born on September 24, 1876 to Welsh immigrant parents in the Southern Tier community of Freedom, New York. He learned English at the age of 10 when his family moved to Machias and his father established a general store. He attended the Ten Broek Academy in Franklinville and graduated from Ithaca High School. Evans spent six years in the Merchant Marine before resettling in Western New York and enrolling in the University of Buffalo School of Medicine. After graduating with honors in 1908 at the "advanced" age of 32, Evans spent four years at The Buffalo General Hospital as a house officer, giving anesthetics as part of his duties . Evans returned to Machias in 1912 to set up a general practice. But he returned to Buffalo within a year after his brother was killed in a train accident. Evans' interest in the administration of anesthetics and his work with Roswell Park during his days as a house officer led to his faculty appointment. From then until the First World War, he was paid $2 per student for teaching anesthesiology. On May 15, 1917, the chairman of surgery promoted Evans to instructor in anesthetics. p y s c a n The First World War interrupted his academic career, when he was commissioned as a captain in the United States Army Medical Corp . He returned to Buffalo after his discharge in 1919 and began to resurrect both his academic and political career by becoming active in the organizations of the specialty. During the 1920s, Evans helped establish two societies devoted to advancing the then-fledgling specialty of anesthesiology. In 1922, he was elected president of the Board of Governors of the International Anesthesia Research Society, an organization over which he would preside for the next 20 years. The group's mission was to promote scientific inquiry into anesthesiology across the world. In 1923, the Eastern Society of Anesthetists was founded by Evans and two nationally prominent ew York City anesthesiologists,] ames Gwathmey and Adolf Erdmann , to promote anesthesiology along the Eastern seaboard. Evans presented a paper at the ftrst meeting of the society entitled "Blood Pressure Guides and Safety in Anesthesia. " In 1927, he was elected president of the Associated Anesthetists of the United States and Canada, the only national anesthesiology organization at the time . The July 1927 issueoftheBritishjoumal of Anesthesia was dedicated to Evans and listed his many accomplishments. In 1928, Evans was elected as the Eastern Society's president and helped present a bust of Morton commemorating the first public demonstration of ether anesthesia to the Massachusetts General Hospital. Photographs of the event were published in Current Re- 5 p 9 9 4 �THEN-NOW his career. Convinced that oxygen injected subcutaneously could improve wound healing and eliminate arthritic pain and improve function, Evans spent long hours testing his theories. Years after, former medical students still remember Evans' demonstration of the technique. In addition to pain management, Evans was embroiled in a scientific debate over how much oxygen could safely be used to treat pneumonia. Evans advocated the use of a high enough inspired oxygen concentration to abolish cyanosis - a radical thought for the day. Many others felt that permanent lung damage would occur when oxygen was inspired in concentrations greater than 60 percent. Evans clearly demonstrated this was not the case, and developed an apparatus for oxygen administration by face mask that today would be recognized as continuous positive airway pressure ( CP AP). When Boston's Coconut Grove Night Club burned in 1942, Evans was called in as a consultant to administer supplemental oxygen to the victims of that fire. The University of Buffalo should be proud of its long tradition in anesthesiology and its first chairman,] ohn Henry Evans. His attitude and his efforts have made possible much of what has become routine academic practice in the 81 years since Roswell Park made his initial appointment. Above, Evans, shown ot left ot his office in Mochios, New York. Below, the University of Buffalo medical school classes of 1907 through 1911. Evans is the first person in the second row at left. - searches in Anesthesia and Analgesia, the Department of Anesthesia; full recognition of anesthesiology as a medical specialty had materialized in Buffalo. Residency training in the field was initiated that year when Rose Lenahan accepted a position as hospital assistant in anesthetics (the equivalent of resident today) at The Buffalo General Hospital. Research into the effects of oxygen captivated Evans for the last 20 years of only American medical journal devoted to the field at the time, and Evans was pictured among the leaders in the field . In 1932, he was appointed professor of anesthetics. Four years later, a publication of Evans' originated at the Department of Anesthesia. The 1938 edition of the University of Buffalo Bulletin cited Evans as professor and head of the B u a 0 p y 5 c a 5 p BY DOUGLAS BACON , M.D . About the author: Douglas Bacon, M.D., is an assistant professor in the department of anesthesiology and director of resident education at Roswell Park Cancer Institute. The author would like to thank Chris Densmore and Shonnie Finnegan of the University at Buffalo Archives, Alfred S. Evans, M.D. and Ann Stewart (Dr. Evans' children), Richard N. Terry and Patrick Sim of the Wood Library-Museum of Anesthesiology fo r their help in preparing this manuscript. n g 9 4 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ' I I Members of the IH study sections are selected on the basis of their demonstrated competence and achievements within their scientific fields. Achievements taken into consideration include the quality of research accomplishments, publications in scientific journals, achievements and honors. UB professor authors several sections for the Merck Manual ames B. Lee, M.D., UB professor of medicine has updated the prostaglandins, thromboxanes and leukotrienes sections for the recently published 16th edition of The Merck Manual of Diagnosis and Therapy. Lee, who is an alumnus of]efferson Medical College in Philadelphia, is director of the Erie County Medical Center's hypertension program. Lee is one of 300 scholars and specialists who have contributed to The Merck Manual. Schimpthauser elected to head medical education research group rank Schimpfhauser, Ph.D., UB assistant dean and director of educational evaluation and research, has been elected president-elect of the Society of Directors of Research in Medical Education. The Society of Directors of Research in Medical Education, which conducts and promotes medical education research and acts as liaison and consultant to other medical groups, is composed of professionals in the field from U.S. and Canadian medical schools. Schimpfhauser, a 1965 UB graduate, has been active in the society for nearly two decades, serving as membership committee chair in 1991 and treasurer in 1992. Schimpfhauser's research in medical education has included topics on Frank Schimpfhauser, Ph.D. Murphy chairs NIH subcommittee imothy F. Murphy, M.D., professor of medicine and microbiology, has been appointed chair of the Bacteriology and Mycology Study Section, Subcommittee 2, Division of Research Grants for the National Institutes of Health. Murphy is chief of the infectious diseases divisions of the medical school, the Buffalo VA Medical School and Erie County Medical Center. He co-developed a vaccine with the potential to provide immunity against middle ear infections and was recognized as Niagara Frontier Inventor of the Year for 1992 by the Technical Societies Council of the Niagara and iagara Frontier Patent Law Association. Director of the UB microbial pathogenesis graduate group, Murphy heads two five-year projects totaling $2.5 million in funding from the National Institute of Allergy and Infectious Diseases to study organisms that cause childhood middle ear infections and adult lung infections. B u 0 0 p h y 5 c o n s cancer education, student career choice and decision making and most recently, on the use of standardized patients for the assessment of clinical competence. An associate professor of social and preventive medicine, he holds master's and doctoral degrees from Ohio State University. He administers program evaluation activities for the School of Medicine and Biomedical Sciences and is the coordinator of the third and fourth year academic programs. He also chairs the Association of American Medical Colleges' mini-workshop program and is a member of that organization's national planning committee. He has published more than two dozen articles in professional journals and has made presentations at more than 30 conferences in the U.S. and abroad. p n g 9 9 4 �...... . ................. ····················· · ················ · ··· · ·····················[!] lii'J Spring Clinical Day agenda set AGENDA he Medical Alumni Association has set the agenda for its 57th Annual Spring Clinical Day, to be held Saturday, April 30, at the Buffalo Marriott. This year's program - Medical Education Into the Next Centuryfeatures Jerome P. Kassirer, M.D., '57, as its keynote speaker. Kassirer, who received the Distinguished Medical Alumnus Award in 1992, is editor-in-chief of The New England journal of Medicine and professor of medicine at Tufts University School of Medicine. He also lectures at Harvard University. Kassirer will deliver the Stockton Kimball Memorial Lecture, "Clinical Reasoning: Teaching It and Learning It." The program, designated for up to 3.5 hours of category credit toward the Physician's Recognition Award of the American Medical Association and 3.5 prescribed hours by the American Academy of Family Practice, will present new approaches to the teaching of medicine. Faculty will explore ways to improve patient-physician communication and investigate its impact on the practice of medicine. Medical informatics and its effect on medical education will also be discussed, as well as the use of standardized patients in medical education. In addition to Kassirer, the faculty includes John W. Loonsk, M.D., '86, UB's director of the office of medical computing and assistant professor of biophysical sciences; RichardT. Sarkin, M.D., coordinator of UB's teaching effectiveness program and director of pediatric medical student education; and Paul::; L. Stillman, M.D., provost and dean of the Medical College of Hampton Roads, Eastern Virginia Medical School, Norfolk, Virginia. B 0 0 p h 7:30a.m. Registration and continental breakfast 8:15a.m. Welcoming Remarks Robert Reisman, M.D., '56 President, Medical Alumni Association John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences 8:25 a.m. Introduction to the day's interactive program Frank T. Schreck, M.D. '79 Program Chairman 8:30 a.m. "The Science of Listening" RichardT. Sarkin, M.D. 9:15a.m. "Information at Clinical Fingertips: Moving Beyond the Promise of Medical Informatics" John W. Loonsk, M.D. , '86 10 a.m. Coffee break and exhibit review 10:30 a.m. "The Use of Standardized Patients for Teaching and Assessment" Paula L. Stillman, M.D. 11:30 a.m. Business meeting Noon Annual Medical Alumni Luncheon and Stockton Kimball Memorial Lecture "Clinical Reasoning: Teaching It and Learning It" Jerome P. Kassirer, M.D. , '57 Andersen '47,and Zizzi '58, lauded by UB and ECMC urray N. Andersen, M.D., '47, and Joseph A. Zizzi, M.D ., '58, were honored for their long-time work at Erie County Medical Center. Officials from the School of Medicine and Biomedical Sciences as well as county and hospital officials, cited the physicians last year at the hospital's annual Springfest dinner dance. The event is held to benefit employee education. Andersen is former chief of thoracic 5 c 0 5 p and cardiovascular surgery at ECMC. He also served two years as president of the medical-dental staff at the former E.]. Meyer Memorial Hospital. Zizzi is director of clinical cardiology. He has also served as assistant medical director, acting medical director, medical director and deputy medical director at the hospital. Celebri-tees- Stephan Commins '74, and Jan Nathanson '74, at last October's Walt Disney World's Pro-Am Golf Classic. LincoiT '88,authors JAMA article orah Lincoff, M.D. , is one of the co-authors of a "Letter from Havana - 'Outbreak' of Optic and Peripheral Neuropathy in Cuba?" published in the July 28, 1993 edition of the journal ofthe American Medical Association. The article concerns a disorder first recorded by Cuban physicians in January 1992 and subsequently spread throughout Cuba. Lincoff and fellow authors Jeffrey G. Odel, M.D. , and Michio Hiano , M.D., of the College of Physicians and Surgeons of Columbia University, studied 20 patients ranging in age from 19 to 63 years afflicted by the disorder, the symptoms of which include decreased vision and sensory symptoms (paresthesia, burning and dysesthesia) predominantly in the feet. Lincoff currently is a neuro-ophthalmologist at Buffalo General Hospital. g 9 9 4 �~ ····························································· _ ····· _ ······_ ······· _ ······_ ··· Q to Grenada and then I got accepted to UB," he says. Deciding to pursue pediatrics, he trained at The Children's Hospital of Buffalo and eventually accepted the position of medical director of the hospital's Roberto Clemente Health Center on Buffalo's West Side. Prior to his arrival, a physician would spend three hours a day seeing patients at the center. "My idea was to offer continuity in a full-time position there and set up a system where we could have a nutritionist and social worker and build up the community so that our kids could stay out of the hospital emergency room," Coyne explains. The effort was a success. When he started at the center in 1988, patient visits averaged 4,000 per year. By the time he left last September, the annual total had grown to 22,000. Last fall, Coyne accepted a position with Niagara Falls Memorial Medical Center, taking on much the same challenge he did at Clemente. He was put in charge of the Kids Clinic at the Hamilton B. Mizer Primary Care Center- a place where a physician came in three or four days a week for three hours at a time. Coyne quickly added two full-time physicians, a nurse practitioner and a social worker. He credits Memorial Medical Center President Timothy J. Finan for taking the initiative in extending continuity of care at the primary care site that has just opened 10 new pediatric rooms and has since been renamed Memorial Pediatrics. "Forty-seven percent of the community in Niagara Falls is on public assistance. Most of those children do not have a physician. Tim Finan felt that was not appropriate and that we needed to do something different," explains Coyne. Services provided by Memorial Pedi- Prtest doctor, advocate for the poor FROM NORTHERN KENYA TO NIAGARA FALLS , JACK COYNE '85 , TREATS THE UNDERPRIVILEGED ost people follow one vocation at a time. Not Jack F. Coyne, M.D. He is both pediatrician and priest. The 1985 graduate of the School ofMedicine and Biomedical Sciences, however, considers himself primarily in social work. "There are those who feel that the priesthood is more sacramental. I honestly believe that the role of the priest is to be a social worker," he says. This view proved to be a renegade attitude with the Church in St. Louis where he was a graduate student in the late 1960s. So Coyne became part of a small group of fellow seminarians who decided to start a new religious community. "There was a full-page article in Newsweek when we made the break in 1968 for doing things differently- not dealing with the liturgy so much as dealing with inner city problems," Coyne recalls. Coyne added another vocation at the time as the group used music to express its work in the inner city, forming a folk-rock quintet known as "The Mission" that made appearances on national TV talk shows hosted by Dick Cavett, Steve Allen and Mike Douglas. The quintet also made an album for Warner Brothers Records with Mary Travers of "Peter, Paul and Mary." In 1981 - 10 years after he was ordained a priest- experiences in Cambodia, Haiti and Borneo convinced Coyne that he needed a knowledge of medicine to continue his work with the poor. "Because of those experiences, I applied to medical school and I got lucky. I had my airplane ticket set to go Jatk Cayne, M.D., and two very satisfied patients, Jeremy and Harvey Brundidge. B u a 0 p 5 c a 5 p 9 9 9 4 �· · · · · · · ·· · · · · ······ · · ·· ·············· ·· · · · · ······ · ··········· · ··· · · · ····· · · · ··· ··· ······ ~ ~ In 1984, Coyne switched from the Roman to Eastern rites, joining the Greek Orthodox Church. Coyne observes, adding, "To get the right mental health services, to get the right counseling, to get a child who's eight or nine through the system now and get the help he or she needs will help prevent them from becoming a painful survivor at 30. This is really a goal of mine and something that child advocacy is dedicated to as well. " Coyne added yet another vocation in 1987 when he became a husband and then a father. Having a continuing problem with the church law of celibacy, he switched from the Roman to Eastern rites in 1984, joining the Greek Orthodox church, which allows priests to be married. "There is no relationship in my mind between priesthood, service and celi- atrics include well child care, sick care, immunizations, sports and school physicals, lead testing, birth control, teenage counseling, 24-hour emergency coverage and supportive services for physical and sexual abuse. In fact , Coyne is the medical director of child advocacy teams in Erie and Niagara counties that investigate sexual abuse. "We see about three children a week who are sexually abused ," he says. He is pleased with Erie County's commitment to revamp a floor of the Prudential Building at Delaware Avenue and Allen Street as an advocacy center for young sexual abuse victims. "I find that a real expression of pediatrics because many of these children are forgotten - not just medically," B 0 0 p y s c o n 5 p bacy. I still think that might change in the Catholic church but I'll probably be long gone when that happens. That brought me to where I am today - to keep my priesthood but be able to get married and have a family," he states. Two years ago , Coyne fulfilled a lifelong dream and journeyed to Africa to set up a clinic in the bush of Northern Kenya for the nomads . "We did some HIV testing and worked with the (missionary) nuns there to create some medical services that could be performed on a regular basis ," he explains. It was a brief visit before his return to Buffalo. "I always thought I would eventually stay in Africa to work but as I grew up and had more responsibilities, such as a family , going to Africa wasn't as easy. My way of expressing the same need was to work in the inner city here, " Coyne declares . It has truly been a multi-vocational road for this Long Island native with a lifelong commitment to working with the poor. "I always wanted to be a priest but I didn't want to be in a parish," he concludes. Instead of administering in a parish, jack Coyne has acted as a shepherd of health care continuity in communities where such enrichment has been rare. And that's good for both the body and soul. - B y j I M B I S C CORRECTION In the last issue of Buffalo Physician, Dr. Franklin Zeplowitz' name was inadvertently omitted from the 1993 Reunion Class donors. Dr. Zeplowitz should have been included with his 1958 graduating class. Our sincerest apologies! n g 9 9 4 0 �! l ······················· . .................. .......... . . . . it is about the only occupation for the people. A coffee picker may earn 11 quetzales ($1.70) a day," Schaefer said. Approximately 2,500 people live in the village, with about 25,000 more in surrounding villages and coffee plantations, Schaefer said. Transportation is difficult in the mountainous region. "Patients often have to walk many hours or days to reach the hospital," he added. The Hospital de la Familia receives surgical patients from all parts of Guatemala and the surrounding areas of southern Mexico, El Salvador and Honduras. Schaefer said the most prevalent diseases there are malnutrition, respiratory ailments, gastrointestinal infections, congenital malformations and traumatic injuries. The region's infant mortality rate is approximately 80 percent, although a substantial improvement in that figure has been reported over the past five to 10 years in the area served by the Hospital de la Familia. Schaefer was accompanied by operating room nurse Karen Kumar and operating room technician Geraldine McGuire. During their two-week stay in Nuevo Progresso, they performed 140 eye surgeries. The ophthalmology team was part of a larger medical group that covered a variety of specialists, including otolaryngologists, general surgeons, OBI GYN and general plastic surgeons. This was Schaefer's second visit. Carolyn Bessette, M.D., in NASA's zero-gravity simulator. surgeries as well as defibrillation and mechanical ventilation. Bessette has completed a flight surgeon's training course offered at the johnson Space Center and is currently pursuing an aerospace medicine residency. Carolyn Bessette completes NASA aerospace medicine fellowship arolyn Bessette, M.D., a recent medical school graduate, recently completed a NASA aerospace medicine fellowship at the johnson Space Center in Houston. She was one of four senior medical students selected to participate. The four-week intensive program included lectures on topics such as cardiovascular reflex responses to microgravity, pharmacodynamics in zero-gravity, controlled ecological life support systems aboard a space station, the mechanisms of decompression sickness, vestibular adaptation to space flight and muscular atrophy and adaptation to microgravity. The fellowship also included zerogravity simulation flights as well as visits to NASA's Space Station Freedom mock-up's medical operations module. The unit is equipped to perform minor B u a 0 Daniel Schaefer '81, volunteers in Guatemala with medical team aniel P. Schaefer, M.D., '81, director of the ophthalmology section at St. joseph Hospital, was a member of a volunteer medical team that traveled to the Hospital de la Familia in Guatemala last spring to administer services to the poor. About 2,500 people live in the Nuevo Progresso, a mountain village about 170 miles northwest of Guatemala City. "The town lies at an altitude of about 2,500 feet in a nearly impenetrable rain forest. This is a coffee growing area and p h s c a . . . ...................... . ..... The Strasenburgh Planetarium, in Rochester, New York, was the site for a recent Medical Alumni Association reception. s p n 9 9 9 4 �Dear Colleague, Donnica Moore '86, honored by Amertcan medical women'sgroup he American Medical Women's Association (AMW A) honored Donnica L. Moore, M.D., '86, at last year's 78th annual meeting, "Women Promoting Women's Health: Prevention Through Research and Education." Moore was presented with the Calcium Education Nutrition Award, sponsored by Proctor and Gamble Pharmaceutical Company. The award is presented annually to the AMWA member who has done the most to educate physicians , medical students and the lay public about the importance of osteoporosis and treatment. Moore is currently the director of medical education at Sandoz Pharmaceuticals. She has spearheaded development of the Sandoz osteoporosis computer education program, a comprehensive, state-of-the-art, multimedia self-directed learning program designed for medical students. She has also been involved in developing AMWA's master faculty training program in osteoporosis and in establishing the Sandoz postdoctoral fellowship in bone metabolism. The AMWA event also marked the first time the association featured a UB School of Medicine and Biomedical Sciences alumni reception at its annual meeting. Moore, who is also AMWA regional governor for New York and New] ersey, organized the reception. B u a 0 p h The Perfect Prescription For Your Conference Needs We are pleased to inform you of your eligibility to purchase microcomputer and information technology products at special educational prices at UBMicro, the University at Buffalo's non-profit computer resale program. Consulting and pricing information is available weekdays 9:30am to 5pm, and until 7pm on Wednesdays and Thursdays. UBMicro is located in The Commons on the north campus at 645-3554. 18,000 Square Feet of Meeting Space "i' Conference Planning Professionals "i' Convenient Downtown Location "i' Quick Metro R ide to Main Street Campus and Medical School "i' __ Close to Buffalo General, Roswell, ECMC and Children's Hospitals "i' Your Guests Can Walk to Theatre, Shops, Pilot Field, Restaurants, Entertainment _.__ "i' CME Friendly "i' Great Banquet Food Please Talk To Us About Preparing A Proposal So You Can Bring Your Group's Next Convention To Buffalo (716) 856-1234 6142 • Apple • IBM • Dell • Insight • Panasonic • Canon • Tl • Software • Supplies • Accessories • Audio • Hands-on Workshops ml Dllllr+l EXTENSION HYATT. WE'VE THOUGHT OF EVERYTHING~M H~Y--A--T,T RE A non·profit University program for students. faculty & staff The Commons • North Campus • (7T6)645·3554 • Fox: 645·3884 c a n 5 p B n U 9 G f E"' C Y A , 0 • 9 9 �----A---- S P-, o o . ·.;n f . u , I" f o H u m o r; THEY SAY YOU NEVER CAN - B U T IT'S STILL FUN TO TRY sis my tradition, I returned to my roots in New York City for New Year's. I never enjoy the ew Year's rituals, since traditionally by 12:45 a.m., you've been asleep for 10 minutes with a pointy noisemaker protruding from your pocket. For the past 10 years, my friends from med school and I have always celebrated the "Third Alternative" party (the first alternative is the usual New Year activity and the second is to stay home or go camping in Central Park) . At this particular party , watches are checked at the door and we have random countdowns on the dance floor and show a video loop of the ball dropping throughout the evening (from 1961, of course, since Dick Clark had the same formaldehyde look then he has today). The goal is to avoid the mechanized rituals of the holiday and still have fun . A trip toN ew York is never complete without a trip to the old neighborhood. People there still know me because I went to medical school. The first person I see is the man B 0 0 across the street with the clever mustache and stretch pants with bass and treble control. "Hi, how's it going in CaliF AWNYA? Are you still interning?" He doesn't ask if I'm an intern, but if I'm still interning. I believe the verb In thi.s old, entrenched, working-class jewish neighborhood, everyone has a doctor who is the ,,best" in their field. "intern" means to confine or impound, especially during a war- which, come to think of it, is not unlike what it feels like to be an intern and go three and a half years without sleep. This guy (for the life of me I have no idea who he is or how he knows me) p h 5 c o n 5 next says to me, "Tell me something ... " (Already I know I'm in trouble.) "My wife sprained her ankle. What's good for it? Dr. Marvin Schanker on the radio says milk is good for this sort of thing. " I'm thinking Dr. Schanker certainly should know since he learned so much about medicine while earning his Ph.D. in communications. Against my better judgment, I continued this conversation and told him milk will help a broken bone but not a sprain. He broke in with, "Oh, what do you know. Dr. Schanker has been around a long time- you're young yet." Dr. Schanker may have been around a long time, but so has Charles Manson and I don't usually ask him for advice on ethics cases. Maybe it's time for Dr. Schanker to be interned. In order to gain brownie points with me , everyone from the old neighborhood tells me about the doctors they know. "My daughter-in-law's brother is married to a doctor. He is doing very well as a plumonologist"- which I believe is either a French expert on ball-point pens or an author- p n g 9 9 4 �jewish neighborhood, everyone has a doctor who is the "best" in their field. When pressed as to why their doctor is the best, they tell you, "everyone says so," and, "he's so busy you have to make an appointment to make an appointment. He's the best 'eye man' in Brooklyn. " The truth is, nobody knows how well their doctor did in medical school. How many even look to see where the doctor went to school. Does anybody actually know how well their doctor did in biochemistry? obody looks! I have a friend, a podiatrist, who actually hangs his dog's pedigree on the wall. For his patients, he's the best "foot man" in Bensonhurst. I even went back to the hospital where 10 years ago I spent my first days on the ward. I recalled my first time in the hospital wearing my white coat that came out of the package five minutes earlier with eight other things, including two stethoscopes, an eye chart and a rectal thermometer key chain. I looked more like a roofer on the way to an insurance inspection. At this point, I don't know anyone who carries that much equipment. But when you're a student and you don't feel like a doctor, you need to at least look like one (orTrapperjohn). I recall standing there with all this equipment on while residents whirled by picking off stethoscopes and eye charts saying 'can I borrow this , can I borrow that?' I felt like a gingerbread man Christmas morning. Of course they never returned any of the equipment, so after a half hour I was picked clean down to my boxer shorts ready to see my first patient. I felt so awkward. I was 22 years old. I wasn't shaving yet, and here I was doing procedures on people, examining patients. You can never say touching or feeling in the medical profession; they teach you very early on it is always "examining, probing, palpating," never "touching." That's too offensive. But it felt good to see old friends and colleagues and to see that I'm not the only one unbuttoning my pants while sitting down to dinner because my pants are shrinking. Happy ew Year. Stu Silverstein, M.D., president of Stondup Medicine Seminars of Son Francisco, California, lectures nationwide on humor in medicine. ILLUSTRATION BY JAY LINCOLN B u a 0 p c a 5 p g 9 9 �a · ····· ····· · ··· · · · · · ············· · · · ···· · ······· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ········ · · search fellow at the Buffalo Institute of Fetal Therapy. Karamanoukian received the award , presented last summer at the society's annual international meeting in Washington, D.C. , for his research combining nitric oxide and surfactant for the treatment of diaphragmatic hernias in newborns. Last year marked the first time ever the Society of Pediatric Research presented the award to a surgeon. Karamanoukian's research suggests combining nitric oxide with surfactant may lower the mortality of newborns with diaphragmatic hernias and significantly decrease morbidity. Further prospective clinical trials to examine the effect of the combined modality are planned. Karamanoukian is working in the laboratory of Philip Glick, M.D., assistant professor of surgery and Children's pediatric surgeon. Frances Nesti, M.D. Children'sfellow wins crttical care medicine research training award he Society of Critical Care Medicine In Training Award has been awarded to Frances Nesti, M.D., a fellow in critical care medicine at The Children's Hospital of Buffalo and UB's department of pediatrics. The award recognizes excellence in critical care research. Nesti was chosen specifically for her research presentation in the area of perfluorcarbon liquid ventilation. Nesti received an engraved plaque and $2,000. Annual Incoming Residents Week set for June 13 -18 The School of Medicine and Biomedical Sciences will hold its annual Incoming Residents Week Monday through Saturday, June 13- 18. Approximately 150 residents will participate in the program about communication skills, teaching skills and issues in medicine such as advanced directives , documentation and medical records. The residents will also receive life support and advanced life support training. Nitric oxide/surtactant research garners national research award he 1993 National Residency Research Award , presented by the Society of Pediatric Research, has been awarded to Hratch Karamanoukian, M.D ., a general surgical resident of the department of pediatric surgery at UB and The Children's Hospital of Buffalo and re- B a 0 p h y s c a n 5 Lalley,Ph.D~ '74,tapped to head HIT student center for the deaf eter Lalley, Ph.D., has been selected to head the Center for Baccalaureate and Graduate Studies at the ational Technical Institute for the Deaf ( TID), a college of Rochester Institute of Technology in Rochester, New York. Lalley, a 1974 graduate of the school of medicine's doctoral program in human genetics, was named to the position last]une. The recently established center is a comprehensive, student-oriented service that offers such programs and services as academic advising, tutoring, notetaking and interpreting as well as pre-baccalaureate discipline-related courses. A geneticist, Lalley has achieved national and international prominence. From 1985 to 1991, he was chairperson of the International Committee on Comparative Gene Mapping. He has served on numerous national and international advisory panels and has written more than 80 research journal articles. He is on the editorial board of Clinical Biotechnology and has been subject area editor of Genomics. He is a former editorial board member of the journal of Experimental Zoology and Cytogenetics and Cell Genetics as well as a reviewer for numerous other publications. The NTID is the world's largest technological college for deaf students. It was created by Congress and is funded primarily by the U.S. Department of Education. NTID represents the first effort to educate large numbers of deaf students within a college campus planned principally for hearing students. More than 1,100 deaf students from across the United States and other countries study and live there. p n g 9 9 4 �·························································································[! ] Rehabilitation Center in Clarence, New York, where he served as medical director. His portrait will be displayed in the center to honor his many years of dedicated service. Dr. Paolini was instrumental in the creation of the Broth- ROSARIE BENDER ' 20, is retired and living in Fort Lauderdale, Florida. Dr. Bender, who was one of the first women plastic surgeons, practiced plastic and reconstructive surgery for 50 years. She is the only living member of her class. ers of Mercy's 40-bed rehabilitation unit. He plans to enjoy retirement with his wife, Emily, eight children and three grandsons. writes, "Surviving: two bypasses, cataracts. Keeping busy, would like to see more entries from my class. Where are you? How are you?" David S. Ba[hman '47 BERNARD S . STELL '46, of Sun City, Arizona, informs us retired surgeon, is a columnist for several newspapers, and the author of a recently published book, Thoughts and Musings of an Arkansas Country Doctor. He also co-authored the book , MAX A. SCHNEIDER '49, received the Silver Key Award from the National Council on Alcoholism and Drug Dependence for "outstanding service in the field of addiction medicine." HENRY H . HAINES '33, that his article "Stereomacrography - The Water Droplet Lens" appeared in the December 1993 issue of Stereoscopy, published by the International Stereoscopic Union. DAVID S . BACHMAN '47 , a with his family and three little grandsons. HERBERT W . SiMPK INS ' 53 , of West Orange, New jersey, retired from practice in December. PAUL L. of Tarzana, California, retired last]uly after 38 years of practice in internal medicine. Breaking the Smoking Habit. informs us he is now fully retired and plans on spending more time BURTON STULBERG ' 52 , FERDINAND A. PAOLINI '47, retired in December from the Brothers of Mercy Nursing and HERBERT A . '55 , LEONHARDT of Florham Park, New jer- sey, informs us that he retired in 1993. He has six grandchildren. J . SULLIVAN '55 , writes, "Still working full time with my practice restricted to forensic psychiatry. My wife, Carol, and I recently purchased a new, large motor home; we are enjoying traveling throughout the West, Canada and Mexico in it." Finally, a Real Retirement Planning Breakthrough for Doctors, Attorneys, and Professional Entrepreneurs... The Tax-Free "Private" Pension V 100% Tax-Free Compounding of All Interest, Dividends and Capital Gains V No Income Tax or Tax Consequences on Withdrawals V Unlimited Contributions V 100% Tax-Free Fund Transfer and Switching V 100% Income Tax and Probate-Free Life Insurance Benefit V o 10% IRS Penalty On Withdrawals Before Age 59-1/2 V o Forced Distributions At Age 70- 112 V Flexibility To Fit Your Changing eeds B a 0 p s c a 5 p ' 54 , lished in the Fall1993 PHAROS (the AO medical honor society magazine). His paper explains the 10 biblical plagues. WILLIAM DAVID HERTZ '52 , WEINMANN wrote a paper, "The Tenth Plague -Deathofthe ewborn? " pub- g 9 9 4 �l! l· ···· ··················· ·· ········· ······· ·· ·· ··········· ····· ······ ···· ······· ······· ··· was re- CAPTAIN ELIAS ROSENBLATT director of clinical services in elected to a second term as treasurer of the Minnesota Medical Association. '68 , writes , "I have been living the department of radiology at the University of Iowa. He has six children and one grandchild. ERICK REESER ' 56 , in Potomac, Maryland for almost 10 years now, long enough to appreciate some of the better parts of the Washington, D.C. , area, and to avoid all the rest. My wife, Ruth, is administrative director of physical medicine and orthopaedics at Suburban Hospital in Bethesda. Our son , Jeremy, is in his junior year at the Bullis School. Our daughter , Alison, graduated from there a year ago and is a sophomore at Kenyon College. Their brother, Michael, graduated from Cornell in 1991 and is now working in the hotel appraisal business in Miami. I'm a captain in the Navy medical corps , currently assigned as the director of the Naval Medical Doctrine Center on the Marine Corps Base at Quantico, Virginia. This assignment followed my graduating from the Naval War College. The center develops, analyzes and tests the doctrine of the utilization of medical assets in support of Naval, joint and combined (i.e., NATO) operations. It's very WILLIAM E . ABRAMSON '60 , writes, "On July 31 , 1992, Iretired after 28 years as a staff psychiatrist at Sheppard Pratt Hospital in Towson , Maryland. I have remained in private practice , with my office in the hospital , and on the courtesy staff. I love my new boss !" presented papers on attention deficit disorder in young adults at the University of Massachusetts MediHARRIS FAIGEL '60 , cal Center, American College Health Association. He is president-elect of the New England Chapter of the Society for Adolescent Medicine. His granddaughter, Madeline, was born January 10, 1993. RONALD S . MUKAMAL '64 , retired from private practice and moved to Baltimore, where he works part time. writes, "Although I returned to Ghana in 1968, I have tried to keep in touch with a few classmates over the years. Notable among these are Charles Ladoulis , Michael Taylor and Steve Scheib~r. From 1968 to 1978, I taught epidemiology and control of tropical endemic diseases in the Department of Community Health of the Ghana Medical School. I joined the World Health Organization in 1978 and served as a senior epidemiologist at the FRED K . WURAPA ' 64 , B u a Irving S. Kolin '65 Tropical Disease Research and Training Centre in Ndola, Zambia. Since 1986, I have been reassigned to the WHO Regional Office as the Regional Adviser on Control of Parasitic Diseases." AUGUST J . D ' ALESSANDRO ' 65 , retired in 1992 from the state of Connecticut after 25 years. He is medical director of Catholic Family Services in Danbury, Connecticut, and a psychiatrist with the New York State Department of Mental Retardation . IRVING S . KOLIN ' 65 , successfully completed the examination of the American Board of Adolescent Psychiatry for certification in adolescent psychiatry last May 20. Dr. Kolin is board certified by the American Board of Psychiatry and eurology and in the past year has also successfully completed examination for added qualifications in geriatric and addiction psychiatry. He is also certified by the American Society of Addiction Medicine and the American Board of Quality Assurance and Utilization Review. 0 p h 5 exciting work. Not only are my clinical and operational experiences utilized , but so are the academic and communication skills learned in undergraduate and prep school years. " IAN M . SCHORR ' 69 , of Englewood , New Jersey , announces a new grandson , born February 4, 1993. is professor of radiology and pediatrics and vice chairperson and WILBUR L. SMITH ' 69 , c a 5 p RONALD H. BLUM '70, was appointed deputy director of NYU's Kaplan Cancer Center. His wife, Diane, is executive director of Cancer Care , Inc. ROBERT DIBIANCO '72 , and his wife, Joan, announce a new addition, Regina Marie DiBianco, born August 1, 1993. The family now consists of David , l2;JohnMichael, 8; Regina Marie, 1/2! DR . ROBERT KROOPNICK was elected a fellow of the American College of Physicians in January 1993. Board certified in both internal medicine and '72 , geriatric medicine, he practices in Randallstown , Maryland. is director of the Englewood Hospital hemodialysis unit. He has a 12-year-old son and two collegeage sons; one attends the University of Vermont and one attends the University of Arizona. RALPH R . HALLAC '73 , RICHARD LEE '74 , writes he has been named medical director of Sierra Summit Rehabilitation, an outpatient facility in Reno, Nevada. A fellow of the American Academy of Neurology and certified by the American Academy of Pain Management, he was recently appointed a fellow of the Royal Society of Medicine, London , U.K. Dr. Lee has also been involved in locum tenens work for the past three years in clinical neurology. g 9 4 �····················· ·· ···································································l ! - ! n ' ton and his wife, Katie, are the R ICHARD I A. WOLF '82 , writes, proud parents of a son, James "still in cardiology at Grand Cody, born in October 1992. Forks Clinic in Grand Forks, North Dakota." He wonders if anyone knows where Rob MARK 5 . BORER '80 , is presi- Dudek, Roger Beneitone and dent of the Psychiatric Society of Ivan Baumel! are? Delaware and co-founder and PATRICK E . RYAN , JR ., '83 , medical director ofMeadowwood is currently in fellowship in Intensive Treatment Options. GASPERE Barlow Lynch '77 C . cardiothoracic surgery at SUNY GERAC I '80 , Syracuse. He is married with writes that he is currently em- three children: 4 l/2 years, 21 ployed by Capital Health Sys- months and 4 months. tem as medical director of pri- NORA MEANEY-ELMAN '84 , mary and urgent care. He reBARLOW LY N CH '77 , is presi- dent-elect of the Washington Urological Society. Dr. Lynch is a clinical assistant professor of urology at Georgetown and cently received board certification in medical management in addition to board certifications in family practice and emergency medicine. George Washington University. He lives in Silver Spring, Mary- JAMES B . BRONK '81 , has land, with his wife, Pauline, and been installed as the 67th presi- son, jason. dent of the Solano County Medical Society. He is a partner in a ORESTES G . ROSABAL '77 , is the Southern Medical Association's state councilor for and Vacaville, California. Florida. In October, he attended the association's 87th Annual Scientific Assembly in New Orleans. Dr. Rosabal maintains a private practice in orthopaedic surgery in Hialeah, Florida. TERENCE CHORBA ' 79 , writes, "I received an M.P.A. from Harvard's JFK School of Government in June before returning to the National Center ' 81 , an had a great time in Cambridge. " BRUCE J . NA U GHTON '79 , is returning to Buffalo as chief of the division of geriatrics at The Buffalo General Hospital. Dr. Naugh- B u a 0 Electrodiagnostic Medicine Megan Elizabeth, on June 25 , meeting. Robin is a neurologist 1993. She continually amazes us, as well as her brothers, Daniel in Pittsburgh; Sarah, Maria and I and Ryan." Arbor, respectively. " is as- practice-in D.C.,Buffalo,and Ann DE I DRE GREENE '86 , writes , sistant director of psychiatric "Accepted a part -time faculty po- emergency services at Montefiore Hospital, Bronx, New York. sition with Egleston Children's was Atlanta. We celebrated the birth elected chairperson of the Chesa- of our third child, Timothy Elvis peake Bay Alcohol and Substance Dixon, in August 1993. " Abuse Program Advisory Board. CARLOS M . ophthalmologist in Amherst, Hospital at Emory University in ISADA '86 , re- com- cently joined the staff of the Cleve- new company, Energy Systems Associates, specializing in elec- pleted a five-year general surgery residency at St. Luke's- land Clinic Foundation in the de- tromagnetic medicine and bio- Roosevelt Hospital in Manhat- His wife, Loretta Isada, is in pri- FRANK New York, recently founded a LACQUA '85 , partment of infectious diseases. logical hazards consultations. He tan and a one-year colon-rectal vate practice in Akron, Ohio, as and his wife, Diane, announce the surgical fellowship in Houston, a noninvasive cardiologist. birth of their son, Michael) oseph, Texas. He is in private practice GLENN on May 29, 1993. He joins proud in Brooklyn and Staten Island, Lithonia, Georgia, and his wife, sisters, Erica and Sarah. New York. He has married Eva Carla Hackett Paris, announce for Injury Prevention and Control at CDC. My family came and at the American Association of DENISE M . DAVIS '85 , ology group based in Fairfield DAV ID J . RODMA N writes, "My husband, Richard Elman '78, and I had a daughter, CAROL W E INSTE IN '84 , private practice diagnostic radi- James B. Bronk '81 GERALD HARSTER '82 , was PARRIS '87 , of Acosta and resides in Brooklyn. the birth of a daughter, Stephanie writes , Delyse Parris, on September 17, JON M . WARDNER '85 , appointed director of laborato- R. ries at jeannette District Memo- "There was an impromptu Class 1993. Dr. Parris is a rheuma- rial Hospital, near Pittsburgh, of '85 mini-reunion in Pennsylvania. He has two sons, leans this October. I enjoyed run- tologist in private practice at the Gwinett Arthritis Center; his Ryan, 10, and jesse, 6. ning into Maria Labi, Robin wife is administrator at Grady Con wit and Sarah Murray White Hospital. p h y s c a 5 p ew Or- n g 9 9 4 �[! ] ·············································· ····································· · ···· and his wife, Marcia, announce the birth of a daughter, Rachel, in DAVID ROSENBLUM '87 , December 1993. She joins her brother, Daniel, 4. Dr. Rosenblum is chief of medical staff at Gaylord Hospital in Connecticut and codirector of its spinal cord injury unit. Active in clinical research, including clinical trials in multiple sclerosis, he also holds appointments at Yale and Columbia-Presbyterian Medical Center. will R ICHARD GILBERT '88, M ICHAEL HALLETT '89 , was recently appointed associate medical director for adult psy- CARLOS C . ALDE N '39, died January 14, 1994. The Army's most decorated surgeon, he was a senior psychiatrist at Buffalo Psychiatric Center for more than a decade before his retirement in 1976. chiatry at Brylin Hospitals. Dr. Hallett completed his psychiatric residency at Erie County Medical Center. He also maintains consulting privileges with Millard Fillmore Health Systems and has established a private practice. In addition to general adult psychiatry, his interests include obsessive/compulsive disorders, mood disorders, anxi- NAT HAN I EL J . P U LVER '48 , Lidia Palcan '90 join the Buffalo Medical Group after completing a urology residency at Georgetown Medical ety disorders, dual diagnosis and schizophrenia. Center in June. He has three children: Ricky, 4; Chelsea, 3; and Alexis, 2 months. pleting a residency in otolaryngology at the University of Pennsylvania. He and his wife, Michelle, WILLIAM PALM ER , JR ., '90, completed a residency at Duke University in proudly announce the birth of a son, Michaeljoseph, on April22, 1993. They have a daughter, Molly Bess, born May 19, 1991. was appointed chief resident of physical medicine and rehabilitation at the University of Pittsburgh. DAVID KATZ '88 , neurology and a fellowship in neuro-ophthalmology at the University of Michigan at Ann Arbor. In july 1993, he joined a group of neurologists in private practice as a junior partner with the subspecialty of neuro-ophthalmology. an ophthalmologist, is a member of the medical staff at ColumbiaGreene Medical Center in Hudson, New York. Dr. Kraus has joined the practice ofSanford Ullman '38. WAYN E Z I MMER ' 89 , Hopkins Hospital. Her husband is an orthopaedic surgery resident, also atjohns Hopkins Hospital. is com- is a third-year resident pursuing a dual certification in internal medicine and pediatrics at University and Children's Hospitals, Cincinnati, Ohio. JOSEPH BARROCAS , ' 91 , finished residency at The Children's Hospital of Buffalo and joined the Delaware Pediatric Group in Buffalo. HARR IET TE F EIE R ' 90 , writes, "I am completing a residency in neurology at UCLA with an eye toward an academic career in neuroimaging. I married Lorain DIANE KRAU S '88 , ANT H O NY L. CAPOCELLI, JR., completed a neurosurgery fellowship at Long Island jewish Memorial Hospital in june 1992. He and his wife, Christy, announce the birth of a son, Bryce Anthony, born September 14, 1992. ' 89 , B a ROHIT BA K S HI '91 , JONAT HAN O ' BRIEN ' 90 , completed internal medicine residency and started a gastroenterology fellowship at Albany Medical Center in july 1993. He has five children: Nathana, 5; William, 4; Shoshana 3; Rebecca, 2; and Eli, born july 21. Baeumler, R.N., daughter ofUB med school alumnus George R. Baeumler '59, on july 17, 1993 in Delaware Park - what a catch! " LI DIA PALCAN '90, announces her marriage to james Wenz, M.D., in Baltimore, Maryland, on June 5, 1993. Lidia is currently a fellow in child and adolescent psychiatry at johns 0 p h y s JOSE P H M . ACCURSO ' 92 , recently reported for duty with Naval Support Force Antarctica in Port Hueneme, California. c a 5 p died last March in Cincinnati, Ohio, of coronary heart disease. Dr. Pulver was in the private practice of pediatrics in White Plains, ew York, for 20 years before moving to Israel, where he managed the health care of children in the development town of Hazor. He practiced pediatrics with the Group Health Cooperative in Madison, Wisconsin after returning to the U .5. A long-standing member of the Academy of Pediatrics, he retired in 1989. R OY J . THURN ' 52 , died on September 12, 1993. His wife writes, "Roy loved medicine and finally retired at age 71 so we could do some traveling, etc., that his commitment to medi- cine postponed. He retired on April 2 as medical director at Bethesda Hospital, St. Paul, Minnesota, and on April 7 was diagnosed with inoperable small cell cancer of the left lung. We attended his class reunions and were looking forward to the next one." D EAN ALLE N LES HER ~2 , of Newark, died oflungand heart failure on August 12, 1993. Before retiring in 1992, he was a researcher at the Ciba-Geigy Corporation where he spearheaded the development of Lopressor. g 9 9 4 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS COR~ECTIOf'j R The only with thi~ Medical Lial Company (ML liability insurer Society of the S Since its fou owned and mar fully defended 1 other available Additionally, and most exper ity claims depaJ largest risk rna: any ew York~ insurer, and th( review of claim Calll-800-A 1-800-356-4056 mation and an < Our def€ 2 Park Ave., Nev. 2 Clinton Sq., S~ 90 Merrick Ave. © 1993 Medical Liabili~ �Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 ' REQUESTED S C I EI'; C E~ ri.\L L ~: L ly liability coverage is seal of approval. jability Mutual Insurance [LMIC) is the only professional rer approved by the Medical eState of New York. :ounding in 1975, the physicianaanaged company has success~d more physicians than all 1le insurers combined. lly, MLMIC has the largest perienced professionalliabilpartment in the country, the nanagement department of ·k State professional liability the state's only true peer .ims experience. )-ASK-MLMIC (metro) or )56 (upstate) for more inforn application. MLM~C ~ Medical Liability Mutua! Insurance Company fense never rests. few York, Y 10016 , Syracuse, NY 13202 we., East Meadow, NY 11554 bility Mutual insurance Company �B U FFALO PHYS ICIAN STATE UN IV E RS ITY OF NEW YORK AT BUFFALO 3435 MAI N STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 © 1993 Medical Liability Mutual Insurance Company Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 31 1 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1994 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n02-1994-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Leading Buffalo's Changing Health Care Scene Changing the Face of Medical Education Medical School Alumni A Spoonful of Humor Graduate Education Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Spring 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n02 Extent The size or duration of the resource. 46 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/21b95c23bbdc6cd130acca62600fe6d3.pdf 1d066aa11bc0b3e94864028a5fe62997 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1994 �BUFFALO PHYSIC I AN Volume 28, Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j Conroy EDITOR Nanette Tramont, R.N. ART DIRECTOR Alan j. Kegler ASSOCIATE ART D IRECTOR Scott Fricker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MED ICINE AND B IOMEDICAL SCIENCES Dr. john Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. john A. Richert, Chairman Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Alan J. Drinnan Dr Timothy Gabryel Dr. james Kanski Dr. Charles Massaro Ms. Melanie McNally Dr. Charles Paganelli Dr. Robert E. Reisman Dr. Thomas Rosenthal Dr. Stephen Spaulding Dr Bradley T. Truax TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Frank Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy ©The State University of New York at Buffalo Buffalo Physician is published quarterly by the State Umversity of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submisstons to· Editor, Buffalo Physician, State Universtty of New York at Buffalo , University Publications, l36 Crofts Hall, Buffalo, New York 14260 Dear Alumni and Friends, C oncerns about the cost of health care in the United States also must include concerns about the cost of educating medical students. The SUNY system has sought to maintain tuitions that ensure students from all socioeconomic backgrounds access. Despite this, the base annual tuition for New York State residents exceeds $8,000, and most students require, seek and obtain major levels of financial assistance. UB's medical school has addressed its commitment to alleviate students' financial pressures by encouragingscholarship support for meritorious and needy students. Thanks to the generosity of many alumni. and friends, direct scholarship support approximates $200,000 each year. But these funds provide only 3 percent of the financial support required by UB's medical students. For example, in the 1992-93 academic year, 88 percent of UB's 555 medical students received some level of financial support from scholarships, grants or loans. Total financial aid from all sources approximated$ 7.5 million. In the 1993 graduating class, 25 students had amassed accumulated debts of $50,000 or higher and one amassed a debt that exceeded $80,000. The average debt for the class neared $30,000. This year's Class Reunion Campaign dedicated its donations to the Medical Alumni Scholarship Fund, as will the next three campaigns. It is anticipated that over five years, a principal of $500,000 will exist; its annual revenues will be used to enrich existing scholarship support. The 1993 campaign provided a fine beginning to this goal with total contributions of about $90,000. These funds not only recognize academic merit and financial need, but reduce our students' debt burdens considerably. The students, faculty and I are thankful for your continued interest in UB and in the well-being of its medical student body. ~ Sincerely, (. J 0 ~, ~ j ohn Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, W ith the beginning of a new academic year, your Medical Alumni Board looks forward to providing experiences that enrich our medical students, house officers and alumni. Recently, we welcomed the incoming residents and the freshman medical class. During the year, we hope to impart to these physicians and physicians-in-training a sense of camaraderie and a feeling of trust for one another that will help the profession go forward. Activities such as the community physician program and career presentations to freshman and sophomore students offer guidance by established physicians in the difficult choice of career planning. We plan another January reception for senior students, as well as a Match Day celebration for seniors, along with out-of-town receptions for alumni in other cities and at major medical meetings. The 1994 Distinguished Alumnus Award will be presented in September to Dr. Noel Rose. Dr. Rose's achievements in immunology have been the cornerstone of many techniques and developments utilized in daily clinical practice. His recognition is a source of pride for all our alumni. The flagship event of our alumni year is Spring Clinical Day and your board is busy putting together another informative event that will also give us an opportunity to renew old friendships. Again on this day, Alumni Achievement Awards will be presented. As your new Alumni Association president, I look forward to this year and I ask for your support in our endeavors. Please feel free to contact me with any of your suggestions. Sincerely, ~ Send address changes to: Buffalo Physrcian, 146 CFS Addiuon, 3435 Main Street, Buffalo, New York l4214 < ===- Russell W. Bessette '76 �V s 0 u a 2 L M M E N o 9 R 3 9 4 Research Hospital News II An Investment in the Future • UB's medical scholarships benefit the students, their benefactors and the profession. m Going Beyond the Curriculum e Today's medical students focus their free time on research and community service. E!J ASpoonful of Humor Using spare time wisely. Page 14. m Alumni EZJ Medical School IJ Classnotes * ~n t~e ~ouer: ffiilnren ~anes ann t~e first ~anes ~c~olar. ~arnara ~earne~. Mat'h Day '94: It was a very gaad year! Page 38. �.. . . . . . . .. . . .. . . . . . . .. . . . . . .. . .. . . .. . . . .. . . .. . . . . . . . . . .. . . . . . . [1] , ' _. I . Buffalo General Hospital to join in national stroke research study he Buffalo General Hospital's neurology department is participating in nationwide research comparing the effectiveness of aspirin with the anticoagulant Coumadin in preventing strokes among patients who have already suffered them. "The data should give doctors clearer scientific guidance about which treatment will best protect patients from a second stroke," said Patrick Pullicino, M.D., the study's principal investigator. The study will last two years and will enroll 2,000 patients in more than 30 centers throughout the United States. The Buffalo General Hospital study team, which includes collaborating investigator Frederick Munschauer, M.D., and study coordinator Margaret Hens , R.N., Buffalo General stroke projects coordinator, hopes to enroll about 60 patients. Patients eligible for the study must have had a stroke within 30 days and be between the ages of 30 and 85. Patients with cerebral hemorrhage, or who are unable to take Coumadin, are not eligible to participate. For further information, contact Pullicino at 845-3703. + New anesthesia regime reduces high-rtsk cardiac complications hanging the type and method of administering anesthesia and pain medication to high-risk surgery patients can dramatically reduce the risk of postoperative cardiac abnormalities and possibly lessen the chance of a heart attack, University at Buffalo researchers have found . A team of anesthesiologists led by Oscar de Leon-Casasola, M.D., UB asB u 0 0 p The study will compare the effectiveness of aspirin with Coumadin to prevent second strokes. sistant professor of anesthesiology, followed the surgery and early recovery of 198 patients admitted during one year to Roswell Park Cancer Institute for upper abdominal cancer surgery. One group of 88 patients received standard general anesthesia during surgery and morphine for pain after surgery, self-administered through an intravenous line. Another group of 110 patients received combined anesthesia therapy using bupivacaine and morphine via epidural. After the operation, the same two drugs, adjusted to pain control, continued to be administered by epidural. All patients had an electrocardiogram every 12 hours for three days following surgery to detect cardiac abnormalities. Results showed that patients in the epidural group had 51 percent fewer incidents of tachycardia (15 versus 58) , 12 percent fewer episodes of ischemia (five versus 15) and suffered no heart attacks. Three heart attacks were reh s c a n 5 ported in the general group; none was fatal. De Leon-Casasola said about 40 percent ofhigh-risk patients suffer ischemia after surgery; 8 to 20 percent suffer heart attacks. When surgeons at Roswell reported a significant drop in heart attacks following major cancer surgeries, a team of anesthesiologists began to investigate why. "We had been using combination therapy for about five years ," de LeonCasasola said, "and there was much data suggesting that patients receiving a combination of anesthesia agents via epidural had better outcomes. So we decided to take a look at that issue." Researchers theorize that the epidural anesthesia dilates the coronary blood vessels to help prevent ischemia and the morphine better controls pain to prevent nervous system stimulation. + B Y LOIS BAKER Smokers at rtsk for pertodontal disease,separate UB studies find making may be a key risk factor in periodontal disease , University at Buffalo researchers have concluded. Results of separate studies by Joseph Zambon, D.D.S. , Ph.D ., and Robert ]. Genco , D.D .S., Ph.D ., found that smokers experienced less attachment of tooth to bone and more bone loss around teeth than non-smokers. In a study of 1,426 adults ages 25 to 74, Zambon found that the loss offiber attachment of tooth to bone was three times greater among current smokers - 12.03 percent vs. 4.28 percent compared to non-smokers. Zambon, professor of periodontics, also reported a 120 percent increased risk of infection with bacteria that cause periodontal disease for every step in levels u m m e 9 9 4 �··· · · · · · ········· ·· ··· ·· · · · · ··················································· · ········· · • .. . . from light to heavy smoking. He reported current smokers had higher levels of Actinomyces actinomy-cetemcomitans, Bacteriodes forsythus and Porphyromonas gingival is- all of which cause periodontal disease- than non-smokers. Genco, chair of oral biology, studied 1,361 adults ages 25 to 74. He found that smoking increased bone loss around teeth, a risk that increased from 3.34 to 7.35 times from light to heavy smokers. Researchers included Sara Grossi, D.D.S., senior research scientist; E. E. Machtei, D.M.D., visiting associate professor; Alex W. Ho, research support specialist; Robert Dunford, senior scientific programmer; and Ernest Hausmann, D.M.D., Ph.D., all with the + department of oral biology. - B Y M ARY BET H S "We are making new versions of human hemoglobin by growing the pro- _ tein in bacteria and doing site-directed mutagenesis," he explained. "We can change any amino acid in a protein into any other amino acid we choose. In this way, we hope ultimately to design a molecule that will function optimally as a blood substitute." + - BY a l. o p h II l The grant will allow UB researchers to continue developing a synthetic form of hemoglobin. that will function outside a red cell, explained that when hemoglobin is removed from red cells it binds oxygen so tightly "a person could have a generous supply of oxygen and still suffocate because the oxygen wouldn't be released to the tissues." Noble's approach involves manipulating the amino acid sequence of the hemoglobin molecule and observing how its structure affects its function . y 5 BAKER multi-center study in which UB researchers from The Children's Hospital of Buffalo participated, has found that high-dose intravenous respiratory syncytial virus immune globulin is a safe and effective means to reduce the severity of the disease in children. The three-year study involved 249 highrisk children in Buffalo, Rochester, Boston, Washington, D.C. and Denver. Debra A. Tristram, M.D., and Robert C. Welliver, M.D., of the center for infectious diseases at Children's, were supporting investigators for the study, published late last year in The New England journal of Medicine. Tristram said between 35 and 40 children have been treated with RSV immune globulin at Children's. "Overall, the treatments had good benefits for the children in the study. They had less respiratory ailments and were less likely to acquire severe RSV," Tristram said. The new treatment compound uses antibodies extracted from the blood of volunteers such as pediatric nurses who have been exposed to RSV and have high RSV antibody levels. "Children were hospitalized less often and required less intensive care treatment than· children without the infusions," Welliver added. + UB receives $1.1 million grant to continue hemoglobin research B LOIS New treatment compound found eiTective in reducing RSV severity PINA esearchers at UB have received a $1.1 million grant to continue developing a synthetic form of hemoglobin, joining researchers from five other institutions participating in the $6 million, fiveyear study funded by theN ational Heart, Lung and Blood Institution. Robert Noble, Ph.D., professor of medicine and chief of the laboratory of protein chemistry at the Buffalo VA Medical Center, is principal investigator on the UB project. The new funding will allow the team to continue research begun with a $1.3 million grant in 1988. "We are trying to obtain the fundamental knowledge that will enable us to design a molecule that will serve better as a blood substitute than normal hemoglobin," Noble said. Noble, whose team is concentrating on developing a form of hemoglobin ' . c a S u m m e 9 9 4 0 �"Chemo Coach"program begins in Western New York hospitals RPCI opens area'sfirst regional Brain Tumor Treatment Center he American Cancer Society's "Chemo Coach" program, which matches chemotherapy patients with one-year post-chemo patients for support, has begun in Western New York hospitals. The program, developed by ACS's Erie County Unit, recently won the society's award for being the most innovative program in the nation. "The program is based on the belief that someone who has 'been there' will encourage and empower the patient. Healing and wellness is promoted by motivation, encouragement , caring and support," said Hillary Ruchlin, director of patient services for the Erie County Unit of the ACS. All coaches are trained not to dispense any medical information or advice and have completed volunteer training. The program, begun last August after nearly two and a half years of development , has served 275 patients to date. It will be introduced nationwide this year. "We match patients and coaches according to age and type and location of cancer. The coaches then meet the needs of the patients by providing information and support and showing them that there is life after chemo," Ruchlin added. Seventy-five chemo coaches have been trained and are available through the Erie County ACS office. The program is available through patient or physician referral. For more information, call689-6981. + n recognition of the somewhat higher incidence of brain tumors in Western New York than in the nation, Roswell Park Cancer Institute has opened a Brain Tumor Treatment Center- the area's first major regional referral center for the multidisciplinary management of patients with brain tumors. B u a 0 p national Chemo Coach program was developed by the ACS' s Erie County Unit. "The Brain Tumor Treatment Center will provide for comprehensive treatment of all types of brain tumors in adults at one centralized location in Western New York," said Kyu H. Shin, M.D., professor and chairman of radiation oncology at UB and chairman of the department of radiation medicine at Roswell. Shin is one of the founders of the new center. h y 5 c a S The center - headed by neurooncologist Laszlo Mechtler, M.D. , clinical assistant instructor and assistant professor of neurology- is a collaborative effort between Roswell, The Buffalo General Hospital, The Children's Hospital of Buffalo, Millard Fillmore Health System and Erie County Medical Center. "By combining these resources and expertise, the scope of care provided goes far beyond what is available in community hospitals and at other regional teaching centers," noted Shin. The center provides diagnostic, treatment and surgical services in multi-specialty areas. In neuro-oncology, under the direction of Mechtler, neuroimaging, chemotherapy (including intra-arterial and intrathecal), neuro-oncological care and neurooncologic pain management are offered. In neurology and neuroimmunology, under the direction of Steven Greenberg, M.D., assistant professor of neurology, microbiology and immunology and chairman of the department of neurology at Roswell, services offered include neurological care, molecular diagnosis and a tumor tissue repository. In neurosurgery, under the direction of Walter Grand, M.D., clinical professor of neurosurgery, and Charles R. West, associate professor of neurosurgery and chairman of neurosurgery at Roswell, services offered include stereotactic biopsy and surgery, both invasive and superselective neuroradiology and photodynamic therapy. In radiation medicine, under the direction of Shin, services offered include radiosurgery, interstitial brachytherapy of brain tumors, photodynamic therapy, u m m e 9 9 4 �intracavitary radiation therapy and cerebral spinal axis radiation. Patients may be referred to the Brain Tumor Treatment Center by calling the Patient Referral Office at 1-800ROSWELL. + must be screened and cleared by their physicians," Ward noted. Since the startup of Western New York's only lithotripsy service in December 1986, urologists have performed nearly 7,000 non-invasive treatments on kidney stone patients at The Buffalo + General Hospital. Memorial Pediatrics provides wellchild care, sick care, immunizations, sports and school physicals, lead testing, birth control, teenage counseling, supportive services for physical and sexual abuse and 24-hour emergency coverage. + iagara Falls Memorial Medical Center has opened a pediatric primary care center. Formerly known as the "Kid's Clinic," Memorial Pediatrics, at 501 TenthStreetinNiagaraFalls, has evolved from a part-time clinic to a full-time pediatric service to improve the quality and continuity of care for families living in the Niagara Falls area. "Our goal is to serve the people in this community who don't currently have physicians," saidjack Coyne, M.D., the program's medical director. "We're here to offer comprehensive, quality health care for families in a pleasant, sensitive atmosphere." appointed president of the medicaVdental staff at Buffalo Columbus Hospital. A native of Cuba, Perez-Bode earned his doctorate of dental surgery at the University of Havana's School of Dentistry. After coming to the United States as a refugee in 1968, he received his New York State dental degree from the University at Buffalo School of Dentistry. He has been on the staff of Columbus Hospital since 1989. A member of the Cuban Dental Association in Exile, he served as vice president of the medicaV dental staff at Columbus before his appointment as president. + Buffalo General introduces new "waterless"lithotripsy technology Niagara Falls Memorial Medical Perez-Bode named president of Columbus Hospital medical staff he Buffalo General Hospital, which Center opens Memorial Pediatrics pioneered the use of extra-corpoene Perez-Bode, D.D.S. , has been real shock wave lithotripsy in Western ew York, has added waterless technology to the water bath lithrotripsy it introduced more than seven years ago. The move is expected to reduce a patient's length of stay to less than one day in most cases and minimize the pain associated with the procedure. During a "dry" lithotripsy procedure, a gel-like substance is applied to the patient's back, which is then positioned against a small water-filled cushion. "Because there is less pain associated with the new technology, the need for general anesthesia is eliminated in most cases. An intravenous sedation is used instead, allowing the patient to return home the same day," said Phyllis Ward, nurse coordinator of lithotripsy services at BGH. "Since the patient is no longer immersed in water, the visualization of the kidney stone by X-ray equipment is dramatically improved and the length of time to localize the stone also is decreased," Ward added. Ward also said that a patient's sizean important consideration in water bath lithotripsy - is no longer an issue. Even with the new technology, she noted, some of the previous eligibility criteria still apply. "Pregnant women still are not candidates for the procedure, and people with cardiac problems e u a 0 p h Memorial Pediatrics will provide full-time pediatric services to families in the Niagara Falls area. y s c a n s m m e 9 9 4 �Investing in the U:U'8 med:ieft;I 8ehoift;:r8h:ip8 p8;y d:i-v:ideii.d8 :ro:r ~he 8~-...deii.~8, ~he:i:r beii.e:rft;e~o:r8 ft;II.d ~he p:ro:re88:iOII. In the 0 ffices of the University at Buffalo Foundation, there is a list. On the list are a couple of dozen names. And on those names hangs the educational fate of a great many future physicians. O 6 u ffo lo Ph ~stcton S u m m e r I 9 9 4 �Pho"to8 b y Do-..g;Ia-8 Le-vere B u a 0 p s c a n s m m e 9 9 4 �~~Themo. .e y ~O-S a-ya-i_In-b i e ft-II_di -tho-..g;h-t;, ~ha--t's -the bes-t; -..se i_-t;!' I o~ deei_ded -t;hn--t;, 0--t; ~o:r Ien-s-t pa-:r-t; I -the gn-Ye -t;o -the medi_en-I sehooi, I ~a-.._-ted -t;o hn-Ye some-t;hi_.._g pe:rmn-.._e.._-t;. EYe.._ a-:1:-t;e:r I ' m go.._e i_-t; ~••• s-t;i_II b e -there.'' 'T'I•cl ma, ~a..-.e~ .~ 0 B u f f a 0 p h y 5 c a n 5 m m e 9 9 4 �It's the listofpeople who have made a commitment to the next generation of healers: they've endowed scholarships for students learning their craft at the UB School of Medicine and Biomedical Sciences. Some are alumni of the medical school, giving back a token of what their education has made it possible for them to earn. Some are former faculty members who've seen firsthand the bright, committed young people who continue to enter the profession. Some are just interested citizens who know that, despite UB's relatively reasonable tuition costs, some students would not be able to make their dreams happen without significant financial aid. And some who have endowed these scholarships, it must be said, are no longer with us. It's an irony of charitable giving that so often a gift is made in the form of a bequest - a provision in one's will. Such support, of course, can be vitally important in building up the endowment funds that are the basis for the medical school's scholarship programs. But other donors have found that there's nothing so satisfying as actually watching your money go to work, seeing the good that you can do in individual lives. Ask Thelma Sanes. A handful of years ago, Sanes established the Harold Sanes and Thelma Sanes Medical Scholarship with a major donation to the school. The scholarship- named for Thelma and her late brother Harold- was in recognition and memory of their late brother Samuel, professor of pathology at the medical school for many years and head of pathology at the former Meyer Memorial Hospital (now Erie County Medical Center). B 0 0 p 0 5 m m e 9 9 0 �Harold Sanes had passed away in 1986. ButThelmaSanes can watch with pride the results of their living gift to the future of the medical profession their brother loved so much and gave so much to . This year, the first of the "Sanes Scholars" graduated from the medical school; at any one time, four such students receive aid from the Sanes B u a 0 p grant. The scholarships, which nearly cover the school's $8 ,450 annual tuition, are renewable for each year of a student's education. "I had written up how I wanted the scholarships to be paid," Sanes said. "They're given every year, but the students who get them, get them for four years. I felt that anybody who met the criteria of the scholarship is someone 5 c a S who is in need , and I didn't want to dump them after freshman year. " The scholars have a genuine affection for their benefactress. "Most of the winners have written me letters of appreciation," Sanes said. "Occasionally I even get a Christmas card from one of them. They're very nice people. " There's an annual luncheon as well, she said, at which donors and scholar- u m m e 9 9 4 �ship winners can meet. Sanes said she has made provision in her will, as well, for an additional donation- "to cover inflation." "I figured, there's going to be enough left. Part of it should go where it will do some good." That it has. The first Sanes Scholar, Barbara P. Kearney, graduated on May 15, having had the scholarship for all four years of her medical education. "It was wonderful," Kearney said of the day she learned she had won the scholarship. By invitation, she had written a brief essay about her accomplishments and stated the case for her financial needs. The good news came in a phone call from Thomas ] . Guttuso, M.D., assistant dean for admissions. Between then and graduation, of course, were the strenuous four years that begin to turn scholars into physicians. But through all the work that those years entailed, Kearney said, she knew that the endowed scholarship - in her case, $5,500 annually -was there to help make it possible. A lot of her fellow students, she pointed out, will leave UB medical school with crushing debt burdens. "I still have some loans that I've taken out," she said. "I had to buy a car, and there are the books. But it's only about half of what I would have had to take out." What that means, she said, is flexibility in choosing a field of practice. (New residents who are tens of thousands of dollars in debt can feel pushed into a high-paying specialization.) Kearney began her residency in pathology with the Graduate Medical Dental Education Consortium of Buffalo onjune 12. "A lot of my friends have parents and relatives who've helped them along through school," she said. "But that's not possible for everyone. 8 0 0 p "Any scholarship or any kind of grant that can be made available, I strongly encourage (potential donors) to do that." Even gifts of smaller scope can make a significant difference in the scholarship aid the school can distribute, said Guttuso. By pooling smaller gifts, the medical school can assemble scholarships for those in need. Right now, he said, about 35 students are benefiting from scholarships that total around $60,000 annually. "It's our hope," Guttuso said, "that we can build a scholarship fund that will enable us to help close to half the class each year." Each class of the medical school has 135 students. Guttuso said students are considered for aid based both on their academic promise and on their financial need. Twenty "scholar incentive awards" are given to applicants solely on their academic promise, he said"we're trying to attract the most intelligent students to come to our institution." But for all other scholarships, need is a factor in the decision. Each spring, Guttuso said, his five-person scholarship committee sits down and sifts through the applicants for aid. It's a wrenching process. "It's kind of tough sometimes, when you get down to 50 or 45 students," he said. "To eliminate some is hard, because they all really need it. That's why we're hoping that we can expand the program to help a greater proportion of the students." Except for the minimal Regents Scholarships, New York State provides no money for scholarships, notedjohn A. Richert, Ed.D. , associate dean for alumni affairs at the medical school. "Monies are few and far between," he said. One major initiative to expand scholarship assistance is the establish- 5 a 5 scope cn..IJ.. d i ffe:reiJ..ce schoo1 cn..IJ.. ASSISTANT DEAN FOR ADMISSIONS m m e 9 9 4 �ment of Medical Alumni Scholarships, to be funded by those who know best how expensive it can be to go through medical school - the alumni themselves. Dr. Donald P. Copley, a cardiologist who was president of the Medical Alumni Association last year when this plan took shape, explains. "Last vear when we began organizing for the reunion class spring session, I brought this idea up to all the (class reunion) chairmen at the same time," he said. "The question I posed was, if we pull together and all of the classes got together quite a few thousand dollars, and the (Medical) Alumni Association promised to retain an identity for everybody involved- that is, identify particular students and maybe associate them with particular classes and link up person-to-person - would the chairmen and their constituencies be interested? "It turned out there was a pretty universal enthusiasm for the idea." So for the '93 class reunions, again this year and for the next three years, alumni class gifts to the school will be funneled into what promises to become a major scholarship endowment. (The five-year cycle was established to give members of every class the opportunity to contribute. Some individual classes, notably the Classes of 1957 and 1973, already have established scholarship funds; but this is the first time all the classes together have the opportunity to contribute to a combined fund.) Class gifts to the school have averaged around $100,000 each year, Copley said, and planners of the Medi- B a 0 p cal Alumni Scholarships hope to ex- books," says Claudia Jaramillo, anpand on those figures . "We're shoot- other alumni scholarship recipient. ing for $1 million," he said, "but at "That's usually what it comes to for a this point it's awfully hard to tell year (of books). (whether that goal is attainable). If we "The budget usually fora (UB) medigot to $500,000 or $600,000, we'd cal student is about $20,000 a year, still be quite happy about it." especially if you're not living at home. There was some controversy, he But still, anything you can get, espenoted, over whether recipients of the cially $1,000, is definitely helpful." scholarships should be chosen on acaFellow recipient] eannie Kao notes demic merit or simply on need. "Half that her student loan was reduced by the people I talked to thought that the amount of the alumni scholarneed should be a major consideration, ship, "and to have that be $1,000 less so that people who had no resources is really nice." With interest, of course, or very little resources would be the loan repayment can be much greater ones who were offered the scholar- than the principal borrowed, so a ships," Copley said. "An equal num- $4,000 reduction (the scholarships ber of my constituency thought that are for all four years) is a major benefit merit should be the only criterion." down the road. The outcome: a time-honored com"As a medical student," says scholpromise, in which academic merit arship recipient Frank M. Lee, "you will be the primary focus in half the really don't have the time to take on a scholarships, financial need the de- job except in the summertime. The termining factor in the other half. scholarship does cover my books at "The idea," Copley said, "is to carry least, which is nice. each of these individuals through four "Since UB is not really that expenyears of school." He noted that john sive to start off with, you do come out P. aughton, M.D., dean of the medi- with a debt, it's not in the hundreds of cal school, has supported the alumni thousands but still it's something you initiative with some discretionary have to think about. The scholarship money he has available. "Dean makes more of a difference in a school Naughton was particularly enthusi- like ours," because it represents a astic and helpful," Copley said. greater portion of the cost of medical Already the Medical Alumni Schol- education. For those with the means to make arships are providing significant support to first-year students. "It's a great a major gift of scholarship money, UB feeling to pick up that $500 check at offers two possibilities: an annual the start of each semester," says one scholarship or an endowed scholarsuch student,]ason M. Andrus. "It's a ship, both of which can be established couple months' rent. It's a terrific through the Office of University Defeeling to think that your school thinks velopment. An annual scholarship is a gift of that you're unique and they're going out of their way to assist you like about $8,000 or more for one year, or that. " annually for several years, to support "Definitely it helps, especially with a student's educational expenses for s c o n 5 m m e 9 �those years. By contrast, an endowed scholarship is a gift of at least $150,000 that is then permanently invested and the income used as scholarship assistance. It's a gift that continues beyond the donor's lifetime. Michael E. Benzin, associate director of special, annual and regional giving for the University at Buffalo Foundation, noted that the foundation has experience in handling gifts of all sizes. The endowment managed by the foundation for the university is now $40 million. (Donations earmarked for the medical school are managed by the B 0 0 p h foundation, but the school itself decides who is to receive the scholarship money they generate.) Unrestricted gifts are encouraged, because they afford the most flexibility in meeting students' scholarship needs. But major donors , Benzin said, can structure their gifts in any number of ways. For example, if a surgeon wants to endow a scholarship that would go only to students who aspire to surgery, that's entirely possible. Or, he said, "if (the donor) worked his way through medical school and would like to assist a student who's in that situation, you can do that, too ." s c a S u Benzin said endowment money is invested conservatively and that a part of the interest is channeled back into the principal so that its "buying power" isn't eroded by inflation. And he reminded potential donors about the james Platt White Society, founded in 1986 to honor donors to the medical school of$1,000 or more. Named after a founder of the school, the society has about 200 members. As Barbara Kearney , the new pathology resident, said of her Sanes scholarship: "There's just so many people out there who could benefit from something like this. " + m m e 9 4 ��o ree time is a scarce commodity for medical students. But one Saturday morning this spring, Amy Ferry was spending some of hers with a homeless man in Buffalo's City Mission. The pain in his feet and knees had gotten so bad he was having trouble walking. And he was feeling run down and depressed. "Any drugs?" asked Ferry, who was completing her fourth year at the UB School of Medicine and Biomedical Sciences. Not any mor_e, the man said, but he still drank. "Do you see your drinking as a problem?" Ferry asked. "I see me as a problem, period," the man replied. After the man had been referred for further treatment, Ferry reflected on why she was devoting this morning to Project Hope, the weekly City Mission clinic run by student volunteers from the UB medical school. "Doctors are expected to be involved in the community," she said simply It's the same reason she spent last summer on Capitol Hill, lobbying over tobacco and mammographies. "It's part of learning to be a doctor," she added. Ferry is among the large number of medical students who take it upon themselves to extend their educations beyond the curriculum requirements. Some work in clinics with underserved populations. Some teach health lessons to school children. Others spend long hours in the laboratory helping to carry out research. They do it to varying degrees and for a variety of reasons: a sense of social responsibility, intellectual curiosity, clinical experience, diversion, career advancement or just the challenge. e a 0 p h y 5 c a n S u m m e 9 9 4 �~ ~ese are talented kids in many respects, and they do a lot of things, " said Richard] ones, Ph.D., medical school registrar . No one keeps tabs on exactly how many students take part in activities that aren't required but are professionally relevant. Thomas Flanagan, Ph.D ., chairman of the Student Research Committee, said that at last count, several years ago , more than 300 UB medical students were involved in research. Recent projects include investigations into DNA, the epidemiology of neuroblastoma in New York State, alcohol-related injuries in children and adolescents and the exposure of medical students to blood and body fluids . And student leaders estimate that half to three-quarters of their classmates get involved in some type of voluntary service activity, from medical clubs to clinic work. Among the larger student initiatives are Project Hope and a pair of programs that put medical students into the schools to teach children about AIDS and healthy diet. "Most students will get involved even at a peripheral level in something," said Melanie McNally, 1993-94 president of Polity, the medical school's student government council. Those who do get involved may spend less than an hour a week on outside activities. Research, however, can easily take several hours a week. And some students find themselves with the equivalent of a part-time job. "I think a lot of it depends on how you handle your own stresses," said Eileen Killackey, a Project Hope volunteer who is going into her third year. "I think it depends on what you're most concerned about doing while you're in medical school. .. . In a way, it's something to keep you going. It gets you out of the classroom and in touch with what you're actually going to be doing at the end of four years. It's like light at the end of the tunnel. " But getting involved at more than a peripheral level can force students to make tough choices. "Your grades can reflect it," said B u a 0 ence on match day. "If you're visible , it does go down in your dean's letter," said McNally. "Right now, that's the only non-personal benefit you get out of it. " But it's the personal benefits that often matter most. It's not uncommon for students to describe their volunteer work in terms of social and professional responsibility. Many see the work as a way of helping others while preparing themselves to become better physicians. "It's definitely a two-way street," said Sarah Ballow, a Project Hope volunteer going into her third year. "Most of the people who get involved in these activities have a desire to do something," said McNally. "That's why they got into medical school in the first place - because they wanted to do something for their community." Flanagan said that while many student researchers take on their projects with an eye toward honors and residencies, a good number do it out of simple intellectual curiosity. "Some have a specific disease interest that they want to pursue," he said. "Some kids have had no research experience and just want to see what it is. " The research projects cover a broad spectrum, from laboratory "bench" research, to clinical investigations and even health policy work. Every year, the medical school supports about 20 students in its 10-week Summer Research Fellowship program. Applicants must submit detailed proposals, and only about half are accepted, said Flanagan. But in most cases, student researchers get started simply by talking to a professor and signing on to projects already under way. Many do it in the summer after their first or second year, when there's a little more time. And if there's a grant supporting the project and some money to spare, there may be a stipend in it for the student. Tom Guttuso,jr. , said that when he started medical school he didn't plan to become a researcher, but he became engrossed in the laboratory after his first year and the experience has "completely changed" his medical education. Guttuso received a summer research fellowship in 1992 to work with physi- Michael Landi, M.D., a Class of 1994 member who conducted several research projects. "I know my first-year and second-year grades were probably a little bit lower because of the time I put into research ." McNally said her student government work has forced her to manage time better - to a degree. "You make the time, you really do ," she said. "Then you go and beg your professors to have mercy. " Dennis A. Nadler, M.D., associate dean for academic and curricular affairs, said UB encourages students to go beyond the classroom. "Our university," he said, "stands on a three-legged stool -academics, research and service." Official encouragement, however, has been somewhat uneven. Some students who participate in research can garner extra points toward Latin graduation honors . But no points are awarded for those who participate in community or university service, such as volunteering at a clinic or serving as a student representative on a university committee. That may be changing. Nadler recommended last year that service activities be rewarded with graduation honors, and as early as this fall- depending on the outcome of a faculty council meeting in late May- a revised honors system could take effect. Under it, new categories of diploma honors would be created for research and volunteer service. Latin honors would revert to the traditional system, in which they are bestowed strictly for academic achievement. "We really feel that we have a commitment to serve the community as a medical school, and that extends all the way down to the students," said Nadler. "What we haven't had in the past was an adequate way of rewarding the students." Even without honors, extracurricular work can mean career benefits. "So many residency programs are interested in whether students have done any research," said Flanagan, a microbiology professor who oversees the medical school's Research Forum and Summer Research Fellowship programs. In some cases, community and university service could also make a differ- p h 6 c a n 5 u m m e 9 9 4 �ology professor Susan Udin, Ph.D., on visual plasticity in frogs. "We were working on basically trying to get the visual nervous system to reorganize and heal after it's been damaged and I just kind of fell in love with it. "I ended up really digging it so much that I did it through the second year of medical school - before classes, after classes, during some of the more boring classes." Then he took off the 1993-94 academic year, which would have been his third, for full-time study of the hormone melatonin with a $23,000 grant from the Howard Hughes Medical Institute. Guttuso was unable to prove an effect on frog visual systems, so he switched gears to pursue his theory that melatonin could prevent or slow the development of Parkinson's Disease. "It's been a lot of work to get this model up and running," he said. But, he added, the results could be much more clinically relevant than his original line of inquiry. His results, unfortunately, have been "inconclusive," but because of a design flaw in the experiment rather than his theory. Guttuso "hopes to do it again this summer." Ultimately, Guttuso said he would like to make research part of his career, mixing it with clinical practice, possibly in neurology. "It's put the thought into my head that I'm going to do something that I never expected to do when I entered medical school," he said. "Once a student gets involved in research, they very frequently will continue," said Flanagan. "They will do it in B u 0 0 f' h gery residency at Mercy Hospital in Buffalo this year, has been involved in several research projects, including a study into the exposure of medical students to patient blood and body fluids. He said he found that about 30 percent ofUB's class of 1993 was exposed through needle sticks, mucous membrane splashes and other means during third-year rotations. "That's pretty consistent with the class of 1994, too," he added. The study began when Landi read a letter in the medical school newspaper from a former student who had contracted hepatitis during her rotations. A snafu left the woman unaware for several weeks that she had tested positive for hepatitis, prompting Landi to look into student exposure rates and the policies for dealing with such cases. "It was just because I was kind of offended," he said. Landi, who is submitting the UB study for publication, is still reviewing results from a larger subsequent survey he conducted with another UB student of exposure rates at seven medical schools across New York State. He also helped develop a comprehensive policy for UB's consortium of teaching hospitals to handle student exposure cases. Previously, there was no consortium-wide policy. Landi never calculated how much time he put into his research, but he remembers spending a lot of evenings and weekends with it. "I wouldsayit'sagood parttime job," he said. "It gets kind of labor intensive when paper writing comes around. " Students who take on significant extracurricular responsibilities say it forces their free time during the school year. They don't have a lot of time, but they make time." Under the graduation honors policy in effect in recent years, students could earn Latin honors points if their work was accepted for presentation at the annual Research Forum, and their supervisor approved. "A lot of the work is very good and leads to publication," Flanagan added. The medical school encourages re- search, partly to make students aware of the career possibilities, but also to turn out more rounded clinical physicians. "It's one thing to read the outcome of research and another thing to actually conduct it, to confront the solving of problems, to be frustrated by things that don't come out the way you expect them to," Flanagan said. Landi, who is beginning a neurosur- y s c o n S u m m e 9 9 4 �them to set prionttes. "Some people manage to pull off the top grades even with this, but most of us are in the B range," said McNally, the Polity leader. Many students describe their extracurricular activities as a good way to experience a broader world that will be relevant to their professional futures. McNally said that in being responsible for the $88,000 in student activity funds distributed by Polity, she's learned something about accounting. "I have become very interested in the administrative side of medicine," she added. "I've found that I'm very good at this, and I'm hoping to make it part of my career." At Project Hope, students deal with unteers how to take histories and talk with the homeless patients. "I've always been interested in serving underserved populations ," said Ballow, who worked in a soup kitchen during her high school years in Connecticut. This summer, she will conduct US-sponsored research at a Navaho reservation in Arizona. She has also managed to keep up a relationship with her boyfriend, who lives four hours away in Pittsburgh. ''I'm a very organized person," she said with a smile. Project Hope began several years ago as an outgrowth of a City Mission clinic run by the School of Nursing. "We just wanted to do more outside the classroom, to use what we were learning," said Joe Kay, M.D., who graduated this year to begin a residency in internal medicine and pediatrics. Kay said he enjoyed his time with the clinic. "You're doing it because you want to, rather than being evaluated all the time," he said. "It's a different atmosphere than the hospital. It gives you an idea of the problems with the health care system, too ." Many students involved with Project Hope agree that the experience has affected them. "I always find that talking to the patient is a very humbling experience," said Killackey. "Medically speaking right now, I don't know how best to help people because I don't have the clinical skills. But with situations they might not see on hospi- these community projects, you find out that your just being attentive and listental wards. "If someone comes in with a simple ing to these men and women can make foot fungus, you tell them to clean their a big difference." There are limits, howfoot and change their socks," said Cook. ever, to how much students can take on. "Then you find out they only have Ferry, who will begin her residency this one pair of socks." year in obstetrics and gynecology, served About 60 students are involved in two years as regional student co-coordiProject Hope, according to Ballow, who nator for the American Medical Women's helps administer the program. Each of Association. "They wanted me to run those students spends at least one Satur- for national co-coordinator," she reday morning at the clinic. Ballow is called. "I said not while I'm an internthere once a month, showing new vol- no way, no how." + "0 think there is definitely a trade-off," said Stephen Cook, who in his first two years has been involved in Project Hope, a pair of Buffalo pediatric clinics and the Primary Care Club. Recently, he also initiated an undergraduate clinic for Niagara University students interested in medicine. "I enjoy doing these things," he said. "It's time I could spend learning gross anatomy or biochemistry, but that's the type of person I am. I'm a more humanistic person. I like dealing with people." Noah Sabin, a 30-yearold attorney who just finished his first year at UB medical school, has been adding to his list of responsibilities. During his first year, Sabin was elected vice president of the American Medical StudentAssociation chapter. He also signed on to a national AMSA task force on tort reform, and will work on environmental health issues with Rep. David Obey, DWisconsin, in Washington this summer as an AMSA fellow. In addition, Sabin said he tries making time to exercise and keep up on his nonmedical reading and current affairs. He described time management as something that's subject to amendment as exam results come back. "I sort of have a sense from looking back at law school of how much those grades really meant in the long run," he added. "They meant a lot if you're looking for a certain amount of prestige in a certain field . ... (But) the people defining what's most prestigious have spent their entire lives in those environments, and they don't really know what else is out there." B u a 0 p h 5 c a n 5 m m e 9 4 �M edical school makes a lot of demands, but it doesn't demand that students volunteer their time for research or public service. Yet many do . Here are some of the things they're involved with: RESEARCH "The student research at UB takes a number of faces, " said Luther Robinson , M.D. , assistant dean of student affairs. Student work ranges from basic biology to the genetic basis of cancer. "The spectrum of research in medicine contributes to the intellectual climate in medical school," Robinson added. Students most frequently get involved by approaching a professor already carrying out a research project. Some departments have grants to sponsor research opportunities, as well. And each year the university supports about 20 students in its Summer Research Fellowship program. Applicants must submit detailed proposals to a faculty committee for the full-time, IO-week program. In addition, student researchers can apply to present their work at the annual Research Forum. At the last forum, in December, more than 70 students made presentations. "This is not the science fair ," said Thomas Flanagan, Ph.D. , chairman of the Student Research Committee. "This is real research. " PROJECT HOPE About 60 students are involved in this Buffalo City Mission clinic, a u 0 0 p American Medical Student Association, the AIDS-prevention program began at UB last year. Since then it's reached nearly 10,000 students in Buffalo-area junior high and high schools. About 55 first- and second-year medical students take part. "We talk about the biological aspects of AIDS- transmission and prevention," said Beth MacDonald, who just finished her second year and is STATS coordinator. "The questions are usually very specific and very explicit," she added. "The questions show that the kids obviously need to learn." which is an expansion of a clinic started earlier by UB's School of Nursing. Each Saturday morning, four or five first- , second- and fourthyear medical students attend. They are joined by a nurse and physician. The first- and second-year students take histories and vital signs, then observe as the fourth-year student conducts an examination. They present their findings to the physician, who then conducts a final examination. Among the administrative problems faced by student organizers has been a lack of insurance for physicians who volunteered to attend. Recently, Project Hope became affiliated with Sheehan Memorial Hospital, which has been rotating physicians to the clinic every other week. "The credit goes to the medical students," said Raul Vazquez, M.D., of Sheehan's Family Care Center, who was attending the clinic one day this spring. Vazquez, a member ofUB's Class of 1989, said that while students were interested in such volunteer work when he was in medical school , programs like Project Hope didn't yet exist. GET HEART SMART In this four-year-old program, medical students visit local fifthgrade classes in teams of four or five to deliver presentations on avoiding heart disease. The 70 participating students, mostly in their first year, reach several thousand 10and 11-year-olds annually. "That's the age to get them, when they're still impressionable and don't have any heart disease," said Brad Davis, who ran the program i.n 199293. "We really consider it the purest form of preventive medicine." PEDIATRIC CLINICS STATS Teen-agers don't like listening to those they see as adults. But if they're told something by another student, particularly if that student is wearing jeans and a t-shirt, the message might get through. That's the theory behind Students Teaching AIDS To Students. Launched several years ago by the s c a S u About 20 to 30 students per semester attend pediatric clinics at the Roberto Clemente and jesse E. Nash health centers in Buffalo. They're mostly in their first and second years, and they help the health center staff with growth charts and sometimes with immunizations. + m m e 9 9 �A Spoon f u I of Humor© ADVICE FROM SOMEONE WHO ' S BEEN THERE ince this issue of Buffalo Phy sician features topics on medical school, I started thinking back to those days. Despite their complications, intricacies, similarities and differences, professors can basically be divided into five categories: tf . MIGHTY FAMOUS BIG SHOT ~ - THE DISDAINFUl EGGHEAD Advantages: His course includes attach- Advantages: Draws in grant money B u a 0 p and monolith residents to the department. Disadvantages: Speaks with a difficult-tounderstand South African accent, despite having spent all his life in a suburb of Cleveland. Choice in clothing qualifies him as legally blind. Warning: May be hazardous to your health. ing state-of-the-art electrodes to the lacrimal glands of domestically raised coyotes, making for interesting chit-chat at family gatherings. Disadvantages: Hates M.D.s and considers them technicians. Warning: Sit in the back row and avoid making eye contact. A ·THE NOVICE DRONER Advantages: Meticulously organized ~.PROFESSOR IN TRUCK DRIVER OUTFIT Advantages: Chain-smoking genius. Car- handouts make going to class very unnecessary. Disadvantages: Includes material that nobody ever heard of, including the people she is citing. Includes material nobody cares about. Warning: This is what the boards and cocktail parties are like. ries lecture notes in a Metallica lunchpail. Disadvantages: Cyanotic mouth breather, occasionally desaturates while lecturing. 5 c a n s /!; . PSYCHIATRIST FROM liCHTENSTEIN Advantages: His three lectures can be u m m e 9 9 4 · �Stu S i Ivers t e in M . D. ~ The social worker making rounds spontaneously combusts from boredom. ~ The patient loses patience and presents hmself to the housestaff. ~ The attending asks you to pull his finger. ~ Alfred Hitchcock walks through the group. ~ The team breaks up into small discussion groups in the stairwell. + FOR THOSE OF YOU who have friends or relatives about to attend medical school, here are some basic rules for success: summed up in one sentence: People who are terminally ill often get depressed. Disadvantages: See above. Warning: When you get depressed you will wait in line with your classmates to see him. , ~ Avoid lecture halls. on rounds, start each sentence with "According to the literature, occurs in 5% (or 95%) of the cases." ~ ever say, "I didn't get the lab results." It's always, "They're not back yet." ~ Begin rounds by handing out articles , nobody will read them anyway, so just randomly photocopy them. ~ Grow a beard with no mustache and nod your head up and down like a toy dog. (Males only please.) ~ Keep repeating, "great case, good pathology," until somebody notices you're naked from the waist up. ~ Offer to look at the smear several times during rounds while staring at the lab reports. ~ ~eep referring to your stethoscope as your pal Hector. ~ When Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California, lectures nationwide on humor in SIGNS THATYOU ARE BORING ON ROUNDS: ~ You are a medical student. ~ Twenty minutes into your presentation the attending says, "how old was that patient? " ~ The patient asks you to leave the bedside because everyone else left for GI rounds 20 minutes ago. ~ When you present the lab results, the intern punches a bunch of numbers into his pocket calculator, looks up and asks if you also get expensive phone bills. ~ The chief resident pulls you aside to tell you you're too intense, relax or he'll give you a wedgie. B a 0 p h ~ 9 c a n 5 m m e 9 9 4 �Mixing medicine and business VIRGINIA WELDON '62, USES BOTH HER MEDICAL EDUCATION AND CORPORATE EXPERIENCE AS SENIOR VP FOR PUBLIC POLICY FOR MONSANTO COMPANY fter listening to a description of her assignments at the Monsanto Company, one of the nation's largest multi-billion dollar enterprises, you might think Virginia V. Weldon possesses degrees in chemical engineering, international diplomacy and marketing rather than a doctorate in medicine from UB. "I'm expecting a phone call from the FDA during the interview. If the call comes, I've got to take it, but I will call you right back." Indeed, Virginia Weldon is a busy person. As senior vice president, public policy, for the St. Louis-based company, the class of '62 alumna is responsible for corporate communications and government affairs, devoting most of her hectic schedule to opening new markets and winning government approval and public acceptance for emerging technologies and products. "Monsanto markets its products worldwide, and I have the responsibility to help sell our products and to get new products approved for sale by the government," Weldon explains. The Monsanto Company manufactures and markets agricultural and chemical products and pharmaceutical and food ingredients. Some of its best known products include Roundup herbicide, Ortho lawn and garden products and NutraSweet. Weldon never saw herself abandoning the operating room for the corporate boardroom. "When I went to medical B u a 0 school, I was thinking about being a practicing physician. I loved surgery. I really enjoyed surgery in my junior year at the E.]. Meyer Memorial Hospital," Weldon said. "And we had wonderful people teaching physiology. I remember going to parties and on picnics with Dr. john Boylan and with other faculty and students. It was a wonderful time. The four best years of my life," she adds. Following an internship and residencyin pediatrics at The johns Hopkins Hospital in Baltimore, Weldon completed a three-year fellowship in pediatric endocrinology at The johns Hopkins University School of Medicine. Shortly thereafter, Weldon joined the faculty of the School of Medicine at Washington University in the department of pediatrics. It was there that her interests in medicine began to shift to matters of public policy. "I became involved with public affairs as a member of the Endocrine Society and the Society for Pediatric Research with issues concerning funding for research and the ethical treatment of human subjects," Weldon says. After serving as co-director of the division of pediatric endocrinology and metabolism, Weldon was appointed assistant to the vice chancellor of medical affairs. The metamorphosis from physician to businesswoman was well underway. Weldon was named deputy vice chancellor for medical affairs and vice president of the medical center at Washington University School of Medicine and p s c a n S Medical Center in 1967. She joined Monsanto as vice president, scientific affairs and was quickly promoted to vice president, public policy, serving in that capacity from August 1989 to October 22, 1993, when she began her present position with Monsanto. One of the greatest challenges facing Monsanto, Weldon says, is to build public trust. "Science-based companies like Monsanto have a responsibility to assure the public that the science on which new products are based is of the highest caliber. It is imperative that our science and assessment procedures are beyond reproach in order to be credible and trusted." Weldon's education and experience as both a physician and corporate executive have helped shape her views regarding health care and, in particular, with the congressional debate regarding health care reform. "It's a very complicated subject, partly because of the size and complexity of the health care system, the entrepreneurial spirit of our country and the public's expectation for continual improvement of medical care." It will be very hard, she adds, to reform the nation's health care system in "one fell swoop." Instead, Weldon said attention should be paid to aspects of the system that are "broken." "We need portability of insurance coverage and we need to provide insurance for those who don't have coverage. And it must be affordable," she maintains. u m m e 9 9 4 J J �l J 1 J "One of the issues being overlooked in this debate is the jobs involved with health care services. No one is considering the consequences to the academic medical centers, pharmaceutical companies and insurance companies," Weldon says. When asked specifically about regulatory delays that affect the timely approval of new pharmaceuticals, Weldon said, "One way to help this country maintain its competitive edge in pharmaceutical discovery is to provide the FDA with enough funds to work efficiently and effectively, to give them resources to hire the scientists they need to evaluate new drug petitions, and to make sure the agency is free from political influence." But, she added, "Our congressional leaders have not seen fit to provide the additional funds the FDA needs. There are numerous, geographically separate facilities for the FDA in Washington, many of them antiquated. There is certainly a need for more resources." As a spokesperson and policymaker for a major international company, Weldon has become, by default and not by design, a high profile example of a successful businesswoman and she has strong opinions regarding opportunities afforded to all individuals within corporate America and within her own company. "What happens to you, whether you succeed or fail, depends upon you as an individual. "I don't believe that women who become militant about their role can contribute effectively. Women who make positive contributions make it easier for other women who will come after them," Weldon said. "My guess is that women who employ 'sharp elbows' in an attempt to further their careers actually make B a 0 p " SCIENCE-BASED COMPANIES LIKE MONSANTO HAVE A RESPONSIBILITY TO ASSURE THE PUBLIC THAT THE SCIENCE ON WHICH NEW PRODUCTS ARE BASED IS VIRGINIA WELDON OF THE HIGHEST CALIBER. " that was purposeful- it happened because, historically, medicine was dominated for so long by men." ot surprisingly, Weldon has taken an active role in promoting the national effort on women's health issues and, in 1993, was appointed by the National Institutes of Health to serve as Chairman of the Women's Health Initiative Program Advisory Committee. UB is one of 16 vanguard clinical centers participating in NIH's landmark things harder ," Weldon continued. "Monsanto is trying to find qualified women and minorities in order to achieve a diverse work force and to provide an opportunity for everyone to succeed. Monsanto is very serious about diversity. " But Weldon also acknowledged the difficult role many women face in advancing their careers. " ... probably every woman in any kind of job that is viewed as non-traditional has felt marginalized or overlooked .. .. we must work very hard to change the culture in our (nation's) businesses and institutions, but it takes a long time." An area in which Weldon sees steady progress, however, is in women's health initiatives. "Women's health has been neglected for a long time. I don't think 5 c a n s studyofwomen~h~hh . As for the future, Weldon says she is constantly challenged in her job at Monsanto and is not thinking about any more career changes. "Someday," she said wistfully, "''d like a little more time + for golf and travel. " - m BY m PETER H . SIGURDSON �~-··········· · ··········································································· IE Kasstrer '53, delivers Stockton Kimball Lecture 1991 DISTINGUISHED MEDICAL ALUMNUS RETURNS FOR SPRING CLINICAL DAY TO SPEAK ON " CLINICAL REASONING : TEACH I NG I T AND LEARN I NG IT" " espite or perhaps because of all sorts of technological advancements, our cognitive skills remain the preeminent part of our work as physicians,"] erome P. Kassirer, M.D., editor-in-chief of The New England journal of Medicine, told the audience gathered to hear him give the annual Stockton Kimball Memorial Lecture at this year's Spring Clinical Day, held April 30 at the Buffalo Marriott. "But despite the importance of the diagnostic process, we spend precious little time trying to understand it," he said. Kassirer's talk, "Clinical Reasoning: Teaching It and Learning It," focused on what he called "the mental process that physicians use when they perform the task of diagnosis." Robert Reisman, M.D., president of the UB Medical Alumni Association and a longtime friend and schoolmate of Kassirer, introduced Kassirer and praised him as "everything a physician should be- a clinician, teacher and researcher who is dedicated to medicine. He's an excellent physician, often referred to in those most admirable of terms as a 'physician's physician,"' Reisman told the more than 300 people, including UB B u 0 0 President William Greiner, who attended. Kassirer, a 1953 UB alumnus who earned his medical degree from the UB School of Medicine and Biomedical Sciences in 1957, began by pointing out that he felt it was a great privilege to be giving the Stockton Kimball Memorial Lecture partly because Kimball was dean of UB's medical school when Kassirer had been a student there. Kassirer praised UB and the Buffalo area, saying "I treasured my experience in medical school and the two years I spent at Buffalo General Hospital." Regarding the diagnostic process, Kassirer said, "The more we study it, the less likely we are to make errors. I want to explain how the process goes, as well as the faults that affect even the best of us." Kassirer pointed out that while phy- p h 5 c o n s sicians often think of themselves as the only people who use diagnosis, nothing could be further from the truth. Diagnosis is a process used by all sorts of people, from politicians to mechanics, Kassirer said. The diagnostic process involves, first of all, inferences that are made from observable facts about the nature of a system malfunction, Kassirer said. Such inferences yield "a series of provisional approximations that are revised continually," he said. But he added that it was important to pay attention to the distinction between a perception and an inference, and to note how much inference goes on in any act of perception. "As an example, if you see a ball bounce into the street, that perception may cause you to immediately slow down your car because of your inference that the ball could be followed by a child," Kassirer said. Kassirer pointed out that there are two basic types of problem-solving methods, which he termed "weak" methods and "strong" methods. Weak methods are general problem-solving methods that do not depend on a particular domain of expertise, are widely applicable across different problem areas and m m e 9 9 4 �·· ····················· ···· ·············· · ················ · ········ · ·· ·· ····· · ···· ·· · · ·· • are characteristic of novice rather than normal and abnormal findings. The com- ciples for teaching clinical problem-solvexpert behavior, Kassirer said. Strong peting hypotheses also have to be proved ing, which included using case presenmethods, he said, are methods used by false at this stage, Kassirer said. tations and giving students data in domain experts and involve rapid recResearch on the diagnostic process "chunks" that allows them to particiognition of patterns and efficient for- has a number of important uses in edu- pate in the diagnostic process. Kassirer mulation of problems in "semantically cation, Kassirer said. It enables better stressed the importance of using real meaningful chunks." Such methods go teaching of that process, and helps stu- cases in order to reflect what he called directly toward the solution of particu- dents learn how to recognize clusters of "the messiness of clinical medicine." lar problems and are domain-depen- cues at the beginning of the process. Other basic principles included stressdent and narrowly applicable, Kassirer Research on diagnostics also helps ex- ing causal relations when possible, and said. plain the rationale behind the tradi- identifying for students the reasoning Kassirer said four basic components tional routine "workup" with which strategies employed, as well as potential comprise the diagnostic process: hy- physicians prepare for every diagnosis, errors in reasoning. pothesis generation, context formula- Kassirer said. It is essential, Kassirer said, to teach tion, hypothesis refinement and hypothBut research on diagnostics also helps by example. Students learn reasoning esis verification. teach students that in certain cases it by seeing others reason, he said. Generating the initial hypotheses and may be appropriate to skip around, to The clinical reasoning process can formulating a context for those hypoth- start from laboratory data, or, in the help minimize errors at all points in eses provide a model for gathering more case of urgent problems, to interrupt diagnosis, and can help avoid such coninformation about the problem, Kassirer normal processes of information, sequences of error as delays in treatsaid. Often based on minimal cues that Kassirer said. ment, unnecessary exposure of patients come in clusters, these initial hypothFurther, students can be taught to to various tests, inappropriate treatment eses "can range from the general to the avoid certain heuristics that can lead to and the anxiety that results from each of specific," Kassirer said. "At this stage, error. Teaching the quantitative ap- these consequences, Kassirer said. hypotheses are intermingled in a pecu- proach to combining clinical data, as "All this will hopefully lead us to a liar sort of way." well as the use of pre-compiled, condi- general model of problem-solving that After developing a context for un- tion-action pairs, can also be improved can help us identify good or bad reasonderstanding why one has come to these by research on diagnostics, Kassirer said. ing," Kassirer said. + initial hypotheses, the problem solver Kassirer listed a number of basic prinBY MARK W ALLACE enters the stage of hypothesis refinement, Kassirer said. At this stage, various hypotheses are deleted, added or made more specific. This phase is dominated by probabilistic reasoning as the problem solver tries to determine which of the generating hypotheses are most likely correct, Kassirer said. By using pre-compiled rules and information about the source of various problems, the problem solver tries to achieve a hypothesis that has near certainty, he said. When one hypothesis clearly begins to dominate, the problem solver has reached the stage of hypothesis verificaThis year's senior medical students were honored by the Alumni Association and President and tion, Kassirer said. The hypothesis has Mrs. William Greiner at the annual Senior Reception last february 26 at the Buffalo Hilton. to be tested for coherence and accuracy, and to see whether it explains both B u a 0 p h y s c a n s m m e 9 9 4 �• ·············· · ······························· · ············ ····· ··········· · ·· · ·· · ······ . I • A test of the effectiveness of hormone-replacement therapy in reducing the risk of heart disease and osteoporosis. • A study of the effect of a low-fat diet on the risk of cardiovascular disease and breast and colorectal cancer. • An investigation of the effectiveness of calcium and vitamin D supplements in reducing osteoporosis and colorectal cancer. In Western New York, 14,000women will be recruited over three years to take part in the clinical trials. The observational study will follow women over eight to 12 years to try to determine physiological and lifestyle factors that can affect health. Participants in this phase - about 2,200 of them in Western New York - initially will give detailed medical histories and then will be contacted every three years to update their information. Women interested in volunteering for the study should call the Women's Health Initiative clinical center at (716)829-3128. + Women's Health Initiative begins MEDICAL SCHOOL AMONG 16 VANGUARD CENTERS TO PARTICIPATE IN LANDMARK STUDY OF WOMEN Trevisan. "We will be taking part in a history-making study that will answer very important questions regarding the well-being of women. "In addition, information we gain from the central study will be the seed for other studies that will contribute to the knowledge of women's health. It is also creating a number of new jobs, and more jobs will be created as other studies are generated. "This is a massive undertaking," he added, "and we will need the cooperation of many people, particularly the women volunteers, to make the study a success." The study itself will be conducted in two parts- clinical and observational. The clinical component will involve three investigations: esearchers at UB kicked off the major recruitment drive for the Buffalo portion of the $625 million Women's Health Initiative with the February 25 grand opening of the new women's clinical center. The Women's Health Initiative, funded by the National Institutes of Health, is the largest clinical health study ever undertaken in the United States. Approximately 160,000 women between the ages of 50 and 79 at 45 centers will take part in identical studies designed to investigate the causes of heart disease, breast and colorectal cancers and osteoporosis in older women and test the effectiveness of various treatments. UB, selected as one of the 16 lead research centers in the 12-year study, will receive $11 million over the life of the project. Headquarters for the UB clinical trials is a newly renovated 5,700-squarefoot clinical center in Farber Hall on the South Campus. The grand opening featured a ribbon-cutting ceremony with UB provost Aaron N. Bloch; John Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences; Mauriz\_9 Trevisan, M.D., principal investigator for the UB portion of the study ana chair of the Department of Social and Preventive Medicine; Jean Wactawski-Wende, Ph.D., professor of social and preventive medicine and one of the UB investigators; and Congressman Jack Quinn, R-Hamburg. "This is a wonderful opportunity for Western New York and UB," said B a a B Y LOIS B AKER Women's Health Initiative MaurizioTrevisan,M.D.,andJeanWadawski-Wende,Ph.D.,atthenewdinicalcenter. p h y 5 a n S u m m e 9 9 4 �. . . . . .. .. . . ... . .. . .. . . .... ...... .. .. . . . . ... . ... . ... . ..... . .. .... .... . . . . • • • • • • • • • • • • • • • •• ~ I Dean honored by Asian Amertcan Physicians'Association recently avid C. Dean, M.D., clinical professor of medicine , received the Asian American Physicians' Association's first "Friend of the Asian American Physicians' Association" award at a dinner held last fall. Dean, who is also chief of cardiac rehabilitationatBuffalo VA Medical Center and co-medical director of the cardiac rehabilitation unit at The Buffalo General Hospital, is a fellow of the American College of Physicians, the American College of Cardiology and the College of Chest Physicians. + Lockwood assumes new PSR post he board of directors of Physicians for Social Responsibility (PSR) has named Alan H. Lockwood, M.D., UB professor of neurology and director of the Buffalo VA Medical Center's Center for Positron Emission Tomography, its 1994 president. Founded in 1961, PSR is a leading national organization of more than 20,000 health professionals and supporters working in 90 chapters across the country for the elimination of nuclear and other weapons of mass destruction, the achievement of a sustainable environment and the reduction of violence and its causes. PSR is the U.S. affiliate of International Physicians for the Prevention of Nuclear War, recipient of the 1985 Nobel Peace Prize. B u 0 0 p h I Lockwood has been a member of PSR for over a decade , serving in its house of delegates from 1986 to 1989, and as chair of that body from 1987 to 1989. He was elected to the national board of directors in 1989 and served as its treasurer for two years before being selected as president-elect in 1993 . Lockwood also serves on the editorial board of The journal of Medicine and Global Survival. Lockwood has been a leading PSR spokesman against the Strategic Defense Initiative. He has also been instrumental in the development of PSR's programs to address environmental health + threats. Curtis Mettlin, Ph.D., (left) receives award fram Irvin Fleming, M.D., ACS president. Curtis Mettlin receives prestigious ACS Volunteer Leadership Award urtis ]. Mettlin, Ph.D., chief of epidemiologic research and director of the department of cancer control at Roswell Park Cancer Institute, received the National Volunteer Leadership Award from the American Cancer Society (ACS) . The award is given annually to ACS volunteers whose service to the national organization has been long and distinguished. Mettlin has written more than 180 articles, chapters and books on cancer. He was the principal investigator of the ACS's multi-institutional study that found the use of ultrasound and the prostate-specific antigen blood test in conjunction with digital rectal exam significantly increases the detection rate for prostate cancer. Mettlin has served on many national ACS committees and task forces dealing with issues as diverse as cancer detection and treatment, public and professional cancer education and developing strategies for all Americans to gain access to + cancer treatment and prevention. Carl Granger wins Frank Krusen Award for rehabilitation medicine arl V. Granger , M.D., associate chairman of the department of rehabilitation medicine, has been awarded the Frank H. Krusen Award for outstanding contribution to the field of rehabilitation medicine by the American Academy of Physical Medicine and Rehabilitation. Granger, who is also director ofUB's Center for Functional Assessment Research and co-director of the Multiple Sclerosis Center, was presented the award at the academy's annual meeting last November. The award was established nearly 25 years ago to honor one of the academy's founding fathers. Granger served as president of the academy from 1975 to 1976. He is the author of more than 90 publications and co-developer of the Functional Independence Measure and the Uniform Data System for Medical Rehabilita+ tion. 5 c a n S u m m e 9 9 4 �developed a powerful system that mimics many types of brain damage ." Langan observes that the close resemblance of the cultures to damaged $534 ,000 WILL FUND RESEARCH INTO ASTROCYTE brain was "a fortunate surprise. " GROWTH AND RECOVERY FROM BRAIN DAMAGE But his lab's efforts to sort out the biochemical controls were even more niversity at Buffalo neurologist percent of all approved grants, resulting surprising. Studying a class of cell-signaling proteins known as G proteins, Thomas]. Langan, M.D., has re- in five years of funding. The NIH reviewers described the researchers discovered that the modiceived a $534,000 National Institutes of Health grant to explore Langan's application as a "very strong fication of these proteins by by-prodthe link between astrocyte growth proposal which emphasizes a very im- ucts of cholesterol metabolism deterand recovery from brain damage. portant aspect of astrocyte cell biology. " mines whether the astrocytes divide or Studies by others have shown that differentiate. "One of the most satisfying (and rare) "We showed that this modification, things that can happen in biomedical newborn astrocytes in culture divide on called isoprenylation, determines research is for a focused area of labora- the normal developmental schedule, whether the astrocytes commit to divide tory work to rapidly provide clues to which in the intact brain is the main several important clinical problems," reason for the growth of the brain after or assume a more differentiated shape. In other words, there seems to be a Langan, associate professor of neurol- birth. common biochemical control mechaLangan discovered that the cultured ogy and pediatrics and an attending nism for these two critineurologist at The cal aspects of astrocyte Children's Hospital of function. " Buffalo , said. The NIH grant will Langan's research foallow Langan and felcuses on astrocytes, the low UB researchers star-like brain cells that Commitment RPoint Ronald Berezney, Ph.D. , "are by far the most nuStart Glls professorofbiology,and merous cells in the brain, Robert]. Plunkett, M.D. , even though their funcassistant professor of Flat, tions were mysterious Stellate, Proliferating Arrested neurosurgery , to study Astrocyte until around 20 years Astrocyte this mechanism and to ago. Modification of the cell-signaling proteins determines whether the astrocytes divide. determine how it ap"During the last deplies to the problem of cade in particular ," brain injury and recovery. Langan explains, "there has been in- astrocytes further resemble their counThe significance of the apparent link creasing evidence that astrocytes may terparts in the intact brain by maintainbetween the role of isoprenylation in be involved in controlling the fate of ing the capacity to divide again for many and differentiation , cell division control neurons , both in terms of normal devel- months. Langan says, "lies in the potential to opment and response to injury. " He also found that when the cultured But, he notes, very little is known astrocytes are stimulated to divide later, manipulate the astrocyte responses once about what coordinates the complex they act exactly as cells that respond to the control mechanisms have been defined. behaviors of astrocytes themselves many types of brain injury. "Since astrocytes play a key role in an area where Langan's recent findings "When stimulated," Langan says, responses of human brain to many types lie that has drawn interest from the "these cultured astrocytes express the of injury, ranging from trauma and mulationalinstitute of eurologic Disor- same proteins on the same time schedtiple sclerosis to Parkinson's Disease, the ders and Stroke. At a review meeting last ule as the cells in intact brain that are autumn , the NIH branch ranked involved in reactive gliosis, the hall- ability to control their actions could + Langan's grant application in the top 4 mark of brain injury. Therefore, we have have immense practical benefit." UB neurologist wins NIH grant B a 0 p h y 5 a n 5 m m e 9 4 �························································································• ·· ~ I I UB has 28 faculty physicians listed in this year'sedition of "Best Doctors in America" wenty-eight faculty members at the School of Medicine and Biomedical Sciences have been included in the second edition of The Best Doctors in America, a directory of the "best and brightest" in the medical profession. Best Doctors lists 7,200 physicians in more than 50 specialties - approximately 2 percent of the nation's 350,000 practicing physicians. The listing is compiled from interviews with thousands of specialists throughout the country who were asked to rate the clinical ability of their peers. UB faculty members who are included in Best Doctors are Mark Ballow, M.D., professor of pediatrics and chief of the division of allergy and immunology; David W. Bentley, M.D., former professor of medicine, director of the Multidisciplinary Center on Aging and director of the division of geriatrics; Clara D. Bloomfield, M.D., professor of medicine; Lawrence B. Bone, M.D., associate professor of orthopaedic surgery; Edward L Bradley, Ill, M.D., professor and vice chair of surgery; Linda S. Brodsky, M.D., associate professor of otolaryngology and pediatrics; Michael E. Cohen, M.D. , professor and chair of neurology; Patrick Creaven, M.D., associate research professor of pharmacology; Patricia Kresse! Duffner, M.D. , professor of neurology and pediatrics; Bradley P. Fuhrman, M.D., professor of pediatrics. Also, Robert Gillespie, M.D. , professor and chair of orthopaedic surgery; Marion Zucker Goldstein, M.D., clinical associate professor of psychiatry; Daniel Green, M.D., professor of pediat- B 0 0 p h Bone Bradley Brodsky Duffner Fuhrman Gillespie Goldstein Greenfield Herzig Hopkins Jacobs Middleton Min dell Nemoto Pincus Reisman Rossi Stapleton Voorhess Ballow Bentley Cohen Creaven Green MacGillivray orthopaedics; Takuma emoto, M.D., research associate professor of surgery; Stephanie Pincus, M.D., professor and chair of dermatology; Derek Raghavan, M.D., professor of medicine; Robert Reisman, M.D., clinical professor of medicine and pediatrics; Thomas M. Rossi, M.D., associate professor of pediatrics; F. Bruder Stapleton, M.D., A. Conger Goodyear professor and chair of pediatrics; and Mary Louise Voorhess, M.D., + professor emeritus of pediatrics. rics; Saul P. Greenfield, M.D. , associate professor of urology; Geoffrey P. Herzig, M.D., professor of medicine; L elson Hopkins, M.D., professor and chair of neurosurgery; Lawrence D.jacobs, M.D., professor of neurology; Kenneth A. Krackow, M.D., professor of orthopaedics; Margaret MacGillivray, M.D., professor of pediatrics. Also, Elliott Middleton, Jr., M.D., professor of medicine and pediatrics; Eugene R. Mindel!, M.D., professor of s o n 5 Raghavan m m e 9 9 �• ··· ··· ······ · ·· · ············ ·· · ·· ·· · ·· ···· ··· · ··· · ········· ·· ······· · · · ···· · ··· ··· ······ . I Judah Folkman, M.D, delivers 1994 Harrington Lecture NOTED RESEARCHER DISCUSSES GROUNDBREAKING THEORY OF ANGIOGENESIS AS WELL AS CLINICAL BREAKTHROUGHS USING ANGIOGENESIS INHIBITORS udah Folkman, M.D. , whose research led to the development of the theory of angiogenesis, delivered the 1994 D.W. Harrington Lecture, "Clinical Applications of Angiogenesis Research," discussing the history of his work with angiogenesis, as well as some recent clinical breakthroughs that saved the lives of children with tumors which, in the past, would have been fatal. Charles Paganelli, Ph.D., interim chair of the UB Department of Physiology, introduced Folkman, who is the julia Dyckman Andrus professor of pediatric surgery at Harvard Med1cal School. Paganelli praised Folkman's interest and achievement in a wide range of areas, including not only the theory of angiogenesis but also development of the contraceptive Norplant and of implantable cardiac pacemakers. Paganelli further praised Folkman for offering fundamental insights into the growth of capillary networks. Folkman, who is also professor of anatomy and cell biology at Harvard, is credited with discovering the mechanisms of angiogenesis, a concept that holds that solid tumor cancers may develop as a result of chemical signals released by tumor cells that cause the blood vessels in surrounding tissue to grow. Research is under way worldwide investigating angiogenesis and its relation to cancer and many other diseases. The theory of angiogenesis has been guided by two central questions , Folkman said. "First is the question of how angiogenesis, or blood vessel growth, is turned off in many physi- B u a 0 Judah Folkman, M.D. ological states," he said. "Then there's the opposite question: why is it not turned off in many pathological states, and why does it persist to the detriment of its host?" In attempting to answer these questions, angiogenesis research has focused on three basic areas, Folkman said: what cancer would be like in the absence of angiogenesis, what would human tissue be like without it and what would happen if all communication between tumor cells in the human body could be stopped, Folkman said. Folkman began his research into angiogenesis in the 1960s while serving a two-year term in the U.S. Navy at the Bethesda National Naval Medical Center. After completing an experiment to study hemoglobin solutions by infusing the thyroid glands of rabbits with those solutions and then measuring thyroid function, Folkman and his colleagues began to ask whether isolated glands p h y 5 c o n S could support growth, he said. That research led Folkman and his colleagues to publish the hypothesis that tumor growth was angiogenesisdependant, Folkman said. In simplest terms, he said, that hypothesis stated that after a tumor exists, every further increase in tumor mass must be preceded by the proliferation of new capillary blood vessels that converge upon the tumor. "Our hypothesis led to many experiments, and the field has now moved in a number of basic directions," Folkman said. In the 1970s, Folkman began to work on isolating a variety of angiogenesis factors. After some years of failed work, Folkman finally managed to compile a list of those basic factors . "The list had great transformative pow ers for angiogenesis research," Folkman said. "It transformed my critics into my competitors." But it wasn't until1990 that researchers finally gained direct evidence that tumor growth was angiogenesisdependant, Folkman said. "Only four years ago did our many years of lab research begin to be translated to clinical trials," he said. Recent clinical trials have fallen into three basic categories, Folkman said: trials of angiogenic peptides that accelerate angiogenesis, the administration of angiogenesis inhibitors for patients with tumors and trials that attempt to understand the principles of prognostic tests in cancer. The discovery of angiogenesis inhibitors has taken place "primarily under weird circumstances," Folkman said, u m m e 9 9 4 �· ····· · ···· ·· · ·· ···· ··· ·· · ·· ·· · · · ·· ···· ··· ··· ·· ··· ···· · · ··· · · · · · · · · ·· · ···· ··· · · · · · ·· · ···[ i ] , ~ I - B BY u M A R K a WA 0 tion is a not-for-profit organization that brings together medical education and research, health care providers, health care manufacturers and health care-related businesses to explore issues facing the industry. + Health Care Industries Association presents Awards for Excellence suggesting that many inhibitors were discovered by accident rather than by controlled experiment. 1989 saw the first successful treatment of universally fatal pulmonary hemangioma by the angiogenesis inhibitor alpha-interferon. On hearing the news, Folkman and others were understandably skeptical, he said, but further investigation proved the treatment was valid. The administration of alpha-interferon has already saved 53 people, mostly children, who otherwise would have died of their tumors , Folkman said. "A whole series of tumors can now be held to dormancy by angiogenesis inhibitors," he said. "We're beginning to think that in the near future cancer patients, on their first biopsy, will have angiogenesis profiles perfomed," Folkman said. "They will also have long-term angiogenesis treatment to extend the dormancy of their cancer. " Folkman served as surgeon-in-chief at Children's Medical Center in Boston for 14 years before resigning in 1981 to conduct research full- time after his 1980 appointment to Harvard. A member of the National Academy of Sciences, Folkman counts among his many honors a 10-year Merit Award from the National Cancer Institute in 1989, the American Cancer Society's Medal of Honor for basic science, Israel's Wolf Prize in Medicine and the Christopher Columbus Award in Biomedical Research from the National Institutes of Health. The Harrington Lecture is sponsored by the School of Medicine and Biomedical Sciences. The D.W. Harrington Lecture Fund was established in 1886 by Devillo White Harrington, M.D., an 1861 graduate of the UB medical school and a professor of genito-urinary and vene+ real diseases from 1886 to 1905. oswell Park Cancer Institute , Herbert Hauptman, Ph.D., and Wilson Greatbatch were among the individuals and institutions recognized by the Health Care Industries Association's first Annual Awards for Excellence. The Economic Impact Award for Excellence was awarded to Roswell Park Cancer Institute. The award was cosponsored by the Western New York Economic Development Corporation. Special President's Awards were presented to Nobel Laureate Hauptman, UB research professor of biophysical sciences, and Greatbatch, adjunct professor of electrical and computer engineering, for their dedication to the Health Care Industries Association and their overall contributions to the health care industries of Western New York. UB President William Greiner delivered the keynote address. The Health Care Industries Associa- Nolan named chair of College of Physicians Board of Regents ames P. Nolan , M.D. , professor and chair of the Department of Medicine has been elected to a one-year term as chair of the American College ofPhysicians Board of Regents. Nolan has served on the 26member board since 1989 and was vice chair in 1993. Prior to joining the board, he was the society's governor for New York State for four years , winning the Governor of the Year Award in 1988. He also served as president of the New York State chapter from 1987 through 1988. In addition to his UB appointments, Nolan serves as director of medicine at Erie County Medical School. + At left, Herbert Hauptman, Ph.D., and Wilson Greatbatch receive Health Care Industries awards. LLACE p h y 5 c a n S u I m m e 9 9 4 �• ··················································································· · ···· . I UB signs unique clinical psychiatry agreement BUFFALO PSYCHIATRIC CENTER , WESTERN NEW YORK CHILDREN'S PSYCHIATRIC CENTER JOIN THE UNIVERSITY'S MULTIDISCIPLINARY CLINICAL TEACHING SITES the state Office of Mental Health; john Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences; George Molnar, M.D., UB associate professor of psychiatry and executive director of the Buffalo Psychiatric Center; and Allen R. Morganstein, M.D., clinical director of the Western ew York Children's Psychiatric Center. UB, ~rimarily through its department of psychiatry, has used the two facilities to train students and residents for some time, but never had a formal working agreement with them. As a result of the agreement, a 10-member committee from the three institutions will be formed to oversee the educational and research programs the facilities operate. he Buffalo Psychiatric Center and the Western New York Children's Psychiatric Center became formal UB clinical teaching sites in a contract-signing ceremony held in March. The five-year renewable agreement between UB and the New York State Office of Mental Health opens new teaching and multidisciplinary research opportunities at the centers for UB faculty, students and medical residents, and provides the centers' physicians and staff access to UB's faculty and research facilities. Participating in the signing were UB President William R. Greiner; Philip B. Wels, M.D., chair of the UB Council; Richard Surles, Ph.D., commissioner of From left: William Greiner; Ri(hard Surles, Ph.D.; John Naughton, M.D.; Philip Wels, M.D.; Allen Morganstein, M.D.; and George Molnar, M.D., at the March signing (eremony. B a a p h s c a n s The new contract opens the centers' doors to the UB schools of dental medicine, nursing, pharmacy and health related professions, as well as to faculty and graduate and undergraduate students in clinical psychology and social work. The centers will provide equipment, lecture rooms and laboratories, in addition to faculty, for teaching and joint clinical research activities. "Collaboration with local providers has already proven to be an outstanding model for clinical training in UB's School of Medicine and Biomedical Sciences," Greiner stated. "We are delighted that the Buffalo Psychiatric Center and the Western New York Children's Psychiatric Center will join UB's group of clinical affiliates. Greiner praised Surles for his support, adding, "This sort of joint effort of the state, local providers and the university can do much both to enrich UB's education and training programs and to enhance care delivery for our fellow Western New Yorkers." Naughton, who will be UB's primary liaison with the centers and was instrumental in negotiating the agreement, said the relationship is a welcome step in the university's efforts to expand opportunities for clinical teaching and research for its students and faculty. "This contract confirms that these two psychiatric centers are very important facilities in our community," Naughton said. "The opportunities the agreement presents for interdisciplinary research and innovative learning are enormous. The inclusion of these facilities in the university family will add u m m e 9 9 �The images assist in pre-operative planning of the implant site, direct visualization of how well the implant will fit and ascertain the need for building up bone tissue before implantation. DelBalso is currently president of the American Board of Oral and Maxillofacial Radiology. He is the only physician in the U.S. who is board certified in both medical diagnostic radiology and oral maxillofacial radiology. + significantly to our educational opportunities, particularly in the areas of pediatric psychiatry and in the care of the chronically ill. " The affiliation offers a model that deserves replication in other areas of the state, Surles noted. "This agreement not only creates outstanding educational and research opportunities for university students and the psychiatric centers' staffs, it provides the agency with a formal role in academic training - a first for the state Office ofMental Health." Molnar praised the mutually beneficial agreement. "Our expectations are high ," he said, "and our enthusiasm is great. We look forward to many new opportunities for joint teaching andresearch activities , and to increased collaboration with the university's schools and departments. " Morganstein said, "The agreement will be beneficial to the university, as well as to the Western New York Children's Psychiatric Center, in providing opportunities for professional growth of staff. Ultimately, this will filter down to the community by providing enhanced clinical services." + B Y L OIS B AKE - 0 0 p 'i( Convenient Downtown Location Quick Metro Ride to Main Street Campus and Medical School 'i( Close to Buffalo General, Roswell, ECMC and Children's Hospitals tephen B. Edge, M.D. , chief of the breast division of the department of surgical oncology at Roswell Park Cancer Institute , has been appointed to a panel of health care experts and consumers to evaluate breast cancer treatment in New York State. The new Breast Cancer Treatment Quality Advisory Panel will gather data on treatment strategies, measure the quality of breast cancer treatment in New York and recommend ways to improve its effectiveness. Edge, the only Western New Yorker appointed to the advisory panel, has served as chief of RPCI's breast division since 1992. He is an investigator with the National Surgical Adjuvant Breast and Bowel Project. A fellow of the American College of Surgeons, Edge is a member of the American Society of Clinical Oncology and the Society of Surgical Oncology. + R h 'i( Conference Planning Professionals Stephen Edge named to state breast cancer advisory panel ngelo M. DelBalso, M.D., D.D.S. , interim chairman of the department of radiology, recently addressed the Third International Congress of the Dutch Society of Oralimplantology. DelBalso, clinical director of Erie County Medical Center's department of radiology, explained how readily available computer software can be used for three dimensional imaging in connection with permanent tooth replacements. u 18,000 Square Feet of Meeting Space 'i( DelBalso addresses Dutch Society of Oral lmplantology Congress B The Perfect Prescription For Your Conference Needs y s o n S u 'i( Your Guests Can Walk to Theatre, Shops, Pilot Field, Restaurants, Entertainment 'i( CME Friendly 'i( Great Banquet Food Please Talk T o Us A bou t Preparing A Proposal So You Can Bring Your Group's Next Convention To Buffalo (716) 856-1234 6142 EXTENSION HYATI. WE'VE THOUGHT OF EVERYTHING ~M H~Y--A--T"T REGENCY BUFFALO m m e 9 9 4 �• ··················· · ·· · ···················· · ················ ·· · · ··········· ·· ····· · ····· . I UB wins federal rehabilitation research grant $2 .4 MILLION WILL FUND NATION'S FIRST CENTER TO DEVELOP OBJECTIVE STANDARDS TO MEASURE DISABILITY AND ITS EFFECTS he University at Buffalo has received a $2.4 million federal grant to establish the nation's first center charged with developing objective standards to measure disability and its effects, and to assess the effectiveness of rehabilitation programs designed to treat disabilities and improve function. The new Rehabilitation Research and Training Center on Functional Assessment and Evaluation of Rehabilitation Outcomes will fund seven research projects over the next four years. The work will involve faculty from UB's department of rehabilitation medicine and its schools of nursing, health related professions and architecture and planning. The new center will also collaborate with five other academic rehabilitation centers - Craig Hospital in Englewood, Colorado; Rehabilitation Institute of Chicago; Kessler Institute for Rehabilitation, Inc., West Orange, New jersey; The Ohio State University; and Brown University. D'Youville College in Buffalo will work with the UB center to develop a curriculum in functional assessment studies. "Our charge is to introduce a more scientific approach to measuring the abilities and limitations of people living with handicaps," said Glen E. Gresham, M.D., professor and chair of the department of rehabilitation medicine and the grant's project director. "We hope to develop uniform standards for measuring disability and the methods disabled people use to adapt that everyone accepts and understands." B u 0 0 Glen Gresham, M.D. Currently, there is no system to classify disabilities according to severity, or to a standard rehabilitation regimen based on severity, Gresham said. "In this era of health care reform," he noted, "the field of rehabilitation medicine must be able to prove the value of its services. Research conducted through this new center will enable us to define disabilities clearly, tell which rehabilitation approaches are most valuable and will allow rehabilitation workers across the country to use a common language to describe patients and their problems." The center's seven research projects and the academic rehabilitation centers involved are: • Handicap assessment - to improve the classification of handicaps (UB and p h y 5 c 0 S Craig Hospital). • Relationship of treatment to outcomes- to determine how much rehabilitation programs help patients (UB, Rehabilitation Institute of Chicago and Kessler Institute for Rehabilitation) . • Measuring handicapping environments - to identify barriers that produce handicaps and measure the extent of their effect (UB). • Characteristics of effective, efficient medical rehabilitation programs - to determine why one program works better than another (UB, Rehabilitation Institute of Chicago and Kessler Institute for Rehabilitation). • Determining which functional assessment measure can best be applied to persons with traumatic brain injury (UB u m m e 9 9 4 �Msall elected to membership in Society for Pediatric Research and The Ohio State University). • Validity of telephone interview versus personal interview for completing the Functional Independence Measure, a score used to follow a patient's progress and measure the outcomes of a rehabilitation program (UB). • Determining whether social support enhances rehabilitation outcomes (UB , Kessler Institute for Rehabilitation and Brown University) . The grant also calls for developing a curriculum in functional assessment studies, which will be offered initially by UB and D'Youville College; writing a training manual on using functional assessment instruments; and hosting a national conference on functional assessment to be held in conjunction with the International Rehabilitation Medicine Association's annual meeting. UB has been in the forefront of medical rehabilitation for the past decade. UB researchers have led a national effort to develop the Uniform Data System for Medical Rehabilitation that includes the Functional Assessment Measure - a standard now employed nationally and internationally by facilities treating severely disabled people to define ability to perform common tasks. UB's department of rehabilitation medicine also established a national database that currently holds more than 400,000 patient records. Byron Hamilton, M.D., clinical associate professor of rehabilitation medicine, is principal investigator on the grant. Nadine Fisher, Ed.D., clinical assistant professor, is program coordinator and james A. Phillips, clinical instructor, is fiscal manager. The new research and training center will function within the framework of the UB Center on Functional Assessment Research, directed by Carl Granger, M.D., professor of rehabilitation medicine. + B B u Y L OIS a B 0 ichael Msall , M.D. , associate professor of pediatrics and rehabilitation medicine, has been elected to membership in the Society for Pediatric Research. Membership in the national organization is based on research record, sponsorship by members in one's specialty area and a vote by the full membership. Msall's research has focused on the problems and consequences of extreme prematurity and functional independence in children with Down 's syndrome, cerebral palsy and neurodevelopmental disabilities. His work was published recently in Clinical Pediatrics and appeared in the February issue of the journal of Perinatology. + • Apple • IBM • Dell • Insight • Panasonic • Canon • TI • Software • Supplies • Accessories • Audio • Hands-on Workshops ATeam Effort -In March, New York State Assemblyman Sam Hoyt presented Dean Naughton with the pen Governor Mario Cuomo used to execute legislation Hoyt co-sponsored that enabled the University Medical Practice Services to be classified as not-for-profit, and therefore, tax-exempt in New York State. lml ,Dllltlri A non-profit University program for students. faculty & The Commons • North Campus • (7 16) 645 -3554 • Fa x: AKER p h y 5 c a n 5 m m e 9 9 �THEN&IiiiiNOW Traditions and training varied for first med students TWO LECTURE COURSES REQUIRED FOR GRADUATION FROM FIRST CLASS OF UNIVERSITY OF BUFFALO SCHOOL OF MEDICINE • ' first medical students differed from their counterparts of today in just about every way: I their demographics , ._ 1i their age , their premedical school training and their medical school training. Sixty-seven students comprised the first class of the University of Buffalo School of Medicine. Students then were required to be at least 15 years old, although the majority of the class were 18 to 21. All 67 students were white males and many were already apprenticed to a "competent physician licensed by a county medical society." Three years of such apprenticeship were required before the degree of doctor of medicine was awarded. Like students now, students then paid fees-$2 for matriculation, $5 for graduation and $10 each to six of the seven professors who gave lectures or demonstrations. The professor of chemistry was paid $12 from each student because they used his equipment. But unlike today, UB had "no provision for gratuitous aid" - no scholarships. The school's first classes were held in a wooden building (formerly the First Baptist Church) on the corner of Seneca and Washington Streets in downtown Buffalo. Sold by the church in 1836, the building was used successively since then as a customs house, post office and police court. The university paid $700 to renovate the church for its use. The yearly rent came to $300. A library of 519 volumes ~ J B ~ a 0 The school's first classes were held in a wooden building (formerly the First Baptist Church) on the corner of Seneca and Washington Streets in downtown Buffalo. was valued at $829.96; its museum of anatomical, pathological and surgical preparations and drawings cost $250. An amphitheater accommodated 200. Instruction nearly 150 years ago was primarily by "lectures, demonstrations , clinical illustrations and recitations." Students weren't required to take notes , but that method of learning was highly recommended. Lecture courses lasted 16 weeks. Two such courses were required for graduation. Students often audited the same course twice. Most clinical experience was gained through apprenticeships in the dispensary of the school and the county p h y s c a S u m m e 9 4 �THENI!IiEIN 0 W .............................. r:_-· .. ./":,·~········· -~· .----on ..._ free to indigent patients and others willing to be observed by students. Students were allowed into the wards of the almshouse at no charge "at such hour of each day as the several medical officers are in attendance." And students then not only had to meet the school's academic standards, they had to be "of good moral character" to qualify for a diploma. The council of the university's first report to the Regents of the State of New York notes that the faculty can "exercise the power of expulsion for crimes of immoral conduct." But, it added, "no occasion for the exercise of this power occurred during the last year." Three weeks before the close of the lecture term, students in the university's first class delivered to the dean or registrar a dissertation "on some medical subject which must be examined and approved by the faculty previous to the examination for the degree" before they could receive their diplomas. Diplomas then were licenses to practice. It was required, however, that they were deposited on file with the Erie County Clerk. Specialists, of course, didn't exist nearly 150 years ago and most students set up their own offices or went into joint practice with an older, experienced physician. Surgery then was confined largely to emergency procedures. In his centennial address in 1946, George W. Thorn, M.D., a UB alumnus, pointed out that 100 years earlier only seven specific medications existed for disease - digitalis or foxglove for heart disease, quinine for malaria, cowpox vaccination for smallpox, vermifuges for intestinal parasites, mercury for syphilis, iron for hypochromic anemia and iodine, which had proved important in preventing goiter. + I ·~;t1 Ill 01 \tf •. ~·- :.·#. ­ :-: -- ......... --- -~ e -u a a p h 5 c a - n 5 u m BY m e MILDRED 9 SANES 9 4 �• ···················· · ······ · · · ········· · ········· · ···· ·· ···· ·· · · ·· · ······· · ····· · ·· · ··· · . I Francis P. Alcedo , Internal Medicine, Yale-New Haven Hospital, New Haven, Connecticut Class of '94 wins big in Match Day Robin] . Arent, Pediatrics, Eastern Virginia Graduate School of Medicine, Norfolk, Virginia 87 PERCENT OF US'S GRADUATING MEDICAL SCHOOL Kenneth] . Baker , Obstetrics and Gynecology, St. Barnabas Medical Center, Livingston, New jersey SENIORS GET ONE OF THEIR FIRST THREE CHOICES Daniel] . Barbero, Medicine/Pediatrics, Ohio State University Hospitals, Columbus, Ohio raduating seniors from UB's medical school fared well in this year's national match for residencies. A full 87 percent of the students who participated in the program were matched with one of their first three choices for residency programs, and 67 percent of them got their first choice, according to Dennis Nadler, associate dean for curricular and academic affairs. Forty-four percent of the class will pursue a residency in one of the primary care specialties: 10 in family practice, 32 in internal medicine, 18 in pediatrics and seven in combined medicine/pediatrics. Thirty-four percent of UB's graduating seniors will stay in the Buffalo area and 14 percent will remain elsewhere in the state to pursue their residencies. Fifty-two percent will pursue residencies out of state. Following is a list of students from the Class of '94 and their matches. p T 0 H 0 y B 5 5 M 0 T N N 0 Chad L. Beatty, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium Martha I. Bennett, Family Practice, University Hospitals of Cleveland, Cleveland, Ohio Paula A. Bennett, Family Practice, University of Maryland-Baltimore, Baltimore, Maryland Jennifer J . Bergoine, Pathology, Medical College of Virginia, Richmond, Virginia Antonio M. Bird, Psychiatry, University of North Carolina Hospital, Chapel Hill, North Carolina Joel S. Brenner, Pediatrics, Eastern Virginia Graduate School of Medicine, Norfo lk, Virginia G Brian P. Brett, Medicine/Pediatrics , Morristown Memorial Hospital , Morristown , New jersey Tracy L. Brobyn, Family Practice, Mountainside Hospital , Verona, New jersey Daphine A. Brown, Internal Medicine, Oakwood Hospital , Dearborn, Michigan Gregory M. Bugaj , Internal Medicine, Mt. Zion Medical Center of the University of California at San Francisco, San Francisco, California Thomas M. Burnette, Internal Medicine, University Health Center-Pittsburgh, Pittsburgh, Pennsylvania Enrico Caiola, Medicine/Pediatrics, Baystate Medical Center, Springfield, Massachusetts Maria T. Cartagena, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium, Uro logy, University at Buffalo Graduate Medical Dental Consortium William L. Cecere, Surgery (Prelim), University at Buffalo Graduate Medical Denta l Consortium james F. Chmiel, Surgery (Prelim), University Hospitals of Cleveland, Cleveland, Ohio Scott P. Cholewinski, Internal Medicine (Preli m), University at Buffalo Graduate Medical Denta l Consortium , Radiology - Diagnostic, Strong Memorial Hospital, Rochester, New York James Chmiel is congratulated by assistant dean Frank Schimpfhauser. B u a 0 p h y s c a n 5 u m m e 9 9 4 �................................ Below, Charles Rocci looks on as Christian DeFazio and his fiancee, Elizabeth Olson, open his match. Left, DeFazio, who will study emergency medicine at the University of Illinois, is congratulated by Olson and Falsone. Dennis B. Chugh, Internal Medicine, St. joseph's Hospital and Medical Center, Phoenix, Arizona Lynn M. Cieslak, Internal Medicine, St. joseph's Hospital and Medical Center, Phoenix, Arizona Kelli A. Cooney, Pediatrics, All Children's Hospital, St. Petersburg, Florida Devin A. Coppola, Family Practice, St. joseph's Hospital Health Center, Syracuse, New York Edwardj. Cosgrove, Internal Medicine University at Buffalo Graduate Medical ~ental Consortium Kirsta Leale Craig, Family Practice, Southside Hospital, Bay Shore, New York Joseph P. Cronin, Medicine/Pediatrics University at Buffalo Graduate Medical,Dental Consortium Ketan C. Dave, Surgery, Providence Hospital, Southfield, Michigan Maria L. Davis, Emergency Medicine, HarborUniversity of California at Los Angeles Medical Center, Los Angeles, California Christian R. DeFazio, Emergency Medicine, University of Illinois College of Medicine at Chicago, Chicago, Illinois Glen T. Feltham, Orthopaedic Surgery, University Hospitals of Cleveland, Cleveland, Tracey I. Demino, Surgery (Prelim), North Shore University Hospital, Manhasset, New York Ohio Nita K. Divan, Physical Medicine and Rehabilitation, University at Buffalo Graduate Medical Dental Consortium Amy E. Ferry, Obstetrics and Gynecology, St. Luke's Hospital of Bethlehem, Bethlehem, Pennsylvania Todd A. Dorfman, Surgery, Maine Medical Sarah G. Finnegan-Sloan, Internal Medicine (Prelim) , University at Buffalo Graduate Medical Dental Consortium, Neurology, University at Buffalo Graduate Medical Dental Consortium Center, Portland, Maine Winston G. Douglas, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium Mark D. Fisher, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium , Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Brian C. Dowdell, Internal Medicine (Prelim), Sisters of Charity Hospital, Buffalo, New York, Physical Medicine and Rehabilitation, Stanford University Hospital, Palo Alto, California Lorna K. Fitzpatrick, Pediatrics, St. Louis Children's Hospital at Washington University Medical Center, St. Louis, Missouri john L. D'Souza, Internal Medicine (Preli m), Strong Memorial Hospital, Rochester, New York, Radiology- Diagnostic, Rochester General David S. Foley, Surgery, Bowman Gray School of Medicine/North Carolina Baptist Hospital, Winston-Salem, North Carolina Hospital, Rochester, New York Darlene A. Durkin, Pediatrics, University at Buffalo Graduate Medica l Dental Consortium Maura P. Foley, Internal Medicine, University of Virginia, Charlottesville, Virginia joseph M. Falsone, Internal Medicine, University at Buffalo Graduate Medical Dental Deborah L. Delozier, Obstetrics and Gynecology, Strong Memorial Hospital, Rochester, New York Patricia A. Geil, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Consortium Maureen A. Fay, Internal Medicine, University of Connecticut, Farmington, Connecticut Petros Ghermay, Psychiatry, University of California at San Francisco, Fresno, California Gloria M. del Valle, Pediatrics, University at Buffalo Graduate Medical Dental Consortium e u a a p h 5 c a n 5 u m m e 9 9 4 �Michael T. Giovanniello, Physical Medicine Presbyterian-St. Luke's Medical Center, Denver, Albany Medical Center Hospital , Albany, New and Rehabilitation, Ohio State University Colorado, Radiology- Diagnostic, University of York , Radiology- Diagnostic, Albany Medical Hospitals , Columbus, Ohio Co lorado, School of Medicine, Denver, Colorado Center Hospital , Albany, New York Douglas J. Golding, Family Practice, University Horacio Gutierrez, Internal Medicine (Prelim), Diane R. Heimback Morrison, Obstetrics and at Buffalo Graduate Medical Dental Consortium Sisters of Charity Hospital, Buffalo, New York, Radiology - Diagnostic, University of Colorado Gynecology, University at Buffalo Graduate Mabel P. Gong, Obstetrics and Gynecology, New Medical Dental Consortium School of Medicine, Denver, Colorado York Downtown Hospital , New York, New York Idalia M. Gonzalez, Pediatrics, University at Buffalo Graduate Medical Dental Consortium james D. Gould, Internal Medicine (Pre lim), Geoffrey G. Hobika , Internal Medicine, Sandra M. Gutierrez, Surgery , The Brooklyn University at Buffalo Graduate Medical Dental Hospital Center, Brooklyn, New York Consortium George E. Haddad , Internal Medicine, Karen L. Houck, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium, Anesthesiology, Duke University University at Buffalo Graduate Medical Dental University at Buffalo Graduate Medical Dental Consortium Consortium Medical Center, Durham, North Carolina Tegest F. Hailu, Family Practice, University of Carline T. Hyppolite, Internal Medicine Theodore S. Grabow, Transitional Year, California at San Francisco, Fresno, California (Prelim), North Shore University Hospital, Manhasset, New York Hennepin County Medical Center, Minneapolis, Minnesota, Anesthesiology, The University of Medical Center of Eastern Carolina, Greenville, Patricia E. Allen Iheke, Obstetrics and Chicago Hospitals, Chicago, Illinois North Ca roli na Gynecology, University at Buffalo Graduate Kim S. Griswold , Family Practice, University at Christian H. Hansen, Pathology, Georgetown Buffalo G raduate Medical Dental Consortium University Hospital, Washington, D.C. Geoffrey M. Gullo, Tra nsitional Year, George]. Hatsios, Interna l Medicine (Pre lim), Steven D. Hammel, Pediatrics, University Medical Dental Consorti um Gregory T. jehrio, Internal Medicine, Mary Imogene Bassett Hospital, Cooperstown , New York B a a p h 5 c a 5 m m e 9 9 4 �.. . ...... . . .. .... . . . ..... . .. .. . . ...... . . .. ..... . ... .. .. . . . .. . . . ....... . ... . ...... . ... • ~ Above, Todd Schlesinger, left, and Atif Zafar get the good news. At left, Charles Rocci, Stephen Machnicki, Michael Giovaniello, Joseph Falsone and Glen Feltham celebrate. Andrew D. jenis, Surgery, University at Buffalo Graduate Medical Dental Consortium Jeffrey W . Kanski, Internal Medicine (Prelim), Roger Williams Hospital, Providence, Rhode Island Joseph D. Kay, Medicine/Pediatrics, University of Michigan Hospitals, Ann Arbor, Michigan Barbara P. Kearney, Pathology, University at Buffalo Graduate Medical Dental Consortium Glenn E. Kershen, Surgery (Prelim), Temple University Hospital, Philadelphia, Pennsylvania, Urology, Temple University, Philadelphia, Pennsylvania Carol Ann Killian, Emergency Medicine, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Richardj . Kozak, Emergency Medicine, Oregon Health Sciences University , Portland, Oregon Michaelj . Krabak, Internal Medicine, Barnes Hospital, St. Louis, Missouri David G. Kupkowski, Internal Medicine, United States Naval Medical Center, Portsmouth, Virginia Michael K. Landi, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium , Neurological Surgery , University at Buffalo Graduate Medical Dental Consortium Timothy J. Larosa, Psychiatry, University Hospitals of Cleveland, Cleveland, Ohio Christian D. Lates, Pathology, University at Buffalo Graduate Medical Dental Consortium s u a 0 p janet M. Lawrence, Medicine/Pediatrics, University at Buffalo Graduate Medical Dental Lauraj. Nicholson, Internal Medicine, Strong Memorial Hospital, Rochester, New York Consortium Paulj . Lee, Internal Medicine, Albert Einstein Affiliated Hospitals, Bronx, New York Michael P. O'Neill, Radiology- Diagnostic, University of South Florida College of Medicine, Tampa, Florida Wendy L. Leffel, Family Practice, Forbes Health System , Pittsburgh, Pennsylvania juliana S. Paik, Pediatrics, University of California at San Fra ncisco, Fresno, California Chien H. Lin , Surgery, Nassau County Medical Center, East Meadow, New York Michaelj. Pelechaty, Jr. , Internal Medicine, Guthrie Healthcare System/Robert Packer Hospital, Sayre, Pennsylvania Stephen C. Machnicki, Internal Medicine (Prelim) , Winthrop-University Hospital, Mineola , New York, Radiology- Diagnostic, Lenox Hill Hospital , New York, New York Michelle D. Penque, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Sean Perini, Internal Medicine (Prelim), University of Washington, Seattle, Was hington, Radiology - Diagnostic, University of California at San Francisco, San Francisco, California Andres M. Madissoo , Surgery (Prelim) , University at Buffalo Graduate Medical Dental Consortium , Urology , University at Buffalo Graduate Medical Dental Consortium Richard G. Pinckney, Internal Medicine, Medical Center Hospital of Vermont, Burlington, Stacey A. Madoff, Obstetrics and Gynecology, George Washington University, Washington, D.C. Vermont john Pollina, Surgery , University at Buffa lo Graduate Medical Dental Consorti um Rita M. Malvaso , Internal Medicine (Prelim) , Baylor University Medical Center, Dallas, Texas, Physical Medicine and Rehabilitation, University of Texas Southwestern Medical School , Dallas, Ulka Prakash, Internal Medici ne (Prelim), University of Mary land School of Medicine, Baltimore, Mary land, Anesthesiology, johns Hopkins Hospital , Baltimore, Mary land Texas Frankj . Mascaro, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium john Pryor, Surgery, University at Buffa lo Graduate Medical Dental Consorti um john R. McArdle, Internal Medicine, Yale-New Haven Hospital , New Haven, Connecticut Nasser Razack, Surgery (Preli m), No rth Shore University Hospita l, Manhasset , New York Elizabeth A. McClintick, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium , Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Edward D. Reidy, Internal Medici ne (Preli m), Sisters of Charity Hospital, Physical Medicine and Rehabilitation , New England Med ical Center, Boston, Massachusetts Lisa L. Miller, Pediatrics, Rhode Is land Hospital , Providence, Rhode Island Stephanie C. Mitchell, Internal Medicine, Overlook Hospital, Summit, New jersey Cindy D. Repicci, Physical Medicine and Rehabili tation, Univers ity at Buffalo Graduate Medical Dental Consortium Paulj . Mus tacchia, Internal Medicine (Prelim), Presbyterian Hospital, New York, New York Charles A. Rocci, Emergency Medici ne, Albany Medical Center Hospi tal, Albany, New York Erns t Nanor, Internal Medicine (Preli m), Norwalk Hospital , Norwalk , Connecticut, Anesthesiology, Tula ne University School of Medicine, New Orleans, Louisiana Thomas Romanelli, Internal Medici ne (Preli m), University Hospitals, SUNY at Stony Brook, Stony Brook, New York , Anesthesio logy, University at Buffalo Graduate Medical Dental Consortium Michael A. Nasiak, Internal Medicine, University at Buffalo Graduate Medica l Dental Consortium Paul J. Sagerman, Pediatrics, St. joseph's Hospital, Phoenix, Arizona Tung V. Nguyen, Internal Medicine, Kaiser Foundation Hospital, San Francisco, California Diana R. Sanderson, Psychiatry, University at Buffa lo Graduate Medical Denta l Conso rtium 5 c a n s u m m e 9 9 4 �• ·············· · ····· · ············ ·· ················ · ··········· · ··· · ········ · ···· ·· ····· ~ I jennifer M. Thompson, Obstetrics and Gynecology,]ersey Shore Medical Center, Neptune, New jersey Gregory V. Tobias, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium, Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Madonna R. Tomani, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium jennifer M. Tufariello, Obstetrics and Gynecology, Ohio State University Hospitals, Columbus, Ohio joseph S. Valenti, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium Yvette M. Vinson, Surgery (Prelim), Strong Memorial Hospital, Rochester, New York, Otolaryngology, University of Rochester, Rochester, New York From left, Carhne Hyppohte, Paula Bennett, Andrea Withams, Gloria Del Valle, Jennifer Thompson and Patrida lheke share their joy. Pina C. Sanelli, Anesthesiology, Albany Medical Center Hospitals, Albany, New York james W. Spain, Radiology -Diagnostic, Milton S. Hershey Medical Center of Pennsylvania State University, Hershey, Pennsylvania Paul Sansone, Internal Medicine, DartmouthHitchcock Medical Center, Lebanon, New Hampshire Michael Stanton, Internal Medicine, University of Michigan Hospitals, Ann Arbor, Michigan, Neurology, University of Michigan Hospitals, Ann Arbor, Michigan Mark W. Sheldon, Internal Medicine, Hospital of the University of Pennsy lvania, Philadelphia, Pennsy lvania Donna M. Stawasz, Medicine/Pediatrics, University at Buffalo Graduate Medical Dental Consortium john T. Sherwood, Internal Medicine, johns Hopkins Hospital, Baltimore, Maryland Donna G. Sinensky, Transitional, Mercy Catholic Medical Center, Darby, Pennsy lvania, Physical Medicine and Rehabilitation, New England Medical Center, Boston, Massachusetts Gregory H. Stiller, Surgery (Prelim), University of Colorado School of Medicine, Denver, Colorado Mary E. Stock, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium Donald M. Slate, Pathology, University at Buffalo Graduate Medical Dental Consortium Sisters of Charity Hospital, Buffalo, New York, Anesthesiology, McGaw Medical Center of Northwestern University, Chicago, Illinois Sharon A. Szukala, Pathology, Duke University Medical Center, Durham, North Carolina Wendy I. Snyder , Pediatrics, University at Buffalo Graduate Medical Dental Consortium Behzad Tabibian,Internal Medicine, CedarsSinai Medical Center, Los Angeles, California Kenneth A. Sobel, Pediatrics, University at Buffalo Graduate Medical Dental Consortium a a h • c a n Amy L White, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Andrea M. Williams, Surgery, University at Buffalo Graduate Medical Dental Consortium Douglas W. Wisor, Transitional, Reading Hospital and Medical Center, Reading, Pennsylvania, Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond, Virginia Theodros Yohannes, Surgery, University of Louisville School of Medicine, Louisville, Kentucky, Urology, University of Louisville School of Medicine, Louisville, Kentucky Atif Zafar, Internal Medicine, University of + Cincinnati Hospital, Cincinnati, Ohio Debra R. Tarantino, Surgery, University Hospitals of Cleveland, Cleveland, Ohio p Christina G. Weston, Psychiatry, United States Air Force Medical Center (Wright-Patterson), Dayton, Ohio Christopher F. Wood, Internal Medicine (Prelim), Strong Memorial Hospital, Rochester, New York, Ophthalmology, Loyola University Hines VA Hospital, Maywood, Illinois Thaddeus E. Szarzanowicz, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium, Orthopaedic Surgery, University at Buffalo Graduate Medical Dental Consortium J. Paul Sla venas,Internal Medicine (Prelim), u jennifer C. Wargula, Pediatrics, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Maya D. Srivastava, Pediatrics, Cleveland Clinic Foundation, Cleveland, Ohio Todd E. Schlesinger, Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio B lauren j . Vriesenga, Family Practice, Riverside Regional Medical Center, Newport News, Virginia 6 u m m e 9 9 4 �········ ··· ··· · · ·· ······ ·· · ······ ···· · ·· · · ·· · · · · ·· ··· · · · ·· ·· ··· ··· ··· · · ··· · ··· ··· ·· ····· · ·• 11 ' is free from Boehringer Ingelheim Pharmaceutical representatives. Dr. Bianco and his wife, Joan, have a new addition, Regina-Marie, born August 1, 1993. She joins David, 12, and John-Michael, 8. "We're all fantastic!! " tinguished Alumnus Award in 1989, received the award as part of the Sixteenth Annual Meeting of the St. Louis Metropolitan Medical Society. 1 9 5 0 s was reelected treasurer of the Minnesota Medical Association last September. ERICK REESER '56, MICHAEL A . SANSONE '73, JOHN R . ANDERSON '57, was Thomas F. Frawley '44 1 9 s 0 4 gives seminars on "Living With Low Vision" as part of the Mariners Hospital Community Lecture Series. Dr. White has low vision and his experience provides the visually impaired with techniques to increase their independence. His program includes a presentation on closed caption TV enlargers and talking books. In March Dr. White received certificates of appreciation from Florida's Department of Elder Affairs and the Alliance for Aging for his volunteer service. named medical director of the Brothers of Mercy Nursing and Rehabilitation Center, Clarence, New York. Frankhn Zeplowitz '58 by the Buffalo News in its 45th Annual Awards for Outstanding Community Service. JOHN WHITE '40, THOMAS F. FRAWLEY '44, chairman of graduate medical education at St. John's Mercy Medical Center, St. Louis, Missouri, was awarded the Robert E. Schlueter Award for "demonstrating excellence in clinical practice, promoting advocacy for patient care in socioeconomic and political matters and for representing the medical profession in community service." Dr. Frawley, who received UB's Dis- B u a 0 FRANKLIN ZEPLOWITZ '58, was elected chief of staff of Our Lady of Victory Hospital, for 1994-96. He is an attending surgeon at the Lackawanna hospital and a past president of its medical staff. He is a UB clinical instructor of surgery. 1 9 6 1 HARVEY LIEBESKIND '63, writes, "Hoping to retire this year, move to California, travel with my mate, buy and sell thoroughbred horses for a living. My oldest son, Louis, trains horses, middle son, Neil re- • c 5 LAWRENCE ZEROLNICK '72, atrics to join Kaiser Permanente in Baltimore. He and his wife, Barbara, announce the birth of their son, Matthew, on November 8, 1993. of Washington, D.C. , just completed a book for patients with arrhythmia entitled, You Can Live With It! This 66-page book ROBERT DIBIANCO '72, cal director of Hospice Buffalo, was named a Citizen of the Year II 0 has left private practice in pedi- ROBERT A. MILCH '68, medi- h 7 recently was honored by theN ew York State Ophthalmological Society for "leadership and commitment to organized ophthalmology in New York State." He is a past president of the state society and has been a member of the Federal Economic Committee, which advises Medicare on health-care reform. Sansone is chairman of the New York State Managed Care Committee. JOHN KEYES '75, is secretary- treasurer of the medical staff at Lake Shore Hospital in Irving, New York. married attorney Carol Siravo in Cranston, Rhode Island, in April. ALAN PERL '77, 1 9 8 0 s JOSEPHT. WAYNE'82, is pro- searches horse pedigrees, youngest son, Stuart, is a movie stuntman and bartender. Lee Baumel '63, moved to Hawaii in 1993. Paul Lessler '63 retired and is doing financial consulting work." p 9 MICHAEL BARON '71 , writes, "I have recently had two positive events occur in my career which I would like to share with the Alumni. I received the Inpatient Teacher-of-the-Year Award, 1992-1993, from the Family Practice Residency Program of the University of Massachusetts Medical Center. In addition, I am now a diplomate in critical care medicine." s 0 I a n 9 u m m e gram director of the combined internal medicine-pediatrics training program at St. Louis University. He announces the birth of his son, Gregory Joseph, on January 9 , 1994. HERBERT NEWTON '84, is assistant professor of neurology and director of the division of neuro-oncology, Department of Neurology at Ohio State University Medical Center. 9 9 4 �• ······· · ······ · ··· · · · ···· · ··· · ···· ··· ············ ··· ··············· · ···· · ···· ·· ···· · ······ I my general surgery internship in Denver, I spent two years as a brigade surgeon at Ft. Bragg, North Carolina, 82nd Airborne Division. We moved back to Buffalo,july 1993, at which time I started my orthopaedic residency. I married Anita Pantera in August 1991. We were introduced by our fellow classmate Virginia Beerel Campion '90. She and my wife went to high school together. We have two beautiful sons, Ryan Douglas, 20 months, and Connor Matthew, 6 months. MICHAELS. WATSON'87,an anesthesiologist, is vice president of the medical staff at Lake Shore Hospital in Irving, New York. Brian Moore Bernard ROBIN CONWIT '85, has moved to Baltimore and is now an assistant professor at johns Hopkins and director of the EMG Lab at the Francis Scott Key Medical Center. MICHAEL SANSANO JR. '85, has opened his own practice in ophthalmology at 515 Abbott Road, Buffalo, New York. He and his wife, Claudia, have four daughters. HELEN CAPPUCCINO '88, has opened an office in Lockport, New York for the practice of general, thoracic and laparo-scopic surgery. Andrew Cappuccino '88, is completing a spine fellowship with Paul McAfee at johns Hopkins and will be practicing in Amherst and Lockport injuly. The Cappuccinos are the proud parents of four children: Jacqueline, 13; Mac, 5;jake, 2; and Nicholas, 1. M DAVID I. KOLE '90, of Santa Maria, California is in private prac- tice and is chief of pediatrics at DAVID R. BLOOM '89, is now a partner of Beach Physicians and Surgeons Medical Group, Inc., Huntington Beach, California. He is also the team physician at Orange Coast College. "Doug Sillart '89, is a travelling anesthesiologist extraordinaire. Marian Medical Center. He has two children, Ben, 6, and Emily, 4. KRISTA M. (PRIGG) KOZACKI '91 of Florence, South Carolina, is finishing a family medicine residency in 1994 and is considering private practice or a faculty position opportunity. She is the recipient of the McLeod Regional Medical Center Merit Award. Her twin sons, Stefan jerome and jacob Scott, were born on February 18, 1993. M DONNICA L. MOORE '86, and her husband, Stan Bernard, M.D., M.B.A., are delighted to announce the birth of their son, Brian Moore Bernard, on Labor Day, 1993. As is obvious from this photo, he is eager to follow in Mommy's and Daddy's footsteps, although with the directions their careers have takenDonnica is associate director, professional relations at Sandoz Pharmaceuticals and Stan is director, pharmacoeconomics at Bristol Myers Squibb Company - a briefcase might be a more appropriate prop! B u a 1 9 9 0 5 MARK A. FLANZENBAUM '90, is completing a residency in combined internal medicine and pediatrics at the Medical College ofVirginia. He has accepted a position as attending physician in emergency medicine beginning in August 1994. Flanzenbaum is engaged to be married inN ovember to Christie R. Boyd, a neonatal intensive care nurse at the Medical College of Virginia. RICHARD G. BENNETT '92, is a second-year psychiatry resident at Case Western University Hospitals. He married Dawna Lynch on july 9, 1993. p h II • CURZON CADY FERRIS, JR . '46, died in july, 1993. He was 71 years old. Dr. Ferris retired from the Hendrick Medical Center in Abilene, Texas, in 1988. LINDA SHRIRO SCHENCK '77, an adjunct professor at the University of Minnesota's School of Public Health, died of complications from an autoimmune disease in December 1993. ESTER MARIE PONCE GRIMALDI '89, was killed on January 18, 1994, when the car she was driving hit a patch of ice, and slid over an embankment. She was six months pregnant with her second child. Dr. Grimaldi had just completed her residency in pediatrics and was working for a health maintenance organization in Michigan. Besides her husband Thomas Grimaldi '89, she is survived by her daughter, Sarah Marie. Buffalo Physician Goes Electronic Now you use the Internet to send classnotes or other information to Buffalo Physician. Our address is: OBITUARIES HOWARD CRAIG KEYES '28, died in Bellingham, Washington, July 8, 1993, three days short of his ninetieth birthday. Until his retirement in 1974, DoUGLAS PATRICK PREVOST '90, writes, "After completing a Dr. Keyes practiced at the Keyes Clinic, consisting of a father and three sons, all of whom graduated from the University of Buffalo Medical School- William Chauncey Keyes in 1896, Roswell Park Keyes in 1926 and Donald Keyes in 1928. c a n 5 u m Notes@pub.buffalo.edu We'd love to hear from you via e-mail or snail mail! m e 9 9 4 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 2194 ADDRESS CORRECTION REQUESTED ME DICAL HISTORICAL LI 3RARY ABBOTT LI BRARY SERIALS DEPT CA PUS MAil. The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of New York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 «:> 1993 Medical liability Mutual Insurance Company Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1994 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Summer Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n03-1994-Summer Table Of Contents A list of subunits of the resource. Research Hospital News An Investment in the Future Going Beyond the Curriculum A Spoonful of Humor Alumni Medical School Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Summer 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/61b2df99f11fd06ae6710c62febd72c6.pdf 18a2e61b4e50fe33e72286625e664e26 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1994 UB'S FACULTY PRACTICE MANAGEMENT PLAN MAKES SENSE FOR ITS FACULTY MEMBERS AND THE PATIENTS AND STU DENTS THEY SERVE �BUFFALO PHYSICIAN Dear Alumni and Friends, \olume .!8, \iumber 4 T ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr C" ole ~m!lh Petro DIRECTOR OF PUBLICATIONS flmothv ). C mwv EDITOR ..1ne·te Ird.:-::.c~,: R l\1 ART DIRECTOR Ala,., I. Kcglr• ASSOCIATE ART DIRECTOR xonl rl(l er PRODUCTION MANAGER Ann R~\slm~mn Br..>wn STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES l'r 'vim aug; t.m. V 1ce Presd•nt for C •• meal Affd: cs. Dean EDITORIAL BOARD Dr john \ Riche t l h~"nn" Dr Russell \\ Bessette Dr \hnm Bul.bc: Dr ll n ld D:--)c.h· Dr \lr Dr Dr Dr Dr Dr Dr Dr 1 Rich.:d L ( .Ji ms Ra' i DrsJi \Ian : Dr""··m l.tmes Kntskt ~I 1zabet h Olmsted Ll·arlrs Pa~•. clli i ho"'as Ra.;~ hts tssuc of Buffalo Phvstcian reviews t\vO activllies of singular importance ~o L B\ medical ~chool- the proposed Academic Medtcal ( ollegmm and the lOth ann!\ ersarv of the operation vf the ~Lhool sF acuhy Practice Management Plan (F PMP, The latter was m:mdated b) the state legtslature to ensure that full-time and geographical full time chmca: faculty members met <.ducauonal and research responsibtliues to Slt Y ,md to dewlop a mechanism to employ talented fa<.ult) at competiuve compensatwn :evels. Such organizations are alwavs dtfficult to implement, It IL'ok t.B almost l 0) ears to wmplv with the legislauve in illative and the '>l ''t Trustees" pohc1es. But the FP\IIP has proven its potenual to cement the tnstltutional rclauon'>hip of a clmi...a' fa<.ulty dispersed throughout \\estern "\e\\ York The 1991 audn mdkates this decentralized plan ts functionmg well Of a tot.1l revenue ha'>t of approximately $70 mtlhon, almost half went 10 support f<~cult\ sala!"ics and $2 9 millio~t .md '>2.7 mil11on respeLt:\el) \\tre returned to the hospitals for overhead and to the school for academtc program developrrent. The \cad(:m1c MedKal (ollegmm represents a broader umverSil\ -cL>mmunlt) effort to mvolve the school, tea<.hiPg hospllals, cimical fac ultv ,md hospital ph\ st.:ian staffs m more cooper<~ the plannmg and work .ts the needs to meet the extgcnnes related to health care an<l medt<.al edu<.atlon reform becomt reality fhts orgamzatwn 1s working to defme its prmuples of orgamzation and w tll follow"' tth more speulk orgamzatlonal planmng. Gtvtn the su<.cec;s ol some ol l B sand the community s <.on~orual expenenees. this new c>rgamzauon could lorm a model from whkh !le\\ c:ooperatl\ e ventures de\ clop m \Ve'itern "le\\ 'r ork, and on-.e o.~g.:~in, .tn orgamzauon that wuld sene as a model for those vther aL.:~demicallv onented medtcal<vmmunmes that are struggling to deal with the c..omplex tssuec, of health care ard health edu<.ation refvrm. Smcerd), ~4---.~ ~lef!-c" <.pau'dt~(. J:c;~dlc) T ; r ax john "\aughton, \1.0. for Chmull \jfa:r~ Own ';c hool of \Jcdrcinr and Biomedtcal -'>ucnLn \'1< c Prc~ident TEACHING HOSPITALS AND LIAISONS fhc r 1iliO (.Je""IC'r"-. Hospll.ll \fi, had ~haw Buffa!<'\\ Vdi"" Center Dear Fellow Alumni, \~knr kt!~v Y The U1: ld:e:o s H•>Si>" !I of Buff. Ene Cvuntr ''~dh.~. Ccntc· "'er,) H"s"l:-Jl ~!tllarJ f til more llospuals frunl' 5m~ Ros\\elll'c.~t~t. Cc.JiiCt..r lnst.:~tc <.tstf'S of Chant~ Hosf>ttll D•.:nms Vc( ar•hv Tite "10:111... l mvers1rv uf "\ie\\ Y.... : k "' Buff,:c• C:uff,;lo PhvSidan i< pcbhs'>cJ qu:~rtc1~y b,· thr ..,Ute l nh~ r;:'"' ·>f !'.rw )ctk Jt Bulf.,Io School ct \1c<i.~ont:: anti F10medacal <;ocf\C("S and the Ltft h r ef i 'uf"'.l,cJtlons. h 1:::. SLnt free vi (hargc w.Ilumni, :.tt ultv Stude:1h, Tt.:.SilkntS .md fn·~"nJs. fhc 5taP rescn.ec;. the nJI'-t t.)edatall ... op) Jnd SlibtnJSstons a.ccpteJ fc.r publa.. Jta_ 11 \ddrcc;s q:~C">Ilons, ~o..cmmc~lh and s.ubmiSS~<)nS to: [d .. tor L:uf(ult, Ph)'')tl~un, ")LJ.tc l mvcrsuy of "l'"w )c•rk Jl Buflalo L'nl\crsttv PuhlcJtHll:S.I ~{>( r.·'t,llJll,U;.:!IJ:u. "'cv. )Jrk 142o(' orb~ .•. r-o~JI Jt notesu-'; >t: h. bu ff~lo.eue>. Send address <hanges to: flu/Jul.• Ph}llc>an. 14 ( l"> \ddittc•o l41j Mam ~t: ec! f.uffJic· "'cw h·rk d 2 I I our alumni board recently held tb mtd-<.ummer me~ting ..1nd pLm<. are well undt:rwav for the upLc'mt.ng medical <>chool year \Vekommg rec ~puons were held for !re'ihm.m and junior students ro1l0w mg form:d pre<;entaticms, the \lumm \s.,ouauon sponsort:d a c;octal event for stud~n•s I he SULLC~sful < ommumty Phv-.toans' Progr.tm w 11l be contmued fhe \t:Jr<. aclt\ 1· ues, '' hKh mclude mtroducing <>tudents to the dJtl) praw,e ol d1ffermt mediul-.peualt.e'>. '' :P be <.o-<.haired bv Dr<;. Roger Daver 'oO, .tnd Beth \tah.:r '85. fhe board arranged for the p""esident of the Mcdicai ">tudent Pol:t) h.> .:mend se\er.tl mectmgs, allowing for mort .:arrfulh C\aluated requesb and opponunitt.:s forLooperauon betwet:n the student bod\ and A.lumm AssL'Uatwn Plans for '>pnng (. hmcal Da) and Reumon Weektnd ,tre begmnmg to sohdify under the dtre.:tk>n of c hJtrperson Dr. j.:~ck ( m ne 8) ln '>epttmbu, \\ e pre~ented the D snnguished \kdical J\lumnus A'' ard to Dr '\Joel Rose '64 Hts achtevementc, are -nHmati<'nalh recognized: 11 IS an honor to have pre.,ented thts award to him ln'-.: ,tgain 'our '\lumm Assocuuon seeks to provide \\ays to a<.si<.t bt>th th nc.:nt and <ocnivr members. II you ha\ e <IllY 1dea<. that' ou \Hsh to sh..1re, plea~c d~' not hestt.tte to LOntact me Smcerelv. ~ c::::: Russell \V Be<;~ette, D D '>, \1 D. '76 P,-esrdmt, \lcdical Alumm As~L'< iatwn �V 0 u A II II II Where's the beef? Page 2. 2 L T u 8 M o N 9 N 4 9 4 Research Hospital News Practice Makes Perfect e After 10 years, UB's Faculty Practice Management Plan makes sense for its faculty members and the patients and students they serve. m Equal Time e The new Academic Medical Collegium gives its members an equal say in the future of health care in Buffalo. m m Medical School Then and Now m m Alumni Then and Now. Page 26. ASpoonful of Humor m Classnotes * l~e new ~cafiemic ffiefiical [ollegium ta~es s~a~e. rage lt �· · · · · · · · · · · · · · · · · · · · · · · ·· · · ·· · · · · · · · · · · · · · · · · · · · il] '' ' / 0 Roswell researchers arrest human cancer xenograft in scid mice B and Roswell Park Cancer Institute scientists have been able to arrest the growth of human lung cancer xenograft in severe combined immunodeficient (scid) mice by administering a long-circulating liposome formulation of doxorubicin known as Doxil. By doing so, Richard B. Bankert, Ph.D., D.V.M., associate research professor and principal investigator on the study, and colleagues, have reported the first direct evidence that antitumor drugs delivered in sterically stabilized liposomes are more effective at halting the growth of human tumors than more conventional systems. Bankert's research also establishes the scid mouse as a viable model in which to study novel chemotherapeutic approaches to treating human solid tumors. "The scid mouse appears to be an excellent model for in vivo testing the activity of anticancer agents on solid tumors due to its ability to produce tumors that retain the histological characteristics and metastatic potential of the original human specimen," Bankert said. Administering drugs in liposomes to reduce toxicity and target the drug to the tumor has been under investigation at Roswell for 20 years. The effectiveness of conventionalliposome preparations has been limited by their brief circulation time, as well as their susceptibility to uptake and clearance by the liver and spleen, and the binding of plasma components to their surface, causing the liposomes to break down and leak before reaching the tumor. Bankert and his team used sterically stabilized liposomes, which exhibit an enhanced ability to accumulate within B u a 0 p The fatty acid found in meats and dairy products may offer some protection against breast cancer. solid tumors in vivo. The researchers investigated the antitumor effects of Doxil, doxorubicin encapsulated in conventional liposomes ( C-DOX) and free doxorubicin against a human squamous cell carcinoma of the lung grown in scid mice. "Doxil completely arrested tumor growth in all of the mice tested , while free doxorubicin only slightly delayed tumor growth and C-DOX was ineffective at arresting tumor growth , although some decrease in growth rate was observed," Bankert said. Clinical trials for patients with lung cancer res is tan t to first -line chemotherapy are underway. + Where'sthe beef? esearchers at Roswell Park Cancer Institute have found that conjugated linoleic acid (CLA), a minor fatty acid found preferentially in meats and dairy products , offers some protection against breast cancer in animal models. "Unlike most fatty acids , CLA prevents rather than stimulates cancer development," said Clement Ip, Ph.D., UB assistant research professor from h c a A Roswell's division of breast surgery. Meat from ruminants contains more CLA than meat from other animals; bacteria from the ruminant's stomach can convert linoleic acid, an essential polyunsaturated fat, into CLA. "Dairy products and cheeses are also good sources of CLA," explained Ip, whose two recent studies provide strong evidence of the fatty acid's anticancer properties. Ip found that rats whose diets contained 0.1 percent CLA by weight - the equivalent of about four times the amount consumed in the everyday diet of the typical American- developed just twothirds as many breast cancers as rats given no CLA. In his paper published recently in Cancer Research, Ip further suggests that CLA may reduce the susceptibility of breast tissue to malignant changes. Of the large number of naturally occurring substances that have demonstrated anticancer activity, all but a handful are plant-derived. CLA is unique because it is present in food derived from animals, and its effectiveness is seen at dietary concentrations that are close to the levels consumed by humans. "We just do not know the impact that CLA alone has in the context of a high fat u m n 9 4 �·························· · ································ · ·············· · ·· · · · ·········· g] . ·~" '· ..• . illegal cigarette sales net state, federal governments big revenues orty-six states garnered $71 million in taxes from the illegal sale of cigarettes to minors in 1991, and the federal government took in an additional $51 million, according to a study led by UB researchers. California topped the states in illgotten tobacco revenues with an estimated $10.2 million, the data show, followed by Texas at $8.2 million, ew York at $7.2 million and Florida at $4.1 million. Louisiana, Missouri, Montana and ew Mexico were not included in the illegal tax-revenue statistics because these states had no law restricting the sale of tobacco to minors as of 1991. Since then, all 50 states and the District of Columbia have passed laws banning the sale of cigarettes to minors. The report, recently published in Are babies who are nursed protected later in life? Women breast-fed as infants may have lower risk of breast cancer ew research from UB indicates that women who were breast-fed as infants may experience a measure of protection against breast cancer later in life. The UB study, involving 1,130 women from two counties in Western ew York, indicated that women who were breast-fed had a 25 percent lower risk for developing breast cancer than women who were bottle-fed as babies. The study appeared in the May issue of Epidemiology. "There is growing interest in exposures in early life, including diet, and their relationship to breast cancer risk," said jo Freudenheim, Ph.D., associate professor of social and preventive medicine and the study's principal investigator. "There has to be some sort of environmental component to explain the geographical variation in breast cancer rates. American journal of Public Health, tracked the illegal sale of cigarettes to minors , by state, using a variety of national reports and studies. It was authored by K. Michael Cummings, Ph.D., associate research professor and senior research scientist at Roswell Park Cancer Institute; Terry Pachacek, Ph.D., associate research professor of social and preventive medicine; and Donald Shopland of the ational Cancer Institute. Other findings included: ~ Approximately 2. 7 million teenagu a 0 p .. ers smoked an estimated 516 million packs of cigarettes in 1991. ~ Federal and state governments collected a total of more than $240 million on the sale of cigarettes to teens 12-18 years old. ~ Cigarette companies earned $190 million in profit from sales to teenagers 94.8 million of it from illegal sales to minors. Cummings said the report was intended to send a message to state governments. "Despite laws prohibiting the sale of tobacco products to minors, it's clear teenage smokers can still buy cigarettes easily. Studies show that when these laws are enforced, illegal sales to minors can be reduced dramatically," Cummings said. + intake in humans," said Ip, who added that the challenge of future research will be to define the potential benefits of CLA in the human diet, to characterize its anticancer activities, to elucidate its mechanism of action at the subcellular level and to design new strategies for enriching foods with CLA. + B '· y 5 a n Risk factors relating to exposures in adulthood don't explain all the variation we see. This finding of a possible protective effect from having been breast-fed could be significant, and it is certainly worth looking at further. " Freudenheim and a team of researchers collected data on an array of potential risk factors from 528 women newly diagnosed with breast cancer and 602 women with no cancer who were randomly selected from the same population and matched for age. The women were between the ages of 40 and 85 during the time of the study, from 1986 to 1991. After controlling for age, education, age at menarche, age at first pregnancy, number of months they nursed their own children, number of pregnancies, family history of breast cancer, history of benign breast disease and body-mass index and height, the researchers found that one aspect of early nutrition - whether a woman had been breast-fed- was asso+ ciated with a decrease in risk. BY u m LOIS n BAKER 9 4 e �Buffalo General initiates third state lung transplant program he Buffalo General Hospital, in cooperation with the School of Medicine and Biomedical Sciences, has become the third hospital in ew York State to initiate a lung transplantation program. "This new service is an extension of our heart transplant program and its primary focus will be patients with endstage lung disease who reside in Upstate New York (west and north of Albany)," saidJoginder N. Bhayana, M.D., associate professor of surgery and director of BGH's Heart/Lung Transplant Program. In ew York State, only Columbia Presbyterian Medical Center and The Mount Sinai Medical Center in ew York City offer lung transplantation in addition to Buffalo General. oting that more than 80 heart transplants have been performed by BGH surgeons since 1984, Bhayana observed, "Our team has extensive transplantation experience and is well-prepared to perform lung transplants. " According to Bhayana, by late April , 28 people had already received preliminary evaluations for lung transplantation, and six were on the United etwork for Organ Sharing (U OS) list of patients awaiting donor organs. Bhayana said his transplant team hopes to perform six to eight procedures annually. "Obtaining lungs is more difficult than hearts because many potential donors are on respirators for several days prior to dying," he noted, adding that the chances of lung infection increase after a patient has been on a respirator for 48 hours. Unlike heart transplants, where organ rejection is the most critical postoperative factor, infection is the most 0 B u a 0 p serious concern after lung transplantation, he said. Bhayana observed that a multi-disciplinary team was developed to manage the evaluation, transplant surgery and post-transplant care in cooperation with the patient's primary care physician. The team consists of representatives in cardiothoracic surgery, pulmonary medicine, cardiology, infectious disease, psychiatry, nursing, pharmacy, pathology, rehabilitation medicine, nutritional + services and social work. edge and technology of genome science. "This very generous gift from the Palisano family will allow Roswell Park to endow its new program in cancer genetics and to use the interest the funds generate to support the research activities of its laboratory," said Thomas B. Tomasi, M.D. , Ph.D. , president and CEO ofRPCl. Roswell now houses several hereditary cancer registries, including the Gilda Radner Familial Ovarian Cancer Registry and the Familial Cancer Syndrome Registry, and has plans to add three new ones. + $1 million gift to Roswell will fund new cancer genetics laboratory Medical/Dental staff officers Buffalo family who lost six of its elected atteaching hospitals members to cancer has pledged $1 million to Roswell Park Cancer edical and dental staff officers Institute to establish a cancer gewere elected recently at several netics research laboratory. DB-affiliated teaching hospitals. The laboratory will be dedicated At Sisters Hospital, Daniel A. to the memory of John and Santa Castellani, M.D., clinical instrucPalisano, whose first born, Vincent, at tor in neurology, was elected age l3 started a delivery business with a president. Also elected were Edward horse and wagon that later spawned a Bartels, M.D., clinical instructor in gynumber of highly successful transporta- necology and obstetrics, president-elect; tion companies, including Boss Linco Kenneth]. Eckhert, Jr., M.D. , clinical Lines. assistant professor of surgery, secretary; Roswell received the gift from the and Nady Shehata, M.D. , treasurer. Charles and Charlotte Palisano family At The Buffalo General Hospital, Scott and from the Vincent and Harriet A. Tulman, M.D. , clinical assistant proPalisano Foundation. fessor of surgery, was elected president. "lt is both a privilege and an honor to Also elected were Daniel A. Mariniello, have a cancer research laboratory at M.D. , clinical associate professor of gyRoswell Park carry the name of my fam- necology and obstetrics, president-elect; ily, said Charles ]. Palisano, whose Nancy Nielsen , M.D., SUNY trustee and mother, Santa, three of his brothers, clinical assistant professor of microbiolVincent, Victor and Samuel, a sister, ogy and medicine, vice president; Daniel Virginia, and niece, Diane, died of can- S. Camara, M.D., secretary; and john cer. DeBerry, M.D. , assistant professor of The laboratory will be located within urology, treasurer. Roswell's new Cancer Genetics and Gene At The Children's Hospital of Buffalo, Therapy Program, established to capi- Daniel Peroni, M.D. , professor of peditalize on the explosive growth in know!- atrics, was elected president; Russell S. y 5 c a n A u m 9 9 4 �························ ··········· ···················································· ·· ·~ liJJ Vaughan, M.D., clinical assistant professor of pediatrics, was elected vice president; and Ehsan Afshani, M.D., professor of radiology and pediatrics, was elected secretary-treasurer. At Millard Fillmore Health System, Thomas Cumbo, M.D., clinical associate professor of medicine, was elected president. Also elected were Thomas Lombardo, M.D., clinical instructor in orthopaedics, president-elect; james Burdick, M.D., clinical instructor in anesthesiology, secretary; and Evan Evans, M.D., clinical instructor and Buswell fellow in surgery, treasurer. + Children'srecruits nationally renowned heart surgeon Eliot Rosenkronz, M.D. liot Rosenkranz, M.D., has joined The Children's Hospital of Buffalo to head its division of cardiovascular surgery. Rosenkranz, who was recruited from The Cleveland Clinic, holds the position ofUB associate professor of surgery. He will participate in clinical and laboratory cardiovascular research at both the medical school and Children's. "The successful recruitment of Eliot Rosenkranz is a coup for Children's Hospital," said joseph A. Ruffolo, the hospital's president and chief executive officer. "By leaving The Cleveland Clinic and joining the staff at Children's Hospital, Dr. Rosenkranz is making a strong statement as to his future investment and commitment to the success of the hospital." A native of Glen Clove, ew York, Rosenkranz is a graduate of the University of California at San Diego School of Medicine. He completed his general residency at the University of California and Los Angeles Medical Center. 6 0 0 p h Rosenkranz was the head of the section of congenital heart surgery at The Cleveland Clinic, responsible for pediatric and adult congenital heart surgery, pediatric heart transplants and arrhythmia surgery, as well as clinical and laboratory research. + NFMMC wins Preferred Prtmary Care Provider DOH designation iagara Falls Memorial Medical Center has recently been designated a Preferred Primary Care Provider by the ew York State Department of Health. lt is one of only two hospitals in the eight county Western ew York area Erie County Medical Center is the other- to have won the designation. Criteria to qualify for a Preferred Primary Care Provider include provisions for preventive and interventive health services, including immunizations and c 0 A cervicaVbreast/colon cancer screening, in addition to standard services such as radiology, pharmacy and clinical laboratory. The designation carries with it enhanced Medicaid reimbursement rates. DOH also mandates that each Preferred Primary Care Provider hospital establish a quality assurance program to determine patient satisfaction and continuity of care. The program includes development of an in-depth patient tracking and referral system, a 24-houra-day telephone service for patient health care inquiries and extended operational hours. The hospital 's primary care resources include its Hamilton B. Mizer Primary Care Center, which houses 18 programs, including Memorial Pediatrics, its family practice residency program, prenatal care assistance program and numerous specialty care clinics; the Summit Immediate Treatment Center; and the Tuscarora Health Center. + m n 9 9 �0 B a 0 p h y 5 0 n A u m 9 9 4 �,-------------------------------------~ I I I I I I I I PRACTICE MAKES PERFECT AFTER 10YEARS, US'S FACULTY PRACTICE MANAGEMENT PLAN MAKES SENSE FOR ITS FACULTY MEMBERS AND THE PATIENTS AND STUDENTS THEY SERVE I I I I I I I I y M A R w K A L L c A E I L _________ __ __________________________ Buff a loP h y sIc i an A u t u m n 1 9 9 4 ~ 0 �,------------------- - ------ - - ----------- Because so many different groups and individuals were involved, and because negotiations were so complex, it has taken a long time, much hard work and a great deal of cooperation to make the University at Buffalo Faculty Practice Management Plan into the efficient, cutting-edge system its proponents believed it could be. But a decade after its implementation, that's what the plan has become. Mandated be ew York State legislature in the midl970s and implemented on january l , 1984, the practice plan manages the income ofUB's widely varied and expert medical and dental faculty in 20 different departments, many of whom are widely dispersed at the school's affiliated teaching hospitals. "The plan has been extremely important to the development of the School ofMedicine and Biomedical Sciences," says] ohn aughton, M.D., vice president for clinical affairs, dean of the School of Medicine and Biomedical Sciences and chief administrative officer of the UB practice plan. PAUL C. HOLMWOOD, M.D., ASSISTANT PROFESSOR OF OPTHALMOLOGY , AT LEFT, WITH MEDICAL STUDENTS JOEL SHAPIRO (SITTING) AND ANDREW FEINBERG , AT MILLARD FILLMORE HEALTH SYSTEM ' S GATES CIRCLE EYE CENTER. AT RIGHT, I I I WITH RESIDENT ESTHER SANTOS, I I I M.D., DEMONSTRATING A PROCEDURE. L _______ __ _____________________ _ _________ _ 0 B u a a p y s c a n u m 9 9 4 �------ - ---- - - - -- - ---- - ---- - --------- ----, the medical school together. Given where we are in medicine right now, without the plan we would be completely disorganized , not knowing how to respond to many concerns," aughton says. The practice plan better defines the role of departmental chairs, creates common ground rules for faculty and provides funds both for the medical school and for hospital overhead, aughton says. "The practice plan brings about a more fairly shared enterprise," he says. The practice plan organizes, limits and audits the amount of money faculty physicians earn from clinical practice. Earning limits are based on faculty rank. Under the plan, physicians are allowed to earn no more than 250 percent, or in some cases 275 percent, of the maximum base salary allowed to a professor of their rank. Physicians also contribute to the fund of the chief administrative officer of the plan. SUNY Central sets a new salary cap every year. "The cap presents different concerns for different types of physicians," says ancy Glieco, assistant vice president of clinical affairs and administrative staff person to the plan since its implementation. "For instance, a family medicine doctor is not going to reach the salary cap, whereas for an orthopedic surgeon the cap may be an issue. " At the time of its implementation, the plan was highly controversial because it controlled physician incomes , Glieco says. o one is more aware of the complexity of the plan's history than William Dillon, M.D., an associate professor of gynecology/a bs tetrics located at The Children's Hospital of Buffalo . President UB's practice plan is its application of the State University of New York (SU Y) Faculty Practice Management Plan. Covered by Article 16 of the policies of the board of trustees of SU Y and negotiated by contract between the Union of University Professors and the Office of Employee Relations , the SU Y-wide plan includes all of the medical schools and dental schools in the SUNY system, as well as the School of Optometry. The plan mandates that all full-time and geographic full-time SU Y faculty (those based at affiliated hospitals) must be members. The plan is not required for volunteer or part-time faculty. At each SUNY institution with a medical faculty, the plan is administered by a governing board of that faculty . The fact that UB faculty do not work at only one nearby hospital, such as at SU Y-Stonybrook, but are dispersed among eight area hospitals, makes the management of UB's practice plan more complex than others in the SU Y system. "Without a centralized clinical faculty, and existing in various places in the Western ew York community as we do , the plan defined and brought together those who make up the full-time faculty ofUB.lt's the glue that holds I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I ------ -- ----------------------------------~ a a 0 p h y 5 a A u m n 9 �~-------- -- -- --- ---- ------ -- -- ----- - ------ 1 I I I I I I to have the honors and accolades associated with fulltime appointment to a medical school and the time to gain professionally and in administrative ability." According to Glieco, the plan has evolved significantly over the 10 years it has been operating at UB. "When we first started, we almost didn't know who all the people involved were," she says. "The organization was very loose - we collected money and patients however we could. "We've gone from being disorganized to being a department-centralized system with 20 departments and very few compliance problems," Glieco says. "The plan forces a member to have an organized practice, so we know who's doing what and where they're based," Glieco says. "Financing medical education has become a much more important issue in the last 10 years, and medical schools have changed from an unstructured environment to becoming a real business. We negotiate with teaching hospitals and each department, and this is the fifth year of the department-by-department audit. Here in the dean's office we think it's one of the best things to happen in medicine in the last decade. " of UB's Faculty Practice Management Plan governing board since 1986, Dillon has been on the board from its inception. "In the beginning, it took a lot of work by the governing board to educate faculty as to exactly what the practice plan was, to answer their concerns and objections and to work towards full compliance with the plan," Dillon says. "It was a learning process for the board also," Dillon says. "We needed to develop policies and procedures, certain guidelines under which the departments would function, and have the departments develop their own plans for the management of clinical income while seeing to it that those plans were consistent both with the overall UB plan and with Article 16. It was not an easy feat, and took a lot of talk and education over several years. " For Dillon, all the work has been necessary and significant because of the plan's importance. "As state employees in a university system, there must be an accounting of our income to the public," he says. "It's important that some limits are placed on the amount of income generated by one's private practice within the plan. Just as there are benefits for being a faculty member of the SUNY system, some of those benefits must be referred back to the school, and back to individual departments also. "The plan tries to allow SU Y faculty members to make competitive earning with other peers and yet do all the things a faculty member does which are not income generating," Dillon says. Although he admits that perceptions of the importance of being a UB faculty member may vary among physicians, for Dillon that importance seems clear. "I view my employment as a teacher, researcher and administrator of a medical school as a privilege," he says. "It's a profound responsibility - the privilege of seeing to it that a new generation of physicians are properly trained. With it comes the chance to be at the cutting edge of one's profession, L ________________________________________ _ B a 0 p h s c a ll. u u m 9 4 �-----------------------------------------, manner," he says. Currently, the plan gets good cooperation from the departments, Dillon says. There's more centralization within departments of their own finances , with reporting on a monthly basis to the office of clinical affairs flowing more freely and in a timely manner. The dean's tax computation, which provides money for the chief administrative officer of the plan, is done on a uniform basis, as is the computation for hospital overhead payment. Com- Beginning with a 1990 audit of 1989 earnings, audits have been done each year on a department-by-department basis by the accounting firm Levin and Associates. As the plan geared up for that first audit in 1990, there was a lot of concern about the cost of the audit procedure, and more effort and education needed to be provided to the departments, Dillon says. "Since that time , what we've seen is that the yearly audit process has become standardized, moves easily and is completed in a timely LEONARD FELD , ASSOCIATE M.D. , PROFESSOR OF PEDIATRICS , AT LEFT , WITH RESIDENTS ROB- ERT WORONIECKI , M.D ., ( LEFT ) AND RANDY CAN- TOS , M.D. , AT AN OUTPA- TIENT CLINICS CHILDREN ' S OF AT HOSPITAL BUFFALO, RIGHT, WITH I I I I I I I THE AND AT PATIENT ANI BAL LARACUENTE AT I I THE CLINIC. I I ---------- -- --- - ------------- - -- --- -- -- ---~ B u a a p h y 5 c a A u m n 9 �, ----- ----- ----- ------- ------- -------- ---- I I I I I I I pliance problems have decreased, and the vast majority of faculty now fund their retirement plans directly through the practice plan. Dean aughton says that the practice plan has defined much more clearly the role of department chairs from the standpoint of operating the various clinical sites of the medical school. "It gives department chairs the ability to manage their faculty," aughton says. "Before the plan, department chairs tended to have responsibility without much authority. The practice plan has helped them organize their faculty, and makes their position as department chair more secure." The plan has led to the formation of a number of facilitating organizations and legal entities to ensure its proper functioning. One such organization is University Medical Physicians Services (UMPS), which is the facilitator for the University Physician's Office, an ambulatory multi-group practice site that operates at two campus locations- the ground floor of the Cary-Farber-Sherman Annex and a sports medicine site in Farber Hall- as well as out of various offices in the teaching hospitals. Currently about 30 practice plan members see patients at the University Physicians Office. The office also provides UB medical students the opportunity to work directly with patients. UMPS received not-for-profit status in 1993, saving UB a great deal of money in state taxes. Most UB departments have become more formalized in their operations and have formed professional corporations, Dillon says. "Many of the more informal agreements between the hospitals and various departments or individuals have been done away with," he says. One department that has formed a professional corporation is the department of medicine, which currently has faculty at five affiliated teaching hospitals. The University Medicine Services Professional Corporation (UMSPC) is a departmentally centralized plan, with the same rules and goals for department faculty at all hospitals. Members of all hospitals, as well as representatives of all specialties, are represented on the department's practice plan governing board. The corporation is governed by the overall umbrella of the UB-wide and SU Y Faculty Practice Management Plan governing boards. The corporation has a ceiling less than the 250 percent mandated by the overall plan. With the exception of a small group of on-campus faculty, faculty in the department of medicine tend to be hospital-based at one area hospital, according to james olan, M.D. , president of the UMSPC, chair ofthe department of medicine and director of medicine at Erie County Medical Center. "Since I took over as chair of the department in 1978, an increasingly large percentage of salary dollars have needed to come from practice," olan says. L _________________________________________ · B u a 0 p y s c a n A u u m n 9 4 �-- --------------- - ------ -------- -----------~ want to say he had to be limited. If there's someone we can recruit who is going to help patients in Buffalo, we should work together to make sure the cap is not a stumbling block. I think people are coming to understand that. " Despite such issues, Feld agrees with Dillon that on the whole the plan has been a great success. "It's appropriate to have a plan that covers all departments, and this plan is individually tailored to meet the needs of various departments ," he says. "For all practical purposes it's worked pretty well. People will always have complaints, and no document is perfect for everyone. But if a majority like it, then it's been successful. "The practice plan provides a system that allows faculty members to supplement their incomes in the academic environment so we can be competitive and keep the people we want," Feld says. "In a university environment there have to be rules so that people can better work together. The practice plan gives UB a team approach , and that's what has made us so successful. " aughton agrees with Nolan that the issue of managed care will be a key challenge for the practice plan in the next decade. "As we experience changes in health care reform and financing, we will have to become more group-oriented," aughton says. "We will have to think as a group about how we interface with the changing financial environment. "We want to make sure the practice plan serves our mission of education and research , and generates the needed patient care activity," a ugh ton says. "The plan is in place, has matured and is functioning well. There are some real challenges out there , no doubt about it, but I + believe we can-face them. " "This has made it necessary for faculty to do a lot more practice, and has often put them in competition with the larger community for patients. "It's important to recognize that the practice plan only organizes income, and is not a plan for organizing the clinical practice of UB faculty, " olan says. "We do not have a university-wide group clinical practice. But having such a practice will be very important as we get into managed care, in which people will want to work with total care and not just particular departments. "Since UB faculty work at so many area hospitals, we have to be very attentive to the practice of our various hospitals , each of which has its own clinical culture ," olan sa y s. " Our department's faculty is spread out between competing institutions , and our faculty have to support the goals of their hospitals as well as [those] of UB." Although Dillon admits that a number of critically important issues still need to be dealt with, he believes the practice plan has come a long way. "Continuing issues will come up ," he says. "But we have a very good track record , and a responsive system that can deal with those issues. " Leonard Feld, M.D ., a member of the governing board from 1987 to 1990 and vice president of the board and chair of finance and policy from 1989 to 1990, says one of those key issues is how income limits will affect UB's ability to be competitive in recruiting physicians in certain fields . "There does need to be some flexibility on the limit," says Feld, who is an associate professor of pediatrics and physiology. "If UB wants to recruit certain individuals, income limits should not be a factor ," Feld says. "For instance, if we wanted to recruit a top transplant surgeon, we wouldn't I I I I I I I I I I I I -- - ------------ -- - -- - - ------- ---------- - - ~ B u a 0 p h y 5 c a A u m 9 9 4 �II THE NEW ACADEMIC MEDICAL COLLEGIUM GIVES ITS MEMBERS AN EQlJAL SAY IN THE FUTURE OF HEALTH CARE IN BUFFALO ANDREW T'S MORE THAN JUST ANOTHER institutional name. To people like Charles B. VanVorst, President of the Millard Fillmore Health System, "Academic Medical Collegium" * says a lot. "If you go back and look at Webster, the definition of 'collegium' is people sharing power on an equal basis." G) a u f f a l o P h y s I c I a n A u t u m n 1 9 9 4 �W LE IT'S STILL A WORK IN PROGRESS, the proposed Academic Medical Collegium holds the promise of creating a strong but flexible alliance among the University at Buffalo, its schools of Medicine and Biomedical Sciences and Dental Medicine and the eight area hospitals already affiliated with the university for graduate medical and dental education. There's also a seat at the table for medical staff and faculty in the novel organization, which proponents see as a vehicle for taking the region's health care and medical education systems into the next millennium. "We're trying to get up a step and do more for the community in a collaborative way," said Thomas R. Beecher Jr. , former Buffalo General Hospital chairman and a key player in the effort. Medical school dean john Naughton, M.D. , a prime mover behind the nascent organization, is optimistic. "There's been a broad foundation of principles to which most people have agreed," he said. "The good news," aughton added , "is everybody sees the appropriateness of moving toward cooperative interfaces in an era of reform directed at health care and health education that can be an overwhelming challenge to existing programs of quality." By incorporating broad representation from the university, hospitals and physicians, the Academic Medical Collegium hopes to build on the success of the existing Graduate Medical Dental Education Consortium, but to overcome the tensions that plagued a previous cooperative project, the Western ew York Health Sciences Consortium . If successful , the Collegium would enhance the region's medical education and health care systems to a point where Buffalo could become a national center of medical excellence. At the moment, the Collegium is more concept than concrete, but the concept is bold and its architects hope to move from artist's rendering to actual blueprints this autumn. The resulting structure would be something of a meeting hall from which members could launch collaborative efforts to enhance their academic and health care missions. "The question ," said VanVorst, "has got to be, how do you develop that forum with institutions that are not merged or economically linked to one another? I don't think it's a problem. I think it's a challenge. " Dean John Naughton, M.D., a prime mover behind the nascent organization, is optimistic it is •moving toward cooperative interfaces in an era of reform directed at health care and health education." B 0 0 p h s c o n u m 9 9 4 �Thomas R. Beecher, former Buffalo General Hospital chairman and a key player in the effort to build the Collegium, believes the organization could harness "a powerful force in the community" to meet the challenges that health core reform will bring. CCORDING TO THE Collegium's statement of m1sswn and principles, its focus would include everything from training and research to quality, cost and access to care. "There's a powerful force in the community if you take these eight institutions and the university medical complex to solve problems," Beecher said. It's too early for the Collegium to be planning any specific projects, but Beecher said there's no lack of possibilities. "If you put the weight of the university and all these hospitals into preventive medicine," he suggested, "a lot could be accomplished. " The Collegium would also serve as a communication forum for member institutions and practitioners, whether they be academic or community-based. And organizers want to keep the doors open for non-member institutions and practitioners to collaborate, too. "It's a very positive, almost ecumenical concept," said Gerald Sufrin, M.D., professor and chairman of urology and chairman of the medical school's Council of Clinical Department Chairpersons. "It's to improve health care delivery in a broader sense. Packed into that goes education and research, making young people the best they can be. " The organization would include the same institutions that make up UB's Graduate Medical Dental Education Consortium: the medical and dental schools, The Buffalo General Hospital, The Children's Hospital of Buffalo, Erie County Medical Center, Mercy Hospital, Millard Fillmore Health System, Roswell Park Cancer Institute, Sisters of Charity Hospital and the Buffalo VA Medical Center. aughton said plans call for the Collegium's board to include three people from each institution, including the chief executive officer or equivalent, the chief operating officer or designee and a medical staff or faculty representative. UB will be represented by its president and vice president for clinical affairs and chairman of the clinical council. Some see the Collegium as a natural next step in the development of cooperative efforts that began more than a B u 0 0 p h 5 c a n m n 9 4 �Charles B. Van Vorst, president of Millard Fillmore Health System, sees the Collegium as a forum from which member "institutions that are not merged or economically linked to one another" can launch collaborative efforts to enhance their academic and health care missions. decade ago with formation of the graduate medical education consortium, the organization that serves as the sponsoring institution for the numerous residency programs spread among UB's affiliated hospitals. While many had once viewed Buffalo's lack of a single university medical center as a drawback, the consortium has come to be seen as a model for other communities and a promising arrangement for implementing graduate medical education reforms , such as greater numbers of primary care slots. "It has drawn national attention," said William D. Pike, president of the Western ew York Hospital Association. The graduate consortium also got the university and the region's traditionally competitive hospitals used to working more closely together. In 1987, they formed a second alliance, the Western ew York Health Sciences Consortium. Its goal was to enhance the quality of health care in the region, and it was soon credited with several high-profile successes, including establishment of the Bone Marrow Transplant Center at Roswell Park, the Heart-Lung Transplant Center at Buffalo General and the Positron Emission Tomography center shared initially by UB and the Buffalo VA Medical Center, and now the Millard Fillmore Health System. Unlike the graduate consortium, the health sciences consortium was incorporated, giving it a more formal structure. And the Buffalo business community, interested in keeping health costs under control, played an important role in its formation and operation, so much so that the organization was headed by a bank executive. Despite its successes, the consortium ran into trouble. "There was always tension about how much involvement the business community should have in decisionmaking," recalled aughton. To make matters worse, physicians felt excluded. And hospitals, ever mindful of their own autonomy, were edgy about being absorbed into a de facto university medical center. Former UB President Steven B. Sample suggested that the consortium could solve some of its problems by putting the university in a stronger leadership position. The idea was seriously considered, but it didn't make nervous consortium members any more comfortable. "Eventually that organization went on the back burner," aughton said. "It hasn't been formally dissolved. But by gentleman's agreement, we decided to strike out in new directions to form a more mutually compatible organization." B a a p h c a n m 9 �LKS TOWARD THAT END have been going on at various levels for four years. UB's new president, William Greiner, also became involved, and by this summer the Collegium reached the point where everyone was preparing to sign off on a statement of mission and principles. It's an ambitious document that targets four areas: medical education; health care delivery; biomedical research; and the region's national standing. The document states that the Collegium would "Enhance the ability of its members to fulfill their respective academic roles, including those related to education of health care professionals .... " While it goes on to indicate that the Collegium would absorb the graduate education consortium, Beecher said that issue will remain uncertain until members get to work on specific operating plans. As for health care, the statement charges the Collegium with developing "organized approaches to meeting community health needs that strike a balance between collaboration and competition in addressing major health care issues, including quality, access and cost of care." Among other things, it says the Collegiu m would: facilitate availability of the best preventive, diagnostic and treatment modalities; foster efficient resource use and avoid unnecessary duplications; promote primary care access for underserved groups in the region; and encourage, where appropriate, resource sharing and joint support of activities. "I think this complements wherever health care reform takes us," said Robert Stanek, chief executive of Mercy Hospital. "But more importantly, it's good for the community." The mission and principles statement also says the Collegium would bolster biomedical research, partly by creating alliances of common interest that would "gain from clinical and organizational diversity among programs, departments and institutions." Such efforts might not only advance the body of health sciences knowledge, but could also help the area compete more successfully for research funds and establish it as a national biomedical research leader. The document also says the Collegium would encourage health services research into issues of quality, 6 u a 0 p h y 5 access, cost and appropriateness. In addition, the organization would develop collaborative information systems, which could also serve educational and administrative needs. "We can do very collaborative research among institutions," said Edwin Mirand, M.D., Roswell Park's vice president for educational affairs and dean of its graduate division of the UB medical school. "We can get greater numbers into the treatment schedules. You're always looking for patients to come into protocols, and one institution may not have one type of patient, but a group of institutions might. " Finally, the Collegium would work to advance the regional and national reputation of not only its members, but of the entire local health care community. In particular, it would identify collaborative opportunities to retain patients within the region and encourage "services of excellence." To answer physician concerns, Collegium planners added a section to the mission and principles statement in May that provides for proportional representation among institutions, medical and dental staff and UB faculty. "I think some of the nervousness between the volunteer faculty and the full-time faculty has been diminished because a representative voice has been assured," aughton said. Sufrin said the medical school's clinical department chairpersons were among the first to endorse the Collegium document. "In a sense, the faculty at large could be considered another institution," he said. "From our standpoint, we look upon the Collegium as an extraordinary opportunity to work with the other health care institutions in the system." The mission and principles statement also says, among c a n A u m 9 9 4 �Gerold Sufrin, M.D., professor and chairman of urology and chairman of the Council of Clinical Deportment Chairpersons, describes the Collegium as "a very positive, almost ecumenical concept" that will "improve health core delivery in a brooder sense." other things, that faculty appointments will not be universally required for medical and dental staff appointments to all teaching hospitals, and that the Collegium itself will not enter arrangements to provide patient care or other services unless all members and their staffs agree. "Keeping the physicians involved helps to round out the system," said Stanek. With Collegium participants concerned about their autonomy and everyone uncertain about the direction of health care reform, it hasn't been easy getting to this point. But many are optimistic. "I think it's good and it'll help health care delivery, research, education," said Mirand. "Yes, you'll lose some independence. But it'll also give us more opportunities. " "There's no question that people are looking out for their turf," said VanVorst. "But I do sense a broader winwin, a broader sense of community. I see a broader vision or need emerging. I think it's good, and I hope we find a way to build on that." If all goes according to expectations, Collegium organizers will work this fall on an organizational structure to carry out the lofty generalities of the mission and principles statement. Will the Collegium be incorporated? Will it absorb the graduate education consortium? What exactly will it do , and who will do it? It will probably be the most difficult part of the process, Beecher said. B u a 0 p h y s c VanVorst said he thinks the Collegium can avoid the tensions that troubled the Health Sciences Consortium. "I think it's a lesson," he said. "Also, that was several years ago .... The environment has changed, the leadership of most of the hospitals has changed. I see that as an opportunity. " The trick, he added, will be to move as quickly as possible "without fracturing the process or creating mistrust." Stanek said member institutions shouldn't feel threatened as long as the Collegium takes a "planned, rational approach." The organization may eventually try to reduce service duplications and encourage specialization among hospitals, but some of that is happening already, he said, pointing to developments like ECMC's traumaburn unit. Collegium or not, he added, downsizing is occurring, and the Collegium could help member institutions cope with it better. a ugh ton said he doesn't expect the Collegium to be finalized overnight. "We're in a preparatory phase," he said. "The actual formal organization may take another year or two. We're in a process of evolution." Still, he said, he sees the organization as being on the leading edge of a trend that will grow, especially if the basis of the Clinton health care plan is adopted. "I don't think there is any doubt that the managed competition theme will push every community to do more to develop + cooperative strategies for survival," he said. a n ll. u m n 9 9 4 �. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . [1] I/ ;;;::::::_lJ 0 I Moncada gives Harrington Lecture INTERNATIONALLY RENOWN RESEARCHER FOCUSES ON CLINICAL APPLICATIONS OF NITRIC OXIDE RESEARCH alvador Moncada, M.D., who is internationally known for his pioneering studies of nitric oxide and its clinical applications, delivered the D.W. Harrington lecture, " itric Oxide: Physiology, Pathophysiology and Therapeutic Implications," discussing the history of nitric oxide research and some recent research on nitric oxide that suggests significant clinical possibilities. Paresh Dandona, M.D., UB professor of medicine, introduced Moncada, research director for the Wellcome Research laboratories in England since 1986. Dandona praised Moncada as "one of the most unique and creative minds of our time," saying his work "has inspired generations." While nitric oxide research was initially focused only on prostacyclin and related issues, Moncada helped expand nitric oxide research to all areas of the body, Dandona said. Moncada, a member of England's prestigious Royal Society who has received their gold medal, is credited with the discovery that nitric oxide is the endothelium-derived relaxing factor. The author of more than 550 publications on vascular physiology and pharmacology, including seminal work on modulation of prostaglandin release and action by blood vessels, platelets and endothelium, he is also a member of this country's ational Academy of the Sciences. Moncada said the determination that vascular endothelial cells generated nitric oxide was made in 1987. A year B a a p later, researchers determined brain synapses also generated nitric oxide, leading to the suggestion that the formation of nitric oxide from l-arginine, the synthetic precursor to nitric oxide, was a widespread pathway for the regulation of cell function and communication. It was determined that nitric oxide acts as MONCADA , A MEMBER O F ENGLAND'S PRESTIGIOUS ROY AL S OC IETY , IS CRED ITED W ITH THE DISC OVERY T HAT N ITRI C O XI DE IS T H E ENDOTHELIUM· DERIVED R ELA X ING FACTOR . h c a n an intermediary in such functions. The discovery that l-M A (methyl nitroso arginine - a derivative of larginine) was a selective and competitive inhibitor of the generation of nitric oxide proved the most important tool for the investigation of nitric oxide, Moncada said. l-MNA produces a longlasting hypertensive response and causes such effects as significant loss of blood flow. Such effects can be immediately reverted by the injection of larginine, Moncada said. The most interesting part of such a finding, Moncada said, is that l-M A does not increase blood pressure by inducing vascular construction, but by blocking the production of nitric oxide. Thus, in its normal physiological state, the cardiovascular system is in a state of active vasodilation, and a balanced system tends toward normal vasodilation. Such research shows nitric oxide is the endogenous dilator in the system, Moncada said. itro-vasodilators act the way they do because they are transformed into nitric oxide. itric oxide, he said, performs numerous functions within the body, interacting with prostacyclin and inhibiting platelet aggregation and white cell activation to regulate platelet and white cell activity within the vessel wall. Evidence is also growing to suggest that nitric oxide modulates vascular smooth muscle cell proliferation via a cyclic GMP-related mechanism , Moncada said. " itric oxide is a general regulator that plays many different roles, " Moncada said. "An interesting question is whether we can make compounds that might be different from normal vasodilators, which can lead to our selectively targeting specific vasodilators." itric oxide is widely distributed in u m 9 ] �. .. . . . .. .. ........... . . . . . ..... . ... .. .. . ... . .. . .... . .............. .. ......... .... .. ··· · ·~-· I in biological fluids may serve as a general marker of disease , Moncada said. "All these functions of nitric oxide are being established," Moncada said. "How could we have understood blood pressure before knowing this? Itnc oxide, which in the atmosphere is known as a pollutant, is also the first known gas to act as a biological mediator. Could it be that other gases also play a role in the nervous system, he said, where neurons are highly interconnected, and nitric oxide neurons are very resistant to processes of neurodegeneration. Moncada said this further suggests that nitric oxide may play a role in longterm potentiation - a major factor in memory. itric oxide may play many other roles in the central nervous system as well , Moncada suggested, including the regulation of cerebral spinal fluid. Research has discovered that white cells also release nitric oxide, Moncada said. Thus, while nitric oxide acts as a biological mediator for physiological purposes, when released by white cells it has defensive purposes. Nitric oxide is cytostatic and cytotoxic for tumor cells, bacteria, fungal cells and protozoan parasites, Moncada said, adding that activated white cells release nitric oxide for a very long time. At the moment, clinical applications of nitric oxide research are focused on the vessel wall area , Moncada said, where nitric oxide-mediated vascular relaxation can help regulate blood pressure. Also, it is clear that excessive nitric oxide production can produce hypertension in cases of septic shock. itric oxide synthase inhibitors can potentially manage such shock , Moncada said. "Whoever has been in an intensive care unit trying to reverse the effects of septic shock will agree this is very important," he said. Recent research has found an increase in nitric oxide production in all parts of the body during pregnancy, Moncada said. Such increased production could cause the decrease in vascular tone in pregnancy and other effects, as well as help prevent heart disease in pre-menopausal women. Other research has suggested that the breakdown products of nitric oxide a u a 0 p h I animal systems? " The Harrington Lecture is sponsored by the School of Medicine and Biomedical Sciences. The D. W. Harrington Lecture Fund was established in 1886 by Devillo White Harrington, M.D. , an 1861 graduate of the UB medical school and a professor genito-urinary and venereal diseases from 1886 to 1905. + B Y MARK WALLACE z Q ~ 3: . § 0 ~ Shirley Sampson, deputy director of Health Systems Agency, and Herbert Hauptman, Ph.D., president and scientific director of The Medical Foundation of Buffalo, speak at a health care reform forum sponsored by Rep. Jack Quinn, R-Hamburg, held at the medical school in May. Ebsary appointed assistant dean and director of development tephen Ebsary, Jr. , has been appointed assistant dean and director of development for the School of Medicine and Biomedical Sciences. He has served the university in various capacities since 1988, including as director of planned giving for the University at Buffalo Foundation, Inc. "Steve will help us continue to build on our y c a n strong base of philanthropic support," said john aughton, M.D. , vice president for clinical affairs and dean of the medical school. "We want to increase the school's endowments and unrestricted support so that we can continue to provide the excellent education for medical and graduate students that has earned us national prominence." Ebsary, a graduate ofMuskingum College in ew Concord, Ohio, is a native of East Aurora, ew York. Active in numerous fund-raising organizations, he is president of the Western ew York Planned Giving Consortium and chairman of the SUNY Task Force on Planned Giving. + m 9 9 4 �- • - ------ · · ··········· · ··· · ·· · ··· ·· ·········· · ·· · · · ····· · ········ ··· · · ············ ·· ··· ·· ·· · ····· z I 32 medical students receive awards at commencement don S. Ehrlich Award, the Mark S. Petrino Award and the American Academy of Family Physicians President's Award hirty-two UB medical students • Thomas Burnette, of Briarcliff were honored during the school's Manor: the Baccelli Award and the Bercommencement held on May 15. nard H. Smith Memorial Award in CliniAmong the recipients were cal eurology eight multiple award winners: • Karen Houck, of Snyder: the Dr. • Sean Perini, of Buffalo: the Cyrenius Chapin Award and the Hans Dr. George Alker Award, the Robin M. ]. Lowenstein Award in Obstetrics Bannerman Memorial Research Award, • Christopher Wood of Williamsthe Dr. Cyrenius Chapin Award and the ville: the Dr. Thomas]. Guttuso Award Upjohn Award and the E.]. Weisenheimer Award • Martha Bennett, of Cleveland, Ohio: Other graduates receiving awards the Charles Bauda Award, the Dr. were: Cyrenius Chapin Award and the Stephen • Diana Sanderson, of Tonawanda: ]. Paolini Award the Gilbert M. Beck Memorial Prize in • Steven Hammel, of Tonawanda: Psychiatry the Buffalo Pediatric Society Award, the • Katherine O'Donnell, of Buffalo: David K. Miller Prize in Medicine and the Buffalo Surgical Society Prize in the Morris and Sadie Stein Neuurgery roanatomy Award • joel Brenner, of Williamsville: the • Andrea Williams, of Buffalo: the Children's Hospital Prize Dean's Award, the orman Haber Me• Richard Kozak, of Buffalo: the Somorial Award and the ational Medical ciety for Academic Emergency MediAssociation Award cine Award • Kim Griswold, of Buffalo: the Gor• Todd Schlesinger, of Cleveland, B u 0 0 p h 5 c 0 n A Ohio: the Dr. Austin Flint Award • joseph Kay , of Amherst: the Bernhardt and Sophie B. Gottlieb Award • Michael Krabak, of Buffalo: the Francis]. Klocke Award • Debra Tarantino, ofBuffalo: the Dr. Heinrich Leonhardt Prize in Surgery • Elizabeth McClintick, of Buffalo: the Lierberman Award •j ennifer Tufariello, ofWilliamsville: the Maimonides Medical Society Award • joseph Valenti, ofBuffalo: the Medical Society of the State of New York Award • Michael Landi, ofBuffalo: the Medical Alumni Association Award • William Cecere, of Kenmore: the S. Robert arins Memorial Award • Douglas Golding, of Kenmore: the G. orris Miner Memorial Award • Glen Feltham, of Amherst: the Benjamin E. Obletz, M.D., Award • john Pryor, of Buffalo: thejohn R. Paine Award in Surgery • Madonna Tomani, of West Seneca: the Clyde L. Randall Society Award in Gynecology-Obstetrics • Mark Sheldon, ofBuffalo: the Emilie u u m n 9 �··························· · ··············· · · · ······· · ····· · ·························· · ·• · ~ I Lambert retires as Red Cross Blood Services principal officer nize those who donate six or more times per year. Under Lambert's direction, the Red Cross' Buffalo laboratory consistently eginald Lambert, Ph.D., has re- extracted the highest number of prodtired his position as principal of- ucts per donated unit of blood in the ficer of Blood Services, Buffalo Red Cross system. In 1993, the national Region after 21 years of service to component production average was 2.6 products per donated unit. The Buffalo the American Red Cross. Lambert, professor emeritus of Region amassed 3.6 products per unit microbiology, achieved many accom- average- enabling one unit of donated plishments during his tenure- among blood to assist up to four patients and them, the establishment of seven fixed fully maximizing each blood donor's blood collection sites throughout West- time and efforts. Also under Lambert's stewardship, ern New York. As a result, the Buffalo Region has consistently had the highest Buffalo was an early leader in the collecratio of donor per 100,000 population tion of platelets, pheresis in the early of any large region in the Red Cross 1970s and was the first Red Cross blood region to utilize a blood product irradiasystem. One of Lambert's proudest moments tor. Donald Dudley, an 18-year veteran came in the early 1970s when he led the Red Cross to adopt a "community re- of the American Red Cross, has been sponsibility" philosophy rather than the named Interim Principal Officer for the former "credit" system of blood dona- Buffalo Region. Dudley, who has served tion. Lambert also fully understood the in a variety of positions at both the strong personal commitment blood do- regional and national level, is currently nors feel to the program, and in 1986 he serving as Interim Principal Officer for established the "Sixer Club," to recog- the Rochester Blood Region as well. + Davis Rodenberg Memorial Award • Donna Stawasz, of Cheektowaga: the PhilipP. Sang Memorial Award • john Sherwood, of Buffalo: the john Watson Award in Medicine • john McArdle, ofYonkers: the john Watson Award in Medicine • Geoffrey Hobika, of Grand Island: the james Platt White Society Award • Michelle Penque, of Grand Island: the Frederick B. Wilkes Pediatric Award • Antonio Bird, ofBuffalo: the Farney R. Wurlitzer Award + SMILES ABOUND AS THE MEDICAL S C HOOL HELD ITS 148T H C OM· MENCEMENT I N MAY. FROM LEFT TO RIGHT , JEFFREY SEYMOUR , M . D ., ' 93 , CONGRATULATES NEW GRAD P I NA C . SANELLI , M . D .; J O S E PH J . FA LSON E. M . D ., MAKES HI S MOT HER MARYANNE PROUD ; AND BEHZAD TABIBIAN ( STANDING) AND MICHAEL LANDI ENJOY THE CEREMONIES . B u c 0 p h I y c c u m n 9 9 4 �• ·· · · · ····· · · · · · ···················· · ·· · ······· ·· ····· ·· ·············· · ··· · ·············· z I Kristen Schenck-Robillard Med student takes first place honors in AAFP research forum B medical student Kristen SchenckRobillard was the recipient of the First Place Research Forum Award at the ew York State Academy of Family Practice's annual meeting May 8, 1994, in Saratoga Springs, ew York. The title of Schenck-Robillard's research paper was "Predictors of First Contact Care in a Poor Urban Census Tract. " She competed against other medical and biomedical sciences students, as well as residents and attending physicians for the award. Carlosjaen, M.D., senior clinical investigator and clinical assistant professor of family medicine, is SchenckRobillard's research faculty leader, supervising her research endeavors. "If Kristen has expressed interest in becoming a family doctor, the specialty would be lucky to have her," jaen said. Schenck-Robillard, a native Buffalonian who attended Canisius College for her undergraduate education, is a member of the Class of 1996. She is expecting her first child in October. Schenck-Robillard will also present her paper to a national audience at the B a 0 p American Academy of Famil y Practice's scientific assembly held in September in Boston , Massachusetts. Two other UB medical students presented papers at the Saratoga Springs conference. jennifer Zubler, Class of 1995 , presented "Use of Ultrasonography." Patricia Krebs , also a member of the Class of 1995, presented "Violent Acts in Rural Settings. " Krebs will also present at the AAFP's scientific assembly in Boston. + - B Y R EBECCA B RIERLEY Rosenthal named chairman of family medicine department homas C. Rosenthal , M.D., associate professor of family medicine and a 1975 UB medical school graduate, has been named chair of the department of family medicine. Rosenthal has served as interim chair for the past year. A member of the department since 1978, he was instrumental in establishing the division of rural health, the medical school's rural health campus in Cuba , ew York, and its residency program in rural health, one of four in the country. Through his initiative, UB was named a ew York Rural Health Research Center in 1992, and one of five universities in the U.S. designated as national rural health research centers. He received the 1992 Distinguished Educator Award from the ational Rural Health Associah y 5 c a A tion for his work in expanding and improving rural health care. Rosenthal also is founding director ofUB's Primary Care Resource Center, headquarters for projects implemented through the school's primary-care initiative, a cooperative effort begun in 1992 to increase the number of medical school graduates entering primary-care practice. Rosenthal is project director of the Generalist Physician Initiative grant from the Robert Wood johnson Foundation. + Sarkin elected chair of pediatric association education group ichard Sarkin, M.D., clinical assistant professor of pediatrics, has been elected chair of the Ambulatory Pediatric Association's Special Interest Group for Medical Student Education. Sarkin also is a member of the executive committee of the council on medical student education in pediatrics. + Departmental name changes better reflect academic disciplines o better reflect the scope of their disciplines and missions , two medical school departments have recently undergone name changes. The department of pharmacology and therapeutics is now officially the department of pharmacology and toxicology, and the department of anatomical sciences is now officially the department of anatomy and cell biology. + u m 9 4 �ity, cost-effective, efficient care to all of the country's citizens in a larger variety of community-sited environments. This can be done only if more physicians are prepared to work in new settings and to focus on our many unmet needs. "UB is proud to be included among the schools that will provide the needed leadership for change in the years ahead," he added. The grant will support the following activities: • Recruiting underserved and rural students • Pairing promising high school students with primary care faculty during the summer • Restructuring some courses to include more emphasis on primary care clinical approaches, as well as developing new courses • Teaching information management skills to medical students • Training medical student in multidisciplinary teams with nurse practitioners, physician's assistants, therapists and social workers • Moving primary care medical clerkships out of hospitals and into clinics and doctors' offices in the community • Hiring a director of education development to help design new courses and programs, and a medical education specialist to train faculty to implement the initiatives "The Robert Wood johnson granl offers us a tremendous opportunity to unite the goals of the primary care departments and to produce high-quality clinical graduates who will be more likely to enter primary care," said Thomas Rosenthal, M.D., chair of the department of family medicine and the grant's project director. "Those who don't enter primary care will have a better understanding of the challenges patients face in our health care system." The medical school has set a goal of UB wins $60,000 Robert Wood Johnson Foundation grant he School of Medicine and Biomedical Sciences will receive approximately $600,000 over three years from the Robert Wood johnson Foundation to support the medical school's efforts to redesign its medical education curriculum and to increase the number of primary care physicians it graduates. In three years, after a successful evaluation, the foundation will continue to support UB's primary care education efforts through a non-competitive threeyear grant. UB is one of 14 U.S. schools to receive a Generalist Physician Initiative implementation grant. The money will allow the university to carry out recommendations developed during an 18month planning period, funded in 1992 through a $150,000 award from the foundation. The Generalist Physician Initiative grant will enable the medical school to begin its primary care recruitment efforts in high school, and to develop projects and programs that will give medical school students early hands-on experience in primary care. Studies have shown that early positive exposure can influence students to choose careers in primary care medicine . "The faculty and I are elated by the designation from the Robert Wood johnson Foundation to participate further in the Generalist Physician Initiative," saidjohn P. aughton, M.D., dean of the medical school and vice president for clinical affairs. "Medical schools and their teaching hospitals have done much since World War II to improve the quality of patient care and to eradicate curable diseases. Today, the challenge is to provide qual- B u 0 0 p h y c o n A u having 50 percent of its graduates eventually practicing in primary care fields. In September 1992, the school launched its own primary care initiative devoted to graduate medical education when it unveiled a $5 million demonstration project involving six Buffalo teaching hospitals, Medicaid, four private health care insurers and the ew York State Department of Health. That effort concentrates on recruiting medical school graduates into primary care residencies, improving faculty and resident teaching, setting up community academic practice sites and developing primary care research opportunities. The Robert Wood johnson Foundation, headquartered in Princeton, New jersey, is the nation's largest philanthropic organization devoted to improv+ ing health care. BY LOIS BAKER Ginsberg receives Triological Society Presidential Citation rwinA. Ginsberg, M.D. ,adjunctclinical professor, has been awarded the Presidential Citation of the American Laryngological, Rhinological and Otological Society. The founder and president of the Buffalo Oto laryngology Group received the award for his internationally recognized contributions to the research, diagnosis and treatment of hearing disorders. The Society, also known as the Triological Society, presented the citation at its annual conference in West Palm Beach, Florida. Ginsberg received the award for his pioneering research and practice in middle ear microsurgery and cochlear implants, as well as his work in the education of the deaf. + u m n 9 9 4 �Roswell Park Cancer Institute founded as part of UB NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER HAD ITS ROOTS AS A THREE-ROOM LABORATORY AT 24 HIGH STREET he first government-supported get into the business of disease research. cancer research laboratory in the But a year later when the bill was world had its beginnings in three passed a second time, he changed his rooms of the old University of mind and signed it. The state continued Buffalo building at 24 High Street. to support the laboratory until 1903 The laboratory, then known as when another governor, Benjamin B. the ew York State Pathological LaboOdell, faced with a shortage of funds, ratory of the University of Buffalo, had threatened to veto the appropriation. been set up under a grant of $7,500 from the state legislature in 1898. The enabling legislation specified that the money was to provide for "the equipment and maintenance of a laboratory devoted to an investigation into the causes, nature, mortality rate and treatment of cancer." Today, it is Roswell Park Cancer Institute, named for the UB professor who fought for its creation and served as Roswell Park Cancer Institute, circa 1935 its director for its first six years. Again, Butler exerted his considerable Park had come to Buffalo as profesinfluence until the bill was signed. State sor of surgery at the 4 7-year-old unisupport was never in doubt again, though the amount was sometimes in question. versity. One of the first things he noted In two years the laboratory outgrew was the greater incidence of cancer here than in Illinois, where he previously the medical school space. With money publicly raised, land was purchased on practiced and taught. He called the disease "the pathological mystery of the High Street across from The Buffalo ages. " Despite that, the University of General Hospital, and the first building in the world constructed solely for canBuffalo had no funds for cancer research, so Park turned to the state. cerresearch was opened in mid-1901.It He enlisted the support of Edward was named the Gratwick Research Laboratory of the University of Buffalo in H. Butler, editor and publisher of The Buffalo ews, who wielded consider- recognition of Mrs. William Gratwick, who underwrote it with a $25,000 grant. able influence with the legislature. In 1911, Roswell Park, no longer The legislature approved a grant, but Governor FrankS. Black vetoed the director but still actively interested in bill,questioningwhetherthestateshould the laboratory, led a move to have it B u a a p h y s c a A taken over by the state and it became the ew York State Institute for the Study of Malignant Diseases. In 1946, its name was changed to the Roswell Park Memorial Institute, in honor of its founder. During its early UB years, the laboratory had a staff of l 2 - five of them professionals. In 1903, they published five scientific papers. The laboratory maintaineda colonyof3,000 mice and 300 rats for research in spontaneous and transplantable tumors, and studied antibodies in mice recovering from experimental tumors. George ] . A. Clowes, M.D. , a member of the early staff, introduced experimental drugs in the treatment of cancer for the first time in the U.S. Later, working for Eli Lilly & Co., he helped develop methods for the commercial manufacture and use of insulin, for which he received the Banting Medal of the American Diabetes Association. Because of his work, four of his former faculty associates at UB were among the first to get insulin for their patients. Today, Roswell Park Cancer Institute is no longer officially a part of UB, although they are both ew York State public institutions. The institute serves as a teaching arm of the university the RPCI Graduate Division; students rotate through it for experience in treating patients with cancer. It was recently designated a Comprehensive Cancer Center by the ational Cancer Institute. + - BY u MILDRED u m n SANES 9 �Spring Clinical Day and Reunion Weekend held April29 and 30 At left, University at Buffalo president William R. Greiner, and below, John M. Canty, M.D., ' 79, associate professor of medicine, address the gathering. his year's Spring Clinical Day and Reunion Weekend, held April29 and 30, was a resounding success that saw friends and colleagues come together to reminisce and renew friendships. As these photographs of the events attest, a good time was had by all! + At left, this year's Reunion Classes enjoying the festivities. Above, outgoing Medical Alumni Association president Robert Reisman, M.D.,' 56, presents an Alumni Achievement Award to James F. Mohn, M.D., '44, as Jerome P. Kassirer, M.D.' 57, editor of the New England Journal of Medicine, looks on. Other Alumni Achievement Award winners were Andrew A. Gage, M.D., '44; William R. Kinkel, M.D., '54; and Max Schneider, M.D., '49. At right, Paula L. Stillman, M.D., former provost and dean of Eastern Virginia Medical School, speaks to participants at the program. e u a a p h y c a u m 9 9 �Reunion Portraits: Pictures of 55 Years of Success ere, Buffalo Physician presents the 10 classes that were honored at this year's Reunion Weekend, including the Class of 1939, which met informally to celebrate + 55 years of medicine. LEFT TORIGHT- FIRST ROW: Frank T. Riforgiato, Elizabeth Olmsted Ross SECONDROW: Anthony V. Postoloff, Roy E. eibel, George C. Brady, john H. Geckler LEFTTO RIGHT- FIRST ROW: Richard Egan, Paul Weygandt, Sidney chaer,james F. Mohn , Irwin Ginsberg SECOND ROW: Anthony Aquilina, Willard Boardman, Raymond Hudson, Frank H. Long, Jr. , Herman Edelberg, Howard Barnett, Helmut Mueller, Sam Cassara, Newland Fountain, Francis Marchetta, Casimir Pietraczek THIRD ROW: Clinton Strong, Raymond Bondi, Frank T. Frost, james Sullivan, Robert G. Wilkinson, Jr. , Theodore Prentice, William Potts, Thomas Frawley, Andrew A. Gage, Edmund Collins, William Nowill LEFT TO RIGHT- FIRST ROW: Carmelo Armenia, jacqueline Paroski, julia M. Cullen, joseph Bradley Aust, Jr. SECONDROW: Ralph S. Canter, Richard Schwanz, james Werick, George Erickson, Paul T. Buerger,john T. Sharp, Pierce Weinstein, Max Schneider, Harold Bernhard THIRD ROW: Charles Bathrick, Philip C. Dennen B u a 0 p y 5 c 0 A u m 9 9 �I - ~ --~ _-- ········· · · ························· · ···· · ············· ~ • lEFT TO RIGHT- FIRST ROW: Edward Wenzlaff, Charles Marino, Allen Lesswing, Paul Weinmann, Robert M. Oshrin, icholas Carosella, Donald Murray SECOND ROW: jacob Lemann, Jr., Donald Wilson, Byron Genner, William Howard, orbert Kuberka, john L. Conboy, Robert Miller THIRD ROW: Richard Mayer, William Kinkel, Edward Rayhill , Alfred Wolfsohn lEFT TO RIGHT - FIRST ROW: Daniel Kozera, Elton M. Rock, andra Wilt e Leininger, Eli M. Isaacs SECOND ROW: Constantine]. G. Cretekos,johnj. McMahon, William Blaisdell, joseph F. Monte, George Baeumler, Thomas Doeblin, james M. Cole, Richard A. Falls, Daniel Ninburg lEFT TO RIGHT- FIRSTROW: joseph DiPoala, Anthony Ferrari SECOND ROW: james Tibbetts, Jr., David Weinstein, john A. Manzari, Elizabeth Serrage, Michael Goldhamer, Charles LaDoulis, Gerald Goldstein THIRD ROW: George Glowacki, Stephen P. Katz, Irving Sterman,]. Frederick Painton, Jr. , Marvin Z. Kurian , Richard Wolin , Bela F. Ballo, David A. Leff, Michael Feinstein, Lawrence Casazza B u a 0 p h s c a n A u m n 9 4 �~- - LEFT TO RIGHT- FIRST ROW: Dorothea Downey, Penny A. Gardner, Moira J. Burke, Marion Wind-Pisick, David M. Sherer, Evelyn Hirschorn Roisman, Madeline White, Barry Weinstein SECOND ROW: Joel B. Bowers, Robert]. Gibson, Michael Pugliese, Michael Pisick, Hachiro akamura, Robert Hartog, louis Hevizy, Gerald Stinziano, James Cavalieri, Samuel Weissman, Bernard Muscato THIRD ROW: David F. Hayes, Timothy Harrington, Daniel Mandelbaum, Hanley Horwitz, James Patterson, Douglas Roberts, Thomas Scanlon,James White LEFT TO RIGHT- FIRST ROW: Lawrence Oufiero, Diane Matuszak SECOND ROW:James A. Smith, Paul Wierzbieniec, Stephen Yerkovich,John H. Clark, Richard]. Buckley, Jr., James l. Budny, Joseph P. Lemmer, Bruce Middendorf, Bradley T. Truax, Roy E. Seibel,Jr. , Thomas l. Walsh, Edward Valentine LEFTTO RIGHT- FIRST ROW: Peter E. Shields, Sonia L. Wornum, Ivonne Cellino, Robin H. Adair SECOND ROW;John Canry, Donald Armenia, Joh n Corbelli , Arth ur Rosiello, joseph Buran, Jr., Michael Cellino, Charles Francemone, Walter A. Balon, Ramon]. Pabalan, Andrew ]. Majka, John W . Crofts B u a 0 f' h c 0 n u u m n 9 9 4 �··· ·· · ·· ·· ·· ·· · ···· ·· ······· ·· ·· · · ··· ·· ·· ·· · ·· · · ··· · ··· · · ···· ·· · · · · ····· · ··· ·· ······ · ··· • ij LEFT TO RIGHT- FIRST ROW: Benson Zoghlin. Michael McMullen, Andrew LEnTO RIGHT -FIRSTROW: Amy R. Jeffery, KaraM. Kelly, Diane M. Cicatello, Knoll, David Pfalzer, Laurajo Booth, Raymond Chan SECOND ROW: Susan Rodney j. Voisine, Mary Schamann, LoriAnn Fraas-Burns, Richard E. Abbott, Evelyn Hurvitz, MoritzaAlvarado, Amy Schueckler, Mark Billinson Ferguson, Debra M. Omiatek, Carolyn]. Piver, Lee R. Guterman SECOND THIRD ROW: Fitzroy Dawkins,john McLaughlin,julie Dressloch, Mina Ohm, ROW: David R. Bloom , Kristina E. Han, Andrea L. Messina, Douglas Sillart, ora Meaney-Elman, Madeline Lalia, Kevin Rosteing, Paul Greenberg, Pamela D. Reed, Dawn A. Gais, Mark Pundt, Thomas Grimald i THIRD Seth Matarasso, William Healy FOURTH ROW: Thomas Mahl, Douglas Bates, ROW:Kevin M. Senn, Raul Vazquez, Michael Licata, Wayne A. Forde, Leonid Kenton Forte, Marc ]. Kublick,John A. Brach , Herbert Shkolnik, Paul]. Lecat, Eric R. Southard, Henry M. Stachura ewton,John G. Dyster,john Lupiano, Paul Misthos, And rew Tanner, Randall A. Solomon Donate $20 to Ronald McDonald House®and Get a Free Phone* From Cellular One® A vailable to all State, RF, UBF and FSA employees. Special airtime rates $12 Monthly fee and 22¢ per minute. I f you've been wondering if or when you'll buy a cellular phone... here's an offer that'll make you feel good about owning one. The program is called Hear The Call, Help The Children, and here's how it works. Your contribution of at least $20 helps fund Pl iO phone from Cellular One. Simple as that. ow, owning a cellular phone from Cellular One never felt so good. To contribute to the Ronald McDonald House* and get your free cellular phone, visit any Cellular One store or participating dealer or call 861-9680. But hurry, Buffalo's Ronald McDonald though. This offer expires September 30, 1994. '-l.~ff.~;;;;~~o..1J House*, one of 160 facilitie CELLUlAR ONE. around the world, each providing a seriously ill children being treated at local hospitals. At the same time, your donation also gets you a free NEC 861--9680 contact Paula Omicioli Make your check payable to: Ronald McDonald House• • Offer conun,amt upon new acovauon, equtpmmt contract and cm:ltt approval w1th Cellular~ m the aevm-county Westttn Nc.- Yorit area. Cellular c::>nt reserves the rteht to substitute equ1pmem. A one-t~ acovaoon fee apphes. EqUipment conmcu and rate plans vary. Certam temu and c.ondiUON apply. �~ -· · · ······· · · · ··· · ········ ·· ····· · ······· · ··· · ···· · ······ · · ·· ·· ·· · · ······ · ·············· 1181 Eugene Farber '43, focused his career on integrating clinical specialty of dermatology with basic science B UFFALO NATIVE SPENT 37 YEARS AT STANFORD AS A C LI NICIAN , EDUCATOR AND ADMINISTRATOR , AND FOUNDED T HE PSORIASIS R ESEARCH INSTIT UTE uring a guest lecture at the Central Research Institute of Dermatology in Soviet Georgia in 1977, Eugene Farber, M.D., attempted to inject some humor into his presentation by projecting pictures of California, his adopted home. One by one, Farber held up pictures of famous West Coast attractions: Fishermen's Wharf, Chinatown, the giant redwood trees. "My interpreter repeated that the redwood trees are so tall that when Sputnik flew over it almost hit the top of the trees," Farber recalled. " obody laughed." It was probably the only "bomb" dropped in Cold War history. Although Eugene Farber may not ever be recognized for his stage presence, the accomplished physician-researcher can be credited with helping to transform dermatology from a clinical specialty to a discipline with a close integration with basic science. A native of Buffalo, ew York, Farber received a B.A. degree from Oberlin College in 1939, his M.D. degree from the University ofBuffalo in March, 1943, his M.S. degree from the University of Minnesota in 1946 and served his residency at the Mayo Clinic from 1944 to 1948. From 1949 to 1986, Farber served at the Stanford University School of Medicine as a clinician, educator, research investigator and administrator. He completed his career at Stanford as a profesB u a 0 p sor of dermatology and chairman of the department of dermatology, a position he held from 1959 to 1986. It was at Stanford where Farber began to pioneer independent departmental status for dermatology. "In order for dermatology to grow as a specialty, with its own individuality and greater room for development, I believed it was necessary to have equal status with other clinical disciplines," Farber said. This desire for independence can be considered the landmark in the evolution of dermatologic research on both the basic science and applied levels, specifically in the study of psoriasis. Until well into the 20th century, published knowledge of this disease was almost entirely descriptive. From the genesis of his career, Farber linked clinical observations with laboratory studies. "I enjoyed teaching the longer I was in it. My professorship at Stanford included teaching combined with patient care and research. When I visited my patients, I would always have three or four students with me. It was important for them to actually see patients and to get first-hand experience with different maladies," Farber said. "The research part occupied my nights and weekends. I worked at least 60 hours per week during my career, but I enjoyed it." It was his desire for expanded knowledge and increased research that led to the First International Symposium on Psoriasis, held in 1971. Three more were h w " c a n A to follow at five-year intervals. Throughout his career, Farber has lectured in 44 different countries and has received honorary memberships and awards from more than 26 foreign dermatology societies. He is the author of several hundred scientific publications and four books. He recalls that one of his most memorable collaborations was in ewfoundland, British Columbia, where Farber teamed up with Dr. Wayne Gulliver, a professor of dermatology at St. John's University. Farber and Gulliver were investigating a five percent prevalence of psoriasis in a population that was considered to be a closed community. "There was a very low rate of divorce and most of the people living there are married within the community," Farber said. "We had an excellent opportunity to undertake genetic analysis of entire families," Farber said. "Evidence pointed to the sixth and seventeenth chromosomes, which demonstrated linkages in the family studies." Upon his "retirement" from Stanford, Farber co-founded the Psoriasis Research Institute, a non-profit foundation in Palo Alto. Originally established with a skin biology unit specializing in psoriasis, the institute expanded in 1989, adding a clinical-pharmacology division and a psoriasis medical treatment center. Although the main emphasis of the institute's work is research, Farber said that patients receive treatment daily at the facility. u u m n 9 9 4 �---------- - --~----=----=-=--~~~---_--- ···· ··· ··· · ··· ··· · ·· ···· · ······ · ················· · ·· · ·· · ······················ ·· · ·······~ • "We have a large program in Farber also recalled Abraham Aaron, psychoneuroimmunology, a field of M.D. , a professor of gastro-neurological great pertinence to people who have medicine, whose strict style of teaching diseases of the skin," Farber said. "We was respected and admired by the stuare investigating biochemical and im- dents. munological mechanisms which account "We were afraid of him, but his discifor the so-called mind-body relation- pline as a physician was exemplary," ships. Farber added. "Seventy-five percent of psoriasis is In 1993, Farber returned to Buffalo stress-related. We are, therefore, look- to attend his 50th class reunion. "I could ing at the sensory nervous system of the hardly believe how old we had become," skin with particular attention to neu- he quipped. ropeptides," Farber said. Theresearch, he said, is aimed at identifying antagonists to the neuropeptides, the suspected trigger of psoriasis and other skin diseases, in an effort to block their release and prevent the occurrence of the skin condition. The Institute also provides a total care program to individuals suffering from skin disorders. Farber believes it is important for patients and family members to learn about their disease. The total care concept includes access to educational materials and conventional and non-traditional Eugene Farber, M.D. treatment, such as auto-hypnosis, re"I was pleased to know what fine careers my classmates had. When I laxation techniques and diet. "After a period of total care, the need graduated from Buffalo and went to the for aggressive skin treatment is less- Mayo Clinic, I found that what Buffalo ened," Farber said. taught allowed me to compete successThroughout his career Farber has fully with students from the top medical assumedleadershippositionsinnumer- schools in the country," Farber said. ous dermatologic societies and organiLooking back to his early days as a zations. He is past president of the Soci- medical student, Farber observed draety for Investigative Dermatology, the matic changes in the way medicine is Pacific Dermatology Association and the taught today. "Medical school faculties Association of University Professors. He have advanced beyond having their stuis an honorary member of the Buffalo dentssimply memorizeGray'sAnatomy, for example." Chapter of AOA. Farber credits his initial interest in "There is much more practical applidermatology to Earl Osborne, M.D., a cation in the teaching of medicine toUniversity ofBuffaloprofessor, who was day," he said. Yet for all the progress in "dynamic and exciting in his teaching of medicine and medical schools, Farber dermatology." laments the "tough choices" facing the B u a a p h y s c a n " u medical students of today. "Medical students are faced with paying off huge debt. This shortens their career expectations because they can't hang on to specializing. It's just too expensive," Farber said. "The coming government requirements on how many specialists can be permitted to enter any particular field will also affect career choices and the possibly the quality of medical care. "The government wants medical schools to produce more family doctors, but medicine is too complicated today, and we need specialists. You can't be a jackof-all-trades," Farber said. Many UB stude nts and alumni will recognize Farber Hall on the University's South Campus. The building, however, is named after the late Dr. Sydney Farber, the noted dermatologist's brother, who, after graduating from the University of Buffalo, taught at the Harvard University School of Medicine for 4 1 years and founded the Dana Farber Cancer Center. There is a long association between the Farber family and UB.Jason Farber, M.D., was clinical researcher of chest medicine at University of Buffalo, while Marvin Farber, Ph.D., headed the university's philosophy department. Another brother, Seymour Farber, served as vice president for graduate education at the University of California in San Francisco. These days, Eugene Farber has reduced his work schedule to five days a week, devoting more time to leisurely reading and other pursuits. "I will take early retirement when I am 100," Farber said. However, there's no sign of the + good doctor slowing down. - BY u m PETER n SIGURDSON 9 9 4 �~ ·········· · ·· ·· · ·· ·············· · ········ · · ·· ·· · ·· ··· ··· ·· ·············· · ···· · ·· ········ ml 48 UB alumni listed in "Best Doctors in Amertca" orty-eight alumni from the School of Medicine and Biomedical Sciences have been named in the second edition of The Best Doctors in America, a directory of the best in the profession as chosen by their peers. Best Doctors lists 7,200 physicians in more than 50 specialties - approximately 2 percent of the nation's 350,000 practicing physicians. UB has 28 faculty members in the listing, compiled from interviews with thousands o f specialis ts throughout the country who were asked to rate the clinical ability of their peers. UB alumni included in Best Doctors are: Bernard S. Alpert, M.D. , ' 74 , Reco n structive and Microsurgery, San Francisco, Ca.; Kenneth Z. Altshuler, M.D., '52, General Psychiatry/Psychoanalysis, Dallas, Tx.; Joel M. Andres, M.D., '68 , Pediatric Gastroenterology, Gainesville, Fl.; William Balistreri, M.D., '70, Pediatric Gastroenterology, Cincinnati, Oh.; Karl R. Beutner, M.D. , '79, Dermatology/Herpes Virus Infections, Vallejo, Ca.; DavidA. Bloom, M.D., '71 , Pediatric Urology, Ann Arbor , Mi. ; Marlene Bluestein, M.D., '76, Geriatric Medicine, Tucson,Az.; Philip A. Brunell, M.D., '57, Pedatric Infectious Disease, Los Angeles, Ca. ;Joseph Caprioli, M.D., '79, Ophthalmology/Glaucoma, ew Haven, Ct.; Antonino Catanzaro, M.D., '65, Pulmonary and Critical Care Medicine, San Diego, Ca.; Carl I. Cohen, M.D., '71 , Geriatric Psychiatry, Brooklyn , .Y.; David Cohen, M.D., '89, ephrology, ew York, .Y.; Michael B u a 0 p E. Cohen, M.D., '61, Pediatric eurooncology, Buffalo, .Y.; D. ]. Coleman, M.D., '60, OphthalmologyNitreo-Retinal Surgery, Haworth, .]. ; Bruce F. Connell, M.D., '52, Facial Aesthetic Surgery, Santa Ana, Ca.; David R. Dantzker, M.D. , '67, Pulmonary and Critical Care Medicine, Roslyn, .Y. Also, Raymond]. Dattwyler, M.D. , '73, Infectious Diseases/Clinical Immunology, Stony Brook, .Y.; Patricia Duffner, M.D., '72, Pediatric eurooncology, Buffalo, .Y.; Demetrius Ellis, M.D., '73, Pediatric ephrology, Pittsburgh, Pa.; Eugene S. Flamm, M.D., '62, Vascular eurosurgery, Philadelphia, Pa.; John F . Foley, M.D. , ' 55 , Medical Oncology/Hematology, Omaha, e.; Richard R. Gacek, M.D. , '56, Otology/ eurotology, Syracuse, .Y.; Robert E.Jordon, M.D., '65, Dermatology/Cutaneous Immunology, Houston, Tx.; Louis Kavoussi , M.D ., '83 , U rology/ Endourology, Baltimore, Md.; Douglas W . Klotch , M.D. , '71 , Head and eck Surgery, Tampa, Fl. ; Thomas ]. Lawley, M.D., '72, Dermatology/Cutaneous Immunology, Atlanta, Ga.; Richard ]. Lederman, M.D., '66, eurology/Electromyography, Cleveland, Oh.; Stephen R. Marder, M.D., '71 , Psychiatry/Psychopharmacology, Los Angeles, Ca.; James R. Miller, M.D., '79, eurology/ Infectious and Demyelinating Diseases, Skaneateles, .Y. Also, Stan ley L. Olinick, M.D., '40, Psychiatry/Psychoanalysis, Washington, D.C. ; Linda Paradowski, M.D., '80, Pulmonary and Critical Care Medicine, Chapel Hill, .C.; Donald Pinkel, M.D. , '51 , Pediatric Hematology/Oncology, Houston, Tx.;Anthony A. Portale, M.D., '74, Pediatric ephrology, San Fran- h ~ " c a n A cisco, Ca.; Cary Amet Present, M.D. , '66, Medical Oncology/Hematology, Los Angeles, Ca.; Linda Rabinowitz, M.D., '82, Pediatric Dermatology, Milwaukee, Wi.; Robert E. Reisman, M.D., '56, Allergy and Immunology, Williamsville, .Y.; Hugh A. Sampson, M.D. , '75, Allergy and Immunology, Baltimore, Md.; elson B. Schiller, M.D., '66, Cardiology, San Francisco, Ca.; John B. Schlaerth, M .D. , '68, Gynecologic Oncology, Los Angeles, Ca.; Max A. Schneider, M.D., '49, Addiction Medicine, Orange, Ca.; Arthur Skarin, M.D., '61 , Medical Oncology/Hematology , Boston, Ma.; Kenneth Solomon, M.D. , '71 , (deceased), Geriatric Psychiatry, St. Louis, Mo.; Paul Stanger, M.D. , '61 , Pediatric Cardiology, San Francisco, Ca.; Morton A. Stenchever, M.D. , '56, Reproductive Surgery, Seattle, W a.; Robert C. Stern, M .D., '82, Pediatric Pulmonology, Cleveland, Oh.; Virginia P. Sybert, M.D., '74, Pediatric Dermatology, Seattle, Wa.; Stanley]. Szefler, M.D., '75, Allergy and Immunology, Denver, Co. ; and Lawrence W . Way, M.D. , '59, Gastroenterologic Surgery, San Francisco, Ca. + Medical school receives gift to create student scholarship fund he School of Medicine and Biomedical Sciences has received a $508,000 gift from a trust created by Helen Hekimian. The gift will be used to fund scholarships for students demonstrating academic merit and financial need. Helen Hekimian was the daughter of the late W illiam Crosby, a prominent Buffalo businessman active in university affairs earlier in this century. She married Ivan Hekimian, M.D., a 1927 u u m n 9 9 4 �..... .... .. ...... .... .. .. .. .. .... ..... ..... ... ... .. ... ... .... .... . r-------------. NEW OPPORTUNITIES FOR FAMILY PRACTITIONERS Hassanali, who practices dermatologic cosmetic surgery, originally had planned to fly to Sarajevo, Bosnia/ Hercegovina, but was turned back. Instead, his group traveled to Zagreb, visiting the main hospitals and rehabilitation centers that house many refugees and war-injured patients. Hassanali, himself a refugee from Uganda, donated $30,000 worth of medical supplies to the Zagreb hospitals and rehabilitation centers. Hassanali plans to bring one 17-yearold patient to Buffalo for reconstructive surgery. The girl, injured in an explosion in which she lost both parents, suffered severe burns on her face and hands. + graduate of the medical school who founded the local Red Cross Regional Blood Program, taught at the medical school and maintained an active practice in Buffalo. + Time to renew James Platt White Society memberships r, he Jomes Plott While Society - ooiSiinguished leodersh~ orgonizotion bosed on the values ond principo~ of the former deon ond founder of the School of Medicine ond Biomedicol Sciences4 ~ is oleoding suppporter of the school'smission of providing the highest quorlly educofion, reseorch ond ~ lient core. Through its membels' generous, choritoble member· ship pledges, the School of Medicine ond BiomeOICol Sciences confinues its leodel5hip role os one of the premier medico! schoo~ in the counhy-one poised to reoctto the dxJIIenges of heolth core refonn ond the burgeoning technology revolution through the use of innovative educooonol ond orgonizofionol progroms !hot benefit the next generotion of both physicions ond their potients. nyou hoven'tolreody, pleose renew your membership pledge for this yeor.And fyou oren'tolreody omember, but would like to join the medico! school'sprincipol supporting orgonizotion, pleose coli Michoel E. Benzin, Director of the Annuol Appeol, ot (716) 64 5-3312. + ynette ieman, M.D., ' 78, has been appointed clinical director of the ational Institute of Child Health and Human Development. She has served as deputy clinical director of the agency since 1990, and more recently as acting clinical director. Board certified in internal medicine , endocrinology and metabolism, Nieman has served on the institute's IRB since 1988 and on a number of clinical center committees focused on issues of patient care. She has been an invited speaker at many symposia and grand rounds , and has offered testimony concerning RU 486 to Congress on a number of occasions. Nieman's research has focused on attempts to improve diagnostic precision in Cushing's syndrome , the evaluation ofluteal function and the uses of antiprogestins in the reproductive cycle. + iyaz Hassanali, M.D., '86, recently returned from a humanitarian mission to Zagreb, Croatia, he coordinated to bring medical supplies and drugs to refugees of the war in Bosnia. u 0 0 p h W e provide everything you need to build a successful practice, as well as an enriching work environment. Salary is highly competitive. Benefits include retirement plan , license fees, health and malpractice insurance, ample vacation and CME time, and research opportunities. Area is eligible for loan forgiveness programs. Call coverage is very good and is managed effectively. Managed care programs are already in place. Lynette Nieman '78,appointed clinical director of NICHD ftiyazHassanali '86,spearbeads humanitarian mission to Zagreb B BEIBC family practitioners needed to staff new family care sites to be opened by ECMC and SUNY at Buffalo Department of Family Medicine. y 5 c o n A u Responsibilities include clinical work and teaching of residents and medical students. Administrative duties are flexible. Physicians must be willing to perform obstetrics. (With in-house OB back-up.) Please contact Rebecca Brierley, Family Medicine Recruitment Coordinator, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, (7 16) 898-4797, fax (716) 898-4750. ERIE COUNTY ~fMEDICAL CENTER • u m n . A 9 9 " �A Spoon f u I MUSINGS ON THE WAY TO of © Humor L.A . finally bought myself a new car. First time! I had always avoided it for fear of having to bargain with the salespeople. But first, of course, you have to deal with the receptionist. I called and said, ''I'm looking for Michael," and she asked, "Is that a two-door or a four-door?" The salespeople always want to know your last name, so they can repeat it over and over to lure you into a feeling of false security. When I was looking I always told them my last name was" o Sale Today." "Will you be buying the car today, Mr. o Sale Today?" " o! And that's Dr. o Sale Today." That's not true. I would never tell these guys I'm a doctor. Then they'd see me as a six-foot chicken on a rotisserie. I decided to take a trip down to L.A. to break the car in and visit a friend . I had a lot of time during the drive to think about things, not the least of which were the present inhabitants of the White House - two lawyers. I liked it better when we had an actor, a diet pill addict and Frank Sinatra doing naked pushups in the Lincoln Bedroom. At least you knew what you were dealing with and they entertained you all the time. As I got closer to L.A. (you can always tell from the lovely red haze in the air) I called ahead to let my friend know that I would be there in a half hour. I was only two miles away, but this was L.A. B u a 0 p Great times we live in- to be able to make calls from the highway - and I'm thinking, "Wow! I'vegotacellularphone in the car," which means I no longer have to stop at a gas station to make phone calls. ow if they could come up with a cellular toilet, that would be great. Cellular phones are still somewhat affordable - especially if you only use them on weekends. I try to avoid the "airphones," though. On a recent flight they announced a contest: make a call on the airphone using your credit card, and you have a chance to win $50,000 -or spend $50,000 if you stay on more than 10 minutes. Before arriving at my friend's house I decided to pick up a bottle of wine. I handed the clerk a 20 bill and he placed it under the drawer. I thought, "Why do they place the $20 under the drawer?" That's the first place a hold-up artist is going to look ... unless he's stupid. What are we dealing with here - remedial criminals? "Gee, all I see are ones and pennies . . . where could the big bills possibly be?" h ~ 5 c a n A u u m n 9 9 4 �Stu S i Ivers t e in , M.D . I also glanced through People magaThat day, the headline of the newspaper (well not the newspaper - USA zine. They had a quiz titled "Are you a Today) said that Congress was hoping genius?" You can pretty much be sure to pass a bill that would ban all assault that if you're reading People magazine weapons. I thought, "well let's see, we've and taking that test - you're not ... got Uzis, AK 4 7s, HMOs and grenades." although I did score pretty high. When l finally got to LA. , one of the Kaiser Permanente is big in Sou them first things my friend and his wife asked California. I believe one-third of the me was how to choose the right doctor. insured population there is with Kaiser. This, in fact, is the model the govern- With the new government health plan ment is following. In order to keep pace looming on the horizon, many people, I heard that Kaiser is thinking of install- including your friends and relatives, ing an outpatient drive-thru window. will be asking you for the same advice. Having recently faced this many times First in the country, in fact. myself, I never know what to say, but do offer to tell people how not to choose the "wrong" doctor. I've even prepared a little handout. Feel free to copy it and do the same. Tips on Choosing Your Doctor • Do not choose a doctor whose office is on a Greyhound bus. • It is probably not a good sign if for every prescription of Prozac your docThe sports page announced that tor writes, he gets 100 frequent flyer Darryl Strawberry signed with the Gimiles. ants. Yeah, I suppose if he gets in shape • If he says, "OK, up on the table and he can lead the league in free-basing. take off my clothes." Stay away! !! And for you real couch potatoes who • Watch out if he keeps referring to his can't program a VCR, now there's a new stethoscope as Hector. device that allows you to command • Ladies, it is not good if there is a sign your VCR. You just lie there on the on the wall that reads, " o Shoes. No couch and say, "Tape Seinfeld. Channel Shirt. No Cervix." 4. 8:30." and it will do it for you. The • Be careful if the fish tank in the waitdeluxe version has an additional feature ing room is labeled "Exhibit A." that lets you say the words, "I have no • Most importantly, leave his office life," and it lifts your skull off and sucks immediately if he asks you to turn your out your brain and you become a huhead and pull his finger. + man futon. And apparently Bill Clinton cel- Stu Silverstein, M.D., president of Stondup Medicine Seminofl ci Son fmncisco, ebrated his SOOth day in office by gain- Colifomio, ledures notioowide on hun101 in med"Kine. He recently published his first book, What About Me?, about growing up with a developmentnDy ing his SOOth pound . tfiSObled sibling, c~H~Uthored with BfYTKI Siegel, Ph.D. B u a 0 p h y 5 c a n A u u m n 9 9 4 �• •• • • • • • • • • • • •• • • • • • •• • The Perfect AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION I Prescription For Your Conference Needs Insuring care for those who care 1 9 4 s 0 Subscriber Owned • Organized • Governed teaches diabetic management in Beijing and anjing, Ch ina for two months each year. He is in private practice in South Carolina. EDWARD M . TRACY '43, GEORGE THORNGATE PHYSICIANS • DENTISTS HEALTH PROFESSIONALS NURSES • RESIDENTS IV, '44, of Pebble Beach, California , writes, "During the trimester break in June 1944, there was a significant number of my classma tes wh o became wedding bound. This was especially true for those of us in the Navy Y-12 program. ine months later our daughter was the first offspring, we think, to be born to the class. With our five daughters, eight Superior policies for academic full-time and voluntary clinical faculty ~ Competitive premiums 0 . LOESER Conference Planning Professionals 'i' Convenient Downtown Location Dividend opportunities 'i' Quick Metro R ide to Main Street Campus and Medical School 'i' Close to Buffalo G eneral, Roswell, ECMC and Children's Hospitals 'i' Y our Guests Can W alk to Theatre, Shops, Pilot Field, Restaurants, Entertainment Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. ' 45 , 'i' CME Friendly 'i' Great Banquet Food Please Talk To Us AbDUt Preparing A Proposal So YDU Can Bring YDUr GrDUp's Next Convention To Buffalo Enrollment open at all times. Tran fers arranged \vithout loss. (71 6) 856-1234 EXTENSION 6142 ACADEMIC HEALTH PROFESSIONALS INsURANCE AssociATION has been elected president of the William A. Little Obstetrical and Gynecological ociety, the association of faculty and alumni of the Department of OB-GYN at the University of Miami(Jackson Memorial Medical Center. It is of a 'i' Complete legal service ~ RAPHAEL 5 . GOOD '48, u of Meeting Space ~ ~ writes, "Five years after closing my private practice, I am again retiring, this time as medical director of a preferred provider organization. Our plans are to spend more time with children and grandchildren, distributed on the east and west coasts, but Youngstown, ew York remains our home." B 18,000 Square F eet Comprehensive coverage grandchildren and one greatgrandchild, Helen (Tweet) and I are looking forward to celebrating our Golden Wedding Anniversary, both of us in good health. We hope the other newlyweds of June 1944 will celebrate their anniversary with joy also." WILLIAM ~ Rewarding educational programs HYATT. WE'VE THOUGHT OF EVERYTHING~ Empire State Building 350 Fifth Avenue, Suite #1512 ew York, ew York 10118 Ph. 212-947-4541 Fax 212-947-4572 0 p h ~ 5 c o n A u u m n 9 9 4 �······· ·· ·· · · · · · ······· · · · · ··· · ·· ·· · ···· ··· · · ·· ····· ···· · ··· · · · ·· · ·· · · · ··· ·· · · ·· ·· · · ·· · · · · · ~- -~- ' particular note that Dr. Good is a past president of the South He is a fellow of the American Florida Psychiatric Society. president of the Georgia Psychi- I Psychiatric Association and past atric Physicians Association. Dr. 9 5 0 '51 , Haberman is clinical associate professor of psychiatry at Emory received the degree of Doctor of Science, Honoris Causa on May and Morehouse University 1 EDWARD SHANBROM 5 University School of Medicine School of Medicine. 22, 1994, from Allegheny College. Dr. Shanbrom has published over 100 scientific articles D IANE and is the author or co-author of over 20 patents. In the 1960s he collaborated with Dr. Kenneth Brinkhous to establish a technique that allowed concentration and purification of factor VIII. Besides funding scientific endeavors, Dr. Shanbrom and his wife, Helen, have also been supporters of the arts and education in their Orange County, California community. HILLIARD JASON ' 58 , has hosted, co-written, and produced more than 50 educational videos in the field of medical education for national distribution. Springer Publishing Company has recently released a new book written by Dr. Jason and his wife (Jane Westberg, Ph.D.) titled: Teaching Creatively with Video: Fostering Reflection, Communication and Other Clinical Skills. Both this new book and a prior book, Collaborative Clinical Education: The Foundation of Eff ective Health Care, are part of the Springer Series on Medical Education. is now retired, after practicing general surgery in ew Mexico since deputy director, Community Health Surveillance within the Maryland Department of Health and Mental Hygiene. Earned my MPH at Johns Hopkins University School of Hygiene and Public Health and am board certified in general preventive medi- Hilt.ard Jason '58 1971. Dr. Wilbee was recently appointed to membership on the State Board of Medical Examiners. He is a former president of the State Medical Society and past president of the ew Mexico chapter of the American College of Surgeons. 1 9 JOHN 6 0 JOHN C . S T UBENBORD '75, has been practicing internal medicine and family medicine in East Aurora for 10 years. He 5 was appointed a fellow of the Royal Society of Medicine, London, in July 1992. He has three boys, Derek, 6, jess, 3 and Wesley, l. SHIELDS '68, of ew York, is medical E. Delphi, director of Bassett Health Care of Stamford-Delhi. Dr. Shields is a member of the American College of Physician Executives. 1 7 9 0 5 GEORGE Y . LOHMANN , JR. '72 , is listed in Compton- Connally Guide to Best Doctors in ew York Metro Area, Who's Who in the East, Science and Engineering and World, Business and Finance. His daughter, orelle Christa Victoria, was born October 15, 1991. u a 0 MICHAE L A . HABERMAN 73, u 5 c a 9 8 0 5 ROBERT J . BRACO '80, of Springfield, Missouri, has joined the Springfield Clinic to do in- PAB LO RODR I G UEZ ' 81 , writes, "I have been awarded the 'Community Service Award' by the AMA young physician section for my work with the Minority Health Advisory Committee to the Rhode Island Department of Health. I have two boys, ages 3 and 5; my wife and I have become avid windsurfers." University and is practicing with term. His 7-year-old son, Keith, Kaiser in Fontana, California. She won first place in the National Radiant Peace Foundation's essay contest for the Midwest region. Besides a cash award, his is an associate GI fellowship director and assistant clinical professor of medicine at Lorna linda University. She and her husband, essay will be considered for publication in a book about children and their contribution to world peace. Chiayu Chen, have a daughter, Katherine, born January 17, 1993. Medical Association of Atlanta. h 1 RONALD A . V IDAL 77, was elected president of the medical staff of Samaritan Health System of Clinton, Iowa, for the '94-'95 was installed as president of the p Ronald A. Vidal '77 dustrial consulting. cine and public health." ROBERT H . WILBEE '59, B L. MAT USZAK '74 , writes, "Recently appointed n u u m PAT RICIA HSIA '85, completed a GI fellowship at Georgetown NIC HOLAS D 'A V ANZ O '86, is practicing pediatrics in a [ourman group in Raleigh, orth n 9 9 4 �• . .. .. . ... . ... . .......................... . ....... . ... .. .... I Peggy Morey Stager '88, was married October 30th to Richard Stager. Carolina. He and his wife have two children, Stephen icholas, 10 months and a 3 V2-year-old daughter. 1 9 9 s 0 FAITH F R ANK E L '91 , completed apediatric residency at Georgetown University Hospital and is now in private practice in Virgm ta. She and her husband, Douglas '88, was married October 30th to Richard Stager. Friends PEGGY MOREY STAGER Power Mac 7100 includes: • 15" Color Monitor • ClarisWorks • CD ROM Bonus: Microsoft Bookshelf Frankel, M.D., have a 1-year-old son, Maxwell Shane Frankel. from near and far joined the special celebration at the Buffalo Hyatt Regency. Mary Davitt and Mitch Tublin arrived from Pittsburgh, Nancy Lisch cruised in from Cleveland, and Cindy and Tom Bellomo road tripped from Milwaukee. The local attendees included Lori and Frank Luzi, Lisa Benson and Lee Guterman ('89) and Helen and Andy Cappucino. A fantastic time was had by all! The newlyweds reside in Cleveland Heights, Ohio. Peggy is an adolescent medicine attending at MetroHealth Medical Center. C Y N T H I A 66 MHz, PowerPC 601 RISC-based processor, 8MB RAM, 250MB hard drive. Macintosh Color 15" display, AppleDesign keyboard, built-in Ethernet, at:ive ClarisWorks 2.1, and the Apple Student Resoun:e Set which includes: The Macintosh Writing Companion; Student Assist; The Internet; Microsoft Bookshelf; The Voyager Offer (a coupon offer to pun:hase interactive CD ROM discs for just $9.95 (normally sold for $24.95 to $79.95)). ( LEBER MAN ) JENSON ' 92 , writes, "Curren tly co mple ting fi rst year of anesthesiology residency at the University of Pittsburgh . Mark and I are celebrating our one year anniversary, May 15, 1994." MI.L. $2358 • 15" Color Monitor • Pentium Upgradeable THOMA S GRIMAL DI '89, writes, ''I'm com- OBITUARIES pleting urology training at the University of Michigan and plan on joining the UB Urology faculty at the Buffalo VA Medical Center. My 1-year-old daughter, Sarah, and I are coping with the death of my wife, Ester Ponce Grimaldi '89. Thank you classmates for all the support. Ester died suddenly in an automobile accident injanuary 1994. A medical school graduation award is being established in her name, to recognize a compassionate and positive approach to clinical medicine." 8 u a 0 66 MHz 486DX processor, 8MB RAM, 340MB hard drive, SVGA 15" color monitor, 3.5" floppy drive, full size keyboard, DELL System mouse, DOS 6.2 . Windows 3.1, and 1 year next business day on-site service. died on March 23, 1994, in Buffalo. Before retiring in 1985, he practiced internal medicine and was associated with Millard Fillmore Hospital. After retiring, he and his wife, Lois, spent winters in Florida, where he enjoyed fishing and golfing. RUSSELLS. K I DDER '41 , KENNET H SOLOMON '7 1 , • Apple • IBM • Dell • Compaq • Panasonic • Hewlett Packard • TI • Sony • Software • Supplies • Accessories • Audio • Hands-on Workshops died unex- pectedly last spring. p h " c a n A u u m n 9 9 4 �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 ADDRESS CORRECTI O N REQUESTED 1773 EALTH SCIE CES SE LS DEPT ABBOTT HALL CAMPUS IL 4 The only liability coverage with this seal of approvaL Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the phy icianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the large t risk management department of any ew York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 tO 1993 Medical Liability Mutual Insurance Company --Oo<- M--Oo< ��\ \ �/ / I ~ach I I / I I I I / year, the University at Buffalo School of Medicine and Biomedical Sciences ad, mits 135 new students. I Over the next four years, I I I I I 1 I 1 I they will learn both the art and science of medicine as they realize their calling and form lasting relationships that will enrich their lives. J I I Here, Buffalo Physician pre, I I I I I \ I \ sents the Class of 1998 and wishes them well on this, the beginning of their four,year journey to become physicians. \ \ \ \ \ \ \ �nHOOl Of MfOI[INf ANO ~IOUfOI[Al ~WNtf~ KRISTEN ANDRESON C 'rnelllJnt\·erslt\ Ammal Sczences LUNA BAilEY LESliE BARR Duke Uniwrsity L:nn·ersity 1t Bufralo Bzology/Chemmry Psychology Bwlo~· LORI BOWMAN SU. 'r J.t Geneseo RICHARD BREMER Clarkson UniversitY Bwlogy BwloJf.i YVONNE BOBEK Cornell Uni\·ersit~ • · · · ·· · · · · · ·· ·· · · · · · · · ·· · · · · ·· · · ERIC BONENBERGER orth Carolma State University Bzology :oology STEPHEN BEKANICH ,j Scranton Lnn·Lrsit~ ~' / ll'·:·. · ···' ,\- "'• JENNIFER BUlGER lJ I at Fred, ma Biology ROBERT BURNS TERRI CAliGIURI EMilY CAlKINS Gannon Umver>~t\ Gannon lJmveut~ UniversitY at Buffalo Biology Biology Anthropology APRil CAMPBEll JOHN CARTER CAROl CHEN Princeton Lmversity SU Y at Plattsburgh Johns Hopkim University CONNIE CHEN Cooper Union History Biology Biology Elecmcal Engmeering 3 �BONNIE CHENG ew York Universtty PETER COBB Davidson College SETH COHEN Yeshiva Umversity JEANINE COOLEY Umversity at Buffalo Biology Biology Biology Health Sc1ences PAM CROWELL Mercyhurst College Sports Med1cme MICHAEL CUMMINGS Cornell Umversity GUL DADLANI Umversity at Buffalo JONATHAN DANIELS University at Buffalo Nurririon Biology Psychology CHRIS DEAKIN Umversity at Buffalo MARYANN DEAN West Liberty State College BARBARA DEGUISEPPE Saint Francis College CLAUOIA DEYOUNG Northeastern University Busmess Art/Psychology Biology Mechanical Engineering = = = = ' PAMELA DIAMANTIS New York Umversity STACEY DIMARTINO Universit} of Rochetser VAMIL DIVAN University of Pennsylvania JANE DOPKINS Harvard-Radel iffe Policies Bwlogy Health Care Management and Policy Women's Studies 4 �HHOOl Of MfOI~INl ANO ~IOMfOI~Al ~WUf~ • · · · · ·· · · · · · · ·· ·· · · · ·· · · ·· · · · ·· · lYNN DUNHAM CRYSTAL DYER JASON EHRLICH ANDREW ESCH Colgate University CUNY City College Umvemty at Buffalo Universitv at Buffalo Bwlogy History Busmess Admmistranon eurosCience JOHN FANTON TODD FEHNIGER CHARLES FETTERMAN MELISSA GARDNER SU Y at Binghamton Uni,·ers1ty at Buffalo Cams1us College Hartwick College Philosophy and Bwlogy Bwlogy Biology Psychology RICHARD GAYlE JENNIFER GEORGE THOMAS GERGEL ROBERT GERSTENBLUTH Cams1us College Fordham Univer ity University at Buffalo Biology Chemistry Biology U Y at Binghamton Bwlogy YOUSSEF GHAL Y HARI GOPAL CHRISTINE GORDON LISA GREEN CU Y Queens College Cornell Umvemty CUNY Lehman UniverSlty of Rochester Bwlogy B1ology Anthropology Cell and Developmental Biology 5 �AlEJANDRO GRUNEIRD L verstt) at Butt:.tlo Btochenust') BRYAN HANYPSIAK LniH:rsi \ MICHAEl HASSETT 01 cr •. :1 C. I qe Bwlogy Flu t o Bwlogy liSA HEICHBERGER U. Y ~t Fred mia Bwlogy/Medtcal Technolog) = = = MICHAEl HERBDWY AARON HOFFMAN Umn:rsny at Buttalo lJni• n College Bwlogtcal Sc~ences Hi.I!OT) = STEVEN HORN UNY 1t Bin,!h~mton Bwlogy ARIEl HOTCHKISS Weslq: n lJnin:rslt\ Psycholoif.i CAlOGERO IPPOliTO PETER JANES THERESA JARMUZ LAWRENCE KANNER ( m1 IUs College SL. ·y ·n Genesco Bost<•n Lmtversit) Bwloi(}/Ps..,cholo!;} Bwchemistn Psychology Han .1rJ universtty Bwlog)' SANJIV KA YASTHA JUDY KIM Ydie Univcrsit) Bwlogy PAUlA KOCIAlSKI LORI KWAN Camstus (., lkgt Lniverstty at BuHalo Biolo10 Btology· c •rnell untn:rsttv A>tan Sttultes 6 �HHOOl Of UfOit!Nf ANO ~IOUfOitAl HlfHf~ • · ·· · · · · · · ·· ··· ·· · · ·· ·· · · · · ·· · ·· • ~JENNIFER lEE DAVID liN NEIL LIPKE CornelllJmn:rslty Cornell Lmvemty Umverstty at Bufhlo Cell Bwlog-y Bwlog) Spwal Studtes PATRICK MAHAR 't Bonaventure lJmvcrsity Bwlug-y TOM MALINICH MICHELLE MANG Bucknell University H·umlton College Mechamcal E"'lgtnee-rmg Bwlug)" AMY MCGARRY H, h Cwss Rus>tan JOSE MACEOA U1 tversi\ RuL 'lLskr Bwlug> JEFFREY MARCHANT lJn H:TSI •t Bu(fal l Health Sctences \ ) 7 J MICHAEl MARKAM PENELOPE MARTIN SlJ"JY at Plattsburgh Untvcrstty ot Rochester Ps,-cholog-y • euroscience THOMAS MCTERNAN Buth<L :->t· L C liege Bwlog-y SUMIT MEHTA GEORGE MOYNIHAN BENNETT MYERS BRETTON NEWMAN ) ale l.Jni\·ermv Ltberal Studtes \ illanova University Economtcs Cornell UntnNt\ Colgate University BwlogJ 7 J eurosLrence �= = = = MARK 0BERLIES JENNY OH lYlE OSTROW TAMERA PACZOS Univers1ty or Notre Dame Tufts University Johns Hopkms Umverstty University at Buffalo Business Administranon Psychology Biology Physical Anthropology PRASHANT PARASHURAMA Cornell Umvers1ty Phys1cs VIRESH PATEl Umvers1ty at Buffalo NICOlE PAZZAGLINI Umvemty at Buffalo Anthropology Johns Hopkms Un1versity Chemical Engineering ACHINI PERERA Biology ClAYTON POlOWY COLIN POWERS JOSEPH REBHAN JAMES REUTHER M1am1 Univer-ity of Ohw Cams1u College SU Y at Plattsburgh M1ch1gan State Biology Biology Biochemistry Physwlogy/ Anthropology ANNE MARIE REYNOlDS t. Lawrence University Biology ANTHONY RICE JEFFREY RICHMAN MARK RICHMAN Cams1us College Worcester Polytechmc Institute Wesleyan Umverstty Bwchem1stry Biology Chemistry B �~~H~~l ~f Ml~I~IU AN~ ~I~Ml~I~Al nllNtl~ • · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · JAYSON ROLAND Queen's University ZULMA ROSADO UniYersity at Buffalo Boston Umverstty Life Sctences Biology Biomedical Engineering JENNIFER SCAROZZA Canisius College Biochemistry CHRISTOPHER SCHAEFFER Harvard Umversity Psychology University at Buffalo ANGELA SCHOEP St. Olaf College Psychology Bwlogy MARY SCOTT Miami University ofOhw Mtchtgan tate Univer ity JOEL SEBASTIEN D'Youville College CARL SEON Umverslty of Mtchtgan Zoology Physiology Biology Classical Archeology DAVID SERRA University at Buffalo MACDUFF SHEEHY Brown Umverstty Umversity of Rochester ANAND SINGH Lehigh University Psychology Aquanc Biology Biology Biology MATTHEW SCOZZARO FRANK SALAMONE MICHAEL SCHARF DAWN SIMON NEHA SANGWAN Michigan State Untverslty Engmeenng �KENNETH SNYDER Cath iL L n vt s1tv , AmcnL B10med1cal Engrnemr. > JOSEPH STOWEll lt Bin {h ,unton Biology SGN! = J. WILLIAM SPARKS .3nl.! Bwlogy Un;ver It\ ut \L SUNIL SRIVASTAVA HANS STELMACH C rrell Ln \t:Nty k.t:ub College Economics Pswhology SOPHIA STREETE GARIN TOMASZEWSKI HANNAH lOON Bufr.1lo '>tate College Unt\'f.Tstt\ at Buftalo Rochestu Institute of Techno log~ Bwlogy Chemmn and Anthropology Btology THOMAS TREVETT CHRISTOPHER TROJAN DORIS VANDERPOOL ANTHONY VILLANI 11, >lv Cn"' C ollc,;e Cnrndl Umverstt\ U'1tverstt' at Butfalo How 1rd University BwloRY Bwchemtstry Health and Human Sciences Btology MICHELE WATSON New Y )Tk Universtty Psychology JEFFREY VISCO KEITH VOLMAR ANDREW WAGNER C ·ndl Untverslt~ Bwlogy lth, c.1 C liege Bostun University Phystcs Biomedtcal Engmeenn~; 10 �~[~OOl Of M!OI[IU UO ~IOM!OitAl ni!H!~ • · 0 0 • • • • • • • • • • • • • • • • • • • • • • t;.{ •.· ·-_ .:~---~ ~---/_ ? ~~-:-:_...:, .·:' . ·, . . ' ......, • r . ' . COllEEN WEBER L nin~r,lt\· '. Rc•Lhestu MARK WEIRICH lmn:r'lt\ c ~I d En~;h.lh/Bwlogy 1\ lrcrtJhwlog:y TAHSINA YASMIN liNDA VAN Y.1le LmvcrsltV Bwlogy m L 111 St John ' L GORDON WINGARD er,,t~ 't R(lLhL 't.:r (ell Bwlog) DANIEl YAWMAN 11\ erslt~ Ln1ver'lt\ Jl ,)tre Oame Hiswn/Prc-~1t?d Bl(,/( .If\ MICHAEl ZIONTS C.uneglv:-..1ell< •n L 111Hrs1ty \kchamcal Engmeenn~ Photographs by S tmon Tong OttJCe of Publ1cau n-., Dln~H.> n of Uni\er Augu•t 1994 C 1037 94 lt'l Sen ICC!l>. . '.·-~'., -.- MEl Yo WONG (_ Pr'1ell L ntYLr,ity Biology lY ZENG Buftalo Broluf!:'IPs)cholol:) Unl\-er>~tv lt 0 0 • • • • �� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1994 Subject The topic of the resource State University of New York at Buffalo. 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Research Hospital News Practice Makes Perfect Equal Time Medical School Then and Now Alumni A Spoonful of Humor Classnotes Class of 1998 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Autumn 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n04 Extent The size or duration of the resource. 56 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB_HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/2ebb0c0f48bdf05c396319ecd4f13792.pdf 1343078c3383bbf7f71de62773f2f9c7 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1995 �BUFFALO PHYSICIAN Volume 29, Number 3 STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john a ugh ton, Vice President for Clinical AffalfS, Dean ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Smtth Petro DIRECTOR OF PUBLICATIONS Timothy j. Conroy EDITOR Nanette Tramont, R. ART DIRECTOR Alan j. Kegler ASSOCIATE ART DIRECTOR DaVId j. Riley PUBLICATIONS MANAGER Dear Alumni and Friends, T his issue of Buffalo Physician highlights selected efforts in the national and international arena of volunteerism in which many faculty and students engage. You are probably already aware that foreign exchanges designed to enhance research and educational endeavors have long been a tradition for the school's faculty. Humanitarian efforts toward aiding the citizens of the global community take that tradition one step further. As the world becomes "smaller," it is even more important for UB's faculty to develop meaningful relationships that serve to enhance humanitarian efforts throughout the world. UB obviously offers a fine environment in which to train physicians and scientists from here and abroad, and its faculty and students have endeavored to "give back"- both to their local and global communities - a measure of what they have received. In all the exchanges, both the giver and the rec1pient benefit. We have many examples of successful exchanges in Europe and Asia, as well as in our own community. lam sure these will continue in the years ahead and that more will be added as national and international collaborations increase, and more physicians become aware of the needs for such humanitarian efforts. Sincerely, judson Mead PRODUCTION MANAGER Ann Raszmann Bro\vn EDITORIAL BOARD Dr. john A. Rtchert, Chairman Dr. Marttn Brecher Dr. Harold Brody Dr. Rtchard L Collins john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Mr. Ravi Desai Dr. Alanj. Drinnan Dr. james Kanskt Dr. Elizabeth Olmsted Dr. Barbara MaJeront Dr. Charles Paganelli Dr. Margaret W. Paroski Dr. Thomas Raab Dr. Robert E. ReiSman Dr. Stephen Spauldmg Dr. Bradley T. Truax TEACHING HOSPITALS AND LIAISONS The Buffalo General llospttal \fichael Shaw Buffalo VA Medical Center Arlene Kelly The Chtldren's Hospttal of Buffalo [ne County Medtcal Center Mercy Hospttal Mtllard Fillmore Hospttals Franll Sa\·a Roswell Park Cancer lnstttute Sisters of Charity llospttal Demus McCar·thy ©The State Umvcrstty of New York at Buffalo Bufftdo Physician is publtshed quarterly by the State University of 'lew York at Buffalo School of Medicme and BIOmedical Sctences and the Office of PublicatiOns. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edtt all copy and submiSSIOns accepted for publication. Address questions, comments and submiSsions to: Editor, Buffalo Phystcian, State University of New York at Buffalo, UniverSity Publications, 136 CroftS Hall, Buffalo, cw York 14260 Send address changes to: Buffalo PltysiCian, 147 CFS Addttion, 3435 Matn Street, Buffalo, New York 14214 Dear Fellow Alumni, T hank you for the opportunity to serve as President of your Medical Alumni Board of Directors. My predecessor, Dr. Russell Bessette, did an outstanding job and will be a tough act to follow. This coming year, 1996, will mark the Sesquicentennial Anniversary of the medical school. Celebration of this event has already begun, with the conferral of an honorary degree to Dr. Gregory Thorn, one of our most distinguished alumni, at the medical school commencement this year. We will also be publishing an updated Medical Alumni Directory, which will include a brief history of our medical school. We hope you will take advantage of this directory to keep in touch with o ld friends. Plans for the 1996 Spring Clinical Day are already under way. Dr. Beth Maher is planning a promising program addressing issues on death and dying. The Alumni Association will continue to sponsor a wid e range of activities for the medical students, including the Community Physician Program, the Senior Reception and orientation events. This past year we donated funds to furnish the medical student lounge. We look forward to a busy and enjoyable year, and hope we can count on your support. We're always looking for new ways to serve our alumni and welcome your suggestions. Sincerely, Margaret W. Paroski , M.D. '80 �8 v 0 5 u 2 L . M M E 9 . o . N 9 R AUG 3 3 9 5 1 95 Research Hospital News Partial liquid ventilation. Page 12. Giving Back e UB's doctors volunteer their skills and themselves to communities throughout the world - including their own. m Breathing Life Through Liquid e The new technique of partial liquid ventilation developed at UB has the potential to revolutionize the treatment of respiratory failure. Medical School Then and Now , Alumni ASpoonful of Humor Classnotes * l~e ~lass of 1~~~. ra~e ~l Robert L. Brown, M.D. '44, dies after brief illness. Page 23. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 / ' ' / . Study shows no increased breast cancer-electric blanket use risk re-menopausal women who sleep under electric blankets do not significantly increase their risk of developing breast cancer, a study conducted by UB researchers has shown. The research is a follow-up to an earlier UB study involving post-menopausal women that also found no increased risk of breast cancer as a result of electric blanket use. It was published in the December 1994 issue of the American journal of Epidemiology. In the current study, a team of researchers led by john Vena, Ph.D., professor of social and preventive medicine, investigated a possible breast cancer-electric blanket association by comparing electric blanket use in 290 premenopausal women who were newly diagnosed with breast cancer with a control group of 289 age-matched women without cancer. Results showed that among those who used electric blankets the most, the percentage of women with cancer and without was identical. In both groups, 8.3 percent said they had used a blanket daily in season and continuously throughout the night for the previous 10 years. "The bottom line," Vena said, "is if there is an effect, it is likely a weak one. Some researchers now think that the pineal-melatonin mechanism [one of the mechanisms suspected to increase breast cancer risk] may only operate for certain types of cancer tumors- those that are estrogen-receptor positive. The next phase in our research will be to look at electric blanket use and certain types of breast cancer." Also participating in the study werejo L. Freudenheim, Ph.D.; james R. Marshall, Ph.D.; Rosemary Laughlin, Ph.D.; Mya Swanson; and Saxon Graham, Ph.D., all of the department of social and preventive medicine. + B u a a p weren't recommending the back position despite the AAP recommendation. Parents were getting conflicting advice from nurses and doctors." Hudak designed the study to determine how physicians feltabout the issue and how their attitudes influenced what they told parents. The AAP recommends the tummy-up or side position. Reasons given most often for having reservations about the recommendation were the lack of published data on the connection between sleep position and SIDS in the U.S., and past experience. Also menUB study has shown that physi- tioned often was the possibility of aspiracians are reluctant to follow the tion after gastroesophageal reflux. + recommendation of the American Academy ofPediatrics and tell parents to put newborn babies on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome. The recommendation, promulgated by the Academy in 1992, broke with University at Buffalo study- the what had been tradition since the 1930s first ever to assess the use of and abandoned the practice of placing assistive devices by elderly perinfants on their stomachs after studies sons with Alzheimer's disease and from Europe, Australia and ew Zealand other cognitive impairments- has showed a significant decline in SIDS found most existing devices for after physicians there urged parents to patients with dementia aren't designed put their infants to bed on their backs or to remain useful as mental health detesides. riorates. The UB study, reported in the january Results of the study, conducted by 1995 issue of Pediatrics, involved 121 researchers in UB's Rehabilitation Engiprimary care physicians. Only 24.4 per- neering Research Center on Aging, cent of them said they strongly agreed showed that elderly persons with cogniwith the AAP recommendation and only tive impairments living at home were 42 percent said they recommended the using fewer devices after one year than supine position to new parents. at the beginning of the study, even Principal author Bonnie B. Hudak, though their need for helpful devices M.D. , assistant professor of pediatrics, had increased due to declining health undertook the project as a result of her and cognitive status. own experience with her new daughter. "Obviously we are not making de"When I had my baby in 1993, no- vices that are as useful as they should body talked to me about sleep posi- be," said William C. Mann, Ph.D., direction," she said. "I began talking to other tor of the center, professor and chair of parents and learned that pediatricians the department of occupational therapy Physicians reluctant to heed ill adrtce about infant sleep position Alzheimer'simpairment outpaces dertces designed to aid patients y 5 a n 5 u m m e 9 9 �m ···· · · · · · · · · · · · · · · · · · ·· · · · · · · · · · ···· · ·· · ···· · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · m ' . . . and lead researcher of the study. "We need to develop more 'smart' devices and devices that will remain useful longer, as cognitive health declines. " Baseline data from the study, reported at a recent Gerontology Society of America meeting, came from a Consumer Assessments Study by center researchers that analyzed the types of assistive devices used by 90 elderly people and their caregivers. Mann and his colleagues based their current findings on a 31-person subset- all with cognitive impairments living in a home setting. Twenty-five of the 31 were diagnosed with Alzheimer's disease; the remainder were cognitively impaired. The researchers intend to follow this group for five years to provide direction for new device development and improvement of existing devices. + researchers say fractal geom- l etry may hold the key to ear- ~l lier detection of osteoporosis. The computational technique that tests and characa. Ill terizes bone deterioration more accurately than methods currently in use was developed by Raj S. Acharya, Ph.D. , associate professor of electrical and computer engineering. He explained that clinicians who look at X-ray images of bones have only been able to track deterioration in bone mass; deterioration in the honeycomb structure has been too subtle to see. But Acharya and his colleagues found a way to examine the fragile interconnections in this tissue , and to determine the level of deterioration. The technique lets them home in on each pixel in an X-ray or MRl and assign it a specific value called a fractal dimension. "With fractal dimensions , we can compute structural information," Acharya B u 0 0 p Genetic evidence of smoking and cancer rtsk shown by UB study said. "Together, mass and structural information give a much better indicator of bone condition. " Working with animal data obtained from Merck Corp. , Acharya and colleagues from the School ofDental Medicine used fractals to compare the trabecular tissue of the bones of normal rats with those of rats with osteoporosis induced through estrogen depletion or the immobilization of limbs. "ln both cases, when we computed the fractal dimension in these data, we found there was a significant difference between the values for normal bones and the values for bones with osteoporosis," he said. In the early stages of osteoporosis, Acharya said, "the honeycomb structure might actually be broken, which would weaken the bone, but because the mass might still be the same, a bone density test would not show anything abnormal. "The advantage of our approach is that if you can pick up signs of disintegration before the bone starts massive deterioration, then you can start therapy ," he said. "And if you can catch it at an early stage, there's a good chance that a deeper osteoporosis will not develop. " + Fractal geometry may aid in earlier detection of osteoporosis - B Y ELLEN esearch has yielded further evidence of a genetic link between cigarette smoking and breast cancer risk in humans. A study conducted by UB scientists has shown that female smokers who have the slow-acting genotype for -acetyl-transferase ( AT2) , an enzyme that detoxifies carcinogenic compounds in cigarette smoke, could have eight times the risk of developing breast cancer as women with the fast-acting NAT2 gene. The research provides new insight into why previous epidemiologic studies may have failed to show a consistent association between cigarette smoking and breast cancer in the face of evidence that tobacco smoke is a cancer risk factor at many other organ sites. Other research has shown that smokers with the slow-acetylation genotype for NA T2 had higher levels of tobacco's carcinogenic compounds in their bloodstream and were at increased risk of developing bladder cancer. The UB researchers - led by postdoctoral fellow Christine Ambrosone, Ph.D., of the department of social and preventive medicine - analyzed the characteristics of the AT2 gene in the DNA of 159 post-menopausal women with breast cancer and 203 cancer-free women in a control group. A strong association between smoking and breast cancer in slow acetylators was shown, with women who began smoking before age 18 at highest risk. Intensity of smoking at two, 10 and 20 years prior to the interview appeared more significant than duration of smoking. Slow acetylators showed a fivefold increase in risk. No significant associations between breast cancer risk and total years smoked, packs-per-average year or pack-years smoked were demonstrated among rapid acetylators. + GOLDBAUM Fractal dimension (FD) graphed for spine (above). e I'Moftsl FD " '-tWill 1.95 1.90 1.85 • 1.80 •••• • •••• 11 1.70 .., 1.65 1.60 1 - - - ' - - - ' - - - - - - _ ; _ - - - - 1 1 3 4 5 6 7 8 9 10 11 11 13 14 15 lime May 30, 1991 y 5 June6, 1991 a B Sept.16, 1991 n s '' m m Y e LOIS B AKER �The nation's first integrated hospice campus combines inpatient care facilities with a 40-bed residential facility containing a 10-bed AIDS unit. The lO-bed inpatient unit, which replaces Hospice Buffalo's former Alden facility, provides care for pain and symptom control, respite , and patients in the final stages of their disease process. The unit includes accommodations for family members to spend the night. Mitchell Campus also serves as a training site for medical and nursing students and allied health professionals and offers community programs on grief, loss and living with a life-threatening illness. + Hospice opens unique integrated residential-inpatient facility he nation's first integrated hospice campus combining residential and inpatient care facilities opened in Western New York last April. Located in Cheektowaga, Hospice Buffalo's Mitchell Campus was designed by the Hospice Association of Western New York to meet the growing need for services to help individuals and families facing advanced illness. The innovative campus includes Kresge Residence - the nation's first hospice-operated skilled nursing facility-a lO-bed inpatient unit, a 200-seat multidimensional educational center, non-denominational pastoral care facilities and centralized offices for Hospice home care and administrative staff. The 40-bed residential S F provides advanced care to those who have a skilled nursing need but a limited caregiving system, or no home in which to receive care. lt includes a lO-bed unit for AIDS patients - the only one in ew York State outside the ew York City metropolitan area. Kresge Residence features a comprehensive activities and recreation program, as well as physical therapy, occupational therapy, speech therapy, mental health services and pastoral care. Hospice support services include medical social work, volunteer support and bereavement counseling. 0 B u a 0 New book names Roswell one of North America'sbest hospitals oswell Park Cancer Institute is one of the "top-rated medical facilities in the United States and Canada," according to The Best Hospitals in America, a new book published by Visible lnk Press. Written by john Wright and Linda Sunshine, the book is a comprehensive guide to the services offered by the most prestigious medical institutions in orth America. Based on physician recommendations, and supported by information from government sources , professional and lay publications, patient satisfaction surveys and interviews with hospital officials, the book identifies for the public those hospitals whose reputation, personnel , basic and clinical research, treatment modalities and other special qualities have earned p h y s c a 5 them the highest standing in the medical community. According to the authors, "these are places to which physicians in other hospitals send their sickest patients - and with good reason." Roswell is the only facility in Western ew York and one of only 27 nationwide to hold the designation of comprehensive cancer center, awarded by the ational Cancer Institute. "We are pleased and proud that Roswell Park has once again been recognized for its exemplary leadership role in setting the national standards for cancer care, research and education," said Thomas B. Tomasi, M.D., Ph.D., president and CEO of Roswell Park. + Roswell opens dedicated HIVrelated malignancy center oswell Park Cancer Institute has opened its Center for HIV -Related Malignancies to meet the needs of patients who have cancer as a result of human immunodeficiency virus infection. The new center affords patients access to unique therapies, several of which have been pioneered at Roswell, said Zale Bernstein, M.D. , center director. "These patients require specialized care and unique approaches to help prevent and treat malignancies and opportunistic infections," Bernstein said. "As a major cancer center, Roswell Park m m e 5 �. . . . .... . . . . . . . . . . . . . . . .... . . .·. . . . . ... . . . . . . . . . ... . [1] has the facilities, resources and expertise to provide the intensive care these patients need. " A 1994 survey by U.S. News and World Report ranked Roswell among the best hospitals in the U.S. specializing in treating HIV-infected patients, based in part on the design , availability and preliminary successes of innovative treatment protocols the cancer center offers. Several current protocols use photodynamic therapy, pioneered at Roswell in the early 1970s. Others use Interleukin-2 in self-administered doses to attempt to ameliorate patients compromised immune systems. "We have recently completed a study which indicates that this therapy is easily administered with good comfort and compliance by the patient," explained Bernstein. In the patients studied to date, there have been no opportunistic infections reponed in over 40 months of accumulated observation. Bernstein added that Roswell is one of only three centers in the nation using monoclonal antibody therapy to treat malignant lymphoma in HIV-infected patients. "We have treated over 15 individuals with this therapy and have witnessed good results, " he said. "We encourage physicians and HIVinfected individuals to look to our treatment protocols as viable approaches to cancer care," Bernstein said. For more information on these and other protocols, call the centerat1-800-685-6825. + the ew York State Department of Health. The heart-lung transplant program completes and complements the alreadyestablished adult cardiac transplantation program in place at The Buffalo General Hospital, and is supported by the School of Medicine and Biomedical Sciences, as is BGH's. Buffalo General was designated the area's regional adult heart transplant center in 1986; its lung transplant program was developed in the early 1990s. Children's has maintained a working relationship with the adult program in an ad hoc role . Children's has had an active cardiac program for more than 30 years. The recent recruitment of Eliot Rosenkranz , M.D., from the Cleveland Clinic to head Children's division of cardiovascular surgery, has intensified the hospital's program. "The designation marks a new milestone in Children's Hospital's more than 103-year history," said joseph A. Ruffolo, president and CEO of Children's. "It's about saving lives ... providing the finest pediatric health care services well below the national cost level ... tapping new research doors that enable us to continue looking for better treatments and cures to heal our children ... and helping to establish new referral patterns from throughout New York State for other specialty pediatric services Children's offers. "One of the most pleasing aspects of this approval process was that Western ew York area hospitals, health insurers, civic leaders and health care stakeholders showed unconditional favor for our effort and participated as supporters," Ruffulo said. Children's filed its CON injuly 1994. At that time, pediatric heart and lung transplantation in New York State was primarily provided at adult health care systems in New York City, or at outof-area pediatric medical centers in Boston, Pittsburgh and Cleveland. + Children'swins DOH approval for heart-lung transplant center he Children's Hospital of Buffalo announced it has been designated Western ew York's regional center for pediatric heart-lung transplants with the approval of its certificate of need application by B 0 0 p y 5 c 0 S u BGH names Salerno chief of its division of cardiothoracic surgery he Buffalo General Hospital has named Tomas A. Salerno, M.D. , chief of the division of cardiothoracic surgery. Salerno is internationally known for his research and the development of the technique of warm heart surgery. He has been a visiting professor worldwide , including at BGH several times in the past. Salerno earned his medical degree at McGill University in Montreal, Quebec. He received his specia lty training at Montreal ' s Royal Victoria Hospital , where he became chief resident in general surgery and then chief resident in cardiovascular and thoracic surgery. Salerno served as professor and chairman of cardiothoracic surgery at the University of Toronto, Ontario, from 1987 until 1992, and head of the division of cardiovascular and thoracic surgery at St. Michael's Hospital in Toronto until1993. He was an honorary professor of cardiac surgery at the University of Chieti, Chieti, Italy, from 1993 until1994. ln addition, he has been on the surgical staffs of Kingston General Hospital, Kingston, Ontario; St. Mary's of the Lake Hospital, Kingston; Montreal Chest Hospital; Montreal Children's Hospital; The Toronto Hospital; and Sunnybrook Health Science Hospital, Toronto. He is a member of many national and international societies, and has published more than 500 papers and abstracts. He is the author of an upcoming book, Warm Heart Surgery. + m m e �-------------------------------------------------------------- . T II () \I .\ "IT IS BETTER TO LIGHT ONE CANDLE," says an old proverb, "than to curse the darkness." Peter, Paul and Mary made a song of that sentiment back in the glory days of social activism. But 1 volunteer service isn't consigned to the memory of the 1960s. Far from it. As dozens of University at 1 Buffalo medical school alumni, faculty and students demonstrate every day, pitching in with talent and energy always makes a real difference in people's lives. From the war-ravaged survivors of the Bosnian civil war, to the rebuilding economies of Vietnam : and the Ukraine, to the mean streets of our own poorest neighborhoods, volunteerism works. The darkness around us does seem deep, and there are many who would curse it. For these physicians, though, there just isn't time to lament the state of the world. There's work to be done. -------------------------------------------------------------- .. 0 B a 0 p h 5 a S u m m e 9 9 �-------------------------------------------------------------- .. From our own baekyard. to loealrs halfway around thr world. tlw nrrd for mrdieal hrlp is strong. 1 [B·s physieians proridr both din'<·t nwdieal earr for palirnts. and training. rrlirf and supplit>s for llH'<Ii<·al prrsomwl. IN TilE MIDST OF WAR some of whom, Hassanali notes, hadn't had a break in two years. Fifteen doctors were ready to make the trip in May 1994, but the on-again, off-again war broke out anew in Sarajevo. "The State Department strongly discouraged us from going," Hassanali said. "It became a dangerous situation to bring a big delegation." Hassanali decided to go alone. He went to Zagreb, Croatia, and joined the United Nations force there as part of a group of medics. But the fighting in Sarajevo was too fierce; the UN could get him into the city, but couldn't guarantee he'd ever make it out. He stayed in Zagreb, treating some of the nearly half-million refugees who fled to Croatia. Meanwhile, Bergs land, who holds dual orwegian and American citizenship, was able to enter Sarajevo with a medical company of the orwegian army. He was in Bosnia for three months, and spent four days in Sarajevo just after a major shelling of the city's central fruit market left 120 dead and scores injured . "To a large extent those patients had been treated already," Bergsland said. "We basically did more for the evacuation. President Clinton had sent a plane to take out Television images of the vicious civil war in the former Yugoslavia have horrified the world and sparked compassion for the innocent victims of the fighting. An initial effort in Buffalo to treat some of the wounds of war now has blossomed into a large-scale initiative for relief medicine and medical training for Bosnia's physicians. Called International Medical Relief of Western ew York Inc., the organization includes about 250 volunteer physicians and has a corporate office and a warehouse for supplies. Its president is jacob Bergsland, M.D., an assistant professor of surgery at UB medical school; its vice president is dermatologist Riyaz Hassanali , M.D. '86. Several other UB-connected physicians serve as officers or on an advisory board. The group began after Hassanali was introduced to the wife of Bosnia's vice president, herself a dermatologist, who was living in Buffalo with her children. After hearing her talk about the situation in her country, Hassanali organized a meeting of local physicians who wanted to find some way to help. They decided to solicit medical supplies and organize a trip to relieve the Bosnian doctors, ______________________________________________________________ .. B a a p h y c a n S u m m e 9 5 0 �r--------------------------------------------------------------., G [ I N I 1 B A 1 1 G K 1 1 1 1 lntt:>rnational Mt:>dital Rt:>lit:>f of Wt:>stt:>rn ~l:'w York providt:>s lwlp for war-torn Bosnia and Zagrt:>b. Croatia. some of the victims, and we had to get them from the hospital to the airport. " That was accomplished , he said, in armored ambulances accompanied by armed guards. He also practiced in his specialty, thoracic surgery, in the north-central Bosnian city ofTuzla. Now the contacts that both Bergsland and Hassanali made have grown into a continuing relationship with physicians at the Tuzla Medical Center. "We had decided that bringing humanitarian supplies was one thing, but the one group that has been completely ignored is the doctors and nurses, " Hassanali said. "Every other organization was helping the victims (of the war) . But we decided that our efforts would go toward the medical personnel. These are people who are really making sacrifices .... We started corresponding with some of the doctors , and found that they were hungry for knowledge. " So International Medical Relief started sending medical textbooks and journals, and put together a shipment of medical instruments. The group also began an exchange program, sponsoring Bosnian doctors and nurses to come to Buffalo for intensive training. The first group includes a cardiologist and a vascular surgeon, as well as three nurses , all training at The Buffalo General Hospital. "Bosnia is not a Third World country by any means ," Hassanali said. "But because of the war situation, they have been completely deprived of outside information and money to continue their research. You have a very educated group of individuals who are now just starving intellectually. " ln addition , teams of Buffalo physicians - one this summer, one in the fall- are heading for Tuzla to treat patients and conduct seminars. ln the past year, Hassanali said, about $100,000 in cash has been raised through two dinners and two medical conferences, and about $500 ,000 in equipment has been donated. "Our long-term goal," he said, "is to set up a 1 cardiac surgery center in Tuzla. " For Bergsland, pitching in is a matter of supporting what's right. "The legal government of Bosnia," he said, "has a policy that's similar to what we have in the United States: that people should be recognized as individuals and not as members of some ethnic or religious group. The Serbs have this terrible policy of ethnic cleansing and destruction of other people. Fifty years after the Nazis had similar policies in Germany, now we have it 400 miles to the south. This is something that we must do something about. " "l can completely identify with what they're going through ," said Hassanali, himself a refugee from Uganda. "Somebody was there to help me, to lend me a hand, and now it's my turn to pay back. ... I don't profess changing humanity. My goal is to make a difference for one person in this world. lf we all thought that way, the world would be so much better. " SEEING ACR<SS BORDERS lt was a bit of volunteer work on the Caribbean island of St. Lucia, back in 1976, that set Yale Solomon, M.D. '50, to thinking about the rest of the world. Said Solomon, an ophthalmologist in Bay Shore, .Y.: "Ophthalmology is the type of work that one can do on kind of a one-shot basis. l realized that you can go in , operate and see patients, and leave, and you don't leave a trail of half-finished work as you might, for example, in internal medicine. " A decade later, Solomon was inspired by a friend who had done similar work in India to go there. "I met the doctor in charge, and he was very happy to have the help ," Solomon said. "I realized that this could be some sort of ongoing arrangement, that they could use help beyond just me for a month. " That realization has grown into Volunteer Eye Surgeons International Ltd. (VESI) , a group of ophthalmologists who volunteer their expertise to serve month-long ______________________________________________________________ .. 0 B a a p h 5 a n 5 u m m e 9 9 5 �r··----------------------------------------------------------·-• I In Virtnam. tlw Voluntwr EyrSurwons Jntrrnational Ltd .. trains physitiansand pnwidPSsuppliPSand updatro nwditallitrratml'. 1 I Scott D. Perrapato , M.D., didn't know what to expect when he went to Vietnam for three weeks in February. What he found was both totally foreign - and oddly familiar. The Ho Chi Minh Medical School, he said, was built in the late 1960s by the American Medical Association, when that city was called Saigon. "It hasn't changed a bit since then," said Perrapato, who serves as an assistant professor of urology at the University at Buffalo medical school. "It was like being in a Southern U.S. medical school in that time. It's a neat place." Through the Friendship Foundation of American Vietnamese, an Ohio-based group, Perrapato joined a team of seven physicians on the trip. They made rounds from 7 a.m. to noon each day , then lectured to medical students all afternoon. "They have a 200-bed, 350-patient urology hospital," he said. "To work in that kind of environment is kind of a dream." The group also traveled to the provincial city of Nah Trang, where Perrapato worked with the staff urologists and saw patients. "''d never been in a place so destitute, " he said, "but the people showed no animosity (toward the Americans). From the street people to the government people, they were just gracious. I'm told the Vietnamese and Asian people have always been very open, and they're certainly not materialistic. . .. There, the families help give care in the hospitals; they're expected to, and they love doing it. And really , it's a big advantage to the patient." Now Perrapato is on the designing board for a new hospital in ah Trang, making suggestions for what the facility should include. He's making a return trip in February, this time with his wife, Tracy, who did her residency in family practice at UB. The hard part, Perrapato said, was the re-entry into American life. "The quality of the doctors and nurses was exceptional (in Vietnam) , but the constraints weren't B A I a 0 p h 5 c a 5 m m e 9 5 c K 1 1 -------------------------------------------------------------- .. u ~ 'KIND OF A DREAM' residencies in India, Thailand, Java, Liberia, the East African nation of Djibouti- and now Vietnam, to which the group has sent eight doctors in the past year, to see patients and train the staff physicians there. "We do not go for volume," Solomon said. "I learned in India that the doctors there are perfectly capable surgeons and physicians, and do an extraordinary amount of work. India has 6 million people with cataracts. "If we send a doctor there every six months , he's not going to make a dent in it. We teach some basic material and do operate, but primarily for demonstration purposes. "It's amazing how many ophthalmologists- both the young ones before they really start their practices and the ones in their later years - have an altruistic sense that they want to go and do something other than sit in their office and work for money," he said. "They feel they want to help and use their unique abilities , and here's an opportunity. " The Vietnam project includes bringing a young ophthalmologist from that country, a professor at Hanoi Medical School , to the New York Eye and Ear Infirmary for training. "He'll go back with books, supplies, and an awareness of new techniques that they just don't have ," Solomon said. "We're sending him back with a lot of books which he is going to translate into Vietnamese. They do not have any medical literature that dates after 1970." VESI makes it easy to volunteer, making all travel and living arrangements for ophthalmologists who agree to a month's service overseas. And the benefits work both ways. "It's very rewarding for the doctor who does the work ," said Solomon, who has cut his own practice in half to manage the organization. "You see cases and see things that you would never have experienced otherwise. The culture, the way people react to their physician - the whole atmosphere is so different. In a sense, this is really fun. " B (1 0 �r - - - - - • • • • • • • - - - • - - - - • - - • • • • - - • - - - • • - - - • • • • - - - - - - • - • - • - • • • • - • • - ., The program also involves bringing Ukrainian physicians to Buffalo for training, as well as an initiative to translate medical textbooks into Ukrainian. Organizers also are seeking to install a computer system in the central medical library in L'Viv, which would make it possible for physicians to teleconference with their colleagues worldwide. Sirkin's first trip to L'Viv was in june 1994; she took with her some donated diagnostic and surgical equipment and supplies. She taught techniques of anesthesia , cataract surgery and lens implant surgery, as well as such basics as how to use a microscope. In March of this year she returned to L'Viv. "They seem to be doing fairly well," she said. "They're starting to adopt some of the techniques and some of the equipment. "But it's very difficult, because you're fighting the political system within the hospital hierarchy , which is very patriarchal and hierarchical. Ophthalmology is almost entirely a female specialty there. But the administrators are all male, and the ophthalmologists don't always get their needs met. " there. There wasn't the paperwork and all the insurance overtures. I'd never been in that environment, where you could just practice medicine. " 1 X I (; I 8 A c K niiTI'IN(l CKRAINE GPTO DATE There's nothing wrong with Ukrainian medicine that about 25 years of scientific progress won't cure. That's what Sara R. Sirkin, M.D. '68, an adjunct professor of ophthalmology at the UB medical school, has found on two trips to the city of L'Viv in that former Soviet republic . "They're very competent people," the ophthalmologist said of her colleagues there. "The difficulty is , their medicine is still back in the late '60s. The facilities were built in the '50s and '60s and are very antiquated. They don't have access to modern medication or equipment, and they don't have the money to buy these things. "Much of their medical care, although adequate , is still very much Third World. We're trying the best we can to teach them modern techniques in surgery- in my case, cataract surgery and lens implants. And we're trying to upgrade their infectious disease control. "They're very eager to learn, and there's certainly nothing wrong with their intelligence. It's just that, under the Soviet system, they haven't had the opportunity to learn. " Sirkin went to L'Viv, an ancient city of 1.5 million people, as part of the American International Health Alliance, a joint U.S.-Ukraine effort to improve the medical conditions in the former Soviet republics. "There are churches that go back to the 13th century," she said. "It's a beautiful city. " The Buffalo connection was engineered by Myroslaw Hreshchyshyn, M.D. , chair of gynecology and obstetrics at UB medical school, through the Millard Fillmore Health System, for which Sirkin is chairman of the department of ophthalmology. ON TilE HOME FRONT It's not only in far-flung locales that the need for quality medical care is great. In Buffalo , two initiatives are directed at addressing the health needs of the city's poorest residents. At Friends of the Night People, a new medical clinic is open on alternate Tuesday nights for clients of the soup kitchen . Its proprietors are M. Steven Piver, M.D., clinical professor of gynecology and obstetrics and a longtime supporter of the organization, and Bobby]. Abrams, M.D. , an emergency physician who serves as a UB clinical assistant professor at Erie County Medical Center. The clinic sees about 20 patients a night, said Abrams , who had run a similar clinic in Philadelphia, where she Tlw eity of L'Vir in tlw l'krairw is plagu~l with antiquat~l fatilitit>s and latk of aeet>ss to tll(XIPrn nr~lieation and ~1uipnwnt. -------------------------------------------------------------B u 0 0 p c c n s u m m e 5 �r•••••••••••••••••••••••••••·-------------------------------·-·• morning clinic for men at Buffalo's City Mission. It's staffed by physicians from Sheehan Hospital, supported by volunteer medical students and nurses from the ursing Center for the Homeless, a project of the UB School of ursing. "We get a wide range of problems," she said. "In the winter there are a lot of colds and infections. Overall there are a lot of foot problems, a lot of athlete's foot, really poor hygiene. A lot of them are on their feet a lot and don't have good shoes." Bonham said about 60 medical students are involved on a rotating basis, doing initial intake, taking histories and vital signs. They also solicit donations of supplies from pharmaceutical companies. She said the clinic sees 15 or 20 people on an average winter morning, fewer in the summer. The clients, she said, are just people for whom life has taken a bad turn. "We had one man who came in, he told me he had a four-year degree. He was an accountant or something like that. He said he had been promised a job in Buffalo, but the job didn't pan out and he had gotten his wallet stolen. He had no ID, and he found himself on the street with no job and no place to live. He was very intelligent and well-spoken, and had all this luggage with him that he had to carry everywhere. "A lot of times you find people who've just had bad luck. The patients generally are quite grateful and very polite. It's actually surprising to some people. There are a lot of misconceptions about this population. For the most part, they're not what you might expect. They're younger than I had expected, for example. Some of the stories you hear will break your heart. "We may not have a lot of skills yet, but we do have time, so we talk to the patients. Often in an office setting you're on a time limit, but we tell them if they want to talk, we'll listen. Sometimes what they need most is a good listener." + served an emergency medicine residency. "As a physician you have to give back something to the community, and probably the best thing you can give back is your skills," Abrams said. "The minute I started this clinic, I can't tell you how many physicians came, asking if they could be a part of it. And the medical students are very eager to volunteer. We can offer them one-on-one teaching there, and it also exposes students to working in the community." Abrams and Piver, with the assistance of medical students, physician assistants and sometimes volunteer paramedics, see patients with such complaints as infections, coughs or colds, and perform routine physical exams. "We don't do anything invasive," she notes- no needles or scalpels - and they refer plenty of cases to hospital emergency departments. "There are whole families that are homeless," Abrams said. "A lot of my patients are a mother, a father and three kids. They have no way to get to a doctor and have basic things done. The kid may have a wound that's almost infected, but many of them are working people. To sit in the emergency room for three hours for a kid to be seenthey can't do it." Part of the job is building trust with patients. Abrams tells of one man who suffers with a seizure disorder that began when his father hit him in the head - with a hammer. The man was institutionalized for 40 years, she said, and "he was terrified, just terrified. Every time I saw him, his question was , 'Are you going to put me back in?' But now he'll come to me voluntarily, looking for help. "These people are really going out of their way to be good patients and help themselves," Abrams said. "And many of them have said: 'We know you don't have to be here. Thank you."' Adrienne D. Bonham is a second-year student at UB medical school who coordinates Hope Clinic, a Saturday HPrP in Buffalo. llw JXXlr and llw honwiPss swk medital altPntion at FriPnds of llw ~ight PP<lpiP and llw City Mission. -------------------------------------------------------------B u a 0 p h y 5 c a 5 m m e 9 v B A c K �DIA E ZwiREKI • lll • • 1 Ul PHoTOGRAPHY BY RoBERT CoLLIGNO THE EW TECHNIQUE VENTILATION DEVELOPED POTENTIAL TO TREATMENT OF 6 a 0 p 5 c OF a n 5 PARTIAL AT UB REVOLUTIO LIQUID HAS THE IZE THE RESPIRATORY FAILURE. m m e 9 9 �CORINNE LEACH, M . D ., PH.D., HOLDS FOUR-MONTH OLD KENNETH LA BARGE, ONE OF T H E BABIES WHOSE LIVES WERE SAVED BY PARTIAL LIQUID VENTILATION. B a 0 p y s c a 5 u m m e 5 �DuRING THE PAST DECADE, the University at Buffalo has grown strong among major medical research centers. Funding has increased, a state-of-the-art research center has recently been built, and the reputation of UB investigators continues to develop. But all this pales by comparison with the thousands of lives that will be saved as the work of these researchers becomes clinical reality. From the tiniest of premature infants to elderly victims of accidents and illness, society will reap the rewards as studies that originated in Buffalo reach fruition and are developed into clinical practice throughout the country, and the world. At UB and The Children's Hospital of Buffalo , along with four other centers nationwide, l3 premature babies who teetered on the brink of death from respiratory failure earlier this year were treated in the first clinical trial using partial liquid ventilation led by Corinne L. Leach, M.D. , Ph .D., assistant professor of pediatrics and attending neonatologist at Children's. This revolutionary technique was first described by Bradley P. Fuhrman, M.D., chief of pediatric critip LA T "THE I cal care at the hospital and a professor of pediatrics at UB. All of the infants responded with I S FUTURE TO improvement in their lung function, and seven ultimately survived . Known also as A CHILDREN perfluorocarbon-associated gas exchange, or PAGE, partial liquid ventilation could significantly enhance treatment for not only newborns, but older children and adults who suffer from lung disease. "Treatment is a way of taking advantage ofliquid to make a collapsed lung available for use ," explains Fuhrman. "It will be especially effective in situations where there is generalized lung collapse, such as acute respiratory distress syndrome and hyaline membrane disease . It showed very good effectiveness in the trial involving the l3 babies, all of B a 0 p h c whom were expected to die and had failed with all conventional forms of treatment, including surfactant. " PAGE also has been used to treat children with viral pneumonia and in patients with bacterial infections that cause lung collapse. "The plan in the near future is to do this in children and adults," as well as newborn babies, notes Fuhrman. "PAGE is a potentially major breakthrough," according to NEAR N THE Bruce A. Holm, Ph .D., dean for research and graduate studies at UB. "Its history lies in anD 0 I N T HI S other development: the development of surfactant. " The results of the D ADULTS " first clinical trials showing the efficacy of surfactant were published in Buffalo in 1985. A combination of phospholipids and proteins, surfactant is normally produced in the alveoli and secreted into the lung, where it is responsible for lowering surface tension. The initial production of surfactant in the laboratory, and later by commercial firms, has changed the standard of care for the treatment of respiratory distress syndrome. PAGE carries the basic concept behind surfactant a giant step forward. a 5 m m e 9 9 5 �R oge r Kais e r , M.D. in back g round , and Bhup e ndra Mepani , M . D. , view X-r ays from th e first clini ca l tri a ls . "It takes a patient who is unstable and poorly oxygenated and offers a more stable course," says Fuhrman. "We think we'll reduce the risk of having this kind of lung disease. " Leach, who collaborates with Fuhrman, and developed this technique in the treatment of respiratory distress syndrome, reported the results of the pioneer clinical trial at the May 10, 1995 meeting of the Society for Pediatric Research in California. Leach came to UB in 1988 from the University of Pennsylvania and the Children's Hospital of Philadelphia , having worked with Thomas Shaffer, Ph.D. , of Temple University, who designed an early liquid ventilator, and is considered the modern-day father of total liquid ventilation. In addition to Fuhrman and Leach , Erie County Medical Center's Roger Kaiser, M.D., clinical associate professor of anesthesiology and clinical assistant professor of surgery, has been instrumentally involved in studies using PAGE on adults . "Brad Fuhrman simplified the entire process of partial liquid ventilation and launched it into the clinical arena ," according to Leach. "While he was in Pittsburgh, he figured out that partial liquid ventilation could work; at the same time I was doing total liquid ventilation research here at UB. We got together, and I modified it to work in the sick premature lung. Since then , our team at UB , including Drs. Michelle Papo, David Steinhorn, Lynn Herman and Roger Kaiser, has developed PLV in the treatment of many dis- B a a p y 5 c eases, which has led to subsequent pediatric and adult clinical trials of PAGE. " And, as the landmark study of the l3 infants proves, it does work. Reaching this milestone took approximately 30 years, during which time one of the major barriers to clinical application was the fact that liquid breathing required a highly specialized ventilator. Fuhrman successfully leapt this hurdle. "PAGE requires the standard ventilator already used in hospitals ," he explains. "It doesn't require a shift in the way we do ventilation. It just makes existing methods work better. "We think it will make the lung more uniform and therefore more available for ventilation," he continues. "The spin-off could be quite large. There are 150,000 ARDS (Adult Respiratory Distress Syndrome) cases in the United States. In addition, many patients develop lung disease as a component of other problems. PAGE actually contributes to the treatment of many different diseases." Describing his role in the development of PAGE, Kaiser notes , "my role has been supportive of Fuhrman. Most of my work has been in sheep, utilizing an acid aspiration lung injury model. " Kaiser used sheep in his laboratory trials because initial work had been done on smaller animals. As a prelude to human adult trials , large animal trials were conducted. Much research has been funded by the Alliance Pharmaceutical Corporation, San Diego , which holds the patent on medicalgrade perflubron, the fluorocarbon commonly used in PAGE. a s u m m e 9 9 5 �"Brad Fuhrman first discussed PAGE in the july 1991 issue of Critical Care Medicine. Alliance contacted him immediately and matched Fuhrman with our chemical, perflubron," according to Hal W. DeLong, executive vice president of business development/marketing at Alliance. "One of the pleasant surprises has been that humans responded so similarly to animal models, which indicated the efficacy of the technique in treatment," adds DeLong. Kaiser notes that three human trials for PAGE- in neonates, pediatric patients and adults- have been initiated since 1993. "We are starting Phase II of trials in adults this summer," Kaiser says. "This will be a controlled study of two separate groups, one treated with PAGE and a control group treated with standard therapy. We will look at a number of different parameters to see how effective this therapy really is, whether it lowers the number of days spent on a ventilator, and whether it affects outcomes regarding mortality. Then, Phase Ill trials, which will be more broad, will be done. " Sites for this summer's adult trials include ECMC and BGH. Kaiser predicts that ifinvestigators' data work and the PAGE technique are shown to be of value, actual clinical application in adult patients could be implemented within the next two years. Perfluorocarbon is much less expensive to manufacture than its predecessor, surfactant. Other potential benefits to the patient include a shorter hospital stay and lower morbidity. And in years to come, the ultimate achieveBR AD L EY P. F u H R M AN, M.D. ment of PAGE researchers could be to prevent ARDS entirely. "Once we demonstrate that this is working the kinks effective therapy for out on that," says " I T TAKeS A PATIENT WHO IS UNSTABLE ARDS, the next step Leach. "Partial liqwould be to look uid ventilation will into its use prophybe one of the theralactically," predicts pies available in the AND POORLY OXYGENATED AND OFFERS Kaiser. "Preliminary '90s and in the fudata show that ture for the treatperfluorocarbon ment of lung dismay also minimize ease. We have a lot A MORE STABLE COURSE. " inflammatory reof data to show that sponse; therefore, other state-of-thewe could actually art therapies such as minimize lung damsurfactant have been shown to combine well with PAGE. This age before it happens. " gives us every reason to suspect we will use them in combinaCombining surfactant and partial liquid ventilation to comtion in the years to come," she concludes. + bat lung damage is also being investigated, although "we're still 6 u a 0 p y 5 a n S u m m e 5 �FuNDING CUTS RESEARCH IMPERIL look at research sites or the opportunity for investigators to visit Washington , D.C. , to present their cases. Furthermore, the effect of federal budget cuts is discouraging for researchers - new and experienced alike- whose applications are turned down by agencies such as NIH. "Because we have a larger number of investigators and a smaller number of grants being funded, more investigators tend to reapply. The work load on their part is tripled. This is demoralizing for young scientists. It has discouraged people from academic research," says Holm. "And , we're seeing senior investigators with 25 or more years' experience being turned down. The statistics are not flattering for anyone." UB , however, seems to be an exception to this national trend . During the past three years the university has seen a 20 percent growth in extramural grant funding into the School of Medicine and Biomedical Sciences. "We've managed to buck the system," concludes + Holm, "but how long can we keep it going? " Thrilling new developments in medical research have moved major centers like UB into the international limelight as the wombs , birthplaces and cradles of cure and prevention for such life-threatening conditions as lung disease . But how will federal funding cuts threaten to nip these pioneer efforts in the bud? The outlook is ominous, according to Bruce A. Holm, Ph.D. , UB dean for research and graduate studies. "The rate of growth for funding is not matching the rate of growth of the body of knowledge or the number of researchers ," notes Holm. The future work of the ational Institutes of Health, foremost agency among research funding in the United States, is severely jeopardized. "There have been dramatic cuts in-house at the IH. It's a matter of time before this impacts on productivity," says Holm. For instance, the NIH has completely eliminated research-related site visits as a means of cutting expenses. Review of applications for funding is now based solely on the written word, without a first-hand RESEARCH THAT CHANGES LIVES: A CHILDREN's HERITAGE with PKU in 19 58- one year before Guthrie discovered the test that screened Thirty-six years ago, Children's Hospital was the site of another life-saving for the disease and 10 years before newborn screening became standard research breakthrough when Robert Guthrie, M.D., who died this year on hospital practice. June 24 alter a long illness, changed the nature of newborn screening for mental PKU babies are born with normal intelligence, but become retarded if they retardation with his heel-prick blood test lor the presence of phenylketonuria follow a normal diet. Early detection and treatment with a specialized formula (PKU). are essential- and must become a lifelong habit. Today, efforts are focused Infants born with the disorder are unable to metabolize the essential amino on caring for older children and adults, as well as acid phenylaline, which builds to toxic levels and newborns, affected by PKU. "It's important to treat leads to mental retardation. If detected at birth, infants as early as possible to lower the level of children can lead normal lives if they follow a phenylketonuria. Within 10days to two weeks alter special diet that excludes foods containing large a child is born, the diet begins," notes Georgirene amounts of protein. Vladutiu, Ph.D., associate professor of pediatrics Guthrie's PKU test is now standard for newand neurology at UB and director of the Guthrie borns in all 50 states and 25 countries, and is laboratory. estimated to have spared 30,000 people worldwide At the laboratory, all PKU patients in from mental retardation. In Buffalo, his legacy Western New York- atleast1 00 at any given time continues through the efforts of the Robert Guthrie - ore monitored, and a nutritionist studies and Biochemical Genetics laboratory, located at modifies their diets as needed. Monitoring for paChildren's Hospital, the site of his original work. 5 Hospital in 1982 • Dr. Robert Guthrie at Children' tienls in North Dakota and parts of Ohio is also done Guthrie credited his son, John, and his niece, there. Margaret Doll, with being the inspiration for his research and campaign to get newborn testing widely accepted. John Guthrie, "Whenever a patient is pregnant, we monitor her PKU level weekly during who had non-PKU mental retardation, died earlier this year at age 47. Margaret the entire pregnancy. We also test the baby, of course. Most of the time, if the Doll is profoundly retarded and lives in a Minneapolis group home. She was born mother has followed her diet, the baby is line," Vladutiu says.+ B u 0 0 p y 0 5 u m m e 9 9 �• ... . ........................................... .. .......... ... .. . ....................... ~ I Naughton to step down as dean after 20 years WILL PURSUE TEACHING AND RESEARCH AT THE MEDICAL SCHOOL ohn P. augh ton, M.D., vice presi- the academic side, clinical practice and among the hospitals loosely affiliated dent for clinical affairs and dean of research . All three activities have devel- with the medical school; residency prothe school of medicine and bio- oped in a very significant way, testi- grams were administered and run by medical sciences for the last 20 mony to the fact that the medical school them , with little cohesion and consishas risen to become one of the top tency from hospital to hospital. years , will resign july 1, 1996. The community's health care sufaughton made the announce- medical schools in the country. " Naughton said he plans to stay at UB, fered for it, with competition between ment to a stunned group of colleagues and well-wishers gathered March 1 in the teaching undergraduate· and graduate the over-bedded hospitals resulting in atrium of Cary-Farber-Sherman to cel- medical students, pursuing his research splintered services, rising health care ebrate his 20th anniversary at the medical specialty- cardiac disease exercise re- costs and fiscal woes for all of them. aughton, in his role as vice president school. His retirement date coincides with habilitation - and working with the the school's sesquicentennial celebration. school's faculty on the evolution of an for clinical affairs, is widely credited with Naughton said he came to his decision interdisciplinary curriculum. Another helping to tum the situation around by to step down, "by realizing that 20 years is project, he adds, will be capturing his bringing the hospitals together in a coopa long time to be dean. The erative rather than comthings I'd planned to accompetitive arrangement that "For 20 years, he's demonstrated a unique and uncanny ability to get parties to the plish have been accomsaw them enter into a plished. It's time for the uniconsortia! agreement in table and work at consensus-building strategies among parties that otherwise would 1983 to respond to guideversity to evaluate the leadership of the school. " He lines promulgated by the credited the university for Liaison Committee on not. His ability to do this in this environment is going to be greatly missed." Graduate Medical Eduits continued "support for cation. the clinical changes made at - John E. Friedlander, president and CEO of The Buffalo General Hospital The Graduate Medithe medical school and its primary care initiatives." cal Dental Education William Greiner, president of UB, "unique experience in Buffalo of col- Consortium of Buffalo has served as a said, "john has led his school into the laboration and health care change." model for the nation and achieved sigAnd in his 20 years as dean of the nificant accomplishments , among them ranks of the nation's top 10 comprehensive medical schools. He has also re- medical school-12 of them also as vice the designation of The Buffalo General shaped the medical school's connec- president for clinical affairs for the univer- Hospital as the regional heart-lung transtions with the Western New York medi- sity- Naughton has seen a lot of change. plant center; the establishment of a single A nationally prominent cardiologist, division of neonatology in pediatrics to cal community at large. He helped to create extraordinary new relationships he came to UB as dean and professor of coordinate neonatal care, research and with UB's affiliated teaching hospitals, medicine from George Washington education; the establishment of a PET relying on a consortia! model that has University School of Medicine and center at the Buffalo VA Medical Center garnered national attention as a new ap- Health Sciences, where he served as and Millard Fillmore Hospital; and the proach to medical education." dean for academic affairs , in 1975. At designation of the regional Trauma-Bum john E. Friedlander, president and that time , UB's medical school was beset Center at Erie County Medical Center. CEO of The Buffalo General Hospital, by a lack of direction and leadership , The consortium also governs all resisaid, "He's dedicated himself to con- with both morale and research funding dency programs in Western ew York, tinuing in an outstanding way the medi- support low after the 1962 merger be- serving as the "institution of record" for cal mission here. Dr. aughton has a tween the once private University of graduate medical education, and is regreat deal of understanding of the three Buffalo and the public State University sponsible for standardizing residents' important aspects of medical school- ofN ew York. Clinical teaching was split salaries and managing their credentialing. B u a 0 p h 5 a 5 m m e 5 1 J �······················································ · ····· · ············· · ·············• · ~' ' 1 J medical staff president] ames P. alan, M.D., BGH president William V. Kinnard, M.D., and the immediate past president of the hospital's board of trustees, Robert S. Scheu, all of whom helped draft the plan with Naughton. Scheu and alan served as associate directors of the project; Kinnard chaired a task force that investigated the business and legal aspects of the proposed merger. The plan was eventually killed in the county legislature when that body failed to establish the nonprofit management corporation that would run the consolidated hospitals by one vote- l3 in favor, 7 against. Perhaps, ironically, many of the recommendations made in the report have been borne out by time - from the closing of the nursing schools, to the conJohn P. Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. version of the former Deaconess aughton was appointed vice presi- recommended that Children's be phased Hospital to a skilled nursing facility and dent of clinical affairs in 1984 after serving into a new nonprofit corporation that the area's decreased inpatient bed capacity. in that capacity as acting vice president of would manage it along with BGH, Deaa ugh ton accomplished much in his health sciences for a year. The position coness and Meyer in the county facility 20-year tenure, for both the medical gave him greater authority over clinical that was under construction at the time. school and its teaching hospitals. His teaching areas- at UB, without its own The merger plan proposed that acute watch saw the school garner significant medical center, the affiliated teaching care would be provided by the new research funding and prestigious grants, hospitals sites- and graduate as well as county hospital and BGH, with the em- among them the Robert Woodjohnson undergraduate medical education. phasis at BGH shifted from inpatient to Generalist Physician Initiative, the But aughton's tenure was not with- outpatient services. It also recommended Women's Health Initiative and the out controversy. Two years after com- that Deaconess Hospital be converted Markey Trust award. He was instruing to Buffalo, he was asked by officials into a nursing care facility, that the mental in making the School of Mediof The Buffalo General Hospital, The nursing schools at BGH and the county cine and Biomedical Sciences a leader in Children's Hospital of Buffalo and the be closed and that Columbus and the the push for primary care, and is also former E. ] . Meyer Memorial and Dea- now defunct lafayette General Hospital credited with unifying the-school's camconess hospitals to head a study into the move into the Children's facility. pus with the construction of the new Bolstered by support from a "Citizen's medical research building and the Caryfeasibility of merging those hospitals. The resulting report- portions of which Committee to Save Children's Hospital" Farber-Sherman complex, as well as inleaked to newspapers months before its that garnered over 200,000 signatures on stituting a consolidated computer netofficial release - set off a storm of a petition to keep the facility open and work among the hospitals and medical protest within both the medical com- independent, the hospital's medical staff school, now operated by the Health Sciand board of directors voted against the ences library and known as HUB ET. munity and the community at large. The report - citing the area's l3 consolidation, as did the medical staff at percent underutilized bed capacity Buffalo General in a sharp rebuke to Con~nued on page 20 6 a 0 p 5 c a n s m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . [1] ~ I Richard Krugman M.D~ delivers 1995 Stockton Kimball Lecture Naughton, Continued from page 19 Naughton also instituted UB's medical scientist training program for M.D.Ph.D. students and its successful early assurance program. His tenure saw steep increases in the quality of the university's medical students and an added focus on CHARGES MEDICAL PROFESSION TO MAKE CHILD minority medical education. He also ABUSE A PUBLIC HEALTH PROBLEM FOR PHYSICIANS spearheaded increased parental involvement in undergraduate medical education at UB with the formation of a parichard Krugman , M.D. , is a man nation's top childhood diseases. Child ents council and other programs. with a mission: to reinvent the abuse affects more than 2.5 percent of Naughton says, "the job for my suctreatment delivery system for vic- children nationwide each year. As a cessor will be to help provide creative tims of child abuse in our society. University of Colorado Medical School leadership in an ever difficult, con"We must change the focus of intern more than 30 years ago, Krugman strained environment" anticipated by child abuse from a social services worked with Dr. Henry Kemp , who conboth federal and state budget cuts. and law enforcement "There's an awful lot of uncertainty ," he mode to a public health remarks , "and we haven't seen all the approach concerned with fallout yet. preventive treatment ," "We've been done dirty in a way. We said Krugman, who shared were moving on pathways that looked his mission with a crowd more at regulation and coordination. of hundreds of UB mediAnd now we're caught in a social whirl cal school alumni on Sat- or maybe whirlpool - where we're urday, April 29 . uncertain of the changes fostered by Krugman delivered the competition and withdrawal of support. " keynote address at the Add to that, he says, the "reductions Medical Alumni Associafrom the hospitals in practice income tion 's Spring Clinical and research, and medical schools Day, held at the Marriott throughout the country will have to try Inn in Amherst. Although to re-sort things. We hope to maintain he is now dean of the Unithe emphasis on what we're all abou t - versity of Colorado Mediquality patient care, education and re- cal School in Denver , search. " Krugman still spends 10 At a Medical School Executive Com- to 20 percent of his time mittee meeting he attended last spring, speaking on and researchGreiner stated he intends to pursue the ing child abuse and neselection of a new dean and to separate glect, his passion since he that position from the post of vice presi- was a medical student. He dent of health sciences. A search com- is a former practicing pemittee will be formed soon to search the diatrician and worked vice president position. briefly as an advisor on In discussing his tenure, Naughton health care issues to Richard Krugman, M.D. said, "I think my biggest accomplishment former U.S. Senator David has to be bringing the hospitals and medi- Durenberger of Minnesota. ducted a pioneering study on battered cal school together to see that they could Krugman explained that child abuse children. "In 1960, we thought we had work for mutually cooperative goals." + is more prevalent than congenital heart uncovered the scope of the problem B Y NANETTE TRAM ONT defects or asthma, making it one of the when we found evidence of a few hun- B u a 0 p h y 5 c a s u m m e 9 9 �........................................................................................• .. · ~ I dred cases in Colorado," Krugman recalled, "and we thought it would be relatively easy to take care of." Today, more than three million reports of child abuse are filed each year. And 15 percent of all men, and 27 percent of all women now report some form of sexual abuse during their childhood, Krugman explained. Child abuse is finally recognized as a problem, said Krugman, but its root causes are not being adequately addressed. "As a society, we have attention deficit disorder," said Krugman. "We are quick to recognize a problem but long to cure it. We simply move on to another problem." Increased childhood and family stress, brought on by a lack of quality time as a nuclear family and events like divorce and out-of-wedlock births (both up 400% since the 1960s, Krugman points out), contribute to the high incidence of child abuse in our society, according to Krugman. "Kids face increasing isolation and stress," he said. "What we have is an emergency. We spend billions of dollars on the downstream effects of not treating child abuse early," he said, "but it is really quite extraordinary that, as a society, we are still in a basic stage of denial regarding this issue. " The impact of childhood abuse is lifelong, linked to an unusually high suicide rate among pre-pubertal children and contributing to such teenage and adult complications as eating disorders, developmental disabilities, even chronic headaches and moderate to severe chronic physical shaking, according to Krugman. To solve the dilemma, Krugman advocates a system of home health visits to sufferers of child abuse by trained medical professionals. Currently, abuse victims are dealt with by social service professionals , who, according to Krugman, are woefully overworked and undertrained to deal with the problem. "Many parts of the country require only B a a p means a system that makes it easy for a potential abuser to pick up the phone, reach a trained professional and say 'I need help ,"' said Krugman. Physician advocacy and market forces will create the environment needed for real reform in child abuse treatment, believes Krugman. The downstream costs of these medical issues will force the health care delivery market to begin making the types of adjustments it needs in order to provide preventive care to children and potential abusers, Krugman predicts. "Health care reform," he added, "is happening already. It is a market-driven force moving, like the weather, from west to east across the country." Krugman is not the first in his family to make a medical name for himself. His father, now retired in Florida, conducted extensive research which led to the first vaccine for hepatitis B. Seated next to UB's long-tenured medical school dean, john Naughton, M.D. , Krugman observed that being dean of his medical school is "not a unique opportunity. l am the ninth dean in twelve years." Looking over the list of past Stockton Kimball speakers, Krugman even noted that he was not even the first dean from the University of Colorado to be featured. Krugman also joked that, being from Denver, he shared Buffalo's pain each football season. Despite four appearances each, neither the Bills nor the Denver Broncos have ever won a Super Bowl. The luncheon's namesake, Stockton Kimball, served as dean of the University of Buffalo's School of Medicine from 1946 until his untimely death in 1958 at the age of 55. Kimball's tenure saw the medical school moved from its old home at Main and High Streets downtown to its current location at Main and Bailey, on the southeast corner of the South Campus. The move poised the medical school, which was still private, for its later merger with + the University ofBuffalo and SUNY. a high school diploma to become a case worker," said Krugman, "and their lack of knowledge is striking." Krugman believes money to finance the shift in emphasis in treating child abuse can be "squeezed out of the already shrinking health care delivery system. " He made an example of two friends of his from Denver, both doctors who owned their own HMOs and decided to merge. "Then another, larger HMO came in and bought them out. othing changed as far as service delivery was concerned, but my two friends split more than $6 million. "If the health care delivery field has enough money out there to make my two friends millionaires, there is money out there to fund child abuse treatment," chastised Krugman. He added that his home health visitation system would also reduce the number of inappropriate visits to emergency rooms, the most costly way to deliver public health services. Krugman praised the recent opening of a multidisciplinary Child Advocacy Center on Delaware Avenue in Buffalo. Though becoming more common in the west, it is the first center of its type in New York State, with the second due to open soon in Niagara County. The Child Advocacy Center is a cooperative effort of representatives from various area social service agencies designed to offer a single outlet for investigation, support, advocacy and medical treatment for sexually abused children and their families. The atmosphere is designed to minimize the amount of trauma involved to the children and perpetrators of abuse in seeking treatment. "Abusive parents love their children very much,just not very well," explained Krugman. Abuse is compounded because today's perpetrators were often abused as children, he added. Early intervention by trained professionals is the best treatment, he explained. "That's why I say that preventive treatment 5 c a 5 I BY m m e STEVE 9 COX �Sisters of Charity Hospital history reflects its mission BUFFALO'S FIRST HOSPITAL BUlLT ON SERVICE TO THE LEAST FORTUNATE he roots of Buffalo's first hospital Humboldt streets. The 30-acre site was to its present location, absorbing St. can be traced to the mid-19th cen- purchased from Austin Flint, M.D., the Louise de Marillac Maternity Hospital tury when the diocese's Bishop, first medical staff chief at Sisters Hospital. into its maternity unit and thus consolijohn Timon, traveled to Baltimore Land was also purchased at Main and dating all the Sisters of Charity health to request the services of the Sis- Delavan streets to help meet the grow- care services. ters of Charity to establish a hospi- ing medical needs of the city. A new Over the years, Sisters Hospital has tal for the Queen City of the Lakes, a hospital, accommodating 300 patients, undergone extensive additions, renovagrowing frontier on its way to becoming was completed in 1876. From 1877 to tion and modernization. The first addia major transportation center. 1882, some 4,420 patients were treated tion, built in 1948, housed the emergency Bishop Timon had purchased a brick there at a total expense of$19,000. About department, family health center, patient school house and adjoining cottage on half the patients were charity cases. rooms and outpatient treatment centers. Pearl Place in the city. The property, By 1884, four distinct Daughters of A five-story building added in 1965 which he turned over to the changed the face of the hossix sisters who traveled to pital, encompassing its adBuffalo to start the hospital, ministrative offices and rnabecame the first site of the ternity service, as well as Sisters of Charity Hospital in patient rooms, conference 1848. The Sisters of Charity areas, the medical records in America became known department and physician two years later as the Daughlounge. Another addition ters of Charity of St. Vincent constructed two years later \"JEW OF TUE llEDlC..!.L COLLEGE, ASD TUE llll:~~~~ll~S~_;-~~F::,T~~-~.o:=u:.:~._._ housed the pharmacy, cende Paul, officially joining with the order established in France in 1633. Charity hospitals filled specific needs in tral supply, diagnostic imaging and purWithin a year of its opening, Sisters the community - the newly opened chasing departments. Hospital was faced with its first test with Emergency Hospital at Pine and Eagle Inl974,theSetonProfessionalBuildthe outbreak of four cholera epidemics streets, Sisters Hospital for the sick at ing and St. Catherine Laboure Health in Western New York. Patients jammed Main and Delavan, St. Mary's Infant Center additions were completed- the the hospital; many recovered, but the Asylum and Maternity Hospital for or- Seton Building housing medical and epidemic would claim 900 lives before it phans and unwed mothers at Elmwood commercial offices along with hospital subsided. and Edward and Providence Retreat for extension offices, and the St. Catherine ln 1854, the Daughters of Charity the mentally ill at Main and Humboldt. facility housing a concentration of rehaexpanded their services to the City of Established originally as a downtown bilitative services including physical and Buffalo with the establishment of St. branch of Sisters Hospital, Emergency occupational therapy, social work and a Mary's Infant Asylum and Maternity Hospital was taken over by the Diocese skilled nursing facility. Hospital. The facility, which remained of Buffalo in 1954. lt is now known as Re-Vision 2000, Sisters Hospital's open for nearly a century at Elmwood Sheehan Memorial Hospital. major modernization project completed and Edward streets, cared for orphans Providence Retreat was closed in last year, added two more stories to the and unwed mothers. 1940. Two years later, Sisters Hospital main structure as well as new surgery, In 1860, Bishop Timon felt the dio- opened the St. Louise de Marillac Mater- coronary and intensive care units. The cese needed an institution dedicated to nity Hospital, which merged with St. project also included the construction the care of the mentally ill. The Daugh- Mary's Hospital in the Providence Re- of a new building named after Sr. Mary ters of Charity opened Providence Re- treat building. Charles Dever, former hospital presitreat the following year on the site of the Sisters Hospital remained at Main dent, to house the information systems present Sisters Hospital at Main and and Delavan untill948 when it moved and finance departments. a u a 0 p y 5 c a s m m e 9 9 5 �························································································• ·· · ~ I baton were designed served as director of the and constructed by Dr. Visiting Nurses AssociaBrown, as well as the tion from 1975 to 1978 case in which they are and was a member of the medical honor society, displayed, and he also Alpha Omega Alpha, the designed the school's Medical Foundation of academic gown, a Buffalo , the Faculty chandelier and doors Club, the Medical Hisin the complex to torical Society, the which he devoted his Albright-Knox Art Gallife. lery, the Museum of SciIn recognition of his ence, the Buffalo and Erie strong support of the County Historical Society Health Sciences Li- Robert L. Brown, M.D. , 44 and the Friends of the brary for 26 years, the historical and rare book collection was School of Architecture. He was also a long named the Robert L Brown History of standing member of the Buffalo Club. He is survived by his sister-in-law, Medicine Collection in 1985. Upon his retirement that same year, he was ap- Mrs. Donald (Virginia) Brown; a niece, pointed consultant to the University Li- LauraMehl;a nephew, Kenneth P. Brown; braries and continued his close associa- and his good friend , Donald]. Savage. tion with the History of Medicine Collec- Contributions may be made to the University at Buffalo Foundation, P.O. Box tion until his death. Dr. Brown received the Dean's Award 590, Buffalo, New York 14231-0590 for + in 1967 and 1973, and the Distinguished the History of Medicine Fund. Medical Alumni Award in 1974. He - B y L I L L I S E N T Z In addition to the facilities located on the hospital campus, Sisters has continually expanded its off-campus sites. In 1981, it opened the Alden Medical Center; in 1989, it opened an outpatient chemical dependency STAR unit in Amherst followed by a second a year later in West Seneca. In 1992, the hospital opened the St. Vincent Health Center on Buffalo's East Side and the St. Louise Health Center on the city's West Side. Sisters moved into the north suburbs with the opening two years ago of its Amherst Health Center. From its humble beginnings nearly 150 years ago, the history of Sisters Hospital is reflected in its services to Buffalo's poor, mentally ill and orphaned. The hospital has grown tremendously from its one-building roots to a network of health care facilities encompassing a full range of acute and long-term care as well as inpatient and outpatient services. + Robert L. Brown, M.D, former associate and acting dean,dies GRADUATION DAY 1995 It was a day for celebration and obert L. Brown, M.D. '44, former associate dean and acting dean of the University of Buffalo's School of Medicine, died April 5, 1995 after a brief illness. Dr. Brown's accomplishments and contributions to the medical school weremanyand varied. He was appointed assistant dean in 1959 and acting dean in 1960, when he directed the intensive planning for the university's merger into the State University of ew York system two years later. He was the first associate dean appointed to the School ofMedicine. In 1974, Brown became the medical school's archivist, beginning a systematic search for the historical records of the school that led to the categorization and preservation of many original records from the early years of the school. The medical school's mace and marshal's B a a p h I festivities as the School of Medicine and Biomedical Sciences graduated its 149th class of physicians and medical scientists this past May. y c a s m m e 9 9 �.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . [1] ~ I Match Day 1995: Success and Celebration UB'S GRADUATE MEDICAL DENTAL EDUCATION CONSORTIUM RESIDENCIES DRAW 35 PERCENT OF ITS GRADUATING MEDICAL STUDENTS THIS YEAR his year's doss of graduating medical students did well on the National Resident Matching Program, with 67 percent getting their first choice and 83 percent getting one of their first three choices. Of the 140 UB students participating in the NRMP, 35 percent will remain in Buffalo in Graduate Medical Dental Education Consortium residencies; 11 percent will stay in New York State, but outside Buffalo; and 51 percent will do their residencies out of state. Seven students were unmatched. Primary care residencies drew 40 percent of UB's graduating physicians, down from last year's 44.1 percent. Nationally, the program matched 17,858 of the nearly 23,000 students who competed for the 20,751 first-year residency positions available. More than half were matched in generalist residencies, including family practice (15.4 percent), internal medicine (24.5 percent) and pediatrics (11.1 percent). Omolora J. Akinbomi, Pediatncs, Children's Nauonal Medical Center, Washington, DC George J. Burnett, Psychiatry, Graduate Medtcal Dental Education Consortium, Buffalo, NY Mory J. Ciotoli, Emergency MediCine, Umverstty of Rochester/Strong Memorial Hospllal, Rochester, Y Trine B. Allen, Psychiatry, Duke Umverstty Medical Center, Durham, NC Timothy R. Byrnes, Internal MediCine (Prehm.), Ststers of Chanty Hospllal, Buffalo, NY Lori A. Cohen, Internal Medicine, Long Island jewish Medtcal Center, ew Hyde Park, NY Darren M. Coparoso, Family Pracuce, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Richard J. DeAsla, Surgery, University of Rochester/Strong Memorial Hospllal, Rochester, NY Michael J. Carlson, Internal Medicine, Medtcal College of Virginia, Rtchmond, VA Tracie l. DiMarco, Family Practice, New York Medical College Mtd-Hudson Family Pracuce Serv1ces lnsmute, Kingston, NY lhuoma U. Alozie, Internal Medtcine (Prelim.), Hospllal of St. Raphael, New Haven, CT Andrew l. Altman, Urology, Case Western Reserve Umversity, Cleveland, OH Barry R. Armondi, Internal Medicine (Pnmary Care), Long Island jewish Medical Center, New Hyde Park, NY Brett D. Arnoldo, Surgery, Graduate Medical Dental Education Consorl!um, Buffalo, NY Robert A. Borroli, Emergency Medicine, Maricopa Medtcal Center, Phoemx, AZ Katherine A. Blum, Obstetncs and Gynecology, Graduate Medtcal Dental Educal!on Consortium, Buffalo, NY Miroslav P. Bobek, eurologtcal Surgery, Universlly of Mtchtgan Hospllals at Ann Arbor, Ann Arbor, Ml Maurits S. Boon, Surgery (Prelim.). Thomas jefferson UmverSily, Philadelphia, PA Otolaryngology, Thomas jefferson Umverslly, Philadelphia, PA Anthony J. Bartkowiak, Internal Medicine (Pnmary Care), Graduate Medical Dental Educauon Consortium, Buffalo, NY Maria D. Bruno, Internal Medicine (Prelim.), Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Ophthalmology, Graduate Medical Dental Educauon Consortium, Buffalo, NY Ross J. Bellavia, RadiOlogy- Dtagnosuc, Umverslly Hospllals of Cleveland, Cleveland, OH Cheryl D. Buck, Medicine!Pedtatncs, Umverslly of Cincinnal! Hospital, Cincinnau, OH Scott J. Belote, Emergency Medicine, Graduate Medical Dental Educauon Consoruum, Buffalo, NY Tony T. Bui, Transitional Year, Wilson Memonal RegiOnal Medtcal Center (Unlled Health Services), johnson Clly, NY Physical Medicine and Rehabilllal!on, Universlly of Texas Southwestern Medical School, Dallas, TX Kathleen E. Bethin, Pediatrics. St. Loms Children's Hospllal, St. Louts, MO B u a Frank P. Carnevale, Pediatrics, Graduate Medical Dental Educauon Consoruum, Buffalo, NY 0 p h liang R. Chang, Obstetrics and Gynecology, Graduate Medical Dental Educauon Consorl!um, Buffalo, NY Craig E. Cheiltez, Internal Medicine, Georgetown UmverSily Hospllal, Washington, DC J~eph C. Dipirro, Pathology, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Anthony M. Dirubbo, Medicine!Pediatncs, Umverstty of Rochester/Strong Memonal Hospllal, Rochester, NY Therese M. Duane, Surgery (Prehm.), Eastern Virginia Graduate School of Medicine, Norfolk, VA Karen A. Chojnacki, Surgery, Thomas jefferson Umverstty, Philadelphia, PA Karen E. Dull, Pediatrics, Umverstty Health Center of Plllsburgh, Plllsburgh, PA Christine M. Chruscicki, Psychiatry, Duke Umversity Medical Center, Durham, NC Christopher J. East, Internal Medicine (Prelim.), Ststers of Chanty Hospllal, Sebastian J. Ciancio, Surgery (Prehm.), Baylor Buffalo, Y College of Medicine at Houston, Anesthesiology, Duke Umverslly Houston, TX Medical Center, Durham, NC Urology, Baylor College of Medicine Affiliated Urology Program, Houston, TX Daryl R. Ehlenlield, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, Y c a 5 u m m e 9 5 �·········· · · · · · ·· · · · · ···· ··· · · · ······· · · · ·· · ·· · · ·· ·········· · ········ · · · ··· ··· ·· · ····· · ·• · tm I lynelle M. Emery, Famtly Pracuce, Famtly Practice Residency of Southwest Washtngton Medtcal Center, Vancouver, WA Cynthia E. Epstein, Pedtatncs, Medtcal College of Virgmta, Rtchmond, VA AndrewS. Feinberg, Transitional Year, Georgia Bapust Medtcal Center. Atlanta, GA Ophthalmology, Emol)' Umverslty School of Medtcme, Atlanta, GA Carole Y.Fenton, Emergency Medtcme, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Faith A. Heavens, Pediatrics, North Shore Umversity Hospital, ew York, NY Andrew D. Henry, Internal Medicine, Umverslty of South Flonda College of Medtcme at Tampa, Tampa, FL Nigel I. Henry, Obstetncs and Gynecology, Brooklyn Hospttal Center, Brooklyn, Y Aravind Herle, Internal Medtcme, The Umverslty of Chtcago Hospttals, Chicago, IL Huiiung Kim, Radiology- Dtagnosuc, George Washmgton Umverslty, Washmgton, DC Donielle S. Noteboert, Emergency Medtcine, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Eric H. Kossoll, Pedtatrics, Eastern Virgtma Graduate School of Medtcine, Norfolk, VA David M. Odell, Famtly Pracuce, St. Joseph Hospttal, Denver, CO Shone C. Ferguson, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Shown P. Ferguson, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Peter Hertz, Surgery (Prehm.), Graduate Medical Dental Educauon Consoruum, Buffalo, NY Dono lim, Obstetrics and Gynecolog}', Universtty of Rochester/Strong Memorial Hospttal, Rochester, :-.JY Tyrone D. Fillyow, Psychiatry, Sheppard Prall Hospital, Baltimore, MD Douglas J. Hickox, Surgery (Prehm ), Graduate Medical Dental Educauon Consortium, Buffalo. NY Arlene D. lobo, Internal Medtcme, Cleveland Clmic Foundauon, Cleveland, OH Meghon A. Higman, Pedtatncs, Unl\·erslty Health Center at Pmsburgh, Ptusburgh, PA Martin C. Moloney, Famtly Medtcme, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Evon Hirsch, Family Practice, University of Cahfornia at San Franctsco, Fresno, CA Michele M. Manko, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Jeanne C. Fitzsimmons, Emergency Medicme, Graduate Medical Dental Education Consortium, Buffalo, NY Michelle Game, Pedtatncs, Eastern Virgtma Graduate School of Medtcme, Norfolk, VA Kathy M. Golding, Famtly Pracuce, Graduate Medtcal Dental Educauon Consortium, Buffalo, Y Randy J. Goldstein, Pedtatncs, Medtcal College of Virgmia, Richmond, VA JeffreyS. Grant, Internal Medicine (Prehm.), Ststers of Chanty Hospital, Buffalo, NY Physical Medtcme and Rehabtlltauon, SUNY Health Sciences Center, Syracuse, NY James C. Ho, Internal Medtcme (Pnmary Care), Long Island Jewish Medical Center, New Hyde Park, NY Toreq S. Horb, Internal :vtedtcine, Vanderbtlt Umverslty Medical School, Nashville, TN B a 0 c a Michele A. Potempa, Famtly Practice, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Susan E. Potts, Pedtatncs, Duke Umverslty Medical Center, Durham, NC Kirk Puttlitz, Pathology, Emory Umversity School of Medicine, Atlanta, GA lrm R. Roio, Psychiatry, Umverslty Hospitals of Cle,·eland, Cleveland, OH Peter D. Roy, Surgery, Umverslty of Alabama Hospital, Montgomery, AL Susan M. Noselli, Internal Medtcme (Prehm.), Jewish Hospttal of St. Louts, St. LOUIS, MO Neurology, Washtngton Umverslty, St. Louis, MO Helen M. Kim, Psychtatry, Massachusetts General Hospital, Boston, MA y Natalie Poppito, Pathology, DartmouthHitchcock Medtcal Center, Lebanon, NH James G. Nalbone, Psychtatry, Albany Medtcal Center Hospital, Albany, NY Marie I. Kessler, Pedtatrics, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY p Jesslyn l. Perry, Internal Medicme, Graduate Medical Dental Educauon Consortium, Buffalo, NY Brenden M. Miner, Surgery (Prehm.), Umverslty of Vermont, Burhngton. VT Heather M. Keene, Obstetncs and Gynecology, Provtdence Hospital, Southfield, Ml James S. Killius, Radiology- Dtagnosuc, Duke Unl\·erstty Medical Center, Durham, "iC Nancy Perez, Pedtatncs, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Gregory A. McDaniel, Medtcine/Pedtatrics, Western Reserve Care System/ NEOUCOM,Youngstown, OH Christina M. Keaney, Pathology, Graduate Medtcal Dental Educauon Consoruum. Buffalo, NY Thomas A. Honno, Famtly Pracuce, Guthrie/Robert Packer. Guthne, PA Tushar Patel, Ophthalmology, Scheie Eye Institute, Unl\·erslty of Pennsylvania, Phtladelphta, PA Madhulika Mathur, Pedtatncs, Graduate Medtcal Dental Education Consoruum, Buffalo, NY Jeoneo R. Hundley, Emergency Medtcme, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Somir Khonior, Obstetncs and Gynecology, New Hanover Regwnal Medtcal Center, Wtlmmgton, NC Margaret E. Partridge, Pedtatncs, Umverslty of Rochester/Strong Memonal Hospital, Rochester, NY Philip l. Monzonero, Medtcme (Prelim.), St. Elizabeth's Hospital of Boston, Boston, MA Anesthesiology, Oregon Health SCience Umversity, Portland, OR David P. Hughes, Emergency Medtcme, Bowman Gray/North Carohna Bapust Hospital, Wmston-Salem, NC Kate l. Guernsey, Pediatrics. Umverslty of Colorado School of Medtcme at Denver, Denver, CO Thomas A. Owens, Medtcme/Pedtatncs. Duke UniverSit}' :vtedtcal Center, Durham, NC Patricio A. Krebs, Pathology, Baystate Medtcal Center, Spnngfield, MA Bryon R. lotzmon, Internal Medicme (Prehm,), Wmthrop-Umversity Hospttal, Mmeola, KY Neurology, Mt. Sinat School of Medtcme, New York, NY Albert B. Fiorello, Emergency Medtcme, University of Anzona Affthated Hospitals, Tucson, AZ Whitney l. Orman, Pedtatncs,Emory Unl\·ersity School of Medicme, Atlanta, GA Dovid P. Kowalski, Famtly Practice, Graduate Medical Dental Educauon Consoruum, Buffalo, NY Mitchell J. Herr, Internal Medtcme (Prehm.), Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Anestheswlogy. Umverslty of Cahforma at San Otego Medtcal Center, San Otego, CA Steven M. Finkelstein, Internal Medtcme (Prehm.), New England Medical Center, Boston, MA Anesthesiology, Brigham and Women's Hospital, Boston, MA I Neal T. Reich, Internal Medicme (Prehm ), Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y AnesthesiOlogy, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Koren M. Roll, Pedtatrics, Hahnemann UmverSit)-, Phtladelphia, PA Renee F. Neely, Psychtatry, Graduate Medtcal Dental Education Consoruum, Buffalo, NY Germaine N. Rowe, Internal Medtcine (Prehm ), Graduate Medtcal Dental Education Consorttum, Buffalo, NY Physical Medtcme and Rehabthtation, Presbyterian Hospital, New York, NY Gory J. Nielan, Pedtalncs, Baystate Medical Center, Spnngfield, MA Amitobh P. Soha, Surgery, Flushmg Hospttal Medtcal Center, Flushmg, NY 5 m m e 9 �~ - . . . ... .. . . . . . . . . . . . . . El Theresa M. Sarafin, Pediatncs, Dartmouth-Hitchcock Medical Center, Lebanon, H Jeffrey Tessier, Internal Medicine, Portsmouth Naval Hospital, Portsmouth, VA Eva H. Sotell, Internal Medicine, Umversny Health Center at Pittsburgh, Pmsburgh, PA Edouord J. Trobulsi, Surgery (Prehm.), Thomas Jefferson Umversity, Pmsburgh, PA Urology, Thomas Jefferson Umversny, Pittsburgh, PA Philip Sauvageau, Medicine!Pediatncs, Graduate Medical Dental Education Consortium, Buffalo, NY Bertram Portin '53,to serve on Sisters Hospital board of directors Rolph P. Tufano, Otolaryngology, Umversny of Pennsylvama, Philadelphia, PA Bethonn Sthober, Pathology, Harbor-University of Cahforma at los Angeles Medical Center. los Angeles, CA Paul F. Updike , Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH Joel A. Shapiro, Orthopedics, McGaw Medical Center of Northwestern Umversity, Chicago, ll Felice Vobnitk, AnesthesiOlogy. Umversity of North Carolina Hospitals, Chapel Hill, NC Chondresh A. Shelot, Emergency Medicine, Mt. Sinai Medical Center, Cleveland, OH Timothy E. VanDuzer, Emergency Medicine, Graduate Medical Dental Education Consortium, Buffalo, NY Fronk Sindoni, Surgery (Prehm ), Graduate Medical Dental Education Consortium, Buffalo, NY Eileen Velez, Pathology, Graduate Medical Dental Education Consortium, Buffalo, NY Michael J. Singh, Surgery, Graduate Medical Dental Education Consortium, Buffalo, NY Andrew W. Worner, Internal Medicine, Graduate Medical Dental Education Consortium, Buffalo, Y Erik D. Skoog, Ophthalmology, Medical University of South Carohna, Charleston, SC Theresa M. Wegman, Pediatrics, Graduate Medical Dental Education C..onsorl!um, Buffalo, Y Romuold Sluyters, Surgery (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, Y Orthopedics, Graduate Medical Dental Education Consortium, Buffalo, Y Dennis D. Weimer, Psychiatry, Umversity of Anzona Affiliated Hospitals, Tucson, AZ Denise K. Sokolofsky, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, NY Wendy l. Weinstein, Psychiatry, Graduate Medical Dental Education Consoruum, Buffalo, NY Stephen P. Sorrentino, Internal Medicine (Pnmary Care), North Shore University Hospnal, New York, NY Timothy P. Whelan, Internal Medicine, University of Colorado School of Medicine, Denver, CO Taro A. Soso, Internal MediCine (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, Y Anesthesiology, Graduate Medical Dental Education Consortium, Buffalo, NY Ellen M. Whyte, Psychiatry, Umversity Hospnals of Cleveland, Cleveland, OH Attending Physicians Matthew Withiom-leitth, Obstetrics and Gynecology, Graduate Medical Dental Education Consortium, Buffalo, NY Peter F. Stengel, Internal Medicine, Umversny of Maryland, Baltimore, MD ertram A. Portin, M.D. '53, has been named to the Sisters Hospital board of directors . Certified by the American Board of Surgery and the American Board of Colon and Rectal Surgery, Portin is chairman of the hospital's division of colon/rectal surgery and a past president of the Sisters Hospital medical staff. "We are fortunate to have someone of Dr. Portin's leadership ability and insight join our board of directors ," said John] . Maher, president of Sisters Hospital. "Dr. Portin's presence on the board is important to further integrate physician expertise into governance and leadership at Sisters Hospital. " Portin is a member of the American College of Surgeons, the American Society of Colon and Rectal Surgeons, the American Medical Association and the Accreditation Council for Graduate Medical Education. + The award far best reunion class atten- William J. Wnuk, Medicine/Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, Y dance this year goes to the 50-year Class Andrew N. Young, Pathology, Emory Umversity School of MediCine, Atlanta, GA of '45, which, under the stewardship of Thomas W. Stone, Internal Medicine (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, NY Ophthalmology, Duke Umversity Medical Center, Durham, NC Brion K. Zebrowski, Surgery, Bridgeport Hospital, Bndgeport, CT class reunion choir Herbert Joyce, posted Erik J. Stumpf, Family Practice, Hahfax Medical Center, Daytona Beach, Fl Jeffrey l. Zondermon, Transmonal Year, Carney Hospnal, Boston, MA Ophthalmology, Tufts New England Eye Center, Boston, MA an approximate Royte R. Syracuse, Internal Medicine (Prehm.), Umversity of Maryland at Baltimore, Baltimore, MD Ophthalmology, Graduate Medical Dental Education Consortium, Buffalo, Y Jennifer M. Zubler, Pediatrics, Graduate Medical Dental Educauon Consortium, Buffalo, NY dance. Congratula- Keith A. Zu!!olo, Surgery. St. Elizabeth Hospital Medical tions to all on a job lisa l. Stephens, Obstetrics/Gynecology, Baystate Medical Center, Spnngfield, MA Eva M. Tokots-Dilorenzo, Obstetrics and Gynecology, Graduate Medical Dental Education Consortium, Buffalo, NY B a 0 Center/NEOUCOM, Youngstown, OH 78 percent atten- + + well done! p h y 5 a s m m e 5 �1995 reunion portraits: 50 years of medicine recalled en classes were honored at this year's Reunion Weekend celebration, and gathered in Buffalo to reminisce, remember old friends and good times, and renew acquaintances. CLASS OF 1945 CLASS OF 1950 FROM lEFT TO RIGHT: FIRST ROW: Richard Adler, Edward Forgrave , john FROM lEFT TO RIGHT: FIRST ROW: William Webster, Alfred Falcone, Robinson , Herbertjoyce,jacob Steinhart, Gilbert Tybring, Earl Robert Bergner , Roland Anthone SECOND ROW: Henry Pech, Sidney Anthone, Karl Manders, james Cantwell, Theodore jewett SECOND ROW: Paul Cotter, Eugene Morhous, William Andaloro, Dunn , Richard Leberer, Leo Manning, Roy Robinson Raymond Barry, Genevieve Howen, Vincent Capraro, Ivan Kuhl, THIRD ROW: Adelmo Dunghe, Eugene Zygaj , joseph Sheedy, William Loeser, William Mcintosh Robert Patterson THIRD ROW: Charles Wiles, john Fairbairn, Edward Valentine, john Hartman, Victor Lazarus, Hilton jacobson, john Long, orman Chassin, George George Ellis, Richard Greenwald, Thorngate, Vito Laglia , Adolphe Schoepflin, Leslie Osborn, Robert Schopp, Peter Terzian, joseph Tannenhaus, A. Arthur Grabau , Wayne Templer B a Reunion Classes Continued on page 28 0 p y c 0 5 m m e �~ ························ · ·· · ·········· •••••••••••••• • ••••• 0 •• • • • ••••••••••• • ••• w~ There· Med Eva H Cen Phili! Den Beth• Cal An! Joel No Chm Me fra1 CLASS OF 1955 CLASS OF 1965 De FROM lEFT TO RIGHT: FIRST ROW: Milton Alter, John Peterson, Leonard Mic Schaer, joseph LaMancusa Ed SECOND ROW: Bertrand Bell, Ray Schiferle, john Foley, john Baker, Eril Frank Gazzo, james unn, Michael Gianturco, Robert Dean, Robert Pittell, john Kent, james Stengel , john LeValley, Shedrick Moore Sc FROM lEFT TO RIGHT: FIRST ROW: Louis Trachtman, Kenneth Kim, joseph Cardamone, George Strauss SECOND ROW: Gary jeffery, W. Scott Walls, Elliott Larson, Antonio Catanzaro, George Moore, Robert Schuder Ro D• 0 c 01 E St 1'- CLASS OF 1960 CLASS OF 1970 FROM lEFT TO RIGHT: FIRST ROW: Harris Faigel, Edward Graber, Algirdas FROM lEFT TO RIGHT: FIRST ROW: Bruce Prenner, Michael Lippman, jeffrey Rothman, Bruce Sobin, Laurence Lesser SECOND ROW: Mary Clemens, Marilyn Kassirer, Roger Forden , William Balistreri, Allan Winzer, Arthur Goshin, Lynn Eckhert THIRD ROW: Dennis DuBois, Seth Craig, Donald Copley, Harold Vandersea, Brenden Thomson, Thomas O'Connor, Sebastian Conti, Allen Davidoff, Donald Gabel, Steven Weinstein, jan Novak, Alan Fink, Arthur Seigel, Shafic Twa!, Elliott Brender Gamziukas, joseph Antkowiak, Sylvia Sussman, Andre Lascari, William Abramson, Charles Riggio, Eugene Partridge SECOND ROW: Marshall Lichtman , Donald Hammel, joseph Chazan, Harry Metcalf, Donald Donius THIRD ROW: Harold Brody, james Kanski, Daniel Gianturco, William Stein, Franklin Glockner, Robert Malatesta, Harris Kenner, Gerard Diesfeld, Daniel Goldberg, Roger Dayer, Theodore Bistany, Thomas Guttuso B u 0 0 p h s c 0 5 m m e 9 9 5 �CLASS OF 1975 CLASS OF 1985 FROMLEFT TO RIGHT: FIRST ROW: Shirley Galucki , Barbara Brar , Elaine Schaaf, Erica Heit Remer, Lynda Stidham , Margaret Reidy, Roberta Moss, Elizabeth Maher, Lucie DiMaggio , Darlene Eldredge Fairchild, Amy Miller O'Donnell , C. Adrianna Alvarez, Donald Tingley, Graciela Desemone , Thomas Cowan SECOND ROW: David Forster, Carol Hammer Forster, Sabino Torre, Raymond Meeks, jack Coyne,jacques Hajjar, Susan Bates, Kenneth Romano, Thomas Szalkowski , jon Wardner, Victor Marino THIRD ROW: Michael Lahood , Michael ancollas, joseph Zizzi , john Leddy, Ira Handler, Blackford Middleton FROM LEFT TO RIGHT: FIRST ROW: Marvin McMillen , Sylvia Regalia, Leo liO Muido , Marguerite Dynski, Ben Echols, Lynne Hochberg-Pace, Alan Calhoun SECOND ROW: Marc Colman , Kenneth Anolik, William Cohen , Dennis Witehead, William Novak, Thomas Rosenthal , Henry Tomiak , jack Cukierman , Paul Trautman , john Stubenbord, Craig Blum, john Hedger, Michael Rade, Peter eumann , jack Freer, Eugene Hirsh CLASS OF 1980 CLASS OF 1990 FROM LEFTTO RIGHT: FIRST ROW: janice Errick , Alicia Stanton, Steven Howard , Suzzette Robinson , Stephen Panebianco , Valerie Vullo, Harriette Feier, Kimberly Blake, Dianne Jaeger Sutter SECOND ROW: Marc Klementowski, joseph Murphy, Mary Rita Murphy, Raymond Paolini , Robert Pitera , Mark agy , joyce Paterson FROM LEFT TO RIGHT: FIRST ROW: Thomas Dougherty, Archimedes Thomas, Edward Rockwood, john Shayne, Constance Lentz , Coral Surgeon, Theresa Stephan- Hains, Mary George, Lynn Steinbrenner SECONDROW: james Twist, Margaret Paroski , Gaspere Geraci , Mark Borer B 0 0 p s c 0 5 u m m e 9 9 �Porrath '61, pioneers integrated care for breast disease STUDY SHOWS THAT HIS MAMMOGRAPHY CENTERS FIND BREAST CANCERS EARLIER THAN THE AVERAGE FOR LOS ANGELES PATIENTS aar A. Porrath, M.D., has known since he was about four years old that he wanted to be a physician. "It was probably the influence of traveling with my father when he visited sick members of his congregation that influenced my early career choice," Porrath explained. His father was Rabbi Samuel Porrath, a long-time rabbi in iagara Falls and Amherst. Ironically, his inital decision to specialize in radiology was made because he thought he didn't want direct contact with patients. After graduating from the University of Buffalo's School of Medicine in 1961 , he served his internship and residency at Mt. Sinai Hospital in Cleveland. Following his military service as the chief of radiology service at Kenner Army Hospital in Fort lee, Virginia, he moved to California. "It was while I was in los Angeles that I started doing more and more mammograms and I found that I liked the patient contact," he recalled. By 1983, his transformation to direct patient clinical service was completed when he founded the Women's Breast Center in Santa Monica , which has pioneered an integrated care approach to breast disease and management. In 1990, he joined the Mammography Center in Burbank. Both centers are operated under the umbrella of the Women's Breast Center Group, which also operates the Mobile Mammography Center in the los Angeles area . Porrath also organized the Foundation for the Study and Prevention of Breast Disease, which sponsored a multitude of county-wide health fairs , attracting more than B u a 0 p 250,000 people over the two-year period from 1985 to 1987. The two breast centers are the largest providers of indigent breast health care outside of county facilities in los Angeles; the foundation has received grants to help cover the costs of treating indigent patients. "My book, A Multimodality Approach to Breast Imaging, published in 1986, was panned by some for being what was considered too clinical," explained Porrath, who is obviously in opposition to these critics. "Breast cancer is definitely increasing - basically for two reasons. About 60 percent of the increase is due to the aging of the population and the other explanation is that we are simply detecting a lot more cancers," Porrath said. He believes the current national controversy over the issue of mammogram screening guidelines for women under age 50 is largely related to cost issues. Porrath points out that of the approximately 180,000 women who will c a n S get breast cancer this year in the United States, nearly 30,000 will be in the 40 to 49-year-old age group. A total of 40,000 will be under age 50. "If we send a message to the American woman that screening has no validity, we will virtually wipe out the detection of all Stage 0 and Stage 1 breast cancers almost 20,000 women. There will be at least 6,000 women who would have lost the chance to prove that breast cancer is a curable disease. That is not including the vast number of people who will automatically jump at the chance of not having a mammogram because of their innate fears of breast cancer. " Porrath acknowledges that detection is more difficult in women under age 50, but points out that the lead time between detection and the spread of cancer is also less- making early detection all the more important. He stresses that breast cancer in the younger woman is a much more aggressive disease. u m m e 9 5 �"Breast centers such as ours are actually quite cost-effective because our statistics from more than 40,000 patients have demonstrated a significant reduction in unnecessary surgical biopsies. Of course this reduction also means less trauma for the patients." Five hundred of the center's approximately 40,000 patients have been diagnosed with breast cancer. But a study demonstrated that the cancers found at the center were smaller and were found earlier than those in other Los Angeles breast cancer patients. For all of Los Angeles County, 62 percent of the patients are Stage 1, I and II, compared to 90 percent of the Women's Breast Center cancer patients who were Stage 0, I and II. While he encourages breast self-examination, Porrath isn't optimistic that its usage will increase greatly. "Self-examination is based on a psychologically wrong principal- it offers a negative reward for a positive action by telling women that they can possibly find breast cancer by examining themselves," he explains. Porrath is well aware of the significant emotional issues involved in breast examination, mammography and breast cancer. His wife, Toni Bernay, Ph.D., is a psychologist and a consultant to the Women's Breast Center and the Mammography Center. Porrath has been elected a fellow of the American College of Radiology and is past president of The American Branch of the International Society for Study of Breast Disease, The National Consortium of Breast Centers and current vice president of the World Federation of Ultrasound. He has taught radiology technology training courses throughout the country, including Buffalo, and has lectured widely on breast cancer and detection issues throughout the U.S. and the world, including Canada, Mexico , Germany, Argentina, Brazil, Greece and Austria. + · B BY u DEBORAH a W a ILLIAMS p cated last September, has received national attention and is being used actively for education and research. A graduate of Western Reserve University, now Case Western Reserve University, he received a doctorate from the University of Minnesota. In receiving his Distinguished Medical Alumnus honor, Brody joins a list of renown School of Medicine and Biomedical Sciences graduates. He will receive the award at a dinner in his honor this October. The SUNY Board of Trustees also named Suk Ki Hong, M.D., Ph.D., UB professor of physiology, distinguished professor in january in recognition of his reputation and contributions to research. A UB faculty member since 1975, Hong also serves as director of graduate studies in the department of physiology. His research interests lie in the areas Harold Brody '61,garners two distinguished UB honors arold Brody, M.D., Ph.D., has been awarded the rank of distinguished professor - the highest in the State University of ew York system- and elected 1995 Distinguished Medical Alumnus. The designation of distinguished professor, made by theSU YBoardofTrustees, is an order above full professorship and has three co-equal designations: distinguished professor, distinguished service professor and distinguished teaching professor. Brody, professor of anatomy and cell biology, was named distinguished teachingprofessor. Thedesignationisawarded to persons who have demonstrated outstanding teaching competence at the graduate, undergraduate or professional level. Brody, who joined the ------·- =~ faculty in 1954, earned an M.D. from the medical school in 1961; for half of his 41 years at UB, he served as chair of the department. He has done research and published widely in the field of neuroanatomy, and has served on several editorial boards, including that of BufHarold Brody, M.D., Ph.D. falo Physician. As a Fulbright scholar to Denmark in 1963, he helped establish of renal and environmental physiology. Hong has authored or co-authored that country's first cadaver donor pronearly 190 articles for scholarly publigram. He was one of the founding members ofUB's Center for Aging and is past cations and more than 40 textbooks, president of the Gerontological Society monographs and book chapters, earned of America. He received the society's numerous academic awards, including Robert W. Kleemeier Memorial Research the Stockton Kimball Award from the Award for Outstanding Research in Ger- medical school for excellence in reontology in 1978. search, education and service, and a Brody left the anatomy department special citation for distinguished serchairmanship in 1992 to continue teach- vice from the japanese Panel on Diving ing, do research and to fulfill a lifelong Physiology and Technology of the U.S.dream of establishing a Museum ofNeu- Japan Cooperative Program in atural roanatomy at UB. The museum, dedi- Resources. + ...., 5 a n 5 u m m e 9 9 �A Spoonful of Humor© Stu Silverstein, M.D. e've all heard the old joke about the man who calls in a plumber and gets presented with a bill for $400. The customer says, "That's outrageous! What is your hourly rate?" "$200 an hour, plus travel And let's face it, men don't like calling for help to begin with, but when you are calling a plumber in, you are not only admitting that you are asking for help, but you are essentially saying that your intestines need to attend a 12-step group. That's not easy to admit to anyone, let alone a guy who shows up in overalls, no socks and asks to use your phone while spinning a monkey wrench around his pinkie (no l don't mean an orthopedist). Why are all plumbers overweight? Why do they all wear blue overalls. And even if they aren't overweight they always wear double extra large overalls. After jiggling the handle for 20 minutes time," answers the plumber. "$200 an hour!" the man replies, aghast. ''I'm a urologist. I went to medical school, residency, did a fellowship and I only charge $75 an hour." The plumber just shrugs his shoulders and says, "Hey, that's all I charged when I was a urologist." The disparity is even worse for pediatricians, and I went look. nobody hkes their job. That's why through a similar experience recently when I had to call in they call it a"'job." If they loved it, a plumber. Since I became a they'd call it something else, like "fun." homeowner, I can no longer just "I love my fun." But if It was fun call the landlord and order him you wouldn't get paid for it. over to the house when the bowl is stuffed up. B u a a p h s a 5 (billed through a lawyer's office) he tells me l will need to replace the toilet. A new toilet? ow that is something you never think about. How many folks have bought a new toilet- ever? And it's not that easy. The plumber doesn't just say, "Okay, just fetch me a toilet!" You have to choose one from a catalogue that he hauls in from his truck. A catalogue of toilets, now that's what l call bathroom reading. So now l have to choose between the flashy, efficient model, and the standard, family one. There you are having dinner with another couple, and the woman says, "You know, Myron and l are thinking about trading in our Lexus LS for a sporty LS 200. " "Yeah, l know what you mean. My wife and I are thinking about trading in our toilet for an intestinal evacuation system. You won't believe what they're showing in the catalogue." Of course everyone always complains that plumbers make too much. Even doctors complain. lf you break it down by the hour, the average plumber m m e �charges more than the average therapist. If I was a therapist and spent all those years in school, I would just go an extra six weeks and become a plumber. What the heck! Combine your fields! Put an ad in the yellow pages: "Purge your drain and your psyche for one low price. We'll even throw in the kitchen sink." "Copper pipes and crackpots - we fix 'em all. " "Whether you're anal-retentive or your toilet is- no job is too small. " "Unclog your drains and your brains - aH our plumbers are also licensed clinical psychologists. " It would be great the plumber shows up with a couch and you get to stretch out and free-associate. "So, how do you feel when your husband ignores you? ... hold on a second, damned tank won't release." I suppose that being a plumber isn't the greatest job in the world, but then again what job is? Everyone wants a job that they will like, so they go to school for 200 years, borrow $200,000 and then they realize that every morni'1g they still have to go to "work. " You can always tell when people hate their jobs, because theygooutoftheirway to tell you how much they like it. Look, nobody likes their job. That's why they call it a "job." If they loved it, they'd call it something else, like "fun ." "I love my fun. " But if it was fun you wouldn't get paid for it. "Sorry Mr. Yakman. You're enjoying your job too much. I'm afraid we're B a 0 p h AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION gonna have to stop paying you. " When I tell people I am a pediatrician and they say it must be "fun " getting to "play with kids all day. " o! I don't get to play with kids all day. If you consider holding a kid down while he screams, spits and sees you as a human rest room with a white coat, then, come along - it's play time. Nobody gets to play with kids all day except other kids, and if you paid them Insuring care for those who care Subscriber Owned • Organized • Governed PHYSICIANS • DENTISTS HEALTH PROFESSIONALS NURSES • RESIDE TS Superior policies for academic full-time and voluntaty clinical faculty ~a. Competitive premiums ~ Rewarding educational progran1s ~ Complete legal service ~ Comprehensive coverage Dividend opportunities Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. Enrollment open at all times. Transfers arranged without loss. AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION to do it, eight hours a day and told them they can't leave, they would hate it too. In fact they would insist on going to work. + Empire State Building 350 Fifth Avenue, Suite #1512 New York, ew York 10118 Ph. 212-947-4541 Fax 212-947-4572 Stu Silverstein, M.D., president of Stondup Medkine Seminars of Son froncisw, Colifomio, lectures nationwide on humor inmedkine. He ~also c!Xluthor of What About Me?, o book oboot growing up with odeveklpmentol~ disabled ~bling. 5 a n s m m e 9 9 �[ IJ························································································· 1 9 THOMAS 3 MARCH s 0 ' 31 , of Tacoma, Washington, has, in his 43 years of practice, tried pri- vate practice in four locations in New York State. He also worked for ew York State and the VA before his retirement in 1973 at age 70. With eight grandchildren and 10 great grandchildren, he tells us he, at age 92, and his wife, at age 75, are well (relatively!). He'd love to hear more of his classmates from 1931. white photography since he was at 5 Country Club Lane, Route medicine in addition to internal 14. He got involved in stereo 11, photography about 22 years ago shire 03257. medicine and pulmonary diseases. He is director of respira- ew London, ew Hamp- and began specializing in pho- tory therapy services and associ- 1 tographic techniques that involve high-speed (l/50,000'h of 9 5 s 0 has been lab. Still actively practicing medi- a second) electronic flash as well as electronic sensors and elec- a professor of pediatrics at ortheastern Ohio Universities Col- cine, he enjoys skiing and fly fishing. He writes that his son, tronic components two years lege of Medicine since 1985. He George, is married and living in ago. Dr. Stell uses two single- KURT J . W E G N ER ' 52 , is director of the residency pro- Chicago and has blessed him lens cameras for his stereo work, gram in pediatrics at Tod with two grandchildren. rather than the Stereo Realist Children's Hospital in Youngstown, Ohio. Still active in pedi- camera produced some 40 years ago for that purpose. His spe- atric consultations in neonatol- cialization has paid off; he has ogy and genetics, he has three of Hol- won numerous awards for his sons, including one who is an lywood , Florida, is understand- stereograms, including the Best orthopedist, and two grand- HAR RY BERG MAN '34 , daughters. Ann B. Matasar, Amoco Distin- of Show medal from the Chicago Lighthouse International guished Professor of Interna- Exhibition of Stereo Photogra- WILLIAM ably proud of his daughter, Dr. ate director of a sleep disorders J. S U LLIVAN ' 55 , IRVI NG S . K OLI N '65 , of Winter Park, Florida, participated in a national meeting of clinical investigators working with Revia (naltrexone HCL) in the treatment of alcoholism. Revia is now approved by the FDA for the of treatment of alcohol dependence. Dr. Kolin served as co- tional Business at Roosevelt phy for his strobed photograph Los Angeles, California, is still University, Chicago, who has of a hummingbird at a feeder, working full-time in forensic investigator in the national been elected American treasurer the PSA Best Coniemporary psychiatry, focusing on medical study. He has also been ap- of the International Federation ofUniversityWomen Professors. medal from the Wichita International Exhibition of Photog- malpractice cases. He recently became a member of the execu- pointed to the advisory board of Dupont Pharmaceuticals for fur- She is that group's financial vice raphy for his high-speed stereo tive board, head of the psychia- ther study of the drug's use president, as well. Dr. Matasar slide of a golf ball landing in try section, of the American in the treatment of alcohol de- will visit Yokohama, japan, for water, and the Best of Show Board of Forensic Examiners. installation before visiting the group's official office in Geneva, Salon for his stereogram portrait Switzerland. Recently, the Uni- of a young woman. Dr. Stell re- versity of Paris- Sorbo nne, in- members that during his medi- an Innovation in Medical Man- creased her yearly tenure from cal school years, he and Ed agementaward from The Ameri- six weeks as professor of Eschner were the only photog- four to finance, and she received an invitation to serve as a visiting professor of finance at the University of Kiev, Ukraine, as well as one to lecture at the University of Vienna, Austria. medal from the Cordova Stereo Apter served as a resident ad- tography. Stell, who retired from junct professor at the oceano- private psychiatric practice in Eggertsville, New York, in 1975, graphic center of ova University in Ft. Lauderdale, Florida. has had an interest in black and He has now taken a well-de- has won ies of the entire record of their visit, which resulted in a reduction of health care costs due to a substantial and sustained drop cago and as a resource psychia- ous awards for his stereo pho- s patients were given written cop- turer at the University of Chi- City, Arizona, has won numer- 0 Health Services program. In it, practice, as a professorial lec- Center. From 1984 to 1995, Dr. 6 can College of Physician Executives for his Brandeis University tired in early 1984 from private trist at Michael Reese Medical 9 HARRIS C . FAIGEL '60, re- of Sun B ER NAR D S . S TELL '36 , 1 raphers in the class. N ATHANI E L S . APT ER '38 , u a a p h y 5 American College of Psychiatrists. The American College of Psychiatrists includes only 550 members elected from the 40,000 members of the American Psychiatric Association. Election to the College is based on peer recognition of accomplishments; elevation to fellowship - further recognition of work in psychiatry- is achieved by less than half of College members. in utilization of clinic services despite increases in student en- S AMUEL C . A RMSTRO N G ' 67 , rollment. is serving as chief of staff of GEO R GE B . P FO ERTNER ' 60 , Providence General Medical Center in Everett, Washington. of Boise, Idaho, was recently board certified in critical care served retirement and is living B pendence, and was recently elevated to fellowship in the c a n 5 m An internist, hematologist and oncologist, he has been with the m e 9 9 �··········· · ···· · ········· ·· ·· ········· ···················································• • ' Everell Clinic there for 21 years. JAMES L. CAVALIERI II '69 , was recently awarded the Buffalo Pediatric Society's "Pediatrician of the Year" award. He's Emory University. His son josh, Medicine in the Bronx, 16, is getting ready to apply to York. falo Pediatric Society, he is a member of the board of trustees of The Children's Hospital of Buffalo. in private practice in physical medicine and rehabilitation in is l2 and his daughter julie is 10. 1 1972. Past president of the Buf- 9 8 Annapolis, Maryland. She and her husband celebrated the birth s 0 of their second child, Margot of Dover, Leigh White, on April12, 1995. Delaware, was recently elected LiLLie Margot joins her older to a fellowship in the American brother, Cameron, who is 5. MARKS . BORER '80 , Psychiatric Association. MARITZA COTT0 '87 , of Dover, IAN M . SCHORR '69 , ew jersey, writes that his twoyear-old grandson, who lives in Chicago, forces him to take much-needed short vacations! 1 9 7 s 0 she is practicing cardiology at that he is moving back East to take a position in Columbus, Rochester Park Medical Group and Park Ridge Hospital in Roch- Ohio with Ross Products Division - Abbott Laboratories, as director of clinical research. ester, ewYork. She tells us that ANTHEA WOODLEY '87 , is also practicing card iology and CAMILLE BUONOCORE '87 , is KEVIN FERENTZ '83 , of Balti- more, Maryland, has a national Brookline, Massachusetts, was radio show heard on W EDAM in Buffalo and on 125 stations around the country. He also has a new son, number three, J. TWAROG '71 , listed in Best Doctors in America, 1994-95. He was also honored by the Asthma and Allergy Foundation of America ew England Chapter- for his contributions to asthma care in 1995. married and practicing endocrinology, and is the proud mother of daughter Corinne. GRETCHEN EBERHART '87 , Noah Samuel, born january 25, of Clearwater, Florida, has been appointed medical director of clinical affairs for Community Dialysis Center. He writes that although he has joined the ranks of physician executives, he still is able to enjoy a busy clinical practice. Community Dialysis Center operates 165 dialysis centers throughout the country. EUGENE HIRSH '75 , is a prac- ticinggastroenteroJogist in north Atlanta. Elected chief of the Gl section at St. joseph's Hospital there for 1995-96, he is an associate clinical professor of medi- 1994. is in private practice with Tri-City cine in digestive disorders at Anesthesiologists in Tempe, Arizona, where he enjoys his busy practice. He was recently board certified in pain management. He and his wife, jennifer, have 1 ' 84 , 9 9 finished his residency in psychiatry at Yale University and is now happily working in the Boca Raton Psychiatric Group in South Florida. His wife finished her Ph.D. in psychology at the University at Buffalo in 1993 and gave birth to their wonderful son , Mitchell , on january 14, of Westchester, ew York, is assistant director of psychiatric emergency services at Mon tefiore Hospital, the teaching hospital 0 0 p h y 5 c 0 n Claire Anita, on December 3, 1994. She joins her two brothers, Ryan, 2 1/2 and Connor, 1 1/2. KRISTA M . ( PRIGG) KOZACKI '91 , of Florence, South Caro- lina, wonders how everyone is doing in Buffalo. She writes that after she finished her fami ly medicine residency, she opened a private practice with another physician she went through residen cy with. They call the practice, "Pee Dee Regional Family Medicine." Business is great, she says, and the art and thrill of join them in September. Her family is doing wonderfully: her husband continues to practice with the same law firm , and their twins, Stefan and jacob, turned two February 18. They talk nonstop, climb the five-foot fence, play in the dirt and give wonderful hugs. Unique to her practice is a nursery built into the office of daughter, with a private nanny to care for the children. "It's the ew York and his wife, best part of medicine and moth- DOUGLAS P . PREVOST '90, of the Albert Einstein College of B Anita, had their third child , for her boys and her partner's 1995. Snyder, Stefan and Jacob Kozacki, 2 family medicine are even more fulfilling. A third physician will s 0 BRIAN FELDMAN '90, for a girl?? " jennifer sends her best regards to Dr. aughton. She was his secretary in 1983 and 1984. WEINST E IN is doing a fel- on january 27, 1995. four boys: Matthew, 7; Brendan, 5 1/2; justin, 4; and joey Jr., l. "Anyone have the secret formula CAROL PANKOW lowship in endocrino logy at Massachusells General Hospital in Boston. She and her husband celebrated the birth of their first child , Lindsay Grace Eberhart, JOSEPH D . CURLETTA '84 , CHARLES J. MCALLISTER '73 , writes that writes ROBERT SHALWITZ '80 , of FRANK is SARAH MURRAY WHITE '85, coaches basketball. His son Ben been in private practice in Williamsville, ew York, since I ew colleges and is in his third year of varsity swimming. He also . s m m e �• ....................................... . BACK TO SCHOOL SALE I erhood," Krista says. "Finally, it's very exciting to hear and read all about the growth and changes at UB med." CYNTHIA ( LEBER MAN) JENSON of Pittsburgh, Pennsylvania, writes that she and Mark '92 , had a baby girl, Alexandra Nicole, on March 8, 1995. She also tells us that jim and Laura Krug had a baby girl, Sarah Eliza- R ICHARD WARREN BR ITT ' 36 , died last ovember 4, in Deer Isle, Maine. Dr. Britt, a Tonawanda, ew York, native, was the son of Dr. W. Warren Britt. He began his medical career in practice with his father and brother, DR . ROBERT C . BRIT T ' 42 , in Tonawanda, and practiced there for 29 years, where he was a member of the medical staff of DeGraff Memo- beth. CATHY K . NAUGHTON '93 , and MICHAEL J . NAUGHTON '93 , are now second-year residents in the general surgery and internal medicine programs at Washington University/Barnes Hospital. Michael will pursue a fellowship in hematology/oncology and Cathy will continue at Washington University in the division of urological surgery. Cathy and Michael were married September 3, 1994, in St. Louis, Missouri, at the inth Street Abbey in historic Soulard. T O DD S C H LES ING E R ' 94 , is completing an internship in internal medicine and beginning one in dermatology this summer. J O HN OBITUARIES TIM OTHY SH E RWOO D recently completed an internship in internal medicine at johns Hopkins Hospital. He plans on making a career change to general surgery and will start an internship at University Hospitals of Cleveland, Ohio, this '94 , summer. He and classmate Debra Tarantino '94, will be married Performa 5200 CD Performa 636 CD rial Hospital, before moving to Maine in 1966. IRVI NG WEINER '37 , died May 6, 1994, at age 82. He had been in private practice in ewburgh, ew York, since 1938, before he retired after 50 years of practice. L EON A RD WOLIN ' 41 , PowerBook 520 of Buf- Power Macintosh 7100CD $1379 Performa 636 CD falo, died May8,1995. Dr. Wolin was the father of DR . MAU R ICE 8MB RAM, 500MB hard drive, CO-ROM drive, 15" color monitor, keyboard, mouse and lots of software. Performa 5200 CD $1819 8MB RAM, 800MB hard drive, CO-ROM drive, 15" color monitor, keyboard, mouse and lots of software. W OLI N '84 . Power Macintosh 71 00 CD $2029 8MB RAM, 700MB hard drive, CD-ROM dnve, 15" color monitor, keyboard, and mouse. died unexpectedly on Christmas Day while visiting his daughter in Colorado. THOMAS J . ENR IGHT '48 , WA L TER A. PowerBook 520 $1469 4MB RAM, 240MB hard drive. PENTIUM NOTEBOOK DELL Pentium NoteBook $4089 OLSZEWSK I ' 54 , died February 23, 1995. An assistant professor of neurology and clinical associate professor of anatomy and pathology at UB, Dr. Olszewski was board certified in neurology by the American Board of Psychiatry and eurology and neuropathology by the American Board of Pathology. He was a fellow of the Stroke Council of the American Heart Association and the American Academy of eurology. 16MB RAM, 810MB hard drive, 75MHz, 10.4" Dual Scan Color Display , Li ion extended life battery. BEST PRICE ON MICROSOFT OFFICE Microsoft Office is an integrated packal)e including Word, Excel, PowerPoint, a workstation l1cense for Mail & Access (professional version only}. $126 $134 $139 $158 • Microsoft Office for Macintosh Standard CD • Microsoft Office for Windows Standard • Microsoft Office for Macintosh Standard • Microsoft Office for Windows Professional .. ~ ,, \!~L ill.\\ - OFFICEI September 16. A non-profit University program for students, faculty & staff The Commons • North Campus • (716) 645-3554 • Fax: 645-3884 B u 0 0 p c a n 5 m m e �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. • Adding to the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. • Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the largest and most successful company of its kind in America. Ca111-::800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area.• MLM~C ~ledical ~ Uability ~lutualln.<Urallef Company Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 01994 Med,cal Ual:111ty Mut.c.u~! ~ra11ee CompZiny �BUFFALO PHYSICIAN Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING TREE UNI)ER WI-ncH Yc)l WILIJ NE ER 7 Srt DR. Dr:Vn.LO W lhRRI <.IU • dass of 1871, knew how to make his monc) grow. In fact, this man who in 1905 prO\idcd $5.000 through his \\ill for Assrs n at Buffalo S<:hc r 150 y I • E <6 a A • I S ••• of \lcdicinc. is still supporting l'B � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1995 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n03-1995-Summer Table Of Contents A list of subunits of the resource. Research Hospital News Giving Back Breathing Life Through Liquid Medical School Then and Now Alumni A Spoonful of Humor Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1282444b30b5d092a8b57c3090a58fe9.pdf 19699087ba777d50ec61ac236db76802 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1995 �BUFFALO PHYSICIAN Volume 29, Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr_ Carole ~milh Pctrl, Dear Alumni cnl Friends, I DIRECTOR OF PUBLICATIONS TunOih) ). Conroy EDITOR Nant'tlc Tramont. R. ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIRECTOR D.mdj. Riley PUBLICATIONS MANAGER )ud,on Mead PRODUCTION MANAGER t\nn Raszm.,mn Brov.n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. John augh1on. Vice President f"r Chnit:al Affa~rs. Drm1 EDITORIAL BOARD Dr. john A Richert, Chairman Dr. Rus.sdl Besseuc Dr. Martin Brecher Dr. Harold Brod) Dr. Richard L. CoUnts Mr. Ra,; Desai Dr. Alan]. Drinnan Dr. james Kanski Dr. Elizalxth Olmsted Or. Barbara Majeroni Or Charles Paganelli Da·. Thomas Raab Dr. Stephm Spauldmg Dr. Bradley T. Truax t's a tremendous pleasure to inform you that UB's medical school was among those institutions to receive one of the last gram awards to be funded by the Lucille P. Markey Foundation. The faculty leadershtp who led thts successful effort, Dr. lam Hay and Dr. Philip LoVerde in particular, deserve the institution's gratitude for the quality of the grant proposal submitted to compete successfully in this national arena. The timing of the award and its announcement could not be better. For example, this issue of Buffalo Ph~ ~ician emphasizes research activity in the school; the new biomedical research building opens this ~pring; and the Sesquicentennial activities are upon t•s. Although scientific merit was the primary criterion on which the I~ Foundation based its judgment. the school was certainly benefitted by ' . ~the enthusiastic support and hard work of the University's administrative officers; many of our alumni, especially Dr. Thomas Frawley, Dr. Virginia Weldon and Dr. Eugene Farber; and the many faculty who helped make this multidisciplinary effort a success. The funds from this award will be used to develop further the school's commitment to the area of molei:ular parasitology. It is a tremendous tribute to the school that the core of this program will be administered bv a basic science department that has had significant historical import to the school, Mi~robiology. Thus. the Center will serve to perpetuate the memory of Dr. Ernest Witebsky, the founder of the department at UB, and his protege who served the school so well, Dr. Felix Milgrom. Both of these outstanding scientists provide the ideal role models for their successors to emulate. All in all, the Markey Award designation to UB was a great event and marks UB's further commitment to pursue its scientific missions in the years ahead. ~·4-.~ john Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medtcal Center ArlawKclly The Children's Hospital or Buffalo Erie County Medical Center Mercy Hospital Millard Ftllmore Health System friDIItSava Roswell Park Cancer Institute Sisters or Charity Hospital Dennis McCardt.Y () The State Unlverllry of New York at Bullalo IJuffalo Physiclo is pu!Jhshed quanerly by the State Un.iverslry of ew York at Buffalo School of Medictne and Blomedial Sciences and ~ Office of Publications. It is sent, fret: ofcharge. to alumni, fill:ulty, students, tcildrnts and l'rlendi.. The staff reserves~ ri&htto edit aD. copy and •ubmisslons accepted for publication. Address questions. commmts and submisstons 10. Eduor. Bllffl&lo Physician, State Umversuy of New York at Buffalo, University Publicauons, 136 Crofts Hall, Buffalo. New York 14260; or by e-mail to notes@pub.buffalo.edu. s.-. ....., ..... tc Buffalo Physician, 147 CfS Addition, <05 MainStrttt.BulTalo,NewYork Iilli 0. Felew Alanlli, A s winter begins to fade and the first suggestions of spring appear, our attention can tum to the upcoming Spring Clinical Day. By this time, we on the Board sincerely hope that you have responded to the AlumniOfficeandarernakingplanstorenewfriendshipsandparticipateintheSpring Clinical Day program. The sub-committee of the Board has been reviewing files and several members from the class reunion years will be chosen for Achievement Awards. The senior medical student class will be honored at an upcoming cocktail reception and we look forward to officially recognizing these new members into the Alumni Association. Once again, we look forward to seeing you at Spring Clinical ay. If there are any matters which we can assist you with, do not hesitate to contact the Alumni Office. Russell W. Bessette, D.D.S., M.D. '76 Prnident. Medical Alumni Association �V 0 s 2 L p R 9 N N G 2 0 9 9 5 Research FDA chief David Kessler delivers Harrington Lecture. Page 20. Hospital News Building the Future of Research UB's new research building brings together researchers in a way designed to produce results far beyond what they can accomplish alone. Restructuring Research at UB The reorganization of scientists and clinicians promises synergistic results. Medical School Then and Now ASpoonful of Humor Alumni Classnotes Garden Spots ECMC' s roots. Then and Now. Page 24. �E J ·························································································· Landmark UB study shows major illness in West Side population esidents of Bqffalo's low-income, largely Hispanic Lower West Side are twice as sick as the U.S. population living in poverty, and face major barriers to receiving adequate health care, according to a comprehensive health survey conducted by the UB Center for Urban Research in Primary Care. The study is one of the first of the health status of a pocket of the urban poor in general, and of an urban Puerto Rican population in particular. The study is also one of the first of Puerto Ricans, who account for threefourths of Buffalo's Hispanics and comprise the major portion of Hispanic populations in ortheastern cities. "Most existing studies of Hispanics have been done with Mexican-Americans in the Southwest and West," said Carlos Roberto jaen, M.D., Ph.D., study project director and UB assistant professor of family medicine and social and preventive medicine. Demographics from the study show the population to be 54 percent Hispanic (three-quarters Puerto Ricanborn) , 29 percent non-Hispanic white and 17 percent African American. The number of men and women are nearly equal. Seventy percent are under 40. Smoking, alcohol consumption, asthma and diabetes are major problems in this population in which conventional written health information isn't very useful because more than a third of the residents did not complete high school. And when members of the Hispanic population go to a hospital or doctor's office in Buffalo, they often can't communicate with the English-speaking staff and physicians, the study noted. The results also indicate that, contrary to early assumptions, most residents of this low-income neighborhood have access to health care and are cov6 u 0 0 p Carlos Roberto Jaim, M.D., Ph.D., UB assistant professor and West Side study director. ered by some type of health insurance. Bilingual interviewers went door-todoor to gather data for the study, completing interviews at 826 households representing 1,873 individuals, for a response rate of about 78 percent. UB-Roswell researchers win $8.9 million in grants from NCI rants totaling $8,914,038 have been awarded by the ational Cancer Institute to UB and Roswell Park Cancer Institute researchers. john A. Blessing, Ph.D., UB adjunct assistant professor of statistics of the statistical office of the gynecology oncology group at Roswell, won a five-year $7,514,692 grant to fund that group's ongoing work of collecting and correlating data. Margot M. Ip, Ph.D., UB research professor in Roswell's department of experimental therapeutics, won a fouryear, 734,752 grant to investigate gene expression in normal mammary cells and try to determine the way this expression is disrupted by malignancy. h y s c 0 5 Enrico Mihich, M.D., of Roswell's department of experimental therapeutics, won a three-year, $342,763 grant to study cancer chemotherapy and immunologic effects. The research will expand previous in vitro work on Adriamycin and examine its effects in vivo. Thomas Shows, Ph.D., UB research professor from Roswell's department of human genetics, won a three-year, $321,831 grant to clone chromosome 11 genes. Questions raised about use of growth hormone for short stature ost short children are well-adjusted and have no serious social or emotional problems, despite assumptions by some physicians and parents, a study by researchers at UB and The Children's Hospital of Buffalo shows. The research hits at the heart of the controversy over whether to treat short children who are not deficient in humangrowth honnone. One rationale to treat was to improve psychosocial functioning. p n g 9 �······ · ····· ··· ····· ·· ········· · ····· · ·· ·········· · ····· · ······· ·· ······ · ··· · · ········· · ·· E : J "Shorter-than-normal children may be teased, and they may be treated as if they are younger than they are, but, despite that, they are doing pretty well," said David E. Sandberg, Ph.D. , assistant professor of psychiatry and pediatrics, B has won a new three-year, and lead study investigator. "Previous 600,000 grant from ASA to reports had led us to believe these chilstudy the physiological mechadren were quite bad off." nisms behind observed cardiovasThe study, published in last cular regulatory phenomenon in December's issue of Pediatrics, is based zero-gravity. on data from 258 children referred to a The award is based on research conpediatric endocrine clinic because of ducted on cardiovascular functioning shorter-than-normal stature. Parents and deconditioning in microgravity on completed a Child Behavior Checklist; two ASA Space Lab flights that found children 12 years of age and older com- blood pressure in flight is regulated by a pleted a comparable questionnaire them- decrease in vascular resistance in reselves. Responses were compared with sponse to an increase in cardiac output those from normal children and chil- induced by microgravity. dren referred for mental-health services. This phenomenon was first observed Earlier studies reported problems in UB research among children with moderate to severe short stature, including socialization based on height rather than age, stigmatization because of appearance, poor social skills, social isolation, low self-esteem and poor academic achievement. But these data were primarily from short children with conditions such as underactive pituitary or chromosomal anomalies. The UB study showed that parents rated boys somewhat less socially competent with somewhat more behavior problems than the normal sample, but without major ·~ psychosocial problems. The short boys ."~ were rated as functioning disor tinctly better than the group referred for mental-health services. Boys' ratings of themselves mirrored their parents on social activ: -~ ity, but they didn't report having more behavior problems. Short adolescent boys rated themselves better athletically than conducted on Space Lab l. Findings in the second study, conother boys their age. Short girls showed little difference in social functioning, be- ducted on Space Lab 2, also showed that havior problems and self-esteem and re- the ability of astronauts to perform work ported being better at athletics than the when they returned to Earth, as meacomparison group. UB wins $600,000 NASA grant to study BP regulation in space B a 0 p y 5 c 0 5 p sured by performance on a specific physical-exercise regimen, was decreased, and that there was a relationship between the ability to perform work and time spent in space. Astronauts on Space Lab 2, who were in flight for 15 days, performed less well upon their return to Earth and remained limited longer than their counterparts on Space Lab 1, in flight for nine days. Both in zero gravity and in readjusting to Earth's gravity, the astronauts' bodies regulated blood pressure by expanding or constricting blood vessels in the presence of increased cardiac output, the results showed, a phenomenon not observed prior to the two UB Space Lab experiments. The experiments and equipment used on both Space Lab experiments were designed by Leon E. Farhi, M.D., UB dis tin- · guished professor of physiology. The new experiments, Farhi said, will be conducted in simulated zerogravity environments. "If we find something interesting through these Earth-bound experiments," he added, "we will go back to ASA for another in-flight experiment." UB researchers involved in the project, in addition to Farhi were Barbara E. Shykoff, Ph.D.; Christopher Eisenhart; Richard Morin; Albert]. Olszowka, M.D.; David R. Pendergast, Ph.D., and Mary Ann Rokitka, Ph.D. n 9 0 �a ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · said, "john has demonstrated a remarkable ability to keep Buffalo General in a leadership position in today's increasingly complex health care scene. "With the advent of health care reform Kinnard and the need to develop integrated health care systems, John's business acumen and creativity will serve General Care Corp. and the hospital well in the years to come." Butfalo General'sKinnard and Friedlander assume new roles fter serving as president and chief executive officer of General Care Corporation since its founding in 1985, William V. Kinnard, M.D., has stepped down to devote more time to his role as president and chief executive officer of The Buffalo General Foundation. Succeeding Kinnard is john E. Friedlander, president and chief executive officer of The Buffalo General Hospital, the main entity within General Care. ln making the announcement, Thomas R. Beecher, Jr., chairman of the General Care Corp. board of directors said that Friedlander, a BGH executive since 1984, will maintain his responsibilities as the hospital's president and CEO. Beecher described Kinnard and Friedlander as "exceptional leaders whose vision and achievements have earned them the respect and admiration of their peers in the health care industry." Kinnard, who relinquished his General Care Corp. responsibilities last September, noted that the move had been planned for some time. Kinnard had served as BGH president and CEO from September 1975 until March 1990 when he was named the hospital's first fulltime board of trustees vice chairman. He will continue as chairman of the board of directors of Friedlander WestLink Corporation, a for-profit joint venture involving General Care and several other Western ew York health care providers. Commenting on Friedlander's appointment to lead General Care, Beecher B u a 0 work more closely with the most visible and respected provider of health care services in the West Side community. "This merger will enable Buffalo Columbus and Buffalo General to jointly develop a strategic direction toward providing a comprehensive array of primary ambulatory care services to address the major health problems in the Hispanic and non-Hispanic communities of the West Side," he added. BGH first WNY hospital to oiTer endoscopic ultrasonography he Buffalo General Hospital now performs endoscopic ultrasonography (EUS), a new diagnostic technique that detects Gl tract tumors with greater accuracy. The technique provides higher resolution images of tumors within the Gl tract and its adjacent structures. Buffalo General is the only hospital in Western ew York to offer the new technique, according to Siddhartha Shah, M.D. , UB clinical assistant professor of medicine. "With EUS , a detailed five-layer structure of the gastrointestinal tract wall can be easily visualized," Shah said. "GI tract tumors distort this normal five-layer structure and can be detected by this new technique , in detail. It allows us to visualize with great accuracy how far the tumor extends through and beyond the wall and whether it involves lymph nodes and adjacent structures. Shah said EUS is superior to CT scanning in staging GI malignancies, with EUS accurate in more than 85 to 90 percent of cases and CT accurate in about 50 percent. The procedure takes one to two hours and is performed in BGH's GI Laboratory, usually on an outpatient basis. Buffalo General and Columbus Hospital begin merger talks n a move designed to improve the delivery and expand the scope of health care services to Buffalo's West Side, the Buffalo Columbus Hospital, its parent organization, Buffalo Healthcare Corp., and The Buffalo General Hospital have agreed to engage in discussions that will result in a plan to merge. Buffalo Columbus president and chief executive officer Andres Garcia described the discussions as a "dynamic opportunity" for the hospital to strengthen its position as the "pre-eminent provider of primary, ambulatory care and substance abuse services for the Lower West Side. "Our aging facility and equipment have made it increasingly difficult for Buffalo Columbus and Buffalo Healthcare Corp. to provide the Hispanic community and all people on the Lower West Side with the health care services they expect and deserve," Garcia said. john E. Friedlander, Buffalo General president and chief executive officer, said BGH "welcomes the opportunity to p y 5 c a 5 p n g 9 9 �- · ·· ·· · -- - -~- - - ···· · ··············· · ····· · ·· · ········· · ·· · · · ·· · ····· · · ·· · · ····· · · · ········· · ECMC officials hope the new facility will provide simpler and faster services for outpatients using the hospital, including dedicated parking, decentralized, "point-of-service" registration and improved patient flow from one service to another. The facility would be funded through the sale of general obligation bonds, with ECMC contributing about $2 million, based on the level of surplus hospital officials expect for 1994. The twostory structure will be the first construction project at the medical center since it was built in 1978. Patients are given intravenous sedation. Routine endoscopy locates the tumor and the dedicated ultrasound endoscope examines the area. Feeley named associate director at Buffalo VA Medical Center illiam F. Feeley has been named associate director at the Buffalo VA Medical Center. He will be responsible for all administrative support services at the facility , including human resources, medical ad- .---------. ministration , fiscal and acquisition and rna teriel management. The position reports to medical center director Richard S. Droske. Prior to coming to Buffalo, Feeley held associate director positions at the VA Medical Centers in orthampton, Massachusetts, and Grand Junction, Colorado. Hospice Buffalo receives training grant to support its CHILD Project fficials at the Erie County Medical Center have announced plans to build a $14 million ambulatory care center r.ext to the hospital. The 80,000-square-foot building will house primary care, diagnostic and specialty outpatient services including family and internal medicine, OB-GYN , pediatrics, chronic dialysis, laboratory specimen collection stations and X-ray facilities. The hospital submitted a CO last December. a 0 p h ·· ···· · ~ ~ they support families in their communities. The CHILD Project team will define conditions of infants at risk and teach others to recognize these risk factors in order to appropriately refer or care for the infant. Project training will include the medical and psychosocial aspects of the problems of prematurity, cocaine exposure, HIV/AIDS, sickle cell anemia, developmental disabilities and failure to thrive. Buffalo General announces ED renovation and expansion project he Buffalo General Hospital has unveiled plans for a $5.6 million renovation and expansion of its he ew York State Department of department of emergency mediSocial Services has awarded Hoscine. pice Buffalo a $42,000 grant to John Friedlander, BGH presiprovide informational and educa- dent and chief executive officer, detional programs designed to im- scribed the project as the "most signifiprove the provision of services to cant construction program" for the hosdisabled infants with life-threatening pital since the mid-1980s when the new conditions. Hospice Buffalo is one of 16-story medical tower building was only two organizations in ew York completed. State to receive grant funding for this The project, to be accomplished in program. phases so as not to disrupt ED operaThe grant was awarded to Hospice's tions, is expected to be completed about CHILD Project, a special program intro- mid-1996 . duced in 1994 as part of a ew York The initial phase will involve conState Department of Social Service spon- struction of a two-story addition on the sored initiative to improve services to Ellicott Street side of the ED , including medically frail infants who are at risk of a new elevator to operate between the medical neglect. The grant will be ad- ground floor and the first floor of the ministered by The Life Transitions Cen- main hospital building. ter, an agency affiliated with Hospice Renovation of the first floor , previBuffalo that provides education, counously occupied by same day surgery, seling and support groups for children, will occur during the project's initial adults and families concerned about phase. In June or July of this year, ED grief, death and living with a serious or operations will move from the ground life-threatening illness. The program, floor to the first floor until renovations which began this month, will continue are complete. through February 1996. Temporary relocation will ensure The CHILD Project will assist and uninterrupted service for the more than support social services professionals as 3,000 patients who use the ED. ECMC submits CON to build $14 million outpatient care center B - - · - -·- - =-- - y s c a s p 9 9 �• • PHOTOS BY K.C . KRATT �UB's new research building brings together researchers in away designed to produce results far beyond what they can accomplish alone BY SCOTT THOMAS It looks sharp. It's built for speed -everything within ready reach, all the amenities for comfort and efficiency. It's roomier than you'd expect from the outside. You might say the new research building of the School of Medicine and Biomedical Sciences is a luxury vehicle perfect for the next stretch of the scientific highway. The new laboratories combine functionality with beauty in a classical design. �The new building features standard. institutional-quality materials used in an innovative and visually pleasing way. Light-reflective materials open up the interiors: maple casework makes the workspace bright and inviting. THE RESEARCH BUILD! G is in the final stages of completion, culminating a project more than five years in the making. The building provides for 60 wet laboratory units , each consisting of a main lab and two auxiliary labs; support facilities such as equipment rooms , utility rooms, darkrooms and "environmental chambers" for heated or chilled materials ; 60 offices for investigators; and six spacious conference areas. It's a significant advance for a school whose progress in research- one of the most significant factors in attracting and keeping high-quality faculty members - had been squeezed by a severe shortage of laboratory space. "It was essential that we make a sizable space readily accessible and functional very quickly ," says Bruce A. Holm, dean for research and graduate studies at the medical school. A faculty member throughout the time the building was being planned, Holm moved to the dean's office in 1993. joseph T. Spence , Ph.D. , Holm's predecessor as dean for research and graduate studies, was heavily involved in helping researchers, administrators and building planners reach a consensus on just what form the new structure should take. "We very much saw the building as a tool , just as any piece of equipment in the laboratories is a tool, " said Spence, who left UB in january 1993 to become head of the Beltsville Human utrition Research Center, a division of the U.S. Department of Agriculture's Agricultural Research Service. "We tried to be one step ahead of where we were today," Spence said. "We asked ourselves what people would be 0 B u 0 0 p 5 doing five, 10, 20 years down the road. And we were particularly interested in coming up with some design concepts that would make it as flexible as possible. " The existing labs in the Cary-Farber-Sherman (CFS) complex, Holm said , not only were inadequate for the number of researchers working , they needed major renovations to bring them up to state-of-the-art standards. "The problem with that," he says, "was that with the laws concerning asbestos abatement, it was incredibly costly to renovate those labs. We actually found that it was cheaper to build the new building. " The old labs will stay, he added , and "we will renovate them , but now we can do it in more of a piecemeal process. " After a competitive bidding procedure, the architectural firm Helmuth Obata Kassebaum was commissioned to design the building and supervise its construction. HOK is well-known in architectural circles - primarily for its sports facilities , including Baltimore's baseball stadium, Oriole Park at Camden Yards, Buffalo's Pilot Field and UB's University Stadium. Andy Wong, a principal at the ew York City office of HOK , served as the firm's project manager for the research building, leading a core team of three architects. He says the job involved drawing people out on what they wanted just as much as it did drawing lines on blueprints. "We understood that the mission of this project was to create more research space," Wong says. "The ability of the institution to attract research grants and talent is really tied c o n 5 p n g 9 �Maintenance-free materials were used to provide longevity as well as workability. Amenities include special flooring. Corian countertops. vinyl wall coverings and granite flooring and sculptured steel walls inthe main elevators. "Ultima tely, a lab bui lding is about the environment in into that. But that doesn't begin to define the goals of the the lab ," he says. "It's about the research environment that project, everything that's wrapped up in the warm fuzzy surrounds the investigator. It doesn't work from the outside stuff, the qualitative issues that need to be addressed. " in, it works from the inside out: how the benching works, In a series of dialogues with investigators and other how much wet space there is , how that relates to service faculty , school and campus administrators and State Univerrequirements ... sity of ew York representatives, the planners defined "We began to get a sense of the some of those qualitative issues. Says academic day there (among Wong: "They ranged from the researchers) , what the global - 'We have X numculture is there. We ber of dollars , get us the "THE MISSION of this project was to create more research discovered that most laboratories posspace. The ability of the institution to attract research grants and talent is really tied to people don' t really sible' - to the more spewant to hang around cific- 'We don't have a that But that doesn't begin to define the goals of the project. everything that's wrapped in a public space sq front door to this acaup in the warm fuzzy stuff. the qualitative issues that need to be addressed." much as have convedemic complex, and we nient access to their serwould like to create that. ' vice areas. They tend to spend "The end product, the building, more time in their research environthe attributes of the building- its modument than in the public rooms. The culture of research is larity, its flexibility- you just can't take that off the shelf and more that they need to be in their own spaces. But we built say, 'Here it is.' You have to tailor those generic approaches, and that includes siting, circulation , connectivity to the it to encourage interaction. For example, the conference existing campus, landscape issues, future connectivity. The rooms are in an area where there's a lot of circulation. " CFS complex is a pretty Byzantine maze of things. We didn't That kind of thinking is evident in the design of the want to aggravate the circulation issues, we wanted to clarify completed building. It's eight stories, including a ground them. " floor , six floors that house laboratory and office space, and a And primarily, Wong said , they talked about how to make penthouse floor with mechanical equipment for the buildthe building work best for the people whose work it was ing. The laboratory floors are laid out identically to each intended to further: the researchers themselves. other- labs , offices, support rooms and conference rooms a 0 0 p y 5 c o n 5 p 9 0 �Outside the laboratories, the floors are built for convenience and easy functionality. Support rooms and equipment rooms hold excess materials and equipment, freeing up space in the labs. Each floor has two darkrooms for developing photos and X-rays; the darkrooms are at one end of a long corridor, but an indicator light in the center of the hall shows whether the darkrooms are in use- saving busy researchers the long walk to find that out. In addition, dozens of small touches make the research building a comfortable place to work. "We had to use very maintenance-free materials, materials that have longevity," says architect Wong. "We were really challenged, because normally that grade of material is not one that the (construction materials) industry features or focuses on to try to come up with a lot of new colors or patterns. Our challenge was to use it in as innovative and visually pleasant a way as possible. "We did that by choosing very pleasing patterns on the floor, in the tiles. We took the standard, institutional-quality things and used them in a different way. We introduced daylight into the corridors by the placement of the windows. We chose to use as light-reflective materials as possible to all located in the same place, making it easy to find one's way around and easy to service the heating/cooling, electrical, water, waste, fiber optic and other supply and disposal lines. The labs themselves combine functionality with a large degree of beauty. Each laboratory unit consists of a large lab space (some with a center island) and two smaller adjacent labs where auxiliary or preparatory work can be done. There are the usual assortments of taps for purified water, natural gas and air. The countertops are a black epoxy resin, built to simulate the old slate tops that researchers have used for centuries. Fume hoods allow for work with materials that need to be vented to the outside. (ln addition, positive air pressure is maintained in the corridors, and negative in the rooms themselves, to prevent potentially hazardous airborne materials from escaping into common areas.) Solid maple cabinetry inset with glass windows gives a classical feeling to the rooms. Across the hall from each lab unit is an office space of about 14 by 15 feet; every office has a window, recessed over the attractive maple veneer that conceals the room's heating! cooling unit. The building completes a circuit with the Cary-Farber-Sherman complex and connects Squire and Harriman halls through tunnels and overhead walkways. The buildings now enclose a quadrangle of grass. ringed by sidewalks and crisscrossed with lights. B a a p h s c a n 5 p g 9 9 �- --- working with microbes or hazardous chemicals, but it can be open up the interiors. ln the labs, the maple casework was to costly in terms of heat loss. make it as bright and as inviting a space to be in as possible, To alleviate that costly loss, exhaust air passes over a because people spend a great part of their day there." series of pipes containing glycol; the heated glycol is then Thus, such amenities as chalkboards scattered throughrecirculated from the top floor down to the out the corridors for impromptu brainstormbasement, where it heats the incoming sessions, Corian countertops ing fresh air. "lt probably traps in the restrooms, vinyl wall one-third to half of the heat covering in a pattern of that would otherwise be "Ultimately. alab building is about the environment in the lab. It's about the tiny squares, special lost," Krygier says. flooring in the first-floor research environment that surrounds the investigator.lt doesn't work from the In addition , to save animal holding areas beelectricity, lights in the outside in. it works from the inside out how the benching works. how much cause it's continually building are controlled being washed down and wet space there is. how that relates to service requirements." motion sensors - no by beautiful granite flooring need to remember to flick and sculptured steel walls in the switch off when you leave. And the two main elevators add a sense of a sophisticated reverse osmosis water purification comfort and beauty as well as functionality. system treats tap water to remove sediments and bacteria by just as notable is the environmental consciousness that forcing it through a screen at high pressure, running it went into the building's design. through a charcoal filter and submitting it to ultraviolet rays. The air in the building is renewed nine times per hour, On the outside, the building completes a circuit with says Theodore R. Krygier, project coordinator for the the Cary-Farber-Sherman complex and connects Squire University's Office of Design and Construction. That's necand Harriman halls through tunnels and overhead walkessary for safety, in a building where investigators might be ways. (A passkey card system will secure the laboratory floors against intrusion from the common pedestrian corridor. ) The buildings now enclose a quadrangle of grass, ringed by sidewalks and crisscrossed with lights. Andback to the "warm, fuzzy" goals that were estabSchool of Medicine and Biomedical Sciences Research Building lished at the outset- serve as a front door to the medical school complex. Laboratory units ................................................. 60 "The materials that we chose were very quiet, so we attempted to give a lot of interest to the pattern and shapes" Equipment rooms ........ ............... .... .............. ...... 12 of the exterior, Wong says. "We chose the glass to be very harmonious with the brick. We attempted to create a diaUtility rooms ............................................... .. ...... 12 logue. The most prominent windows are for the office areas, and there are areas of large glass, such as the big vertical element at the corner of the building near the front entrance. Common work rooms .. .......... ......... .... ...... .. ......... 6 "In everything we did on the exterior, there was a very conscious effort to create an articulation of the exterior Darkrooms .. ... ... ... ...... .. .. .... ... ........ .... ... .... .. .... .. ... 12 walls. Shadow and play give this building a sense of scale. We chose to use as many of the given elements in as artistic a way Environmental chambers ................................. .. . 18 as possible. "We tried to create a sense of balance and harmony with Conference areas ............ ........... ................. .. ......... 6 the other elements that were pre-existing. The CFS complex had a fairly warm tone, and we attempted to borrow from that. The dental school had a palette that was a little more Offices ................................ .......... .. ..................... 60 rich. We tried to create a sense of harmony that would bridge all the elements that were there and at the same time create Laboratory space ....... .............. 110,000 square feet an identity distinctive to the medical school." An identity - but as yet, no name. Building .. .................... ... .. ... ... . 210,000 square feet "We do hope to name it," Bruce Holm says. "There have been some ideas. There are lots of people you can name About $54 million, funded by the State COST buildings after. " For the research building's new tenants, at least, the name University of ew Yorl? Construction Fund is excitement. B a a p h y c a n 5 p 9 9 9 �Rror~anization of scientists anrf rlinicians 111lomises srner~islic results t ��"The building is more than just a building," Holm said. "It's really meant to be a catalyst to put into effect an overall plan that's part of our mission for the next decade or two. It's allowed us to bring together people who wouldn't otherwise have come together. I'm very excited about it." Much of the school's research is performed at the hospitals of the Graduate Medical Dental Education Consortium of Buffalo, where many of the medical school's faculty both teach and practice. That hospital-based research will continue , Holm said ; the new research centers, or "affinity groups" as they are known, each comprising from 10 to 30 people, will do their work in the new building, and in renovated dry-lab space in the Cary-Farber-Sherman complex. "What we're moving are highly productive, highly thematic research groups, " he said. "They've actually in large measure self-formed. We left it to the investigators to find their own affinities, and some people are members of more than one group. " It's hoped that the new alignments will help continue a decade-long trend that has greatly strengthened the medical school's position among major medical research universities. Holm estimated that during the 199394 academic year, the school's faculty members brought in $30 million in grant money- excluding the approximately 200 faculty on the staff of Roswell Park Cancer Institute. Add in the grants to those Roswell Park researchers , and the figure climbs to $58 million. "It's dramatically on the increase ," Holm said. "My guess is that, 10 years ago , we were lucky if we were talking $10 million. "We've recruited new faculty members and initiated some new programs, and it's taken off in a big way. It's been a concerted effort to build up the research program in the school of medicine," he added. A thriving research program has two major benefits. Foremost, of course, it advances the frontiers of scientific knowledge and medical treatment. But it also gets the medical school's name out in front of the national scientific audience, making it much easier to attract the top-quality investigators and teachers who , in turn, create the best education for future physicians. Holm points out a third advantage, one that directly benefits medical students: "We have a variety of programs for the medical students centered around these research activities, that in fact teach them how to think. "When they go out into a world of medicine which is constantly changing, their education will be continuing for the next 30 or 40 years. "They need to be able to look at the literature and to be able to critically read journal articles and determine what is the best type of treatment for their patient. Having a strong research program means that we're imparting that creative thinking quality. " A comprehensive survey of research at the medical school would fill a book. But a quick overview gives a snapshot of the variety of projects being undertaken , both in basic medical science and in the clinical application of that science. Here, then , are some highlights of the medical school's research activity: Thomas]. Langan , M.D., associate professor of neurology and pediatrics and an attending neurologist at The Children's Hospital of Buffalo , coordinates an affinity group in Neurosciences focusing on the provocative idea that the brain, long thought to be unable to repair itself, "doesn't simply age and deteriorate but has a potential for a positive kind of change. " The eight members of the group , he says, are looking into such areas as how the visual system changes over time, and how it can regenerate and repair itself. Research on the cellular level, into such mechanisms as ion channels and protein secretions, seeks to discover how the nervous system changes with time and how clinicians might manipulate that. One member, a neurosurgeon , is investigating transplantation strategies to address conditions such as Parkinson's disease. Langan , whose own research concentrates on the plentiful brain cells called astrocytes , says formation of the new affinity groups can only help researchers' collaborations. "We don't talk enough to each other," he said of investigators in general. "The kind of exchange that most people find most productive is running into each other in the hall and talking things over. This will enhance that kind of day-to-day collaboration. " And Langan, who sees young patients with such brain insults as cerebral palsy, mental retardation and epilepsy, welcomes the alliances between basic scientists and clinicians. "Scientific illumination has to come before any attempt at treatment," he said. "The draw really was to try to understand some of these terrible brain syndromes, and by understanding them better, find out how to change things. " Robert Hard , Ph.D. , and his colleagues in the Imaging Center are accomplishing what was unimaginable before the invention of the microchip. Using powerful new technologies of video microscopy and computer methodology, they study tissues , cells- even individual molecules within cells. They accomplish that by using fluorescent markers to The new alignments continue adecade-long trend that has greatly strengthened the medical school's position among major medical research universities. B u a 0 p h c a 5 p n 9 9 �Bruce A. Holm. Ph.D. Associate Dean for Research and Graduate Studies Associate Professor of Neurology and Pediatrics �John A. Krasney. Ph.D. Professor of Physiology target molecules , attaching them covalently in a way that doesn't disturb the molecules' function , and then following them at low-light levels. The group has 16 members from five teaching departments. "There are people doing the same kinds of research in these different departments , and these interdisciplinary programs afford an opportunity for them to interact on a more formal basis than usually occurs," Hard , associate professor of anatomical sciences, said. Other sophisticated technology that the Imaging Center has in place or hopes to install: confocal microscopy , which enables the researcher to collect information in three dimensions and make 3-D computer models of cells; atomic force micro copy, so incredibly sensitive that it can measure forces between molecules; and laser tweezers , which use a laser beam to move parts of an individual cell around, even slicing chromosomes off a mitotic spindle. "The idea is to get everybody on a common Ooor and use (the Imaging Center) as a resource for the whole medical school, as well as promote more interactions on applying this technology to a variety of medical problems," Hard said. The Cardiopulmonary Center was initiated in 1990 to build on the medical school's diverse faculty interests in cardiovascular and pulmonary physiology. About 40 investigators are working in three major subgroups- cardiovascular medicine, pulmonary medicine and developmental biology. B u a 0 p h "Over the years here at Buffalo, one of the great research strengths of this university has been in cardiovascular and pulmonary research ," saidjohn A. Krasney, Ph.D., professor of physiology and liaison for the group. "The problem has been that we've been geographically separated. Many of the labs are at Erie County Medical Center and at other hospitals , and some of us who are doing basic science are here on the Main Street campus." ow, bringing together the affinity group can result in much more convenient and frequent interaction. "We're interested in the physiologic mechanisms that regulate and control the circulation in various situations," Krasney said. He gives as examples the problems of coronary artery disease, pulmonary disease , high blood pressure and changes in circulation that occur at birth. Cardiopulmonary Center investigators also are exploring how nutrients are carried in the blood to the body's organs and cells, and how that nutrient transfer is accomplished. One high-profile project under way is a ASA-supported study of how elevated carbon dioxide affects circulation to the brain. ln both the U.S. space shuttle and the Russian Mir space station, carbon dioxide levels have approached a very high 3 percent. "This can lead to problems in the ability of the astronauts and the cosmonauts to function, " Krasney said. One part of this study is being done in Cologne, Germany, in collaboration with scientists of that nation. c a 5 p n g 9 9 �---- -- - Robert Hard. Ph.D. Associate Professor of Anatomy and Cell Biology At the Center for Microbial Pathogenesis, researchers are looking at parasitic, bacterial and viral pathogens involving such projects as vaccine delivery systems and vaccine development, host-parasite interactions, the body's immune response to bacteria and how various viruses work in cells. One development being tested: a vac- .----.-------cine to prevent middle-ear infections in infants. The researchers point to four prevalent infectious diseases that have arisen in the past 15 years - AIDS, Lyme disease, Legionnaire's disease and toxic shock syndrome - as evidence of how much work remains to be done. This center in january announced that it has received a $1 million grant from the Lucille P. Markey Charitable Trust, which will be used primarily to hire additional researchers. Medical school officials hope that funds from this leading grant-giving organization for fundamental biological and medical research will contribute to the school's ability to attract new investigators. In announcing the award , UB President William R. Greiner said, "This important award indicates the Markey Trust's confidence in, and support for , UB's work in crucial areas of biomedical research. It will be the critical ingredient that supports major progress in the study of infectious disease." 'The Markey Trust's award will play a crucial role in the university's ability to seek matching funds for infectious disease research from other private and public foundations and agencies," said john aughton, M.D., vice president for clinical affairs and dean of the medical school. john Hay, Ph.D., professor and chair of the medical school's microbiology department and a principal investigator for the Markey award, noted, "This award will allow a marked expansion of the center's important disease investigations. It also will give a substantial boost to the national and international reputation of the center and UB. " Holm , also a principal investigator for the award, says the center developed from a collaboration initiated in 1981 by three scientists in different departments in the medical school. The center now includes 15 senior investigators , as well as support staff, and input from five departments. The pmgmms for the medical students centered around the school's research activities, in fact teach them how to think. B u a a p h y 5 c a n 5 p n g 9 9 5 �Other research efforts involve basic scientists and clinician scientists: The Metabolic Regulation Group studies how cells regulate their metabolism by hormones and other mechanisms. Investigators are looking at how cells use copper, the regulation of insulin secretion, the mechanisms governing obesity and the use of surfactants in treating lung disease in newborns. In the Molecular Mechanisms of Cell Regulation Center, researchers are investigating how proteins work in regulating cell processes and metabolic pathways, in addition to their function in such diseases as cancer, endocrine disorders and skin diseases. An overall goal of the group is to understand how these proteins affect expression of the genetic code in the body's development and aging, as well as its pathologies. Discovering the physical configuration of cells and their component molecules is the focus of the Structural Biology Center. Its investigators use X-ray crystallography and nuclear magnetic resonance imaging to discern molecular structures, including those of proteins, D A and RNA, carbohydrate and membranes. The Toxicology Research Center is in its seventh year of operation. Its focuses include developing in vitro methods of studying the body's reaction to foreign substances, in contrast to toxicology's traditional in vivo animal-based research. For example, in a study funded by the ational Institute of Environmental Health Sciences, researchers are seeking to develop biological markers that would indicate exposure to a particular substance. "The goal," says james Olson, M.D. , associate professor of pharmacology and liaison for the group, "is a simple test, like a blood test, to determine whether someone has been exposed to a substance or is susceptible to damage from exposure. " The investigators, he said, are looking for changes in molecules or cells, such as levels of enzymes or messenger R A. The group's other main focus, Olson says, is measuring levels of the chemicals themselves in the blood. For example, toxicologists have monitored the health of people who live along the Great Lakes and eat fish that may expose them to such contaminants as PCBs, dioxin and myrex. Excessive exposure may lead to reproductive and developmental problems. Initiatives in outcomes research and primary care constitute another major area of medical school investigation. Several new projects of the Rural Health Initiative study health policy and practice in the nation's rural areas. One, funded by the federal Office of Rural Health Policy, looks at the impact of managed care on rural communities throughout the United States, and the impact nurse practitioners have had on health care in rural areas. Another explores how the spread of AIDS has affected rural health care systems. A companion study looks at why immunization rates vary John Hay. Ph.D. Professor and chair of Microbiology �~~~- ~- -- -- ~ James Olson. M.D. Associate Professor of Pharmacology fighting coronary artery disease , osteoporosis and endometrial cancer; studying how a low-fat diet affects risk of cardiovascular disease and breast and colo rectal cancer; and investigating whether calcium and vitamin D supplements reduce the risk of osteoporosis, colorectal cancer, high blood pressure and breast cancer. Initiatives in Rehabilitation Medicine include the Uniform Data System, which is being developed into one of the largest databases in the world on issues in medicine , pediatrics and gynecology. "They're able to provide different subsets of this data to different people who need it for generating policy decisions, in the clinical management of patients, or to do outcomes research ," says Holm. Again , a brief survey only hits the highlights of the wideranging and growing research program at the medical school. Holm , for one, expects research to remain a strong part of the school's activity. "Our IH funding is growing, and it's as high as it's ever been," he said. "Realistically we're not going to be able to keep up this level of growth in the current (political) climate. But even if we were to plateau at the current level, I would not be unhappy. "I think it's a very exciting time ." greatly from county to county. Thomas Rosenthal, M.D. , chair of family medicine, says a new Department of Health grant will enable researchers to study how rural primary care physicians use the government's medical guidelines in treating the fast-growing illness of congestive heart failure. "We'll look how closely physicians in rural ew York State follow those guidelines, and if not, why not; and what kinds of things could be done to increase the use of those guidelines, if that's appropriate ," Rosenthal said. That's not specifically a rural issue, he acknowledged. "But there are differences in how medicine is organized in rural communities and in urban areas. We've developed a reputation for being able to look at these things in a rural environment. " Another initiative in outcomes research and primary care involve UB as one of 16 vanguard clinical centers nationwide that are part of the $635 million Women's Health Initiative , the largest clinical trial ever undertaken in the United States. Investigators are recruiting as many as 3,500 women from Western New York, and the study will include both clinical and observational components. Among the investigations: testing how effective hormone replacement therapy is in B a a p y s a 5 p n g 9 9 5 �a ······································ · ···· · ········· · ······················ · ··········· FDA chief David Kessler, M.D, J.D, delivers 1995 Harrington Lecture SAYS AGENCY HAS A RESPONSIBILITY TO DETERMINE THE POTENTIAL BENEFITS NEW DRUGS CAN BRING AS WELL AS THE POTENTIAL HARM THEY CAN BRING esponding to recent public criticisms that his agency moves too slowly in approving new drugs , Food and Drug Administration Commissioner David Kessler , M.D. , ].D. , told a standing-room only crowd at the medical school that the FDA has dramatically increased the access that patients with life-threatening diseases have to promising new drugs. Kessler delivered the D.W. Harrington Lecture February 9. He said the FDA has sped up the approval process for new drugs and increased patients' accessibility to new drugs that are still in the clinical stages of testing. Kessler, who was appointed by President George Bush in 1990, said the AIDS epidemic changed the way the FDA handles the approval process for B u 0 0 p new drugs offering potential treatments for patients with terminal diseases. He said in today's world , it is important for these patients to have the right to take a chance on a new drug when seemingly all other treatments have failed. "Experimental sources of therapy, such as new drugs , represent a rare source of hope for those people with conditions that have seemed to outsmart medical science," Kessler said. He said he realizes the FDA must address the unique problems facing those patients who have nothing to lose by trying experimental treatments. "In urgent cases where people are dying and no effective therapy exists, something more is required of the FDA," he added. The FDA has come under sharp criticism recently from conservative groups y s c o n 5 that believe the government over-regulates the pharmaceutical industry and hurts its ability to compete globally, as well as causes unnecessary deaths to people who could be helped by therapies awaiting FDA approval. Full-page ads in national newspapers trumpet, "If a murderer kills you, it's homicide. If the FDA kills you , it's just being cautious. " But Kessler points to widespread misconceptions about the length of time it takes for the FDA to approve a new drug. "For most drugs , the average approval length is l3 months, " he said, "not seven years or 10 years like most people think. " Sometimes the agency moves even quicker. Kessler, a graduate of Harvard Medical School and the University of Chicago Law School, said that in the past few years four new drugs- most notably the potential AIDS treatment, DDI - received approval in less then seven months. Kessler said this kind of fast-track approval is one of the best ways the FDA can address the needs of patients afflicted with life-threatening diseases. In 1992, he noted, the FDA also began granting conditional approval to certain drugs before final confirmation of direct evidence of their effectiveness is made. Drug manufacturers now can p g 9 �I ~- --- - ~- ---- -- · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·a I ' I I "The riskiest thing we can do is to not take risks. Especially since patients have said that they are willing to take the risks." said it is "not enough for the FDA just to get new potential therapies to people who need them. " lt is also its responsibility to "get answers" about the potential benefits a drug may bring as well as the potential harm it can cause. "The challenge," he said, "is to strike the right balance between access and answers. "One day we're going to make a mistake ," he said. "But the riskiest thing we can do is to not take risks. Especially since patients have said that they are willing to take the risks." The magnitude of these risks depends on the precision of the FDA approval process, which Kessler said "is only as good as the scientific research on which it is based. " Participation in the clinical trials phase of that research, he said, was closed to the most seriously ill patients - ironically, those who might benefit most from the experimental drugs being tested - until 1987 when the FDA opened the doors for tens of thousands of seriously ill people, mostly AIDS patients, to receive drugs free of charge while the drugs are in clinical trials Kessler said the FDA had to realize that while diseases such as AIDS "have no geographical boundaries, access to cuLLing-edge medical technology often does. " ln 1992, this program was expanded "Experimental sources of therapy, such as new drugs, represent a rare source of hope for those people with conditions that have seemed to outsmart medical science." apply for conditional approval if they prove a drug is "reasonably likely" to successfully treat a disease. Kessler said drugs receiving conditional approval are still held to the same standards as drugs receiving full approval and that manufacturers must conduct post-marketing studies to ensure efficacy. But, he said, "the less time a drug is in clinical trials, the less we will know about it and the more risks we will take when we make it available." Kessler B u a 0 p h y 5 a n 5 p to include even more patients. "Today, drugs that show promise are being made available to patients before they have received final approval from the FDA and before they are marketed to the public," said Kessler. The D.W. Harrington Lecture Series was established in 1896 by Devillo White Harrington, an 1861 graduate of the UB medical school and a professor of genitourinary and venereal diseases from 1886 to 1905. BY CHRIS SHEA Hershey appointed to Veterans Affairs Neurology AdrtsoryGroup inda A. Hershey, M.D., Ph.D., associate professor of neurology and chief of neurology service at the Buffalo VA Medical Center, has been appointed to membership on the Department of Veterans Affairs eurology Advisory Group. The appointment was made by john Booss, M.D., VA's director of neurology service for the 171-medical center system. The 11-member advisory group, composed of both VA and non-VA physicians, will serve as a policy advisory body for the nation's largest health care system. g 9 5 �a ························································································ Hauptman-Woodward Institute honors Kanski and Tomasi Nolan granted mastership in Amencan College of Physicians he Hauptman-Woodward Medical Research Institute, Inc. (HWl) honored two local physicians during its Fourth Annual Awards Luncheon held in january. james R. Kanski, M.D., clinical associate professor of medicine and a practicing physician with The Buffalo Medical Group, received the Helen Woodward Rivas Award for service to HWl. Thomas B. Tomasi, M.D., Ph.D., president and chief executive officer of Roswell Park Cancer Institute, received James Kanski, M.D. the George F. Koepf, M.D. Award for his contributions to the advancement of biomedical research. The awards were instituted in 1992 to honor the founders of HWl. Kanski received his medical degree in 1960 from UB's School of Medicine and Biomedical Sciences. A member of the HWI board of directors since 1975, he served as vice president and chairman of the nominating committee for most of his tenure. Kanski stepped down from the board in january after 20 years of service. He has also served as chief of the endocrine clinic of The Buffalo General HosThomas B. Tomasi, M.D. pital. Tomasi received his medical degree from the University of Vermont Medical School and his Ph.D. from Rockefeller University. The author of more than 300 publications and abstracts, he also serves as chairman of Roswell's department of molecular medicine. B a 0 p ames Nolan, M.D., professor and chair of medicine, has been granted mastership in the American College of Physicians by that body's board of regents. Masterships are given to fellows who have made distinguished contributions to the medical profession because of personal character, positions of honor and inOuence, eminence in practice or in medical research or other attainments in science or the art of medicine. olan received the award at the College's 76th Annual Session in Atlanta this month. Naughton receives honorary degree from Kosin University ohn aughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences, received an honorary degree of doctor of medicine from the Kosin University in Pusan, Korea, last month. Naughton, dean of the school since 1975, is an acknowledged authority in the areas of exerci e physiology, exercise testing , cardiac rehabilitation, graduate medical education and regionalization of health care. His professional training is in internal medicine, cardiology and psychosomatic medicine. He holds fellowship status in the American College of Physicians, the American College of Cardiology and the American College of Sports Medicine. He has authored or co-authored over 120 peer-reviewed articles and two textbooks. He formerly directed the rehabilitation center at the University of Illinois School of Medicine in Chicago, h y a n 5 the Division of Rehabilitation Research and Training Center at the George Washington University Medical Center, Washington, D.C., and the ational Exercise and Heart Disease Project. Hui elected to fellowship by American Physical Society ek Wen Hui, Ph.D., research professor in the department of biophysics at Roswell Park Cancer Institute, as been elected a fellow by the American Physical Society. Each year the society's council elects members whose distinguished efforts have advanced physical science or its applications. Election to fellowship is limited to no more than half of one percent of the membership, or one in 200. Hui, a specialist in electron optics, was honored for his "innovative application of electron diffraction and other physical methods to elucidate membrane and liquid crystal structures, phase transition and membrane diffuse mechanisms." Sarkin named to chair pediatric association'seducation panel ichard Sarkin, M.D., clinical associate professor of pediatrics and attending physician at The Children's Hospital ofBuffalo, has been elected to the position of chair of the Ambulatory Pediatric Association's Special Interest Group on Medical Student Education. As chair, Sarkin is responsible for making recommendations on curricular structure and teaching methodologies for medical students across the country during their pediatric rotations. Sarkin is also a member of the executive committee of the council. p g 9 5 �I - -----~-~-- - ~-- - ~.- · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · o March Foundation'ssupport to school approaches $1 million loan fund to ensure help is available for students when unanticipated needs arise. lara March graduated from the University of Buffalo School of Medicine in 1907 and never treated a single patient. But she helped thousands of sick and injured people through her generous support of education for generations of physicians. At her death in 1967, the assets from March's estate were used to create a foundation for the medical school's benefit. Each year for nearly a quarter of a century, the Clara March Foundation has provided significant support for the school's students. Last year the foundation presented another generous gift of $65,000 for loans and scholarships, brining its total support to nearly $1 million. The foundation's annual gifts to the medical school provide 20 to 39 scholarships a year, in amounts from $1 ,000 to $10,000. A portion of the foundation's support is also set aside in an emergency illS elects RPCI researcher Joel Huberman,Ph.D, to rank of fellow oel Huberman, Ph.D., rese~rch professor at Roswell Park Cancer Institute and one of the nation's leading experts on D A replication, has been elected to the rank of fellow by the American Association for the Advancement of Science. Huberman, a cancer research scientist in the department of cellular and molecular biology at Roswell , was honored by the AAAS for his "pioneering studies of D A replication, particularly for his discovery and characterization of eukaryotic DNA replications origins. " Each year the AAAS elects members whose "efforts on behalf of the advancement of science or its applications are scientifically or socially distinguished. " Brodsky first woman officer of pediatric otolaryngology society inda S. Brodsy, M.D. , UB associate professor of otolaryngology and director of the pediatric otolaryngology department at The Children's Hospital of Buffalo, has been elected treasurer of the American Society ofPediatric Otolaryngology. She is the first woman officer elected to the organization. She has also been elected to the board of directors of the Society for Ear, ose and Throat Advances in Children, as well as the American Academy of Pediatrics, Section on Otolaryngology and Bronchoesophagology. At a reception for Clara March Foundation staff, trustees and recipients: from left, medical student and scholarship recipient, Aisha Prim; Foundation accountant M. Jane Dickman, C.P.A.; Foundation trustee Carmella DiPasquale; vice president of clinical affairs and dean of The School of Medicine and Biomedical Sciences John Naughton, M.D.; Foundation trustee Frank W. Warhus and his wife; and medical student and scholarship recipient James Murray Jr. B u a 0 p y 5 c o n s p n 9 9 9 - �One of the many gardens at the Buffalo City Hospital. Circa 1930. EtM~ built ~m ~e~ t~ peoJ~e mf its commmmity MEDICAL CENTER'S ROOTS DATE BACK TO AN OLD SCHOOL BUILDING REQUISITIONED IN 1909 TO DEAL WITH SCARLET FEVER EPIDEMIC rie County Medical Center had its roots in two Buffalo hospitals and an old , school building requisitioned in 1909 as a temporary contagious disease hospital by the then-commissioner of health Ernest Wende, M.D., and the mayor of the City of Buffalo,]. N. Adam. ~ B 1 ~ a 0 p y 5 a n 5 p n 9 9 5 �I -- - --- - -- - - - - THEN a 0 p A N D ~ N0 W In 1918, the new Buffalo City Hospital and opened in 1951. It was later named opened its doors; it was one of only 12 in the Donald C. O'Connor Memorial Wing the country that accepted all diseases for in honor of the hospital's third superintreatment. Later that year, the Erie County tendent. The last building added to the hosAlmshouse and Infirmary, located on the pital was the new School present site of the Univer84 for crippled children, sity at Buffalo's Main Street renamed the ComprehenCampus, burned to the sive Care Center for Chilground. Patients from the dren, which opened in Almshouse were moved to 1971. the new Buffalo City HospiGround was broken tal - abruptly and unexfor the present Erie County pectedly turning the new Medical Center on Octotuberculosis hospital into a ber 27, 1971, culminating public general hospital. 10 years of meetings, disThe original buildings of cussions, consultations the Buffalo City Hospital and planning. housed administrative ofThe new hospital fices and patient beds. In on Grider Street building 1922, more patient care became a reality because of the untiring space and the original urses Home were efforts of a group of civic-minded citiopened. One year later, communicable dis- zens led by then-county executive B. john Tutuska; Mrs. ease space was opened. And Mildred Campbell, chairin 1924, the Crippled woman of the Meyer HosChildren's School84, a day pital Advisory Board; and school for children with the Dr. Kenneth Eckert, presiresidual handicaps of polio dent of the Comprehenand other crippling diseases, sive Health Planning was opened. Council of Western ew The name of the Buffalo York. City Hospital was changed Designed by Gordon to the Edward J. Meyer MeFriesen Associates of morial Hospital in April Washington, D.C., the 1939 in honor of Edward]. new Erie County Medical Meyer, M.D., a prominent Above, Alpine Sun Lamps Center was one of the most were used in the treatment Buffalo surgeon who served of tuberculosis, rickets, modern and inefficient, as president of its board of scurvy and some skin novative hospital buildmanagers for 20 years. A diseases. Below, ings in the country when member of the University of fluoroscopy. Both pictures it opened its doors on july Buffalo School ofMedicine's circa 1930 from "Views of 9, 1978. class of 1891, Meyer also the Buffalo City Hospital." Today, it serves as one served as an instructor in of the medical school's afsurgery and adjunct profesfiliated teaching and resor of clinical surgery. Editor's note: Special thanks to Ed Leisner of Erie County In 1946, control of the search sites, as well as the Medical (enter's medica/library Edward]. Meyer Memorial area's designated Level I for his help in compiling this Hospital was transferred Trauma Center, burn article. from the City of Buffalo to treatment center, AIDS the County of Erie. unit and a host of other The last addition to the acute care and ambulatory Grider Street hospital was services available to the built for psychiatric patients community. n the winter of 1909, Buffalo was gripped by an epidemic of scarlet fever. With some 3,000 reponed cases and no contagious disease hospital facilities in the area, Wende and Adam, on February 19, 1909, urgently converted an abandoned school building on the corner ofBroadway and Spring streets into a temporary contagious disease hospital. The only other public hospital facility in Buffalo at the time was the Municipal Hospital at 770 East Ferry Street. Frequently referred to as the "pest house," it was operated by the Buffalo Health Department exclusively for the care of smallpox patients. In 1910, the city saw an alarming increase in the incidence of tuberculosis. That year, 561 tuberculosis deaths were reported, prompting the city fathers to plan a hospital for the treatment of tuberculosis patients. The 70-acre West Farm on Grider Street was purchased for $200,000 as the site of the new Buffalo City Hospital. It would cost another $3 million to build and equip it. In 1913, due to the rapid decline in the incidence of smallpox as a result of the gradual acceptance of the smallpox vaccine, Municipal Hospital was converted into a tuberculosis hospital to be used until the new hospital was erected on the Grider Street site. The high rate of tuberculosis in the city and the total lack of facilities to care for children with the disease attracted the attention of Edward H. Butler, Sr., the founder and publisher of the Buffalo Evening ews. As a result of Butler's efforts, a temporary tent hospital, large enough to accommodate 50 children, was erected on the Municipal Hospital grounds adjoining the original building. With the onset of a typically frigid Buffalo winter, the children were moved inside. Before the Buffalo City Hospital was completed, three separate units were added to the Municipal Hospital for the care of patients suffering from venereal diseases, alcoholism and psychiatric problems. B ------- y 5 a 5 p n 9 9 9 �A Spoonful of Humor© Stu Silverstein, ( BUT NOT QUITE AS MODEST AS SOME ithin the next few months we will once again have to face the ugly specter of the health care debate in the " ew Congress." As a physician, l feel it is my duty to give my congressman (whoever he is) my thoughts on the matter. l plan on making my own proposals. Here in California we witnessed the passing of Prop 187, "the illegal alien initiative. " lam currently collecting signatures in anticipation of getting the "Silverstein" initiative on the ballot: anyone in California who tries to start up another HMO or managed care company automatically qualifies as an illegal alien. Recycling is important in California, so my health care package will respect this by taking the 1,000-page plan that Clinton came up with and cuLLing it into 16th's to use as prescription pads. We can use half of them to prescribe sedatives for ewt Gingrich. (You know, if Elvis were alive today he'd be 60, and probably look something like ewt.) The guy is going wild , on the first day Congress was in session he climbed into Tom Foley's seat screaming like some kind of a rodeo clown running away from Richard Simmons. ewt is calling for us to sign on with his "contract with America. " Look , Democrat or Republican, you have to wonder about a guy who is willing to solve all your problems if you sign a contract with him. l suggest we shave his head and see if he's got three 6s tattooed on his skull. That might even explain the election results. "Network marketing" is big these days, especially among physicians try- B u a a p OF NEWT'S !) ing to augment their incomes to pay malpractice premiums. l think we should apply the concept to health care reform. For instance, if you are a patient having a spinal tap, you've still got your hands free , so you'd have the option of doing a spinal tap on the person in the next bed. Then you can bill him for your services, thus reducing your health care costs. He works on the person next to him and so on. The last person out just files for bankruptcy and even..-.--=~ tually nobody pays, and (almost) body gets hurt. My plan would inc I u de thing from warehouses. The Clinton plan requires that states set up large consumer groups called health alliances to collect premiums and bargain with health care providers. All companies with 5 ,000 emplo yees or fewer would have to buy coverage through an aliiLook, why don't they just hand over the job to WalMart? Pretty soon everyone will be employed by them anyway . We could call it "The Slice Club." You walk in to the shop, pick up a bag of Almond Joys, leg warmers and pick a urologist off the shelf to fine-tune your prostate. We could even have a driv ethrough out p a tientwindow .... that's where Ross Perot gets his hair cut and look what it's done for him. ... just to make sure it gets approved in the House and Senate, the definition of therapy will include chiropractic adjustments at clinics that charge $7 a drink. These days everyone is buying everyh 5 c a n M.D. Slll Si /rcrstci11, p•csidc111 of Sta11dup Mcdici11c Scmi11ars of Sa11 Fra11cisco, lect ures 11aliollwidc 0 11 5 humor ill mcdici11c. p 9 9 9 5 �- - -- . . . . . . . . . . .... ·. . . . . ... . . . . .... . . . ..... . ..... . . . ... E!j -- - -- - -- Stockton Kimball talk highlights annual symposium MEDICAL A L UMNI ASSOC IATION ' S 1995 SPR I NG CLINICAL DAY PRESENTATIONS FOCUS ON "THE PHYSIC IAN - hysicians are men and women of commitment, conscience and skill who face some of society's most challenging problems on a daily basis. Indeed , life and death issues are at the heart of medical practice , and so even private domestic relationships become part of a history and physical. The School ofMedicine and Biomedical Science's 58th Annual Spring Clinical Day, Saturday, April 29 , at the Buffalo Marriott, will address a variety of subjects encountered by physicians and other professionals concerned with the field of child sexual abuse, neglect, adolescent trauma and violence to the elderly. The conference, entitled , "The Physician- Healing the Abuse in Our F amily ," is intended to increase professional skills in prevention , recognition , assessment and treatment of all forms of maltreatment in the family system. The pres en lations will emphasize the awareness physicians need to recognize abuse in their patients and to encourage their roles as advocates for their patients. Specific approaches to these issues will be offered by the experts who have been carefully selected to speak at this year's program , designed to touch both the heart and the mind. The program has been designated for up to four hours of Category I Credit toward the Physician's Recognition Award of the American Medical Association and four prescribed hours by the American Academy of Family Physicians. B a 0 p h HEALING THE ABUSE I N OUR FAMILY" Faculty of this year's program inIntroduction clude: john F. Coyne, M.D. '85 "Amy" - Outreach Coordinator, Program Chairman PACT Clinic ofThe Children's Hospital of Buffalo Richard David Krugman, M.D. Landmarks in the Field of Child Abuse Dean and Professor of Pediatrics, School Stephen Lazoritz , M.D. of Medicine, University of Colorado , Denver, Colorado Stephen Lazoritz, M.D.- Medical Post Traumatic Stress in Abused Director , Child Advocacy Center , Children and Adolescents Children's Hospital of Wisconsin ; As- Susan V. McLeer, M.D . sistant Professor of Pediatrics, Section Head , Medical College of Wisconsin , Milwaukee, Wisconsin HIV: The Physician Can Make the Susan V. McLeer, M.D.- Professor Difference and Chairman, Department of Psychia- "A1ny" try, School of Medicine and Biomedical Sciences, University at Buffalo Kathleen G. Pharris, M.S.W. Coffee Break - Exhibit Reviews Director of Senior Day Center and Family Focus Program, Catholic Charities of Buffalo The Physician's Role as the Child Robert M. Reece , M.D.- Director, Advocate Institute for Professional Education , Robert M. Reece , M.D. Massachusetts Society for the Prevention of Cruelty to Children, Boston, Massachusetts The Tragedy That May Be Overlooked The agenda follows : Kathleen G. Pharris, M.S.W. Registration Business Meeting Welcoming Remarks Russell W. Besette, M.D. '76 President, Medical Alumni Association john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicin e and Biomedical Sciences 5 a n 5 p Annual Medical Alumni Luncheon and Stockton Kimball Memorial Lecture Child Abuse Prevention: Is It Too Little Too Late? Or Is It the Light at the End of the Tunnel? Richard D. Krugman , M.D. + g �~ ·········································· · ············································· Alumna dedicated her life to helping othe~ LISA BECHTEL '86 , PRACTICED WHAT SHE SAW AS THE IDEAL OF MEDICINE: A PATH OF SACRIFICE TO HELP THOSE WHO NEEDED IT MOST he lesson of Lisa Bechtel, M.D. '86, is one of humility. She died May 10, 1994, in Las Vegas, evada, where she made her home, conducted a private practice, managed a clinic and was in the process of raising three children. She and I palled around in medschool. What drew us together was what we saw as the ideal of medicine: a path of sacrifice to help those who needed it most. She went to Pittsburgh to do her family practice residency at Shadyside Hospital and I went to Rochester's Highland Hospital to do mine. Pressures of residency ate up time for both of us, and we drifted apart, losing touch. I married, adopted a child, and- the old storygot pregnant and had a second child. The majority of my family medical practice centered on inner city clinics in Buffalo. What I didn't know at the time was that in significant ways, Lisa's life was paralleling mine. She found a spouse, they adopted three children, and true to our ideals, she worked where people needed her most. From a alive American reservation in northern evada, she moved back to her home town, Las Vegas. By this time-Ilearned later, almost too late - her life and work had begun a new phase. This phase as much as anything defined the ideal of self-sacrifice - going beyond anything we had talked over so ardently back in med school, and the truth is, surpassing anything l had imagined for her or myself. Lisa was lesbian, so she was well B u a 0 p Lisa Bechtel, M.D. 5 c a 5 p n 9 9 9 5 �- --- - ---- . --- ························································ ~ ACADEMIC H ALTH PROFESSIO ALS I Insuring care for those who care Subscriber Owned • Organized • Governed PHYSICIANS • DE TISTS HEALTH PROFESSIONALS NURSES • RESIDENTS acquainted with the gay subculture, by then ravaged and haunted by the AIDS epidemic. She began working with AIDS patients, partly because of her innate sympathies, but largely because they weren't on top of doctors' lists. In fact, the Las Vegas AIDS clinic was unable to attract a medical director - low pay, very long hours, draining work, emotionally costly. The position was offered to Lisa. She took it. At once she became an indispensable figure of hope, charity, comfort and support, as well as medical attention. And it went further. Pediatricians asked her if she would see HIV -positive children who weren't getting the attention they needed. Way too few physicians knew how to treat them. She agreed. Her partner, Ann, a nurse practitioner who also worked at the AIDS clinic, was well aware of the need. Together they took another step. First they adopted an HIV-exposed baby, naming her Mariah. A year later she tested negative. Then they took in another unwanted baby - HIV-exposed in utero , plus various teratogens such as crack and alcohol. They not only kept her alive, but she thrived with them , and continues to as of this writing. Then a third baby, ate, was adopted. He was a year old last December. His HIV results are still inconclusive. Then, the wretched misstep occurred. Cleaning up in the clinic, depositing syringes in the dirty needle box, Lisa nicked herself. She filed a report and promptly forgot about it. That was in Aprill993. Six weeks later she developed a raging fever and viral syndrome. Her T cells fell so rapidly that within a few months she was diagnosed with full-blown AIDS. She grew too weak to carry on in medicine. In a little more than a year, she died. But not before the gay community rallied around her. By this time, we had renewed our contact after so many years, finding our friendship intact, reaffirming our beliefs. At a large, astonishing benefit in Las Vegas, the kind of celebration that snubs death , Lisa was honored . I attended and I don't think I've seen such an outpouring of gratitude and sympathy for one person. All good physicians dream of making a difference. Lisa Bechtel made a difference- a very, very big difference. Her example continues to make a difference in me, an object lesson that in this one profession whatever we think is enough, is never enough. All good physicians Superior policies for academic full-time and voluntary clinical faculty dream of making a ~ Competitive premiums ~ Rewarding educational programs ~ difference. Lisa Complete legal seiVice ~ Comprehensive coverage ~ Dividend opportunities Bechtel made a difference- a very, Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. Enrollment open at all times. Transfers arranged \vithout loss. AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION Empire State Building 350 Fifth Avenue, Suite #1512 ewYork, ewYork 10118 Ph. 212-947-4541 Fax 212-947-4572 B u a 0 p h very big difference. 5 c a n 5 p - BY n DEBORAH 9 9 RICHTER 9 5 �E ; ] ···················································· ·· ·· Four receive 1994 Lifetime Career Achievement Awards ifetime Career A hievement Awards were presented to four alumni last year. Andrew A. Gage , M.D ., '76, William R. Kinkel , M.D ., '5 4 , James F. Mohn, M.D. , '44 and Max A. Schneider , M.D., ' 49 , received the Medical Alumni Association's 1994 Lifetime Career Achievement Awards at last year 's pring Clinical Day and Reunion Weekend celebration. The awards are presented in recognition of conspicuous and outstanding career achievement. y ft \1~; Andrew A. Gage, M.D. William R. Kinkel, M.D. James F. Mohn, M.D. ~ Max A. Schneider, M.D. \.hi OFFICH uestionnaires for the special Sesquicentennial edition of the alumni directory have been sent out by the Harris Publishing Company. Please be sure to complete and return your directory Call UB questionnaire before the deadline indicated. cro to nqu~re' • Apple • IBM • Dell • Compaq • Panasonic • Hewlett Packard • TI • Sony • Software • Supplies • Accessories • Audio • Hands-on Workshops Prior to the publication date, the Harris Company will contact you after the data have been compiled to verify the information in your listing. B a 0 p 5 c a n s p n g 9 5 �"EJ ... .... ................. .. ......... ... .. . ........ . .................................. became board certified in critiof Johns Island, South Carolina, writes that after interning at Buffalo's Deaconess Hospital and HAROLD J . ELLIOTT '38 , cal care medicine in addition to internal medicine and pulmonary diseases. He is director of respiratory service and associ- orthern Westchester Hospital, he practiced medicine for six years in the mountains of Kentucky, eight years at orthern ate director of the sleep disor- igeria Mission Hospital, 18 years in southeast Minnesota and and living in Chicago. for the past 23 years in Johns Island, Charleston County, South Carolina, in a poor people's clinic in a church building. At age 80, he's still active ders lab - still actively practicing medicine, skiing and !ly fishing. His son, George, is married board certified examiner of the American Board of Forensic Examiners. '65 , of STANLEY L. OLINICK '40 , Winter Park, Florida, was certified in forensic psychiatry by points out a crowning irony of The American Board of Psychia- his career. In what may be his final (or nearly so) year of private practice of psychoanalysis, try and eurology after successfully completing the first exam given in the field last October. He has previous certification he has been included in the second edition of "Best Doctors in America." He continues to write papers for psychoanalytic journals, teach and enjoy his family, tennis, music and reading. LEONARD WOLIN '41 , of was appointed president and to professor of radiology at Northwestern University Medical School. He is director of chief executive officer of the Long neuroradiology and a member of Island Jewish Medical Center. the strategic planning committee -AS R. His is a senior partner at Kenmore Pedi- was atric Associates, P.C.; medical director for ight Call, an afterhours telephone triage service for elected president of the Chi- of JAN ARTHUR SCHWARTZ Westwood, Massachusetts, was elected president of the Massachusetts Academy of Dermatol- '75, is a pediatric anesthesiolo- ROBERT A . KUWIK '72 , of Johnson City, Tennessee, left private practice to accept a position as assistant professor of psychiatry at East Tennessee State University Quillen College of Medicine. His oldest son, Brian, is a Fulbright scholar in Cameroon, Africa, until October 1995; middle son, ick, is a junior at Florida State University. psychiatry since 1992 and is certified by the American Society of Addiction Medicine and the American Board of Quality Assurance and Utilization Review. Rhode Island. He wrote that he and his wife were expecting their Marrow and Blood Stem Cell Severin-Salzman. third child, a son, in January 1995. JOHN R . AND E R SON '67, RICHARD ofDepew, ewYork, was named medical director of the Brothers Sparks, PFOERTNER '60, of Boise, Idaho, recently B u a 0 BARNETT SALZMAN '65 , of Mercy ursing and Rehabilitation Center in Clarence, New p ARTHUR C . SGALIA '73 , of Wrentham, Massachusetts, was named chief of internal medicine at Rehabilitation Hospital of S. LEE '74 , of evada, was appointed chief of neurology and director of neurosciences of orthern Nevada Medical Center. 0 Society. 12; and Meredith, 7. of Bowling Green, Kentucky, was appointed medical director of the adult unit of Riverdell Psychiatric Hospital as well as a new member of the American Board of Forensic Examiners. He recently married Stacy Jean B. cal can Academy of Pediatrics. he's now "retired" but keeps up with his computer and the latest news, including the very latest from the Los Angeles Times, about his son, MAURICE J . WOLIN '84 , of Westlake Village, California, and his work for the Westlake Medical Center's Bone GEORGE cago RadiologiThey have two children: Gabrielle, ogy. He has two daughters. with added qualifications in geriatric psychiatry and addiction recently New York Chapter 1 of the Ameri- ALLEN BERLINGER '71 , Amherst, New York, writes that Transplant Center. K. Fernbach, physicians; and vice president of three days a week. KOLIN DAVID R. OANTZKER '67 , ROGER A . FORDEN '70, '65 , of Newton, Connecticut, recently became a diplomate and S. ERIC J . RUSSELL '74 , of Chicago, Illinois, was promoted wife, Dr. Sandra AUGUST J . D 'ALESSANDRO IRVING York, where he has been a staff physician for two years. 5 p gist at the Geisinger Clinic, in Danville, Pennsylvania. She recently spent three months as a visiting professor of pediatric anesthesiology at the department of anesthesia of Soroka Medical Center, Ben Gurian University of the egev, Beer-Sheva, Israel. DENNIS WHITEHEAD '75 , chief of emergency services for Dickinson County Memorial Hospital in Iron Mountain, Michigan, is serving a two-year term as speaker of the council of the American College of Emergency Physicians. He recently became the 36th person (and second physician) to climb the highest point in each of the 50 states. He writes that he's looking forward to his 20-year class reunion this spring. B E NNETT VOG E LMAN '78 , was appointed to the University of Wisconsin Teaching Academy and promoted to professor in 1994. g 9 9 5 �~ -··· ····· ··· ········· ······· ····· ·· ········· ······· ···· ······························ · ···· 1 9 8 KATHERINE DECARIA '80 , s 0 VINCENT JASNOSZ - of Murrysville, Pennsylvania , is a staff pathqlogist at Allegheny General Hospital in Pittsburgh. She has two children: Daniel, 5; and Anna, 4. of LOIS M . MCNALLY '82 , ew York City, was appointed director of medical student education for the ophthalmology department of the ew York Eye and Ear Infirmary where she JOSEPH 1 FASA - '86 , and his wife, NE LL O Donna, announce the birth of their second child, Diana Christine, on December 20, 1994. JESSIE JEAN -RUSH '86 , 9 9 s 0 of Cleveland Heights, Ohio, write ship at Naval Hospital in Jacksonville, Florida. He is now serv- that joe is currently a fourth-year ing as a general medical officer E T resident at the Cleveland Clinic. Mary completed her pe- on board the amphibious dock BONAFEDE '91 , MARY CAPPUCCINO '91 , Tucson, Arizona, is a general pediatrician and major in the U.S. Air Force at Davis MonthanAir Force Base. She has three diatrics residency at Children's landing ship the U.S.S. Gunston Hall, currently deployed to the Hospital of Philadelphia in 1994 Mediterranean Sea. and is currently doing a pediatric infectious disease fellowship at beautiful children: Kira, 10; Rainbow Babies Hospital in Eddie Jr., 8; and Kesha, 6. OBITUARIES BENNIE MECKLIN '35 , practiced family medicine in the Thousand Islands T I NA MARIE GARDNER '87 , practices ocular oncology and of Malone, attended by many classmates. A Watertown, ophthalmic pathology. ''I'm a family physician working great time was had by all. 46 years, died MARC KOBLICK '84 , and his wife, Helene, proudly announce the birth of their third child, EricJordan, born June 21, 1994. ern New York. We are teaching .P. students in our practice. My son jake is 4 of outdoorsman, with a strong in- Westlake Village, California, is terest in plants and trees and co-director of the Westlake gardening. I'm expecting my sec- Medical Center's Bone Marrow ond child next month. " of Stamford, Connecticut, joined ROBERT HESS a private practice group of six '37 , died ovember 8, 1994 in pediatricians there. She writes Oceanside, California. He was an assistant plant physician and and sends news about "lots of surgeon at Bethlehem Steel in babies Lackawanna, to our classmates: a baby girl, Ilana; has INGRID ew York, for 38 years before his retirement in 1972. has a baby girl, Natalie; PATRICK E . RYAN , JR . '87 , CRUSE is an associate professor at the COLLEEN of Bal- University Hospital in Syracuse, ZITTEL timore, Maryland, is director of KINGA the EMG Laboratory at Johns ew York, where he's been an in physician attending girl, Alexa. Hopkins Bayview Medical Cen- cardiothoracic surgery since last but a new house desperately in ter and an assistant professor of july. His \vife Denise, he writes, need of a new roof and paint job, neurology at Johns Hopkins is staying at home for now, tend- so lots to keep Joe and me busy." School of Medicine. Her son ing to their children: Sean, 5; Alexander was born March 6, Erin, 3; and Kieran james, 18 1994. She writes that classmates months. ROB I N CONWIT '85 , MEHNERT that she "is really enjoying it!" ELISSA JAFFE BOOKER and Blood Stem Cell Transplant Center. ovember 14, JENNIFER F . HENKIND '91 , years old and is quite an MAURICE J . WOLIN '84 , and ew York, area for 1994, at age 83. for the Mohawk Tribe in Northmedical, P.A. and who Cleveland. They were married on November 19, 1994 at a ceremony ew York, writes, com- and JOE of PAUL D . SEEMAN '93 , pleted his family practice intern- AND GREG have a boy, George; and TIBOLD has a baby o babies for me yet, MAT THEW J . PHILLIPS '91 , died july 14, 1992. CHARLES TANNER ~3 , a Buffalo cardiovascular surgeon and former president of Mercy Hospital, died December 7, 1994 after a long illness. WALTER A . OLZEWSKI '54 , ew York, and his assistant professor of neurology wife, Toula, announce the birth and clinical associate professor of of their second son, Michael of anatomy and cell biology, died Ventura, California, has been Nicholas, born December 12, February 23, 1994. and practicing internal medicine 1994. He joins his brother , are there since August 1992. She james, who turns 2 on April 7. expecting second babies this and her husband Thomas Alfano, AMY MILLER O 'DONNE LL had her third son, Michael , in February RE ICHARD of Snyder, VINCENT J . PARLANTE '42 , 1994; A L I S ON PETERSO N SARAH MURRAY WH ITE YASMIN PANAHY '89 , STEPHEN J . KIMATIAN '92 , who were married in December spring. ANDRE MIDGETTE ' 79 , drowned in Brazil in june 1994 of Navarre, Florida, writes that 1991, welcomed a son born September 15, 1994. while on vacation with his wife and daughter. he is a [light surgeon for the U.S. Air Force in Special Operations at Hurlburt field , Florida. a a 0 p h 5 c a n 5 p n g 9 5 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. • In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. • Adding t..o the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. • Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. • Find out more about the protection you'll receive from the largest and most successful company of its kind in America. Call1-800- 356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area.• MLM~C ~1edical ~ u ab1litr ~lutuallnsuranl't' Company Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracu5e, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1995 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n02-1995-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Building the Future of Research Restructuring Research at UB Medical School Then and Now A Spoonful of Humor Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n02 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/6ad5c5c491ee4c72591c41beb85f0f08.pdf 5ad80e3fc2f2a5f1d081bbd5f459504f PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1995 FROM DARI<NESS TO DAYLIGHT UB's Traumatic Brain Injury Rehabilitation System repairs broken lives �BUFFALO PH Y S I CIAN Volume 29, umber 4 ASSOCI ATE VI C E PRESIDENT FOR UN IVERSITY SE RVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j. Conroy ED ITOR Nanette Tramont, R.N. ART DIRECTOR Alan J Kegler ASSOCIATE ART DIRECTOR Dav1d R1ley E DITO RIAL MANAGER judson Mead PRODUCTION MANAGER Ann Raszmann Brown Dear Alumni and Friends, T his issue of Buffalo Physician describes the Traumatic Brain Injury Rehabilitation System that has proven so successful in Buffalo. The story provides yet another example of how collaborative efforts among institutions can facilitate patient care, enhance the education of health professionals and promote meaningful clinical opportunities that can utilize the resources of other institutions to positive advantage. As importantly, the system has ensured that patients can be treated in Western New York rather than be transferred to service delivery sites in other parts of New York, or in other states. The latter actually provides an economic savings for the citizens of Western New York since such services are more costly, as well as inconvenient, when patients with head injury are treated in other states. We congratulate the medical, hospital and other leadership that worked to make this system a reality and a success. Sincerely, STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john Naughton Vice PreSt den! for Cluucal Affairs j ohn Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dean EDITORIAL BOARD Dr. john A. Richert, Chairman Dr. Marttn Brecher Dr. Harold Brody Dr. R1chard L. Collins Dr. Alanj. Dnnnan Dr. James Kanski Dr. Barbara Marjeroni Dr. Dr. Dr. Dr. Dr. Dr. Elizabeth Olmsted Charles Paganelli Margaret W. Paroski Thomas Raab Stephen Spauldtng Bradley T. Truax TEACH ING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center Arlene Kelly The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital M1llard ftllmore Hosp1tals Frank Sava Roswell Park Cancer Institute Sisters of Chanty Hosp1tal Dennis McCarthy ©The State Umversity of New York at Buffalo Buffalo PhySician IS publtshed quarterly by the State University of New York at Buffalo School of Medicine and Bwmed1cal Sciences and the Office of Publications. It IS sent, free of charge, toalumm, faculty , students, residents and friends. The staff reserves the right to ed1t all copy and submissions accepted ror publicatiOn. Address questions, comments and subm1ssions to: Editor, Buffalo Physietatt, State Universny of New York at Buffalo , Universuy Publications, 136 Crofts Hall, Buffalo , New York 14260 Send address 1hanges Ia: Buffalo Physiciatt, 147 CFS Addition, 3435 Matn Street, Buffalo, New York 14 214 Dear Fellow Alumni, T his year is Oying by, and we are rapidly approaching the beginning of our Sesquicentennial. Numerous events have been planned to celebrate the 150th anniversary of our medical school, and we hope you will be able to join us for some or all of the festivities. As you know, this past year the Medical Alumni Association purchased furnishings for the medical student lounge. The students were most appreciative, and acknowledged our efforts with a reception and commemorative plaque. Our Alumni Association was also honored with representation on the newly formed Dean's Advisory Council, which held its first meeting October 25-26, 1995. The Council has broad geographic representation, and alumni traveled from as far as California to attend the meeting. The group toured the new Biomedical Research Building, which is a spectacular addition to our medical campus. Dr. Beth Maher informs me that plans for Spring Clinical Day are shaping up nicely. Dr. Sherwin Nuland, author of How We Die, will be the Stockton Kimball lecturer. His topic will be "Death, the Doctor and Hope." He wrote to Dr. Maher, "Your school is a place I have long admired, and the feeling is always enhanced by my visits." We hope you will enhance Spring Clinical Day with your presence, and I'll look forward to seeing you there on May ll, 1996. Enjoy, ~~ W. ?~~J Ml) Ma rga ret W. Paroski, M. D. '80 President, Medical Alumni Association �V A 0 2 L U T U M o N 9 9 N 4 9 5 II Resear(h II Hospital News GME Maelstrom e UB's graduate medical educaII The tion consortium girds itself for fundamental changes in financial support system. m Putting Ba(k the Pie(es e UB's Traumatic Brain Injury Rehabilitation System repairs broken lives. IIJ Medi(al S(hool EiJ Then and Now m m ASpoonful of Humor Flying the friendly skies. Page 21. Alumni m Classnotes * l~e meuical sc~ool' slon~ ~istor~ of e~ual o~~ortu­ UB' s teaching hospitals plan for the worst. Page 6. nit~. ra~e ~~. �.... . ......... . .................. . ....... . ............................. . ... . .............. UB biologists build better mouse model for Duchenne MD research mark absence of dystrophin and increased mast cell activity characteristic of the disease, it doesn't exhibit the progressive weakness that is a symptom of Duchenne muscular dystrophy. He said the mice exhibit a degree of muscle weakness and degeneration , but only after they are physically stressed by running on treadmills for periods of time or are injected with chemicals that induce mast cell activity. "We wanted a model that would express the full symptoms of the human disease ," Hudecki said. He and his colleagues bred mice with the dystrophin deficiency and the exaggerated activity of mast cells throughout the body. The findings show that not only does d ys trop hin-deficien t muscle contain a greater number of mast cells, but the muscle tissue also appears to be hypersensitive to mast cell products, he added. niversity at Buffalo biologists have developed a new mouse model of Duchenne muscular dystrophy that may more accurately simulate the progression of the disease than current models. The research, which should also provide an enhanced understanding of the - formed about pain management, and that this lack of knowledge interfered with the nurses' ability to provide adequate treatment. The study, which appeared in the May issue of the journal of Pain and Symptom Management, points to a problem with nursing and medical school curricula, according to lead author Kathleen G. Wallace, Ph.D., assistant professor of nursing and postdoctoral nurse fellow at Buffalo's Department of Veterans Affairs Medical Center. "Nurses and physicians are not taught enough about pain management," she said. "Schools have not made the commitment to teach it. ln the meantime, the knowledge base of pain management is exploding. " The pilot study involved 108 staff nurses selected from a random sample of hospitals in Georgia, Louisiana, ew York and Washington , D.C. Since staff nurses are usually the first on the scene when a patient is in pain, their sensitivity to, and skill in dealing with, pain problems is critical for effective pain management, Wallace said . Study participants were asked to rate themselves in several areas related to pain management-educational preparation, practice skills and knowledge of legal, financial, political and ethical issues - and to rate the importance of each area. They also listed the three most important problems of pain management in their facility. Undermedication surfaced as the most significant problem of pain management. This finding is a step forward , Wallace said, because previous reports have shown nurses and physicians generally did not believe patients were being undermedicated. The researchers found that most of the nurses interviewed thought their pain management skills were adequate, even though other studies repeatedly had found the opposite to be true. B Y ELLEN GOLDBAUM The new mouse could provide enhanced understanding of the disease. role mast cells play in the disease, was published in the july issue of the journal of Neurological Sciences. Michael S. Hudecki, Ph.D. , research associate professor ofbiological sciences, ndermedication is the most signifiis the senior author. Coauthors are jocant problem of pain management seph A. Granchelli, postdoctoral fellow , in hospitals, one of the first studies and Catherine M. Pollina, research asto investigate how nurses assess sociate. The work was funded by the their knowledge of pain and their Muscular Dystrophy Association. skill in alleviating it has shown. "There has not been a good model for The pilot study, conducted by UniDuchenne muscular dystrophy ," versity at Buffalo nursing researchHudecki said. "This specially bred mouse ers , also revealed that nurses think gives us a very good handle on studying they are adequately informed about the Duchenne disease. " managing pain, despite research Hudecki explained that while the pre- showing they aren' t. vailing animal model, a mouse deficient But the nurses interviewed believed it in dystrophin, closely simulates the hall- was the physicians who were ill-in- Nurses see undermedication as major pain management problem e B a 0 p 5 0 B A Y LOIS m B AKER 9 9 5 �···· · ·························· · ·········· · ················· · · · ·· · ··· · ·········· · ········· · · s . " ' '~ ..~.. . Rural AIDS cases increasing three Improved survival seen with new times faster than in urban areas head and neck cancer treatment IDS cases in rural areas appear to be increasing at a rate three times faster than in metropolitan areas, where health care facilities are better equipped to deal with the problem. Rural AIDS cases increased 9.4 percent from 1991 to 1992 - the last period for which comparable statistics are available- compared with 3.1 percent in major metropolitan areas , according to a review of scientific literature focusing on rural HIV/AIDS conducted by UB's ew York Rural Health Research Center. The review also found that unlike the typical urban AIDS patient, likely to be homosexual males, rural AIDS patients are more likely to be heterosexual females. "In terms of both total cases and research, rural AIDS remains dwarfed by the urban epidemic," said Robin Graham, Ph.D. , senior research scientist at the center and lead author of the study. "But our literature review indicates that AIDS is a serious rural problem, with growing numbers of patients requiring services from illequipped local health care systems." The studies reviewed revealed several distinct characteristics of the rural epidemic: <§> The rate of increase of AIDS cases in proportion to the population is much greater in rural areas. ©> Rural AIDS is distributed unevenly, with 30 percent of cases concentrated in the South Atlantic states. ©> Rates are particularly high among black women , adolescents , ative Americans and migrant workers. ©> A substantial portion of rural HlV patients have migrated to metropolitan areas , returning home to family exhibiting advanced cases of the disease. <§> Intravenous drug use and heterosexual contact are becoming significant modes of transmission of rural HlV. BY B u LOIS c p h .. chemotherapy shrunk it to 1/2 centimeter, we still took it out as if it were two centimeters," Lore states. Significantly, all the patients in the study were evaluated and treated by Lore , who resected the tumors to .5 to 2 centimeters beyond the point at which they had been marked by tattoos following diagrams , anatomical stamps and photographs. new treatment regimen for head and neck cancer developed at the Head and eck Center at Sisters of Charity Hospital could hold promise for some of the estimated 30,000 Americans who are diagnosed with the disease yearly. The new regimen, which combines preoperative chemotherapy with an innovative surgical technique , was pioesearchers and clinicians from neered by John M. Lore, M.D. , medical several UB departments are orgadirector of the center. Lore presented nizing a Group for Advanced Vihis research , scheduled for publication sion Research to bring together in the American journal of Surgery, at people working in the field to the annual meeting of the Society of collaborate on research , coordiHead and eck Surgeons last May. Lore demonstrated a five-year sur- nate funding efforts, share resources vival rate of 76 percent in one group of and enhance teaching. 93 patients with advanced squamous William Coles, M.D. , professor and cell carcinoma of the head and neck he chair of ophthalmology, is the group's treated over 15 years with one of two executive director. Malcolm Slaughter, preoperative chemotherapy protocols. Ph.D., associate professor of biophysical Previous survival rates , as demonstrated sciences and ophthalmology, has been by the ational Cancer Institute's 1987 named director of basic research , with Head and eck Contracts Program, av- James Reidy , M.D. , assistant professor of eraged 35 percent. ophthalmology, serving as director of The Head and eck Center's dramatic clinical research. 76 percent survival rate was seen in the 40 Researchers from the UB Departments patients who received cisplatin and 5-0uo- of Clinical Laboratory Science, Anatomy, rouracil preoperatively. Another 48 who Pediatrics, Biochemistry and Social and received preoperative Preventive Medicine have alcisplatin and bleomycin ready affiliated with the group. posted a five-year surCurrent members are conducting funded research 1n- - vival rate of 43 percent. (Five patients were diabetic retinopathy, noncompliant.) retinopathy of prematurity, The crux of Lore's age-related macular degenregimen is the strict aderation, corneal inOammaherence to preoperative tion, neuro-ophthalmology chemotherapy planand outcomes of surgical proning of ablative cedures in the developmenuncompromised surtally disabled. gery regardless of a fa- Angiogram displaying abnormal The group is organizing a vorable response to the retinal vascular pattern. research conference for 1996. chemotherapy. "If the tumor was 2 cen- Periodic grand rounds and continuing edutimeters prior to chemotherapy, and the cation seminars are also planned. UB researchers,clinicians form advanced vision research group BAKER 0 '· y c c m �Buffalo General and Buffalo Columbus finalize merger plans merger plan involving Buffalo Columbus Hospital; its parent organization, Buffalo Healthcare Corp.; and The Buffalo General Hospital has been finalized, hospital officials announced recently. The merger agreement, according to BHC board chair Vincent]. Muffoletto , represents "a major step toward providing vastly expanded services to our medically underserved community. " The Honorable joseph S. Mattina, chair of the board at Buffalo Columbus Hospital, observed that board members had "agonized" over the future of the institu- john E. Friedlander, Buffalo General's president and CEO , praised judge Mattina, Muffoletto , Garcia and members of the BC/BHC boards for exhibiting "extraordinary vision and determination. "Columbus represents a critical service provider for the community and specific patient populations, including the indigent, people who are HIV-positive , substance abusers, the chronically ill and people noting that Buffalo Columbus has a work force of 290 and Waterfront 200. "With approximately 500 staff, the campus will be a major employer on the WestSide." Sisters Hospital fights domestic ~olence with Crtsis Services he Safe Passage Program, Sisters of Charity Hospital's domestic violence program, has implemented an innovative working relationship with Crisis Services, a nonprofit human services agency that specializes in crisis response. The pilot collaborative effort between Sisters and Crisis Services will provide for the training of both crisis advocates from the agency and hospital staff, beginning with social workers , to serve as victim advocates. "We are training staff who will respond to victims' needs on a 24-hour basis," said Kathleen Slammon, M.S.W. , coordinator of the Safe Passage Program. Approximately 50 volunteers from Crisis Services' Advocate Program previously experienced in working with rape victims will receive additional training specific to domestic violence, including the dynamics of abusive relationships, standards of care for victims and community resources. The volunteers will supplement the services provided by Sisters Hospital social workers, who will also receive training specific to domestic violence. "The intent of this collaborative effort is to provide victims with consistent and comprehensive care," Slammon noted. Physicians, nurses and other hospital staff will be trained in domestic violence identification and intervention following the first phase of instruction for social workers and advocates. f tion for several years. "This agreement with Buffalo General will allow ~ us to mamtam our presence on the Lower West Side, provide better services than ever before, proceed with construction of a diagnostic and treatment center, and preserve as many jobs at this facility as humanly possible," Mattina explained. Earlier this year, the hospitals and BHC announced that discussions were under way to develop a merger plan in an effort to preserve, enhance and expand health care services for the city's West Side. Under the plan, the current Buffalo Columbus facility will be replaced with a diagnostic and treatment center. "Throughout the negotiations, the good of the community always came first ," remarked Andres Garcia , president and chief executive officer of Buffalo Columbus Hospital. "Our foremost responsibility is to the people of the Lower West Side, and our goal is to make this work so that they will have a community health care facility they can be proud of. " ?) with special needs ," Friedlander said. According to Friedlander, the merger plans include "the extension of new and existing services, while moving ahead with the process of developing a health care campus, including a diagnostic and treatment center at the site. " The 160-bed Waterfront Health Care Center, a residential health care facility operated by General Care Corp. , parent organization ofBuffalo General , has also been mentioned in the plans to create a health care campus. "Currently, we are exploring ways in which Waterfront and Buffalo Columbus can work together to create a West Side health care campus," Friedlander said, ;o. u m 9 9 �. . . . . . . ... . . . . . . . . ... . . . . . ... .. ... ... . ... .. ... ... . . ... . ... [1 "The entire hospital staff will be required to receive training. The extent of that training will depend on a person's position," Slammon added. The Safe Passage Program recently received a $10,000 Legislative Local Initiative Award from the New York State Department of Social Services. Funds from the award will be used to further develop the domestic violence program in the areas of intervention, advocacy and counseling services. Medical staff reappointments announced at Mercy Hospital hree UB physicians have been reappointed to key medical staff positions at Mercy Hospital of Buffalo. Saleela Suresh, M.D. , clinical assistant professor of rehabilitation medicine , has been reappointed as chair of rehabilitation medicine, a post she has held since 1979. She earned her bachelor's degree from the University of Calcutta, India , and her medical degree from the R. G. Kar Medical College in Calcutta. She served rotating internships in Calcutta and at the D.C. General Hospital in Washington, D.C. Suresh holds membership in the American Academy of Physical Medicine and Rehabilitation, the Medical Society of the County of Erie, the Medical Society of the State of New York and the American Association ofElectromyography and Electrodiagnosis. Noel Chiantella, M.D. , clinical assistant professor of radiology, has been reappointed as chair of Mercy's radiology department. He earned his bachelor's degree from Mount St. Mary's College in Emmitsburg, Md., and his medical degree from the University of Maryland Hospital. He served as a lieutenant, general medical officer, in the U.S. avy. John Fanelli, M.D. , has been appointed chief ofMercy's division of family practice, department of internal B u 0 0 p medicine. He earned his bachelor's degree from Niagara University and was an Army ROTC Distinguished Military Graduate. Fanelli earned his medical degree from UB , and served a rotating internship at the Ireland Army Hospital in Fort Knox , Ky. CHOB wins approval for acute pediatric inpatient rehab unit he ew York State Department of Health has approved The Children's Hospital of Buffalo's certificate of need to develop an acute pediatric inpatient rehabilitation unit. "There are no certified inpatient beds for acute pediatric rehabilitation in the Western ew York area, " said Joseph A. Ruffolo, president and CEO of Children's Hospital. "The acute needs of these patients are being met usually via transfer to acute inpatient rehab units outside of Western ew York and often outside of New York State. The gap in health care delivery results in fragmented and duplicative care for patients who require intensive rehabilitation services. Patient relocation forces temporary relocation for the family, which creates inconveniences and increased cost and stress," Ruffolo said. The inpatient rehabilitation unit will provide a multidisciplinary team approach for the treatment of brain dysfunction, traumatic spinal cord dysfunction, stroke, amputation of limbs, congenital deformities , neurological conditions , arthritis and other conditions. The treatment team will consist of the following medical disciplines: developmental pediatrics, education, occupational and physical therapy, social work, psychology, nutrition, rehabilitation nursing and speech therapy. "With a strong outpatient rehabilitation unit in place and numerous inpatient services providing referrals and direct clinical expertise, Children's Hospital demon- s c a A strates a strong commitment to provide a comprehensive continuum of care for this special population. A dedicated rehabilitation inpatient unit will ensure focus on functional outcome, so as to return each patient to the most independent setting possible," Ruffulo added. The Robert Warner Rehabilitation Center is the outpatient rehabilitation component of Children's Hospital. Grant named chief of pulmonary and critical care at VA center rydon Grant , M.D., has been named chief of pulmonary and critical care medicine at the Buffalo Department of Veterans Affairs Medical Center. A graduate of Charing Cross Hospital Medical School, London, Grant became interested in research during his residency and became a research fellow at the Royal Postgraduate Medical School in London. He continued his clinical training at Middlesex Hospital Medical School in London. ln 1977, Grant continued his research in pulmonary gas exchange and mathematical modeling at the University of California at San Diego. In 1979, he joined the faculty Brydon Grant, M.D. at the University of Michigan. He has been in Buffalo since 1983 as an attending physician at Erie County Medical Center in the pulmonary and critical care division, and as director ofECMC's pulmonary function lab since 1990. Grant has served on the editorial board of Respiratory Physiology and the American Review of Respiratory Disease. He recently completed a term as an associate editor of the American]oumal of Respiratory and Critical Care Medicine. u m n 5 0 �n interestin_ times THE ONLY CERTAINTY FOR ACADEMIC MEDICINE IS FUNDAMENTAL CHANGE t portrait photo s by Robert Walion EVERY ASPECT OF ACADEMIC MEDICINE WILL BE AFFECTED BY THE FlNA CIAL REFORMS BEING PLANNED FOR THE MEDICARE A D MEDICAID SYSTEMS - FROM THE NUMBER OF RESIDE CY SPOTS AVAILABLE TO NEW PHYSICIANS TO THE PRODUCTIVITY OF THE PROFESSORS WHO TEACH THEM . AT UB A D ITS AFFILIATED TEACHING HOSPITALS , THE MOOD IS OT HOPEFUL �by Andrew Danzo THE Fl A CIAL U DERPl Naughton describes the forces at work: the need for costtion are undergoing a fundamental reorganization. Medicontainment and a more rational approach to medical work care is being cut back and restructured. Medicaid, too. force policy; political promises of tax cuts; widening accepGrants are getting harder tance of business notions and harder to come by. of productivity. "These And in ew York, it's forces are going to collide anyone's guess what will here very shortly," happen when the system Naughton predicts, leanthat has regulated hospital ing forward during a disreimbursements for more cussion in the wedgethan a decade comes up shaped office that he will for renewal in several soon leave. He suggests a months. label: "Call it the GME "It's all under attack, evmaelstrom. " ery bit of it," says john Graduate medical eduaughton, M.D. , UB vice cation cost $3 billion in president for clinical afNew York State in 1994. fairs and dean of the School About a third of that came of Medicine and Biomedifrom Medicare hospital recal Sciences. imbursements, with most o one is sure exactly of the remainder from how it will play out. The Medicaid and non-governonly certainty is that ment insurers. The fundthings will be different , ing scheme is complex, to starting with teaching put it mildly. Medicare rehospitals and rippling outward. imbursements are driven by costs Among the hospital members in base years updated for inOa.JOHN NAUGHTON, M.D. tion, calculations of overhead atof the Graduate Medical Dental tributable to education, estimates Education Consortium of Bufof illness severity among teachfalo, there is talk of "integraing hospital patients and various tion " and "downsizing. " Fewer other factors. Reimbursements residency slots, perhaps. A testfrom Medicaid and other insuring of relationships among coners are determined by the New sortium members. Pressure on York Prospective Hospital Reimfaculty to find time for more bursement Methodology ( YPHRM), which adheres to clinical service. some parts of the Medicare formulas . "The CEOs know what's going on and know that something will have to give, but they are really unsure ," says Paul The average reimbursement per resident in 1994 ranged Candino, chief executive officer of Erie County Medical from more than $200,000 in the ew York metropolitan Center. "Once we see what the damage is, we'll be positionarea to about $149,000 in Western New York, a differing for redirecting our strategic initiatives. " ence that at least partly reOects regional variations in It may all end up producing something that is more health care costs. With 788 residents and fellows in the collaborative and attuned to the needs of a reorganized GMDECB, it is easy to see how changes in GME reimhealth care system, but the transition will not be painless. bursement could quickly translate into huge losses for ult' s all under attacl<, every bit B u 0 0 p c 0 of it. " A u u m 5 0 �ACADEMIC MEDICINE FINDS ITSELF IN INTERESTING TIMES affect medical education, but they are preparing for a individual hospitals. That could be compounded by major challenge. Asked what's at stake , Candino reother changes in Medicare, which covers nearly half the plies , "Everything. " patients in GMDECB institutions, and Medicaid. One obvious response would be reducing the number of Meanwhile, growing proportions of publicly and privately insured patients are residency slots, and some in managed care. HMO hospital executives say that can't be ruled out. "I penetration among those with non-government inthink the decisions will have to be what can we all surance in the metropoliafford from an educational tan Buffalo area is now about 60 percent, accordperspective as well as an ing to William D. Pike, operational one," says Ripresident of the Western chard Braun, vice presiew York Healthcare Asdent for finance and chief sociation. HMOs in Buffinancial officer of The falo have generally been Buffalo General Hospital. following the prevailing He says the consortium reimbursement rates set might also have to conunder NYPHRM, even sider consolidating some though they' re not reprograms, such as interquired to, Pike says. But nal medicine, which is the HMOs are beginning now split into two parts. to get more aggressive, he Naughton agrees that adds , pointing to one the government must get plan's recent exclusion of residencies under control hospital labs from a contract for nationally. In the three decades outpatient work. since Medicare began, training P A U L CANCINO programs and slots have prolifAs YPHRM approaches its june 30 renewal deadline , all erated. The knocks on the system are well known: public bets may be off. It is YPHRM funds helping to subsidize a surthat controls the bulk of hospiplus of specialists; geographic tal reimbursement for such maldistribution encouraged by "public goods " as graduate concentration of residencies in medical education and indigent a handful of states- New York care, and the insurance industry is already pushing to be realone has one-sixth of the leased from the dictates of diagnation's total; far more residents nosis-related groups , according than there are new American to jeannie H. Cross of the M.D.s , with programs sucking Healthcare Association of ew up young doctors from counn York State. "We're moving in tries where they are needed and the direction of a more marketmedical schools stymied in their oriented system ," Cross says. "The question is how fast. " efforts to rebalance the physician work force . GMDECB officials warn that there are still too "Obviously, the feds have a big job to do ," aughton many unknowns to predict exactly how all this will says. But Buffalo , he quickly adds , is not the place to do it. uThe CEOs l<now what's going on and l<now that something will have to give, but they are _really unsure. c a n m n 9 9 5 �ACADEMIC: MEDICINE FINDS ITSELF The GMDECB has been a national model since it adopted a self-imposed cap on residency slots several years ago. "We only have a few programs where we could say in the most rational sense of the word that we have a few excess residents," Naughton says. "We'd rather not lose any because we think the size is about right. " Final decisions on residency slots will be inOuenced by a variety of factors. For instance, disincentives for training graduates of foreign medical schools would be felt in the consortium, where about 45 percent of the slots are filled by international graduates. And even though the GMDECB is committed to training half of its residents in primary care (it's now at 43 percent), new disincentives for specialist training could pose difficulties. "We have a high surgical component at Buffalo WILLIAM General," says Braun, "and as you start to cut at that, you tear away at the whole system." To some degree, hospitals have already begun weaning themselves from their reliance on residents because the programs have been putting greater emphasis on the educational component of resident training. "They're not the slaves that they had been," says Roseanne C. Berger, M.D., associate dean for graduate medical education. Nevertheless, residents are still important. "Of our 21 clinical departments, 19 of them have relationships with graduate medical programs," says Michael F. Noe, executive vice president and medical IN INTERESTING TIMES director at Buffalo General. On average, the hospital has about 150 residents. "They are very much involved in patient care in the course of their learning experiences," Noe says. "Once they reach a certain level of competency, they directly provide patient care, particularly in urgent situations. If we did not have them here in the hospital, it would be very difficult to replace them. " Eventually, fewer residents could also mean fewer physicians in Western New York , Noe adds. "As there are fewer people in training, there will be fewer individuals familiar with the area who have developed a preference for this area as a place to practice ," he says. "lt could have an impact on the availability of people who go into practice. " Even if hospitals did cut back D. P I K E on residents, it wouldn't solve their problems. GME reimbursements have become intricately woven into teaching hospital budgets, supporting things that will continue to run up bills whether or not the residents are there. The largest part of the Medicare reimbursement goes not to direct costs - resident salaries and benefits range from about $20,000 to $60,000 in New York- but to compensate hospitals for the indirect, and somen what abstract, cost of being a teaching institution. Based on the ratio of residents and interns to beds, the indirect component is designed to pay for such educational costs as the greater number of tests that aWe have a very lean machine as far as health care delivery in Western New Yorl~. But we can do better, and we can do better by collaborating for shared services. B a a p h y s a n A u m 9 0 �ACADEMIC MEDICINE FINDS ITSELF residents tend to order, as well as for things like greater illness severity among teaching hospital patients. It is sometimes called an "add-on " to the direct Medicare reimbursement, which is paid according to diagnosis related group. "Our add-on is gigantic," says ECMC's Candino, who administers a hospital that is not only a major academic affiliate, but also has regional trauma and burn units and provides more than $20 million a year in indigent care. In New York, hospitals also receive indirect education reimbursements from Medicaid and nongovernment insurers through NYPHRM, which uses a formula that is similar to Medicare's but adjusted to encourage primary care residencies. The total indirect component is about 57 percent of the $3 billion in GME reimbursements in ew York. "A lot of it goes to the bottom line of the hospitals," says James RICHARD olan, M.D., director of medicine at ECMC and former chairman of medicine at UB. Likewise, other reimbursement streams help to indirectly support the educational mission of teaching hospitals. GMDECB officials say they will have to consider the potential revenue losses posed by overall changes in Medicare and Medicaid as they reassess their teaching activities. "If education stayed the same and you cut out $20 million of other funds , it's hard to say it would have no impact," says BGH's Braun. "The reality is, if someone cuts your budget by 10 or l3 percent, you have to react to it. The reaction IN INTERESTING TIMES has to be, what programs can we afford? " Teachers as well as residents are likely to feel the pinch. "This , of course, comes at a difficult time for faculty ," says Nolan. "There's been a decrease in state funding and hospital funding even without these cuts," he adds. "The hospitals have had to decrease the support they can give faculty. And grant support also has been decreasing." The combined effects of various revenue losses "are going to make it more difficult for full-time faculty to be financially supported," says oe. "In New York State in particular, our hospitals have operated very close to the margin. We have worked in a very heavily regulated environment for many years. The impact in New York State is going to be significantly greater than in other states." Berger sees that leading to some tough choices for adminisBRAUN trators and faculty. "I think there will be an increase in pressure for clinical activity, which may take them away more from the teaching endeavor," she says. That pressure had been growing already in recent years, and clinical practice now accounts forabout$75 million in UB medical school gross income. Berger says faculty could also be affected by financial pressure in the practice environn ment. "As managers begin observing the clinical productivity of faculty more closely, if there are no allowances for teaching time built in there , the standard will be maintained, whatever level is set for uTh e reality is, if someone cuts your budget by 10 or 13 percent, you have to react. The reaction has to be, what programs can _we afford? B u a a p y 5 c a A u u m 9 9 �ACADEMIC MEDICINE FINDS ITSELF seeing patients," she says. "You're not going to be able to teach as much while you're seeing patients if you're expected to see more patients." The coming year will be a crucial one for the GMDECB as it reacts not only to the federal changes, but to those at the state level as well. In addition to NYPHRM, New York's Medicaid managed care program is still taking shape, and another round of state budget cuts looms. "People are saying that next year is going to be a health care Super Bowl in New York," says Cross, the Healthcare Association spokesperson. "NYPHRM is a playoff game by itself." The situation could present some opportunities. For instance, the current system of GME reimbursement does not pay as much for ambulatory residencies as those in hospitals. Within the GMDECB, the salaries and benefits of ambulatory residents are covered, but RO SE ANN E C. there is no mechanism to pay the overhead costs. "Until there is real reform of financing, it's going to be hard to make the changes that are needed, shifting the locus from the hospital to the ambulatory setting," says Leonard A. Katz, M.D., director of research and education programs at Health Care Plan, which trains two internal medicine residents a year in the primary care: group practice!HMO track. The debate over such issues and the ongoing evolution of health care delivery are likely to put stress on relationships within the GMDECB. With managed care expanding and a continued push to replace DRGs with negotiated fees , hospitals that make teaching a part of their mission will IN INTERESTING TIMES have trouble competing unless there are adequate mechanisms to compensate them for their higher costs. "You have people at the consortium table collaborating for graduate medical education, but at the same time, these collaborators are competitors for patients," says Pike, of the Western New York Healthcare Association. "As competition heats up more and more, it's hard to sit down and say, 'let's work together."' But Pike and others say they expect the consortium toweatherthestorm. Ifanything, cooperative efforts will become more important. "The consortium is a good example of how the market is reacting in general," Pike says. "We have a very lean machine as far as health care delivery in Western ew York. But we can do better, and we can do better by collaborating for shared services." Examples of new partnerships are already emerging as hospitals form networks that unite B E R GER, M.D. a variety of providers and facilities to offer patients a "continuum of care" through a single organization. "l think you're going to see tremendous changes from a standalone hospital system to an integrated delivery systems environment," says Robert V. Stanek, chief operating officer of Mercy Health System, the network that now occupies the Mercy Hospital chair at the GMDECB table. Stanek says the n ew environment will pose challenges for clinical education . "Will it strain the mission? Sure it will," he says. "But in the long term, we're going to continue to provide services to the community, and as part of that, an educational mission needs to be maintained. " uYou' re not going to be able to teach as much while you're seeing patients if you're expected to see more patients." B u a 0 p h y 5 c a n A u m n 9 9 �PUTTING BACK THE PIECES US'S TRAUMATIC BRAIN INJURY REHA I ITATION SYSTEM REPAIRS BROKEN LIVES BY PHOTOS B u a BY SCOTT THOMAS COLLIGNON/JAROSZ 0 p h c a n ;o. u m n �-------- - HE ACCIDE T ITSELF, Anthony DeLabio doesn't much remember. He and a couple of friends were just fooling around. Too young to drink in ewYork State, they had walked across the Rainbow Bridge into Canada and spent the evening hitting the bars. Then they had walked back and were hanging around in the parking lot of the Rainbow Center mall. "We started horsing around by the edge of the parking lot," DeLabio, now 22, says of that fateful September night in 1992. "I leaned over ... and I fell. The next thing I knew, when I got percent of traumatic brain injuries are motor-vehicle-related. If you add in pedestrians who are hit by cars, it's closer to 60 or 70 percent. "And now, in some cities (though not Buffalo) , gunshot wounds are coming close to those numbers. " The medical school's Traumatic Brain Injury Rehabilitation System is a regional consortium that operates at three levels: ECMC, with its Level I trauma unit and acute-level rehabilitation; Our Lady of Victory Hospital in South Buffalo, for intermediate-term rehabilitation; and, until recently, the Deaconess Center ofBuffalo General Hospital, for long-term in-patient rehab. Labi says she and her colleagues are working with patients who , had they sustained such injuries 20 years ago , never would have survived - people with multiple body traumas Each year, an estimated half million people nationwide suffer a head injury; a significant proportion of them will require a course of rehabilitation. The medical school's Traumatic Brain Injury Rehabilitation System is a regional consortium that operates at three levels: acute-level, intermediate term and long-term, in-patient. from crashes, or horrific gunshot wounds. "In the past," she says, "most of them would have died of complications from their injuries. Now the emergency medical services are so much better. With the use of helicopters, patients are getting to trauma centers much more quickly. And the earlier we can treat them, the better. " But reckless drivers and trigger-happy gunmen aren't the only risks to gray matter. "just about anything can result in a head injury," Labi says, and she ticks off some examples: industrial accidents; falls , particularly among older people; blunt trauma , such as assault with a baseball bat. All can damage the brain and its delicate neural pathways - and forever alter the life of the victim. Anthony DeLabio says of his time on the eighth floor of ECMC, the head injury rehab unit: "I was totally confused. I had no idea what was going on. I remember that a couple my senses back, I was on the rehab floor (of the Erie County Medical Center)." He had been in a coma for five days before he opened his eyes. "The strangest thing was, for a while after the accident I had these dreams of people falling. ever me, always other people. And I'd say to them in the dream, 'Don't worry, you won't remember it."' DeLabio's story is in some ways typical of the events that conspire to injure the human brain. Each year, an estimated half-million people nationwide suffer a head injury; a significant proportion of them will require a course of rehabilitation. Most such patients are young, male - and have been around alcohol, automobiles or both. "We live in a fast world," says Maria L. C. Labi, M.D. , Ph.D., medical director of the University at Buffalo Traumatic Brain Injury Rehabilitation System. "More than 50 B u a 0 p y a u m 9 9 5 �of my friends came to see me; other than that, it was just very confusing. "But all the people, the doctors and nurses, were very nice to me. They calmed me down a lot of times, because I felt like I was caught in a whirlwind. I didn't know why I was in the hospital. They told me day after day that I fell, but I just couldn't make the association. I couldn't remember going out that night. " But slowly, in the nine-and-a-half weeks he was in the hospital , and throughout a long course of outpatient rehabilitation, Delabio made the connection. He worked with physical therapists to learn to walk again. Occupational therapists helped him relearn "the day-to-day things" showering, getting dressed. Speech therapists helped him learn to organize his thoughts and taught him strategies to course. The brain is a delicate and complex instrument, and damage may forever wipe out a lifetime of accumulated skills and memories. Labi, who is an assistant professor in UB medical school's department of rehabilitation medicine , makes the distinction between functional and neurologic recovery. It's not necessarily true , she says , that the central nervous system can 't regenerate itself: severed nerves sometimes reconnect through a process called sprouting. "lt's not always as efficient as it was before ," she says, "but even if the injured area does not recover , the brain has a lot of redundancy in it. Other parts can take over the function of the injured part. " Failing that, though, the goal is functional recovery. A patient may be paralyzed, for example, but if he can learn to PHYSICAL THERAPIST LESLIE MOREDOCK ASSISTS ROGER HOUSER. improve his memory. They also worked with him to relearn how to swallow and eat and talk. He worked painfully to regain coordination in his left hand that was impaired by the fall. He tried cooking. He passed his driver's test. Eventually, he got his life back. "I think that's one of the finest rehab centers around, " Delabio says now about the Buffalo TBl system. "Besides being great physicians and therapists, they have an empathy for the patient. They try to understand what the patient is going through. That's important." Delabio's remarkable recovery is the kind of outcome the rehabilitation teams hope for. It's not always possible, of B u a 0 p s live independently with the help of a wheelchair and maybe a part-time aide, he has made a functional recovery. "The system," Labi says, "is intended to make people as functional as they can be through excellent and cost-effective care. "It's very rewarding work," she says. "The perception of most people is that these patients are hopeless, that if they don't come out of it right away, they're never going to get better. But with good, appropriate, timely care, they do get better." Such as: {i;l The man in his 40s who was hit on the head by an 800pound weight at work. He was back on the job in six months. {i;l The patient in his late 30s who was run over by a train. 0 u m n 5 �"He pretty much broke every bone in his head," Labi notes. He, too, was recovered well enough to consider returning to work in six months. @ The lawyer in his late 20s who was in a car crash in California- back practicing law in a year-and-a-half. These cases, Labi says, are different from stroke, the other assault on the brain, because with trauma, the damage to the body is generally much more widespread. Patients come with fractures, blood clots, multiple traumas. Treating them, and rehabilitating them, means intervening early so their injuries don't snowball. "These cases are not typically one little problem you're working on," says Carolyn Teter, who administers the head trauma rehabilitation unit at Our Lady of Victory Hospital. "We're working on many problems at a time." they hadn't bargained for; they may have trouble accepting this changed person. One thing is for sure: The family will never be the same again. Richard T. Linn, Ph.D., an assistant professor in the department of rehabilitation medicine and program director of the UB Traumatic Brain Injury Rehabilitation System, says accepting what they've lost can be the most difficult part for head injury patients. "Most of these folks , when they're on the inpatient unit, are very confused and still showing quite a bit of disorientation," Linn says. "Many of them are not really ready for intensive supportive therapy. It's only when they get better and realize something of what they've lost that it really starts to sink in." Linn performs neuropsychological assessments of pa- "It's veryrewardingwork.The perception of most people 1s that these patients are hopeless, that if they don't come out of it right away, they're never going to get better. But with good, appropriate, timely care, they do get better." tients with head trauma, trying to establish a baseline level of functioning and then, later, to assess the patient's progress six months to a year after the injury. He also does some psychotherapy with these patients. "There aren't many psychologists in town who will do psychotherapy or supportive therapy for people with a brain injury," he says. "They may have memory problems, for example, and how can you do psychotherapy when they have to be reminded each time where we had progressed to? The answer is, you adapt your therapy to work more on reintegration issues: How do you get back to work? Isn't it frustrating not making as much money as you're used to? Maybe you can't drive, and that's dehumanizing. " Labi says the TBl system was conceived as a continuum of care- from the trauma intensive-care unit, through levels of in-patient rehabilitation, from acute to long-term and on to outpatient rehab. It's a system that makes sense economically as well as medically, says Glen Gresham, M.D. , professor and chairman of the medical school's department of rehabilitation medicine, and director of rehabilitation at ECMC. "For years patients were being sent out of state, all over the place, because there wasn't any coordinated system close For example, Teter says, if a patient is immobilized by his injuries, his joints can become tight and bent with muscle contractures, requiring surgery. And the whole range of skills that often is lost to a head injury takes time to relearn. That's why the TBI system employs a panoply of therapists, working as a team to decide how to work most effectively with a particular patient. They include occupational therapists, physical therapists, speech pathologists, recreational therapists , neuropsychologists, social workers, case managers and the attending physiatrist. And their work doesn't end at the hospital doors. "The shortest piece of a rehabilitation is the in-patient program," Labi says. That typically is followed by continuing outpatient therapy and monitoring. And the patient's family becomes deeply involved, whether or not he ends up living with them. Head injury happens not just to an individual, but to the family as well. The person they knew and loved may be irrevocably altered. They may have new care-giving duties B 0 0 p h s 0 u m 9 �OCCUPATIONAL THERAPIST SANDRA SEILER HELPS CHAD STUDLE Y IN THE K I TCHEN . to home," Gresham says. "It was just sort of a chaotic situation." with a lot less care on the outside. " The TBI rehabilitation system, he says, "put it all on the "We're working with the insurance companies and the basis of cooperation, so everyone could win. Particular hospigovernment to make this as efficient as possible," Labi adds. tals are guaranteed of a role; the health department (which "The financial climate in medicine with patients like this is very pays for many patients' head-injury rehab) is pleased because precarious. But our philosophy is that every patient deserves a patients are not sent out of state, which is much more costly; trial of rehabilitation regardless of their insurance source." and private insurers are pleased because they feel they can Sometimes that rehabilitation takes a turn even the best depend on the cost-effectiveness of the care, that this consortium is interested in good "The financial climate in medicine with patients like this care and not just interested in a big profit. "This is a model of regional 1s very precanous. But our philosophy 1s that every care that we're very proud of and that we think can be a model for the whole country." patient deserves a trial of rehabilitation regardless of their james A. Phillips, clinical instructor and administrator for the medical school's department of rehabilitation insurance source. " medicine, says having the Department of Health and private insurance carriers represented on the system's board of directors brings unity of therapist couldn't have predicted. Anthony Delabio, whose purpose instead of squabbling over fees. parking-lot fall put him into a coma, is back to the books at the "That's the cosmic glue that keeps things together," Phillips University at Buffalo. He had been studying environmental says. "At least we have reasons to communicate, which is not science, but now he wants to get into a different field: medicine. necessarily what's been happening elsewhere in health care. " Delabio, who lives with his parents in Niagara Falls, still He also notes , "The amount of money that we're spending has some impairment. "I get distracted easily," he says. "And in the hospital is only 20 percent of (a head-injury patient's) memory is a problem. " lifetime care cost. The real burden of care is when they leave But he's in great physical shape, having taken up body the hospital. The amount of care that the family has to give , building. He doesn't drink anymore: "I've been working so or an aide has to give , is really more substantial. We're trying hard on my rehab, I don't want to jeopardize it. " And the to make the community aware of alternatives: assisted living whole experience has changed him, not entirely for the worse. centers, for example. lf we can improve a patient's function"It's made me grow up a lot," he says. " ow I have ing by just a little bit, sometimes that means he can get by direction in my life .... I know what I want to do ." B u 0 0 p c o n u m 9 9 �TRAUMATIC BRAIN INJURY RESEARCH FOCUSES ON FUNCTIONAL OUTCOMES much care patients will need after they leave the hospital. " THE CLOSE ASSOCIATION between the medical school's Labi will report preliminary results from the study at a Department of Rehabilitation Medicine and the rehab proUB-sponsored international conference on head injury rehagrams in the Traumatic Brain Injury Rehabilitation System bilitation, to be held at iagaramakes possible some important reon-the-Lake, Ontario, in july 1996. search into an epidemic problem. • RichardT. Linn, Ph.D. , under a Two academic studies in grant from the ational Institute progress: on Disability and Rehabilitation • Dr. Maria Labi has a grant from Research , an ann of the U.S. Dethe federal Centers for Disease Conpartment of Education, is studying trol and Prevention, now entering individuals who have sustained its fourth year, to study head-injury mild head traumafor example, patients as they progress through who have lost consciousness those the rehabilitation system. Labi is for less than 30 minutes after a looking at the functional outcomes blow to the head. About 5 percent of head injury over a long period of of the people who suffer such ::1 follow-up care, and trying to idenconcussion, he says, continue to tify risk factors for complications have problems- attention deficit, from such injuries. headache, fatigue, depression , anxi"By having this regional system, etya year after the injury. by identifying all the patients comNow in the third year of the ing into the system, we've been able project, Linn is seeking a way to to collect data from the point of DR . MARIA LABI , JAMES PHILLIPS (LEFT) AND predict who will have such probimpact and follow them out for the RICHARD LINN , PH . D . (RIGHT). lems and who won't. Patients who rest of their lives," says james A. agree to participate undergo a positron emission tomography Phillips, clinical instructor and administrator for the mediscan within a couple of weeks of their injury, and Linn will cal school's Department of Rehabilitation Medicine. "That try to correlate the amount and areas of change in brain study will be a benchmark for the rest of the country. lt will function with later problems. also give back to insurance carriers information on how CUTHBERT SIMPKINS II , M.D . , {LEFT) ASSOCIATE PROFESSOR OF SURGERY AND DIRECTOR OF THE VIOLENCE AND VICTIMIZATION PROGRAM , WITH RESPIRATORY THERAPIST JOHN GUAGLIARDI . B u a 0 p h c a u m 9 9 �Michael Msall,M.D, receives 1995 Sir James Carreras Medical Award in care, clinical research, education and advocacy for children with neurodevelopmental disabilities. His efforts include team approaches, family supports and developmental interventions for children with Down's syndrome, cerebral palsy, spina bifida, congenital malformations, prematurity and related neurodevelopmental disabilities. His work was recently published in Clinical Pediatrics and the journal of Perinatology. Msall is a member of the Society for Pediatric Research. The Robert Warner Rehabilitation Center is a cooperative effort of families , rehabilitators and professional and voluntary not-for-profit community agencies, including Variety Club of Buffalo Tent #7 and The Children's Guild. The Sir james Carreras Award was established in 1986 and honors the name of Sir james Carreras, MBE, a former president of Variety Club International who still serves on its board. ichael E. Msall, M.D. , associate professor of pediatrics and rehabilitation medicine, has received the 1995 Sir james Carreras Medical Award. The award and an accompanying $10,000 prize are presented annually by Variety Club International to the physician who has done outstanding work in the field of pediatric medicine during the previous year. Msall was chosen to receive the award from among 60 physicians nominated from around the world. He is chief of the division of developmental disabilities and medical director of the Robert Warner Rehabilitation Center at The Children's Hospital of Buffalo. A UB faculty member since 1987, Msall received the award for his efforts UB medical student named to academic medicine fellowship niversity at Buffalo medical student Aisha Prim has been named an Academic Medicine Fellow by National Medical Fellowships, Inc. Prim is one of 35 minority medical students selected for the honor, funded by Bristol-Myers Squibb Co. , and established by The Commonwealth Fund, from among 90 students nominated by 58 medical schools. The $6,000 fellowship funded her participation in a summer research project at Roswell Park Cancer Institute to study how certain components of the immune response may help kill tumor cells. She worked with her mentor, Richard Bankert, V.M.D. , Ph.D., associate chief of Roswell's department of molecular immunology and professor of microbiology. Prim will present her research findings at a threeday symposium in january. Prim has received the Buffalo Urban League Youth Award and the medical school's Dean's Commendation Award for Academic Excellence. ln addition, she has received the Buffalo Foundation Award and the Special Merit Fellowship for 1993 to 1995, and is copresident of the UB Chapter of the Student ational Medical Association. Two former UB medical students , Andrea Williams, M.D. , and Yvette Vinson , M.D. , are previous recipients of the national award. -!11'1'"'--...,..------...... Michael E. Msall, M.D. B u a a p 5 c a ... u m n 9 9 �SUNY trustees namelJrouy-and-- -versrty~erecei~ed a doctorate from the , , , Umversny of Mmnesota. Hong distmgmshed professors suk Ki Hong, M.D. , Ph.D., uB professor of physiology, was named a distinguished professor in january in recognition of his reputation and contributions to research. A UB faculty member since 1975, Hong also serves as director of graduate studies in the department of physiology. Before coming to UB, he was professor and chair of physiology at the University of Hawaii. Hong's research interests lie in the areas of renal and environmental physiology. He has authored or co-authored wo School of Medicine and Biomedical Sciences faculty members have been awarded the rank of distinguished professor, the highest in the State University of ew York system, by the SUNY Board of Trustees. The rank is an order above full professorship and has three co-equal designations: distinguished professor, distinguished service professor and distinguished teaching professor. The rank of distinguished teaching professor was conferred upon Harold Brody, Ph.D., M.D., professor of anatomy and cell biology. The designation is awarded to persons who have demonstrated outstanding teaching competence at the graduate, undergraduate or professional level. Brody is a 1961 graduate of the medical school, and has been a faculty member for 40 years, serving for half of that time as chair of the department. He has done research and published widely in the field of neuroanatomy, and has served on several editorial boards, including that of Buffalo Physician. As a Fulbright scholar to Denmark in 1963, he helped establish that country's first cadaver donor program. He was one of the founding members of UB's Center for Aging and is past president of the Gerontological Society of America. He received the society's Robert W. Kleemeier Memorial Research Award for Outstanding Research in Gerontology in 1978. Brody left the anatomy department chairmanship in 1991 to continue teaching, do research and to fulfill a lifelong dream of establishing a MuseumofNeuroanatomy at UB. The museum, dedicated in january, has received national attention and is being used actively for education and research. A graduate of Western Reserve University, now Case Western Reserve Uni- B a a p nearly 190 articles for scholarly publications and more than 40 textbooks, monographs and book chapters He has earned numerous academic awards, including the Stockton Kimball Award from the medical school for excellence in research, education and service, and a special citation for distinguished service from the japanese Panel on Diving Physiology and Technology of the U.S.-japan Cooperative Program in Natural Resources. Hong received a medical degree from Yonsei University in Korea and a doctorate in physiology from the University of Rochester. 1995 Spring Clinical Day Awards given for research presentations T HIS YEAR'S FIRST- PLACE SPRING CLINICAL D AY AWARD WENT TO HANI ABDEL-NABI , M . D. , AND HIS TEAM FOR " CLINICAL APPLICA- TIONS OF W HOLE BODY PET FOG IN CANCER PATIENTS" ( R IGHT) ; SECOND PLACE WAS WON BY B IRGIT JURLANDER, M . D . AND HER TEAM FOR " CORON ARY A NGIOGRAPHY AND B IOCHEMICAL MARKERS IN UNSTABLE A NGINA PATIENTS" (BELOW) ; AND T H IRD PLACE WAS AWARDED TO H RATCH L. K ARAMANOUKIAN , M . D ., AND HIS TEAM FOR " D ECREASED P ULMONARY N ITRIC O XIDE S YNT H ASE A CTIVITY IN THE R AT M ODEL OF C DH" (R IG H T) . y 5 c a n A u u m 9 9 5 �THEN . . . . NOW Medical school enjoys rtch African-Amellcan herttage RECENT FOCUS ON UNDERREPRESENTED MINORITIES BUlL T ON A HISTORY OF_ " COLOR-BLIND" ADMISSIONS AND EDUCATION POLICIES FOR MEDICAL STUDENTS !though early records do not indicate race , it is University of Buffalo and completed his degree . clear that black students attended the University of Dorsette helped organize the ational Medical AssociaBuffalo School of Medicine before the turn tion for black physicians and was a trustee at Tuskegee of the century. Institute in Alabama, which Booker T. Washjoseph Robert Love was described ington built from a small normal school in a newspaper article about the into a nationally known institution with school's 1880 commencement as an 1,500 students. Episcopal clergyman who studied Other early black medical school medicine as "an auxiliary to his graduates include Frank L. ministerial calling," and was Watkins , who came to the Uniidentified then as the Univerversity of Buffalo from Montsity of Buffalo's first black gomery, Ala., graduated from graduate. His intention was the medical school in 1891 and "to undertake under Bishop died in Buffalo in 1921. Henry Holly of the island of Hayti, Harrison Lewis, who graduWest Indies, the introducated in 1918, was a member tions of the church in San of the university's first class Domingo ," according to in the College of Arts and the commencement arSciences before he transticle. Love's later writing ferred to the medical school. exerted an important inPerhaps best known locally was W. Yerby jones , a fluence on jamaican history, it was indicated. graduate of the medical Cornelius athaniel school's class of 1924, who Dorsette, a member of the lived in Buffalo for 50 years. class of 1882, was the second A prominent ophthalmologist, jones served as chief of African-American to receive a medical degree from UB. He was staff of the former E. ] . Meyer Memorial Hospital. BookerT. Washington's physician, and often was mentioned by WashMary B. Talbert, for whom the ington in speeches as an example of university's Talbert Hall is named , black perseverance and initiative. was a native of Ohio who graduated Born into slavery in onh Carolina , from Oberlin College in 1885 , married a Dorsette was separated from his mother at Buffalo bookkeeper and spent most of her life two months of age. He was raised by his grandin Buffalo. Active in local and national organizamother and graduated from the Hampton Institute in tions, she was chairman of the executive board and then 1878. Failing health forced him to president of the ational Association resign from the Medical College at of Colored Women , and vice president JOSEPH ROBERT LOVE Syracuse. After regaining his health of the ational Association of Colored and being rejected by the University Medical College of People. In 1922, a year before her death, she received the New York City because of his race , he came to the Springarn Medal from the AACP. 8 a 0 p c c u m n 9 �A Spoonful of he airline industry is in trouble. With utilization down , and many airlines cutting back on both personnel and flights , airline executives have looked to successful industries as models for their reorganization. Here's what might happen if airlines were run like the medical profession. Humor © Stu S i lverste i n , MANAGED CARE AIRLINES The terminal is neat and clean, the attendants courteous, the pilots capable. In the event of an emergency landing, M . D . HMO AIRLINES Passengers arrive eight hours before their flight after calling an "advice reservation desk" and then carry their seats out on the tarmac. They then take seats to the middle of the plane and flap their arms and hum "Anchors Aweigh. " Film: "Any Which Way But Up. " MEDICARE AIRLINES PEDIATRIC AIR They have the largest budget. Nobody can find the airport. There are three committees working around the clock to figure out how to make the airport more accessible. Problem is, the committee can't find the airport either. All seats will be first class, as soon as the seats are installed. Passengers walk out onto the runway, a short man with a bow tie hands them stickers in between answering advice calls and running to the back to help deliver the food . Every first-class seat is next to a colicky infant and breastfeeding mother. The movie: "Sophie's Choice: Augmentim" Complimentary drink : Pediatri c cocktail: amoxicillin and jack Daniels. PSYCHIATRY AIR First-class seats are couches. Coach passengers break up into small discussion groups. Flight destination is "wherever you want to go." Midway through the flight the pilot announces "I am experiencing some turbulence, but we aren't here to discuss me." The movie: "julia Child: Cooking with Lithium." SURGERY AIRWAYS The cashiers, flight attendants and pilots all wear shower caps and shoecovers, even though the flight isn't a sterile environment. Midwa y through the flight a steering wheel and earphone piece are thrown out of the cockpit, and you hear the pilot admonishing the crew, that "these aren't the ones I iike to use. " Th e movie: "A Broviac Runs Through It" The meal: Nobody has ever eaten it. B a a p h the pilot has to call an 800 number to get approval to lower the oxygen masks. They also have a fleet of Lear jets for the CEO of the airline. The crews receive lucrative incentives for talking passengers out of flying at all. s c a Stu Silverstein , M.D., pres ident of Standup Medicine Seminars of San Francisco, California, and Stamford, Connecticut , lect ures nationwide on humor and medicin e. He is also co-author of What About Me?, a booh on growing up with a develop- mentally di sabled sibling. u m n 5 �Fierro '66, inspiration for fictional, best seller M.E. AS THE REAL-LIFE VIRGINIA CHIEF MEDICAL EXAMINER , MARCELLA FARINELLI FIERRO SEES HER ROLE IN THE " KAY SCARPETTA" MYSTERIES AS "GREAT FUN" r. Kay Scarpetta and Dr. Marcella modest about her role as the model for Farinelli Fierro '66 are both bril- Kay Scarpetta. She is also quick to liant medical detectives, forensic point out that she doesn't physically pathologists who are among the resemble the fictional medical exambest in the business at unlocking iner. ''I'm definitely not 105 pounds the secrets of the dead and letting and five feet tall with blue eyes," she them tell the tales of how they lived and died. The fictional Dr. Scarpetta has gained worldwide fame as the heroine of Patricia Cornwell's best-selling mysteries. The latest, From Potter's Field, follows Scarpetta from Virginia, where she is chief medical examiner for the Commonwealth of Virginia, to ew York, where she confronts her principal adversary, psychopathic killer Temple Gault. While Scarpetta is fictional , she is, according to Cornwell, based on her mentor, Marcella Fierro, who is the real-life Virginia chief medical examiner. "1 consider her the best forensic pathologist in the world, and she has been a tremendous inspiration to me. " During an interview promoting her new book, Cornwell told a national audience how sur- Dr. Marcella Farinelli Fierro '66 prised she had been to discover a woman serving as a medical examiner says with a laugh. when she walked into the M.E.'s office She also doesn' t followthe lifestyle 10 years ago. Cornwell, a former news- of Scarpetta, who is divorced and enpaper reporter, ended up spending five joys affairs with FBI agents. Fierro and years working as a technical writer in her physician husband have two chilFierro's office and researching the op- dren , neither of whom is following erations of a real-life morgue for her their parents' medical career path, almurder mysteries. though their son is in law school and Fierro considers her role in the best- is interested in criminal law. Their selling mystery books "great fun" and is daughter is a legislative assistant to a s u 0 0 p h 5 o n A orth Carolina congresswoman. Fierro and Cornwell have become close friends, and she remains one of Cornwell's chief advisors, reading every manuscript for factual errors. Growing up in Buffalo, where she attended D'Youville College and the University of Buffalo School of Medicine and Biomedical Sciences, Fierro never dreamed of serving as a mystery book heroine , or even working as a pathologist. "While in medical school 1 was very interested in internal medicine, but once I did my pathology rotation I found this area of medicine fascinating," she recalls. "I was also inspired by the late Dr. Judith Lehotay (formerly Erie County's chief medical examiner), who was one of the first female forensic medical examiners." After medical school graduation in 1966, Fierro did her internship and additional training in Ottawa, Canada's capital, where her husband , Robert, was in training as an obstetrician-gynecologist. She had two more years of pathology training at the Cleveland Clinic, and another year of forensic pathology training at the Medical College of Virginia. She was certified in fo rensic pathology by the American Board of Pathology in 1975, becoming just the ninth woman certified by the ABP in forensic pathology. She served as Deputy Chief Medical Examiner for Central Virginia u m n 9 �············································· · ·········································· ~ for 17 years, followed by 18 months association's board of directors and as professor of pathology at East the executive committee. Fierro is a Carolina University School of Medi- fellow of the pathology-biology seccine, where she taught general and tion of the American Academy of Foforensic pathology. In 1994, Fierro rensic Sciences. She has also served as returned to Virginia to assume her a consultant to the FBI and on a panel current positions as chief medical studying gunshot wounds. She has examiner and chair of the depart- been published in professional jourment of legal medicine for the Com- nals and contributed chapters to sevmonwealth of Virginia, and profes- eral books, and is currently editing sor of pathology at the Medical Col- the second edition of a text on identification for the College lege of Virginia. of American "Forensic Patholopathologists. gists are reAlthough ally medical detectives an~M~nr a l1 o f who are helpcases ining the living volve dead by uncoverpeople, she is ing the causes philosophical of death," she about her work. explained. "lt all "There are a depends on million ways your focus. to look at difWithout the ferent cases, information and this field we have requires crelearn ed your focus. Without the ative thinkthrough paing and is information we have learned thology , for never borinstance, we ing." for through pathology, would never Testifying know what in criminal instance, we would never we know tocases is an day about important know what we know today child abuse part of a foand how to rensic about child abuse and how to recognize pathologthe signs of ist's job, and recognize the signs of abuse." abuse. We Fierro enjoys are saving the experi1 i v e s ence. through our work and that helps "I regard the court time as an opporus. We also owe it to the dead tunity to teach, to instruct the court," to find the cause of death and she explained. discover the killer in case of She is past president of the National Association of Medical Examin- homicide . " ers and presently serves on the - s v o E a o R A H w 1 L L 1 A M s B a 0 p h y s c a n A • Stephen Kimatian '92,is 1994 Air Force Flight Surgeon of the Year tephen]. Kimatian, M.D. '92, has been named 1994 Air Force Flight Surgeon of the Year. Kimatian, a flight surgeon with the 16th Operations Medical Flight, 16th Operations Group, at Hurlburt Field, Florida, competed against representatives from nine other major air commands to win the annual competition for the Malcolm C. Grow Award. Last year, Kimatian spent 189 days supporting joint special and national security operations in Bosnia, Somalia and Haiti. Kimatian was the first medical officer to reach the scene when an Air Force AC-l30H gunship crashed in the Indian Ocean in March. After triagingand treating the survivors, and transporting them to a avy vessel for further treatment, Kimatian returned to the crash site to coordinate mortuary affairs and collect information as part of the interim accident investigation board. Before activation of the 16th Operations Medical Flight, Kimatian evaluated the contents of medical rucksacks and medical Rapid Response Development Kits used during deployments. He served as a clinical instructor for medical technicians, advanced cardiac life support instructor and clinical advisor to joint medical planners preparing for training. Kimatian entered the Air Force after his graduation from the School of Medicine and Biomedical Sciences in 1992. He completed his internship at Wilford Hall Medical Center, Lack land Air Force Base, Texas; the USAF Hyperbaric Medicine Course, Global Medicine Course, Brooks Air Force Base; and Combat Casualty Care Course, Camp Bullis, Texas. He served with the 55th Special Operations Squadron at Hurlburt Field until activation of the 16th Medical Operations Flight in October 1994. u m n 9 �Arthur J. Schaefer, M.D. '47,wins Lucien Howe Award from 1954 to 1956 as chief of ophthalmology at hospitals in Korea and japan. He was named technical advisor to japan's first eye bank in 1955. A specialist in ophthalmic plastic and reconstructive surgery, Schaefer has maintained a private practice in Snyder since 1959. He has been a member of the medical school's teaching staff since 1952, and is a clinical professor of ophthalmology and a clinical assistant professor of otolaryngology. Schaefer has published widely in professional journals, and has been an invited guest lecturer in the United States and abroad. Active in professional organizations, he is past president of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He is a fellow of the American College of Surgeons, the American Society of Ophthalmic Plastic and Reconstructive Surgery, the American Academy of Ophthalmology and the European Society of Ophthalmic Plastic and Reconstructive Surgery. In 1989, he was elected chairman of the advisory board of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He has been a member of the editorial board of the journal Ophthalmic Plastic and Reconstructive Surgery since 1985. rthur J Schaefer, M.D. '47, anationally known ophthalmic plastic and reconstructive surgeon, has received the Lucien Howe Award for contributions to the field of ophthalmology. The award is presented jointly by the School of Medicine and Biomedical Sciences and the Buffalo Ophthalmology Society. Recipients are selected by a national committee. The award was first made in 1928 to Dr. Edmund B. Spaeth, director of ophthalmology at the Wills Eye Institute in Philadelphia. Schaefer is the 22nd recipient of the prestigious award, and the first Buffalonian. He received the award, a specially cast gold medal, in ceremonies held this past spring. Howe was a pioneering oph- Arthur J. Schaefer, M.D. thalmologist and researcher who practiced in Buffalo in the late 19th and early 20th centuries, and was a member of the UB medical school faculty. In 1926, he founded the Howe Laboratory of Ophthalmology at Harvard Medical School, known worldwide for its research. Schaefer graduated from Canisius College, took his medical internship and ophthalmology residency in Buffalo hospitals, and has spent most of his career in Western New York. He started the oculoplastic, lacrimal, orbital and reconstructive surgical clinic and service at the former E. j. Meyer Memorial Hospital in 1961. The service was the medical school's first subspecialty clinic. Schaefer served in the U.S. Army B u a a Paulette Smart '92,wins AMAI Burroughs-Welcome award aulette A. Smart, M.D. '92, has received the 1995 American Medical Association/Burroughs-Welcome Leadership Award for leadership in community service. A third-year resident in physical medicine at Ohio State University Medical Center when the award was made, she was one of 40 residents and fellows selected for the honor that allows them to participate in the Ameri- p h y s c a n ll. can Medical Association meetings for resident physicians. One of Smart's goals is to be a mentor to young people. She was active in the Big Brother/Big Sister program when she was a student at Pace University in Pleasantville, N.Y. , where she received her bachelor's degree in 1988. While in medical school, she taught physics on weekends to gifted high school students, and participated in musical groups that performed in nursing homes and children's units. She also spent five weeks in jamaica, West Indies, providing medical services to the less fortunate. Smart joined other resident physicians in session at the AMA's annual meeting in Chicago last june. She will also attend the group's interim meeting in Washington, D.C., in December. Seibel '66,honored for years of work at ECMC'strauma center he Erie County Medical Center Lifeline Foundation recently honored Roger W . Seibel, M.D. '66, at the foundation's annual black tie dinner dance. Seibel is ECMC's clinical director for the department of surgery and also serves as director of trauma services and the burn treatment center. Seibel, affiliated with the medical center since 1973, was influential in the establishment of one of the first trauma units in the country there. In 1989, the New York State Department of Health recognized the unit as the regional adult trauma center for the eight-county Western New York area. The unit treats over 1,600 trauma cases annually. Since 1989, Seibel has also been director of Western New York's regional burn treatment center at ECMC- the only one of its kind between Pittsburgh and Rochester. Seibel is a clinical professor of surgery u u m n 9 9 5 �and clinical associateprofessor of orthopaedics. He has published chapters in several books and authored articles in refereed journals. His article, "Blunt Multiple Roger W. Seibel, M.D. Trauma, Femur Traction and the Pulmonary Failure-Septic State," changed the way trauma patients are cared for. A 1966 graduate of the School of Medicine and Biomedical Sciences, Seibel began his residency program at the former E.j. Meyer Memorial Hospital in 1967, and was drafted by the United States Air Force in 1968. After a year in Texas and a year in Vietnam, he returned to Buffalo in 1970 to complete his residency. Franklin Zeplowitz '58, chief of staff and medical director of Our Lady of Victory Hospital, was honored recently for his distinguished service by hospital president and CEO Albert Candino (far left), chairman of the board, and retired Bishop of the Catholic Diocese of WNY Edward Head (center) and Bishop Robert C. Wurtz (far right). Irene Snow '80,among alumni elected to medical society posts The third woman physician to head the were Russell W. Bessette , M.D. , D.D.S. organization since its founding in 1821, ' 76 , president-elect; Franklin she succeeds David Scamurra, M.D. Zeplowitz , M.D. '58 , vice president; edraj. Harrison, M.D. '77 , secretaryeveral alumni of the School ofMedi- Snow is a diplomate of the American cine and Biomedical Sciences have Board of Internal Medicine, and is cer- treasurer. been elected officers of the Medical tified by the National Board of Medical Examiners. Society of the County of Erie. As a member of the county medical Irene S. Snow, M.D. '80 , clinisociety, she has served as president cal associate professor and chief elect, vice president, secretary-treaof general medicine for Buffalo Medical Group , was installed as president at the surer and as chair of the group's pubargaret Paroski , M.D. '80 , society's annual meeting held in June. lic health committee. She is also a president of the Medical member of the Alumni Association, has been Medical Society of elected a vice president of the State of ew Erie County Medical Center's York, the American lifeline Foundation , a notMedical Association, the American for-profit corporation that raises e sure to set aside time to celebrate the Sesquicentennial at Spring Clinical Day, May College of Physi- funds to develop programs and encians and the hance patient care at the medical 11 , 1996. Sherwin B. uland , M.D., author of "How Women Physicians center. Paroski is clinical director ofECMC's We Die ," will deliver the annual StocktonAssociation. department of neurology and an associAlso elected to Kimball lecture. ate professor of neurology. one-year terms Paroski '80,named vice president of ECMC'sLifeline Foundation Mark Your Calendars B a 0 p y s c a 1>. u m n �• ······ · · ····· ·········· ···· · · ····· ··· ··················· ····· · ··· ·· ····· ······· ···· ····· Sesquicentennial Reunion Weekend set EXT YEAR 'S REUNION WEEKEND AND SPRING CLINICAL DAY WILL COINCIDE WITH THE CELEBRATION OF THE MEDICAL SCHOOL'S SESQUICENTENNIAL ANNIVERSARY , WITH REUNION CELEBRATIONS ON FRIDAY , MAY 10 , AND THE STOCKTON KIMBALL LECTURE ON FOUNDERS' DAY , SATURDAY , MAY 11 . HAROLD J. LEVY, M.D. '46 Al ROWE, M.D. '46 MARVIN PLESKOW, M.D. '51 AllEN GOLDFARB, M.D. '51 JOSEPH KUNZ, M.D. '56 JOHN HODSON, M.D. '56 ROBERT REISMAN, M.D. '56 MIKE COHEN, M.D. '61 JARED BARLOW, M.D. '66 JOEL PAUll, M.D. '71 DENNIS NADLER, M.D. '71 JOHN BODKIN, M.D. '7 6 STANLEY BUKOWSKI, M.D. '81 BRIAN SAME, M.D. '81 PANO YERACARIS, M.D. '81 SANFORD LEVY, M.D. '86 PAUL HOLMWOOD, M.D. '86 SUSAN llnLER, M.D. '91 B 0 0 p h s o n m 9 9 �CLASS OF 1 946 CLASS OF 1981 CLASS OF 1 966 "Fifty years and still going strong! join us and celebrate. So many memories to share! " Harold J. levy "We would like to see you all back for the 30th reunion. Looking forward to reminiscing, renewing friendships and the fellowship. Please join us. " Chairman Jerry Barlow AI Rowe Chairman "It's been a rapid 15 years. Let's get together and try to catch up. Hope to see you in May '96! " CLASS OF 1 971 CLASS OF 1 951 Morv Pleskow Chairman AI Goldfarb Co-Chairman CLASS OF 1956 Stanley Bukowski Co-Chairman Co-Chairman "Can you believe it? Forty-five years! Our class reunion- May l l , 1996. Please, reserve this weekend! It's too important to pass up. It will be great fun to become reacquainted , renew old friendships, and enjoy the warm companionship we shared in the past. Do your best to join together for this very special celebration! " "Why wait five more years7 Come to Buffalo in the spring and relax with a few choice classmates! " "After 25 years it will be great to see one another. Looking forward to our Silver Reunion! " Brion Some Co-Chairman "Enough time has passed so that at least some of us will have grown up! Hope that as many as possible will be able to come and that all are well. " Joel Poull Co-Chairman Dennis Nadler Co-Chairman Pono Yerocoris Co-Chairman CLASS OF 1 976 "Class of 1976- can you believe 20 years have gone by?! Come back to your medical beginnings. There will be only one 20th-year reunion. Don't miss it! " "Come back and see how the medical school has changed and how all of us have changed in 10 years. " John Bodkin Sanford Levy Chairman Co-Chairman CLASS OF 1 986 "Forty years! It is time to celebrate! " Andrew Gage Paul Holmwood Joseph Kunz Co-Chairman Co-Chairman Co-Chairman John Hodson CLASS OF 1 991 Co-Chairman Robert Reisman "It's hard to believe that five years have passed since medical school and that some of us are still residents! I am looking forward to seeing all of you for a little wine , a few stories, laughs and baby pictures. " Co-Chairman CLASS OF 1961 "Set aside the time and help us celebrate the Sesquicentennial at the school and our 35th reunion in Buffalo, the weekend of May 10, 1996. " Susan littler Chairperson Mike Cohen Chairman Ed Manning Co-Chairman B u 0 0 p 5 a A u m �1995 Alumni Achievement Awards made IVE MEDICAL SCHOOL ALUMNI WERE THE RECIPIENTS OF THIS YEAR ' S ALUMNI ACHIEVEMENT AWARDS . ALL PICTURED WITH OUTGOING ALUMNI ASSOCIATION PRESIDENT RUSSELL BESSETTE '76 ARE : AT TOP LEFT , HARRY METCALF ' 60 ; AT BOTTOM LEFT , THOMAS GUTTUSO ' 60 ; AT TOP RIGHT , ROLAND AND SIDNEY ANTHONE '50 ; AND AT BOTTOM RIGHT , NORMAN CHASSIN ' 45 . HURWITZ & FiNE, P.C. I ATTORNEYS AT LAW I SERVICING THE LEGAL NEEDS OF THE HEALTH SCIENCES COMMUNITY Managed Care • Purchase&SaleofPractices • Business&Tax.Planning • HCFASafeHarborRegulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 1300 Liberty Building • Buffalo, New York B 0 0 p h s c 0 m �Harold Brody, M.D. '61, professor of anatomy and cell biology and former chair of the department, received the 199S Distinguished Medical Alumnus Award from John Naughton, M.D., vice president of clinical affairs and dean of the School of Medicine and Biomedical Sciences. The award, a specially designed crystal bison, was presented at a dinner honoring Brody in October. ~niuersit~ at ~uffalo meaical ~lumni ~irector~ UNIVERSITY AT BUFFALO 1 B-MONTH SES~UICENTENNIAL C: DESK CALENDAR TIIE 1996 Universily al Buffalo Medical elebrate 150 years of tradition with the University at Buffalo 18-Month esguicentennial Desk Calendar, an elegantly designed calendar featuring illustrations culled fi·om University Archives. Each month's images-selected for their Alumni Directory has officially been released! character and umguenesschronicle UB's history. The calendar comes with a custommade lucite holder and stand, and is gift boxed. Medical Alumni. Dislribulion has already begun for Since Lhis is our Sesquicenlennial Edilion, you won'L want Lo miss oui. It is not too late to order your own copy of the directory. This comprehensive new volume is a compJation of tbe mosl current data avaJable on over 5,300 Lhose who reserved dreir copies early. If you wish to place an order or have any queslions about tbe directory, please contact our publisber directly at the (allowing address: CUSTOMER SERVIC E D E PARTMENT B E RN A RD C . HARRIS PUBLISHING Co., INC. 22 KO GE R C E NT E R NOR F OLK , VA To order, please call Stella Ryndak at (716) 645-6969. B u a a 23502 Or call t/1e Customer Service Department toll /ree at 1-800-877-6554 p h y 5 a n A u m n 9 �SPRING CLINICAL DAY Spring Clinical Day and Reunion Weekend '95 EDICAL SCHOOL ALUMNI AND OFFICIALS GATHERED AT THE BUFFALO MARRIOTT FOR THIS YEAR' S SUCCESSFUL SPRING CLINICAL DAY , FEATURING STOCKTON KIMBALL LECTURER RICHARD KRUGMAN , M . D . �AND REUNION WEEKEND REUNION CLASSES FROM THE PAST 50 YEARS CELEBRATED IN GRAND STYLE AS THESE PICTURES CLEARLY DEPICT . �• ················ · ·········· · ········ · ··· · ·········· · ······················ · ··········· · ··· . I November. In ad- 19505 E D W A R D of SHANBROM '51 , Santa Ana, California, received an honorary doctor of science degree from Allegheny College. THOMAS HAMILTON elected president of the Buffalo on March 8, 1995. He joins his Surgical Society and secretary- sister, Leah, 4 , and brother Paul, establishing an an- treasurer of the Medical Society 2 1/2. nual award in his name to honor fu- of the County of Erie. She also recently became a partner in the ture leaders in the formation of Delaware Surgical field of palliative Group, P.C.,agroupoffivegen- pain and symptom eral surgeons working at Millard WILBUR '69 , South and South west and Who's Who in the World. 6 9 IRVING KOLIN '65 , 0 5 of Winter Park, Florida, was invited to the and named professor of pediatrics and radiology and interim chair of radiology at the University of Iowa. He has six children and one grandchild. Governor's Institute in North Carolina to present recent re- 7 9 0 5 naltrexone in the treatment of alcoholism. Dr. Kolin also spoke at Duke University's department of psychiatry, where he addressed the topic of neurotransmitter systems and the use of medication in the treatment of alcoholism. JOAN G lAM POLl '90 and CRAI G were recently wed NARINS '90, in Scarsdale, New York. Or. Giampoli completed her resi- 8 9 0 DAVIDS . K OU NTZ '81 , 5 ofPhila- Strong Memorial Hospital, in ew York, where she Rochester, delphia, has moved from was chief resident in pathology. Hahnemann University Hospital to Temple University as asso- She is a fellow in surgical pathology and cytology at Strong. Dr. ciate professor of medicine and arins completed his residency director of ambulatory care at Duke University Hospital in there. He has two sons, David, 4, Durham, and Matthew, 18 months. cardiology fellow at Strong. SH I RA R UBINSTEIN '85 , search findings on the use of 5 dency at Vanderbilt Medical Center in ashville, Tennessee, and of Iowa City, tion of University Radiologists, 0 Fillmore Health System and St. SM I TH elected president of the Associa- 9 9 joseph Hospital. Iowa, has been new edition of Who's Who in the third child, Michael Nicholas, oring Dr. Milch by II ' 57 , oflasVegas,Nevada, Marvin A. McMillen '75 has been listed in the has been dition, CHI is hon- management. P . NEDRA HARR ISON '77 , directs orth Carolina. He is a R OSALIND N OLAN S U LAIMAN married of the Child and Adolescent Out- '91 , Wrentham, Massachusetts, has patient Psychiatry Clinic at M . D ., been appointed chief of internal Georgetown University, Wash- cember 1994. She is expecting a medicine at the Rehabilitation ington , D.C. She will present a baby this December. She is com- Hospital of Rhode Island. Or. paper at the American Academy pleting her med-peds residency at Sgalia currently practices inter- of Child and Ado- Baylor this year; her nal medicine and cardiology in lescent Psychiatry's husband is finish- Hopedale, Massachusetts. He has annual meeting in ing his ID fellow- A RTH UR C . S G A LI A '73 , A D E L S U LAIMAN , (Georgetown '90) in De- medical served on the faculty of the Uni- ew Orleans. She ship. They plan to director ofHospice Buffalo, clini- versity of Massachusetts Medi- cal professor of surgery and ad- cal School since 1978. writes that she and her husband love where his father is ROBERT A . M I LCH '68 , Washington, D.C. Elaine Ziavras '85, ambassador, for a has been named chief of surgery of she adds, is in the settling, probably Michael Reese Hospital in Chi- Georgetown on the East Coast. cago, Illinois, and professor of ophthalmology surgery and physiology at the department. junct clinical professor of family medicine at UB's School ofMedicine and Biomedical Sciences, has recently been named therecipient of the prestigious Award for Lifetime Achievement from Children's Hospice Interna- practice in Oman, MAR V IN A . M C M ILLE N '75, University of Illinois at Chicago. few years before NAVY L T. PAUL D . Rosalind Nolan Sulaiman '91 S EE MAN '93 , is currently halfway He has been program director in J EFFREY surgery at the Yale Affiliated Pro- STEI NIG '88 , commitment to children's hospice care. The award will be pre- gram at Bridgeport Hospital, director of the surgical intensive York, has completed a surgery ment to the Mediterranean and residency in Savannah , Georgia, Adriatic seas and has been serv- sented at a banquet during the care unit at the West Haven and is now a partner with ing off the coast of Bosnia- tional. Dr. Milch was recognized for his personal contribution and P . of Lancaster , New through a six-month deploy- 1995 CHI National Conference OVAMC and clinical associate South towns Surgical Associates. Herzegovina aboard the dock held in Washington, D.C. , in professor of surgery at Yale for He and his wife, Maria, had their landing ship USS Gunston Hall. the past eight years. B u a 0 p y a n m n 9 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. Adding t,o the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the 2 Park Avenue New York. NY 10016 2 Clinton Square Syracuse. NY 13202 90 Merrick Avenue E. Meadow. NY 11554 largest and most successful company of its kind in America. Call1-800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area. Our defense never rests. Cl1994 M.-:d1call ab ty Mutulll lt1!:11Jrance Company �Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No . 311 BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING A TREE UNDER WHICH You WILL NEVER Srr DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE 150 V£AAS (716) 829-2773 ��SCHOOL OF BUFFALO MEDICINE AND PHYSICIAN CLASS OF 1 999 · BIOMEDICAL • �RENEE ABDERHALDEN BETTINA ACKERMANN DANIEL ALEXANDER MARTHA ALIWALAS University of New Hmnpshire Biochemistry Johns Hopkins University Biology University at Buffalo English Cornell University Biology MICHAEL AMENT .JOYCE ANDERSON LYNN-MARIE ARONICA .JORGE ARZOLA, .JR. 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CRAIG HENRY RENEE HERNANDEZ KEITH HERR .JONATHAN HERSHBERGER Houghton College Humanities Fordham University Chemistry University at Buffalo Biochemistry University of Rochester Biology/ Philosophy STEPHEN HESS ARAM HEZEL KELLY HOLES SHANNON HOWE Wake Forest University Biology Vassar College English Niagara University Biology University at Buffalo Biochemistry .... 6 �OF 1999 HARUKA ITAKURA AMY .JONES Cornell Uruversity Biology Stanford University Biology University of Rochester Neuroscience EDWARD KIM WON HEE KIM KRISTINE KLEIN MARGARET LAFFERTY SUNY at Cortland History/ Biology University ay Buffalo CheiTilStry St. Lawrence College Biology St. John Fisher College Biology WAYNE HWANG Johns Hopkins Biology LEENA ISAC \ Du LAM KAREN LEE HENRY LEE Harvard University Psychology SANDRA LEE Barnard College Psychology Columbia College Mathematics Uruvers1ty at Buffalo Biology .JUDI LETTMAN .JONATHAN LEVINE TINGTING Ll MICHAEL LIOUDIS Cornell University B1ology New York University Biology University of Rochester B1ology University at Buffalo Biology ... 7 �OF SCHOOL MEDICINE AND BIOMEDICAL SCIENCES I MICHAEL LIPKE STEFAN LUCAS PATRICIA LUGAR KELLY MARONEY SUNY at Binghamton Biology University of Michigan/ University at Buffalo Chemical Engineering/ Biophysics University at Buffalo Anthropology University of Rochester Health and Society BRETT MASCIA TALIA MCNAMARA CARRI - ANN MEGARGEL MICHAEL MELMAN University at Buffalo Biochemistry University at Buffalo Biology Lehigh University Behavioral Neuroscience Cornell University Biology DANIELE MERLIS SUSAN MILLER KATHRYN MONTGOMERY AMY MORROW Bowdoin College Biochemistry University at Buffalo Psychology Boston University Mathematics Smith College Chemistry KHADER MUl:;)TADIR ELANA NAPOLITANO HEIDI NARINS .JEFFREY NECHLEBA University at Buffalo Biological Sciences St. Johns Uruversity Biology Williams College Chemistry Yale University Economics A 8 s �OF 1999 DANIEL NOSEK University of Rochester Electrical Engineering .JOY NWACHUKWU Canisius College Biology MICHAEL O'BRIEN CHARLIE PAN Stonehill College Biology Massachusetts Institute of Technology Electrical Engineering/ Biology NATESH PARASHURAMA PARAG PARIKH RUPAL PATEL DAVID PAWLOWSKI Massachusetts Institute University at Buffalo Biology/ Political Science University at Buffalo Anthropology University at Buffalo Biochemistry ELIZABETH PELTON DANIEL PERREGAUX STEPHEN PRZYNOSCH Wheaton College Chemistry Middlebury College Biology/ Psychology Cornell University Biology MARY ROSE PUTHIYAMADAM MICHAEL RAUH MICHAEL REMINGTON KEVIN ROBILLARD University at Buffalo Early Childhood/ Health Sciences St. Bonaventure University Biochemistry University at Buffalo Biochemical Pharmacology Cornell University Natural Resources of Technology Chemical Engineering AMY PECK Wheaton College Biology ... g �SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES CHARLES ROCHE ARI RUBENFELD SAMUEL S' DOIA AHLAM SALEH University at Buffalo Biochemistry/ Pharmacology Cornell University Biological Sciences University at Buffalo Biophysics Ccmisius College Biology ANTHONY SANTILLI KIM SCHINDLER MARSILIA SEIWELL STEPHEN SELKIRK SUNY at Allxmy Mathematics Cornell University Biochemistry SUNY at Binghamton Biology Boston University Psychology ELLYN SELLERS SONIA SHAH SHAMS SHEIKH GREGORY SHIPKEY Hartwick College Biology Williams College Biology University of Rochester Chemical Engineering Canisius College Biology NATALIE SIKKA .JENNY SPERANZA BRIAN STOUT RENEE TAEFI Cornell University Human Development and Family Studies Rochester Institute of Technology Biology University at Buffalo Biological Sciences Ithaca College Physical Therapy .A 10 s �9 IVAI University at Buffalo Biology KA~HERINE TIMOSZ Cornell University Biology Lt EBNER ER A ~A. E A~ MYW AS Cornell University BiologJcal Sciences Boston University B1ology v T Uruversity at Buffalo Pharmacy and Pharmaceutics Tufts University International Relations z Hofstra University Cherrustry Individuals Not Pictured University of Pennsylvania History • H -Y Brown University Blomedical Engineering R C UE 0 1A Cornell University Anthmpology R AN University at Buffalo Biology �:c - . . ~ _L . - _A - S - -_ . - S . . - ~. , 0 .. -· - -- . - - - F . -__ ·_ _ --- - -- -_, . - - -· .....,.___ "- ~ ---- -------- - -. ...-~ ---- __.,.,.. :-_:-9=_-_:-__:~--=-~-9_::-_- ~; __-=:~_:g_-_-: ·: -------- ..... - · - -- ~-- ------ -~J � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1995 Subject The topic of the resource State University of New York at Buffalo. 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Research Hospital News The GME Maelstrom Putting Back the Pieces Medical School Then and Now A Spoonful of Humor Alumni Classnotes Class of 1999 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n04 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/334b5777f1ce947055f51673d3f1b7f0.pdf acc839f8ffcd24c4660cac3bc145a771 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1996 �BUFFALO PHYSIC I AN \olumc 30. '\umhcr I ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole ~mnh Petro DIRECTOR OF PUBLICATIONS Timoth) j Conro\ INTERIM EDITOR judson \lead ART DIRECTOR \Ian j hcglcr ASSOCIATE ART DIRECTOR "'cott l:ri<.:kcr PRODUCTION MANAGER -\nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John '\:aughton \tee Pre>tdcnt for Clmical \[fat". Dean EDITORIAL BOARD Dr John \ Richert Chatrman Dr. \1artm Brecher Dr. Harold Brod\ Dr. Richard l Colltns Dr. Alan J Dnnnan Dr Timoth' Gabrwl Dr. James Kanskt · Dr. Charles \1a,;aro Dr. Charles Pagancllt Dr. Robert L. Rct>man Dr. Thomas Rosenthal Dr. Stephen ~pauldmg Dr Bradley T Truax Dear Alumni and Friends, N ineteen ninety-six has arrived; thanks to the dedication and hard work of the school's History CommiLLee, everything is in order to celebrate UB's and its medical school's sesquicentennial. The committee, chaired by Dr. Ronald Batt and Dr. Harold Brod) and ably assisted and supported by Dr. joyce Vana, has orchestrated a fine program of events. The initial opening activities will be held on February 22, 1996, when the newly completed Biomedical Research Building will be dedicated and the formerly undesignated Cary-Farber- herman Addition will be named the Biomedical Educatio n Building. These acth·ities will be conducted from 10:00 a.m. till noon. That afternoon, an academic convocation will be held in the elegant Austin Flint Reading Room of the Health Sciences Library. Thanks to the help of its director, Dr. Gary Byrd, and its excellent staff, the room will be available from 3:30 to 6:00p.m. The uNY Trustees and UB's president will confer an Honorary Doctor of Science degree on Dr. Saxon Graham, Professor Emeritus of Social and Preventive Medicine and the department's former chairman. This will be followed by a major Harrington Lecture by Dr. Steven A. Schroeder, president of the Robert Wood johnson Foundation. These activities are already complemented by the publication of the Medical Alumni Directory and by the publication of a special supplement in Business First dedicated to the medical school's sesquicentennial. In early April, the pictorial history compiled by all members of the History Committee and edited by Dr. Brody, Dr. Vana, and Dr. Richard Lee will be available for purchase. Thanks to the efforts of Ms. joyce Buchnowski, an im pressive flyer describing the book has been widely circulated. A series of other events are programmed throughout 1996 and up to mid-year 1997. We hope you will be able to participate in as many of the e,·ents as possible. \-tore important, all of us who have worked on preparing the sesquicentennial hope you will take the time to reflect on the significance of the school's past, its influence on you, and the pcomi>e' >nd '"P""'ibili''" 'h" will "~' <n ~"~ ' ....._, TEACHING HOSPITALS AND LIAISONS Batana \.\ \1edtcal Center Adem· Kclh The Buffalo (,cneral il<"pnal .\ ltdwd Slta" Buffalo \ .\ \1cdical Ccmcr The Children\ Hospnal of Buffalo Lric Count\ \1eclical Center \!ern Hospttal \1tllard Fillmore Hospnals fnmh Sma Roswell Park Cancer lnstnute '-,i~tCr"t or Charity llo~pital Dnuu~ \fc'Cwtln <0 The ~tate L 111\·crsll\. of :\cw York at Buffalo Bt4ffalo Ph\ \1(1<111 IS publtshcd quarterly b~ the State Lni\·cr..,it~· of :\e" York at Buffalo ~chool of \tcdtunc and Biomcdi<:al St:icnccs and the Office of PublicatiOns. It ts .,t.:nt free of charge. toalumm , facultY, students, re>tdents and fnends. The staff reserves the nghtto cdtt all COl" and ..,uhmi-,"otons at:ccptcd for puhliGttiOn . \ddrcss quc ... tions, comments and Eduor Bu(fcllo Ph)\icicm, State Lnin:-rsuy of '\"n, ... ubmission.., to : )ork at lluflalo . Unl\crstt\ Puhltcatll>t". I 3{> ( rofts llall,lluffal<i, '\c" York 1-+loO Send address thanges Ia: Buffalo Pin siw111. Ho (I~ \ddt! ton . 34 35 \lam ~treel. Buffalo. '\e" York 142 1-+ j ohn aughton, M. D. \!icc President for Clinical Affairs Dean, Sclwol of Medicine and Biomedical Sciences Dear Fellow Alumni: T he medical school's sesquicentennial celebration is well under way! We will keep you posted regarding the various e\'ents marking this historic m ilestone (there is a rou ndup on page 22). On February 22, 1996, we will ha\"C dedication ceremonies for the opening of the Biomedical Research Building and the designation of the CaryFarber-Sherman Addition as the Biomedical Education Building. In the ncar fu tu re, you wi ll be receiving a brief alumni sun-cy. The Board ofGo\'ernors tries hard to represent the alumni at large, but wedon'tgettosee many of you regularly, and we'd like to knO\\ what you're thinking. A variety of topics will be covered and we really hope that you'll find a few minutes to reply. If there arc any questions or topics you'd like covered in the survey, please let me kno\\. \Vhen I introduced Dr. 'laney Nielsen as a speaker at Spring Clinical Day in 1993, I was O\-cmhelmed by the list of her accomplishmenLs. Well, get ready for another line on her C.V. I Dr. :\!ielsen has been selected as this year·s recipient of the State University of New York at Buffalo's most prestigious alumni award, the Samuel P. Capen Award. Congratulations are also in order for Dr. james olan, who rcceml) retired as chairman of the Department of Medicine! Dr. "lolan will recci,·e the Walter P. Cooke Award, the university's award for notable and meritorious contributions to the uniYersity by a non-alumnus. I'm looking forward to seeing many of you at Spring Clinical Day in May. Warmest regards, ~... a. ~ . - ()a.JtJZX w. T ~sJt.,;. , MD Margaret W. Paroski, M. D. �V 0 w 3 L N T N 0 E R o 9 9 6 IJ Research II Hospital News II Treating Violence e ECMC's Trauma Center isn't finished working with the victims of violence when they are healed. The doctor's in. Page 26. m Sleep Without Rest e At the Sleep Disorder Center of Western ew York, patients may discover that what ails them during the day is the result of what they don' t know about their nights. Medical School · Then and Now , A Spoonful of Humor Alumni Treating violence with more than sutures. Page 6. 1 Classnotes *James ffiar~s. m.~. '?l ta~es t~e ~elm at What happens once you go to sleep? Poge 12. t~e ~~~~r~. rage{~. �weight-loss treatment programs showed that at 10 years, more than 20 percent of the children had maintained a 20 percent decrease in overweight, compared to fewer than 1 percent of the adults. "These results suggest that as a public health policy issue, it may be a better use of limited resources to focus on preventing obesity in children, instead of trying to reduce obesity after it is well established in adults," says lead researcher Leonard H. Epstein, professor of psychology, social and preventive medicine, and nutrition at the University at Buffalo. The study appeared in the September 1995 issue of Obesity Research. Epstein, who heads B's Behavioral Medicine Laboratory and has studied childhood obesity for more than 20 years, is now working with overweight children who participate in a four-month comprehensive, family-based weight-control program called the Stoplight Diet. The Stoplight Diet teaches children to ea t a nutritionally balanced diet by linking foods to the three signals on a traffic light: "red " high-calorie foods should be eaten rarely; "yellow" moderate-calorie foods can be ea ten in moderation; and "green" low-calo rie foods can be eaten freely. The program combines diet with exercise, behavior modification , and a maintenance program and is the only Dorn receives NIH "FIRST"grant treatment program in the country to document success in children over an extended period. In the current study, Epstein compared treatment results of children and parents from 113 families who had participated in behavioral weight-control programs conducted by his group. Children and parents in these programs were given similar diet, exercise, and behavior-change recommendations. At six months, about 40 percent of children and 20 percent of adults showed at least a 20 percent decrease in pounds overweight. While both children and parents regained weight after this initial drop, children's weight gain at five years stabilized at about 7 percent below baseline and remained there at10 years. But adults returned to their baseline weight by five years, and at10 years they weighed about 7 percent more than they did at the beginning of the study, results showed. Epstein cited several factors that could explain these results, including the nature of most adult treatment programs. "Typically, adults are treated by themselves, while children are treated within the family, which provides important support for habit changes and maintenance." Other reasons include the natural tendency of children to be more active, a difference in motivation in children and adults, children's fewer number of fat cells, and the fact that children's habits aren't as deeply ingrained. Epstein calls for more studies to replicate these findings and to better understand the mechanisms that may be responsible for the differences in effectiveness. The research was supported by grants from the ational Institutes ofHealth. + Leonard H. Epstein, Ph.D. (right}, meets with a CBS reporter. LOIS BAKER oan Dorn, Ph.D. , research instructor of social and preventive medicine at the University at Buffalo, has received a $350,000 five-year First Independent Research Support and Transition (FIRST) Award from the ational Institutes of Health. The FIRST award is given to new researchers to support their first independent research project and help them become competitive for traditional IH grants. Dorn's award is based on a research proposal to investigate the role of physical activity in disease prevention. he will conduct long-term follow-up and analysis of two epidemiological studies relating to this issue: a general population study conducted in Buffalo in the 1960s containing detailed health and lifestyle information collected from residents of that city; and a multi-center, randomized clinical trial conducted in Western ew York in the late 1970s as part of the ational Exercise and Heart Disease Project that was designed to study the effects of a regular, medically prescribed, supervised exercise program on the rehabilitation of survivors of a myocardial infarction. Dorn will determine the current status of all original participants and the cause of death of those who have died , and will analyze various health factors determined at one and three years and their relationship to long-term survival. + Kids better losers than parents he first study to compare weight loss and weight-loss maintenance in children and adults enrolled in the same treatment program ha shown that obese children take pounds off easier and keep them off longer than their obese parents. The follow-up study of participants in B 0 0 p h y o n w n e 9 9 6 �..•. .. . • . . . . . . . • . . . . . . . . . . . . . . . . . . . . • . . • . . . . • . . . . . . . . . • . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . • m . !lj , . ' . . '. Study points to new treatment for recurring UTis in women ings held even when several months tant professor of nuclear medicine and passed between recurrences. pharmacy, says about 10 percent of the "If our results are confirmed in fu- U.S. population experiences migraines , ture studies, they may have significant with women suffering the headaches n a study of 23 women with recur- therapeutic implicarent urinary tract infections , re- tions for women with searchers at the University at Buffalo recurrent UTis ," have found that most patients were Russo states. "Data being reinfected by the same strain from at least two preof E. coli bacteria that caused their vious treatment studinitial infection and not by different ies suggest that longstrains each time, as reponed previ- term remission can be ously. In addition , they found that the achieved with antimibacteria causing recurrences in most of crobials in some the women were harbored in the patient's women. We also own intestinal tract. know that certain anResults of the study were reported in tibiotics can eradicate the August 1995 issue of]ournal oflnfec- bacteria in the fecal tious Diseases. flora better than oth"These findings give us a new under- ers. Given these constanding of the mechanism of recurrent siderations, further urinary-tract infections," says Thomas data on the impact of A. Russo , M.D. , University at Buffalo different treatment Women suffer migraines three times more often than men. assistant professor of medicine and lead regimens on longinvestigator on the study. "It's possible term cure clearly are needed. " three times more often than men. that alternative approaches aimed at Migraines are thought to start with A specialist in infectious diseases , eradicating a persisting strain from the Russo began the research while with the a narrowing of blood vessels in the intestinal flora, and not just the urinary Bacterial Pathogenesis Unit of the NIH's brain , which decreases blood flow and tract , would result in a long-lasting, ational Institute of Allergy and Infec- can cause the flashes of light and dark permanent cure," Russo says. tious Disease. Also participating in the bar-like visual aura some migraine Urinary-tract infections in women ac- study were Ann Stapleton, M.D., Tho- sufferers experience, Bednarczyk says. count for an estimated 7 million office mas M. Hooton, M.D. , and Walter E. This vasoconstriction is thought to visits a year, at a cost of more than $1 Stamm, M.D. , of the UniversityofWash- be followed by a widening of the blood billion. About 20 percent of women ington-Seattle, and Suzanne Wenderoth vessels in the brain, or vasodilation , with an initial infection will develop of the ational Institutes of Health. + which causes the characteristic recurrences , some as many as 20 a year. pounding pain. B A K E R L 0 5 Previous studies concluded that o consistent relationship has been more than 75 percent of the recurestablished between migraine symptoms ring infections were caused by a new and cerebral blood flow , however , acstrain of bacteria from an outside cording to Bednarczyk. source. Using a genomic-analysis University at Buffalo researcher His study will attempt to show such a technique similar to D A fingerhas received a $114,000 two-year relationship by measuring cerebral blood printing unavailable to earlier regrant to study the mechanism flow at three intervals-during a headsearchers , Russo 's group found that underlying migraine headaches. ache episode, following treatment with 68 percent of recurring infections in The research is funded by the De- sumatriptan, and during a headachethe 23 young women were caused by partment of Defense, with funds free period-using positron emission the same strain of bacteria that made available through the Women's tomography, or PET scans, which are caused their first infection. The fig- Health Initiative. extremely sensitive and allow researchure was 76 percent among women Principal investigator Edward M. ers to monitor biological processes as with the most recurrences. The find- Bednarczyk, Pharm.D. , research assis- they occur. + Migraine study funded B a 0 p c a n w e 9 9 6 e �r r . : n · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · t!JJ UB dental school helps set up clinic for underserved children First pediatric heart transplant performed at Children's he School ofDental Medicine at UB is joining forces with Mercy Hospital and The Children's Hospital of Buffalo to establish a pediatric dental clinic expected to serve 4,0006,000 children who currently receive little or no dental care. The new clinic is expected to open in February in Mercy Hospital's Marian Professional Building. UB dentists project that they will serve 1,500 children covered by Medicaid the first year. "This project is a prime example of how a successful health consortium can work ," says Louis]. Goldberg, D.D.S. , Ph.D. , dean of the UB dental schooL The new pediatric dentistry clinic will be a six-chair expandable facility , managed jointly by the three participating institutions. The cost of the project (approximately $375,000, including equipment, computers, and furnishings) will be shared by the two hospitals. Dental students and residents will rotate through the clinic, with UB dental school faculty serving as attendings. Initially, only basic pediatric dentistry services will be offered; oral surgery and orthodontic services will be added as resources become available. "The Children's Hospital of Buffalo is very excited about the new partnership between Mercy , Children's, and the UB dental school," says Mary M. Ward, Ph. D. , vice president of clinical services at Children's Hospital. "O ur joint-venture pediatric dental clinic on the Mercy Hospital campus allows us to ensure that the children of our community have access to a pediatric dental network that is responsive to their unique needs. " Several other UB dental school outreach initiatives for underserved residents of Erie County and the Southern Tier are currently under way. + he Children's Hospital of Buffalo was designated the Upstate New York Regional Referral Center for Pediatric Heart and Lung Transplantation in june 1995 by the New York State Department of Health. Three months later, on September 27, CHOB successfully performed its first pediatric heart transplant. The patient , ten-week-old Evan Kentile , son of Mark and judy Kentile of Claysville, ew York (near Utica), was born in Syracuse on july 6 with a severe congenital cardiomyopathy. Immediately after birth he was transferred to CHOB's Level Ill eonatalintensive Care Unit, where his case was managed by neonatal and pediatric intensive care teams. Once his condition stabilized, he was approved for heart transplantation and his name was placed on the national organ donor list. A donor became available at The Children's Hospital of Buffalo on September 26. The heart was matched to Evan's specifications , and with the assistance of Upstate ew York Transplant Services, the donor's liver was sent to The Children's Hospital of Philadelphia for transplantation . Evan's heart transplant operation was -LUCY GARDNER CARSON performed by Eliot Rosenkranz , M.D., chief of the Division of Cardiovascular Surgery at The Children's Hospital ofBuffalo, with the assistance of orman Lewin , M.D. , a cardiothoracic surgeon from the Department of Surgery at Buffalo General Hospital. (T he transplantation program at Children's was developed in coopera- Eliot Rosenkranz, M.D., holds young transplant patient Evan Kentile. o L 0 B 5 8 A 0 K E 0 R p h o n tion with the adult-based transplant program at BGH .) "This initial transplant procedure demonstrated the benefit of having a transplant program at Children's Hospital equipped to deal with the most critically ill newborns, " says Rosenkranz. "This patient truly benefitted from the availability of all aspects of high-intensity care and teamwork that have been put together here ." Evan was discharged from The Children's Hospital of Buffalo on October 27. After remaining in the area for several weeks to allow for continued monitoring and regular follow-up examinations, he and his family returned home to Claysville. They visited Buffalo in December for a Christmas celebration at the Ronald McDonald House. "Evan is doing very well after receiving his new heart, and has not experienced any significant complications," Rosenkranz says. "His parents can now look forward to the opportunity to enjoy a long, healthy life together. " Before CHOB's designation as the Upstate ew York Regional Referral Center for Pediatric Heart and Lung Transplantation, such transplants in ew York State were primarily provided at adult healthcare systems in ew York City, or at out-ofarea pediatric medical centers in Boston, Pittsburgh, and Cleveland. + w n e 9 9 6 �······ · ············· · ···· · ···· · ··········· · · ·· · · ······························ · ········· · · [ i ] Western New York VA medical centers complete merger significant new partnership between the Veterans Affairs medical centers in Buffalo, Batavia, and Rochester became official in january, when the management structures of the three health care facilities completed their merger into one organizational unit. The Veterans Affairs medical centers are being integrated into a single healthcare system called the Department of Veterans Affairs Western ew York Healthcare System (YAW YHS) . Richard S. Droske, present director of the Veterans Affairs medical center in Buffalo, will serve as director of the new VAWNYHS. "Our goal is to make the best use of resources to give veterans the best health care possible," he says. Other goals of integration include providing a full continuum of care to patients, including primary care to every patient, expanded clinic hours, additional points of access for care, and decreased waiting times; better coordinating patient transfers and referrals; processing admissions in a more timely fashion; establishing one telephone number that veterans can call for care, information , and appointments; mak- B u 0 0 p ing patients' medical files available at any of the facilities in the integration; and reducing travel for veterans by transporting staff to provide specialized care at the facility closest to the veteran. The VAW YHS at Buffalo will continue to serve as the tertiary referral center for patients from throughout Upstate ew York and northern Pennsylvania, offering complete inpatient/ outpatient services and acute care. The VAW YHS at Batavia will specialize in comprehensive geriatric and long-term care, but will continue to offer limited outpatient and primary care services. Patients in need of acute care and hospitalization will be treated in Buffalo. Perhaps the greatest change will take place at the VAW YHS at Rochester, which presently consists of a small clinic in the downtown federal building whose space limitations preclude anything other than providing the most basic mental health and general medical outpatient services-to only 9 percent of Monroe County's 64,000 veterans. The Rochester outpatient clinic will soon be relocating to a new building dedicated solely to providing the area's veterans with more complete health care services. The goal of the VAW YHS at Rochester is to double its annual patient visits to 55,000 within the first year. Following national trends, all three medical centers (plus the VA's satellite center in Jamestown) will emphasize more ambulatory surgical procedures and outpatient care, and will expand the use of physician assistants and nurse 5 c 0 w practitioners whenever possible, in order to cut costs and streamline service. Cost savings realized through these measures, and through integrating the three medical centers into one management structure, will be reinvested into patient care and making more services accessible to more veterans. + - L UCY G A R D N ER CARSON Dawidson named transplantation services director at BGH he Buffalo General Hospital has named Ingemar Dawidson, M.D. , Ph.D., F.A.C.S., DirectorofTransplantation Services. Dawidson, whose clinical expertise is in kidney and pancreas transplantation and vascular access surgeries, earned his medical degree at the University of Gothenburg , in Gothenburg, Sweden. After completing his surgical residency at Sahlgren's Hospital in Gothenburg and his research fellowship in surgery at Tulane University, Dawidson underwent renal transplant training at the University of Gothenburg and earned his Ph.D. in surgical physiology at the University of Gothenburg Medical School. He then underwent liver transplant training at the University of ebraska Medical Center and pancreas transplant training at the University of Minnesota Medical Center. A prolific contributor to research and education (he has authored 123 abstracts and has been the selected speaker at more than 30 international lectures and symposia), Dawidson is a fellow in the American College of Surgeons, and a member of the American Society of Transplant Physicians, the American SocietyofTransplantSurgery, the American Council on Transplantation, and the Association of Academic Surgery. + n e 9 9 6 �BY JESSICA ANCKER Beepers sound in the corridors of Erie County Medical Center's trauma center. A paramedic is signaling to the doctors, nurses, and staff that his ambulance is bringing in a patient with stab wounds. Minutes later, the doors swing open and a young man is wheeled in, bleeding from scratches on his cheek and shoulder and from a third deceptively small spot in the left side of his chest. The two paramedics brief the doctors (" He says it was a six-inch knife"). The patient writhes and asks if he can get anything for the pain. "If we gave you something now, you'd just throw it up when you go into surgery," a resident says. PHOTOGRAPHY e u ffa lo BY Physic ROBERT 1 an WALION wInter 19 9 6 ��An unceasing thread of blood The program has its roots in the research of Simpkins, who found thatas he and other doctors had long suspected-assault victims were likely to come back to the hospital many times. "I kept noticing that I was operating on the same individuals," Simpkins says. His research in Washington , D.C. , and Baltimore found that 35 percent of the victims of violence in the emergency room had been to the hospital at least once before. Within five years , Simpkins found, 44 percent of these patients would return to the hospital after other violent episodes-and even worse, 20 percent would wind up dead. "I realized operating on them wasn't getting to the root of the problem," Simpkins says. In Buffalo , ECMC head of surgery Roger Seibel was noticing the same thing. During one two-year period, the number of gunshot wounds, stab wounds, and other violence injuries skyrocketed by 50 percent. Many patients were repeat victims. "It's a feeling of hopelessness just to patch them up and send them back out," Seibel says. >\T \1A~'t HO~PITAL':J , that would be the end of the Simpkins and Seibel teamed up with Karen Romano and story. But at Erie County Medical Center, it's where a new eville Francis to create the Violence and Victimization story begins. Prevention Program in March 1994. Before the patient leaves the hospital , social worker eville Their first step is to take advantage of the patient's pain Francis and surgeon Cuthbert Simpkins might come to chat. and confusion to urge him to rethink his life. And after the patient goes home, Francis will probably call to "The best time to intervene check in, and maybe suggest a is when that person is in the meeting. hospital ," Simpkins states . Those simple human con•PEOPI.£ T£ND TO B£ • "They've got a tube in their tacts are the beginning of the chest-that hurts. They've got hospital's aggressive follow-up a colostomy. They're scared. I for assault victims , called the try to make sure they're scared. Violence and Victimization PreI tell them 'You almost died ,' or vention Program. More than just 'You almost lost your leg."' stitching up wounds and set"People tend to be a little ting bones, ECMC's staff tries to more insightful when they realize they came close to dying," rescue patients from the kinds of violent lifestyles that could Francis agrees. "Coming close to death gives you a greater land them right back in the emergency room. "let's think of this as a demographic problem , rather appreciation for life. " They hope the pain and fear might be enough to make than something that just happens ," says Karen Romano , even the toughest young man or meekest woman wake up. ECMC's trauma nurse coordinator. winds down along his ribs as he is stripped, x-rayed , catheterized, questioned , reassured. An anesthesiologist takes the young man's hand and explains that the surgeons want to see if the knife has nicked his heart. "We're going to put you under and do what we call a pericardia! window, " she tells him. "How long will I be out' " he asks nervously. "It depends on what they find. More than likely it will be less than two hours, " she says. "But I'm asking your opinion," he insists. "lf there's something wrong, how long will it take? " She answers , "It's different for every person." He asks to make a call to his mother, and a young nurse takes the phone number and relays his message. An operating room is cleared, and the flock of doctors and nurses whisk the patient in. The operation finds no damage to the heart, and in a few hours he is stitched up and recovering from the anesthetic. 0 B u a 0 p h s a n w e 9 �If it does, they're ready to suggest help. For a drug dealer wounded in a street battle, that might mean substance abuse treatment, a trip to the welfare office, and job training. For a battered wife, it might mean shelter, and the emotional and legal assistance to help her get protection from her spouse. For many patients, it means help getting or keeping a job. "Unemployment is one of the risk factors for violence ," says Simpkins. That's when he began to lean on Francis for help in finding a new job , and sometimes just for comfort. "He's the best friend I have. Sometimes I feel like he's the only friend I have ,'' Truitt says. "He's got an understanding of me." With Truitt's good job history and six years of Army service, he was able to land another machining job. But after a few days , Truitt said, he couldn't handle the heavy pieces of steel with his weakened arm. His employer told him he could come back after his arm regained its strength, but when Truitt called after weeks of physical therapy, he found the job had been filled. ''I'm still looking, I don't give up. But it's tough. Whatever color you are ," says Truitt, who is black, "it's tough ." A natural optimist, Truitt will probably only need counseling and physical therapy to become one of eville Francis' success stories. But Francis deals with tougher cases every day, people who could spiral into poverty and end up as more grim statistics in ECMC's emergency room. The social worker's challenge is to find options for even the toughest cases: the young drug dealers who don't want to let down their macho street image, the battered women who are too scared to leave their spouses, the people who haven't held a steady job in years. Francis draws on his own varied experiences to connect with his clients. A native of Jamaica who emigrated to Toronto as a teenager , he worked in a factory for 12 years until the plant closed down and laid him off. "It was scary , and that's how I know how some of these people feel , " says Francis , a tall man who wears dreadlocks pulled into a ponytail above a casual jacket and tie . "I do identify with struggling people . I know the frustrations of being there. I know what it's like being on the outside looking in. " But he also knows that it's possible to take advantage of misfortune , a lesson he tries to impart to his clients. When he Bt.,FFA.LO RESIDE T GREG TRLITT was barely conscious under a turban of bandages when Francis first visited him. Two robbers had smashed his head with a board and grabbed his knapsack and wallet as he was walking home from a Fourth of July picnic. "I didn't even have any money in that wallet," says Truitt. At first, Truitt didn't think he had anything to talk to a social worker about. As soon as his head felt better, he was planning to go back to his good job, his girlfriend, and his two little children. But the next month, the manufacturing facility where Truitt had been doing lathe work went bankrupt. Also, Truitt realized his injury was worse than he had thought when he self-confidently checked out of the hospital against his doctor's advice. The head injury had left lasting nerve damage in his right arm and hand that robbed him of strength and made his hand clench up unexpectedly during work. He was also pursued by unexplained fears. "I was getting ready to cross the street and go between the cars, and I couldn't do it. My buddies were across the street, saying, 'Come on, man ,' and I just couldn't cross the street," recalls Truitt, a small, energetic 32-year-old who talks about his problems with a kind of exasperated wonder. "It's like being a kid all over again. Completely helpless." B u a 0 p h y 5 c a w e 9 �was laid off, Francis went to school, earning first a bachelor's degree and then a master's in social work from the University of Toronto. He conducted street workshops on AIDS and worked with the boys who accompanied their mothers to a battered women's shelter before joining ECMC in March 1995. Francis tries to approach every one of the 500 ECMC patients each year who are victims of violence, and tailor a unique approach for each. Some just need jobs, and the hospital's fledglingjob bank has provided housekeeping and cafeteria work at the hospital and at the University at Buffalo. But for someone who has been without work for a long time , job placement isn't enough. The social worker will talk about the responsibilities that work entails, such as showing up every day, and calling in sick rather than just staying home. Sometimes he even drives his clients to work. Francis recalls driving one client to her first day on a new job. She became very quiet in the car, and finally admitted that she was Cuthbert Simpkins. M.D. so nervous that she might never have made it alone. "We're talking about people doubting that they can live up to the experiences and responsibilities of working," Francis says. "But she ended up doing very well. " His job might also include visiting clients' homes and getting to know their families, visiting the welfare or unemployment office with them , or persuading an employer to hire someone with a prison record. lt also includes being patient. One man recovering from a drug-related shooting said he had no interest in talking to Franci . But two weeks later, he called and said, "What was that program you were talking about? " Francis was able to get him involved in drug rehabilitation , and hopes that he might be ready for a job soon. he tells how bigots bombed his family home when he was a child because his father was helping to register blacks to vote. Even before that horrific moment , which forced the family to leave their Louisiana hometown , he recalls that the library wouldn't let him in because he was black. These experiences , as well as his experiences with his patients, have helped convince him that American society is deeply violent. "There's a willingness at all levels of our society to use the tools of violence that are advantageous to them-whether it's the pen or the sword," he says. Middle-class families , he believes, are likely to express violence by sniping at their spouses, criticizing their children, or firing their employees. The poor tend to use guns, knives , and fists instead of just words , so they are more likely to land in the emergency room. Furthermore , Simpkins says, generations of oppression have forced disproportionate numbers of blacks into poverty and the violent lifestyles it can engender. As a first step to their overhaul of society, the staff of the violence prevention program created a videotape aimed at children. Filmed with the help of a local television station, the video traces four patients as they enter the emergency room, bloodied and battered; watches surgery in gory detail; and listens to the patients afterward as they talk about the violence and wish they had led different lives. Karen Romano and eville Francis, who take the film to the city's classrooms every week, say the patient that makes the biggest impression on kids is a young man who was crippled by a bullet and now must use a wheelchair. ln the long run, Simpkins wants the violence prevention program to launch the same type of peaceful revolution his father sought through voter registration. "l'd like to see the community organize itself. Register people to vote , take their fate in their own hands. Then l think we can see the community solve some of its own problems," he says quietly. "l don' t think we can really solve this problem until our entire country has a differ- r------------------------, THf C.RC\TORS OF THE \!OLE CL PRE\ E TIO program share a conviction that their work should be part of a greater overhaul of society. Simpkins, who is also black, doesn' t sound bitter when B 0 0 p h y s c o n w n e �FRANCIS TRIES • en t sense of interpersonal relations . I think we need a higher moral and ethical plane." eville Francis puts it more simply. "The problem is in the community, but the solution is also in the community." For now, the program's staff is taking it one patient at a time. "Let's say you get 400 patients who come in to the emergency room injured because of violence or a violent lifestyle. If you can getlO patients out of your 400 to change, that's something to start with," Karen Romano says. + Trauma Center - Life-saving teamwork The violence prevention program is just one example ofthe smoothly running support structure that underpins ECMC's trauma center. "We have a commitment from generalists and specialists to come in any time of the day or night to take care of trauma patients," says Karen Romano, the hospital's trauma nurse coordinator. The planning begins well before a patient is admitted. Paramedics or emergency medical technicians decide whether to bring a patient to ECMC based on state guidelines, including severity of injuries, extent of damage to the car in a car accident, and minutes away from the hospital. They then dial a number that reaches a network of beepers throughout ECMC. The beepers can display a simple message of what the injury is and how soon the patient will arrive. Incoming patients are brought to one of the trauma rooms, directly inside the emergency wing's doors. Each trauma room is equipped with portable x-rays and sonograms, lights, and surgical equipment. Once patients are diagnosed and stabilized, they con be sent to one of the operating rooms, intensive care units, radiology rooms, or other facilities clustered in the immediate area. Asurgical "pod," a corridor with nine small rooms branching off it, is available for patients whose injuries aren't as severe, and doctors in a similar medicol"pod" care for non-emergency illnesses. The emergency wing is designed to make it easy to get patients from one specialty area to another. Dr. Roger Seibel, who worked with the architects who built it, says it is being redesigned to make B u 0 0 p h s c movement even easier, and to add more space for outpatients and their families. The trauma system also provides services for recovering patients. Special outpatient rehabilitation areas provide such services as specialty dressings, water tub rehab, counseling, and occupational and physical therapy. Crucial to the center's work is its staff. All nurses have advanced training in trauma care and cardiac life-support. Residents receive onthe-job training from senior doctors, including many who have been in trauma care their entire careers. The staff evaluates cases in weekly and monthly morbidity and mortality meetings. Equally important, Karen Romano says, is the fact that they receive emotional support from one another. The ecstatic high of saving a life and the crushing disappointment of losing a patient create an atmosphere of both tension and camaraderie, she says. "It's very physically demanding and emotionally demanding to see, for instance, ayoung person permanently disabled," says Romano, who practiced critical care nursing before taking over as nurse coordinator. "It really does toke a special breed to practice in trauma." ECMC's 1,600 trauma patients come from all walks of life and have every conceivable injury and illness. The average age is 31 ; 75percent are men. While car accidents cause the greatest number of injuries (538 in 1994 ), assaults with guns, knives, fists, and other weapons come in a strong second with a total of 419. --::JA 0 w n e 9 9 6 �B u a a p h II 5 c a n w n e 9 9 6 �b y J u d s o n M e a THE HYPOTHETICAL truck driver, taking micro-naps at 65 miles per hour and headed for disaster, has thousands of very real counterparts on the road who are excessively sleepy because sleepdisordered breathing is waking them up hundreds of times every night-and they don't even know it. The ew England]ournal of Medicine editorial was prompted by publication in the same issue of findings from the largest population-based study of obstructive sleep apnea that had ever been conducted. Sleep studies of 602 employed men and women between the ages of 30 and 60 revealed that 4 percent of the women and 9 percent of the men in the group had a level of breathingrelated sleep disturbance that would warrant treatment. Edwin Manning, M.D., clinical professor of neurology and director of the Sleep Disorder Center of Western New York, says that sleep problems are still misdiagnosed or under-diagnosed, although awareness of them has increased greatly in the past 15 years. "There was a survey done at Stanford recently that found that in 1980 something like 80 percent of persons presenting a certain set of symptoms were diagnosed as depressed ," Manning says. "By 1985, physicians considered 50 percent of the persons presenting the same symptoms were depressed and 50 percent had some kind of sleep disorder. By 1990, it was recognized that only 5 percent of this population was actually depressed. " On a ovember afternoon, Manning explains obstructive sleep apnea in a small observation room as a technician monitors a patient sleeping in an adjacent bedroom. The patient is an overweight middle-aged man; the sleep study is run during the day because he is a shift worker. As far as the patient is concerned, he is asleep. But there are a number of signs that the sleep is not peaceful. The EEG readout crawling across the tee h n ician 's computer screen shows the tight amplitude of stage 2 sleep. His heart rate , audible from the EKG , is slowing noticeably; his blood oxygen level is dropping rapidly toward less than 70 per- d Anyone who sees a long-haul tractor-trailer driver nodding over the wheel as he barrels down the Interstate after ten years without a single restful night's sleep would call his situation , at the least, potentially catastrophic. But as Eliot Phillipson, M.D., pointed out in a 1993 editorial in the New England Journal of Medicine, "Ten to fifteen years ago, obstructive sleep apnea was considered to be a medical curiosity that was of little importance, and snoring was more a subject of humor than one of serious scientific curiosity. " Images B a 0 b y p h K . C . s K r a t t a w n e 9 6 �Sleep has an architecture that was only discovered beginning in the 1950s when a University of Chicago graduate student started running EEG tests on his eight-year-old son and found brain-wave activity that resembled a waking state during certain periods of sleep. These periods, coinciding with the eyes darting rapidly from side to side beneath closed lids, we now know are dreams; the sleep stage is REM, for rapid eye movement. The normal sleeper passes through four stages of increasingly deep non-REM sleep: stage 1 being a barely sleeping state of drowsiness, stage 4 being a profoundly deep sleep characterized by delta waves. During these four stages, the sleeper maintains muscle tone. After an hour to an hour and a half, the sleeper moves back to stage 2 and enters a first episode of REM sleep: brain activity increases dramatically; heart rate, respiration, and blood pressure all go up; but the muscular system is effectively paralyzed. As the night proceeds, the sleeper cycles through stages 2, 3, and 4 and REM sleep, with the lengths of REM sleep increasing while delta sleep decreases. Persons who suffer repeated arousals throughout the night never achieve stage The patient is in the sleep center cent. He is not breathing, but the instrumentation on his chest and abdomen because he reported to his physician that he is leepy all the time during record that he is trying to . Then a loud snort is broadcast into the day. Indeed , excessive daytime the observation room from a micro- sleepiness is one of the most comphone on the headboard. The EEG bursts mon presenting complaints related into activity, the heart rate shoots up to to sleep disorders. And such a com80, and the blood oxygen level begins to plaint is far from a triOing inconverise. The readout from a thermistor at- nience: a report prepared for the ational Commission on Sleep Distached under his nose shows that he is orders Research and published in breathing again. "He's awake now, but he doesn't know Sleep, in 1994, estimates that for the year 1988, the total cost of accidents it," Manning says. On the video monitor, the patient is lying on his side, head on an outstretched arm, his other hand tucked under his chin, apparently soun d asleep. Hi EEG quiet back to the relatively uneventful trail of stage 2 sleep. Then, after a few seconds, he stops breathing again. His heart rate and blood oxygen level start to drop. The cycle of arousal and return to sleep repea ts regularly about every 30 seconds. "His upper airway relaxes until it collapses completely after a few seconds of normal breathing. Then he tries unsuccessfully to breathe until the effort arouses him ," Man- Edwin Manning, M.D. ning says, watching another sudden related to sleepiness in the United burst of brain activity. "He may be States was between 43.1 billion and $56.02 billion. waking up 300 times a night. " "Wherefore to some, on being abed, they be taken to sleep, presently in arms and legs leapings and contractions of the tendons , and so great a restlessness and tossings of their members ensue that the diseased are no more able to sleep than if they were in a place of greatest tortu re. " B a a p h y 5 c a w n e 9 9 6 �"His upper a ir way relaxes until it collapses completely after a fe w seconds of normal breathing. Then he tries unsuccessful ly to brea t he until the effort arouses him, " Manning says, watching another sudden burst of brain activity. "He may be waking up 300 times a night. " 4 sleep. This deprivation is associated not only with sleepiness during the day, but also with diminished cognitive functioning and memory loss. "Obstructive sleep apnea is primarily a mechanical problem, so we use mechanical interventions to treat it, " Manning says. "Conservative treatment includes such things as weight loss, correcting posture, and smoking cessation. " A more aggressive intervention , for those who can tolerate it, is to splint the upper airway by the application of continuous positive airway pressure (CPAP) through a mask or nasal splint. A small com- Francis Gengo, Pharm.D. pressor is used to supply air at between 4 and 20 cc of pressure. located While such a device (which produces in the Dent eurologic Institute at the sensation of being slightly inflated) Millard Fillmore Hospital, runs approximight well bother a person not suffering mately 1,000 sleep studies a year, operobstructive sleep apnea, Manning says ating 24 hours a day with a technical that it can produce dramatic results for staff of eight. The center has four sleepsome of the patients he sees at the sleep ing rooms , outfitted with double beds and other furniture to be more homecenter. ''I've had patients who have been than hospital-like. Patients bring their chronically sleepy and lethargic for years own sleepwear. It is, naturally, a quiet wake up here after one night with CPAP work environment. For a typical overnight sleep study, intervention bursting with energy ," he says. "They tell me they've had their first the patient arrives in the evening, gives good night's sleep in years. " Surgery is a a brief history, changes into sleepwear, treatment option for a small group of and then is fitted with an array of electrodes on the scalp , beside each eye, and patients. The sleep center, B a 0 p s a n w on the chin, the chest, and both legs; a thermistor under the nose ; an oxymeter on one finger ; and belts around the chest and abdomen-these produce what is called a polysomnographic record. Although sleeping in a strange place and so thoroughly instrumented can cause what center technical director Thomas Maurer refers to as "first night effect, " getting patients to sleep is not a significant problem: after all, the reason most patients are there is that they are too sleepy . In the morning , patients complete a questionnaire that asks about such things as how long it took to get to sleep and the quality and duration of the night's sleep. "Some people have poor perception of their own sleep," Maurer says. "Some patients will report that it took two hours to get to sleep when the sleep study shows that it only took 10 minutes. " Technicians can monitor two studies simultaneously, watching data on a split computer screen and the sleepers on two video monitors. Data from a sleep study is scored later, with technicians paging through computer screens, each one of which shows 30 seconds of the study, to record arousals, oxygen levels , heart rate , and other pertinent condi- e 9 9 6 �"We ' r e one of j u s t a h and f u I of centers 1 n the co u ntry- and the on Iy one in New York-where the pharmacological studies look at both sleep a nd daytime effects , the real-world end-points of drugs that suppress the central nervous system, " Gengo says. tions; screens that show significant events can be printed out. The days of turning pages through thick sheaves of pen tracings ended when the center computerized its data management in 1992 after running both ystems in parallel for six months. ManningsaySthatsleepdis- (The sleep center has conducted clinical studies of the drug's effect on both sleep and next-day psychomotor performance-see box , facing page.) As for melatonin , which is enjoying a vogue as a sleep-inducer, Manning says that there is evidence that it has a role in directing the time relationships in sleep and that it can be of some help in controlling sleep problems related to jet lag orders fall into four broad categories: not being able to get to sleep or stay asleep, excessive daytime sleepiness, sleep-wake schedule disorders, and abnormal behavior and activity during sleep. Because everyone, at one time or another, has trouble falling asleep or staying asleep, a popular poll would probably name insomnia as the nation's number-one sleep problem. The aggre sive advertisement of overthe-counter sleep-inducing medications reinforces the belief. But the medical approach to insomnia is changing. "U ntil fairly recently, 15 percent of all prescriptions written were for Polysomnographic technician Pam sleeping pills," Manning says, "but Farina scores the digital record of a that's beginning to decline." sleep center patient's night. Manning, who lectures on sleep to first-year medical students at UB, tells them that 70 percent of insomnia prob- and other sleep phase disorders. But lems can be solved without medication Manning would discourage long-term by a regime of proper sleep hygiene. use of melatonin because its other acManning's first commandment for get- tivities in the body may interfere with ting to Jeep: "If you can't get to sleep, get reproduction and complicate heart disout of the bedroom." For transient ea e; another problem with the unreguinsomnias that need medication, Man- lated nostrum is that consumers can't ning favors the relatively new, rapid- be sure what they are buying. Excessive daytime sleepiness may be acting non-benzodiazepine zolpidem. 8 a 0 p h 5 a n w caused by various disturbances of a person's sleep, by chronic insufficient sleep, or by narcolepsy, the condition that causes a person to drop off to sleep suddenly during the day, sometimes directly into REM sleep; these episodes are often coincident with the experience of a strong emotion. A patient being tested for narcolepsy will spend a night at the sleep center for a regular sleep study, and then the following day undergo a Multiple Sleep Latency Test (MSLT) . This test consists of taking four or five 20-minute naps , two hours apart, to determine how quickly the patient goes to sleep and how quickly he or she moves into REM sleep. Achieving REM sleep during two of five naps indicates that the patient suffers from narcolepsy. The MSL T can show that a person is excessively sleepy-rapidly achieving stage 2 sleep in all four nap sessions but never REM sleep-indicating some factor other than narcolepsy. The abnormal behavior during sleep-or parasomnia-that Manning sees most frequently at the sleep center is sleep myoclonus, or periodic movements in sleep. In this disorder, the sleeper's legs jerk periodically during non-REM sleep, causing brief arousals from sleep and disturbing the normal sleep architecture by decreasing stage 4 sleep. The movements stop during REM sleep. Periodic movements in sleep are as- n e 9 9 6 l J �l 1 sociated in some cases with a condition called restless legs that particularly bedevils some persons before and during the onset of sleep. Manning likes to cite a description of the condition written in 1685 by the London physician Thomas Willis: "Wherefore to some, on being abed , they be taken themselves to sleep, presently in the arms and legs leapings and contractions of the tendons, and so great a restlessness and tossings of their members ensue that the diseased are no more able to sleep than if they were in a place of the greatest torture." Fortunately for its sufferers, the condition of restless legs responds to treatment with dopamine. The key to treating any of the many sleep disorders-from the sleep that won't come , to the sleep that gives no rest-is discovering that the problem exists. "There are many, many people suffering from sleep disorders who don't feel they can discuss them with their physicians, " Manning says. "People spend about one third of their lives asleep and for those who have problems with sleep there is often a remediable underlying cause. Physicians should be aware of sleep disorders and aware of the public health consquences of sleep disorders. " + Sleep Center Drug Research Cows mooing and dogs barking are not something one would expect to hear in the usually quiet corridor of the Sleep Disorder Center of Western New York. But they do occasionally disturb the center's morning peace as road hazards that test the alertness of volunteer subjects negotiating a virtual highway on a driving simulator. Gengo, who is the author of Drug Effects on Human In addition to diagnosing sleep disorders, the center maintains an active program of pharmacological research Functioning and numerous papers, has pioneered an ap- under the direction of Francis Gengo, Pharm.D. , associate proach to clinical studies that uses one drug as a marker professor in the departments of pharmacology and neurol- for evaluating another. Alcohol is an obvious marker for ogy and director of neuropharmacology at the Dent Neuro- comparative assessments of psychomotor impairment, logic Institute. Gengo's group is as interested in their and Genge's group has done extensive testing to establish subjects' waking state as in the contours of their sleep. the magnitude of effect of different blood alcohol levels. "We're one of just a handful of centers in the country- B "We can now say that the effects of a certain amount of and the only one in New York-where the ..,.....,.,..,._ benadryl are equivalent to the effects of a pharmacological studies look at both sleep certain amount of alcohol," he says. and daytime effects, the real-world end-points In current studies, Gengo is comparing the of drugs that suppress the central nervous effects of Zolpidem, Tamazepam, an over-the- system," Gengo says. counter antihistamine-based sleeping aid, and During sleep studies, Gengo 's research a placebo. Because the effects ofTamazepam group uses polysomnography to look at the have been fairly well studied, it serves as the effects of different drugs on such things as the time of sleep onset and the character of -·~------'- two nights, the first at home and the second in marker for Zolpidem. Subjects are treated for the ensuing sleep. In the morning, psychomotor tests the sleep center, and then undergo a battery of waking- reveal the subject's ability to think clearly and react state psychomotor tests. The over-the-counter sleep aid quickly. One such testing device is the driving simulator. causes the greatest morning-after impairment. Gengo has used it to establish baseline data that helps For studies of the effects of certain drugs not intended to to determine the relevance of psychomotor impairment. promote sleep--such as muscle relaxants or deconges- "There has been a lot of research that looked at the tants- Gengo' s group uses the Multiple Sleep Latency Test effect of a new drug against a placebo," Gengo says. "You (MSLT) and psychomotor assessments during a regime of find a statistical difference, but what is the functional scheduled naps for subjects taking regular doses of the significance or relevance of the difference?" medication (or placebo). u 0 0 p h s c a w n + e 9 9 �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · [I] ~ ' tial for those types of resources to grow. We are considered a resource library, regionally and nationally, and we provide materials to other libraries for a fee. The fees actually cover the cost of those services and even generate a little bit of extra income that we can use to supplement other services and resources. "T he last initial impression I'd like to mention is the very strong support from the faculty community here on campus ....._....__ _ _ _....;..J From bound volumes to HUBNET GARY BYRD REFLECTS ON HIS FIRST YEAR AS DIRECTOR OF US'S HEALTH SCIENCES LIBRARY ary D. Byrd, director of the University at Buffalo's Health Sciences Library since january 1995 , came to Buffalo after nearly 12 years at the Health Sciences Library at the University of orth Carolina at Chapel Hill as Associate Director (198387) and Assistant Director for Finance, Planning, and Research (1987-94). He completed his doctorate in library science at that university in 1994. His first year at the helm ofUB's H L has confirmed his initial positive impressions. "First, this is a beautiful facility-it's one of the nicest facilities on the orth or outh Campus, in my estimation. This was the original Lockwood Library at the old private UB, and the main reading roomthe Austin Flint Reading Room-is a showplace for both campuses. "We have a very knowledgeable, service-oriented staff. They've gotten well-deserved service excellence awards from the university administration; they're well respected on campus and in the region and nationally , and that was one of the real attractions to me in this job-being able to work with such a highly motivated , competent staff. "Another obvious thing that impressed me right away was the information resources that have been gathered and made available under the heading of HUB ET [Hospital and University at Buffalo library resource ETwork]. B u a 0 p HUB ET is an array of bibliographic and full-text electronic information resources that have been gathered and made accessible over a wide-area network, so that health sciences faculty , students, and practitioners at the university and its affiliated teaching hospitals , as well as at other practice and teaching sites throughout Western ew York, can easily log on to this array of databases and search the medical literature-including full texts of many journals-and get an impressive amount of other information resources at their fingertips. This is a wonderful array of for this library, and the Friends of the information resources, and a model for Library organization that we have. Also, the way in which electronic inforI sensed in meetings with the deans , mation resources can and before l took this job, that they were also should be provided in very supportive of this library and that this kind of a setting. they were eager to support our resources "The gem of our and services. One demonstration of their collection is our commitment is that this year the deans History ofMedicine all agreed to help support the ongoing Collection, which I costs of the HUB NET system from their would call a worldown budget, as well as from the hospiclass history of tals' and the library budget, so that's a medicine collection. new source of support." It includes not only loByrd first became interested in inforcal medical history, but a mation resource management through very impressive assortment his work for Ship Hope in Tunisia in the of other historical materials illustrating late 1960s, when he was in the Peace the history of medicine and the health Corps. The mission of Ship Hope , a sciences. The School of Medicine is the volunteer project of American health oldest part of the university , and the professionals who refitted a World War sesquicentennial will be drawing pretty ll vessel as a floating hospital , was to significantly from those collections. dock at ports of developing countries "I was also impressed by the potenfor nine months to a year at a time, tial to strengthen resources in the seroffering modern medical services and vices despite budget constraints. Some training for local doctors. Byrd credits of our services actually generate income his experience as a volunteer assisting that helps us support those and other the ship's chief of staff with inspiring services, and I think we have the potenhim to pursue a fellowship in biomedi- h 5 c a n w e 9 6 �··················· · ······ · ············ · · · ·· · ······ · ·········· · ··· · ················· · ··· · · ~. ~ I future , we may not have a separate circulation department, for instance. We may be providing reference services in new locations and in different ways, and providing an increased array of reference services , such as more in-depth consulting." Byrd hopes to make better use of limited resources by restructuring the HSL and granting greater flexibility to the staff. He praises the experience and HSL director Gary Byrd in the library's Austin Flint Reading Room. dedication of not cal library science at the University of only the library's faculty and profesMinnesota in Minneapolis. sional employees but also the support One of Byrd's first projects upon ar- staff and clerical workers, and he pledges riving at UB was to work with his staff to to use these most valuable human recreate a vision statement of the long- sources more effectively: "We've got term goals and guiding principles of the many people with many years of service HSL. He would like to see the library to the university and to this library, and become more flexible and better able to my feeling is that we need to find ways respond to the health information needs to use their energy and creativity, and of both local and remote users. give them opportunities to use their "This library has had a fairly tradi- skills in new ways." tional organizational structure," he says, Byrd notes that the evolution of per"with public service units and technical sonal computers and the Internet has services units-cataloging, acquisitions , changed the way information resources and management of all our serial collec- are managed. "An increasing number of tions. ow we're in the process of re- our resources are available electronistructuring, somewhat. We're consoli- cally from computer terminals all over dating our technical services units into a campus, and at remote sites in our affilisingle collection management services ated hospitals and practice sites all over unit, and we're looking at possible new Western ew York, and even from models for organizing our public service people's homes. We have an increasing units and consolidating the way in which need for telephone support for remote we provide services from all of our public users. We need to use staff more flexibly service points-the places where the in ways that will allow them to go out public can approach the staff and ask for and work directly with users in their help or information, such as the circula- offices, or in their labs, or in classrooms. tion desk, or the reference desk. In the We need to strengthen the library's in- B u a a p h y 5 c a w I ternal computer and telecommunications infrastructure and its links to campus, regional, and worldwide electronic information networks. "The library is organized in many ways like an academic department: We have library faculty as well as professional and support staff. Our library faculty not only provide reference and other services, but they help instruct students, faculty, and staff on the effective use of information resources. And not only do we provide classes that we teach here in the library, but our faculty also go out and serve as guest lecturers and instructors in courses that are taught by other faculty. "I personally think there will be an increasing need in the future for courses that are actually taught by library faculty as part of the regular university curriculum. In some areas of the health sciences, especially, courses may really be needed on how best to manage information resources; how to use appropriate computer hardware and software to manage information, to browse the Internet, to use library resources, to understand the concept of effective search strategies, to understand how to use controlled vocabularies or Boolian logic or other strategies that make for effective use of the literature. "We still have a ways to go to strengthen and build on the resources that we have, but I think that we've gotten a strong commitment from everyone to work together to help make that possible. We don't have any magic bullets. I think the ammunition that we do have is our ability to demonstrate the value of the resources and services that we provide to the community, and then work collaboratively with the other parts of the university and with our affiliated hospitals to pull together the resources to turn those things into reality." + -LUCY e GARDNER CARSON 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I BARANSKI ADVERTISING Your advertising presents your company image to the public ... and to prospective clients and cu tamers. At Baranski Advertising, we are proud to represent some of the finest publication in Western ew York, publications where your advertising message is sure to reach a quality audience. Medical students enjoy new lounge tudents in the School of Medicine and Biomedical Sciences have a new place to prop up their feet, thanks to the generosity of the Medical Alumni Association. Over the past two years the alumni group has donated approximately $4,000 to refurbish a former conference room in Cary Hall, which recently was outfitted with couches and a coffee table; a conference table; electronic equipment, including a television and VCR, a photocopier, and a microwave; a foosball table; and artwork. The purpose was to make the free time medical students have at lunch and between classes more CALL US TODAY enjoyable, according to Neha Sangwan, president of Medical School Polity. (716) 645·6933 "We wanted a little more of a social place than a study area. We wanted to get students to start to interact and to get to know people in different years, and to give them something to do," she said. "We greatly appreciate all the efforts and support of MICHAEL J. BARANSKI the Medical Alumni Association because it's helped to Marketing Representative bridge the gap between the first· and second·year students. This has provided a really comfortable P.S. We did this book! B u a atmosphere so we can get to know each other." 0 p y c a w e + 9 6 �················· · ································ · ·····································• ·· ~ •• ::» Percent and number of graduates from 1989-91 entering primary-care specialties-45th and 23rd, respectively; first among SU Y medical schools. (UB's total graduates for the three years, at 4 3 7, is larger than that of 70 percent of U.S. medical schools, a factor which lowers its percentage ranking compared "All medical schools share the broad to schools with fewer graduates. Also, and essential missions of education, re- the rankings in this category do not search, and patient care," Cohen said. reflect the success of the medical school's "However, within this context, individual Primary Care Initiative, begun in 1990, schools have different priorities and goals. which has raised the percentage of UB Because of this, a single ranking of medi- graduates entering primary care from cal schools is inappropriate and mislead- an average of 28 percent for 1989-91 to ing. The Institutional Goals Ranking 40 percent for the class of 1995. [In the Report is designed to provide medical AAMC survey, schools with 40 percent schools and the public with several scales of their 1989-91 graduates entering primary-care specialties by which they can mark ranked 5th.]) an institution's achievements in various areas." ::» Percent and numUB received its highest ber of 1995 graduates marks in the category of planning to practice inpercent and number of state-58th and 42nd, 1981-90 graduates who respectively; fourth are faculty, ranking 14th among SU Y schools in and 18th, respectively. percent, second in numAmongSU Yschools, UB bers. ranked first in percentage ::» Federal research and second in numbers. grants and contracts in aughton said UB's 1993-94-67th overall; second among SUNY high ranking in this category reflects the emphaschools. sis the school's faculty John P. Naughton, M.D. Naughton noted that places on teaching and education in its UB's listing doesn't include research fundbasic-science and clinical-training pro- ing administered by its affiliated cancer grams. research center, Roswell Park Cancer "Our graduates learn that as faculty Institute. Research funds attributable to members, they can play an important UB faculty working at Roswell Park torole in guiding the future of students taled $21,771,842. If these funds had and residents, can influence the future been included with those administered of medicine, and can enrich their per- directly by SU Y, UB's ranking would sonal and professional lives," he said. have been 36th instead of 67th. UB's rankings in the remaining cataughton said the report, prepared egories were: since 1990 but released to the public for ::»Percent and number of thefirsttimeinl995, isusefulforgaugunderrepresented minority graduates ing the medical school's progress in during 1990-94-27th and 23rd, re- important areas and for judging its perspectively; second in both listings among formance in comparison to medical SU Y schools. schools of similar size and scope. + UB ranks high as contributor to medical school faculties he University at Buffalo School of Medicine and Biomedical Sciences received high marks from the Association of American Medical Colleges (AAMC) in its 1995 Institutional Goals Ranking Report, released in late December. UB received its highest ranking14th among the nation's 125 U.S. medical schools-in the category of percent of graduates who are on the faculty of a medical school. UB was one of only two public universities in the top 15. In the remaining categories, UB placed in the top fifth to the top half in all listings but one, and was first or second among the State University of ew York's four medical centers in all listings but one. john P. aughton, M.D., UB vice president for clinical affairs and dean of the medical school, said he was very gratified by the results of the report. "These rankings indicate we have been able to achieve a successful balance between academic excellence and clinical relevance ," he noted. The AAM C report assessed the success of the nation's medical schools in meeting five goals considered important in today's medical climate: graduates entering primary-care specialties; graduates planning to practice in-state; graduates who are medical-school faculty; graduates who are underrepresented minorities; and total research grants and contracts. jordanj. Cohen, M.D., AAMC president, said the report is not intended to determine which medical school is "best," but should be used by medical schools and the public to evaluate these institutions in selected categories. B u a 0 p h y c a n w n e 9 6 �. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . .. . . . . [1] t, I sociation of the History of Medicine in Buffalo in honor of the medical school sesquicentennial (May 9-12 , 1996) >- Bestowal of honorary degrees at commencement in 1996 and 1997 >- Symposium on Epidemiology and Preventive Medicine (September 20-21 , Exhibits to highlight medical school's sesquicentennial year 1996) three-day national symposium on Ethics and Values in Medicine, the national meeting of the American Association of the History of Medicine, and a special opera performance will highlight the celebration of the 150th birthday of the University at Buffalo School of Medicine and Biomedical Sciences. Founded in 1846, the medical school was the first component of what is now the niversityatBuffalo, which is marking its sesquicentennial during an 18month period in 1996 and 1997. A 24-member commiuee composed of physicians, historians , archivists, scientists, and representatives from UB's teaching hospitals has spent the past three years planning special events to commemorate the medical school's century-and-a-half record of excellence in education, research, and service. Ronald E. Ball, M.D., clinical associate professor of gynecology and obstetrics, and Harold Brody, M.D., Ph.D., SU Y Distinguished Teaching Professor in the Department of Anatomy and Cell Biology, co-chair the committee. joyce Vana , Ph.D., clinical assistant professor of social and preventive medicine, serves as its coordinator and liaison to the dean of the medical school. For residents of Western ew York, the most visible sign of the medical school's sesquicentennial celebration will appear in january 1996, when 50 blue-and-gold commemorative banners will be installed along Main Street and Bailey Avenue on UB's South Campus, home of the medical school. The celebration will begin officially on February 22 , 1996-University Day-with the dedication of the medical chool's new $33 million biomedical research building, the awarding of an honorary degree, and the presentation of the 1996 D.W. Harrington Lecture. Events planned for 1996 and 1997 include: >- Publication of a pictorial history of the medical school (February 1996) >- ational symposium on Ethics and Values in Medicine (November 1416, 1996) >- One-day scientific colloquium and bestowal of an honorary degree (February 1997) >- Special performance by the Greater Buffalo Opera Company (Februwy 1997) >- Special exhibits at the Buffalo and Erie County Historical Society and the medical school's affiliated teaching hospitals + "How We Die"Author to Deliver Stockton-Kimball Lecture in May Dr. Sherwin B. Nuland, the author of National Book Award winner How We Die, will deliver the annual Stockton·Kimball Lecture at Spring Clinical Day on May 11. The tiNe of his talk will be "Death, the Doctor, and Hope." Nuland earned his M.D. from Yale University in 1955 and trained at Yale in general, cardiothoracic, and cardiovascular sur· >-Mounting of memorial plaques marking the three original medical school buildings in downtown Buffalo (May gery. Anoted speaker on medical topics, he has also written monographs on historical figures in medicine, such as Hippocrates and Napoleon's surgeon, Dominique Jean Larrey. In his 1994 book, How We Die: Reflections on Life's Final Chapter, he discusses haw modern doctors too 1996) often try desperately to save life, abandoning an >ational meeting of the American As- older mission to help people die with dignity. Sesqui(entennial banners now festoon the medi(al S(hool (ampus. a u 0 0 p y 5 c o n w e 9 9 �······································ ~ ~ I UB medical faculty appointed to national panels l 59th Annual Spring Clinical Day Cedric M. Smith, M.D., professor of pharmacology and toxi- Saturday, May 11, 1996 Buffalo Marriott cology at the University at Buffalo, has been appointed to a five-year term on the Expert Advisory Panel on Drug Information Science of the United States Pharmacopeia (USP) . The USP, founded in 1820, is a non-profit organization responsible for establishing public standards of strength, quality, purity, packaging, and labeling for drugs, medicines, and other healthcare devices and services. The standards are published in the USP- ational Formulary and are enforced by the U.S. Food and Drug Administration. The Expert Advisory Panel on Drug Information Science will be concerned primarily with expanding the USP drug and therapeutic-information database, which recently combined with the AMA Drug Evaluations database. Germaine Buck, Ph.D., associate professor of social and preventive medicine at the University at Buffalo, has been appointed to a three-year term on the ational Research Council's ( RC) Committee on Toxicology. The Committee on Toxicology, a component of the RC's Commission on Life Sciences, provides expert advice to government agencies on a broad spectrum of toxicologic issues and problems. Buck has won national recognition for her epidemiologic research in human reproduction and fetal and early-childhood health. + Medical Alumni Association State University of ew Yorh at Buffalo Continuing Medical Education End of Life/Quality of Death Death and the dying process hove traditionally been ignored by the treatment· and technologyoriented medical profession. Medical schools hove only recently begun to offer any curriculum in palliative medicine or death and dying. For many physicians the death of opatient is seen as opersonal failure. As oresult, dying patients and their families ohen feel shunned by and distanced from the physician at this critical moment. The advent of odvonced-<ore directives and heolthcore proxies has mode issues of dying o necessary topic for discussion between physician and patient. The objective of this conference is to help physicians become more comfortable with death and thereby be better equipped to help patients and their families through the dying process. Participants will be exposed to the basic concepts of palliative medicine, learn about end· of·life core resources in Western New York, and discover strategies for easing the transition from curative to palliative core. Principal Presentations "Dying Healed-The Nature of Care at the End of Life" Robert A. Milch, M.D. '68 "Delivering Bad News with Compassion and Hope" Judith Skretny, M.A. "Confronting Difficulr Emotional and Ethical Issues in the Care of the Dying" (panel discussion with case presentations) Martin Brecher, M.D. , )ach P. Freer, M.D., Ross G. Hewitt, M.D., Robert A. Milch, M.D. "Death, the Doctor, and Hope" Stockton-Kimball Memorial Lecture Sherwin, uland, M.D., F.A.C.S., author of How We Die The 1996 Spring Clinical Day will begin with registration at 7:30a.m. and welcoming remarks at 8:00 and conclude with the annual Medical Alumni Luncheon at noon, followed by the Stockton·Kimboll Memorial Lecture. UB chemistry professor Philip Coppens (right)was honored by the HauptmanWoodward Medical Research Institute with its first David Harker Award for outstanding contributions to the field of crystallography. Coppens received the prize at the dinner commemorating the 1Oth anniversary of the awarding of the Nobel Prize to Herbert Hauptman (left), institute president and UB research professor of computer science. B u a a p 5 The Accreditation Counci l for Continuing Medical Education designates this program for up to 4 hours of Catcgor) I credit toward the Physician's Recognition Award of the American Medical Association. This program has been reviewed and is acceptable for 4 prescribed hours by the American Academy of Family Physicians. a w n e 9 9 6 �Afriend called him "idealistic in apractical way" DR. ROSWELL PARK WAS A PIONEERING CANCER RESEARCHER AND " LIVING ENCYCLOPEDIA" WHOSE LEGACY LIVES ON IN TWO GREAT LAKES CITIES country, and was led by a well-known and well-respected his many achievements, founding the world's medical faculty. Park also relished the challenge of establishfirst cancer research institute in Buffalo in 1898 ing himself in a new city-and he was challenged. A piece is the one for which Dr. Roswell Park is probably published in the Buffalo Medicaljoumal commented on the best remembered. Rechristened the Roswell Park acquisition of Park by the university, questioning why a Memorial Institute in 1946 and known today as Buffalonian couldn't be found to fill the vacancy: "We fail to the Roswell Park Cancer Institute , this vital research and educational center was born out of Park's ascertain , after repeated inquiries in surgical circles, that the conviction that the increasing incidence of cancer around new appointee brings to this responsible position any ex tenthe turn of the century called for more immediate and sive experience or reputation. " It wasn't long, however, constant attention. Although the severity of his claims was before Park's indisputable character and aptitude won over the disgruntled columnist and the two achieved a friendly originally contested, he even went so far as to predict in 1904 that cancer deaths would one day outnumber deaths from relationship. tuberculosis. Park's concern about the increase of cancer In 1891, Rush Medical College tried to recapture Park by cases was as humane as it was scientific: He realized offering him the post of chairmanship of surgery-a that both professional and public attitudes toward tempting invitation that would have been an errorcancer patients during the nineteenth century mous promotion for Park. But a local group of were harsh, primitive, and counterproductive to influential medical professionals and public infinding a cure for the disease. dividuals coordinated a campaign to convince Park to stay in Buffalo, countering the Chicago Roswell Park was born in 1852 in Pomfret, offer with an offer of its own: Would Park be Connecticut, into the ninth generation of a prominent family that had arrived in America interested in a third building for the medical on the Mayflower (and had entered England school, on High Street, to be constructed to Park's specifications? Yes , Park would. with William the Conqueror). The first generation of Parks to venture from the East Coast, Park worked diligently and, aided by his many government and professional contacts, Roswell's family relocated to the Midwest when his father founded Racine College in Racine , Wislaunched an ambitious campaign to secure canconsin. After completing his B.A. and M.A. lr-=o=--R-= R-o_s _w_ E_L_L---:P:-A - R- K --,1 cer-research funding. In 1898, he and Edward degrees at Racine , Roswell Park earned his H. Butler Sr. , publisher of the Buffalo Evening M.D. at orthwestern University in 1876. After three years ews, won the world's first public-fund appropriation for cancer study. This 7,500 from the ew York State legislaas adjunct professor of anatomy at his alma mater, Park left to pursue his medical studies in Germany, France, and ture helped establish the ew York State Pathological LaboAustria. Indicative of his growing reputation , he was apratory of the University of Buffalo, the first lab in the world pointed lecturer of surgery at Chicago's Rush Medical Coldevoted exclusively to the full-time study of cancer. Within lege and an attending surgeon at Chicago's Michael Reese two years , the three small rooms the medical school had Hospital while still in Europe. Park did soon move to designated for laboratory use could no longer meet the Chicago, and it was there that he began what was to be a long demands of Park's research. Public donations and private and successful medical career in two Great Lakes cities. giving from Mrs. William Gratwick made it possible for land In 1883 Park left Chicago for the medical department at to be purchased for construction of the Gratwick Research the niversity of Buffalo, where he became professor of Laboratory at the University of Buffalo. Completed in 1901, surgery and later joined the new dentistry department. He it was , this time, the first lab in the world to be built and also worked as a surgeon at the Buffalo General Hospital. equipped solely for cancer research. Several things about the niversity of Buffalo appealed to Although by 1904 a ew York State grant annually Park: It had one of the oldest and best medical schools in the allotted the lab 15,000 for maintenance, it was not a state B a a p y a n w n e 9 6 �sidered among his most influential publications are the facility; that is , until19ll-thanks to the concerted efforts Mutter Lectures on Surgery, given in Philadelphia; the Lecof Park, along with the support of government officials and tures on Surgical Pathology; the Epitome of the History of the public. It was renamed the ew York State Institute for Medicine; Surgery by American Authors; and the Practice of the Study of Malignant Diseases, a title it retained until1946, Surgery, deemed when it was reby many his finest named after its iniwork. As a musitiator. cian , he was reFor thirty-one ported to be highly years until his skilled; he prideath, Park served vately published as a UB professor his musical pieces of surgery and Bufin a collection he falo General modestly titled A Hospital's chief Little Music. surgeon. Both inIt is not surprisstitutions would ing that one of feel Park's influPark's admirers ence for another called him a "livthirty-one years ing encyclopedia. " after his demise, as "When others each was led by his sought rest in novformer students. elty, gaiety, and Park's medical change," the friend expertise and reexplained , "Park assuring profescould be found sionalism earned Roswell Park (lacing the camera) operates before medical students and faculty, c. 1895-98. storing his splenhim the presidid mind with dency of the American Surgical Society, as well as American fresh material. " membership in the International Congress of Surgeons. As one ofBuffalo's most trusted and well-known surgeons, Park Rarely did Park slow down, even was appointed medical director of the Pan-American ExpoFrom its meoger three-room beginning in 1898, the as he got older sition of 1901, held in the city, and he was among the team Roswell Pork Concer Institute today spans twenty-five and intermitof physicians who attempted without success to save the life acres in downtown Buffalo, maintains osatellite tentlyill. Uncharof assassinated President William McKinley. acteristically, he research facility in Springville, New York, ond includes Park's achievements in medicine alone would guarantee made plans to go him a place among Buffalo's most successful citizens; howamong its fifteen buildings in Buffalo o 218-bed away and simply ever, he did not rest at the borders of his own profession. As hospital. The institute is currently undergoing o $241 relax in 1914, but a dedicated member ofUB's University Council, Park fought million renovation ond modernization of its facilities, died two days for the expansion of the university into the arts and sciences, slated to be completed in 1998, its centennial year. later on February prompting one colleague to describe him as "idealistic in a Cancer survival rates hove increased dramatically 15-almost cerpractical way. " His desire to be involved in creating a comfrom Pork's day, when being diagnosed with cancer tainly of heart plete university led to the establishment of the College of was virtually equivalent to odeath sentence. Only one failure-emArts and Sciences shortly before his death-and his son Dr. in five people survived the disease in the 1930s, one bodying perhaps julian Park would become its first dean, a position he would in four in the 1940s, and one in three oscore later. his favorite and hold for forty years. In men's social circles, Park was called Equally impressive is the fact that survival rates for often-quoted a "notorious mixer"; he held the presidencies of both the aphorism: "The those stricken with leukemia tripled between 19 50 Buffalo Club and the Liberal Club. As a scholar, he wrote 167 future reserves textbooks , articles , and monographs dealing not only with and 19 60- thanks, in no small port, to the for us repose medicine, but also with thanatology, student life in the early pioneering efforts of Dr. Roswell Pork. enough. " + Middle Ages, and sixteenth-century Italian philosophy. Con- Roswell Park'sButfalo Legacy s 0 0 p h 5 c o n w e 6 �A ,, Spoon f u I of Humor© gotten sick and they've called out over the P .A. for a doctor. There I am, resting comfortably in the middle seat with my knees in my eyes (I believe they call it the "chiropractor position"), when I hear the announcement: "If there is a doctor ACTUALLY , THE FIRST TIME I ANSWERED A CALL FOR on board, please make yourself known HELP , THIS PAST SUMMER , IT WAS A S ICK CHILD to the flight attendant." My first thought is, maybe they are looking for a date, or they have an Amway 111•111 his summer I made the deci- (Stamford, to be exact, but I still prefer on the side and are looking to business sion to move from the prom- to think of it as the ew York Metro ised land (California) to the area). Things are different here: obody bring doctors fleeing managed care into homeland ( ew York Metro has a sense of humor. For instance, the their group. The scary thing is, at this area). Perhaps it was the trickle- woman at the rental agency's name was point I might even be interested-espedown effect of managed care. I Anita Head. When I laughingly asked if cially if I begin as a Double-Diamond believe I reached my low point that was her real name, she retorted, Attending. Sometimes I am reluctant to respond when I was moonlighting in an occupa- "What's so funny about that?" I thought to these mid-air announcements. What tional medicine clinic (despite my train- to myself, "You not only need a head , if it's a situation I can't handle? This ing in pediatrics) and examining an but you need a sense of humor. " When I moved back East I needed to time, however, I literally jumped at the employee of Federal Express. The patient, a graduate student in finance , was fly one way, and there was only one opportunity, since l was trapped in the explaining the wonderful benefits pack- airline that would sell a one-way ticket. middle seat between two guys named Barry who were taking turns age offered to Fed Ex employpicking their teeth while disees who work as few as 20 cussing their favorite episode hours a week-a benefits of the Carney Wilson talk package that includes free I CHOSE THE SAME AIRLINE WHEN show ("Good-Samaritan Docflights to anywhere they fly. RETURNED TO CALIFORNIA FOR tors Who Get Sued While The only catch, he noted, i Helping Transsexual Patients that you have to be willing to VACATION DURING CHRISTMAS BREAK , with Kleinfelters"). You can sit in the "jump seat." ow, ON A " MANAGED-CARE VISA" (YOU see why I welcomed this opI'm not even sure what a jump portunity to get up and seat is, but I figure any seat KNOW , JUST ONE HOUR AND NOT A "work. " Anything to escape that includes the word the "dueling teethpickers." "jump" sounds like it has MINUTE LONGER ). Another reason l am usumore room than the average ally reluctant to get up and coach cage-! mean seat. assist in these situations is, I I even went so far as to jot down the name of the person in charge I don't want to name the airline, but let am a pediatrician. It's not very often that of personnel at FedEx (I still have her me just say it sounds like "terror air" kids get sick on planes, although l have number, in ca e l ever decide to move and leave it at that. lt is also the only considered supplementing my income back to California). Then it occurred to airline that has no frequent-flyer pro- by offering an impromptu pharmacy me that I may be overqualified: After all, gram (probably because it doesn't have service specializing in Benadryl and other I've written a book, and I am a pediatri- any frequent flyers-except me, that benign sedatives for children in the back cian ... maybe I could specialize in lift- is). I chose the same airline when l of the plane (I could make a killing on ing crates filled with children's books? returned to California for vacation dur- flights to Orlando and Anaheim). Actually, the first time I answered a As I said, that wa the low point. o ing Christmas break, on a "managedcall for help, this past summer, it was a care visa" (you know, just one hour and now l find myself in Connecticut, in the child-one who had had corrective sick middle of the "Blizzard of '96"-not not a minute longer). surgery for cyanotic heart disease two For some reason, every time l have unlike the Blizzard of '77 in Buffalo ('nuff said). I am living in Connecticut flown this airline (twice) someone has years earlier. A little oxygen did the ...adoctor on board?" B u a 0 p h y 5 c a n w n e 9 9 6 �Stu S i Ivers t e in, trick, and I was an instant hero. The second time it was a very un-pediatric problem: a 38-year-old with tingling and numbness down his arms and legs. He was only a couple of years older than me, so 1 knew there was no way he could in the back, I had to prove I was a doctor. Like somebody is going to try to take on that responsibility just to impress people: "Stand back! 1 am a doctor ... okay, I have a Ph.D. in political science, but you did ask for a doctor. " be suffering from a stroke or heart attack (could he?!). I quickly asked the usual questions: What did you eat? Do you have a past medical history? Taking any meds' (Are you a lawyer?) ow, believe it or not, before they would even let me touch this guy or open up the bag of equipment they keep As soon as I got over there and identified myself as an M.D., you could see the guy felt better right away, which just goes to show the importance of touch in medicine-and let's face it: touch is about all you can do on a plane. There is no CBC, no enzymes to measure, and no pulse oximeter. The guy's blood pressure B u a 0 p y 5 c a w M.D. and vitals were stable, and he improved with a little reassurance, so I concluded that he was most likely suffering from hypoxia coupled with flu symptoms. But just to be on the safe side, I decided to radio an internist on the ground, which meant that I got to take a trip to the cockpit. When I got there the pilot, co-pilot, and flight engineer all turned around to talk to me-and I'm thinking, "Who the hell is flying the plane?!" Automatic pilot or no automatic pilot, I want to tell you it is unnerving in the extreme to see these guys all looking backward while the plane is moving forwardkind of like riding in a ewYork City cab and having the driver climb into the back seat to chat while the car is going down Fifth Avenue at 45 miles an hour. (Come to think of it, that's probably not so unusual, ew York City cabbies being what they are.) Anyway, the pilot gave me his card (first time that's happened to me) and promised he would put in a word for me so I could get a free flight. So wouldn't you know it? I'm headed back to the East Coast from California (trip number three on "Terror Air"), minding my own business, and I hear that call for help on the P.A. again. This time it's a 33-year-old woman who has fainted in the back of the plane. I get up to answer the call to duty and the flight attendant says, " ot you again," which is precisely what I was thinking. So now I am three for three. Well, by now I am even ready to consider working for this airline instead of Federal Express, provided the benefits package is better. In these days of economic uncertainty, you have to find work wherever you can- even on cross-country flights. + Stu Silverstein, M.D., president of Standup Medicine Seminars of Son Francisco, California, and Stamford, Connecticut, lectures nationwide on humor in medicine. e 9 6 �~ -················································· · ······ · ·················· · ··········· lEI Promoting prevention at the CDC JAMES MARKS '73 IS THE NEW DIRECTOR OF THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION same pragmatic approach to the agency's long list of target issues: eeing one patient at a time isn't enough for James S. cancer, diabetes, heart disease, adolescent behavior, nutrition, Marks, M.D. '73: He prefers to take them in batches of physical exercise, community health, oral health, teen pregnancy, hundreds of thousands. family planning, reproductive health, infant mortality, and smokMarks is the new director of the ational Center for ing. Some current projects include monitoring mammogram rates, Chronic Disease Prevention and Health Promotion, a expanding state cancer registries , and helping redesign principal unit of the federal Centers for Disease Control school health curricula to emphasize prevention. The agency also and Prevention. puts out several hundred publications a year, including its famous "People don't realize that chronic disease causes 70 perSurgeon General's Report on Tobacco, an annual summary of cent of the deaths in the United States and 60 percent of the research on smoking and health. healthcare costs. We're having trouble paying for it already. "Our responsibility is to see that the findings of research That means either we are going to have to curtail care, or we'll about prevention are disseminated widely so that people have to reduce the incidence of these problems through know what to do to avoid chronic disease," Marks says. prevention. And we believe prevention is the only humane That entails distributing most of the agency's $400 milsolution," Marks says. lion budget in grants to state health departments , universiMarks was appointed director of the 550-person agency ties, schools, and other organizations to fund education, by CDCP Director David Satcher in June 1995, but long monitoring, and research programs. before that he had made a name for himself as an outspoken Marks grew up in Alden , near Buffalo, and majored in advocate of preventive health. His numerous publications psychology as an undergraduate at Williams College in include editorials for the journal of the American Medical Massachusetts. He earned his M.D. from UB in 1973 (where Association in which he applies science to social problems his father, Eugene, had earned his M.D. in 1946), and to come up with non-ideological, although not necessarily completed his internship and resinon-controversial, solutions. dency in pediatrics at the UniverIn a 1985 JAMA commentary, " THAT' S WHEN HABITS BEGIN , IN sity of California at San Francisco, he recommended creating a desigADOLESCENCE . WE' VE GOT TO SHOW where he also worked in a Planned nation called "fetal tobacco synTHEM THAT GOOD HEALTH HABITS Parenthood Teen Clinic. drome" to call attention to the "I realized while I was pracARE TO THEIR OWN BENEFIT , AND well-known correlations between ticing in San Francisco that the smoking and low birth weight and THAT THEY' RE NOT JUST problems I was seeing were pregnancy complications. An ediACCEPTABLE , BUT COOL. " broader problems than just the torial in 1987 advocated commuclinical ones," he says. Dispensnity-based sex education that ing antibiotics and vaccinations did nothing to remedy the would teach teens not only how to say "no " to sex-but also poor nutrition , teen motherhood, and other societal probhow to protect themselves if they said "yes." lems he saw day after day. "l got interested in the broader "Sexual messages pervade our lives-at home, in schools, community issues. " in media, in shopping centers, on airplanes , and even in He was hired by the Centers for Disease Control as an physicians' offices," began another JAMA editorial urging Epidemic Intelligence Service Officer in Ohio. On his universal sex education. His next sentence no doubt surfirst day at work, he was sent to Pennsylvania to help prised readers expecting disapproval of our sex-obsessed investigate what would become known as Legionnaires' society: "Rightly so, since being sexual is part of being Disease. "It was tremendously exciting, my first day on human." the job! " Marks remembers. He also investigated outAs head of the preventive health agency, Marks is applying the B a 0 p h y s c a w e 9 6 �························································································ ra~ . • breaks of measles and diarrhea , as well as complications from the swine flu vaccine, and was sent to Hawaii to monitor an outbreak of German measles in adults. With a growing conviction of the importance of epidemiology and public health, Marks left the CDC to earn a master's d eg re e in public health from Yale University, winning a Robert Wood Johnson Clinical Scholars fellowship. Toward the end of his studies, Marks served James Marks, M.D. '73, on the Centers for Disease Control and Prevention campus near Atlanta, Georgia. six months as "It's the leading cause of preventable mortality in this Connecticut's acting state epidemiologist. He also returned country," he says. "The tobacco companies have to deny to pediatric practice. "I just wasn't sure l wanted to stop what science is most clear on-the links between toseeing patients," he remembers. bacco and cancer and heart disease-every time we Marks rejoined the CDC in 1981. Since then, he has held publish the Surgeon General's Report on Tobacco. They a number of science policy appointments in various departhave to have 3,000 children start smoking every day ments, including the Birth Defects Branch and the utrition because 400,000 of their best customers die each year Division of the Epidemiology and Research Branch. Most and 600,000 quit." recently, he served for four years as the director of the However, the same issue has provided the most encourDivision of Reproductive Health, a subunit of the agency he aging example of the success of public health education, currently heads. Marks also teaches at Emory University he says. School of Public Health and has served as a consultant to the "When the Surgeon General's Report of 1964 came out, World Bank and the World Health Organization. which was the first to publicly state the risk of smoking, One of his goals for his agency in the coming years is to try nearly 50 percent of the adult population was smoking. Now harder to reach adolescents with the messages of preventive it's down to the low 20s. That's an incredible change and an health. "That's when habits begin, in adolescence. We've got incredible success." to show them that good health habits are to their own benefit, Marks, 47, lives in Atlanta with his wife, Judy (a 1968 and that they're not just acceptable, but cool." graduate of UB, where she was named "Outstanding FreshHe also hopes to begin attacking Americans' sedentary man Woman" and served as president of the Honor Society), way of life by promoting physical exercise, and to continue and his 16-year-old son, Adam. His 19-year-old daughter, to monitor the health problems of the uninsured. "We are the Amy, is at college, where she is tentatively pre-med. Alonly industrialized country that doesn't cover our entire though he has enjoyed living in Atlanta for many years, population. When we're designing programs for HMOs and Marks retains fond memories of his alma mater. insurers , we can't lose sight of the fact that they don't cover "l still miss the snow and the Bills," he says. + 20 percent of the population." One topic that never fails to get Marks' juices flowing is E 5 5 c A A N K J c E R tobacco. B u a a p h 5 c a n w e 9 9 6 �• ······························ · ······························· ·· · · · ·· ············ · ········ I BERNARD 5 . STELL '36 , of un City, Arizona, had l l slides-ofhis30 acceptedexhibited in imernational stereo photography exhibitions in 1994. 1 9 5 s 0 MORTON A . STENCH EVER '56, of Merler Island, Washington, continues to teach and practice after resigning as chair of the niversit)' ofWashingwn's DepanmenL of Obstetrics and Gynecology, a position he held for 19 years. He also serves as associate editor of Obstetrics and Gy necolog} , and has coauthored Comprehensive Gynecology and authored three books. He serves as treasurer of the American Board of Obstetrics and Thomas March '31 (arrow} at the 1966 reunion. Gynecology, and is a member of the OB/ GY 1 9 3 s 0 Residem Review Commiuee. He won the 1995 Wyeth/Association of Professional Gynecology and Obstetrics Annual Recog- THOMAS A . MARCH '31 , of Tacoma, Washington, writes: "As an ancient alumnus of the medical school class of '31, I am perplexed at the silence of other alumni from the class of'31. Perhaps it is because they feel 'too old.' nition Award. He and his wife, Diane, recently celebrated their fortieth wedding anniversary, and enjoy their three children and four grandchildren. 1 "A slwrt biography is perhaps indicated at this point: 9 WILLI AM "After internship at Toledo Hospital (Ohio), I attempted general practice in 6 s 0 E. ABRAMSON '60, of Baltimore, Maryland, teaches aCME course on substance-abuse education for primary care physicians at Maryland-area hospitals, four different locations in ew York State during the Depression of the '30s. sponsored by the state medical society. He "Economics forced me to tahe a staff appointment at Harlem Valley State Hospital. Before I knew it I became eligible for Psychiatric Boards, after continues his private psychiatry and addiction medicine practice at Sheppard PraLL Hospital in Townson, Maryland. I R V I N G 5 . KOLIN '61 , ofWinterPark, postgraduate courses at Columbia University. Florida, appeared as a guest of Ted David on "After service overseas in the Army Air Force in 1942 (as a Lieutenant Colonel; I resigned in 1945), I joined the staff of a VA Hospital. I became a recent edition of C BC-TV's Money/inc LO discuss the economic costs of substanceabuse disorders. The program was televised nationally. Hospital Director in VA, then continued in Veterans Administration as a J OH N J . LAMAR JR . '63, of Salem, director in two different locations. I retired in 1973 and had a private ew jersey, is happy to announce that he neuropsychiatric practice for about a year. will be retiring in 1996. His youngest daughter, Danine M. LaMar, who married Glendon "And now I am enjoying complete rest and retirement." grade at Quinton Elementary School. Lodge in 1994, will be teaching the third a a 0 p h y s c a n w n e 9 9 6 �...................................................... . .......... Orange, Connecticut, coedited with Hal ange County Medical Society. He and his wife, Colleen Mulligan (B.S.N . '79 , B. Jenson and 50 contributors a 1,600- D'Youville) , are raising their two "big boys": page text this summer entitled Pediatric Todd , 8 , and Trevor, 3. ROBERT 5 . BALTIMORE '68, of SURF THE NET! INTERNET SOFTWARE Many Titles!! Infectious Diseases: Principles and Practice, PABLO RODRiGUEZ '81 , ofWarwick, published by Appleton and Lauge. He is professor of pediatrics and epidemiology at Yale University School of Medicine, where his E-mail address PC Anywhere Rhode Island, has been appointed associate chief of OB/GY DOS ... $67 Windo"s... $69 at Women and Infants • .\merica Online ~lac & \Yindows...$11.-49 • Internet Starter Kit \Vindo\\s...$3-'.49 \lac...$3-'.95 • Prodig_' \lac & \\ indo\\s...$15.95 • '\etscapc :\a,·igator for\\ indows...$32 Hospital, the teaching hospital of Brown is University in Providence, Rhode Island. He baltimorrs®maspo3. mas. yale.ed u. has two children: Rafi, 6 , and Kika, -1-. 1 9 7 s 0 ROSLYN '86 , of ROMANOWSKI SUSAN A. BARDE '76, of Dayton, Snyder, Ohio, who is in private practice in allergy, Western wrote in to announce that her husband, Millard Fillmore Ho pita!. She returned to Christopher A. Barde '76, is chief of medi- the area in 199-t, and assumed her latest ew York, is thrilled to be back in ew York doing heme/one at cine at the Dayton VA Medical Center and position after working one year at Buffalo chair of gastroenterology at Wright State General Hospital. Can 't connect from home ll'ithout one' INTERNAL STARTING AT $84.95 EXTERNAL STARTING AT $94.95 niversity. They have two sons: Christian, ANNA KRISTINA ELISE HART '89, 13, and Andrew, ll. of Portsmouth, Virginia, has completed a 1 9 8 second tour of duty as flight surgeon in the s 0 Florida, is chief of the Department of Plastic cared for four squadrons and was head of Surgery at Florida Hospital in Orlando and a legislative committee member of the Or- UNIVERSITY AT BUFFALO S C HOOL OF M EDI C INE 150 I SO 1846 Y E - A RS 19 9 ManY Brands! • Supra • US Robotics • Boca Modems • Practical Peripheral • Global Villiage nited States avy, most recently at AS Whidbey Island, Washington, where she WALTER SIEMIAN '80,ofWindermere, CONTINUED ON PAGE 32 BOOKS 20% off Retail 150 Years of Medical School History Using the Internet............. $15 The User-Friendly Reference Easy Internet. ............... $18.95 Using the Internet............. $29 Special Second Edition INTERNET WORKSHOP In celebration of its sesquicentennial year, the School of Medicine and 6 Biomedical Sciences has published a 192-page history chronicling its accom- Learn How to Use the Internet! plishments and its everyday life over the past century and a half. 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Fri 1/am-Spm. ned & Thurs /lam-6pm C Order your copy today for delivery in March 1996. •r rrt n an r awlul'" Pnl'•• ·hJtltooiuo,f(l'"lll t 11<•tll' To place credit orders, call Walsworth Publishing Company at 1-800-369-2646, ext. 3339 A non-profit Umversity program for students faculty & staff The Commons • North Campus • (716) 645-3554 • Fox: 645-3884 6 u a 0 p h y 5 a w n e 9 6 �• ·························································· Why dtay home for the holidayd? I J e nni fe r (Broman) Moman, who is practicing pediatrics in Beaver, Pennsylvania, and is happily married to Dr. Moe Moman, a dentist. STEVEN P. HARRIS '91 ,ofPittsburgh, Pennsylvania, and his wife, jane, announce the birth oftheirson teven Phillip Jr., born September 1, 1995. The front-wheel drive lnfiniti®130"' MICHELLE PI ETZAK '92 , of Los An- ing her residency at Children's Hospital of Eln int~rt;>r 11/0t'l' ,•pact;>u,• than a Rolf,, Rove~ Si!..o· 5purlll. An ~.\-ceptulttal~v.tJm~mu,• o/ ,•tandard lu.rw:v f~atur~.•. 1! /90-hp 1'6 mpaM~ o/out-acal~ratti'.tJ many !u.\·w:v Jl<l:•. Elntl o/ <'tl/11".'~• th~ ,•tantlartl-,•ettin.tJ Los Angeles. Currently, she is in the first p~tj;>rlllilll<'~ anti ,•~r<'lt"e geles, California, married a fellow pediatrician, Derek Wong, in june 1995 after finish- year of a fellowship in gastroenterology at the niversity of outhern California. it;,, t>/ ln!i'niti. S.J 79 mo. -12 IIIli. lea.•e SO£11111'11 OBITUARY DONALD HALL '41 , of Buffalo, died Michelle Pietzak ' 92 january 7, 1996, after a brief illne s. He was a past presidentofthe Medical School Alumni the Aviation Medicine Department at the Association. After service in the Army during World War !I and residency at Buffalo hospital. During her two years at Whidbey Island, she spent much of the time traveling General Hospital and The Children's Hospi- and participating in training exercises both tal of Buffalo, Dr. Hall entered private prac- in the area and as far away as the East Coast. tice in obstetric and gynecology. He was an he attained the distinction of being the first assistant clinical profe sor at the medical female assigned to two aircraft carriers, and Achievement Medals for her accomplish- Blood Services and the Deaconess Center of Buffalo General Ho pita! Family Planning. Pro_qram. cine, working with several area medical or- ments while on her assignment. She reports ganizations, including American Red Cross that she mi se the days of nying while a night surgeon, but is enjoying being a resident in the world's largest and busiest naval 9 9 s 0 MICHELLE SKRETNY SUSCO '91 , Correction of Clifton, Virginia, is a board-certified pediatrician practicing in a four-pediatrician ELLEN GIAMPOLI '90 AND group practice in Manassas, Virginia, after CRAIG NARINS '90 were wed in completing three years of residency training Tarrytown, ewYork,onjune 10,1995. at Children's National Medical Center in Readers of the Autumn 1995 issue who Washington, D.C. She and her hu band , arc friends of the couple have noted joel, a CPA, who married in cptcmbcr 1995, will be living in their new home in The editors regret their error. ~.\·t~n.•il'~ a a -12 1110. !ea,•e SO tiown I N F I N IT I AUTOPLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall that we mi identified Dr. Giampoli. G20 42 mo. '130 42 mo. lease W<th cash or trade eqUity dawn. (G20-$495) (130-$450). Bank fee + tax and license due almcepbon. 12,000 annual m<leage. $.12 Clifton. Susco also provided an update on a an S2 79 IIIli. hospital. 1 Lit..-~ ~"ay !t~/i'nitl·, th~ (;]{!com~, , "•ith li.•t o/ ,•tandarti /u.\'111"1/ f~atur~.•: a -l-ymr/60,0£/0 mil~ Ba,•ic x~:,. l '~hic/~ ll'~u·ranty; 2-1- hour Roal/,,itl~ JJ.,,,[,•tana Pro_qram Trtp Interruption B~n~fi't,•; and our Fra Sal'ia f_,oan Car school until his retirement in 1983. After his retirement, Dr. Hall remained active in medi- most recently was awarded two Navy The front-wheel drive lnfiniti® G20'" per m1le p 5 a n w 1n excess. e 9 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. 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MLM~C ~ \l<'li!Cal ljabilit) \lntuallnsuranct' Compan) Our defense never rests. 2 Park Avenue New York. NY 10 016 2 Cl'nton Square Syrac"e>e. NY 13202 9() Merrd Avenue E. Meadow. NY 11554 �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING A TREE UNDER WHICH You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed fu nds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVII!RSITY AT aUFFALO SCHOOL 0,. ME:DICINII! t5~ 150 YEARS � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. 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Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f4209f935ca3475fdb4248c5ca161ddc.pdf f8f3e3241eb62160d7d97da33858a740 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1996 8 4 6 9 9 6 �BUFFALO PHYSICIAN Volume JO , Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dear Fellow Alumni, Dr C uole 5rnth Petro ACTING DIRECTOR OF PUBLICATIONS Kathryn A. ~"''ncr AS WI: CELEBRATE the University at Buffalo s sesqUiccntenmal this EDITOR many talented physicians and scientists who have contributed to that year, we reflect on the rich history of our med1cal school and the jesSica Ancker history. These indi\'Iduals were visionaries in their own era, lookmg ART DIRECTOR co~ld Alan J. Kegler into a future that others ASSOCIATE DESIGNER sesqlllcentenmal celebrate not only our school's past, but also our julrr c.rerten not sec. So it is fittmg that the vision for the future PRODUCTION MANAGER We have a tendency to thmk that the past was somehow a Ann Raszm;.mn Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john :-.jaughton, \'icc PreSident for Clmrcal Affarrs. Dccm kinder, simpler time, when doctors were unburdened by the complicated issues we face today, and inspiration and dedication were all that , \vas needed It seems unfair, somehow. Roswell Park did not have to spend two hours on the phone arguing to get an MRI approved . James Platt \Vhite did not have to pay outrageous malpractice premiums. Matthew Ma.nn did not have the quality-assurance police hounding hun about his C-scction rate. Austin flint EDITORIAL BOARD Dr John A RKhcn , Chairman Dr. Martrn Brecher Dr. Harold Brody Dr. Richard L. Collms Dr. Alan J. Drinnan Dr james Kanski Dr Barbara Marjcroni Dr, Elizabeth Olmsted Dr. Charles Pagand, Dr. Margaret W . Parosk1 Dr. Thomas Raab Dr. Stephen Spauldmg Dr. Bradley T Truax TEACHING HOSPITALS AND LIAISONS The Buffalo (,encralllosprtal ,\.ticlwd Shu11 The Children's llosprtal of Buffalo Erie Count\' Medrcal Center Mercy Hospital Jl,llllard fillmore llosprtals rrani~ Sm·a • N ragara ralls Memorial \1cdrcal Center Roswell Park Cancer lnsmute Sisters of Charity llosprtal Dnmis MrCcuthv \'rterans Affairs \Vrstcrn New York Hcalthcan· Svo.,tem did not have to worry about a \1edicaid audit. They didn't have to get CMI: credits, write triplicate scripts, or attend endless hospital committee meetings Things were so simple back then-if you call operatmg wnhout electric lights or antibiotics simple In real It}, each generation has its own umque problems to face Our common denominator is that we overcome the challenges and learn ways to solve our problems. Despite all the woes of modern medical practice, you?g people are applymg to our school in record numbers. \\'hy? One reason is that despite the stresses It bnngs, medicine still offers the intrinsic satisfaction of t._uring illness or helpmg people cope with what we cannot cure. The other reason is that we have a ternfic medical school. I may sound like a proud mother offering a somewhat biased opinion about how good-looking her children are but our med1cal school offers an excellent education at a reasonable cost hy any objective standards Our school has been acknowledged as an outstanding primary care/comprehensin' medical school by a national magazine (which arrived at that conclusion \V nhout any mput from me)! So how do we keep our medical school top notch m tough tunesl _Our Medical Alumni Association is a key player in that mission Since its mceptwn m 1875, the Medical Alumni Association has served to better the school in many ways. It allows us to stay in touch giving us the opportunity to network and exchange Ideas. A casual conversation at an alumni ©The State t niwrsrty of New York at Buffalo reception ca"n lead to a major project for the Medical Alumm Association. C.cneral class Buffalo Phv"rrun rs publrshcd students choose what field of medicine they want to pursue. quarterly by the State UnrvcrSlt)' of New York at Buffalo School of Medicine and BiomcdJCal 'icit:nu.·s and the Olfrce ol Publicatrons. It rs sent free of charge. toalumnr , fanrltv , students, rcsrdrnts and frrends. I he staff resn\'l's the rrght to edrt all copy and suhmisstons accepted for publicauon Address question.._, comments and submisSions to: The Edrtor Bu{julo Physificm, Statr l~ nivcrslt)' or New York at Buffalo , Offit-c of Puhlr callons 136 Crofts llall , Buffalo , New York 14260 Send address (hanges to: Buffalo Physician. 146 Cl'~ Addrtron , H35 Miun Street, Buffalo, New York 14 214 reunion gifts fund much-needed scholarships. The Coi~munity•Physi<.ians Program helps In treating a patient, any physician can tell you the difference a supportive familr makes family serves ro motivate, comfort, guide, and care for the patient. As medical alumni, we are the family of our school. As a family, we are proud of the 150 years of tradition this yearlong sesquicentennial celebratiOn marks, and the MediCal Alumm Association looks to its . , members for a \ tsion of the next 150 years. We also plan to have fun in the process. \Vannest regards, ~~ W. ?OA.o~, MD Margaret W . Paroski, MD. Prrsidcnt, l\.1cdical Alumni Association �v 0 5 p L . R 3 N 0 , o . N G 9 2 9 6 150 Preparing for the 21st Century -by john Naughton, M.D. UB's MEDICAL ScHOOL AT THE fOUNDlNG OF THE U 1\'ERSITY OF BUFFALO The stories of three of UB's founding father -by judson Mead BUFFALO's U !QUE NETWORK OF TEACHING HOSPITALS How the unusual relationship between the University at Buffalo and its teaching hospitals evolved. -by Ann Whitcher PHOTO ESSA'r: LIFE AT THE MEDICAL SCHOOL Two students bring us along during their daily routine. -photos by Don Heupel, story by jessica Ancker The medi cal faculty of the Uni versity of Buffa lo in 1861. PHOTO: UNIVE R SITY A RCHIVES . UNIVERS ITY AT BU FFALO _.J CoNTINuiNG A TRADITION or ExcELLENCE Profiles of some of UB's young faculty . m m MEDJCI'\J E or THE F UTURE Members of the UB community speculate on what is to come. C LASSNOTES �• ICa Preparing for the 21st Century This special issue of the Buffalo Physician celebrates UB's Sesquicentennial. The school's birthday is May 11, 1846, when New York State granted the charter to form the University ofBuffalo. Our Sesquicentennial Celebration parallels the events from early 1846 through mid-184 7, when the first class was graduated. The medical school was founded with strong community ties and a dedication to preparing excellent physicians committed to the highest quality of patient care and community service. At least three ofUB's first seven faculty members were unquestioned giants in medicine. Dr. james Platt White, one of UB's founders and a gynecologist-obstetrician, extended clinical teaching to include the demonstration of live birthing. Dr. Austin Flint was a peripatetic teacher, expert diagnostician, prolific writer, and editor. Dr. Frank Hastings Hamilton, a surgeon, introduced the use of ether as an anesthetic in BY JOHN the iagara Frontier. These three set the course for UB's medical school, consistent with Chancellor Millard Fillmore's dream that UB should be "eminently useful" to the citizens of Buffalo and western ew York. Like all institutions in the young nation, UB had its ups and its downs. A few of the high points: • The recruitment of Dr. Roswell Park from Chicago to head the Departments of Surgery in both UB and Buffalo General Hospital was a major accomplishment. Park was an internationally recognized surgeon with a broad range of interests and tremendous energy and foresight. His NAUGHTON , M . D . DEAN , SCHOOL OF MEDICINE AND BIOMEDICAL S CIENCES VICE PRESIDENT FOR CLINICAL AFFAIRS ••• a u a 0 p h y 5 c a n s p n g 9 9 �Buswell, and a UB alumnus, Dr. Harry Laforge, helped secure this bequest, which was shared between UB and the University of Rochester Medical School. • A group of local physicians (alumni and non-alumni) formed a fund-raising organization, the Annual Participating Fund for Medical Education (APFME). The first funds were used to recruit Dr. Hermann Rahn to become chairman of the Department of Physiology. Today, the funds are endowed and the revenues support Continuing Medical Education programs. Barbara Mierzwa serves as the APFME Director for CME. • The Medical Alumni Association supports the professional development of medical students, residents, and its other members. A major new initiative is the annual recognition of a Distinguished Medical Alumnus. • UB and its teaching hospitals established a nationally recognized model for graduate medical education. The Graduate Medical Dental Education Consortium of Buffalo has demonstrated the importance of shared gover- memory is honored through the cancer institute and the local society of surgeons that bear his name. • During the troubled years around UB's centennial, a leader emerged who served as dean for 12 years, Dr. Stockton Kimball. 1 regret that we never met. He is reputed to have been a warm person with a great deal of foresight, tenacity and fortitude who provided the leadership to broaden the medical school's missions and to relocate the school to the University Campus. • During World War 11, the school added two strongwilled, well established educators and scientists to its basic science faculty , Dr. Ernest Witebsky and Dr. Oliver P .Jones. These two , who helped establish UB's strength in fundamental biomedical research , were named Distinguished Professors by the SU Y Board of Trustees. • The school received its largest endowment from a Buffalo industrialist, Ralph Hochstetler, after his death in 1955. The revenues support physicians as they prepare to become clinical scientists and faculty committed to biomedical research. Hochstetler's brother-in-law, Dr. Henry s a 0 p h y 5 c CONTINUED a s p 9 9 ON PAGE 9 6 54 e �"For a long time the defects in the system of medical instruction in the neighboring colleges at Fairfield, Geneva, and Willoughby had been the subject of remark among my medical associates and myself It was on all hands agreed that the great desideratum, clinical instruction, could not be supplied in these rural schools. Without an opportunity to apply at the bedside the precepts inculcated in the lecture-room, the system of teaching by lectures can never be successful in making good practitioners. "Moved by these considerations, and influenced partly, no doubt, by the hope of personal professional advancement, ifthey could show they merited it, two or three young men, after careful deliberation, set about procuring a charter for a medical college. In this enterprise the older practitioners not only declined to participate but tried to discourage its undertaking. Nothing daunted by this opposition, aided by a few laymen, we proceeded in the winter of I 845-6 to procure a charter for a University. In the latter part of the same year we organized a medical department and appointed a corps of professors."- from remarks by Professor James P. White, M.D., at the inaugural dinner of the Alumni Association on Feb. 23, 1875. The "two or three young men" were White himself, Austin Flint, and Frank Hastings Hamilton, all then in their early or mid-30s, and all destined to make their marks on medicine and medical education in the United States. By B judson a Mead 0 p y s c a n 5 p g 9 6 �6 JAMES PLATT WHITE A pioneer in American obstet- rooms and laboratories for les- rics and gynecology and in the sons in practical anatomy and teaching of clinical obstetrics, chemistry. The faculty con- James Platt White may rightly be sisted of White, Flint, Hamil- considered first among equals in ton, Charles A. Lee, James Webster, Charles B. Coventry, the founding of the University of and George Hadley. Hamilton was Buffalo School of Medicine. a faculty member of the Geneva Of the three principal founders, Medical College but had taken up resi- White had lived in Buffalo longer than dence in Buffalo two years before; he re- Austin Flint and Frank Hastings Hamilton. cruited Lee, Webster, Coventry, and Hadley from White's father had moved the family from Austerlitz, Geneva. Y (near Albany), to the Buffalo area when White was five White cooperated in the founding of the city's first years old. He was educated in local schools and at hospital, the Buffalo Hospital of the Sisters of Charity, as Middlebury Academy in Vermont. White began his medical education in Buffalo in the well as in the establishment of Buffalo General and the office ofDr.Josiah Trowbridge in 1830 and then spent three Providence Asylum for the Insane. He was also instrumen- years attending medical lectures at the Fairfield Medical tal in the establishment of Buffalo State Hospital. College in Fairfield, Y. After receiving his medical degree On Jan. 18, 1850, White wrote a new chapter in Ameri- from Jefferson Medical College in Philadelphia in 1834 at can medical education when he conducted a clinical dem- the age of23, White set up a practice in Buffalo specializing onstration in obstetrics before 20 students in the new in the diseases of women and children. He also traveled to facility the university had built the previous year. The Europe to further his studies in Edinburgh, Paris, and students were permitted to perform a vaginal examination Vienna. According to one biographer, "he possessed of a woman in labor and then to witness her delivery. White, boundless physical energy which gave him a forceful , who knew this teaching method to be accepted in many aggressive personality." European medical schools, and who believed that medical students should witness a delivery before entering general The first class of the new University ofBuffalo met in the practice, called it "demonstrative midwifery." spring of 1847. The facility , a renovated Baptist church, included an amphitheater that could accommodate 200 The demonstration became a topic for vociferous public students and also served as a dispensary, as well as lecture discussion. Physicians who had opposed the founding of 8 a 0 p y c a 5 p n g 9 �the medical school were quick to attack White, while his nal of the Medical Sciences, published in Philadelphia, but students passed a resolution congratulating and thanking White was supported by medical journals in Louisville and him. The Buffalo Commercial Advertiser editorialized in Cincinnati. The Committee on Education of the American favor of his demonstration, but a few days later the Buffalo Medical Association reponed in 1851 that demonstrative Courier carried a highly charged editorial, signed "L," midwifery was entirely unnecessary. stating that "a precedent had been set for outrage indis- Clinical teaching in obstetrics was soon well established, criminate." In a letter to the Buffalo Medical journal, 17 nonetheless. Twenty-five years later White was pleased to Buffalo physicians called demonstrative midwifery unnec- remind an audience of medical school alumni that "this essary and "grossly offensive." When Dr. Horatio Loomis method of teaching has now been introduced, in some form had additional copies of the Courier editorial printed and or other, into all the leading institutions of the land, and in distributed, White sued him for libel. White was supported many, is made a prerequisite to graduation." at the trial by the testimony of Dr. Chandler Gilman, james Platt White was the only one of the three principal professor of obstetrics and disease of women and children founders of the medical school to spend his entire career in at the College ofPhysicians and Surgeons in New York City. Buffalo; however, he was far from parochial in his associations. Gilman stated that he had performed similar examinations He was a founder of the American Gynecological Society and, in while two or three students observed, and that he hoped to 1877, chairman of the section on obstetrics and gynecology and emulate White's demonstration of an actual delivery. vice president of the American Medical Association that had Loomis was acquitted, primarily inveighed against his clinical teaching because the jury ignored the judge's a quarter of a century before. He was Physicians who had charge; however, White felt that demonstrative midwifery had been also extremely active locally and was one of the founders of the Young opposed the founding of Men's Association, the Academy of vindicated. White's demonstration and Fine Arts, the Buffalo Historical Soci- the medical school were ety, and the Buffalo Club. At the time Gilman's testimony on his behalf quick to attack White, were the target of a vehement editorial by the influential American jour- of his death, he was for the second lime dean of the medical school he while his students passed a had brought into the world. resolution congratulating and thanking him. 0 B u a a p h c a n s p n g 9 �AUSTIN FLINT G In 1836, 24-year-old Austin Flint, during his eight-hour visit was with his wife and baby son, arrived enough to generate three papers, in Buffalo from published in 1845, 1852, and 1875 orthampton, MA, to set up a medical practice. (presented in 1873), on the com- Within five years he had pub- municability of typhoid. lished papers on rubeola, sudden The illness had struck 28 of the death, the use of quinine in intermit- 4 3 inhabitants of the village, killing 10 ting fever, and the connection between of them, a few weeks after a traveler from dyspepsia and the mind. By the time of his Massachusetts had fallen ill and died at the death in 1886, Flint had published more than 240 village inn. Flint discovered through correspon- articles on almost every aspect of internal medicine, as dence that the traveler had probably "left home with the well as several books and a widely adopted medical germicidal principal of typhoid in his body"; he con- textbook. He had also made significant contributions to cluded that "the subsequent cases were due to infection or the fields of physical diagnosis and epidemiology, served contagion introduced into the closely congregated com- as president of the American Medical Association, helped munity. " Although he noticed that three families who did found the University of Buffalo and another medical not drink from the village well escaped the disease, he college, and been a faculty member at four other schools. attributed their health to better nutrition because they Flint was the fourth generation in his family to practice were also wealthier. After diagnosing the disease and medicine (and he was followed in the profession by a son testing the well water, Flint dismissed an accusation from and grandson). He was educated at Amherst College and villagers that the epidemic had been caused by deliberate received his medical degree from Harvard College in poisoning of the well. 1833. Although he did not study abroad, Flint was well Flint's early papers on contagion were quoted by john acquainted through his Harvard teacher with the statis- Snow, a pioneer in epidemiology, in a famous oration in tical case recording methods advocated by the Parisian 1853. After that speech, Snow succeeded in stopping an clinician Pierre C. A. Louis. In 1843, Flint, who had been outbreak of cholera in London by taking the handle off a appointed health officer in Buffalo the year before, was pump to prevent people from drinking the contaminated called to the village of water. onh Boston, 18 miles away, to investigate an outbreak of severe illness. He diagnosed the Years later, after the transmission of typhoid fever illness as typhoid fever. The information he collected through contaminated water had been demonstrated, u a 0 p h y s c a n 5 p n g 9 9 6 0 �Flint revisited his North Boston findings and found that natural gift, nor does it accompany as a matter of course there had been a privy close enough to the public well to the acquisition of knowledge one acquires from reading or contaminate it with infected excreta from the first victim. didactic lectures. It is an art to be acquired." Flint was In his 1873 presentation to the American Public Health described as "a large man, with a full voice," always Association, Flint said, "It is perhaps the most remarkable solicitous of the comfort and feelings of his patients. experience on record as embracing a combination of In 1852 he left Buffalo to take a position at the University circumstances proving, in the first place, the communica- of Louisville. That year he received an American Medical bility of typhoid fever and, in the second place, rendering Association prize for his essay "Variations in Percussion vastly probable, if not certain, the communication by and Respiratory Sounds." Four years later Flint returned to means of a contagium contained in drinking water. " He Buffalo as professor of pathology and clinical medicine. His recommended sanitation precautions that, unfortunately, work on heart sounds resulted in a second AMA prize in went unheeded for another half-century. 1859. In 1862 he published a paper describing the particu- The reputation Flint had established through his early lar heart murmur that still bears his name. publications prompted an invitation in 1844 to teach at The characterization of the "Flint murmur" occurred at Rush Medical School in Chicago. He accepted, but soon Charity Hospital in New Orleans. The peripatetic Flint realized that he preferred living in Buffalo. Once resettled was by then dividing his time between Buffalo in the in Buffalo, he founded the Buffalo Medical]ournal, which summer and he edited for the next decade. ew Orleans in the winter. Flint left Buffalo permanently in 1860 to become professor In 1845, Flint attended the ational Medical Conven- of pathology and practical medicine at Long Island College tion in New York City as the delegate from the Buffalo Hospital. He helped establish Bellevue Hospital Medical Col- Medical Association. He was appointed to a committee lege and spent the rest of his life in New York City. charged with studying the requirements for granting medi- Flint's son Austin Flint Jr. described the variety of cal degrees. The committee's recommendations ultimately experiences that had made his father one of the great included extending the year's lecture period from four to six clinicians and teachers of his age: "During his professional months; requiring attendance for two years of lectures; career he encountered soldiers in camp and in barracks; requiring a total of three years of study, including three the rich and the poor; those afflicted with diseases inci- months of dissection; and requiring that all medical facul- dent to lives of ease and luxury and paupers in hospitals; ties have at least seven professors. the pioneers of western New York After helping to found the Uni- and the inhabitants of the metropo"The ability to observe versity of Buffalo, which held its first classes in 1847, Flint served as lis ... cases observed in the experience of a quarter century as a gen- is not a natural gift," the school's professor of medical eral practitioner, and of more than theory and practice for six years. He another quarter century as a con- Flint said. "It is an art shared james Platt White's belief in sulting physician, including epito be acquired." the utility of clinical teaching, say- demics which have occurred in this ing, "The ability to observe is not a 0 B a 0 country within the last 50 years." p h 5 a 5 p g 9 9 6 �FRANK HASTINGS HAMILTON 1813-1886 5 1 e Something of the single- growing city of Buffalo in or- mindedness of Frank Hastings der to have greater access to Hamilton, who once wrote (about surgical cases. He continued himselO that "a man whose busi- to teach at Geneva untill848. ness is in information rather than When the medical de- pleasure does best to travel alone," partment of the University of is evident in what he accomplished Buffalo enrolled its first class, r very early in his life. Entering Union e College as a sophomore at 14, he earned Hamilton was professor of principles and practice of surgery and his bachelor's degree three years later, then clinical surgery, a chair he held until studied anatomy in the office of Dr. John G. 1860. He was also the school's first dean. A contemporary described Hamilton as "rather cool and Morgan in Auburn, NY, for a year before attending medical .t lectures at the Fairfield Medical College in Fairfield, NY. He reserved to strangers, but open-hearted to trusted friends . 11 was licensed in 1833 by the Cayuga County Medical He could not conceal his utter abhorrence of the arro- ,, Censors; he earned a medical degree from the University gant. " .- of Pennsylvania in 1835. By then he was 22. ., Before the advent of anesthesia, surgery was performed As surgeon for the Auburn State Prison, Morgan could as rapidly as possible and the surgeon depended on a k obtain the bodies of prisoners who had died. Hamilton thorough knowledge of anatomy. In his first lecture at ,_ Was his demonstrator in anatomy untill834, when Mor- Geneva in 1840, Hamilton told his students, "You must gan was called to the faculty of the Geneva Medical persevere in penetrating and threading the windings of College. Hamilton returned to Auburn after his study in anatomy, and you must obtain complete mastery over 11 Philadelphia and taught anatomy and surgery in his pri- your nervous cords, that ... the keenest cry of suffering 1- vate office, mainly to students from the Theological Semi- shall not cause a thread to vibrate. " 1- nary at Auburn. In 1839, Hamilton was appointed profes- Hamilton was a preeminently skillful and inventive s sor of surgery at Fairfield Medical College; not quite two surgeon. In The History of Surge1y in the United States years later he succeeded his former teacher at Geneva 1775-1900, Ira M. Rutkow, M.D., calls him "one of the when Morgan left the schooL Hamilton traveled and most versatile of 19th-century American surgeons. " A studied in Europe during 1843-44, then moved natural mechanic, Hamilton invented a variety of surgical 6 9 u 0 0 p h 5 to c the 0 5 p n 9 9 9 �instruments, according to an article by Oliver P. Jones, the first battle of Manassas, he rapidly gained a wider Ph.D., M.D., for the 1973 Buffalo Physician. Jones also scope of responsibility as brigade surgeon, medical direc- said Hamilton was one of the first surgeons to excise the tor of a division, medical director of an army corps, and metatarsophalangeal joint for bunions and to remove the finally, in 1863, Medical Inspector of the United Stares central portion of the thyroid. To make joint amputations Army. He had published A Practical Treatise on Military more precise, Hamilton described what he called 'keys Surgery in 1861 and brought out a second, enlarged and guides' to the articulations. edition in 1865. During the war , he wrote to his wife that At the Buffalo Hospital of the Sisters of Mercy, in 1854, "it is no uncommon thing for a surgeon in the field to be Hamilton demonstrated the efficacy of closing old ulcers compelled to change his position once or twice during an by skin graft when he successfully transplanted a 7" x 4" operation, on account of a change in the direction or range flap of skin from the left leg of a patient to close an ulcer of the shots. " on the right leg. It was also in Buffalo that Hamilton wrote Hamilton resigned his commission late in 1863 and the preface to his influential book A Practical Treatise on returned to teaching at Bellevue. He was made professor Fractures and Dislocations , published in 1860. The first of the principles and practice of surgery and surgical American text to deal in depth with fractures , it was used pathology there in 1868. Four years later he published The throughout the country and appeared in seven editions, Principles and Practice of Surgery. He described its purpose the last in 1884. as "to supply within the compass of a single volume of Frank Hamilton and Austin Flint were both members moderate size, the instruction necessary to a full under- of the Long Island College Hospital's first faculty. Here standing of all the subjects belonging properly and exclu- Hamilton realized an ambition in clinical instruction that sively to surgery. " The volume went through three edi- he had harbored for 20 years: at the new college in tions , the last published shortly before Hamilton died in Brooklyn , students were able to 1886. In an address to the graduates pass directly from the lecture hall Hamilton was a surgeon in to the hospital wards for bedside of the University ofBuffalo in 1853, Hamilton gave them his final ad- teaching. the 3 I st Regiment of the A year after moving to Brooklyn, Hamilton became professor of monition as a teacher , urging them to study advances in medicine New York Volunteers in military surgery, fractures, and dis- during their careers. He warned the Civil War. His two sons locations, and professor of clinical that those who did not would , as surgery at Bellevue Medical Col- old men, " ... discover in their cruwere in the regiment and, lege. He volunteered as surgeon for the 31st Regiment of the New cibles some few scanty facts which , if they had looked to the experi- he wrote, "I wanted to be York Volunteers immediately after ence of others, they might have near my dear children in the outbreak of hostilities in the known at 30. It is quite as often, Civil War. His two sons had joined we fear , that they die wholly uncase they were wounded." the regiment and , he wrote , "I conscious that the science which wanted to be near my dear children they faithfully intended to prac- in case they were wounded. " In tice all their lives is a century or charge of a general field hospital at more ahead of them." B 0 0 p y 5 c a 5 p g + 9 9 �r i In 1953, the medical and dental school moved to this new building from its old High Street home next to Buffalo General Hospital. Samuel P. Capen Hall (renamed Sidney Farber Hall in 1974) became the nucleus of UB's South Campus. PHOTOS : UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO ��BY ANN WHITCHER When the University of Buffalo opened in 1846, medicine was about to begin a half-century of dramatic advances, and the hospital Was about to change from a charity service for the poor to a pivOtalcommunityinStitution. ln the mid-19th century, mostmedicalpractitioners had little ~BUFFALO GENERAL HOSPITAL BEFORE THE TURN OF or no formal education; such primitive opened in 1858, it, too, became an affilimethods of therapy as bleeding, blister- a ted teaching hospital for the medical school. Medical school faculty had twice ing, and purging were still in use. Clinical training for physicians, too, been part of unsuccessful efforts to found Was extremely limited, owing to the a city hospital, in 1846 and 1854; with state of hospital care. A sojourn at even the establishment of Buffalo General, the best endowed of hospitals was sta- they finally succeeded. The association tistical!y riskier than home care, due to between the school and the birth of the the hygienic horrors of the time. Surgi- hospital inextricably linked the two in cal anesthesia was gradually introduced the public mind. When Buffalo General appointed its only after the late 1840s; asepsis was not Practiced until much later in the cen- first medical staff, most of the physitury. cians were associated with the univerNonetheless, hospitals were valuable sity, a pattern that still holds true today. Places for young doctors to see a variety By 1869, the medical school could asof patients and gain the kind of ex peri- sert that Buffalo General "will be open for clinical instruction . . . o hospital ence they would need in practice. . The University of Buffalo established fees are required; the Faculty having lts first relationship with a hospital when made arrangement for the admission of Sisters Hospital was opened in 1848 by all the members of the class without the Sisters of Charity. Frank Hastings charge." liamilton and Austin Flint, both faculty A rapid acceleration in medical unmembers at the medical school (then derstanding followed the introduction located a block away from the hospital of antisepsis in the 1870s and asepsis in at Main and Virginia streets) became, the 1880s. When the renowned German respectively, Sisters' attending surgeon surgeon Ernest Von Bergmann was asked and physician. When Niagara Univer- in 1882, "What's new in surgery?" he is Sity formed a medical school in 1883, said to have replied, "We wash our hands Sisters switched its primary affiliation; before we operate ratherthan afterward." however, Niagara's medical school was Actually, the surgeon of the 1880s iissolved 15 years later, and the UB- was likely to give a cursory wipe on the lsters connection was restored, al- sleeve to a dropped instrument, then though probably not with the intensity sanguinelycontinuewiththeprocedure. lt had once enjoyed. By the 1890s, however, aseptic surgery When Buffalo General Hospital became a more and more common hos- 0 0 p h 5 c 0 5 p pita! practice; there were now autoclaves, sterilized dressings, and rubber gloves. Knowledge of pathogenic microorganisms also played a major role in increasing ~ the public's trust in ~ hospital surgery be- --~ tween 1875 and ~ World War I. ~ When the ~ medical school re- 9 ~ cruited Roswell al THE CENTURY . Park from Chicago in 1883 to become professor of surgery, he quickly took on additional duties as attending surgeon at Buffalo General. A man of wide culture who had studied in Europe, Park "taught the value ofLister's approach, as well as aseptic methods," Evelyn Hawes wrote in her history of Buffalo General. "The faculty of the medical school was virtually the same as the attending staff of The Buffalo Genera! Hospital; medical students attended the hospital clinics, and observed procedures of their university professors at close hand." "The growth of the whole idea of residency-hospital training after medical school-really evolved from the mid1800s," says Roseanne Berger, M.D., UB associate dean for graduate medical education. "People graduated from medical school and didn't have sufficient medical training, so they sought apprenticeships in hospitals, but these experiences were highly variable." By 1890, the johns Hopkins Hospital had coined the term "resident" to describe individuals who had completed one year of hospital training, followed by specialized training provided by the medical school faculty. "What made it unique was that, up to then, such training was under the auspices of various hospitals," Berger says. "A teacher of residents may or may not have been affiliated with a medical school, or hold n 9 9 9 �Research Laboratory (forerunner of today's Roswell Park Cancer Institute) to be built on High Street, neighbor to both Buffalo General and the medical school, which had moved to a new building on High Street in 1893. In 1911, Gratwick became a state facility, initially known as the Institute for the Study of Malignant Diseases. A number of new hospitals and smaller clinics were established in Buffalo between 1870 and 1920, some run by specialists in rival schools of medicine. According to Another Era, thesesquicentennial pictorial history of the medical school , "competition among regular, homeopathic, and eclectic physicians intensified, culminating in the founding of the Buffalo Homeopathic Hospital (later Millard Fillmore) and Pierce's Invalids' Hotel. Ethnic and religious groups started their own hospitals, some of which became affiliated with the medical school while others have since closed or consolidated." Mercy Hospital, now one of the nine teaching hospitals, was opened by the Sisters of Mercy in 1904. A more clinically oriented medical education evolved throughout the country after 1910, when the Carnegie Foundation for the Advancement of Teaching published a harshly critical evalua- a faculty appointment. radical at the time to introduce this concept of organizing residency training-as opposed to medical school training-under the auspices of a medical school." By the 1890s, Buffalo General's medical staff included many distinguished practitioners; the close connection between the hospital and the university helped their efforts to integrate scientific medicine and hospital care. When Roswell Park became ill with diphtheria in 1893, he chose to recover in Kimberly Cottage, Buffalo General's facility for contagious patients-a clear endorsement of the therapeutic standards that had been achieved. The gesture must have been appreciated by the house staff and ward nurses. This was an age, after all, when those running the hospital were not often its patients, and when those with financial means usually preferred treatment at home. Forging another link in Buffalo's health-care network, Roswell Park and Buffalo Evening News publisher Edward H. Butler Sr. secured legislative funding in 1898 for a cancer research laboratory in the medical school. By 1900 the institute had outgrown its lab spac: of just a few rooms. A gift from the Gratwick family enabled the Gratwick a u 0 0 p 5 c o n tion of medical education, the Flexner Report. Charles E. Rosenberg says in his book, The Care of Strangers: The Rise of America's Hospital System , "That evolution grew out of an intricate symbiosis between hospitals constantly in search of staff, on the one hand, and on the other, physicians who sought clinical training and status. " By 1914, more than 75 percent of medical graduates in the country were taking an internship. "One of the things that grew out of the Flexner Report," says UB medical school dean John Naughton, "was that more and more medical schools did have an identifiable hospital or two that were, by perception anyway, controlled by them. That has never existed in Buffalo." By the time the Flexner Report came out, a number of other hospitals were also loosely affiliated with UB. One was the Children's Hospital of Buffalo, which had opened in 1892. Another was an institution devoted to tuberculosis that evolved into City Hospitalin 1918. Later renamed E.j. Meyer Hospital, the institution in 1946 became a county hospital that was the forerunner of Erie County Medical Center. UB's affiliations with Children's and City Hospital were informal by today's standards, but they made possible the variety of clinical settings enjoyed by medical students of the period. 5 p g 9 6 �A 1934 evaluation report from the C_ouncil on Medical Education and HosPitals lists clinical facilities for teaching ~t Buffalo City Hospital, Children's and . uffalo General. Heads of depanO.:ents In the me d'ICa] school held equivalent Positions m · t h e Bu ffalo City Hospital. Staff · appomtments, however, were reserved for the hospital's board of managers. Buffalo General and the medical school h d ha a no formal agreement, perps because of their long history of Wok' r mg together. "All visiting men are llJ.emb ers o f the faculty " the report noted A « · f , . · n m ormal agreement" also existed b Ch· etween the medical school and Ildren's. had lobbied for a new building on High Street. The Buffalo General Hospital had offered a block ofland on High Street for the new building; others saw what is now the university's South Campus as a more logical site. Some feared that put- l . By 1945, most of the medical school's k c Inical Wor was done at E.J. Meyer. All THE HOUSE STAFF OF MILLARD casesent . h FILLMORE HOSP ITA L, 1 93 1. enng t e hospital, including out. Pallent . ' were available for teaching. Buf- ting the new medical-dental facility near f 1 a o Gen l era treated all types of patients except" , Buffalo General would allow the hospi. mental, contagious and tubercu- tal to dominate it. In the end, the counIosis" . to an evaluation report cil approved the South Campus plan, rrollJ.' thaccordmg A , . c . e MAs Council on Medical Edu- and Samuel P. Capen Hall was opened allon and H . l ospita s and the Association in 1953 (it was renamed Sidney Farber of Am . encan Medical Colleges. Hall in 1974);Sherman followed in 1958. According to council minutes, UB P The relationship with Children's apeared t b h 194 . 0 e t e most solid, the AMA's Chancellor Samuel P. Capen displayed ·· h epresenceof his customary judiciousness and vision a 1. 5snetea msa1·d ,citmgt . laJson · th h commntee representing both in weighing the thorny matter. "He cited ""e ospital and the school that deter- the advantage of cooperation in every .,,Inect t ff w sa appointments. Although there possible way, not only with all the hosas still f th no ormal agreement between pitals with which the medical school llJ.ed· I e h lea sc h ool and the two general now cooperates, but probably also, as b ospitals, the report noted that "mem- time goes on, with a number of others. ers of th ff llJ. ct· e sta are also members of the As he saw it, medical education is just at e leal h 1 "" sc oo and the heads of depart- this moment at the beginning of a large '"ents at h h . te t e ospnal are on the commit- expansion into somethmg distinctly dif! es Which head the din ical departments. " ferent and more popular than it has n 1948 y , ground was broken for a new been in the past. There is an intensive eterans Ad .. Pin mmistration hospital, cap- drive in public interest in better and fo gByears of effort to secure a VA facility more extended medical care." r uffalo. ~~~~~~~~if.~ t What must have been a ense m . eetmg of the UniVersity C on J ounciltook place · une 10 , 1948 , [o IIowlog ct· a period of contentious lscuss· of h Ion on the location . ,s new h t e uni·versny d OllJ.e for its medical and ental schools which had l on · ' lii ~ smce outgrown the · g Street facility Many TH E ST AF F OF B UF F ALO GENERAL IN In the d. . me leal community B UI L DIN G AMPHITH E A TE R , C . 19 38. Medical school dean Stockton Kimball echoed these thoughts. No one hospital would be sufficient for the teaching needs of the university, he contended. Indeed, it was his view that the strength of the medical school lay in the large amount and variety of clinical material available at all the hospitals. By 1950, the medical school had teaching agreements with E.J Meyer, Buffalo General, Millard Fillmore Hospital, and Children's. While there was no formal agreement with Roswell Park, the two institutions were affiliated for teaching purposes. By 1956, extensive clinical facilities were available through agreements-now written-with Buffalo General, E.J Meyer, Children's, and Millard Fillmore, plus an "understanding" with Roswell Park. A 1965 report from a visiting team representing the AMA and the Association of American Medical Colleges noted that the school had since been given full accreditation, but repeated past concerns about "the basic hospital domination of the medical school and the need for strengthening the basic science areas." Following the university's merger with the State UniversityofNewYorkin 1962, there were new layers of complexity to be considered. For one thing, faculty communication was hampered, partly by "the geographic separation of clinical facilities," the 1965 evaluators commented. "''m sure the state did not have an understanding of all these relationships between the medical school and the hospitals," Naughton says. "There was the assumption, at least locally, that the state would build a medical center for UB." Various studies ensued "and a lot of money was spent on the planning ... Somewhere along the line, as I understand it, (UB) President (Martin) Meyerson and Governor Nelson Rockefeller decided that ~ the better place for this <~ medical center would be ~ i: the Amherst Campus and ~ not on the old campus." In g 196 7, plans were an- & g nounced to construct a ~ university hospital on the ~ Amherst Campus, but ll a 0 p y s a 5 p n g 9 �g ,~ . "0 these plans never materialized. "By the time I came here in 1975," Naughton says, "it was pretty clear that the state wasn't going to put another hospital in Buffalo, and therefore that if we were going to survive as a medical school in a teaching community, we needed to develop a different strategy." Paving the way to the modern hospital network were several key reports in the 1960s that urged institutional responsibility for graduate medical education. The 1966 Millis report of the AMA's Citizens Commission on Graduate Education ofPhysicians, for instance, said that teaching hospitals must demonstrate responsibility for medical education through the creation of a medical education committee. They also recommended that an agency be authorized to plan, review, and coordinate standards for graduate medical education. "The formation of the Graduate Medical Dental Education Consortium ofBuffalo in 1983 was really the culmination of an arrangement that had existed in Buffalo for a long time," UB's Roseanne Berger states. "Residency programs were based in hospitals throughout the city, because there was no single university hospitaL A single program actually shared the resources of multiple hospitals, and the oversight of that single residency program would be charged to a particular educator, a program director, but the financial arrangement-as to who would be responsible for supporting the program-became very complicated." By the early 1980s, there were new B u a 0 p requirements for accreditation under the auspices of the Accreditation Council for Graduate Medical Education. "That organization accredits the various residency programs and the various specialties and ensures that each program meets a set of standards that are established by a specialty-specific residency review committee," Berger explains. "In 1982, it required that each program identify a single sponsoring institution. In Buffalo-since the majority of programs were located at multiple hospitals-just deciding who that single sponsoring institution was became a problem. 'This became an opportunity to establish the consortium, and in so doing it pulled the hospitals together around one mission: graduate medical education. A governing structure was then established to create a formal process for the hospitals to work collaboratively for structur- Today'steaching hospitals: The Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital The Veterans Affairs Western New York Healthcare System y 5 c a s ing, reviewing, and thinking about issuE of resident training in the region." Today, the consortium plans and di rects all Accreditation Council residenc and fellowship training in Buffalo aill Western New York. Resident salarie and benefits are equal for each training year level throughout the region and ar paid by the consortium. A second initia tive, the Western New York Health Sci ences Consortium, formed in 1987, i directed toward improving the area' health-care delivery system. Michael Noe, M.D., vice presiden for professional affairs at Buffalo Gen eral, provided key leadership in orga nizing the consortium. "From the be ginning," Naughton says, "Mike and th1 residency training directors furthere1 the understanding of the strength, eco nomics, and improved training qualitj that could come from a single, coordi nated organization committed to share governance." Today, the Graduate Medical Denta Education Consortium coincides wit separate university agreements with th teaching hospitals. Resulting joint en terprises have produced more resideD cies in primary care, regional centers fo organ transplants and positron emi5 sion tomography imaging, and a rura health initiative. Medical school an consortium initiatives are flourishing i biomedicine, epidemiology, and clini cal trials, and the school has receive major funding to expand its generaliS medical education programs. Throughout its history, the medici! school has drawn on a network of affih' ated hospitals to advance its missiofl according to a ugh ton and joyce Vana Ph.D., clinical assistant professor of so cial and preventive medicine. The tW0 collaborated on a recent article in the: American Journal of Public Health. 'This arrangement," they wrote, "ha5 been sometimes divisive and always challenging, with conflicting loyalties an~ allegiances occasionally placing hosp1til service needs before medical educati011. However, mutual tolerance and depefl' dence have also developed. In Buffalo rhC need for collaboration in education, re' search, and service has proved stronger than the drive for autonomy." + p n 9 9 9 �These students were some of the last to study at the High Street university building. By 1949, when this picture was taken, the decision had already been made to move UB to Main Street. PHOTO: UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO Old Alumni Hall was the lecture room in the High Street building. TIAN YEARBOOK, PHOTO : t947 MEDEN ERSITY AT BUFFALO L E R S I T Y ARCHIVES . UNIV �BY .JESSICA ANCKER THE PHOTOS BY DON LONG THING HOURS ELSE EVOLVES ABOUT NEVER CHANGE, MEDICAL CONSTANTLY TO BUT EDUCATION KEEP EVERY- UB AT ABREAST HEUPEL OF NEW TECHNOLOGIES, TREATMENTS AND ATTITUDES. TWO CUR- STUDENTS TYPICAL DAY TO KRISTEN BROUGHT PROVIDE A ANDRESEN, A US GLIMPSE 24-YEAR-OLO ALONG INTO WITH LIFE SECOND-YEAR AT THEM ON UB TODAY. STUDENT, WANTS PRIMARY CARE DOCTOR IN EITHER GENERAL MEDICINE OR PEDIATRICS . WHO GREW UP ON A LONG ISLAND FARM, WILLIAMSVILLE THAT OVERLOOKS A HAS RENTED A A TO BECOME A KRISTEN, SMALL HOUSE IN NEIGHBOR'S PASTURE, COMPLETE WITH HORSES. SHE DOESN'T HAVE MUCH TIME TO ADMIRE THE VIEW, THOUGH . ANY FREE TIME SHE CAN SNATCH FROM HER COURSES IS SPENT PREPARING FOR HER FIRST NATIONAL BOARD EXAMS IN ..JUNE. MOST OF KRISTEN'S DAYS ARE SPENT IN THE LECTURE HALL, AS HAS LONG BEEN TRADITIONAL FOR FIRST- AND SECOND - YEAR STUDENTS. BUT US IS INTRODUCING CLINICAL MATERIAL EARLIER AND EARLIER IN THE T H E �CURRICULUM. KRISTEN'S PATHOLOGY LECTURES, CORRELATIONS DISEASES IN WHICH STUDENTS ARE PRACTICING PHYSICIANS PRESENT RECENT EXAM. IN THE IT'S PROBLEM-SOLVING. THAT ILLUSTRATE THE CHANCE TO LEARN ABOUT PATIENT CARE BY SEEING PATIENTS AT BUFFALO 1 960S AND 1 970S, THIS "INTRODUCTION TO ONE-SEMESTER COURSE THAT TAUGHT STUDENTS HOW TO TAKE A PHYSICAL CASES BY CLINICAL LEARNING ABOUT. SHE'S ALSO GETTING A GENERAL HOSPITAL. FOR EXAMPLE, ARE ROUTINELY FOLLOWED NOW A INSTEAD PRECEPTOR FULL OF YEAR JUST COURSE, WITH LECTURING CHALLENGES HER TO HER TRY AN ON TO HISTORY AND ADMINISTER A EMPHASIS THE MEDICIN~ CLINfCA- c ON CASE-BASED PATIENTS EXPLAIN THEIR SHE COMPLETE LEARNING EXAMINES, SYMPTOMS WAS - A - AND KRISTEN'S AND ILLNESSES. HER EARLY EXPERIENCE WITH CASE-BASED LEARNING AND PROBLEM-SOLVING IS INTENDED TO INTRODUCE HER TO THE SKILLS SHE'LL BE DEPENDING ON IN HER THIRD AND FOURTH YEARS, TRADITIONALLY KNOWN AS THE "CLINICAL YEARS." KEN LEVEY, 24, A THIRD-YEAR STUDENT WHO PLANS TO GO INTO OBSTETRICS, INTRODUCES US TO A TYPICAL DAY IN THOSE "CLINICAL YEARS." KEN, IN THE MIDDLE OF A CLERKSHIP AT THE LUCKY TO HAVE FOUND CHILDREN'S A HOSPITAL OF BUFFALO, FIRST-FLOOR APARTMENT ON COUNTS HODGE HIMSELF STREET, WITHIN STROLLING DISTANCE OF THE HOSPITAL. HIS CLERKSHIP CONSISTS OF THE TRADITIONAL FOUR WEEKS ON A WARD. IN A RECENT INNOVATION, THE CLERKSHIP INCLUDES TWO ADDITIONAL WEEKS IN CHILDREN'S OUTPATIENT CLINIC. KEN IS ALSO PART OF ONLY THE THIRD CLASS WHO WILL SERVE A CLERKSHIP IN FAMILY MEDICINE. HEALTH PRIMARY CARE NOW INCLUDE CARE AND SOME COMMUNITY HEALTH OF THE FUTURE AMBULATORY PROBABLY SETTINGS, EXPERIENCE IN CENTERS. WILL CLINICS, SO DEPEND MOST PRIVATE OF US'S HEAVILY ON CLERKSHIPS DOCTORS' OFFICES OR KEN'S TIME IN THESE SETTINGS WILL PREPARE HIM TO WORK WITH RELATIVELY HEALTHY PATIENTS, IDENTIFY DISEASES EARLIER, AND EMPHASIZE PREVENTIVE HEALTH CARE. IN HIS FOURTH YEAR, AT LEAST ONE OF HIS ROTATIONS WILL BE SERVED ENTIRELY IN AN AMBULATORY SETTING. THESE NEW ASPECTS OF KEN AND KRISTEN'S EDUCATION ARE PART OF U B'S GENERAL PRACTICE INITIATIVE . THE SCHOOL IS IMPLEMENTING A NUMBER OF CURRICULUM CHANGES AS IT STRIVES TO GUIDE AT LEAST 50 PERCENT OF ITS GRADUATES INTO PRIMARY CARE FIELDS. "THE IDEAL FOUR-YEAR CURRICULUM INTEGRATES ALL ASPECTS OF MEDI- CINE, INSTEAD OF TEACHING THEM M.D., ASSOCIATE DEAN TO TEACH PROBLEMS, WANT TO STUDENTS INSTEAD PREPARE IN ISOLATION," SAID DENNIS A. FOR CURRICULAR AND ACADEMIC AFFAIRS. HOW OF TO MERELY STUDENTS ACCESS HOW TO FOR THE KNOWLEDGE MEMORIZE NATURE AND HOW "WE WANT TO INFORMATION. OF PRACTICE AS NADLER, WE IT IS SOLVE ALSO INFLU- ENCED BY AMBULATORY CARE AND MANAGED CARE. THESE ARE THE KINDS OF THINGS THEY'LL NEED TO KNOW AS r~ 0 DOCTORS." + w --------------------~ a 0 p y c a 5 p n g 9 6 �+- B: 1 1 A.M. KRISTEN ANDRESEN PACKS HER LUNCH BEFORE TAKING OFF FOR A FULL DAY OF LECTURES AND CLINICAL CLASSES. ~ 9 A.M. 1 1 :30 A.M. TODAY'S PHARMACOLOGY LECTURER , ..JERROLD WINTER , PH . D., COVERS A WIDE ARRAY OF TOPICS, INCLUDING NEUROLEPTICS AND THEIR SIDE EFFECTS, AND DRUG DEPENDENCE, TOLERANCE AND WITHDRAWAL. WINTER ALSO WARNS THEM ABOUT ILLICIT RECREATIONAL USE OF THE THERAPEUTIC DRUGS THEY WILL HAVE EASY ACCESS TO I N THEIR PROFESSIONAL LIVES. HE CITES THE CASE OF A DOCTOR WHO DIED AFTER A LOCAL SELF-ADMINISTERED OVERDOSE OF ANESTHETIC. "DOCTORS ARE MORE LIKELY TO GET IN TROUBLE WITH THESE KINDS OF DRUGS," HE SAYS. �i- l 1 :40 A.M. "iHe: ME:DICAL STUDE:NTS' COMPUTER ROOM IS C:ROWDe:D DURING THE LUNCH BREAK. FINDING A ~'"Re:e: TERMINAL, PRINTs OUT A KRISTEN QUICKLY EDITS AND REPORT ON THE HISTORY AND PHySICAL OF A PATIENT SHE EXAMINED LAST We:e:K. THE PAPER IS DUE TO BE HANDED IN THIS "'-~'"TE:RNOON. ~'"e:w HER WORK FINISHED, SHE TAKES A MINUTES TO SURF THROUGH HER E-MAIL. t 1 2 P.M. KRISTEN MEETS A GROUP OF OTHER SECOND-YEAR STUDENTS IN THE ATRIUM OF THE NEW BIOMEDICAL RESEARCH BUILDING TO PLAN BOARD REVIEW SESSIONS. THEY ARE CHECKING THROUGH A LIST OF PROFESSORS WHO MIGHT BE WILLING TO GIVE EVENING REVIEW LECTURES. "IT'S KIND OF TOUGH ON THEMTHEY HAVE TO TAKE THE STUFF WE'VE BEEN STUDYING OVER THE PAST YEAR AND SQUEEZE IT ALL INTO A TWO-HOUR LECTURE," KRISTEN POINTS OUT. t 1 2:30 P.M. KRISTEN TAKES HER LUNCH TO A QUIET CARREL AND EATS WHILE STUDYING FOR AN UPCOMING EXAM IN HUMAN BEHAVIOR. �t 3:35 P.M. -+ KRISTEN AND THREE CLASSMATES ARRIVE AT BUFFALO GENERAL HOSPITAL. IN THE OFFICE OF THEIR PRECEPTOR, TALAL BAKI, M.D., THEY DON THE SHORT WHITE COATS THAT MARK THEM AS STUDENTS. BAKI DESCRIBES ONE OF HIS CARDIAC PATIENTS, AND KRISTEN HAZARDS AN EXPLANATION OF WHAT THE PATIENT'S SYMPTOMS COULD MEAN AND HOW THE HEART TROUBLE MIGHT SHOW UP IN VARIOUS TESTS. "YOU HAVE 90 PER- CENT OF THE ANSWER. KEEP GOING, TELL ME THE REST," BAKI SAYS, ENCOURAGING HER TO COMPLETE HER IDEAS. �4:40 P.M. KRISTEN READS ALOUD THE CASE HISTORY SHE PRINTED OUT DURING HER LUNCH BREAK AND DISCUSSES IT WITH BAKI. EVERY TWO WEEKS, KRISTEN GETS A CHANCE TO TAKE A HISTORY AND PERFORM A ON A PHYSICAL BUFFALO GENERAL PATIENT WHo AGREES TO MEET WITH A MEDICAL STUDENT. ON ALTERNATE WEEKS, SHE PRESENTS THE CASE HISTORY TO BAKI, WHO SUGGESTS ~UESTIONS SHE MIGHT HAVE ASKED THE PATIENT, THEORIES ABOUT WHAT IS WRONG, OR BETTER WAYS TO WRITE UP THE REPORT . _, 6:40 P.M. KRISTEN HAS FINALLY ARRIVED HOME , WHERE SHE TAKES A MINUTES TO PLAY WITH HER BLACK LABRADOR , SHADOW, AND FIX DINNER. THEN SHE HEADS TO HER DESK FOR A STUDYING. SON I'M "I PREFER TO STUDY AT HOME. I'M A FEW NIGHT OF BOOK PER- I NEED TO HAVE ALL MY TEXTBOOKS AROUND ME WHEN STUDYING SO I CAN LOOK THINGS UP." + �+- :20 A.M. KEN LEVEY RISES EARLY DURING HIS CLERKSHIP AT CHILDREN'S HOSPITAL. "I GIVE MYSELF A MINIMUM OF FOUR HOURS OF SLEEP. I THINK THAT'S THE ABSOLUTE LEAST YOU CAN GET BY ON. WHEN GET SIX I FEEL GREAT." �6:50 A.M. -+ EARLY MORNING MIST WAFTS BY LEVEY THIS THURSDAY IN FEBRUARY AS HE WALKS TO THE HOSPITAL . HE'S ON HIS WAY TO ONE OF THE INFANT WARDS, WHERE HE'S SERVING A WEEK CLERKSHIP . FOUR- LATER, HE'LL SPEND ANOTHER TWO WEEKS IN ONE OF THE HOSPITAL'S CLINICS TO GET TRAINING IN AMBULATORY SETTINGS. 1 0:00 A.M. -+ MANY DOCTORS AT CHILDREN'S HANG TOYS FROM THEIR STETHOSCOPES OR WEAR GOOFY TIES WHEN THEY ' RE TREATING CHILDREN. "WE'RE TRYING TO DISTRACT THE KIDS FROM THE THINGS WE MIGHT HAVE TO DO TO THEM," ONE PHYSICIAN SAYS. �• • 0 •.40 AM -+ KEN ASKS INTERN THERESA WEGMAN, M.D., FOR SOME ADVICE. THERE'S ALWAYS THE SOUND OF ONE OR TWO BABIES WAILING ON THIS FLOOR, AS DOCTORS AND NURSES CATCH UP ON PAPERWORK AND ORDERLIES PUSH BROOMS AND LAUNDRY HAMPERS. ~ 1 1 A.M. ATTENDING PHYSICIAN FERDINAND YATES, M .D ., HOLDS AN IMPROMPTU LESSON ON DOWN'S SYNDROME FOR KEN AND HIS FELLOW STUDENTS, TIM LIESCHING AND LISA MENDONZA. AFTER CROWDING AROUND THE BED OF A SMALL DOWN'S SYNDROME PATIENT SUFFERING FROM A RESPIRA- TORY INFECTION, THEY RETREAT TO THE HALLWAY WHERE YATES TALKS ABOUT THE MEDICAL PROSLEMS OFTEN ASSOCIATED WITH DOWN'S. ~1 1:20 A.M. KEN TAKES A FINAL LOOK AT PATIENTS, BRITTNEY MOREY, lNG FROM RESPIRATORY ONE OF HIS TINY WHO IS RECOVER- SYNCYTIAL VIRUS !RSV) PNEUMONIA, ONE OF THE AILMENTS ON THE FLOOR. MOST COMMON BRITTNEY IS DOING FINE, AND CHECKS OUT LATER NOON. "WE WANT TO GET HER BEFORE SHE CATCHES OUT OF HERE SOMETHING REALLY BAD FROM ONE OF THE OTHER TO BRITTNEY'S MOM, THAT AFTER· KIDS," KEN EXPLAINS DAWN SMITH. �1 2:00 P.M. ~ KEN JOINS OTHER STUDENTS AND RESIDENTS IN A CONFERENCE ROOM OFF THE CAFETERIA FOR A LUNCHTIME LEC- TURE BY JEFFREY TUCKER, M.D., THE MEDICAL DIRECTOR OF THE HOSPITAL'S POISON CENTER. TUCKER APOLOGIZES FOR THE SUBJECT-INGESTION OF CAUSTIC SUBSTANCES. "IT PROBABLY ISN'T THE BEST LUNCH TOPIC!" BUT HIS LECTURE DOESN'T SEEM TO DULL ANYONE'S APPETITE. �/ 3:00 P.M. -+ A .., 7:1 s P.M. RADIOLOGY CONFERENCE GIVES "USUALLY I TAKE THURSDAY JAMES BACKSTROM , M.D . , THE NIGHT OFF TO WATCH 'FRIENDS,' DIRECTOR OF M Rl, THE OPPOR'ER,' AND 'SEINFELD,' BUT TUNITY TO SHOW STUDENTS HOW TOMORROW I HAVE TO DO A TO MAKE DIAGNOSES FROM PRESENTATION ON VARIOUS IMAGES . 'FAILURE TO HE SLAPS A THRIVE,"' KEN SAYS. HE CHEST X-RAY ON THE LIGHT SPENDS THE EVENING AT THE TABLE AND CALLS KEN TO THE HEALTH SCIENCES LIBRARY. + FRONT OF THE ROOM TO QUIZ HIM . KEN SCRUTINIZES THE IMAGE AND CAN'T FIND ANY PATHOLOGY . "ARE YOU TELLING ME I'D SHOW YOU A CHEST X-RAY? " NORMAL BACKSTROM ASKS . " NO, YOU WOULDN'T DO THAT ," KEN ANSWERS , PUZZLED . BUT THAT'S WHAT IT TURNS OUT TO BE. AFTER THE OTHER STUDENTS LAUGH , BACKSTROM POINTS OUT, "THAT ' S THE HARDEST THING OF ALL , TO HAVE THE CONFIDENCE TO SAY , 'THERE'S NOTHING WRONG WITH THIS PICTURE.' " �1916, WHEN HAROLD REIST WaS finishing his final year at the University of Buffalo, students were required to take one year of arts and sciences courses before entering medical school. Reist would have spent his first two years performing dissections and studying such standard scientific subjects as organic chemistry, physiology and bacteriology. In his third and fourth years, he would also have studied at Buffalo General and other hospitals. This photo was taken by a classmate, Victor Reinstein. BY PHOTO: DR. VICTOR REINSTEIN ALBUM , UNIVERSITY ARCHIVES . UNIVERSITY AT BUFFALO �WITHOUT ITS FACULTY, a school would be nothing more than an assemblage of buildings and labs~ microscopes and machines. The quality of UB's School of Medicine and Biomedical Sciences ultimately resides in the quality of the people who work, teach, and learn here. It was the innovative, forward-thinking doctors and scientists of the past, such as Austin Flint, Roswell Park, and ErnestWitebsky,who made UB a leader in medicine and research today. And it is the young doctors and scientists joining UB and its affiliated hospitals who will continue that tradition well into the 21st century. I. ~. .:.:I /.. _f;gJ . ••::1 we showcase a number of the ·~-- ~B uffalo In this issue of Buffalo Physician, lJlJ\ out~ standing young professionals on our Phys ician Spring 199 6 �faculty Some are practitioners who are turning their everyday experiences in treating disease into research that will benefit thousands of patients lg they will never see. Others are lab scientists whose patience at the bench may Pay off with undreamed-of drugs and therapies. Some are working on such )S, high-profile diseases as AIDS; others focus on problems that rarely touch )'s Americans, such as trypanosomiasis. In this issue, we can profile only a few of the e. innovative young men and women who have Joined our faculty in recent years. We plan to continue the series in future Issues with articles on new faculty to keep our readers in touch with the ever-changing medical school. We hope the articles on the next few ts Pages and in coming issues will demonstrate the range of talent and wide array of specialties that \!viii continue to provide UB's students with the best in medical education n, t~ for years to come. * Photographs J( by e K.C. Kratt 1 " f f a 1 o Physician 9 9 6 ED �in emergency medicine at the Medical College of Pennsylvania. Abrams is now an assistant professor ofemergency medicine at UB and the associate residency director at ECMC. Abrams helps train emergency department residents in fluoroscopy for quick diagnosis of injured extremities, and in telemedicine for long-distance communication. "Ultrasound and fluoroscopy aren't the kinds of things you'd use in every situation. But in some cases they can help you weed out what's serious from what's not," she says. "You take a look at an ultrasound and, boom! you find the bellyache iS caused by gallstones. That's not an emergency situation-you tell h1m he can go home. You st1ck someone's finger under a fluoroJ. scope and f1nd out it's not broken. Fine! That person can go home instead of waiting around for hours while you take care of all the gunshot wounds first." Abrams, who vollltlteered as an EMT while she was in medical school, continues to feel strongly A MAN WALKS INTO an emergency department complaining of about community service. She haS established a clinic for the homea vague back pain. Hours of tests reveal nothing, and soon the less at Buffalo's Friends of the N1ght pain itself disappears. As he dresses to go home, he collapses People shelter. A volunteer teafl'1 and dies of a ruptured aortic aneurysm. of nurses, medical students and doctors visits the shelter two eve"The suspicions we had weren't Ultrasounds are non-invasive, nings a month, providing routine high enough to bring in the radioloquick, cheap and portable, and have medical care to 15-20 people a gists and order up an ultrasound. no side effects. They night. Abrams But if we'd had an ultrasound maare particularly good hopes to enroll chine available in the emergency at picturing fluid build"If we'd had an more volunteers so department this wouldn't have hapup. All these factors she can offer the pened. That's unconscionable that ultrasound make them ideal for services more frehe died," says Barbara J. Abrams, quick diagnoses in quently. "It's a great machine available M.D. (known as Bobbie), as she certain life-threatenopportunity for the recalls the crisis from her residency ing situations, such as in the emergency medical students that led to her cunrent career as aneurysms, ectopic because they get 3 director of ultrasound education in department, this pregnancies, and carchance to take hisErie County Medical Center's emerdiac tamponades. tories and do physiwouldn't have gency department. Her latest research cal exams and start Abrams, 34, is bringing ultrashows that tilting a happened. That's doing some cofl'1sound technology into emergency trauma patient backmunity service. The departments around the country. In unconscionable wards in the T renpatients are also Incourses for the American College delenburg position credibly appreciathat he died." of Emergency Physicians, she trains can help doctors ditive." emergency physicians in ultrasound agnose injuries that Abrams orgause, develops protocols to help involve intraperitonized a similar cliniC them decide when the procedure is neal fluid build-up. atherlastpostin Philadelphia "I saidt0 appropriate, and tailors diagnostic Abrams received her M.D. from myselfthat wherever I go, ifthey need techniques for traumas. Brown University and did a residency a homeless clinic, I'll do it" -:J.A Barba r a Ab r ams , M. D . Adding to the ER's Diagnostic Arsenal * e s u a 0 p c a n s p g 9 �Bumpers , l . Harvey M. D . Ji~s :rJ- doctors and patients are slow to recognize the waming signs of cancer when they appear in younger patients, so the disease in these patients progresses further before it Creating New Models of Cancer in Mice HARVEY l. BUMPERS, M.D., HAS BEEN SO BUSY making breakthroughs Vvith animal models of cancer that he hasn't had time to begin a set of experiments he has been imagining for years-experiments ;e ~s :'s IS. ,d is Hl rn :k that he believes may hold the key to cancer. U .Bumpers, 40, a graduate of the n1versity of Rochester School of Medicine, completed his surgical Internship and residency at SUNY Stonybrook, where he was chief ~esident. He held surgical oncology ellowships at SUNY Stonybrook and Roswell Park Cancer Institute. An · U ass1stant prefessor of surgery at EB, he is an attending surgeon at [; CMe, the VA medical center, Bufpalo General Hospital, and Roswell ark as al ;ly 3.5 e- ;0 e Bumpers has succeeded in growIng human colon polyps in severe combined immunodeficient (SCI D) l'l'1lce. He has also implanted cancerous tissue in such a way that it con· p Slstently metastasizes to the liver. revious researchers treated cancerou s t.1ssue w1th . enzymes or chem·leas I 1n . order to get it to grow lf'lb sites under the skin or in the ae do men. Bumpers found, howVer, that pieces of solid tumor no special manipulation to needed g row· In the mice's gonad fat pads1 ~ fact, he believes that the tumors · ••etastas1ze · because their natural st n ructure and cell components are ot altered. perfonm genetic studies to compare precancerous polyps with cancer, and premetastatic cancers with metastatic ones. He also hopes to evaluate treatments in the mice with cancer. "This is all working so well, I haven't had time to get started on what I I 00 percent believe is the answer to cancer," Bumpers says. "I think the answer will be found in the adhesion proteins in cell membranes. But I have some other work to do before I can look into that." Bumpers has also done epidemiological studies of fisk factors in colo rectal cancer and breast cancer. In both, he found that younger patients had worse survival rates than older ones. He believes that both is diagnosed. A major in the U.S. Anmy Reserves, Bumpers recently created a unique reservist training program at the Buffalo VA medical center. He and several nurses in the Reserves arranged to perfonm surgery on Saturdays at the VA to fulfill the requirements of their drill duty. The arrangement allows reservists who are surgical scrub technicians to maintain their training by regularly helping in the surgery. It has also helped the VA reduce the length of time patients wait for non-emergency surgery. Bumpers also participates in public education on cancer through radio shows, workshops, and mailings organized by churches. "I feel strongly that if there is a possible solution, you should do your best to tell people what it is," he says. "Otherwise, they hear something on the news about cancer, and don't do anything about it." -J.A. * L. (I) u c: 8 In another breakthrough, t Umpers has used similartechniques a- s~lgow human breast cancer in able t mice. "No one has ever been 0 grow human breast cancer lf'l ,•. any animal before" he says "and •ve d ' ' ' th on t know exactly what it is that prevents it from growing. I lf'lklt'sb Call ecause breast cancertypi" y has a lot of fibrous tissue and ••Ot V ery many cells." · new exPe .His sue cess ·1n creat1ng ca nmental models for two kinds of Ofncer has provided him with a lot Pr · OJects to work on. He plans to 0 0 p h ctS u 5 c 0 5 p g 9 9 �A. M chaeI Ca I M. D . g ur Boosting the Immune System with lnterleukin-2 MICHAEL A CALIGIURI, M.D ., is researching new approaches to preventing cancer and controlling AIDS via the immune system. He is also part of an unusual team that develops treatments from the concept stage all the way through the laboratory bench to the patient's bedside. "It's incredibly satisfying to see our own observations translated into a treatment for a patient," says Caligiuri, 40, who is based at Roswell Park Cancer Institute. Caligiuri holds an M.D. from Stanford University and did his internship and residency at Harvard Medical School in Brigham and Women's Hospital in Boston. He did a fellowship in medicine at Harvard, and fellowships in oncology and bone marrow transplantation at the Dana-Farber Cancer Institute. Now a tenured associate professor of medicine at UB, he is a member of the department of hematologic oncology and bone marrow transplants. Caligiuri and colleagues including Zale Bernstein, M.D., recently studied a small sample ofHIV-positive patients and found that daily injections of interleukin-2 substantially boosted levels of natural killer cells, one of the types of immune cells that is decimated by the virus. As a result, none of the I 0 patients suffered opportunistic infections during the 90-day treatment period. The interleukins are part of a class of honmones called cytokines that regulate the growth of certain immune cells. According to Caligiuri, this was the first cytokine trial in AIDS patients. The findings raise the possibility that AIDS could be controlled with daily self-administered injections. The injections would boost the immune system to fight off fatal opportunistic infections, such as pneumonia and Kaposi's sarcoma. "Like diabetes, this would be hormone replacement therapy," says ED B u a 0 p Caligiuri, "but instead of sex hormones, we're working with the honmones of the immune system." Caligiuri is also studying the relationship between compromised immune systems and cancer. People with AIDS and other immune system problems suffer I 00 to I ,000 times as many lymphomas and sarcomas as the general population does. In research on severe combined immunodeficient (SCID) mice, Caligiuri and his colleagues have found that low doses ofinterleukin2 prevent certain lymphomas. The mice are bred to have severely inadequate immune systems, and h 5 c a s can be induced to develop a human-like immune system with injections of lymphocytes from human donors. Humans who are seropositive for Epstein-Barr virus are at high risk of a certain fatal lymphoma; mice who are injected with samples from these humans will be at risk for the same cancer. But with surprisingly small daily doses of interleukin-2, Caligiuri says, the mice were protected from the cancer. Caligiuri also led an international team that recently discovered a genetic defect linked with one common fonm of leukemia, acute myeloid leukemia. The defect was discovered on chromosome I I , and it was already known that many patients with acute myeloid leukem1a have three copies of chromosome I I. The researchers, who include UB oncology division chief Clara Bloomfield, M.D., say it is the first known molecular defect associated with a trisomy. Caligiuri predicts that more molecular defects will be identified and linked with different cancers, opening the way to gene therapies. Much of the research on leukemia. he says, may be performed at Roswell Park, which runs the world's largest leukemia bank. -J.A. * p n 9 9 �J1- J- ·e JS al ,d ~s Michael G. Ca t y' M. D. al a l- ysit ala 1e le Teaching Generalists as a Specialist ra st ~d tDUCATING GENERAL PRACTITIONERS IS A CHALLENGE for special- ists like Michael G . Caty, M. D ., a pediatric surgeon at the Children's Hospital of Buffalo . -s. ~s. a. at l's t.... "To provide them w1th a rTieaningful education, we apply our day-to-day work to their needs," Caty says. . Some of his students are pediatnc surgery fellows who have already ~eceived general surgerytraining and ave chosen pediatric surgery as thew subspecialty. These students need to be taught very specific details of pediatric surgery that will enable them to sue~eed in their newfield. Ut Caty also teaches general surgery residents, the majority of 'Nhom aren't likely to go on to pediatric sur~ery. These students, e explains, need to 1 earn basic surgery Pnnoples and only as much about pediatric surgery techn1ques . th as eymayneed in their Practice. th As the director of C eclin1cal clerkship at hildren's Hospital Caty also trains med 1 ~ cal h students who aven't yet decided on a 0 p h their future. They will leam enough about pediatric surgery to help them decide when to refer a patient to a specialist, and may also spend time in the division's clinic, where they'll see a variety of patients. "You can be a role model and a mentor even being in a different field," Caty says. Caty, 37, earned his M.D. from the University of Massachusetts, and did a general surgery residency at University of Michigan Hospitals, where he served as admlnistrative chief resident. He was a clinical fellow in surgery at Harvard Medical School in the Chiidren's Hospital of Boston. H1s field of pediatric surgery has given Caty a chance to develop a wide range of expertise, because although he specializes in one population, he doesn't limit himself 5 0 5 p to a single type of surgery. One of his specialties is laparoscopic splenectomies, performed on patients with spherocytosis. Because the disorder is hereditary. many of his patients' parents also underwent splenectomy operations when they were young. "The parents vividly recall having big incisions and being in the hospital for a month, and they're very appreciative when their children can have it done with laparoscopy," Caty says. Caty's research has centered on understanding and preventing organ damage caused by ischemia and reperfusion. lschemia/reperfusion damage is often linked with necrotizing enterocolitis, an intestinal infection among premature newborns. lschemia/reperfusion research can also be applied to transplant surgery, because organs can easily be damaged by the interruption in blood flow that occurs during a transplant. Caty's recent experiments on the intestine indicate that histamine produced by the body during ischemia/reperfusion events may contribute to organ damage. His research suggests that drug therapy against histamine could be an effective treatment to help prevent the -J.A. damage. * g 9 9 �Ke v n G b b n s 0 M D Going after Brain Tumors from a New Direction KEVIN GiBBONS , M.D., IS TAKING NEW APPROACHES to neurosurgery and head-injury management. Gibbons, 35, is the director of Millard Fillmore's neurosurgical intensive care unit. He holds an M.D. from Albany Medical College and did his internship and residency at UB. He also did a fellowship in surgical critical care at UB. Gibbons specializes in skull-base neurosurgery, particularly in novel exposure techniques for internal aneurysms, blood vessel malformations, and tumors once thought to be unresectable. These are often benign tumors; that is, in a different part of the body their slow growth and lack of metastases would pose few problems for the patient. But when they are situated deep within the brain, or in bone separating the brain from the face, their pressure on the brain, the cranial nerves, or the cerebrospinal fluid leads to debilitating symptoms or death. Traditionally, surgeons would open up a section of the cranium and push or pull aside the healthy brain to reach at least part of the tumor. But Gibbons says this procedure is often not successful in exposing the entire tumor and can injure healthy tissue, leading to complications such as hemorrhage. infection, stroke, and spinal fluid leakage. Instead, he and colleagues at Millard Fillmore and Roswell Park are entering the brain at the base of the skull or through the face. Using these newer approaches, surgeons are more likely to reach the entire tumor without disturbing or injuring the healthy parts of the brain. Gibbons twice a year teaches 3 . I national course on neurosurglca critical care sponsored by the American Association of Neurological Surgeons. He is working to popularize a change in treatment of traumatiC head injuries and aneurysms. Doctors typically treat strokes and an. ve eurysms by working to 1mpro blood flow to the brain. However. after a traumatic head injury, they' focus on controlling brain swelling by administering diuretics or other medications. According to Gibbons. these measures don't work for very" long, forcing repeated treatment after a day or so. The new guidelines recornmend increasing blood flow and perfusion to the injured brain: regardless of what caused the InJury'· Gibbons recommends ventilating · patients and increasmg cardiaC output through drugs to ·lncrea se blood flow. "The swelling problems may' be worse in the short term, but 1n the long term, they improve more rapidly," he explains. "It's the sarne experience with other organs whefl they are inJ·ured-they do better · st with better blood flow. It has JU taken us a while to realize that the brain should be treated the sarne way." 11 Gibbons was also a part of team that pioneered a new pal~ treatment in surgery for rupture discs. He and his colleagues lrl' serted a naturally degradable mor. 1 s ite phine sponge into the surglca and found that it provided longterm pain control. -J.A· * a 0 p y 5 c a s p n 9 9 9 �e r Carlos Jaen Roberto M.D., Ph.D. ' '/ g :r s. 1 ,t laking the Pulse of a Whole Community ''F AMILY PRACTICE IS LIKE TAKING CARE OF FRIENDS," says Carlos 1\oberto Jaen, M.D., Ph.D. "You have a chance to be close to People at so many important times in their lives. You form a Partnership with them to improve their health or their function . It's a challenge intellectually and at the level of your heart." fil ain -ed inor;ite ngJ.A· th Jaen has made many friends in l e Poor communities of Buffalo's tower West Side, where he prac~ces at the Niagara Family Health lJ enter and directs UB's Center for J ~an Research in Primary Care. ~n, 39, earned . his M.D. and a .D. 1n ep1dem1ology from UB, . ~,amlly . pract'and did h.IS res1.d ency 1n ~~e at University Hospitals of feveland. An assistant professor 0 both family medicine and social :nd preventive medicine, Jaen Perves on the New York State t' Ubi'IC Health Council and the na~onal Agency for Health Care ohcy and Research. Jaen has gained special insight 0 0 p h into the largely Puerto Rican community of the Lower West Side by supervising a comprehensive health survey of the area. The survey, conducted in 1993 and 1994, found high levels of asthma, diabetes, heart disease, hypertension, and other chronic conditions. The researchers also found high numbers ofsmokers-47 percent of the men and 32 percent of the women, compared with a national average of about 23 percent. In addition, they found that barriers such as language, distance, and lack of health insurance often prevented families from getting adequate health care. The researchers also y 5 c o n s p charted beliefs about HIV, use of preventive services, drug use, and experiences with crime. "One reason we were able to get such a high response rate is that our people were very persistent. They wouldn't take 'no' for an answer," he says. His group shared the research with community groups, who in turn shared their own insights and joined the efforts to solve the problems. "The community became empowered," he says. The survey has also spun off new projects for jaen and many of his students. Jaen has won a grant to reinterview the asthmatics in the study population. "Mortality from asthma has been increasing in poor urban communities over the past I0 years. Is it environmental exposure? Is it tobacco smoke? Is it lack of knowledge? Is it poverty? What is it that is causing this problem?" he asks. Jaen also writes columns for Panorama Hispano, a Spanish-language monthly that circulates in western New York. "I pride myself on my ability to make things that are very complex simple. I do that when I do direct patient education in my office, but also in a more public way when I do it in print," he says. "It makes me feel good when a patient comes into my office and says, 'I read your article about smoking.' It's a way of reaching more people than just the ones I can see in my office." One ofhis anti-smoking projects is a survey of how cigarette advertising and promotions are tailored to the inner city. Jaen says that although tobacco companies spent $6 billion on advertising last year, he is not intimidated by their strength. "I follow in the tradition of Don Quixote, I suppose. I have a picture of some windmills in my office that my mother got me when she went to Holland, and they inspire me. I just keep working in my circle of influence and see what happens. I think we have -J.A. right on our side.'' * n g 9 9 6 0 • !.. LL bO c: • �D a v d J a m e s M D task than they may have been Jed to believe." t In Canada, James points ou ' about 50 percent of me d .ICa1 stu- Specializing in Everything DAVID jAMES, M.D., is working to reintroduce a concept as old as professional medicine, and as new as 1990s health-care reform: the family doctor. "My father's family doctor took out his tonsils on the kitchen table, and amputated mygreat-uncle'sanm on that same kitchen table," James says. "The family doctor looked after you from birth and the cradle to the grave." A Toronto native, James, 37, earned his M.D. from the University ofToronto. In the Canadian system, James says, family practitioners are trained in all primary care areasobstetrics, pediatrics, and emergency and internal medicine. In his solo practice in a Toronto suburb, he saw patients in his office for about 44 hours a week, spent another 25 hours in emergency practice, and delivered two to four babies a week. "You're expected to have almost specialist knowledge in every area," James says. As an assistant professor of fam- dents become family practloners· d 11 Underthe country's publicly funde . health plans, pat1ents can 't get free . I.1st un less theY care from a spec1a are referred by their fam1 IYd0 ctor. . es "The family doctor superviS their care, acts as a curator. The . amount of money .It sav es iS remarkable," he says. d James welcomes the pu brIC an . private pressures t hat are driving d this country towar . eon agreaterre I1anc . general practl'tiO' ily medicine and the new medical director of Deaconess Center's family medicine center, James hopes to train a new generation of U.S. doctors in the same wide range of knowledge. He teaches family medicine, low-risk obstetrics, pediatrics, In Canada, about emergency medicine, and a wide range of other procedures. 50 percent of James is also an attending physician at medical students Deaconess and in Buffalo General's emergency and obbecome family stetrics departments. "Part of my job is to practitioners. show students that being a family physician is a much more broad, demanding ners. "General prac~ tice is not seen a being glamorous, the hours are irregular. and you don't rnak~ the same kind o dough, so students tend to go into sp ecialties. But I ber1e ve0 that in five to 1. years everybody iS going to earn a bout the same amounpS the health-care rn ar- ------ - -- ~-~--- e B a 0 p y s a s p n ket changes." * A - J.. g 9 �c. Shahrokh Ph. D. M. D., Khan Fighting Blindness through Surgery and Research SHAHROKH C. KHANI, M.D., PH.D., woRKS ON RETINAL degenerative disorders on two levels- the operating table and the laboratory bench. His primary research interest is in retinal gene therapy; currently, he is engaged in a search for the key to retinitis pigmentosa. Khani, 33, eamed his M.D. and a Ph.D. 1n biological chemistry from the University of Michigan. He was an · 1ntem at Saint Joseph Mercy Nosp1tal in Ann Arbor, Mich., and ~ a residency in ophthalmology at ash1ngton University. He also did fellowships at Harvard Medical ~hool and the Medical College of ISconsin before coming to UB. An assistant professor of ophthalmology and biochemistry, Khani teaches residents and biochemistry graduate students and is UB's director of retina services. Retinitis pigmentosa is a congenital disorder that interferes with the eye's ability to adaptto light and da.L . . Ioss o f '"' caus1ng progress1ve vision that can range from night blindness to total blindness. In young patients, whose only symptom may be night blindness, an electroretinogram can detect the functional problems that signal more severe problems to come. The disorder is also characterized by, and named for, the presence of extra, clumped pigmentation in the ret1na. Because the enzyme rhodopsin kinase helps photoreceptors to adapt to light by catalyzing the phosphorylation of the visual pigment rhodopsin, Khani believes that a mutation in rhodopsin kinase may be responsible for retinitis pigmentosa. As an initial, but substantial, step toward identifying the defect, Khani has succeeded in isolating and cloning the gene and identifying several mutations. Next, Khani's research team w ill try to express the mutant proteins in bacteria or cell cultures and analyze them, then introduce the mutation into a mouse and perform electroretinograms to see what effect it has on retinal response. "Retinal gene therapy is in its infancy. 1 th ink that more and more work wi ll be done in this area," says Khani. Although retinitis pigmentosa affects only a small number of people , Khani believes that the techniques he is establishing will have widespread applications. ''I'd like to find more genes responsible fo r retinal degenerative disorders-particularly age-related macular degeneration, which is the cause of blindness in about 2.2 percent of the population," he says. Even after genetic defects are identified In retinal degenerative disorders, the re are many hurd les that need to be overcome before gene therapy can be establ ished as routine, Khani explams. Unlike the cornea, the retina is re latively difficu lt to infect with the viruses that could be used to transfer genes, he says. Also, when researchers have succeeded In transferring genes to the retina, they have been d isappointed to find that the new genes are not functionally expressed. Because functional gene therapy is so far in the future, there is still plenty of demand for the retinal repairs Khani performs In the operating rooms at Erie County Med1cal Center and Millard Fillmore Hospital. As a vitreoretinal surgeon, Khani uses Iase r treatment to correct diabetic . retinopathy. He is also engaged In clinical trials on the use of high-density periluorocarbon liquids to reattach detached retinas in complex cases. Khani's trials compare the usefulness oftwo ofthe fluids, periluoron-octane and periluoro-n-octyl bromide. The high-density liquids are injected into the eye, where they settle under the fluid in the eye and gently press the retina into its proper place, stabilizing it while scar tissue is removed by lasers. The liquids can easily be removed after the opera- J.A. tion. * a 0 p h 5 c a n 5 p n g 9 9 6 i) �Ro b n S t e nhorn, H. M. D . neonatology department Nitric oxide, which is naturally produced in endothelial cells, was being used for the first time to relax the smooth muscle layer around the blood vessel, and enable an oxygen-deprived baby to breathe. For infants that do not respond to medication, she brought her expertise in heart-lung bypass surgery, which she calls a "safety net" and a "last-ditch effort." The complicated procedure of handing an infant's respiratory and cardiac functions over to machines for five to seven days requires 24-hour vigilance from two professionals, but gets positive results. Saving Newborns Who Can't Breathe RoBIN H. STEINHORN, M.D., HAs MADE A CAREER out of saving newborn infants who are literally blue from lack of oxygen. The window sill in her office at the Children's Hospital of Buffalo is filled with pictures of her now-thriving patients. Steinhom is fascinated by the moment when a baby takes its first breath of air. "Never at any time in anybody's life is there such a dramatic change with such rapidity," she says. In more than I in I,000 live births, that first breath can't oxygenate the baby's blood, and the infant is diagnosed with persistent pulmonary hypertension. These are the babies who are sick enough to qualify for the specialized treatment Steinhom can offer as medical director of Extracorporeal Life Support Services at Children's Hospital. Babies with persistent pulmonary hypertension are brought to Children's via helicopter from all over the state for treatment. Steinhom, 39, got her M.D. from Washington University and did a residency in obstetrics and gynecology at the Bames Hospital Group. She then swrtched fields, completing a resrdency rn pediatrics at the University of Minnesota, where she became an assistant professor of pediatrics. Steinhom also helped develop a program to train doctors, nurses, and technicians in heart-lung bypass while she was at the Variety Club Children's Hospital at the University ofMinnesota Hospital and Clinic in 1986. She brought the program to Children's Hospital of Buffalo. Her current area of research is cyclic guanosine monophosphate (cyclic GMP), a naturally occurring substance that relaxes blood vessels and works in concert with nitric oxide. She hopes that an understanding of how the cyclic GMP system develops naturally will help explain why it fails in some babies. Steinhom came to Buffalo four years ago because she was interested in the pioneering work being done wrth nrtnc oxide in the hospital's Steinhom prescribes passion for one's work. "Have some real excitement about what you are doing," she advises medical students. "I never go to the nursery without thinking about what I am doing in the lab, and I never go to the lab without thinking about the nursery." • She recalls her false start in obstetrics. ''After my first year of training I realized that I was more interested in the babies than the mothers." She was particularly intrigued by the blood vessels in infants' lungs. which can be manipulated in anumber of ways after they are bom. "It aroused the scientist in me," she says. Steinhom calls the examination of blood vessels and cyclic GMP her main contribution to medicine, and hopes the future holds not only a cure for persistent pulmonary hypertension but also a way to prevent it LL (]) .c. 1- * -BT a 0 p h c o n s p E !rN g I T. joHN 9 K ELL 1 9 �>(- Stephen in T e ach, J . M. D. Jr :h s!d lo Diagnosing Bacteremia in Febrile Children UP TO ·e IS PERCENT OF THE CHILDREN who come to a pediatric emergency department present with nothing more than a fever. But their diagnosis can be as innocuous as a cold, or as serious as meningitis. '0 ·e •P S, ;s b ric n ;- h n IC ill e )- s. 1t n b )- 1- 1- d 5, 1:' It e ,- c t J Polymerase chain reaction (PCR) technology, which has been used for years in laboratories to replicate DNA and create samples large enough to identify, will soon move into the hospital and become a speedy alternative to cultures, Teach predicts. PCR could identify a disease in 3 to 6 hours. "It will begin the molecular triage of sepsis," he says. PCR diagnosis will improve treatment by Doctors must quickly determine Which of the feverish children are suffenng from occult bacteremia, the bacterial infection in the blood that precedes and can blossom into a full-fiedged disease, such as a urinary tract infection or meningitis. Current culture techniques, wh1ch rely on watching the growth of bacterial colonies from a blood sample, can take from I 2 to 72 hours to diagnose bacteremia. Children who appear to be at risk are not only started on antibiotics but often hospitalized for the entire time 1t takes for the culture to Prov1de an answer. "The approach to that complaint hasn't really Changed in years, and I believe it is about to change," says pediatrician Stephen Teach, M.D., a clinical asSistant 1n pediatrics who specializes 1n ped1atric emergency medicine at the Children's Hospital of Buffalo. Teach, 40, earned an M.D. from Narvard University and a master's degree in public health from the University of California at Berkeley. l-ie did a residency in pediatrics at Children's Hospital of Boston, and Vvas a clinical fellow in pediatrics at Narvard Medical School before com1ngto UB as an assistant professor of pediatrics and emergency mediCine. accurately identifying the small percentage of feverish children who are suffering from a serious illness. It will also help hospitals cut down on costs by shortening the length of inpatient stay. Many hospitals are already building "short-stay" units designed for treatment ranging from a few hours to a full day. PCR will be particularly valuable in identifying bacteremia because the various organisms that cause bacteremia are well known. "You can't just screen for everything. You have to know what infections are epidemiologically likely to be present in this patient, and for bacteremia those bacteria are well described." PCR is already used at Children's Hospital to identify herpes, pertussis, HIV, Lyme disease, and some other diseases, Teach notes. "This will just be an expansion of an existing technology," he says. 'k - J.A. Teach's research into fever among children has shown how ~ifficult bacteremia is to identify. or example, in a 1995 paper, he demonstrated that one of the standard observation scales for classifying fevers 1s not very useful for children under three years old. "This is where I think we're go 1ng to see the world of molecular d1agn ost1cs · enter 1nto . the world of ambulatory pediatrics," Teach says. a 0 p h y s c o n 5 p g 9 6 6) • �their livestock, so that even if people do settle there, they can't support themselves. And then it kills the people as well," Williams says. T rypanosomes have a number of unique adaptations that make them particularly tough to kill or immunize against. They easily elude the human immune system because they change the glycoproteins. in their coat as antibodies recogntze them. The constantly changing coat makes it next to impossible for the immune system to recognize them as invaders. w No reen I I T rypanosomes also have an unusual genetic structure. The organism's genes are shorter than needed, so in order to express functional proteins, the trypanosome edits its own genes, spltctng togetherthe necessary components. a ms , p h. D. Williamsisfocusingherresteabr~ SLEEPING SICKNESS IS A DEVASTATING DISEASE endemic to Africa and on the organism's energy me a . Iism, which is also unusual. Leamtng more about what distinguishes trypanosomes' biochemistry from that of the cattle and humans it infects could lead to a drug that will target · h no efand kill the protozoan wtt Battling Parasites with Molecular Biology South America that saps strength and induces fatal comas in people and cattle. The key to fighting it may be to block the metabolism of the tricky parasite that causes it, according to microbiologist Noreen Williams, Ph.D. "It gives me some satisfaction to be working on this disease," she says. "It's a disease of developing countries, and so it hasn't been the focus of much research. The countries where it's endemic don't have many resources, but that doesn't make them any less cycle in the tsetse fly. It infects the insect's salivary glands and is injected into cows, antelope, or people as the fly bites them. The trypanosome thrives first in the bloodstream, then-over months or years-invades the lymph nodes, the heart, and the central nervous system. If important." Williams, 40, holds a Ph.D. in biochemistry and molecular bioiogy from New York University. She did postdoctoral work at The johns Hopkins University and was an assistant professorwith the Uniformed Services University of the Health Sciences before coming to UB in 1992. An assistant professor of microbiology, Williams is also the di- quickly identified, the disease can be cured by drugs. If not treated before it reaches the central nervous system, sleeping sickness leads to headaches, confusion, lassitude, coma, and death. An East African strain moves more quickly, often killing through congestiveheartfailurewithinweeks or months. A closely related illness in South and Central America is called Chagas' disease. rector for microbial genetics and "It's a severe problem in devel- physiology. The parasite that causes sleeping sickness, trypanosoma brucei, is a protozoan that lives part of its life oping countries. The tsetse fly breeds in water, meaning it lives in the parts of a country that would be good places for people to live. But it kills G B a 0 p 5 c a n 5 feet on the host. .. 1 "We're looking at the cnttca 't to enzymes that are necessary ~,or 1 survive. If you knock them out, you 'd knock out the organism," she says. Williams is particularly interested tn an ATP synthase that helps the trypanosome generate A TP for.''tS energy requirements. Compltcattng the research is the fact that trypa. rn nosomes change their metabo 1IS as they move between their insect and mammalian hosts. In a recent paper, Williams and her colleague~ identified an inhibitor pepttde tho apparently helps regulate ATPase function. "Modern biochemical approaches are new to parasitolog}'• · 1tg ht and they've helped .1t JUmp years in the past I 0 years," she says~ "It's a microcosm of what '.: hap pening in science in general. . Williams is also entering into t~ new collaboration to study plan that are chosen-apparently for medicinal purposes- by animals like chimpanzees and gonl.I as. Sh e Plans to help test substances firom thef plants on the "tryps" in the hopes 0 finding new leads to a cure. * -J.A· p n 9 9 �"The real lady is as much out of place in the practice of medicine as in a regiment of dragoons. " So ran an editorial in the Buffalo Medicaljournal in 1857. But by 1880, l3 regular medical colleges around the country admitted women. The University of Buffalo was one of them, having graduated its first woman, Mary Blair Moody, i.n 1876. By 1912, when these medical students were photographed in the library, it was not uncommon for women to make up about 10 percent ofUniversity ofBuffalo's graduating class. PHOTO : UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO /cfcf:?l The university was also progressive in admitting black students. Early records do not list race, but a number of black students are known to have graduated in the 19th century. joseph Robert Love, class of 1880, is believed to have been the first. The second, Cornelius Nathaniel Dorsette, was rejected by the University Medical College of New York City because of his race before being accepted to the University of Buffalo. Pictured here wi.th his class in 1882, Dorsette became Booker T. Washington's doctor and a founder of the National Medical Association. PHOTO: UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO �Medicine o t WHAT DOES THE FUTURE HOLD FOR MEDICINE? A procedure to lengthen life indefinitely?The eradication of disease? Genetic manipulation to create the perfect human being? Members of the UB community don't think so. Instead, they believe the next 50 years will bring little change in disease, and continuous progress in technology and treatments. What will change quickly and dramatically, they predict, is the profession of medicine as it is buffeted by social, political, and economic forces. Their speculations, which are presented on the following pages, were summed up by Gerald Logue, M.D., chief of staff at the Buffalo VA medical center. "If you look at the last 50 years in medicine, we've made enormous advances that you couldn't possibly have predicted. That's probably going to happen in the next 50 years as well. "Nevertheless, the diseases will always be there. We may alter . . . . some presentations, and there may be a few new viruses. But people 0 have a finite life span. Even if we eliminated cancer, it wouldn't extend 0 life span very much.There are factors that are age-related that aren't disease-related. m z < > ,0 ~ "Violence and war will probably still cause trauma and longlasting effects," he concluded."We're much more likely to look back in 50 years and be impressed with man's inhumanity to man than with nature's inhumanity to man." The top worry for all our respondents was the economy of health care-how it will be affected by spiraling costs, managed care, changes in Medicaid and Medicare, and politically driven systemic reform. Almost all of our experts predicted some type of universal health-care system, either public or private, in the near fui:tJre.Thomas Rosenthal, M.D., chairman of UB's Department of Family Medicine, 1 9 9 6 �uture ( PHOTOS BY FRANK CESARIO ) was optimistic that economic pressures would result in some improvements in care-a return to family medicine, for instance. But many of our respondents had more worries than hopes, fearing losses in doctors' traditional autonomy and in quality of care. Susan Regan, a prominent health-care attorney, summed up the topic of health-care financing for us, also touching on issues of market competition and tax reform. Another topic of concern was drug resistance in disease-causing organisms. jerome Schentag, Pharm. D., provided hope for the future in his discussion of the issue, pointing out that while discovering new drugs will help, changing the way doctors use existing drugs may do even more to fight the problem. Two bright views of the future were provided by David Ellis, M.D., who discussed the burgeoning field oftelemedicine,andAian Lockwood, M.D., who talked about the emerging possibilities of modern imaging technology. Both felt that their specialties have the potential to bring progress to medicine: imaging by discovering new information, and telemedicine by disseminating information. james Nolan, M.D., speculating on the future of medical training,thought that greater demand for primary care physicians may lead to a new system in which almost all medical school graduates enter generalist residencies. He also speculated that the cost of residency training may in the future be shouldered by the public sector: f Medical ethics specialist Stephen Wear, Ph.D., offered a thoughtful look at the moral ., aspects of medicine. He believes that it is poor communication between doctors and patients that causes many of today's ethical tussles. Although these may melt away as doctors change their attitudes, he anticipates that there will always be new problems. Finally, 5 Wear wasn't the only member of our panel who was concerned that cost considerations, rather than medical ones, might begin to constrain care. e u 1 1 a 1 o Ph ys l cla n 5 p r I n g l 9 9 6 �---- T ( H u T u - R 0 GERALD L . LOGUE , M . D . , ON MEDICINE . M D ----··- -- c - N ) The future will change how • practiced IS DISEASES OF THE FUTURE WON'T BE appreciably different from today's, but the practice of medicine will change radically, accordingto Dr. Gerald L. Logue's peek into the crystal ball. Logue says that because recent research has brought breakthroughs in understanding the genetic basis of cancer. breakthroughs in cancer therapy may be only a few years away. "We're going to see a tremendous reaping of benefits ofthat research in the next five to I 0 years.'' However, advances in treating other problems, such as cardiovascular disease, substance abuse, and environmentally triggered illnesses, will probably be incremental ratherthan revolutionary. 'We'll just keep chipping away." says Logue, chief of staff at the Buffalo VA medical center. What will change more radically. Logue predicts, is the way medicine is practiced. Burgeoning health-care costs and politically driven systemic reform will change how doctors pract1ce mediCine, and who pays for it. Obvious changes surround1ng the advent of managed care include more ambulatory care, and more control by payers and less by doctors. Logue also predicts greater cooperation between doctors and other health professionals, such as nurse practitioners, nurse-midwives, and physician assistants. primary care can be delivered by these other professionals, he notes. He also predicts a change in the way doctors use the tools of their trade. "We are slaves to our technology. Our technology is way beyond our ethics, or our methods of using it," he says. Because life-prolongmg technology IS available, doctors and families tend to use it on patients even when the patient's uality of life is poor and there's no hope of recovery. "It isn't !e right thing to do," Logue insists. "We're at the mercy of our ·::ome technology-we love it, we idolize it, we worship it." Logue hopes that this will change as doctors become more educated, and as more patients are urged to appoint health-care proxies and make advance-care directives. The change will be driven not only by concern for skyrocketing costs but also by a desire for better and more rational health care. "We will have to tum around our technology-driven health-care system," he says. "But we'll also have to be careful that we don't head back into a dark age of medicine where we don't offer that care to anyone." Even with federal aid, training residents drives up costs at hospitals. In an increasingly competitive market, hospitals may . . become unwilling to continue foot1ng the bill. In other countries, graduate medical education can be funded through a tax on health care, but America's political cl1mate makes that approach unlikely here. ''I'm not sure who 1s going to end up pay1ng for it," Logue admits. . Logue sees future research funding coming more from the pnvate sector and less from public sources. He also says that there's ~goo~ chance ther~.will be fewer students going into pure research. They re not dumb, he po1nts out. 'They look and they see that in the future, there's not going to be as much money." The "baby boom" demographic increase in the number of the elderly, plus rising costs and continuing fragmentation and mobility ~f fam11ies, ~ill cause a crisis in care for the elderly, Logue predicts. Everybody s go1ng to want to go into nursing homes and no body's going to want to pay for it," he states. "This is not really a medical problem, but s1nce 1t gets paid for out of the same pot, it will end up be1ng a problem for medicine." _ J.A . s p n g 9 9 6 �T u H T 0 R M N D DAVID G. ELLIS, M.D., ASSOCIATE DIRECTOR of the emergency department at Erie County Medical Center, is at the vanguard of sharing med1cal data, expertise, and protocols using personal computers and videoconferencing-an emerging technology called medical informatics, ortelemedicine. "Every specialty is going to look at this and apply it," he predicts. Computer- ( DAVID G. ELLIS, M.D., ON MEDICAL INFORMATION TECHNOLOGY ) ized protocols and video link-ups are the future as surely as managed care is, he believes; in fact, telemedicine will be inextri- Com put e r s w iII cably linked with managed care in the name of efficiency. The goal of informatics is to organize information so it can be shared by doctors and other medical staff in numerous, widely separated locations. The system will enable professionals to share information about specific patients, as well as protocols concerning entire classes of patients. Ellis hopes it will make treatment as efficient and uniform as possible in a manner cons1stent with the latest literature and practice, and in keeping w1th the goals of managed care. "The goal of the new medicine IS to keep people 1n the best health at the lowest cost, preferably at home," he says. Videoconferencing helps doctors and hospitals make scarce expertise and resources available over a larger geographic area. With a v1deo camera wired to a personal computer, doctors can examine a pat1ent and consult with each other even if they are miles apart. As an example of the possibilities, a new distance education room 1n the Health Sciences Library at UB's medical school allows nurse-practitioner students in the town of Olean to attend class in Buffalo without physically making the trip. Ellis is also pioneering the use oftelemedicine at the Erie County Holding Center and the Attica Conrectional Facility. T elemedicine makes its possible for doctors at ECMC to examine prisoners at Attica and consult with nurses at the prison without any of the financial, security, or time concerns that anse when prisoners are transported. The telemedical examination at the prison takes a few minutes, while the round trip from the hosp1tal would take several hours. And because the patient isn't taken out of the prison, there's no security risk. Even the prisoners like the new arrangement. Ellis has found that prisoners would rather get qu1ck emergency care in the prison than be taken to a public hosp1tal in shackles. Ellis's vision of the future includes doctors connecting to a medical Internet through their personal computers, or joining doctors from the community on virtual grand rounds without leaving thew respective hospitals. T elemedicine will keep doctors cunrent, curb feelings of isolation, and aid in the development of consistent clinical pathways and protocols, he believes. In his own field of emergency medicine, Ellis dreams of ultimately eliminating the Waiting room altogether, instead collecting registration and medical information through portable computers at the patients' bedsides While they are being treated. Ellis stresses that while technology will help establish consistency in practice, it willnever eliminatetne art of medicine. Medicine will always require flexibility because patients, diseases, and computers are not completely predictable. However, protocols can shorten e 0 0 p y 5 0 medical communication length of stay, reduce costs, and improve survival rates. Doctors should considertelemedicine a tool "just like a stethoscope," he says. "This technology is no longer a big deal. The real challenge now is relationships. This presents new ways for people to deal with each other." Technology will not replace primary care physrcians, either, he notes. It will merely enhance their capabilities. Consequently, Ellis is not worried that medical students win resist informatics. As an assistant professor at UB, he has found this generation of students computer-literate and cognizant of the value of technology. "Even doctors trained before the advent of personal computers are learning more about computers and reaping the rewards of more efficient practices," he says. - BY ERIN ST. jOHN KE L LY 5 p g 9 9 6 �u H T T u ( D M 0 R N Medical imaging will bring to medicine ALAN H. LOCKWOOD, M . D . , ON MEDICAL IMAGING NEW WAYS OF iNTEGRATING INFORMATION will make medica\ imaging nd new technologies will make 1t cheaper and more morepowe rfiul . a . 'bl d'cts Alan H Lockwood M.D., director of Pos1tron access1 e, pre I · ' Emission Tomography (PET) Operations for UB and the Buffalo VA medical center. . . . PET , one of the newest imaging technologies,. will be Invaluable .h in studying diseases and abnormalities-espeoally ones w1t out · tom·1cal manifestations-because 1t measures chang1ng 0 bV\OUS ana . · 1 · 1 processes such as blood flow and glucose metabolism. phys1o og1ca · f . ood explains in some cases o Intractable For exampIe, Lockw .' . ·1 magnetic resonance 1magmg (MRI) and computed ep1epsy, · · B 'd ·fy· reveal no anatomical abnormalitieS. y 1 ent1 1ng tomograp hY(CT) underactive regions of the brain, however, PET scans can find the locus without the hazards of more invasive methods. PET will also lead to steady progress 1n leam1ng about normal, · 1 av he believes Because 1t can measure blood flow I hy phys1o heat obt' · to various sections of the brain, PET is an ideal tool for finding out how the brain performs everyday yet still mysterious tasks, such as thinking and talking. Lockwood and his colleagues have already begun PET studies of people as they process language. "We'll begin to see the neuroanatomy of language production," he predicts. "One of the future developments in PET technolo'6f is going to be the fusion of physiological information with other sources of data," Lockwood says. Computer programs to integrate and superimpose PET scan information with MR\s already help doctors locate the site of a physiological abnormality with precision, he says. Further progress will be made by combining PET, which records events lasting about one minute, with electrophysiological methods that work on a fraction of that time scale. The combination will show how various brain regions work together to perform tasks such as talking and reading. Lockwood says it's unlikely that PET imaging itself will change much. ''I'd say we're pretty close to optimal in that technolo'6f." Instead, he believes, the invention of new radiopharmaceuticals will expand how PET is used and make PET technology more widely available. New tracers to study the brain, the heart, and the origin and spread of cancer are on the horizon. Lockwood also says less expensive tracers will be developed that will be widely distributed and used in existing primary care facilities. For example, a new generation of tracers can be used in Single Proton Emission Computed Tomography (SPECT) machines. These machines are often available in community hospitals and outpatient facilities that cannot afford PET systems. Regulatory barriers will also fall as a consequence of the work done in PET centers like the one in Buffalo, Lockwood predicts. Currently, the U.S. Food and Drug Administration classifies PET radiopharmaceuticals as experimental because their short half-life makes it impossible to subject them to the kinds of testing required for most drugs. Although PET studies are expensive, they are far less costly and hazardous than other alternatives such as exploratory surgery. That means PET can be used to help physicians decide on treatment options. Buffalo is the home of a unique committee made up of physioans. hospital administrators, and insurance companies that is establishing guidelines for the use of PET in the clinical setting. According to Lockwood, this makes Buffalo a leader in facing the challenge of determining how to use PET and other imaging technologies in ways that are sound both medically and economically. - J·A · B U a 0 p h y 5 a n 5 p n g 9 9 6 �T u H u T H 0 R D ( N ( JAMES P. NOLAN, M.D ., ON RESIDENCY EDUCATION ) Residency training will create more :1 tt s. s, tg .0 :Jf ys \. RESIDENCY MIGHT CHANGE SUBSTANTIALLY in the future, with most residents heading for a generalist education and a small number choosing super-specialties, according to James P. Nolan, M.D., immediate past chairman of the Department of Medicine. Residency training will need to reflect the medical community's increasing emphasis on primary care, says Nolan. Primary care skills will need to be taught from the first year of medical school, and residency training will need to develop into more of a continuation of medical training. It could even be that most young doctors will go through one generalist residency, instead of selecting specialties. T rain1ng will be very different for the m1nority who choose specialties, Nolan believes. "Those who do choose to enter the more technical aspects of med1cine probably will see their education differentiate in the third year of medical school, and they will go on to a highly specialized residency after that. he says. Specialist residencies will become much more focused and narrow, he believes. For example, radiologists could become wedded to one imaging technology. "We also will see changes in managed care and the way we've originated that system," says Nolan, who expects to see a universal health-care system like Great Britain's. Inpatient care will decrease as hospitals focus on the sickest patients. Most health care, Nolan predicts, will take place in ambulatory settings. And while there still will be a need for critical care doctors, Nolan said, residency training in the future will become more heavily oriented toward preventive care and wellness. "I think we also will see norms of treatment become similar for all physicians, and variations from treatment guidelines will have to be justified," he says. These care guidelines will be implemented to 8 0 0 p h 5 c a achieve efficiency, cost-effectiveness, and universality of care. The downside, he wams, is that physicians may have less discretion in terms of treatment. The roles of different types of health-care professionals will be undergoing a change, Nolan believes. "I think we will see a blurring of the roles of physicians, nurses, pharmacists and other health-care providers. I think we will see more working as a team, and blending certain aspects. For example, prevention and counseling will be emphasized across the board for all practitioners," he says. UB already is working to meet the needs Nolan sees developing. ''Moregeneralistskillswill be taught to students earlier, and that's what we're doing now," he notes. But medical educators will need to do even more to facilitate the changes he sees on the horizon. Medical schools, Nolan says, need to develop more ambulatory sites and clinics throughout the community that are staffed by university and clinical faculty. "We have not been able to use physicians' offices as much as we'd like. We still find that most tra1ning is in the inpatient setting. We've got to find the resources to move out into the community." Residency will likely become more a period of education and less a term of work. "The service component is decreasing now. Residents are not providing the same amount of service that they once were required to. The education of residents is being stressed much more than it has been in the past." That may lead to a change in the way residency training is funded. Residents are now generally on hospital payrolls, so their training is paid for by patients and thirdparty payers. If residency becomes more education-oriented, that cost may be picked up by the government, Nolan explains. - BY CHRISTINE VIDAL n 5 p n g 9 9 6 �~~~~~-- I u H T u -~·-·----~- - R 0 M D N the family doctor, a narrowing of the salary gap between specialists and generalists, and a smaller role for the hospital as more routine care is performed in ambulatory or home settings. Although she believes that managed care can bring new efficiency, she does not think it will miraculously erase the high cost of care. "Medicine is always going to be labor-intensive, and it's always going to take a long time to train doctors and other professionals,'' she explains. "And it's always going to take time for patients to respond to treatment ( SUSAN G. REGAN ON HEALTH CARE FINANCING ) Competition, not regulation, will and get better. No matter how much you pay the cellist, it takes the same amount of time to play the string quartet. "We will have to develop a better sense of distributive justice," Regan says, pointing to the current lack of service to the poor and to people in rural areas. "It's a form of rationing, but it's not based on any legitimate reasoning~ it's either how much you can pay, or the cost of health care THE COMING REVOLUTION IN AMERICAN health care will create a system that is vastly more efficient and, ideally, more fair than today's, says Susan G . Regan , a member of the New York State Public Health · · E · Council. Regan, who is also a member of UB's Center for Clin1cal th1cs and Humanities in Health Care, is an attorney who regularly lectures at the medical school. She heads the health law department at her firm of Magavern, Magavern & Grimm, which serves as counsel to a number of hospitals and health care prov1ders. . R Pred icts that the country will reshape 1ts health-care egan k "I h system through market forces, not government ta eover. n t e next 1 0 to 1 S years, we'll have a strong, deliberate movement toward competition in health care," she says, po1nt1ng out that a New York State government task force recently recommended that ·t 1 begin to negotiate reimbursement rates w1th all payers. h osp1 as · · b 11 Under this plan, not only health maintenance organ1zat1ons, ut a third-party payers~including Medicaid~would negot1ate payment rather than follow rates set by the state. These are the k1nds of measures that will likely begin to bring costs down, Regan bel1eves. "This will undoubtedly cause some problems, but overall 1t will lead us to greater efficiency. The days of the planned economy in health care are gone," Regan says. She does believe, however, that the nation'straditions of consumer protection will probably lead to some government supervision ofthe emerging system. "We may well dec1de that we need regulation a~ a balancing force, just as we discovered the need for ant1trust laws, she notes. "In the future, we will also reexamine how our tax policy contributes to our problems," she predicts. For example, current law subsidizes employer-provided health care by allowing employers to deduct the insurance they provide their workers; yet it does not force all employers to provide health insurance. The result is that people who get no insurance from their jobs indirectly subsidize those who do~the government collects the full amount of taxes from the uninsured, and uses that money, in part, to give a tax break to companies that provide health insurance for their workers. Regan agrees with the many observers who forecast a return to B 0 0 p h s whether in your town there happens to be an orthopedic surgeon." At the other end of the scale, she observes, a few people at the end of life receive far more care than they want or can benefit from. Concerns about cost and about good medical care will necessitate a more rational system of distributing care to those who need it. There is a serious risk that managers may try to save money by cutting back on needed services, or that doctors will be overly constrained by cost considerations. We have not yet found ways of avoiding those dangers, according to Regan, but it is essential to do so ifhealth-care reform is to succeed and make Americans better off "Our country is unique in that we have enormously creative thinking in the insurance industry and among health-care providers, so I can't help but think we'll come out of it with a better system," she states. ~J.A. c 0 5 p 9 9 9 �T u H T u 0 R M c 0 N ( THOMAS ROSENTHAL, M. D ., ON FAMILY MEDICINE ) M.D .. CHAIR oF UB's Department of Family MediCine, believes that the future of primary care is the future of medicine. "Primary care is going to reemerge as the base around which we build our health-care system, the same as it is now in every developed country with national health insurance," he states. "Family doctors have been managing the care of the family for centuries." Rosenthal himself practiced for eight years as a family physician in the farming community of Perry, NY. He became medical director of Buffalo General Hospital's Department of Family Medicine in 1986. He helped establish UB's DIVISIOn of Rural Health in Cuba, NY, and its residency program in rural health. Rosenthal was also the founding director of UB's Primary Care Resource Center. Managed care and the need to control costs are strong incentives to return to the model of the family doctor, Rosenthal explains. He expects to see health care move toward some sort of national insurance system within five years. As primary care becomes more important, Rosenthal says, schools will have to produce more generalists. "Medical schools will have to focus on producing 50 percent oftheir graduates who go into primary care careers. We will have to model primary care as the exc1t1ng career it can be." Rosenthal also predicts a move toward decentralization. "More medical education will have to occur in the communities, and less in hospitals,'' he says. Decentralization will make care more accessible. People will be able to see doctors in nearby clinics, or have phone consultations, or even receive home visits. The result will be earlier detection of disease, and better prevention and management of chronic illness. Hospitals will care foronlythe sickest patients. "If we improve the access to quality primary care, we'll see fewer admissions because THOMAS RosENTHAL, they will have their illnesses better managed in an outpatient setting. This has already been proven." Hospitals will therefore specialize in caring for advanced and complex disease processes, and incurable, terminal illnesses. Doctors will have to receive better training in pain management and end-of-life decisions, he says. "These are issues thatfamily practice residencies have always stressed,'' he adds. "We'll need at least as many hospital beds as there are today because the population will be larger, but we will need fewer beds per thousand people,'' he predicts. "However, the cost per day will probably go up." It is possible, Rosenthal says, to provide better and cheaper care without cutting back on the amount of care. "Managed care gets around rationing health care because you make wise decisions and treat people appropriately,'' he explains. "You make a decision based on a history and knowledge of a patient and their values, saving the lives of people with the potential to return to a reasonable state of well ness rather than prolonging the lives of people for more suffering." Technology presents its own set of problems, Rosenthal observes. Medical practitioners will have to decide whether technological advances are saving lives or merely prolonging suffering. "That's a real tricky, difficult question that we've put off answering." For example, imaging and advanced tests have made it possible to detect prostate cancer earlier than ever, but there's still no consensus on what to do with that knowledge. Surgery and other aggressive treatments may save some lives, but sometimes the treatment causes unwelcome side effects and does not prolong life. A second stage of research is needed to determine how best to treat prostate cancer, says Rosenthal. -BY CHRISTINE VIDAL The future . . of medicine IS In care B a 0 p h y c a 5 p g 9 9 6 �T u H u T R 0 M D ( N JEROME J. SCHENTAG , PHARM . D ., ON PHARMACEUTICS DISEASE ORGANISMS ARE BECOMING RESISTANT to drugs faster than drugs are being developed. In the next five to _1 0 years, doctors will see increasing numbers of patients dying from 1nfect1ous diseases such as pneumonia. But pharmaceutics professor Jerome j. Schentag, Pharm. D., he d oes n't believe this crisis spells the end of med1c1ne. .Instead, . believes that doctors will find better ways of using ex1stmg drugs, d that research will focus on boosting the immune system to an . . .. take over the fight against disease. "It's not a hopeless SJtuatJon, bugs were laying their strategy. They came back in force." Although the imminent crisis has spurred new research, experience shows that it takes an average of seven years for new drugs to progress from the test tube to the patient. 'There isn't anything in the pipeline now that looks like a miracle drug. We are getting new drugs, but they're mostly knock-offs of things we already have," Schentag says. Two classes of powerful broad-spectrum drugs developed in the 1980s together make up 50 percent of the antibiotics sold today. The third-generation cephalosporins attack bacteria by inhibiting key reactions in the cell walls, while the advanced fluoroquinolones interfere directly with bacterial DNA. "What we need, frankly, is another one of those advances," Schentag says. he says. . . "Five years ago, it looked like we were w1nn1ng. The bugs were on the run," says Schentag, who is also the director of Millard Fillmore's clinical pharmacokinetics lab. "The pharmaceutical industry pulled back a little, started investing in other areas. Meanwhile, the Hospitals are beginning to address the problem by finding better ways to use the antibiotics they have. Most hospitals save money by buying drugs in bulk and then using up their supply, but according to Schentag, using the same antibiotic over and over in the same setting helps breed resistant strains even more quickly. Instead, Millard Fillmore and other hospitals are beginning to rotate antibiotics every few months. They are also paying closer attention to dosing by testing patient cultures for resistance and boosting dosages in some cases to kill slightly resistant strains before they have a chance to develop higher resistance. In the long term, medical research will concentrate more on active and passive immunity, Schentag believes. That may include attempts to create immunoglobulins that are specific to certain diseases instead of the general ones in use now, as well as bacterial vaccines like the one against Hoemophilus in~uenzoe that helps prevent pneumonia and meningitis. In the short term, however, only changes in drug use can slow the development of drug-resistant bacteria. A simple thing like instant diagnostic tests could allow doctors to determine bacterial strains and prescribe very narrow-range drugs. More important, according to Schentag, is getting doctors to be more restrained in their use of drugs. "If we ever get to the point where we stop giving antibiotics to everybody with a cold, it would be the most revolutionary thing of all," he says. - J. A . The diseases are the drugs B u a 0 p h y s c a 5 p 9 9 �u H T u T H 0 R D ( N New ethical are on the horizon TouGH CHOICES IN MEDICINE will always involve ethical questions, but better communication between doctors and patients could someday resolve many of the day-to-day problems that require the intervention of ethicists like Stephen W ear, Ph.D. "I hope people who do what I do at the bedside won't be needed," says Wear, the co-director of UB's Center for Clinical Eth1cs and Humanities in Health Care. The author ofthe 199 3 book Informed Consent Patient Autonomy and Physician Beneficence in Clinical Med1one, Wear holds joint appointments in the departments of Medicine, Gynecology and Obstetrics, and Philosophy. He heads the ethics consultation team at the Buffalo VA medical center, where he is on call 24 hours a day, seven days a week. He is also a member of ethics committees at Hosp1ce Buffalo, Buffalo Mercy, Millard Fillmore, Children's Hospital, and the Erie County Medical Center. Wear is most often called to a hospital to resolve disputes between families, patients, and doctors on issues of clinical ethics such as informed consent. end-of-life decisions, and aggressiveness of treatment. Frequently, he says. the debates are caused by misunderstandings between doctors and families. He often clears up problems by simply helping physicians explain diseases and treatments, and by translat1ng "doctorese." Many of the issues around end-of-life decisions have already been charted out conceptually, says Wear, whose doctorate is in philosophy. What will hapSTEPHEN WEAR , PH . D . , ON MEDICAL ET HICS ) pen 1n the future, he predicts, is that doctors will do a better job of putting the theories there will be little need for bedside dispute resolution, Wear into practice by clearly informing patients about their disease, prognopredicts. However, new ethical questions are always cropping up. SIS, and choices. ·'One ofthe reasons people like me are around is that "We'll be going through a very ugly phase as issues of health care the profession has resisted internalizing these issues. financing are worked out," Wear believes. "We have to have this "A great deal of conceptual progress has been made in biomedicrisis because we have only so many resources to go around." cal eth1cs in the last 20 years," explains Wear. For example, at one Concern for cost may force insurers to limit treatment. Health point. refusing aggressive treatment was considered a suicidal act. maintenance organizations may prohibit doctors from prescribing Now, the concepts of informed consent and the right to refuse expensive dnugs or discussing effective treatments outside the treatment are widely accepted and have changed the terms of the network. ''I'm very nervous about that. My guess is, society w ill make debate. some poor choices along the way. I am hopeful that the right choices Wear says that institutions will probably be pressured to change will have been made in 50 years." as well. Hospitals now concentrate on trying to cure diseases, rather The emerging technologies of gene mapping and manipulation than on managing death. Each death is discussed in detail in hospitals' will raise new issues. The Human Genome Project, when completed, morbidity and mortality meetings. "Deaths have to be defended, could provide information about an individual's risk of illnessbecause there's always a suspicion that somebody m1ssed the boat. information that. in t he best case could be used to prevent disease, But 1n many cases, death is the only realistic outcome of a disease. or in the worst case to cut off insurance. Parents may get the power Why not focus the discussion on how the patient was treated, to select the qualities of their offspring. "It's a way of making choices whether pain was alleviated? Hospice has a lot to teach us," he says. regarding another individual," Wear cautions, "and whenever you As doctors and patients become better informed about ethical do that. you raise ethical questions." - J.A . questions of health care-and communicate better about them- c e u a a p h s c a s p n 9 9 9 �CONTINUED FROM PAGE 3 nance in resident and fellowship training. • The merger of the University at Buffalo with the SUNY system in 1962, of course, was the most significant event of these 150 years. The merger was traumatic but important, bringing an infusion of resources to make UB a major public institution. The period between 1962 and 1975 was characterized by confusion, instability, diminished institutional self-esteem, disillusionment, an uncertain direction, and little cohesion. The UB faculty had spent much effort in defining its dreams for a medical center comparable to those at Rochester, Stonybrook, and Syracuse, but found that those dreams were not shared in Albany. When the bubble burst, poor morale pervaded the school. This was reflected in critical accreditation reports in 1962, 1966, and 1972, a decline in academic productivity, and deterios v J OHN NA ration of the physical facilities. The situation improved in 1973 with the recruitment ofUB's first full-time vice president for health sciences, Dr. Fitzhugh Carter Pannill. I was recruited as UB's first full-time dean in 1975, and am forever grateful to Carter and to UB's president at that time, Dr. Robert Ketter, for offering me this exciting opportunity. Certain facts were apparent when I came: •UB and the community possessed a wealth of resources which included capable personnel, diverse hospitals, and a large population base. Those could provide the cohesiveness, ethos, and energy to develop a mature medical school. •Many of UB's best faculty had not received the national recognition they deserved. Now that UB's ability to compete with the best is established, this should never occur again. • Continued achievement of excellence required the acceptance that UB and the community were interdependent, and that meaningful programs were more likely to flourish through cooperation than competition. UB's medical school of 1996 is far different from thatof 1946. It has experienced five successful accreditation visits between 1976 and 1995. It has developed a core academic center with a world-class Health Science Library, magnificent educational facilities , a modem vivarium and biomedical research complex, and the schools of dental medicine, nursing and allied health professions. UB and its affiliated hospitals have defined both their individual missions and their shared ones. A strong volunteer faculty supplements UB's academic faculty. Most importantly, the medical school attracts academically competitive students, residents, and biomedical graduate students. Enough of the past and present. What of the next 150 years? In my opinion, the faculty, the university leadership, and the hospital and community leadership have positioned UB well for the future. For UB and all institutions of higher education, the new economy and social order will encourage sharing, collaboration, and interdisciplinary activity. There will be B a 0 p s increased emphasis on independent learning, increased use of technology, less classroom experience, and more attention to outcomes rather than to process and regimentation. Such change is already occurring at UB . Continued transformation will take another generation. But by building on past achievements and today's optimism, UB's medical school and its community partners will provide the best in education, health care and leadership. These assets will help us meet the challenges ahead: • The medical school has a core of educational and research facilities to sustain its mission well into the next century. • The new fiber optic network linking the campus and hospitals with other places in the state provides the infrastructure for distance learning, transmission of library information, and the continued development of the region's health system informaUGHTON , M . D . tion superhighway. • UB's biomedical research program generates more than $30 million annually. Together with a faculty practice plan that generates almost $80 million dollars a year and the complementary resources provided by New York State and the hospitals , the school will be able to educate physicians for the future. Two projects are planned in the next five years to help the school meet its obligations to its students andiacult.y: •The Comprehensive Health Education Center will be built in the old dental school building at the north end of Farber Hall. It is envisioned as an interdisciplinary center for community health education research, problem-based education, and the teaching of interview skills and physical diagnosis. The center will provide a modicum of patient care shared by the various health science faculties , and, we hope, a centralized autopsy facility coordinated among the teaching hospitals. •The second and third floors of historic Harriman Hall will become the locus of the medical school's administrative offices while its first floor continues to provide student support services. The building is connected to the Biomedical Research Building at the second floor level, uniting the South Campus health sciences core. As we celebrate UB's Sesquicentennial, there are many reasons for optimism. Future research, education and patient care will be interdisciplinary. Biomedical research will become more cooperative and collaborative. Education will be interdisciplinary, combined with more independent learning. Patient care will become more integrated and comprehensive. My dream for the year 2146 is that UB's leaders of the past, present, and future will meet in the great unknown to evaluate how each generation has remained faithful to the dreams of Millard Fillmore and UB's founders . Happy 150th B ir t h da y UB ! + c a n s p g 9 9 �\ ', - l HE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES has a long and distinguished history-and you ore port of it_ In celebration of its Sesquicentennial, a beautifully illustrated pictorial history of the Medical School is available for your personal library or office_ This hardcover, 192-poge keepsake, Another Ero, contains 250 photos, including rare, historical photographs that will transport you to a time when___ Medical School tuition was $65 a year and "good board, with room, fuel and lights" could be found for $4_50 a week_ UB medical students were the first in the United States to witness a clinical demonstration of a live birth-which caused an outcry in newspapers nationwide! Retrace 150 years of achievement, trials and tribulations in this special limited volume, and toke pride in the Medical School's vision for its future_ To order Another Era by credit card call Wadsworth Publishing Company at 1-800-369-2646 exL 3339 $39_95 including shipping and handling. Gift cards available upon request. Charges will appear on your statement as Wadsworth Publishing. B u a 0 p y s c a n 5 p g 9 �• ······················································ I 9 0 3 5 ARTHURT . SKARIN ' 61 , ofNeedham,MA, E . GORMAN ' 36, of Hilton Head, SC, published the second edition of his Atlas of has been active at the Volunteers in Medicine Clinical Onco logy. Skarin is the chief of the Clinic on Hilton Head Island since 1993. The hematology laboratory and the medical di- FRED organization provides free medical service to rector of the thoracic oncology program at 6,000 to 8,000 people who have no other Dana-Farber Cancer Institute, and teaches at medical care. Harvard Medical School. The book is the first The State University of New York at Buffalo Department of Family Medicine is continuing to grow and expand. We are seeking BE/BC Family Practitioners to join us in varied urban and suburban settings throughout Buffalo and Western New York. The candidates we seek must have interest in OBI GYN and assume teaching responsibility for medical students and residents. Benefits include competitive salary, ample vacation, sick time, CME time, and licensure/board fees. If any of these opportunities sound of interest, your colleagues here at Family Medicine would welcome the chance to speak to you. of its kind to cover all aspects of oncologic 9 0 4 ALEXANDER GRINSTEIN '42 , tumors and malignancies. About half the 5 photos in the atlas come from Skarin's teach- of Beverly ing collection, gathered as part of his hobby Hills, MI, announces his most recent publi- of photography. Skarin's post-UB career be- cation, The Remarkable Beatrix Potter. His gan with a fellowship at Boston City Hospi- previous publications include Freud's Dreams, tal. Near the end of the Vietnam War, Skarin Freud at Crossroads, Conrad Ferdinand Meyer was drafted and spent two years in the U.S. and Freud, and Freud's Rules of Dream Inter- Air Force. After returning to Boston, he helped pretation. Alexander is president of the Dr. Sidney Farber develop a medical oncology Sigmund Freud archives. 9 program at the Children's Cancer Research 0 5 Foundation, which later became the Dana- 5 Farber Cancer Institute. Skarin says he some- of Dallas, TX, times reminisces about Buffalo with friend while chairman of psychiatry at the Univer- who is a daughter of longtime UB professor sity of Texas Southwestern Medical Center at Oliver P. Jones, Ph.D., M.D. KENNETH ALTSHULER ' 52 , Dallas, was named 1995 Professional of the E. of Delhi, NY, was Year by the Dallas Alliance for the Mentally JOHN Ill. The group honored Altshuler for helping selected a fellow of the American College of establish Mental Health Connections, a co- Physicians. He recently completed health- operative program ofUT Southwestern's De- care management training at the Kenan partment ofPsychiatry and the Dallas Mental Flagler School of Business, University of Health and Mental Retardation Center. North Carolina at Chapel Hill. SHIELDS '68, Altshuler, who holds the Stanton Sharp Dis- 9 tinguished Chair in Psychiatry at UT Southwestern, recently assumed the presidency of 7 0 JAMES J . MCCOY JR . '71 , 5 of Charleston, sc, is medical director of the Charleston the American BoardofPsychiatristsand Neurologists. Please contact Rebecca Brierley, Professional Affairs, Department of Family Medicine, 462 Grider Street, Buffalo, NY 14215 (716) 898-4797; Fax (716) 8984750. EOE/AA Surgery Center and a member of the Arthroscopy Association of North America, 9 6 0 5 and was recently installed as president of the of Waltham, MA, was South Carolina Orthopedic Association. He elected to the executive committee of the has seven children and soon will be a grandfather. HARRIS FAIGEL ' 60 , section on Ado lescent Health of the American Academy of Pediatrics and was appointed STEVE TUCKER '72 , chair of the finance committee of the Society of Anchorage, AK, is in solo practice in nephrology. He is gover- for Adolescent Medicine. His third grandchild (first grandson) arrived last June. His nor-elect of the ACP in Alaska and serves as wife, Frayda, is enrolled in the psychiatric director of the Alaska/Northern Alaska Kid- nursing track for a M.S.N. at Northeastern ney Center and chairman of the pharmacy University. and therapeutics committee. He has two We encourage the inquiries of women and minorities. adopted children, Jacob Ian, 5, who skates, B a 0 p h y s c a n s p n 9 9 9 6 �\ ......................................• II Ifyou thought ' you knew us... do J.OU know what's NE.W? ..;,~ ~ '<' skis, and plays soccer and hockey; jackie (5 1/2), Alex ( 4), and Eric and Alanna Elizabeth, 15 months. (19 months). JAMES P . o""e'( \ of BU R DICK '75, is the director of anesthesia ser- for an essay about lesbian battering entitled Strike One. Apractic- ban Hospital in Buffalo and a ing psychiatrist, she ha also pub- member of the board of directors and president-elect for the medi- lished features , es ays, fiction, and poetry in the U.S., Canada, cal staff of Millard Fillmore the United Kingdom, and Aus- Health System. He also serves on tralia. Her first book, a collection the board of the ew York State of interviews with female musi- Department of Health's Office of cians-including Marianne Professional Medical Conduct. Faithfull, joan Osborne, Laurie Lewis, and Grammy-winnerjanis of ment. He was also promoted to lieutenant colonel in the medical Ian-will be published this year. Post lives with her long-term partner, judith Avery, a psychiatric nurse. corps of the U.S. Air Force Re- 9 serves at Langley Air Force Base, where he serves as a gynecologist in the Women's Health Center. s 0 9 M ICHELLE SKRETNY SUSCO '91 , of Clifton, VA, is a board- certified pediatrician in a small of group practice in Manassas, VA. Washington, D.C. , has spent the She married joel Susco on Sept. 2, 1995. T ER EN C E CHORBA , '79 , past year helping improve disease surveillance systems in five OBITUARIES central Asian nations as a CDC epidemiologist in Kazakhstan. MARVIN N . W I NER , '39, of Sarasota, FL, died Dec. 27, 1995. Rooms .1vailahlc for UB Alumni Weekend October 4-6, 1996 9 Congrarularions to The University at Buffalo School ofMedicine & Biomedical Studies on celebrating I 50years ofteaching, healing and research! FromnNf-~ 8 0 S He was born in Buffalo, and after MAR K 5. B O R E R '80, of Dover, earni ng his M.D. , served three DE, was rated a "Top Doc" in the years in the U.S. Army Air Corps. state by 200 medical colleagues in the ovem ber 1995 issue of He practiced dermatology in Buf- Delaware Today. Mark is board- an instructor at UB. A Fellow of falo from 1946 to 1981 and was certified in psychiatry and child the American College of Physi- psychiatry. cians and of the American Medical Association, he was also a MARC BUFFALO~arrtoft 1340 Millersport Highway, Amherst, NY 14221 (716) 689-6900 or (800) 334-4040 At the Univers1ty at Buffalo Complex 0 STANLEY '78, of the Richmond Health Depart- • A first-class hotel with outstanding amenities, comforts and conveniences - centrally located at the University at Buffal o Complex. u L . Richmond, VA, is acting director And Your Choice To Stay In WNY! B CA, won first prize in the Ari- vices at Millard Fillmore Subur- COVIA ~ .("~ ~;:. ~ s~ of Oakland, zona Authors' Association ationa! Literary Contest in 1995 ;:.S· • 14,000 sq . ft. of flexible ~'b~~~ ~;:. . "/)~ e"\ meeung space on property ~ ~ 'o~;:. PLUS direct access to an -0-fJ ~~ ~0 additional 250,000 sq. ft. 'o~ 0~e;r. with state-of- the-art capabilities. ~ ~~~~~s~· s'~ .;;s' . and mnovauve . . • Super b catenng ~~s ~ 'o theme dinners PLUS expert ~\~ ~ 'b~o" planning assistance from -0-fJ ~~;:.';:. pre-event through closing. ~0 ~ LA U RA POS T '87, East Amherst, NY, is the president-elect of the ew York State Society of Anesthesiologists. He \ Oo ~~,o See Why ,:~'~~ ~;:.O~ e,C.\.~ \~ '( We're Your Ideal _,~~ s~~,,o<:'> ~~~~ . Fact·1·tty... \~ <i>'1~~s J. M eeung ~s ~o I 0 p h y J . K O B LICK '84, of Ormond Beach, FL, became a form er pre ident of the Central tales Dermatologic Society. He fellow of the American College was a member of the Landings of Surgeons. He and his wife, Racquet Club. He moved to Helene, have three children : Sarasota 10 years ago. He is sur- 0 n s p n g 9 9 6 �• •• • ••••••••••• • • • •• • • • HUR\VITZ & FINE, P.C. I I ATTO R NEYS AT LAW I THE ULTIMATE DRIVING MACHINE: S ERVICING THE L EGAL vived by his wife, Helen M.; his daughters, Beth Berenson of New York City, and Ellen N EEDS OF THE Litman of San Francisco; and four grandchildren. Memorial donations may be made to University of S. Florida Allergy Research, Account #25040, care of the Division of H EALTH S CIENCES COMMUNITY Allergy and Immunology, University of S. Florida College of Medicine, VA Hospital, 13000 Bruce B. Downs Blvd., Tampa, FL 33612. PAUL ROBERT MOYCE, • Managed Care • Purchase & Sale of Practices • Business & Tax Planning '70, of Mountain Checkpoint Foreign Car, Inc. View, CA, died peacefully Oct. 19, 1995 as the result of a severe head injury. He was surrounded by his loving family. Born in Buffalo, he graduated from the University of San Francisco in 1966. After earning his • HCFA Safe Harbor Regulations and Physician Self-Referrals Sales and Service • Contracts with Private • • Employee Relations & Public Entities M.D., he served in the U.S. Air Force as a flight surgeon. He was board-certified in anesthesia in 1977 and began his practice at Dominican Hospital in Santa Cruz. He vol- Counseling 487 Kenmore Avenue Buffalo, NY 14223 836-2033 unteered for the Santa Cruz Suicide Prevention program and Hospice. A growing interest in mental health led him to enter a residency in psychiatry at the University of California at Davis in Sacramento. He obtained his second board certification and began a private practice in psychiatry in Menlo Park, CA., in 1990. He enjoyed literature, travel, music, and the exploration of the spirit. An accomplished pianist and vocalist, he sang bass with the Cabrillo College • Fringe Benefit Programs • Representation Before Government Agencies on • Audit & Business Issues • Facility Finance Your WNY Leasing Specialist Serving WNY proudly for 33 years and Construction • Credentialing and By-Laws Slavonic Chorus and toured the Soviet Union with them in 1987. He is survived by his • Hospital/Medical Staff Issues wife, Kaki; his daughter, Audrey; and his son, Gregory, of Seattle, WA. Donations Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 may be made to the Audrey Saxon Moyce Education Fund, care of David Moyce, trustee, P.O. Box 1883, El Grenada, CA 94018. We have more class notes than we could fit into this special issue. They will appear in the Summer 1996 issue.-The Editor 1300 Liberty Building Buffalo, New York ' j B a 0 p y 5 c o n s p g 9 9 6 �The jury is out. Your practice and assets are on the line. 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Bank fee + tax and hcense due at •nception. 12,000 annual mileage $12 per mtle m excess. · · a 5 p g 9 9 �.I • PLANTING A TREE UNDER WHICH You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money ' grow. In fact, this man who in 1905 provided $5,000 through his will for. the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowll)ent in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. ) Uf he DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to prov1de scholarships to outstanding students, .ve At enhance scientific research, support excellence in teaching and meet the ever-changing needs of the scho,ol. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you deve I0 P a smart financ1al . plan. Acharitable bequest prov1des . the. sat1sfact1on . . that comes from PIantmg . a tree ere ure under which you will never sit, but which will bear fruit for generations to come. FOR ACONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: r STEPHEN A~EBSARY, JR. ~ - - - -- ~ Assistant Dean and Director of Development, School of Medicine and B1omedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE ISO YEARS •e•e · •••e a 0 'p h y 5 c o n 5 p n g 9 9 �·--- BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT"BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED -11 . .>.~.: l .,)TJ .!C ·- L Y .;TT L.i. .~ ><Y ,L, ... _ T ~ -- ~-- - Non-Profit Org. US Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. 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UB's Medical School at 150 The Founding of the University of Buffalo Buffalo's Unique Network of Teaching Hospitals Photo Essay: Life at the Medical School Continuing a Tradition or Excellence Medicine of the Future Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-20 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n02 Extent The size or duration of the resource. 64 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0f398d8e93b4093e754ecd5a751e5e2b.pdf fd716ff75fda5971dc3bbf631ad69b56 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1996 oes me 1c1ne deal with death? �BUFFALO PHYSICIAN \olume 30. Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole '>nuth Petro ACTING DIRECTOR OF PUBLICATIONS Kathryn \ Sawner EDITOR Je>SICa Ancker ART DIRECTOR \ian J Kegler ASSISTANT DESIGNER Julie Gmten PRODUCTION MANAGER \nn Raszm~1nn Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John Naughton, Dean , \ ·"c Ptcsidcrll fo• Cliniwl A{f<111 s EDITORIAL BOARD Dr John A RIChert . Cluurmmt Dr Martm Brecher Dr llarold Brod) Dr. Rtchard L. Collms Dr. Jack f Co) ne Dr. Alan J Dnnnan Brian Dufh Dr James Kanskt Dr Barbara MaJerom Dr Elizabeth Olmsted Dr Charles Paganelli Dr Stephen Spaulding Dr BradiC\· T. Truax Dr r rankltn Zcplowttz Dear Alumni and Friends, THE SESQviCENTE:-o'\IAL E\E'\TS during the first two weeks of May truly rel1ected the commitment of the school's alumni, faculty, and friends to its missions and accomplishments. A major highlight was the opportunity to have Helen Ranney, M.D., deliver a stellar Harrington Lecture, receive an honorary Doctor of Science degree, and give very warm, well-directed remarks to the 1996 graduates. The commencement was also highlighted by the attendance of 29 members of the class of 1946, gowned and hooded and sitting on the stage with other faculty and distinguished guests. Spring Clinical Day was a resounding success in its own right. It drew probably the largest gathering of medical school alumni ever to attend this annual event. The session focused on issues related to preparation for death, the theme of this issue of Buffalo Physician. For me, it was amazing to experience the warmth and humaneness exhibited by a UB alumnus, Robert Milch, M.D., the medical director of Hospice Buffalo and an organizer of the session. He, with Ms. judith Skretny, set a tone which served to galvanize the audience into a cohesive, concerned, attentive group which ensured a successful learning experience for the entire day. The program was further highlighted and enriched by a singularly gifted presentation by the Stockton Kimball lecturer, Sherwin Nuland, M.D. As I rel1ect on the school's focus on its 150-year history, it is indeed rewarding and a pleasure to see a renewed awareness ofUB's successes and its willingness to commit itself to another 150 years of dedication to educate outstanding physicians and biomedical scientists. Sincerely, ~~. John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS fhe Buffalo (,eneral llospttal \ftdwd )lww I he Chtldren·s Hospttal of Buffalo [ne Count\· Medtcal Center Mercy llospttal 'vltllard fillmore llealth System Dear Distinguished Alumni, fnmll.Sa\'a Ntagara Falb Memonal Medtcal Center Ro"sell Park Cancer lnstilllte St>te" of Chanty lio>pnal DCillll\ \f<Cmllt) \eterans Aff.m> Western '-Oew York lleahhcare sy,tem © The State L·rmnSit) of '\ess York at Buffalo Buff<~lo Phnrcwn " publtshed quarterly b\ the !>late Lmve"nv of Ness York at Buffalo School of \.1cchunc and Biomcd1c.:al Science~ and the Offtle of Publtcallons It rs sent , free of charge.toalumm , faculty , student; , re;tdents and fnends. fhe staff r._enes the nghtto edn all cop) and submi.,c,lons accepted for puhltcallon. 4\ddrcss questions , comments and >ubmisstOns to: The [dnor, Buf{lllo Ph)-\itian. '-,tate Uni\·cr'-tll\. of r\e\\ York at Buffalo . Office ·o r Publt callon; , 136 (rafts I tall , Buffalo, '\1) 14260 Send address changes to: Buff<~ln Phl;t<illn, 1-!6 CFS Addnton , H35 \lam Street , Buffalo, 1\Y 1-!2 H (over Image: Scala/Art Re;ource. 1\Y Fdsard \lunch , Thr Dc<tth Chwnbcr , Munch Museum , Oc,lo, r\orway. THA'\K YOL FOR the opportunity to serve as the president of the Medical Alumni Board of Directors. Much gratitude is due to Margaret Paroski, M.D., whose shoes I need to fill-a task that will be hard to accomplish. She served with vision and commitment, and was an example to our students of a caring, effective teacher and clinician. Also, congratulations to Beth Maher, M.D., for an outstanding Spring Clinical Day program, "The End of Life: The QualityofDeath." The program attracted more than 300 physicians and was one of the best attended Spring Clinical Days ever. 1 It is with great pleasure that we continue the celebration of the sesquicentennial anniversary of our medical school with the Distinguished Medical Alumni Award, to be presented this Septemberto Elliott C. Lasser, M.D., class of 1946. Dr. Lasser's research in radiology has been the cornerstone of some of our present-day diagnostic techniques. This recognition is a source of pride for all our alumni. Plans for the 1997 Spring Clinical Day are already under way. Richard Collins, M.D. , is planning a program addressing the impact of managed care on the physician and the patient. The Alumni Association will also continue to sponsor a wide range of activities for medical students, including the community physician program, the senior reception, orientation events, and receptions at national medical meetings. As your new Alumni Association president, I look forward to this year, and I ask for your support and any ideas to better serve you and our future physicians. Sincerely, ~if C'~ /W:J Jack F. Coyne, M.D. President, Medical Alumni Association �V OL UME 30 , 3 NUMBER SUMMER Buffalo Hospice 5 A TEAM THAT CARES FOR DYING P ATIENTS TAKES ON A NEW ROLE: EDUCAT- 10 Physician-Assisted Suicide How FAR SHOUL D DOCTORS GO? by Jessica Ancker lNG YOUNG DOCTORS. 18 1996 The End of Life and the Quality of Death U S 'S S PRING CLINICAL DAY OPENS DISCUSSION ON CARING FOR THE by Andy Danzo TERMINALLY ILL. by Scott Thomas Research Medical School News BUFFALO GENERAL DISTINGUISHED GETS KUDOS. ALIENS AND ASTHMA . HELPER DOGS . PROFESSORS . ROBERT N. SPENGLER . EUGENE MINOELL. MATCH DAY . GIFTS TO UB . Alumni News LYNNETTE NIEMAN ' 7 8 OF THE History of Medicine NATIONAL INSTITUTES OF NATIONAL MEETINGS HELD HEALTH. THREE GENERA- IN TIONS AT UB . BUFFALO . AStudent's Perspective " I HAD NEVER KNOWN SO MUCH ABOUT ANYBODY. " BY CHRIS SCHAEFFER, CLASS OF 1 998 . Classnotes �! l··· ·· · ·· ······· · ········· · ·· · ··· · · ··· ······· · ··· ··· ········· · ·· ·················· · ········ Dogs can help people with impaired mobility ervice dogs promote independence and high self-esteem among individuals with impaired mobility, and they can also save money, according to UB researcher Karen Allen, Ph.D. The research by Allen and her colleague,Jim Blascovich, Ph.D., found specially trained dogs more cost-effective and useful at performing certain tasks for people with severe mobility problems than human helpers. They reported their findings in the April 3 issue of thejoumal of the American Medical Association. The ubjectsofthestudy suffered from muscular dystrophy, muscular sclerosis, spinal cord injury, or traumatic brain injury, and had used wheelchairs for mobility for at least two years before the study. The dogs were trained to pull wheelchairs, carry parcels, help with daily dressing, open and close doors, assist in getting in and out of cars, and pull people up from lying or sitting positions. They were even trained to pull their owner to safety in an emergency. Some canines have learned to assist with as many as 100 tasks, Allen said. Twenty-four of the individuals were given the trained animals one month after the study began. The other 24 received their canine helpers 13 months later. In both groups , the dogs' assistance cut the amount of time required by human helpers by approximately one half within six months. Also , the subjects' self-esteem scores nearly doubled in six months, and tripled by the end of the two-year study. The 0 individuals reported newfound independence, increased psychological well-being, and positive effects in other areas of their lives. At the end of the study, 40 out of the 48 subjects were able to get pan-time employment, and 18 of the subjects started school. A service dog costs about 5,000 to train and about $1 ,100 to maintain annually, far less than the cost of home health aides or other assistants , Allen said. While seeing-eye dogs are well-accepted and covered by many insurers, other types of service dogs are often not covered. However, the state of Montana is providing Medicaid coverage on a trial basis as a result of this study, Allen said. Allen , a member of the psychology department, is the former assistant director of UB's Center for Behavioral and Social Aspects of Health. + H E R 5 C H E L E M E L 5 0 N Buffalo General honored by national accreditation group he Buffalo General Hospital has been awarded a three-year accreditation with commendation by the joint Commission on Accreditation of Health Care Organizations for the first time in its history. Accreditation with commendation recognizes excellence and places Buffalo General in the top 12 percent of the 5,200 accredited hospitals in the country. joint Commission members reached their conclusion after spending about three weeks last December conducting surveys at Buffalo General, its Community a u f f o t o Mental Health Center, and its long-term care facility at the Deaconess Center. "Buffalo General is to be commended for its commitment to providing quality care to the people in its community and region," said Dennis S. O'Leary, M.D. , president of the joint Commission. "You have a lotto be proud of: superb people, excellent staff really doing a great job. It's clear they really care," said joint Commission surveyor Robert eher. "The quality of the programs really stands out. " + Aliens and asthma n innovative experiment involving a popular children's movie may have pinned down the neurological pathway by which unpleasant emotions constrict airways in asthmatic children. UB pediatric psychiatry researchers Bruce Miller, M.D., and Beatrice Wood, Ph.D. , reported their results at the annual meeting of the American Psychosomatic Society, March 7-10 , in Williamsburg, VA. The researchers invited 24 asthmatic children ages 8 to 18 to watch the video of "E.T.- The Extraterrestrial," while their heart rates , respiration rates , and blood oxygen saturation were monitored . Airway reactivity and pulmonary function were tested before and after the movie by spiro metry and methacholine challenge tests. The researchers were particularly interested in the children's physiological responses during a highly emotional scene in which the young hero , Eliot, talks to what appears to be the dead body of his friend , E.T. -then discovers that E.T. is alive. The mood shifts suddenly from hopelessness to relief and joy. Results showed that during the sad scene, heart rate and oxygen saturation became unstable, reflecting airway con- Physician Summer t 9 9 6 �··· · ···· · ······· · ······· · ·· · ··· · ····· · ··· · · · ·········· · · · ······· · ········ · ··· ·· ···· · · · ···· • . striction. During the happy scene, heart rate and blood oxygen stabilized , indicating open airways. In addition , the researchers noted that changes in activity of the vagus nerve , known to influence both heart rate and airway constriction, correlated closely with changes in the children's emotional responses . They believe the finding points to the vagus nerve as one pathway by which emotions affect asthma symptoms. "These findings are clinically important because they suggest that emotional conditions, such as depression and hopelessness, may be important triggers of airway constriction in asthmatic patients," Miller said. "Knowing that the vagus nerve is a specific pathway for inducing these psychophysiologic responses, we can now target this pathway for treatment intervention. " Miller suggested that antidepressant medications with strong anticholinergic properties may be the best choice for treating depression in asthmatic children. "These medications may have the dual effect of treating depression, while at the same time lessening vagal responsivity , which would directly improve asthmatic symptoms, " he said. "We need to point out to physicians that treating the depression can improve asthma symptoms , as well as mood. " The "E.T ." study is part of a long-term collaborative effort by Miller, the director of pediatric psychiatry at Children 's Hospital and a UB associate professor of psychiatry and pediatrics , and s u f f 0 l 0 P hys i Wood , the assistant director of the pediatric psychiatry department and a UB assistant professor. The two came to UB last year from the University of Rochester. An earlier study published by the two colleagues in 1994 found that children who experienced more intense physiological reactions and described their emotional experiences in more intense terms also experienced decreased pulmonary function and heightened airway reactivity. Miller and Wood believe that in this subgroup of asthmatic children, strong emotions activate a specific pathway in the autonomic nervous system that causes or aggravates asthma. In the long run, Miller and Wood hope their work will help bring the study of the body a little closer to the study of the mind. "We believe that's where medical education needs to go . It's stilted and artificial to practice psychiatry in a vacuum , or to practice medicine in a cian 1 9 9 6 '. vacuum ," Miller said. Wood adds that health care professionals must also include a concern for the patient's family and social setting. "It's no good to treat the child individually. It's important to engage the family , and see how that impacts the child's physiological functioning. " She hopes , too, to begin to develop a model for health , not just for illness. "We need to look more at the positive ways families impact on physiology, not just the negative ways. " Miller established his reputation in the field with a benchmark 1987 study on the links between depression and fatalities from asthma. He conducted in-depth interviews with families of asthmatic children who had died from their disease and with the families of others who had survived near-death experiences. He found that the children who had died were much more likely to have experienced psychological stress and family turmoil , such as a divorce or an impending separation . Also, around the time of their death , they were much more likely to have experienced feelings of despair and wishes to die. "My clinical practice had suggested this link long before, but this was the best-designed study to establish the link ," says Miller, who practiced family medicine for several years before specializing in psychiatry. Wood joined Miller's research after studying the impact of family stress on children with Crohn's disease . + -LOIS Summer .. . B AKER �nt How does medicine deal with death? DoES MEDICAL SCHOOL ADEQUATELY PREPARE DOCTORS to treat dying patients? Is it always possible .. .. to control pain, or to facilitate a dignified death? What should the law say about a dying patient who asks a doctor for a lethal dose of drugs? These are some of the topics brought up for discussion at UB's Spring C lin ical Day, held May I I on the topic of "The end of life: The quality of death." This issue of Buffalo Physician further explores these questions in several re lated articles. The first, "Hospice Buffalo," follows medical students and young doctors as they leam about palliative care in UB's new hospice education program. "Physician-assisted suicide: How far should doctors go?" explains recent developments in the legal and social debate about assisted suicide, and tries to put them in ethical perspective. Our Spring Clinical Day coverage includes excerpts from a panel discussion about dying patients, their families, and their doctors, and a story about the Stockton Kimball Lecture delivered by Sherwin Nuland, M.D., author of How We Die. In our new student column, third-year student Chris Schaeffer reflects on how death robbed him forever of the chance to know one fascinating and mysterious patient. We hope that this special issue will invite discussion and reflection on these difficult questions. -The Ed ito r 0 B uffalo P hysician Summer l 9 9 6 �• ICe by Andrew Danzo Photos by K.C. Kratt A team that cares for the dying takes on a new role: educating young doctors 0 CAR PIEDAD, M.D., was still getting used to people calling him "doctor" when he visited some old friends at Hospice Buffalo in late spring. At the nurse's station there were hugs for the young bear of a physician, freshly graduated and preparing to leave for a residency down south. Here he was still Oscar. Piedad looked at the Family Room, decorated with soothing pastels and simple, comfortable furnishings . He recalled the Christmas party there. The family pets that came for visits. The meetings with spouses and children to discuss final arrangements. He seemed "IT OPE:\lED M\ EYES TO Buffalo Physician A to miss it. \\'HOLE NE\\ C0:'KEPT OF MEDICINE," he explained. Summer l 9 9 6 0 �HOSPICE BUFFALO lN THC 18 'v10 HIS Physicians have a since Hospice Buffalo hard time saying became a clinical "enough," according training site for the UB to Thomas Raab, School of Medicine M.D., clinical assoand the Graduate ciate professor of Medical Dental EdumedicineatUB. "We cation Consortium of are trained to treat, Buffalo, some 70 residiagnose, and evalu- ____dent and lJ) medical ate; and if we don't students have shared know what's going an exposure to palliaon, we treat, diagtive medicine that is nose, and evaluate still relatively unsome more," he said. usual. They have "We must compaslearned about pain management, symptom sionately communicate to the dying patient management, and working in interdiscipliand the family when medical technology "You learn a nary teams. They have comforted dying padoesn't have any more to offer them and it's tients-some calm, some haunted by nighttime to stop. So many times, doctors don't lot of loving mares. They have made house calls. Overall, do that. " they have learned something about accepting the inevitability of death , and maximizHospice as Education and caring ing the quality of the life remaining. "Doctors just don't get good trammg in "There are a lot of life issue you have to caring for patients at the end of their lives," that before address," said Piedad. "For the family memsaid Raab. "It's sad what we do to some bers, too. The spouses and the children. people at the end of their lives. " They have to go through the dying process, The hospice educational program began you might too ... You learn a lot of loving and caring under the state-funded Indirect Medical Eduthat before you might only have shown to cation Demonstration Project. It now inonly have your own family." cludes lectures at the medical school and Advances in medical techniques and techconsortium hospitals by Hospice Buffalo nology have raised troubling questions about medical director Robert Milch, M.D., and shown to when efforts to save a life merely prolong a short- and long-term rotations for residents and medical students. painful death. The Robert Wood Johnson your own Foundation recently funded a study to deRotations include rounds of the inpatient termine whether better prognostic informaunit and home visits with a social worker or tion and patient-physician communication a clergy member. Students also work with family." would prevent overtreatment and pain at the the bereavement staff, who keep up with end of life. families for l3 months after a loved one's Dishearteningly, the "SUPPORT" study, reported death in order to provide support for the first-and in the ov. 22/29, 1995 issue of the Journal of the hardest-year of loss. American Medical Association, found that the interThe official hospice training program began in late ventions did little or nothing to improve care or 1994, but two students paved the way more than a year outcomes. The study documented that fewer than earlier. The first was Piedad, whose father , also named half of physic ians knew when their patients did not Oscar, is a retired general surgeon in Buffalo. want CPR,-cand half of conscio us patients were in The other was Maria Bruno, M.D., then a secondmoderate to severe pain before they died. The article year student. states that physicians "p rovide more extensive treat"I had some family members with cancer and bad ment to seriou ly ill patients than they would choose illnesses, and I knew people who just weren't satisfied for themselves." with the way they were treated. I wasn't sure if it was the 0 a u f f a 1 o Physician Summer 1 9 9 6 �HOSPICE physicians, or the system in general," said Bruno, who has just finished her internship in internal medicine in Buffalo. " ow I think it's the system in general." Bruno remembered her grandmother's death in the 1970s. "It was one of those situations where they opened her up , found cancer and closed her up without telling her ," she said. She thinks the doctors didn't want to upset her grandmother, but the result was sending her home without preparing her for the pain that would come. Bruno did a summer fellowship at Hospice Buffalo between her second and third years. Once the training program was up and running, Bruno returned for an elective rotation in her fourth year. She also researched the literature on physician-patient communication , and assembled a presentation that is still given to students and residents at the beginning of their hospice rotations. The presentation is entitled "Talking about Difficult Subjects: A Survival Guide for Giving and Getting Bad News. " "Medicine isn't all about science," Bruno said. "Hospice medicine is about the art of medicine as well as the science of medicine. " The training program got into full swing when Hospice Buffalo opened its Mitchell Campus, a complex of low cream-colored buildings in the Buffalo suburb of Cheektowaga. The campus includes a lObed unit for hospice patients in the final stage of disease, a lO-bed nursing unit for AIDS patients, and a 30-bed skilled-nursing residence for both hospice and non-hospice patients with advanced illness. It also includes a 220-seat auditorium for conferences and educational activities. UB residents in family medicine , internal medicine , and geriatrics now routinely visit Hospice Buffalo as part of their training, ac- B u f f a l o Physician BUFFALO "We must cording to Liora Ziv, R. ., Ed. D. , the organization's director of education. For other residents, the hospice rotation is available as an elective. Medical students can also choose hospice rotations as third- or fourthyear electives. compassionately communicate to the F r o m T h eo ry to P ra c ti ce Medical student oelle M. Stevens spent a week at Hospice Buffalo last summer. She remembers visiting a woman who had no family. The woman had put off seeing a doctor about the growing hardness in her breast, and by the time she did, the cancer had spread. "She wasn't going to benefit from chemotherapy, " Stevens recalled. "She was living alone in her apartment and wasn't even able to get up and go to the kitchen." The hospice team brought her back to the Mitchell Campus. Before the woman died, she confided to the student her surprise at the warmth of the Hospice staff. "She was one of the reasons why I would like to go into geriatrics, and why I would also like to continue working with Hospice in the future, " Stevens said. The opportunity came sooner than she had expected. During a hospital clerkship later in the year, Stevens became friendly with an elderly woman who had been admitted after a seizure. A CT scan and an MRI revealed that a cancer had metastasized to the brain, but its origin wasn't clear. "The medical team was really set on trying to figure out what the cancer was, " Stevens said. "They had a surgical consult coming in , and they were focused on trying to cure her. But they were not focused on what her wishes were." The woman, a retired nurse, insisted that she didn't want surgery or chemotherapy, and the family agreed. Stevens became the interme- dying patient and the family when medical technology doesn't have any more to offer them and it's time to stop. So many times, doctors don't do that." Summer 1 9 9 6 0 �HOSPICE BUFFALO diary between the patient and the medical team. Stevens advised the family to make their wishes known to the oncologist, and gave them the Hospice phone number. The woman ended up spending her last days at Buffalo Hospice. "I won't forget this lady," Stevens said. unsettling. You don't know where to sit ... You find yourself looking at disease in a totally different way. You look at the faded pictures on the wall. At the things on the coffee table. At the picture in the wedding dress. And then you see the patient in bed, and you see what the disease has done. " The Life Students are Hesitant Qua lit y of When the hospice lessons click, medical stuStudents and residents aren't exactly breakdents and residents no longer feel a sense of "When you go ing down the doors for hospice electives. futility in the face of serious illness. Instead, They often call for information, then call they have the skills and the desire to improve into a patient's back and say they've changed their mind. the quality of the life that remains. "In hosLauren Michalakes, M.D., isn't surprised. pice you don't have the expectation that people She remembers being an internal medicine are going to get better, so you don't have that home, you're resident a decade ago, intrigued by the techsense of failure that you have in a hospital," nology and intellectual challenge of the hossaid Robert Patterson, M.D. , who heads the on their turf. It pital. "We used to love intensive care," she lO-bed inpatient unit. recalled. "You'd feel like you were doing a Pain management is a key component of lot, and you'd write up these wonderful can be the hospice training. At the start of rotations, three-page reports. Being so busy technostudents and residents complete a 39-queslogically, you really didn't have to talk with tion test to assess knowledge and attitudes unsettling... the patient." about pain, drugs, and addiction. Clinical During five years of private practice, howpractice guidelines are also distributed. "In You find ever, her views changed. medical school you talk about 15 milligrams "In the hospital, people die in double of morphine as a therapeutic dose," said blaring rooms with strangers and with C Patterson. "Sometimes we use up to 4,000 yourself lookon the other TV," she said. "They die with milligrams of morphine a day to control pain, their clothes pulled off and hooked up to and the patients are still responsive; they can ing at disease things and all alone." talk. " Michalakes remembers sitting with an A former professor and associate chair of elderly woman at her home when she died. in a totally the OB/G department at UB, Patterson has "I just watched her in her big post bed with been volunteering at Hospice since retiring all her Ouffy pillows and her daughter and from obstetrical practice three years ago at age different way." husband and her poodle," Michalakes re70. Some days, after putting ina morning at the called. "What's wrong with that? I felt like I hospice inpatient unit, he goes home and spared her something. I felt a sense of accomplishment babysits his grandchildren and great-grandchildren. that I hadn't felt in medicine before. " "In my practice as an obstetrician, I dealt a lot with She now works full-time at Hospice Buffalo. families, " he said. "That was one of the joys of mediMichalakes thinks it's important for students to visit cine. Surprisingly, I feel the same about this .. .. It's two patients at home. "When you go into a patient's home, things that happen to all of us-we're born, and we die. you're on their turf," Michalakes explained. "It can be Hopefully, we can help at both ends." B u f f o l o Phys ician Summer 1 9 9 6 �HOSPICE BUFFALO A Sp iri t ual P la ce "You hydrate a healthy patient, you don't do it for a Buffalo Hospice medical director Robert Milch started dying patient," explained Ziv, the education director. "You his career as a general surgeon with a philosophical bent can really cause more suffering and pain in exchange for and a nagging discomfort about modern medicine. He's maybe prolonging for a few hours the life of the patient." been increasingly involved in Hospice Buffalo since it Tchernov said this aspect of hospice went against his original training. "In my Russian medical school, the started in 1978, and he gave up private practice several years ago to serve as its first full-time medical director. preserving of life as long as possible was the philosophy. We would never let a patient dehydrate." "There's something that hearkens to why you became a physician in doing this kind of work," Milch said. "It's Stude n ts F i nd Men t o r s not about dying. It's about how we live." During his recent visit to Hospice Buffalo, Piedad spotted Life and death are tightly interwoven at the hospice Patterson down the hall. He campus. After traversing a remembered the older brick walkway dotted with mephysician's manner, the way morial stones to former pahe touched and talked with tients, visitors arrive at an inis as much a philosophy as a facility gravely ill patients. "just his formation desk, where they voice, you could see them right can buy shirts, baseball caps, HosPICE BuFFALO ISBASED at the Mitchell Campus, a away calming down," Piedad and other souvenirs with the $6 m Ilion complex on 20 wooded acres, part of a hospice logo. There's a sunlit recalled. "I remember one pnvate nature preserve in Cheektowaga. chapel, usually the scene of time, a patient was very close But Hospice IS as much a philosophy as a facility. memorial services, but also the to the end. He went into the More than three-quarters of hospice pat1ents are place where a patient's daughand held her by the hand. room cared for 1n the1r own homes. Medical, nurstng, ter had her wedding this year. He told her not to be afraid." counseling, and pastoral serv1ces are prov1ded Then there's the bulletin board In a letter to the hospice through Hospice Buffalo and a networl< of affiliated outside Milch's office, where non-profrt agenoes under the umbrella of the Hosstaff after his rotation, Piedad someone has tacked up a dyp1ce Assooat1on. Serv1ces are also prov1ded in area wrote: "I was introduced to an nurs1ng homes and hosp1tals. ing patient's joke. aspect of patient care I had Medicare, Medica1d and maJor nsurance plans "They say the hearing is the never seen before. Pet therapy, will pay for hosp1ce care, and Hosp1ce Buffalo last thing to go. It's not. It's the music therapy, birthday paroffers a sliding payment scale for the uninsured. sex," the woman quipped. A ties, Christmas gifts, family According to med1cal director Robert Milch, dinners, decorated rooms, and few days later, she revised her M.D., bereavement serv1ces are an important part evaluation: "You know what I the list goes on. I began to of hospice care. "It doesn't stop when the mon1tor realize that the facility treated was saying about the hearing. stops. It goes on, and you've got to take care ofthe more than pain; their treatI think maybe I was wrong. " surv1vors." Bereavement care, wh1ch lasts 13 months Death itself, however, is ment involved quality of life, after a death, includes counseling and support groups. resolution of life, family innot trivialized. "It's a very spiritual place," said Andrei volvement, staff involvement, G. Tchernov, M.D. , who bereligious beliefs, personal life decisions, and bereavement ... I have never seen a team on lieves the hospice rotation he completed as a resident will help him in his family medicine practice. His a unit work so cohesively and with so much heart." experience also forced him to change his views on Piedad is now doing his residency in family medicine and sports medicine at Richland Memorial Hospital in practicing medicine. Columbia, SC. Shortly after his visit, Liora Ziv reflected For example, he learned that hospice professionals are on the impact of the educational program. "I don't think willing to withhold interventions that would postpone we can say yet that we've made a big difference," she an inevitable death. A hospice patient who suffered a concluded. "But I think we have made a dent in the stroke, for example, might use the physical therapy room surface if people like Oscar come back and say they'll at the Mitchell Campus to regain the ability to lift a fork. take what they learned here into their practice." + But patients near death and with no hope of recovery Buffalo j ournalist Andrew Danza, a frequent contributor to Buffa lo Physiwould be unlikely to receive antibiotics if they develop cian, also works as a writer for UB's Department of Family Medici ne and the pneumonia, or water if they become dehydrated. L_ _ _ _ _ _ __J ew Yorh Ru ral Health Research Center. e u t t a l o Physic i an Summer l 9 9 6 0 �Choices at the end o f Ii f e • • 1an Sl SSI How far shouldsdoctors go? COURT DECISIO S, SE SATIO AL CASES, STATE REFERENDA, and one-cause crusaders are dragging the intensely controversial issue of physician-assisted suicide out of the closet and into the public arena . ... Whether or not the nation's legal landscape is irrevocably altered as a result of the controversy, the public mind has already changed. A topic once taboo is now dissected on editorial pages and joked about on talk shows. Polls demonstrate increasing support for the idea of physician-assisted suicide during a terminal or unbearable illness. The new openness about DNR orders, health-care proxy appointments, and withdrawal of life-sustaining technologies may also be making it easier to discuss all sorts of end-of-life decisions. For the majority of Americans, the figure who has done more than any other to turn assisted suicide into a public issue is retired pathologist jack Kevorkian. By May of this year, Kevorkian had admitted auending 28 deaths, and had been acquiued in his third trial for assisting in a suicide. At about the same time, a nationwide Gallup poll showed that 75 percent of respondents favored allowing a doctor to end an incurably ill patient's life at the patient's request. "Public relations-wise, Kevorkian's done a tremendous job-he's converted a huge egment of the public," said rightto-die activist Derek Humphry, author of the how-to suicide book Final Exit. It's the kind of public relations most of the medical community would rather not have. Many doctors-even those who support physician-assisted suicide-believe Kevorkian is not qualified to perform it. They object that he had no experience treating patients during his career as a pathologist, and that he does not know BY P H 0 T 0 his clients well, does not try to manage their pain, and does not adequately screen them for clinical depression. In the end, what many doctors, nurses, and ethicists dislike the most about Kevorkian is that he does not appear to reflect at all about his individual cases. Because he believes so strongly that assisted suicide should be available, they say, he distributes his treatment without seeming to ask himself if this option is the right one for this person at this moment. "Physician-assisted suicide shouldn't be easy. It should always be a hard decision," said Timothy Quill, M.D., the Rochester, Y internist who opened a professional dialog on the subject in 1991 with an admission in the ew England journal of Medicine that he had prescribed a lethal dose of barbiturates to a dying patient. In his account of his eight-year relationship with "Diane," Quill described diagnosing her leukemia, discussing her desire for suicide, and asking her to consult her psychologist. Only when he was convinced that she was acting rationally on the basis of an unwavering wish, and only after wrestling with his own emotions, did he prescribe the drugs she requested. There is no consensus on the morality of physician-assisted suicide. While activists like Kevorkian and Humphry want to make the practice widely available on compassionate grounds, opponents argue that it is wrong under any circumstances to take a life. Many doctors also believe that their very mission prohibits assisting in death. "It's absolutely appalling that a doctor would take deliber- .JESSICA 8 S B u f y f F a l R o A ANCKER N K Phys CESARIO ici an Summer 1 9 9 6 �"A SUICIDE THREAT IS A CRY FOR HELP. OUR ANSWER MUST BE TO PROVIDE THAT HELP, NOT TO HELP THEM COMMIT SUICIDE. " Denise Hanlon, R.N., member, NYS Task Force on Life and the Law ate steps to end someone's life," said Evan Calkins, M.D., a member of the Buffalo Medical Group and UB professor emeritus. "It violates the Hippocratic oath to do no harm , and it weakens the ethical standing of the medical profession. We are a healing profession, not a killing profession." Other doctors take a middle view. They feel that before the American medical establishment considers assisted suicide , it should learn how to provide good end-of-life care for all dying patients. If assisted suicide is to be an option, they say, it should be decided as Quill and "Diane" decided it; not in the courts or on the editorial pages, but one case at a timecarefully, deliberately, and with anguish. Even some opponents respect Quill. "If all doctors were like Quill , then this wouldn't be a great concern," said Denise Hanlon, R.N. , an opponent of physician-assisted suicide who serves on the ew York State Task Force on Life and the Law. "Or if all patients were like 'Diane.' But they're not. " The l aw The courts and state legislatures are the current forums for debate about physician-assisted suicide. The 1994 Oregon "Death with Dignity" law is the first in the country to explicitly condone physician-assisted suicide, although legal challenges have so far prevented it from going into effect. In March 1996, the Ninth Circuit Court of Appeals, a federal court in San Francisco, overturned a State ofWashington law that banned assisting in a suicide. The plaintiffs were four physicians, three terminally ill patients who died before the ruling, and a non-profit organi- B u f f a l o P hysician zation called Compassion In Dying. The court broke new ground by determining that the U.S. Constitution guarantees a "right to die;" that is, to choose the manner and time of one's own death. Depriving patients of that right therefore violates the due process clause of the 14th Amendment. The court wrote that doctors should be able to prescribe life-ending medication for terminally ill, competent adult patients who want to hasten their own deaths. The judges said that their decision , in essence, removed them from the issue. "We are following the constitutional mandate to take such decisions out of the hands of the government, both state and federal , and to put them where they rightly belong, in the hands of the people. " The ruling has the potential to affect California , Washington , and Oregon, which all fall under the jurisdiction of the Ninth Circuit Court. In a similar ruling on April 2, the Second Circuit Court of Appeals, with jurisdiction over ew York, Vermont, and Connecticut, struck down part of ew York's ban on assisted suicide. The case was brought by three terminally ill patients and three doctors, one of whom was Quill. The patients all died before the ruling. The judges ruled that a doctor can prescribe drugs to hasten the death of a competent, terminally ill patient at the patient's request. They explained their decision in commonsense language: "What interest can the state possibly have in requiring the prolongation of a life that is all but ended? And what business is it of the state to require the continuation of agony when the result is imminent and inevitable?" legally, the rationale was more complicated. It was de- Summer 1 9 9 6 �"IF WE DON'T HAVE ANY LEGAL WAY TO DO TH I S, THEN IT TURNS INTO ONE DOCTOR MAKING THE HARDEST TREATMENT DECISION POSSIBLE IN A VACUUM - WITHOUT CONSULT I NG ANYBODY , WITH- OUT DISCUSSING IT . THAT TO ME IS NOT GOOD MEDICINE. " Timothy Quill , M.D., plaintiff in Quill v. Vacca cided that the ban violated the equal protection clause of the 14th Amendment. All patients already have the right to hasten their own death by refusing medical treatment. However, the argument goes , terminally ill patients who were not being kept alive through medical intervention had no comparable way to hasten their own death . lf patients can essentially commit suicide by refusing treatment,Justice Roger]. Miner wrote, "they should be free to do so by requesting appropriate medication to terminate life during the final stages of terminal illness. " Stil l a crime While these rulings are being appealed to the U.S. Supreme Court, and while Oregon's law remains entangled in the courts, it remains a crime for doctors to assist in suicides. Yet it's clear that they are doing it anyway. An anonymous survey recently published in the journal of the American Medical Assodation found that a small percentage of doctors in Washington state had helped terminal patients who wanted to die. A survey of Oregon doctors published in the N E]M in February showed that 7 percent of respondents had assisted in a suicide. Forty-six percent of the respondents said they might be willing to assist in suicides if the practice were legal, and 31 percent said they would refuse on moral grounds. "l think the issue at this point is how to respond to physician-assisted suicide , not whether it's going to happen ," said Stephen Wear, Ph.D ., co-director of UB's Center for Clinical Ethics and Humanities in Medicine. "Whether or not the legal situation allows it, it's happening, and in some jurisdictions it's likely to become legal. " B u f f a l a Does the law matter? Timothy Quill firmly believes that liberalizing the law is necessary to protect doctors like himself who choose to help patients die. But jack Freer, M.D. , chair of Millard Fillmore Hospital's ethics committee, uses Quill's case to prove that the law is already practically powerless to touch doctors. After Quill's E]M letter, prosecutors referred the matter to a grand jury, which refused to indict him. "They couldn't indict Quill. Kevorkian is unconvictable," Freer said. "lf that's the case, if you can't be convicted, then [the legal decisions] don't matter because you don't need extra protection. If a doctor acts in good faith, if it is clear that someone is suffering and asks for help, then that physician is unlikely to be prosecuted, anyway. "There would have to be a compelling need in order to justify such a sweeping change in the status quo. l don't see that need, especially when the change would jeopardize so many vulnerable people who have not availed themselves of good palliative treatment," Freer added. P u b lic debate? Quill and some other activists argue that since the practice is happening, it is important to discuss it. His purpose in writing the NE)M letter and joining the Second Circuit Court lawsuit was to open up discussion on what he felt was a widespread practice. "lf we don't have any legal way to do this, then it turns into one doctor making the hardest treatment decision possible in a vacuum-without consulting anybody, without discussing it. That to me is not good medicine," Quill said in a recent interview with the Buffalo Physician. Physician Summer 1 9 9 6 �Choices at the end o f "IT'S ABSOLUTELY APPALLING THAT A DOCTOR WOULD TAKE DELIBERATE STEPS TO END SOMEONE'S LIFE. WE ARE A PROFESSION, NOT A Iif e HEALING KILLING PROFESSION." Evan Calkins, M.D., UB professor emeritus ew Yo rk State Attorney General Dennis Vacco (UB Law School class of 1978) is leading the appeal because he feels allowing doctors to take life is wrong, and that vulnerable patients could be pressured into suicide for economic or other reasons. He also fears that ew York could become home to a sort of cottage industry of commercial death clinics. But even if he succeeds in getting the U.S. Supreme Court to uphold the ban on assisted suicide, Vacco does not plan to launch a drive to prosecute doctors- such as Quill- who have admitted doing it. "I don't think we need to change the prosecutorial scheme," he told this magazine. "No law can eliminate proscribed behavior, but the deterrent would discourage a sufficient number of professionals from engaging in this conduct. "I think that the system we had until this decision was working well. " Public po li cy Doctors, nurses , lawyers, ethicists, and members of the clergy from around ew York State meet once a month as part of the ew York State Task Force on Life and the Law to wrestle with some of the hardest questions in health care. Some of the task force's recommendations have led to ew York's health-care proxy law and the Family Care Bill, which has not yet been passed into law. The group's 1994 report When Death is Sought recommended against decriminalizing physician-assisted suicide. Some members of the task force felt that it was inherently wrong to take a life. Others felt that it was unethical for a doctor to do so. A third group felt that in some cases, providing a quick death for a terminal patient who asked for help would be B u f f a 1 o P hysici a n S compassionate and ethical. The task force was in agreement, however, in concluding that legalizing physician-assisted suicide would be dangerous public policy. The cost of health care and the perceived value of the patient could come to bear on who ends up committing suicide , they cautioned. They were also concerned that patients would not be properly referred for psychiatric or palliative care, and that attitudes about assisted suicide might become casual. "Over time, as the practices are incorporated into the standard arsenal of medical treatments, th e sense of gravity abo u t the practices would dissipate," the task force warned. Also opposed to physician-assisted suicide are professional medical societies, including the American Medical Association, which say that it violates a doctor's mission, and some religious groups. "It's a non-negotiable with us," said Sister Sally Maloney, a vice president at Mercy Health System of Western ew York, a Catholic hospital group. "It's completely opposed to our commitment to life. The ethical directives by the Catholic bishops are very clear on that. " Good end-of-l i fe care Since 1978, Hospice Buffalo has cared for more than 13 ,000 dying patients. Only one has committed suicide, according to medical director Robert Milch, M.D. "It's not unusual for us to go into a patient's home and hear that patient say, 'Look, doc, if things get too bad, I've got the ummer 1 9 9 6 �Choices at the end o f Ii f e usually they're looking forreassuram:e on rwo-points: one, that you can take care of their symptoms and their pain; two, that they will not be alone." "These fears are what drive people to consider suicide. lf you support patients and families, if you address their needs and fears, then the urge to do self-harm essentially disappears," he said. However, study after study has shown that doctors often fail to control patients' pain. "lf l make someone uncomfortable enough, put them in enough pain, l can convince them of anything," Milch said. "That is the principle of torture. "l would rather establish as a standard that the presence of unassessed, unmanaged pain is prima facie evidence of incompetence on the part of the physician," Milch continued. "lf physicians can't manage physical suffering, why would we give them the ability to do omething even bigger-end a life? " For Milch, and many other , physician-assisted suicide is at best a glamorous distraction from discussion of the real needs of terminal patients, and at worst a quick fix that society finds easier than spending the time, money, and emotional energy necessary for good care of the dying. "A suicide threat is a cry for help," said Hanlon, an adjunct professor at the UB School of ursing. "These people are in an impo iblesituation and they don't know what to do. They fear the unknown, and they fear that they won't get the help they need. Our answer must be to provide that help, not to help them commit suicide." But for Stephen Wear, the lack of good palliative care itself becomes an argument in favor of legalizing assisted suicide. "lf we can make people feel that they won't be needlessly overtreated and that their pain will be managed-and right now that is nota reasonable expectation, and people know it-then we should agree with Milch. lf we can't, then for compassion's sake we should be with Kevorkian and Humphry-and I loathe saying that," Wear said. "But it isn't enough to make philosophical arguments against assisted suicide. Doctors have to change their practice so assisted suicide is no longer the compassionate alternative." Even in the best scenario, where palliative care eases symptoms of terminal disease and hospice-type programs support patients and their families, many people believe that there will still be patients who cannot be helped by medicine. "ln most patients we can relieve their suffering, and we have to get better at doing that," Freer said. "But l also think it's clear- and most doctors agree-that there are people whose suffering cannot be relieved. There are people whose suffering can only be relieved by ending their lives." A s l i ppe r y slope The recent legal decisions on assisted suicide have made a distinction between helping a patient take his or her own life, and actively taking the life of a patient through euthanasia. But many fear that condoning one will lead to the otherand worse, to euthanasia of patients who are incapable of consent. ln the etherlands, euthanasia is illegal, but is not prosecuted if doctors demonstrate that the patient explicitly requested euthanasia, document their actions, and stay within other guidelines established by the national medical society. "IF PHYSICIANS CAN'T MANAGE PHYSICAL SUFFERING, WHY WOULD WE GIVE THEM THE ABILITY TO DO SOMETHING EVEN BIGGER-END A LIFE?" Robert Milch, M.D., med1cal director, Hospice Buffalo ® B u f f a l o Physician Summer 1 9 9 6 �"THE PROBLEM WITH THE PHYSICIAN-ASSISTED SUICIDE QUESTION IS THAT IT DISTRACTS FROM REAL ETHICAL DILEMMAS IN MEDICINE, AND COMPASSIONATE CARE OF DYING PEOPLE. " jack Freer, M.D., ethics committee chairman, M illard Fillmore Hospital Law might be the group that could provide leadership on the issue ," said Quill. Hanlon responded, "We will investigate any topic the governor tells us to, but we have already looked at this topic and come up with recommendations on it. " The task force's report warned that it would be impossible to draw up guidelines that could not be bent or broken. However, at least one study there has shown that more than one-fourth of euthanasia deaths occurred without a specific request from the patient. Many argue that this proves legalizing assisted death for consenting patients can lead to officially sanctioned euthanasia of patients who are incapable of consent. Also, Milch points out, "Nothing in medicine is a sure-fire bet. " If some physician-assisted suicide attempts fail to kill the patient, he asks, would that lead to sanctioned euthanasia? "Whose responsibility will it be to administer the coup de grace? " W h o w ill dec i de ? For the moment, the courts are making the decisions. If they decide to decriminalize physician-assisted suicide , the resulting legal void could open up more questions than it answers. The medical profession and American society as a whole will then have to decide how to handle the new freedom-to use it, abuse it, or reject it. "We're a complex society , a society of tensions, and there are not very many things that have a clear 'yes' or 'no' answer anymore, " Wear said. Also remaining to be solved is the issue of giving the proper care to dying patients-educating doctors and allocating resources. Whatever their opinion on physician-assisted suicide, observers believe that improving end-of-life care would drastically reduce the number of patients who find life so unbearable that they would choose suicide. "The problem with the physician-assisted suicide question is that it distracts from real ethical dilemmas in medicine , and compassionate care of dying people ," said Freer. "It's just such a simplistic way of dealing with such a small number of people, when the focus should be on the vast majority whose pain we just are not treating. " + jessica Andur is the editor of Buffalo Phy sician . T i me for gu i de li nes ? Some believe that the potential loosening of assisted-suicide laws means that it is time for medical professionals and patient advocacy organizations to cooperate in setting up guidelines to provide direction and protection for both groups. "We need guidelines and rules so people know that if they dot their i's and cross their t's, they can do this out in the open ," Quill said. His recommendations for safeguards include ensuring that a patient who elects suicide is terminally ill and not clinically depressed; that the patient is not pressured into the decision; that the wish to die is not a transient one; that there is proper access to palliative care; and that a second opinion is sought from an independent practitioner who has expertise in caring for dying patients. Quill's first concern is that palliative treatment and hospice care be extended to all who need it. "Hospice care must have failed , or not be acceptable to patients , before they should be able to choose assisted suicide. " He suggests that safeguards would have to be passed into law at the state level. "The state Task Force on Life and the B u f f a l a p h y c a 5 m m e 6 �Shades ofGr by Scott Thomas Four Buffalo doctors discuss the care of the dying BLACK A D WHITE aren't options for the physician caring for a patient in the final stage of life. All decisions are made in the gray zone in between. These shades of gray were the topics of a panel discussion, "Confronting Difficult Emotional and Ethical Issues in the Care of the Dying" at the 59th annual Spring Clinical Day, moderated by Elizabeth L. Maher, M.D. '85. The panelists were: Martin Brecher, M.D. '72, chairman of pediatrics at Roswell Park Cancer Institute and chief of hematology oncology at Children's Hospital. Jack P. Freer, M.D. '75, an internist and ethicist at Millard Fillmore Hospital who teaches at UB Medical School. Ross G. Hewitt, M.D., medical director and principal investigator for Erie County Medical Center's immunodeficiency services. Robert A. Milch, M.D. '68, medical director of Hospice Buffalo. Case No. I: A 36-year-old HIVpositive homosexual man. Following complications of AlDS, he began to develop memory loss . He made his partner his health care proxy and told his family in Wisconsin of his illness . When he was hospitalized for PCP pneumonia, his mother demanded that he be intubated for respiratory distress over the proxy 's objections. Hewitt: When the family is not aware of the diagnosis until much Buffalo Physician Summer 1 9 9 6 �Care of the dying later in the course of the disease, it puts patients and perhaps their significant others literally years ahead in terms of acceptance of the situation, coming to grips with their loss, the realities of having AIDS. They've gone through that process and are probably at a better stage to make health care proxy-related decisions on CPR and life support. So now the family is faced with going through all of those same processes that the patient has already been through years earlier. That very often leads to conOicts regarding care at the end of life. I think it's very possible in this particular case that the mother is still in shock and not able to listen to the facts that we might present in terms of what the prognosis is. Freer: This also points out the importance of a health care proxy, particularly in situations where there may be a number of different friends and family who may have conOicting views about what is best for the patient. This is in part because of the legal climate and the popular culture both presuming that people would want everything done to keep them alive as long as possible unless they've said otherwise . With that presumption, if you had somebody like the parent coming in and saying 'yes , you'd better intubate that person,' that is in keeping with this predominant view within the hospital culture and the courts, and there- B u f f o l 0 Physician fore it's important to have somebody who has the legal authorization to make decisions like this. Milch: Sometimes it's helpful to word things just a little bit differently. I've always been uncomfortable with defining ventilation and things like that as "life support." I think the connotation of discontinuing "life support" weighs heavily down the road, and if we redefine them as "function supports"-that's what we're doing with the ventilator is supporting the failed function-then perhaps that could be part of the first step over the bridge. Case No. 2: A 4-year-old boy with Stage 4 neuroblastoma. After chemotherapy, he had remission until age 6, and with a bone marrow transplant did well for another 18 months. At this point the mother requested no aggressive therapy. He was hospitalized for seizures, and required progressively larger doses of Phenobarbital to control them; hospital staff objected to giving such massive doses, and reported the case to administrators. Brecher: When a family faces potential loss of a child, perhaps this is the greatest tragedy that one can face in life. The family is really never the same thereafter. The parents are faced with this overwhelming tragedy in their lives; the siblings, who are sometimes forgotten elements in all of this , are profoundly affected by the parents' full attention on the sick child. The grandparents sometimes feel left out of the loop, and of course they're heavily emotionally involved. There's a tremendous impact on all the family. After the child dies , this family is going to have to live with what went on for many years to come and hopefully feel comfortable, not with the death of the child, but with what went on, that everything that should have been done was done correctly. There is such a loss of control when something dreadful happens to your child. After all, these are parents who used to decide what their kid would wear in the morning, what they would eat at lunch, Summer 1 9 9 6 �and suddenly it seems like everything has spun out of control and they have no impact at all on the course of their child's life. And to be able to bring that into the care-giving aspect of things , to have the child at home with as much support as they need , makes them feel that they have an important pan in this and gives them more comfort about a terminal situation. tain level , we relieve some of their bone pain, we improve their exercise tolerance or what have you. Brecher: The issue of the emotional impact on the care-givers is an important one. The longer you work with a child and a family , and the more you get to know them , the more they become a part of your life and the more difficult it is if there's suddenly a bad turn of events. Freer: Cases like thi also raise an important point for l think the after is important, too , sticking with the people involved in medical education. These are very family. I've had families tell me that not only was losing complex, difficult cases in terms of medical managethe child difficult, but they ment, in terms of commuhad devoted so much of their nication, in terms of settime and so much of their ting where the patient is life energies for months or going to be cared for. And years to the care of this child yet there is still that rem"I'VE HAD FAMILIES TELL ME that suddenly there was this nant of the old medical incredible void , when even education system where THAT NOT ONLY WAS LOSING though they might have cases like this are not inthree other kids, they didn't teresting, they're not good know what to get up for in teaching cases. l still get THE CHILD DIFFICULT , BUT the morning. infuriated when l see patients drop off the teach Milch: Even our choice of THEY HAD DEVOTED SO MUCH ing curve when they go to words is significant. On the hospice or a palliative care one hand we have "do not plan. These are very comOF THEIR TIME AND SO MUCH resuscitate, " on the other plicated management ishand we have "aggressive. " sues, and maybe we have Why would we refer to it as to emphasize this in trainOF THEIR LIFE ENERGIES FOR an aggression, rather than ing. trying to examine it as someMONTHS OR YEARS TO THE Milch: The issue of whether thing that may or may not a patient does or does not be appropriate to a certain have a do-not-resuscitate clinical setting7 l am as CARE OF THIS CHILD THAT order is but a small commuch troubled by standing orders of daily blood draws . ponent in his overall plan To what end? lt doesn' t imfor care, and should really SUDDENLY THERE WAS THIS pact our therapies. Then be kept to the side of deciperhaps it's appropriate to sion-making. The plan of INCREDIBLE VOID. " examine that. CAT scans, care is daily reassessed , MRls, other procedures ofeven hourly reassessed . ten do little more than docuYes , we would transfuse Martin Brecher, M.D. ment the natural progrespatients with metastatic sion of disease and do not prostate cancer, for example , if in getting their affect our decision-making hemoglobin up to a cerprocess. + e u f f a l o Physi c ian Summer l 9 9 6 �Care of the dying se in uland explains how we die by Scott Thomas OTHI G E~E," said Sherwin B. uland, M.D., "we should teach them that they must never let their patients lose hope." Hope-an elusive concept, and one that might seem to have more to do with poetry than with the science of medicine. Yet uland, who delivered the Stockton Kimball Memorial Lecture at the 59th annual Spring Clinical Day on May 11, told a large luncheon audience that hope is a most critical component of care at the end of a patient's life. As death approaches, he said, the role of healer and counselor is most important, not the science of T-cells and high-tech machines. Nuland, a clinical professor of surgery at the Yale University School of Medicine, is best known for his 1994 book How We Die, a frank and anecdotal account of life's last chapter as he has seen it played out in his family and his patients. The book won the ational Book Award for nonfiction and the Book Critics Circle Award, and was a finalist for the Pulitzer Prize. Though the ideas of hope and approaching death may seem irreconcilable, uland offered three ways in which a dying patient can be given the gift of hope. He was once asked, "What is the worst way to die?" His response was, "Alone"-whether physically alone or emotionally isolated. "Hope becomes a promise," he said, "that we will let no one die alone." Second, uland said, hope is the promise that no extraordinary measures will be taken that will make things worse. And finally, he said, physicians can impart the hope for immortality. "I don't believe in an afterlife," he said, "but I do believe in immortality. There are, for each of us, maybe one, maybe five people whose lives are dependent on what we are. We can share with them what their existence means for us. That's the kind of immortality that I would cherish." A person's actions and life affect loved ones for years and perhaps generations. Thus, a life well lived confers immortality. uland also quoted Czech President Vaclav Havel: "Hope is not the belief that things will turn out well. It is the belief '"lr \\ E TE \CH a u f f a 1 OLR qt_,DE TS o Physician that things will make some sense however they turn out." Nuland recounted the circumstances that led him to write How We Die-a persistent literary agent, a family history touched by many early deaths. "Death had been part of the lore of my family," he said. "Going to medical school meant learning to understand, to take part of the mystery away." In his practice he realized that most of his patients had no concept of what life's final stage was like, medically or emotionally. Romanticized Hollywood images of the family patriarch dispensing pithy wisdom from his deathbed, or the beautiful young woman going peacefully into that good night, are all we have to go on, he said. Hence his unflinching collection of stories about how real people die, sometimes easily and quietly, sometimes in pain or unable to resolve their life's unfinished business. uland pleaded for his fellow physicians to pay close attention to comfort care for their dying patients. "How did physicians forget that even more important than saving life is the duty to relieve pain?" he asked. "When did we begin converting every ethical and moral decision into a clinical decision? How have we begun to value triumphs of technique over triumphs of reason?" He traced the genesis of that attitude to the entrance of molecular biology into medicine. "We began teaching our students that one can learn more about a patient through the proper tests than by developing a real relationship with the patient. We moved farther and farther away from the fellow human beings who came to us for help, and before we knew it, we no longer knew who they were." But, uland argued, it benefits the practitioner as well as the patient to embrace a more human connection. "Among the greatest rewards we derive from medicine," he said, "are those we derive when we get emotionally involved with the people who come to us for healing." + Thomas, a frequent contributor to Buffalo Physician, is an editor and freelance writer with specialties in medicine, the arts, and religion. Summer l 9 9 6 �The historic context ot medicine Nationwide history of m edicine meetings draw scholars to Buffalo B Y JESSICA ANCKER for thousands of years, but in every age societal prejudices have colored their interpretations of th ose observations. H EALERS HAVE MADE ACCURATE MEDICAL OBSERVATIO S This lesson was a recurrent theme at the national meeting of the American Association for the History of Medicine, which was held in Buffalo May 9-12 in honor of UB's sesquicentennial. The event drew more than 400 scholars from around the country to the Hyatt Regency Buffalo. In the keynote address, Thomas Benedek, M.D., a rheumatologist and the president of the a sociation, discussed medical theories on the occurrence of gout in women. "The story of gouty women is an example of the interaction of science and the society in which it is practiced. It should not be considered unique," Benedek cautioned. "Despite our tremendous advances in science and technology, an unexpected stress makes us retreat to moralizing." Gout is caused by high levels of uric acid, which is produced by the metabolism of purine. The disease is characterized by sudden attacks of pain, swelling, and stiffness of the joints, often in the feet and legs. Inheritance, overeating, and alcohol can play a role in triggering the illness. Because estrogen help women excrete uric acid more efficiently than men, premenopausal women rarely suffer from gout. Ever since the 4th century B.C., Benedek said, healers have noticed that gout is rare among women. The earliest known pronouncement on the disease"A woman does not take the gout unless her menses be stopped"-is attributed to Hippocrates himself. The Roman writer Seneca blamed the disease on licentious and intemperate lifestyles. While these activities may have been regrettable in men, Benedek said, they were considered despicable in ® women. "Because of their vices, women have ceased to deserve the privilege of their sex; they have put off their womanly nature and are condemned to suffer the diseases of men ," Seneca wrote in a passage echoed by doctors for centuries. An 18th-century comic poem played on the alleged connection with lechery: "Where does one see a wife irate Because her spouse suffers gouty feet? In hot passion's embrace, as e\·e1yone /mows, Tl1 e gouty most often arc mighty heroes!" Doctors trying to explain gout in apparently blameless men and women offered alternate explanations. A few speculated that gout could be inherited from ancestors. Others held that gouty symptoms were not always gout. One doctor wrote that slender women with symptoms of gout were really suffering from hysteria. In the 18th century, the prestigious Philadelphia doctor Benjamin Rush absolved a respectable woman patient of the imputation of indelicate behavior by calling her gout rheumatism. "The cultural response to gout meant that women with gout were scorned: doctors often believed it was due to their unacceptable behavior," Benedek said. "The same thing happened when AIDS appeared. That shows how helpful it is for doctors to know something about the history of medicine-it helps them better analyze new problems that they encounter." The 69th annual meeting of the American Association for the History of Medicine drew 66 papers. The Society for Ancient Medicine, the AIDS History Group, the American Veterinary History Society, the American Association for the History of ursing, and seven other affiliated history societies also held their meetings in Buffalo the same weekend. Papers covered a multitude of topics, including fetal alcohol syndrome, the treatment of insanity in the 19th century, medical scholars in medieval Paris, traditional Korean medicine, the polio vaccine and public health policy, and dissections in the paintings of Rembrandt. + UB history professor Jomes Bono, Ph.D. (left), coordinated local affairs for the national meeting of the American Association for the History of Medicine, May 9-12 in Buffalo. Thomas Benedek, M.D. (right), of Pittsburgh, PA, is the association president. B u f f a l o Phys ici an Summer 1 9 9 6 �.......... . ............ . ............ . ........... . . . .. . .... . ...... .. .. . ... . ... •••••••••• ••• ~ I Dean Naughton to stay for additional six months ohn P. aughton, M.D. , the dean of the medical school and vice president for clinical affairs, has agreed to keep his current posts until the end of the year. aughton said he had planned to retire in June, but agreed to stay on for an additional ix months while the search for his successor continues. "As always, I appreciate your everwillingness to respond to the needs of the university," Provost Thomas Headrick told the dean. "UB greatly appreciates John's dedication and willingness to serve the university," UB President William Greiner said. After his retirement, aughton will John Naughton likely be as busy as ever. He plans to teach, do research in cardiology, and get involved in other educational projects. "''ve begun my transition by teaching a course in health care organization, and I'm continuing my activities in graduate medical education reform, and immunology and heart disease," he said. + Endowment established for scholarships and awards \ J director of admissions and the scholarship committee, I see the tremendous financial need of nearly 50 percent of the school's medical students. It made me realize how crucial financial assistance is to these students. " + ophthalmology. Recipients will be chosen on the basis of academic standing and financial need. "1 owe my success in medicine to UB, and 1 appreciate the opportunities I received when 1 was a student," saidGuttuso " ow, as Thomas Guttuso Registrar Dick Jones organizes the 1996 graduates in the Center for the Arts atrium. Twenty-nine members of the doss of 1946-who graduated during UB's centennial-returned to help the school celebrate its sesquicentennial. scholarship and award fund for UB medical students has been established through a gift of residential property from Thomas]. Guttuso, M.D. '60, the medical school's director of admissions, and his wife, Barbara. The Dr. Thomas ]. and Barbara L. Guttuso Scholarship and Award Fund will provide an annual scholarship for four medical students, as well as an award for a senior with an interest in B u f f a l a Physician Timothy Y. Jordon, M.D., was the class speaker at commencement. Summer 1 9 9 I 6 �• ································································ . I Match Day 1996 UST U DER HALF ofUB's graduatin g class ( 49 percent) were placed in primary care residencies in this spring's Match Day, putting the university within a hair of its 50 percent goal. The ational Residency Matching Program results were announced March 20 by associate dean Dennis adler at the Lord Amherst Motor Hotel. Eighty-two percent of the 136 graduating UB students got their first, second, or third choice of residency. Thirty-one percent will remain in Bu ffalo to train in UB's Graduate Medical Dental Education Consortium, while 53 percent will go out of state. JOHN l. BUTSCH, Stngfl), Rush- Presbyterian-St. Luke's Medical Center, Chicago, IL LAWRENCE R. CANFIELD, Famil) Practice, niversity of ew Mexico, School of Medicine, Albuquerque, M RICHARD E. CHARLES, lnccmal Medicine, The list below includes fou r additional students who were matched on UB Graduate Medical Dental Education Consortium, Buffalo, NY KATHERINE B. CHATIGNY, Psychiauy, Umversity of ew Mexico, School of Medicine, Albuquerque, NM Match Day but were not graduating seniors. Of the primary care specialties, 15 students went into internal medicine and four chose internal medicine-primary care. Twenty-two students chose BASIL CHERPELIS, Internal Medicine (P1clim.), orth Shore Universit) Hospital, Manhasset, Y KRISTEN M. CHRISTIAN, Pediatrics, S Y Y Health Science Center, Syracuse, pediatrics, 21 went into family medicine, and seven chose med!peds. EILEEN (Primal) Ca1c), Emory Universit)' School of Medicine, Atlanta, GA Universi ty of Michigan Hospitals, Ann Arbor, Ml SARAH BALLOW, Pediatrics, KIMBERLY M. BONISCH, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, NY Jo ANNE ARNOLD, Obstetrics & Gynecology, UB Graduate Medical Dental Education Consortium , Buffalo, NY PETER AUGUSTINOS, Surgery, St. Elizabeth's Medical Center, Boston, MA UB Graduate Medical Dental Educauon Consortium, Buffalo, Y JOHN P. BARRETT, Obstetrics & Education Consortium, Buffalo. Gynecology, Womens and Infants Hospital, Providence, Rl MARY(. BOPP, Pcdiauics, UB Graduate Medical Dental Education Consortium, Buffalo, Y RENIER J. BRENTJENS, lntcmal Medicine, University of Virginia, Charlouesville, VA MICHAEL BEECHER, Medicine/Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, NY SUSAN E. BEHR, Pediatrics, Univer it)' of B u f f a l o TIMOTHY M. ComR, Diagnostic Radiology, Univcrsit) of Chicago Hospital, Chicago, IL HOLLY H. CROMWELL, TlansJtional, Cook County Hospital, Chicago, IL F. DAVIS, Internal Medicine, LOS Hospllal, Salt Lake Cit)', UT ALLEN GINA R. BRESCIA, lntcnwl Medicine, BRADLEY R. DAVIS, SurgCI), University of Yale- ew Haven Hospital, New Ha,·en, CT (P1immy Care), University of Rochester, Strong Memorial Medical Center, Rochester, NY SALVATORE BIANCO, Family Practice, Spartanburg Regional Medical Center, Spartanburg, SC Y Yale- ew Haven Hospital, ew Haven, CT PAUL C. BURNS, lntcnwl Medicine Texas Medical chool. Houston, TX Radiolog), Universit) of Rochester, Strong Memorial Hospital, Rochester, Y STEPHEN R. COOK, ,\fcdicinc/PcdJatrics, UB Graduate Medical Dental MATIHEW f. BARTELS, Pediatrics, DAVID ANDERSON, Surgery (P1elim.), UB M. BOBEK, Emergency MediciltC, ONEIL BAINS, lntcmal ,'1-fcdicine mversity Health Center, Piusburgh, PA JOSEPH E. CHRUSCICKI, Diagnostic Phys ici an Cincinnati Hospital, Cincinnati, OH JOSEPH S. DEJAMES, Family P1actice, UB Graduate Medical Dental Education Consortium, Buffalo. NY MANNY A. DELUCCA, Pediatrics, Medical College of Virginia, Richmond, VA Summe r 1 9 9 6 �········································•~ ··· I I ;; :.•> u ~ z Rhode Island Hospital, Prolidence, Rl (LARA E. KIM, lntemal Medicine, University of Nonh Carolina Hospital, Chapel Hill, NC MEEGHAN A. HART, Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y ANDREW B. KLAFTER, Psychiatry, Thomas jefferson University, Philadelphia, PA STEVEN G. HEINTZ, Family Practice, ANTHONY J. LANGONE, lntemal Medicine, University of Vermont, College of Medicine, Milton, VI Baylor College of Medicine, Houston, IX JASON K. Ho, Family Practice, KEUNG W. LEE, In/ental Medicine, Yale- Glendale Adventist Medical Center, Glendale, CA MATTHIAS K. LEE, Psychiatry, Stanford BRIAN HANLON, lntemal Medicine, ROB L. DEMURO, lntmwl Medicine Dermatology, Stony Brook Teaching Hospitals, Stony Brook, NY (Primar) Care), Bassett Healthcare, Cooperstown, 'Y JAMES W. FOIT, Family Practice, UB DAVID J. D'SOUZA, Diagnostic Graduate Medical Dental Education Consortium, Buffalo, NY RadwlogJ, UniYersity of Texas Medical School, Houston, IX KATHLEEN M. DYSON, Pediatncs, UB RICHARD A. EDWARDS, Obstetncs & Gynecolog_1, UB Graduate Medical Dental Education Consoruum, Buffalo, NY LLEWELLYN A. FOULKE, Patlrologj, Hospital of the University of Pennsyh·ania, Philadelphia, PA UniYersity of Cincinnau Hospital, Cincinnati, OH MICHAEL J. ENDL, /rue mal ?lfedrcinc (Prelim.), Sisters of Charity Hospital, Buffalo, NY; and Dwgnostic Radiolog) , Duke Uniwrsil) Medical Center, Durham, C JOSHUA J. FISCHER, /ntemal Medicine, Universit) of Virgmia, Charlonesnlle, VA SAMUEL GOODLOE, Surgery• (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, Y Gynecology, SU Y Health Science Center, Syracuse, NY THOMAS J. GUTTUSO, lntemal Medicine Einstein College of Medicine, Montefiore Medical Center, Bronx, y ERIK J. JENSEN, lntemal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY PATTI A. HAMERNIK, Pediatrics, UB TIMOTHY JORDEN, General Surger), GINA l. FLORES, Far111/; Practice, New STEPHANIE C. HAN, lrllcntal Medicine Hampshire-Dartmouth Famll) Practice, Hanover, H (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, Y; and Radiation Oncolog), Yale- e\\ Haven Hospital, New HaYen, CT (Prelim.), Ston) Brook Teachmg Hospitals, Ston) Brook, Y; and B a 0 p y PAULY. JEE, lmemal Medicine, Alben (Prelim.), University of Rochester, trong Memorial Hospital, Rochester, NY; and 1 curolog), University of Rochester, trong Memorial Hospital, Rochester, Y Hospital at Queens, Flushing, NY SCOTT L. FLUGMAN, lmernal Med1cine BABAK JAHAN-PARWAR, Research Fellowship, Swgical Pa!holog), Roswell Park Cancer Institute, Buffalo, Y CHRISTOPHER JAYNE, Obstetrics & Graduate Medical Dental Education Consortium, Buffalo, 1Y DORNA E. FLASH, Transitional, New York Graduate Medical Dental Education Consortium, Buffalo, NY Graduate Medical Dental Education Consortium, Buffalo, NY Universil) of Virginia, Charlonesville, VA DAVID J. FIORELLA, lntcmal Medicine THOMAS F. HUGHES, Family Practice, UB MARK JAJKOWSKI, Surgery, UB THOMAS J. GENNOSA, Family Practice, (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, NY; and Oplttlralrrwlog_\, Louisiana tate niYersity Eye Center, Ne" Orleans, LA MICHAEL S. LEONARD, Pediatrics, UB RAJIV K. JAIN, Medicine/Pediatrics, Duke UniYersity Medical Center, Durham, NC TIFFANY B. GENEWICK, Obstetrics (.-. Gy necoiOg)', UB Graduate Medical Dental Education Consortium, Buffalo, Y GARY J. ELKIN, /ntcnwl Medrcrne, Health Service, Stanford, CA Gynecologj, Temple University Hospital, Philadelphia, PA Louis University School of Medicine, St. Louis, MO (Prelim.), i ter of Charity Hospital, Buffalo, Y; and Diagnostic RadiologJ, johns Hopkins Hospnal, Baltimore, MD Graduate Medical Dental Education Consortium, Buffalo, NY JEAN(. HSIAO-WANG, Obstetrics c~ Yu-LUEN Hsu, lntenwl Medicine, St. BRIAN J. FORTMAN, /ntcnwl Medicine c a 5 m (Prelim.) Madigan Army Medical Center, Tacoma, WA WALTER J. KANTOR, Emergency Medicine, University Health Center, Pittsburgh, PA DAVID KAUFMAN, Pathology, Mt. Sinai Hospital, m New Haven Hospital, New Haven, CT e ew York, 9 9 Y Graduate Medical Dental Education Consortium, Buffalo, NY KWOK Ll, lntenwl Medicine (Prelim.), UB Graduate Medical Dental Education Consortium. Buffalo, Y; and Ophthalmology, Louisiana State University Eye Center, ew Orleans, LA DOMINIC R. LIPOME, ln!enwl Medicine (Primary Care), UB Graduate Medical Dental Education Consortillln, Buffalo, NY HAROLD I. LITT, lrHemal Medicine (Prelim.), Mt. Auburn Hospital, Cambridge, MA; and Diagnostic Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA CHENG H. Lo, Surgery, Stony Brook Teaching Hospital, Stony Brook, Y JIADE J. Lu, Internal Medicine (Prelim.), Sisters of Charity Hospital, Buffalo, Y; and Radiation Oncolog), jackson Memorial Hospital, Miami, FL BETH M. MACDONALD, Family Practice, Southwest Washington Medical Center, Bush Prairie, WA MICHAEL A. MANKA, Emergency Medich1e, UB Graduate Medical Dental Education Consortium, Buffalo, NY DEBORAH J. MANN, Emergency Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY CHRISTOPHER (. MASCIA, Pediatrics, Medical College of Virginia, Richmond, VA �• ·········· ·· ··············· · ············ ~ I L. WALK, Family Practice, Highland Hospital Program, Rochester, NY PAULS. MAll, Pcdiatncs, Children's JOHN P. PATTI, \1rdiclllc/Pediatrics, UB KARIN A. SELVA, Graduate Medical Dental Education Consortium, Buffalo, NY Pcdtatrics, Uni,·ersity of ew Mexoco, School of Medocine, Albuquerque, M LISA Hospital of Pholadelphoa, Philadelphia, PA L. MCNALLY, Surgery (Prelim.), University of Rochester, Strong Memorial Hospital, Rochester, NY: and Urology, niversity of Rochester, Strong Mcmonal Hospital, Rochester, N'r OSCAR E. PIEDAD, Family PracL!cc, Richland Memorial Hospital, Columboa, SC EDWARD SILVERMAN, Obstctncs & G_\IICcolog_\, Mamwnodes Medical Center, Brooklyn, N'r JAMES G. WAXMONSKY, FREDERICK J. PIWKO, Fanlll) PnJctice, \\ olllamsport Hospital and Medocal Center, Wolliamsport, PA INDRANI SINHA, Pedtatrics, Unovers1ty of Florida, Shands Hospital, GameS\ille, rL KEE Y. WEE, KATHRYN A. MCVICAR, Pcdwtrics, JONATHAN W. SIRKIN, Psychiatl}, UB NAOMI D. WEINSTEIN, f.,Gynecology, Unl\erslt) of Rochester, Strong Memonal Hospotal, Rochester, NY STEVEN R. POSNER, urger\, Unoversit) of Michigan Hospitals, Ann Arbor, Ml JOHNS. PULVINO, Obstetrio & G) necology, Mmne Medical Center, KAREN A. SNELL, Obstetrics f.,Gynecology , Ba)'State Medical Center, Springfield, MA WILLIAM J. MEDWID, KAVITHA T. RAM, Obs!Cims MELANIE Presbytenan Ho pita!, Ne" York, Y THOMAS P. MEAD, Obslrtms Family Practice, Beverly Hospital, Danvers, MA PracL!ce, t.;B Graduate Medocal Dental Education Consortium, Buffalo, NY KIMBERLY E. METZ, Fanuly DAVID T. MILLER, Surge'} (Prclun.), UB Graduate Medocal Dental Education Consortium, Buffalo, Y: and Orthopedtcs, B Graduate Medocal Dental Education Consoruum, Buffalo, Y Emergency Medicine, Long Island jew1sh Medical Center, Long Island, NY PINAKI MUKHERJI, DWAYNE A. NARAYAN, Psychiatry, noverslty of Virgmia, Roanoke,\ A Obstru 1c; f_,Gynecology, noverslty of Texas Southwestern Medocal School, Dallas, TX EMMEKUNLA K. NYLANDER, NAYOMI E. OMURA, Internal Medicine (Prclun.), George Washmgton University, Washmgton, DC J. 0STEMPOWSKI, Orthopedics, Universit)' of Cincinnati Hospital, Cincinnati, OH MICHAEL CHRISTOPHER PACE, Urology, Unoversit) of Texas Southwestern Medical School, Dallas, TX Emngency Medtchtc, UB Graduate Med1cal Dental Education onsortlum, Buffalo, 'r PARAS PANDYA, Medtwoc, Unoversoty of Connecticut, Farmington, CT NEIL N. PATEl. Internal ® C" G\IICcolog_v, LB Graduate Medocal Dental Education Consortium, Buffalo, Y SUNG Y. SoN, Fwmlv TranstL!ollal, Evanston Hospital, Ch1cago, IL Graduate Medical Dental Education Consortium, Buffalo, Y J. RIEGEL, llllernal \trdicine, St. Elizabeth's Medical Center, Boston, MA KRISTIN A. STIEVATER, Psychiatt) , UB Fwnily Practice, UB Graduate Medocal Dental Education Consortium, Buffalo, N'r MICHAEL(. STONER, H. WILLIS, JR., i\eurosurgery, CleYeland Clinic Foundation, Cleveland, OH BYRON MARY M. WILSCH, Obstetrics & Gynecology, University of Rochester, Strong Memorial Hospital, Rochester, Y Graduate Medical Dental Education Consortium, Buffalo, NY KRISTEN M. ROBILLARD, ARLENE S. ROGACHEFSKY, Dw11a!Oiogy. Cle,·eland Clinic Foundation, Cleveland, OH JOSEPH(. WITIMANN, Pediatrics, UB Surgcty, Medical College of VIrginta, Richmond, VA Graduate Medical Dental Education Consoruum, Buffalo, Y Obstcutcs & G\nrcology, Albany Medical Center Hospital, Albany, NY TOVA R. STRAM, l. WRAZEN, Pedialt ICS, Oregon Health Sciences ni\-ersity, Portland, OR JENNIFER Medicine! Pechatms, Baystate Medical Center, pnngfield, MA SUSAN M. SZIMONISZ, Practice, LB Graduate \ted1cal Dental Education Consortium, Buffalo, Y MARY A. RYKERT, Fanul_1 Practice, Niagara Falls Memorial Hospital, Ntagara Falls, Y CHARLES YATES, FamilJ Pedtautcs, B Graduate Medical Dental Education Consortium, Buffalo, Y MAXINE E. SZUMIGALA, STARLEEN (. SCHAFFER, \lcdicine/ Pediatncs, Jackson Memonal Hosp1tal, Moamo, FL MARK R. ZAMBRON, Medicinc/Pediallics, UB Graduate Medical Dental Education Consortium, Buffalo, NY Emergency Mcdicme, UB Graduate Medical Dental Educauon Consortium, Buffalo, ) RENATE TREADWAY, DAVID F. SCHMITZ, Fcuml) Practice, Famoly Practice ResidenC) of Boise, Boise, ID Fanuly Practice, Niagara Falls Memonal Hospital, iagara Falls, Y DANIEL W. ZORICH, Obs!CIIics f., Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY MILLICENT H. TREVETT, J. SCHROT, Surget) (Prelim.), t. Louis niverslty chool of Medicine, St. Louis, MO RUDOLPH J. SCHUECKLER, Orthopedics, McGaw Medical Center, orthwestern Uni,·ersity, Chicago, IL JON UDWADIA, Pccliatr tcs, UB Graduate Med1cal Dental Education Consortium, Buffalo, N) EROL VEZNEDAROGLU, Surgcl) (Prelun .), Thomas jefferson UmverSll), Philadelphia, PA: and 1\eurosurget) , Thoma jefferson UmverS!l), Philadelphia, PA DOUGLAS A. SCHULTZ, 0 + Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, NY OTTO 0 lntetnal Medicine (Prelim.), St. Mary's Medical Center, Long Beach, CA: and Radiation Oncology, Stanford University Hospital, tanford, CA Scan S. WILLIAMS, PATRICK J. STEIN, Psychiatl), UB BRIAN f Pediatrics, University of South Florida, College of Medicme, Tampa, FL Ptactice, Lancaster General Hospnal, Lancaster, PA EILEEN B. REILLY, u Dtagnostic Radiolog_\, Uni\·ersll\ Hospitals of Cleveland, Cleveland, OH Graduate Medocal Dental Education Consortmm, Buffalo, NY Portland, ME B Psychiall), UB Graduate Medical Dental Education Consortium, Buffalo, NY p s o n S u m m e 9 9 6 �··················································· ·· ···································• · · ~ •• New UB Chair honors professor HE U IVERSITY HAS HONORED a respected faculty member, Eugene R. Mindell, M.D., with the establishment of the Eugene R. Mindell M.D. Chair in orthopedic surgery. Mindell, UB professor emeritus and chair of the department of orthopedics from 1964 to 1988, conducts research in orthopedic oncology and bone pathology. Eugene Mindell He is particularly interested in new treatments that avoid total amputation. For example, Mindell takes pride in saving the arm of a 19-year-old woman with osteogenic sarcoma just above her wrist. After the cancer was removed, along with part of the radius, the patient's bone was reconstructed with bone from a bank. Ten years later, the patient has a good arm with an excellent grip, and no recurrence of disease. After interning at the Cincinnati General Hospital, Mindel! was stationed as a naval officer at the Veteran's Hospital in Columbia, SC. He completed his residency at the University of Chicago Clinics. Mindell met his wife of 50 years, june A. Mindell, while he was a medical student and she was an undergraduate at the University of Chicago. They have four children and three grandchildren. Robert Gillespie, M.D., chair of UB's Department of Orthopedic Surgery, said of Mindell: "He is a man of great charm and obvious integrity and leadership qualities. His greatest accomplishments are his dedication to the residency program and his work as a teacher. He is a true academic surgeon." The chair is funded by a charitable remainder trust commitment from Byron A. Genner III, M.D., UB class of 1954. Further gifts toward the chair are being sought. Genner's gift places $825,000 in real estate in trust for the medical school, while still generating income for Genner during his lifetime. The school will seek more money to bring the total funding for the chair to between $1 million and $1.5 million. "UB provided me with an outstanding undergraduate and medical education," said Genner. "This became evident during my internship and orthopedic surgery residency. It was satisfying being as well or better prepared than my peers in my academic endeavors." Genner spent 15 years on active duty in the U.S. Air Force, retiring as a lieutenant colonel. His career includes posts as associate clinical professor at George Washington University and assistant clinical professor at Georgetown University. He continues a part-time orthopedics practice, along with an active + medical-legal consulting service. -8 Y P A U L A W I T H E R E L L As part of UB's sesquicentennial celebration, these plaques were installed in downtown Buffalo to commemorate the first three homes of the medical school. B u f f a I a Physician Summer 1 9 9 6 �Robert N. Spengler, Ph.D. Neuroimmunologist WORKING AT THE INTERSECTION OF IMMUNOLOGY AND NEUROBIOLOGY IT' 5 o sEcRET that the mind has a profound effect on healing. Quantifying that relationship and examining it at the molecular level is the work of Robert Q) sity of Michigan, where he also did postdoctoral work in pathology. He joined UB as an assistant professor of pathology in 1989. His primary area of interest is cytokines, a class of immune system hom10nes that serve as cellto-cell communication signals. Once thought to be active only in the immune system, cytokines have been found to have many functions in the nervous system, as well. This has led researchers to believe that cytokines participate "We're looking for a better understanding of how the brain controls body functions , and the other way around-how cells associated with the immune system control neuronal functions," says Spengler, assistant professor of pathology. "Each system is interdependent on the other. " Spengler, 4l,isparticularlywell qualified to explore the fruitful intersection of immunology and _Eeurobiology. He earned his Ph.D. in pharmacology from the Univer- B U f f o . Spengler, Ph.D. l o Physician in neuro-immune communication and may even act as neurotransmitters in certain situations. Spengler is particularly interested in tumor necrosis factor. Like many other cytokines, it was first identified and named for its connection with an immune function (killing tumor cells). ow researchers believe it also has neurologic functions. Because the concentration of tumor necrosis factor often governs how it functions in different disease states, much of Spengler's work focuses on investigating how the body regulates the release of the substance. Another of Spengler's research areas is psychotropic drugs. He has investigated the biochemical activity of antidepressant drugs and how cytokines may be linked to depression. He also studies the use of antidepressant drugs to alleviate neurological pain, which occurs when a disorder such as arthritis causes chronic pain that creates a continuous circuit in the brain, causing the sensation of pain even without any further stimulus from the site of the disorder. Drugs that affect neural behavior may do so by regulating cytokine expression or sensitivity, according to Spengler. "We use drugs as a tool to understand a disease, " he explains. "Drugs are used because they work, not because we know how they work." Spengler is also beginning experiments on a second group of cytokines, the interleukins, which seem to perform many of the same functions as tumor necrosis factor. This redundancy, he theorizes, shows how important these functions are. "It's clearly the body's way of backing itself up," he says. + Summer 1 9 9 6 �·· · ··· · ········· · · · ·········· · ·········· · ··· ·· · · ···· · ··· · ········· ··· ·· · ···· · ···· · ··· · · ·• · · ~ I Two D~tinguished Professors named wo members of UB's medical fac- a department-wide commitment to upulty have been named to the rank holding the policy. It is largely through of Distinguished Professor, the his work that UB has been recognized highest rank in the State University as a national leader in recruiting and of ew York system, by the SU Y retaining students and facBoard of Trustees. ulty from traditionally James P. olan, M.D. , was named underrepresented groups. Distinguished Service Professor, awarded olan has been a memin recognition of extraordinary service to ber of the Governor's the community, state, or nation. Council on Graduate Perry Hogan, Ph.D., was named Perry Hogan Medical Education, and Distinguished Teaching Professor , has served as president of the ew York an equivalent honor that recognizes State chapter of the American College of outstanding teaching competence. Physicians. olan, who recently stepped down Hogan teaches cardiovascular physiafter 16 years as chairman of the Depart- ology, cell membrane phenomena, and ment of Medicine, is an internationally the electrophysiology of excitable cells. recognized expert in For many years he has taught cardiac liver function, liver and circulatory physiology to first-year disease and injury, medical and graduate students. and endotoxins. Hogan received the Louis A. and Ruth His efforts in the Siegel Award for Outstanding I eacher in 1970s led to a the Preclinical Sciences five times during full and fair affirma- a 16-year period. The award is given by tive action policy and medical students and fellow faculty. + James Nolan I UB microbiology professor dies at 76 ugene A. Gorzynski, Ph .D. '68, of Homburg, NY, a professor of microbiology and pathology at UB and chief of the microbiology section at the Buffalo VA Medical Center, died May 16 after a lengthy battle with cancer. He was 76. In 19 55, Gorzynski and the late Erwin Neier, an internationally known bacteriologist, were the first to describe enteropathogenic f. coli bacteria as a toxin producer that could cause severe diarrhea in infants and young children. Aveteran of World War II, Gorzynski served as director of bacteriology with the Army General Hospital in England. While there, he met his future wife, Ruth Repp, an Army nurse and Missouri native. She died in 1992. At different times, Gorzynski worked at the VA, Children's Hospital, and Roswell Pork Cancer Nielsen and Nolan Win Alumni Association Awards Institute, and served as an assistant director oft he ancy H. ielsen, M.D., a 1976 and serves as regional medical director graduate of the medical school for the Board of Professional Medical and a former member of the SU Y Conduct in the ew York State DepartBoard of Trustees, has been given ment of Health. A specialist in internal medicine the Samuel P. Capen Award , the and infectious disUB Alumni Association's most ease, she is a clinical prestigious award. assistant professor of The award recognizes alumni who medicine at UB. have made "notable and meritorious The Alumni Ascontributions to the university and its sociation also gave family ... influencing growth and imthe Walter P. Cooke provement of UB and stimulating othAward to James P. ers to give their active interest and olan , M.D. The material support to the university. " honor recognizes ielsen was the first woman to be exceptional service elected president ofThe Buffalo General to UB by a nonHospital medical staff. She is past presialumnus . + dent of the Erie County Medical Society Nancy Nielsen B u f f a I o P hysici a n Summer 1 9 9 6 Erie County Health Department. He hod taught at the UB School of Nursing and Erie Community College as well as at the UBmedical school. Amember of the UB-based Ernest Witebsky Center for Immunology, he served on the admissions committee of the School of Medicine and Biomedical Sciences. An amateur violinist, Gorzynski performed with the Amherst and Orchard Park Symphony orchestras for more than 30 years. He also was commanding officer of the 365th General Hospital for the U.S. Army Reserves in Amherst from 1966-69. He retired as a colonel in 1979. + ® �••••••••• • • 0 •••••••••• • ••••••••••••••• •• •• • • 0 ••••••••••••••• "I had never known so much about someone " ••• BY CHR I S SCHAEFFER , UB MEDICAL SCHOO L C LASS OF 1998 n the summer of 1995, after my first year of medical school, I spent six weeks at The Buffalo General Hospital's Outpatient Clinic. The story of that externship is the story of the 100 people I saw. I was fascinated by their stories, by their problems, by the factthatl was sitting in the room with them, wearing a white coat and writing it all down. Of all the stories that I came across that summer, one will always stay with me. Mr. R was a 54-year-old man, divorced, with one son. His face had the look of worn shoe leather. He was gaunt, with uncut white hair and skinny legs inside cowboy boots. In our first interview, during a checkup, Mr. R gave me the gist of his complaints. But what fascinated me was that his life had been so different from mine. He was poor, he had grown up without any of my advantages, and he had taken pleasure where he could find it. Later, my preceptor, Dr. Richard Schifeling, explained alcoholic cirrhosis and the attendant problems Mr. R was having-ascites and hemorrhoids, to name two. Mr. R returned the next week, before his scheduled appointment, complaining of pain and worsening ascites. I waved to him in the hall, oddly glad to see a familiar face in the crowd. ext week Mr. R was back. This time I asked to see him. In the sea of everchanging, ever-similar complaints, Mr. R seemed like a rock of certainty- ! already knew what was wrong with him. I talked to Mr. R about his belly and how things were going at home. Frankly, I was curious about how his life had come to this point. He could barely move himself around the examining room. I wanted to know, 'Who is this person who has done this to himself?' I put all of my empathy and listening skills to work, and for my efforts learned only that he lived with "a woman friend" and had just decided to give up drinking. Mr. R asked me to take off his boots becau e it hurt too much to bend over. That day, Dr. Schifeling recommended a transjugular intrahepatic ponosys-temic shunt, or TIPS, to bypass his failing liver. Mr. R looked at us, then looked away, and consented by saying, "Whatever you got to do.l just want to get this over with." When Mr. R was admitted, I thought, "Hah! He'll be here all the time-now he'll have to talk to me. " My increasing familiarity with his medical condition made my complete lack of understanding of him bother me more and more. When I visited, we chatted about nothing-the nurses, the food, the TVs remote control. What I really wanted to know was if he was nervous about the surgery, if he really had kept drinking even with his liver destroyed. I left without answers. Mr. R went from poor to worse. His kidneys began to fail , so he couldn't • •••••••••••••••••• • •••••••• have the surgery after all. Over the next two weeks I saw a myriad of people in the outpatient clinic, but every morning and evening I visited Mr. R. We tried everything we could to help, including multiple abdominal taps to relieve his ascites. One memorable day I stood with an attending, a resident, an intern, and a fourth-year student as the intern began an abdominal tap. After the initial excitement, everyone left except the intern and myself. The intern looked at me, considered his aching arms, and asked ifl would like to finish the tap. The next thing I knew, the intern had left, I was holding a needle somewhere inside Mr. R's belly, and Mr. R was talking on the telephone. All I could think was, "What is going on?? I hope nothing goes wrong! " Every day he was in the hospital, I saw his complete medical report, from his blood and urine to how he had slept the night before. I had never known so much about someone. In the final weeks of my externship it became clear to me (long after it had become clear to everyone else) that Mr. R was going to die, and die soon. Whenever I saw him, I waited quietly so he could bring up anything he wanted to talk about. I asked how he felt, I joked with him. Nothing changed. He still complained about his roommate, his girlfriend, his son. I never got to know Mr. Rduring our talks. He stayed private and separate from me. Knowing his prognosis, Mr. R decided to go home. He tried to cheer our blank faces by joking that he'd come to the clinic, "just like before." He left on Friday. When I got to work on Monday, Dr. Schifeling took me aside and told me that Mr. R had died over the weekend. + Chr-is Schaeffer, l-..ho will enrcr h1s !hird year a! L'B School of \.fed1cme and Biomedical Sciences 1h1s fall, is the secretan- of tht' \.1edical Studen! Polit\ s u f f a I o Phys i cian Summer t 9 9 6 �1996 reunion portraits en classes were honored at this year's Reunion Weekend festivities as they gathered in Buffalo to remember old times and renew acquaintances. FIRST ROW:john Crissey, Raymond Trudnowski, Stanley Cyran, William Walsh, Myron Williams, john Allen, Annabel Irons, Edward Gudgel, Donato Carbone. SECOND ROW:Lawrence Golden, William Marsh, orman om of, Harry Petzing, Fred Schwarz, Charles Bauer, Harold Levy, Herbert Pirson, Ross Imburgia, Thomas Morgan, R. joseph aples, Maynard Mires, Albert Rowe, Eugene Marks. THIRD ROW: Raymond Osgood, Richard Munschauer, Bernard Groh, Carllmpellitier, Willis Allen, Guy Hartman, Charles joy, W. William Tornow, Amo Piccoli, Frederick Musser. B u f f a l o P hysician FIRST ROW: Lester Wolcott, August Bruno, Donald Pinkel, Leonard Danzig. SECOND ROW: Alvin Volkman, james LoVerde, Allen Goldfarb, Milton Robinson, Eugene Leslie, Marvin Pleskow, Eugene Teich, Carl Conrad, Edward Shanbrom, Harold Krueger. Reunion Classes Continued on page 30 Summer l 9 9 6 �~ -········· ··· ·· · · · · · ························ · · ··· · · ··························· · ········· lEI FIRST ROW: Peter Goergen, Bernard Sklar, Helene Buerger, Sue McCutcheon,john Bartels, Robert Reisman, Fred Lee, Herman Schoene. SECOND ROW:john Hodson, joseph Kunz, Fred uessle, Robert Corretore, Paul Ronca, john Walters, Hugh 0' eill, Carl Schueler, jean Haar. THIRD ROW:Edmond Gicewicz, Mark Dentinger, Fred GoldsteinGretan, Erick Reeber, Dennis Heimback, George Christ. FIRST ROW: Eugene Cimino, Harold Brody, Michael Cohen, james Markello. SECOND ROW:joel Bernstein, William Hewett, A. Thomas Pulvino, Thomas Ciesla, Washington Burns Ill, Sylvia Kennedy, ]. Anthony Brown, Wende Young, Henry Goller, Edwin Manning,Jonathan Logan,joseph Fermaglich, Howard Wilinsky. FIRST ROW: Edwin jenis, Murray Yost, Robert Barone, jared Barlow, Cary Presant. SECOND ROW: Roger Seibel, jeffrey Kahler, Virginia Rubinstein, David Buchin, Rudolph Oehm, Ross Guarino , William Sperling, Frank Barbarossa, james Cuffe. THIRD ROW:Harold Grunert, David Wallack, Eugene Spiritus, H. john Rubinstein, Michael Weintraub, Louis Antonucci, Thomas Bradley, Wayne Fricke, Marcella Fierro, james Moran, john LaDuca. FIRST ROW: Colleen Livingston, Annie Terry English. SECOND ROW: Marvin Stein, Askold Mosijczuk, Dennis adler, Scott Kirsch, David Rowland, David Bloom, Sigmund Gould, Roy Oswaks, Allen Berliner, Robert Kaufman, Richard Manch, joel Paull. THIRD ROW:jay Harolds, Donald Marcus, David Hoffman, Martin Mango. FOURTH ROW:Manny Christakos,] ames McCoy,] ohnAntkowiak. FIFTH ROW: Charles Yeagle. B u f f a l o Physician Summer 1 9 9 6 �FIRST ROW: Gregg Broffman, Arnold Wax, Linda Wild, Susan Barde, Robin Lazar-Miller, Patrick Hayes, Karen Glasgow, Louise Isenberg-Dallaire, Stephan Levitt, Hartwig Boepple, Paul Schwach. SECOND ROW: Martin Barron, Grant Golden, Daniel Wild, Jon Yerby, Christopher Barde, Melvin Pohl. THIRD ROW: David Myers, Christopher Brandy, William Bishop, Dennis Pyszczynski, John Bodkin. FIRST ROW: Suzanne Bradley, Beth Heitzman Donahue, Betty Wells. SECOND ROW:George Bancroft, ToddJacobson, Pablo Rodriguez, Stanley Bukowski, Daniel Castellani, Pano Yeracaris. FIRST ROW (KNEELING AND SITTING): Carmen Todoro, Katrina Guest, Donnica Moore, Sanford Levy, Molly 0'6-orman, Paul Holmwood, Deborah Puckhaber, Mary Bennett. SECOND ROW: Megan Farrell, Shirley Anain, William Beneke, Andrew Giacobbe, Edward Stulik, Lance Besner, Riyaz Hassanali, Leonard Portocarrero, Karin Choy, Sean O'Brien, Mark Vickers, Deborah Richter. FIRST ROW: Alison Koehler, Kathylynn Southard, Susan Littler, Grace Alessi, Mary Bonafede, Rosalind Nolan Sulaiman, Elissa Bookner. SECOND ROW: Kinga Tibold, Joseph Barrocas, Joseph Bonafede, Steven Abbey, Richard Alessi, Jennifer Ferraro. B u f f a l o P hysician Summer 1 9 9 6 �Treating children from around the world LYNNETTE NIEMAN , '78, CLINICAL DIRECTOR OF THE NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT ynnette Kaye Nieman, M.D., values the knowledge and practical experience she carried from UB to her career at the National Institutes of Health (NIH). However, one thing she hasn't found a use for was an adage she was taught here: in medicine, if you hear hooves, it's more likely a horse than a zebra. "Around here, that just isn't true: hooves mean it's probably a zebra," explained ieman, 43, clinical director of the ational Institute of Child Health and Human Development, one of 16 component institutes at NIH. Nieman encounters the exotic and uncommon every day as she studies and treats afflicted children who come from throughout the world to the Institute's Bethesda, MD, clinic for treatment of rare endocrinological disorders. "Simply put," ieman explained, "we get to see weird things from all over the world." ieman oversee patient care, protocols, credentialing and medical education at the Institute , administering a 36bed inpatient unit and large outpatient clinic. More than 70 physicians, from fellows and trainees to experienced, board-certified experts , provide direct care through affiliation with the Institute. Young doctors who complete fellowships at the Institute are frequently recruited into academic medicine, the pharmaceutical industry or regulatory posts, including the Food and Drug Administration, A Buffalo native, ieman is board-certified in endocrinology and internal medicine. She obtained her undergraduate degree in molecular and cellular biology at Smith College and attended UB School of Medicine and Biomedical Sciences between 1974-78. She performed her residency in Buffalo as well , rotating between Buffalo General, the VA hospital, and what is now ECMC. She rose to chief resident during her third residency year. ieman served as an endocrine fellow in Buffalo for a year before joining IH explains ieman. Although the federal government has tightened its belt in recent years, ieman says that IH still enjoys relatively stable funding. Independence from constant grant-garnering enables IH clinicians and researchers to pursue "more high-risk research where there might not be a clear-cut payoff," explains ieman . Some of the work the Institute does in vaccine development is "really cutting edge," she added. Field trials take place all over the world , including current projects in Vietnam, Egypt and Israel. in 1982. ieman has authored more than 100 major journal articles and book chapters, most on Cushing's Syndrome or female reproductive anatomy. Cushing's Syndrome is a rather uncommon disease which ieman has researched , written about , and spoken on extensively. A natural overproduction of cortisone by the adrenal system, Cushing's comes in varying degrees of severity. Although relatively treatable, early Cushing's symptoms can be difficult to distinguish from more com- ® B u f f o l o Physician summer l 9 9 6 �Cushing's. In addition, she has examined other potential uses for the drug, which the FDA is now examining. "The drug seems to have potential for reducing fibroids and stalling endometriosis ," she explained. Thirty million women a year experience these problems, which are the most common reasons for hysterectomies, according to ieman. Dr. "Pepper" Davis, ieman's first attending physician in Buffalo, deserves credit for steering her toward endocrinology, she recalled. "I was mon ailments, ieman explains. "The early signs, such as weight gain, hypertension and interested in gynecology, but we talked a lot and he mood swings, are frequent even among the general popula- introduced me to the idea of medical endocrinology." ieman also credits UB medical school for showing tion," she said, "so we do a lot of work teaching clinicians how her how to examine philosophical and bio-ethical conto distinguish Cushing's from more common ailments." siderations during her training, tools Later stages of Cushing's, however, are which she has now revisited in dealing unmistakable. Patients will develop round, 11 with the RU 486 research. Simply put1 we reddened faces and weight gain in the center ieman, her husband and their two of the body, with purple stretch marks around children live in Bethesda. After years the midsection. Fully developed Cushing's get to see weird dedicated to the study of endocrinologican be fatal. Generally, victims succumb to cal change , ieman is occasionally ancillary problems including hypertension, tempted to "treat" her 13-year-old son infection, or adrenal cancer. things from all for puberty. "His mouth definitely went ieman's research into Cushing's has into puberty before the rest of him," says brought unique opportunities to study potenNieman. "There are those days, when I tial uses for RU 486, the controversial drug over the world." tell my husband , 'You know, I could used in other countries as an "abortion pill." cure this!"' ieman has found that RU 486 is an + effective cortisone blocker in treating B u f f a l a Physician Lynn ette Nieman, M.D. Summer 1 - 9 9 6 STEVE COX �SURF THE NET! Three generations of UB doctors he University at Buffalo's sesquicentennial celebration serves as a special milestone for the Levy family. It will mark the 50th anniversary of the graduation from B of Harold]. Levy, M.D., and the lOth anniversary of the graduation of his son, Sanford H. Levy, M.D. It will also be the Slst anniversary of the graduation of Harold's father, Sidney H. Levy, M.D., a radiologist who started the Levy line of UB physicians. Sidney, who died in 1945, received his M.D. in 1915 from the then-private nivcrsity of Buffalo, interned at the old Eric County Hospital, and then served as aU .. Army medical officcrduringWorld War 1. When idncy opened his practice in diagnostic radiology, he was only the second physician to render such services in post-World War I Buffalo. "When he started his practice, some hospital did not have radiologic equipment, o the patients were brought to my father's office in ambulances for such ser- vices," said Harold, a Buffalo psychiatrist. Harold graduated with honors from the UB medical school in 1946 at the young age of 21, and served for a short time in the U.S. Army Medical Corps. ln 1948, Harold was recalled to active duty and served as chief of psychiatry at army hospitals in Korea and Hawaii. Later, Harold entered the growing field of psychosomatic medicine. ow, at age 71, Harold, a life fellow of the American Psychiatric Association, continues his private practice at Psychiatric Associates of Western ew York and serves as a clinical associate professor at UB. Exactly 40 years after Harold received his medical degree, he watched his son, anford, graduate with highest honors. 'Tve wanted to be a doctor for as long as I can remember," recalled Sanford, an internist at Sisters Amherst Health Center. "Seeing my father working in medicine and the strong relationship he had with patient had a positive influence on me. Even today, my father continues to teach me." A fellow in the American College of Physicians, an ford is also an authority on alternative and complementary medicine. Following his father's lead, Sanford also teaches and mentors UB medical students and residents at Sisters Hospital. Harold is a member of the james Platt White ociety, a past president of the Medical Alumni Association , and reunion co-chair for the class of 1946. "I have an extreme sense of pride both as an alumnus ofUB and as a physician," he said. "Medicine is the highest calling and i one of the most commendable professions to enter. There is no greater sense of satisfaction and gratification than to serve your fellow man and improve his + quality of life. " The Levys ® • INTERNET SOFTWARE Many Titles!! 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A non-profit UnwefSJfy program for students faculty & staff The Commons • North Campus • (716) 645·3554 • Fax: 645-3884 P B u A f U f L a A l W o ITHERELL Phys i cian Summer 1 9 9 6 �........ . .. Reunion classes support UB his year's reunion classes made generous donations to the medical school during the annual Spring Clinical Day and Reunion Weekend festivities. In all, $130,030 was pledged to the medical school to be used for scholarships for worthy students. Following is a list of participating class members and class totals. Dr. Thomas]. Murphy Dr. Edward A. Penn CLASS OF 1946-$58,900 Dr. john G. Allen Dr. Charles D. Bauer Dr. Robert A. Brown Dr. Donald P. Pinkel Dr. Marvin j. Plcskow Dr. john T. Crissey Dr. Robert E. Ploss Dr. Stanley j. Cyran , Jr. Dr. Milton Robinson Dr. Maier M. Driver Dr. Lawrence H. Golden Dr. Gerard E. Schultz Dr. Edward Shanbrom Dr. Bernard F. Groh Dr. Edward F. Gudgel Dr. Eugene M. Teich Dr. Alvin Volkman Dr. Guy L. Hartman Dr. Lester E. Wolcott Dr. Charles A. joy CLASS OF 1956-$3,050 Dr. Elliott C. Lasser Dr. M. David Ben-Asher Dr. Harold J . Le,·y Dr. Robert B. Corretore Dr. Eugene M. Marks Dr. Joseph j. Darlak Dr. Dennis P. Heimback Dr. William L. Marsh Dr. Arthur T. Skarin Dr. Lawrence D. Lubow Dr. Donald H. Marcus Dr. Merrill L. Miller Dr. Elizabeth Donahue Dr. Paul D. Fadale Dr. jonathan Gewirtz Dr. Wende W . Young Dr. Richard L. Munk Dr. joanne G. Gutliph Dr. Denms A. Nadler Dr. LyndaM. KarigHohmann Dr. Todd A. jacobson CLASS OF 1966-$13,825 Dr. Paul M. Ness Dr. Louis]. Antonucci Dr. joel H. Paull Dr. Robert E. Kaplan Dr. Frank j. Barbarossa Dr. Dadd W. Potts Dr. Girard E. Robinson Dr. jared C. Barlow Dr. Douglas S. Richardson Dr. Daniel P. Schaefer Dr. Robert M. Barone Dr. Da,·id M. Rowland Dr. Anne Shain Dr. Thomas \V. Bradley Dr. Richard I. Staiman Dr. Evan B. Shap1ro Dr. james j. Cuffe . Jr. Dr. William C. Sternfeld Dr. Ross A. Sih erstein Dr. james D. Felsen Dr. Melvin f'ox Dr. Annie Terry-English Dr. Da,·id Small Dr. Harold Trief Dr. Lloyd D. Stahl Dr. Harold F. Grunert . Jr. Dr. Edwin H. jenis Dr. Francis j. Twarog Dr. Roberta C. Szczurek Dr. Stephen . . Vogel Dr. David M. Thomas Dr. jeffrey L. Kahler Dr. Bennett G. Zier Dr. Frederick L. Williams Dr. Georgianne ZigarowiCz Dr. KcnnethV. Klementowski CLASS OF 1976-$6,300 Dr. ~tichael L. Aaron Dr. Serafin C. Anderson CLASS OF 1986-$4,920 Dr. Laurel A. Bauer Dr. William j. Beneke Dr. Donald M. Pachuta Dr. Cary A. Presant Dr. Dr. Dr. Dr. Dr. Ben W. Rappole Dr. james F. Shaffer Dr. Michael R. Bye Dr. Anthony Camilli Dr. William L. Sperling Dr. John E. Spoor Dr. David Wallack Dr. Michael !. Weintraub Dr. Paul B. Cotter. Jr. Dr. David A. Della Porta Dr. Geraldme K. Kelley Dr. james Kern Dr. Sean T. O'Bnen Dr. Dr. Dr. Dr. R1chard j. Lederman Charles H. Michalko james]. Moran john j. O'Connor Dr. joseph L. Kunz Dr. Maynard H. Mires, Jr. Dr. Thomas W. Morgan • Dr. Paul Stanger Dr. Ronald H. Usiak, Sr. Dr. Martin E. Leber Dr. Annabel M. Irons - ~ Deborah Beller Marlene Bluestein Christopher f' . Brandy Soma Y. Burgher Dr. Michele]. Armenia Dr. Mary K. Bennett Dr. john H. Bloor Dr. Marsha E. Brooks Dr. Lucy A. Campbell Dr. Timothy E. Frey Dr. Katrina A. Guest Dr. Camille Hemlock Dr. Thomas]. Kufel Dr. Sanford H. Le,·y CLASS OF 1971-$17,225 Dr. Richard W . Munschauer Dr. Fred Lee Dr. Sue A. McCutcheon Dr. jennifer S. Kriegler Dr. john Y. Lambert Ill Dr. Micha Abeles Dr. Stephan M. Ledtt Dr. janice j. Pegels Dr. R. joseph Naples Dr. Frederick C. Dr. john M. Antkowiak Dr. Nancy H. Nielsen Dr. Roslyn R. Romanowski Dr. Norman Nomof Dr. Jordon S. Popper Dr. Michael B. Baron Dr. Christine Privitera Dr. Mark E. Schweitzer Dr. Raymond W . Osgood Dr. Paul D. Barry Dr. Denms R. Pyszczynski Dr. Rita R. Sloan Dr. Harry Petzing Dr. Paul C. Ronca Dr. Herman R. Schoene Dr. Allen I. Berliner Dr. Thomas L. Ritter Dr. joy D. Steinfeld Dr. Amo j. Piccoli Dr. Matthew W. Szawlowski Dr. David A. Bloom Dr. Paul Schwach Dr. William H. Stephan uessle Dr. Herbert S. Pi rson Dr. jerald A. Bovino Dr. Carole Shear Dr. Edward j. Stulik Dr. Alben G. Rowe CLASS OF 1961-$9,250 Dr. Barry G. Brotman Dr. \Varren Thau Dr. Carmen M. Todoro Dr. Fred S. Schwarz Dr. Richard H. Baker Dr. Kenneth A. Burling Dr. George Toufexis Dr. Michael \V . Wood Dr. W. William Tornow Dr. Nicholas j. Capuana Dr. Bernard M. Wagman Dr. Richard j. Valone Dr. Harold Brody Dr. Washington Burns Ill Dr. Kenneth j. Clark , Jr. Dr. Arnold Wax Dr. William P. Walsh Dr. Michael E. Cohen Dr. Manny E. Cristakos Dr. Linda Wild Dr. Myron E. Williams. Jr. Dr. H. Howard Goldstein Dr. Arthur C. Cronen Dr. Herbert S. Wolfe Dr. Henry F. Goller Dr. Lawrence]. DeAngelis CLASS OF 1981-$5,915 Dr. Paul L. Nadler Dr. Thomas G. DiSessa Dr. George Bancroft Dr. Anthony T. CLASS OF 1951-$9,645 Dr. William j. Hewett Dr. Howard M. Hochberg Dr. Pasquale D. Baratta Dr. Michael D. Plager CLASS OF 1991-$1,000 Dr. jennifer f. Hen kind Ferraro Dr. Colleen A. Mattimore g Dr. Carl R. Conrad Dr. Leonard S. Danzig Dr. Sylvia R. Kennedy Dr. Sigmund S. Gould Dr. Harvey Greenberg Dr. Andrea C. Bracikowski Dr. Philip j. Rados Dr. Seymour j. Liberman Dr. jay A. Harolds Dr. Suzanne F. Bradley Dr. Barry D. Shaktman Dr. Allen L. Goldfarb Dr. jonathan Logan Dr. Barbara I. Karpel Dr. james B. Bronk Dr. Mitchell K. Spinnell Dr. Mark E. Heerdt Dr. Edwin j. Manning Dr. Robert B. Kaufman Dr. Stanley L. Bukowski Dr. Harold P. Krueger Dr. Dave B. Olim Dr. Scott D. Kirsch Dr. Daniel A. Castellani Dr. Eugene V. Leslie Dr. Saar A. Porrath Dr. Stanley B. Lewin Dr. James j. Czymy Dr. james V. LoVerde Dr. A. Thomas Pulvino B a 0 p h y c a 5 u m m e 6 �~ -··································· · · · ··· · ············· · Why c~tay home for lEI the holiiJayc~ ? Medical Alumni Awards The front-wheel urive Infinitt-® I 50"' An interuw more .•paciow thana Rolf,, RL>yce Silm· Spur 11/. An e:>:ceptionally .fJetzerOild IL:•t of dtanJarJ lu.."l.·wy feat/ire.•. A 190-hp V6 capah!e ofout-acceleratin.lJ many lll.Ylli:J V&•. tlnd of cour.•e, the ,ltandarJ-,,etting pet:formance anJ .•erl'ice of lnfiniti. The Medical School Alumni Association presented three Lifetime Career Achievement Awards at Spring Clinical Day on May ll. The awards are given to alumni/alumnae in honor of lifelong achievements in important areas of medical Like e<'ery lnfiniti, llu G20 come.• ll'ith an e;t:/en,lil'e liA of .•tanJard !u.-wry feature,•; tl -1-year/ 60,000 mile Ba.•ic Nell' Vehicle Wtzrranty; 2-1-hour RoaJ.Jitle tl.•.•t:ttance Program Trip interruption Benefit.•; anJ our Free Serl'ti:e Loan Car Pro_qram. $3 ]9 mo. endeavor, such as teaching, research, 50 mo. !ea.Je $0 down practice, or community service. Michael E. Cohen, M.D. '61 (top left), is a neurology professor at UB. IN FIN IT I Robert E. Reisman, M.D. '56 (top right), is an allergist in Buffalo. Edward Shanbrom, M.D. '51 (bottom), is retired from his internal medicine AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 practice in Santa Ana, CA. All are pictured with Margaret Paroski, M.D., East of Transit Rd. , Near Eastern Hills Mall the outgoing president of the Medical Alumni Association. G20 42 moJ130 42 mo. lease with cash or trade equity down. (G20-$495) (130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage. $.12 per mile 1n excess. ® B u f f a l a Phys ician Summer 1 9 9 6 �--~- -~ ---~- - - Spring Clinical Day and Reunion Weekend '96 SALE OR LEASE CONTEMPORARY MEDICAL OFFICES Spring Clinical Day (May 11) kicked off a lively reunion weekend. Alumni from the past SO years attended the Stockton Kimball lecture, CME panel discussions, and poster exhibits at the Buffalo Marriott. But the weekend's social events, receptions, and dinners also provided plenty of time for meeting old friends and making new ones. 4800 sq. ft. onNiagam.PallsBlv4.inAmhent Close to l-290 • Ample Parking • Handicapped Accessible Competitive Rent 3,000 sq.ft.Delaware Awnue a: \'irginillStreet Plenty of Parking • Can be divided or expanded ALANT.HASTINGS • 847-1100 • HXT.286 ~ ?~\~t?~ B u f f a t o P hysician Summer 1 9 9 6 �• ·························································· ; HURWITZ & RNE, PC. I I 1 9 3 0 5 CARLJ . STREICHER '35 , of Lake Havasu City, AZ, ha retired from his ophthalmology-otolaryngology practice. He writes, "After a direct experience with insertion of a stent into a coronary artery, I am now as active as a golrer rive days a week can be, and hope to continue in this career for some tune! " BERNARDS . STELL '36 , FRANKL. TABRAH '43, SERVICI G in the Department of Physiology at the Uni- THE LEGAL versity of Hawaii's School of Medicine, and H EALTH Straub Clinic and Hospital. recognized with a plaque from the Hidalgo• Managed Care Starr County Medical Alliance for his lifetime dedication to the citizen ofHidalgo and Starr • Purcha e & Sale of Practices • Business & Tax Planning 1 9 5 0 WILLIAM J . SULLIVAN '55 , 5 of los Angeles, CA, is self-employed in forensic psychiatry. will be memorable: in May will be the 60th anniversary of the granting of my M.D. de- He is president ofW.j. Sullivan, M.D., Inc. gree; the 50th anniversary of my having earned an Cd.M. degree from the Millard . of Buffalo; the 50th • HCFA Safe H arbor Regulations 1 9 6 HARRIS FAIGEL '60 , 0 5 of Waltham, MA, anniversary of my induction into Phi Delta Kappa, honorary education fraternity; and pediatrics at Tufts School of Medicine and the 50th anniversary of my membership in was elected to the boards of the American the American Psychiatric Association." College Health Foundation and the American College Health Association. One son, 9 4 5 Douglas, is Hnishing a GI fellowship and taking a position at the Portland (OR) VA '40, ofjacksonville, FL, was Hospital and Oregon Medical School; Faigel's awarded a special citation by the American other son, jordan, is a vice president at Association of Retired Persons in appreciation Paine Webber in New York City. JOHN D . WHITE 0 and Phys ician Self-Referrals • Contracts with Private was appointed associate clinical professor of 1 Scm CES CoMMU ITY of McAllen , TX, was ciety of America. Stell adds, "The year 1996 Fillmore College at N EEDS OF THE director of th e Baromedicine Center at the IVAN W . KUHL '45 , I of Honolulu, HI , of Sun Cit), AZ, the tereo Division of the Photographic So- AT LAW is emeritus professor of community health Counties through his medical practice. won the Master Stereographer Award from ATTORNEYS & Public Entities • Employee Relation Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Bus iness Issues • Facility Finance and Construction of outstanding service to the community. of Pittsburgh , PA, was elected president of the Pennsylva- • Credentialing Hills, Ml , received the second annual Grad iva Award from the ational Association for the nia Academy of Ophthalmology at its an- and By-Laws Advancement of Psychoanalysis and the Biglan is director of ophthalmology at ALBERT W . BIGLAN '68 , ALEXANDER GRINSTEIN '42 , of Beverly nual meeting in Pittsburgh March 29-30. American Board of Accreditation in Psycho- Children's Hospital of Pittsburgh, and con- analysis for his book The Rcmwlwblc Bcatrix sults for the Neonatal Intensive Care Potter. The Gradiva Award, named for igmund Freud's 1907 work, Delusions and Dreams in jensen's "Gradiva," honors poets, ery at Magee-Women's Hospital , the Veteran'sAdministration Hospital , the West- artists, writers, and others who create works Rehabilitation Institute of Pittsburgh. urs- ern PA School for Blind Children, and the • H ospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849 -8900 that advance psychoanalysis. Grinstein's of Orchard book won in the category of childhood- BERNARD C . MUSCATO '69 , related books. He was presented with the Park, NY, has been appointed chair of Mercy award on Apri l 20 at the annual Hospital's Department of Obstetrics and Gy- conference in ew York City. AAP necology. He is past president of Mercy 1300 Liberty Building Buffalo, New York Hospital's medical staff and is serving a six- ® B u f f a l o Ph ysician Summer 1 9 9 6 �••••••••••••••••••••••••• II 0 BARANSKI ADVERTISING • I THE ULTIMATE DRIVING MACHINE= year term on the hospital's board of directors. Since 1974, he has been in private p ractice at Hambu rg Gynecological and Obstetrical Group. 1 9 WILLIAM J. 7 0 5 was appointed FIDEN '70 , clinical director of Erie Countr Medical Center's Department of Familr Medicine. He also serves a clinical assistant professor at UB. A colonel in the ew York Air a- tiona! Guard, he is clinic commander of the 107th Medical Squadron in iagara Falls, Checkpoint Foreign Car, Inc. NY. He and his wife, Susan, live in Buffalo. Sales and Service Medical College of Wisconsin . His daughter Lisa, a sophomore at Duke University, will Your advertising presents your c o mp a ny image t o the public .. . and to prospective cli ents a nd c ust o me rs. At Baranski A dvertising, we are proud to represent some of the finest publications in Western ew York, publications where your advertising message is sure to reach a quality audience. LAURENCE J . POHL '72 , of San Diego, CA, recently received an M.P.H. from the be taking herMCATin August1996, follow- • ing in her father's foots teps. Pohl writes that his classmate, Michael Gordon '72, is the 487 Kenmore Avenue Buffalo, NY 14223 most successful ophthalmology physician in San Diego, do ing radial keratotomy. 836-2033 ERIC J . RUSSELL '74 , of Chicago, ll, currently serves as acting chair of the Department of Radiology at • orthwestern Univer- sity Medical School and was elected treasurer of the American Society of Neuroradiology. Your WNY Leasing Specialist Serving WNY proudly for 33 years His wife, Sandra K. Fern bach, M.D., recently completed her term as president of the Chicago Radiological Society. CALL US TODAY REBECCA JACKSON SCHEITERLE '79 , (716) 645·6933 of Olean, Y, is doing full-time emergency medicine and is ER director at Olean General Hospital. She has four children: Stacy (18), Zachary (10), Jonathan (8), and MICHAEL J. BARANSKI Kathryn (7). She was remarried injuly 1995 to Rick Scheiterle. Marketing Representative 1 9 8 0 SU S AN STEPH E NS-GROFF '82 , P. S. We did this book! 5 of Phoe- nix, AZ, pediatrician for Maricopa County (AZ) Regional Schools, was honored as an outstanding healer by the YWCA ofMaricopa County at its third annual Tribute to Women B u f f o l 0 P hysician summer l 9 9 6 ® �• ···· · ··· · ······························· · ; Ifyou thought you knew us... do J.OU know I luncheon. She was chosen for her extensive efforts to provide medical services to the poor, especially her work running the clinic at the Thomas j. Pappas Regional counseled their parents about the limitations and possibilities of their children's conditions. She was the widow of RussellS. Kidder, M.D. Center for homeless children. ROBERT C . BAHN '4 7 diedApril 1 9 9 0 s 30, 1995,at his home in Rochester, M . He was 69. He was emeritus ROBERT P . P ITERA '90 , of Holbrook, Y, recently com- consultant in pathology and anatomy at the Mayo Clinic. He earned a Ph.D. in pathology from pleted a lecture series at the Beijing Hospital in the People's the University of Minnesota in 1953. He had a longterm interest Repub lic of China for the hospital's 75th anniversary. "My in the application of computers to medicine and belonged to the lectures focused on sports medicine with emphasis on diagnosis and treatment." The series drew over 100 physiatrists from all parts of China. Interested alumni Mathematics Association of America and the Association for Computing Machinery. Bahn also played trombone and tuba with local groups, including the Rochester can contact him at the Empire State Building, 350 Fifth Ave., Civic Music Concert Band and Suite 6606, New York, Y 10018 (212-293-7800), or at his home, what's NE.W? ~"~~ ., s~"s 'loJ· ._;;.~""'os"<'" • 14,000 sq. ft . of flexible ~~"~~ ~<:• 'b-~ e'-' meeung space on property ~ ~ 'o"<:PLUS direct access to an .,;::.f) {"~0 additional 250,000 sq. ft . 'r>" { 0~~ with state-of-the-art capabilities. "~(('X ;;."s;;. • Superb catering and innovative <1$"s~'~{ 'Q~s' theme dinners PLUS expert ~\'l ~ ~'l 0~ planning assistance from .,;::.f) ._~{;;.'<:pre-event through closing. <.0 Trombones Anonymous. His wife, Miriam Ruth Huer, died in 1992. 405 Sadd le Rock Road, Holbrook, NY 11741 (516-5638346). "It was great seeing everyoneatourfifth reunion. Keep in touch and keep smiling." And Your Choice To Stay In WNY! Buffalo Physician is on e-mail! OBITUARIES RUTH F . KRAUSS-KIDDER '4 3 , a respected member of the Children's Hospital staff and the UB faculty, died March 29, 1996, at the iagara Lutheran Home. She was 75. Before • A first-class hotel with outstanding amenities, comforts and conveniences - centrally located at the University at Buffalo Complex. Our new address for classnotes is Rooms bpnotes@pub.buHalo.edu. associate professor of pediatrics in UB's department of neurology. After graduation from UB's medical school, she interned at the former news about your fife, career, or famay. Don't forget to include your name, your home BUFFALO~affiOft address, and the year you E.]. Meyer Memorial Hospital. She joined Children's medical staff in earned your MD from UB. 1340 Millersport Highway, Amherst, Y 14221 (7 16) 689-6900 or (800) 334-4040 At the University at Buffalo Complex 1945. As a pediatric neurologist, she not only treated patients but ® B u f f a li.1r Congrarulations to The University at Buffalo School ofMedicine & Biomedical Studies on celebrating I 50years ofteaching, healing and research.' FromTN'f-~ Please send us the latest her retirement, she was director of electroencephalography at Children's Hospital and clinical ,t\'ail.tbl~: lJ B Alumni W~:~:k~:nd Oc.tob~:r ·1-6, I 'J'J6 l a P hysician Summer 1 9 9 6 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. 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U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED 1 77 3 ri £ 1-1L l H ~C E CE S St:R LS Dt:PT B TT ti l I.,. r - PLANT'ING A TREE 'Z'S' ·= UNDER WHICH You WILL NEVER SIT OR. OEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Or. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart fi nancial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 U N I V I!:IIISITV AT .UFFALO SCHOOL 01" MEDI C INI!: I li 0 1848 Y ll · A R 5 1998 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1996 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1996-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v30n03-1996-Summer Table Of Contents A list of subunits of the resource. Buffalo Hospice Physician-Assisted Suicide The End of Life and the Quality of Death Research Medical School News History of Medicine A Student's Perspective Alumni News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n03 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/036b61aa5ed92170adcc2621130b772d.pdf 6e9fd3da5c49d53bd021792690850f6a PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1997 �BUFFALO PHYSICIAN Volume 31, umber l ASSOCIATE VICE PRESIDENT FOR UN IVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICAT IONS Kathryn A. Sawner EDITOR jessica Ancker ART DIRECTOR/DES IGNER Alan j. Kegler PRODUCTION MANAGER Ann Raszman n Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MED IC I NE AND BIOMEDICAL SCIENCES Dr. john Wright, Interim Dean , Vice President for Clinical Affairs EDITORIAL BOARD Dr. Bertram Portin Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. jack F. Coyne Dr. Alanj. Drinnan Brian Duffy Dr. james Kanski Dr. Barbara Majeroni Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz Dear Alumni and Friends, UB's SESQUICENTENNIAL EVENTS WILL END with the award by the SUNY Board of Trustees of an honorary doctor of science degree to Dr. james Holland at commencement on May 11, 1997. Dr. Holland, the Distinguished Professor of eo plastic Diseases and the director of the Cancer Center at the Mount Sinai School of Medicine and Hospital will also participate in teaching students in medicine, and will present a Harrington Lecture during the course of the weekend. Between now and the closing events of May 11, two additional special activities are planned. The first, on Feb. 21-22, 1997, will be held in connection with University Founders Day. Franklyn Knox, M.D. '65, Ph .D. '65, formerly dean of the Mayo Medical School and director for education of the Mayo Foundation, will be honored by a special symposium coordinated by the UB Department of Physiology. He will present a Harrington Lecture, entitled "The Kidney Performs Under Pressure." The SUNY Board of Trustees will also confer the honorary doctorate of science degree upon him as part of the sesquicentennial festivities. A very special event will focus on advances in medical education. It will be held on April25, 1997, the day before the annual Spring Clinical Day meeting. Four major leaders in medical education who had their roots at UB will return to join other faculty with whom they had worked, in addition to the current generation of medical education leaders at the medical school, to discuss the past, present, and future of medical education. The four are Dr. George Miller, Dr. Steven Abrahamson, Dr. Edwin Rosinski (Ed.D. '58), and Dr. Hilliardjason (M .D. '58, Ed.D. '62) . As the sesquicentennial activities draw to a close, it is my observation that each served to reconfirm the medical school's commitments to the intent of its founders and to provide excellence and leadership in education, research, patient care, and community service. As medical education and health care enter into a new, challenging era, UB stands ready to maintain its professional integrity, while preparing to make its contribution to the necessary growth in knowledge and needed advances that lie ahead. ~·'~.~ TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System John Naughton , M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Frank Sava Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy Veterans Affairs Western Healthcare System ew York ©The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: The Editor, Buffalo Physician, State University of New York at Buffalo, Office of Publications, 136 Crofts Hall , Buffalo, NY 14260 Send address changes Ia: Buffalo Physician, 146 CFS Addition, 3435 Main Street, Buffalo, NY 14214 Dear Fellow Alumni, WELL, IT'S WI TER IN BUFFALO ONCE AGAIN. We brace ourselves for the cold weather ahead, and follow our Bills. But something is different. Things are not the same. Someone is not here. It is the individual who has directed and guided our medical school for the past 21 years, Dean john Naughton, M.D. When I was talking with him about some of his accomplishments, he quickly turned the discussion to one of h is favorite interestssearching his family tree. As he speaks of his travels through Ireland and the Northeast, you see a glimpse of the passion with which he engineered this medical school into the 21st century. He follows no model, but creates innovative ways to reach his goals. Hence, the reason why the Robert Woodjohnson Foundation has provided UBgrants fo r primary care, and why he currently chairs the New York State Council on Graduate Medical Education. His medical education interests have centered on reform of graduate medical education, medical student education, and collaborative and regionalized models of health care and education. It's hard to envision our future without Dr. aughton's leadership. He will be tru ly missed, but his legacy will live on in the students he has touched. Today's health care system has certainly benefited and will continue to benefit from his vision, passion, and dedication. Thank you, Dr. aughton! Cover photo by K.C. Krall Sincerely, ~cf2C'~~D Jack F. Coyne, M.D. President, Medical Alumni Association �VOLUME 31 , NUMBER 1 WINTER 4~~~~ ~,~~~~~~~"~.0. 8 C~unch ~me THE MANAGED CARE NAUGHTON DISCUSSES HIS REVOLUTION GOES INTO CAREER FROM SPORTS HIGH GEAR IN BUFFALO WRITER TO CARDIAC by Jessica Ancker 12 97 Making histo~y in the histo~y of medicine U 8'S TREASURES ON DISPLAY photos by K.C. Kratt RESEARCHER TO DEAN. II ..JOHN R. WRIGHT, M.D. NAMED INTERIM DEAN 2 Then and Now WHEN THE GERM THEORY WAS STILL A THEORY by George F. Haddad, M.D. '94 3 Research Alumni RADIOLOGIST WENDE W. LOGAN-YOUNG , GRANTS FOR BREAST GENOME RESEARCH. LIJ:¥UID VENTILATION . 2 Medical School News Astudent's perspective NEW BOSNIA PARTNERSHIP • A ..JOHN BORDER, M.D. IDEALISM INTO PRACTICE PRIMARY CARE EXTERNSHIPS. by Christopher J. DiMaio, Class ..JOHN KOLEGA, of 2000 PH.D. THE NPR CAREER OF US's MIRIAM SHUCHMAN, '61. ..JACK RICHERT RETIRES. CANCER AND HUMAN POLICE SUICIDES. M.D. M.D. CHANCE TO PUT 3 Classnotes �. . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . .. . . . . [1] I ' I " . $1.6 million funds study of alcohol and breast cancer an drinking alcoholic beverages increase the risk of developing breast cancer? If the answer is "yes," as many scientists suspect, what are the mechanisms involved, and are some women genetically more susceptible to the risk than others? University at Buffalo scientists will attempt to answer these and other questions about alcohol through a $1.6 million grant from the U.S. Army's special program for breast cancer research . The study was led by] o Freudenheim, Ph.D., UB associate professor of social and preventive medicine. "There is a fair amount of evidence that alcohol may be related to breast cancer, but most research has used inadequate measures of alcohol intake," Freudenheim explains. "We will be making careful measures of lifetime alcohol consumption, as well as collecting data on diet, physical activity, and reproductive history. The researchers also will assess genetic differences in the way individuals metabolize alcohol, and will compare breast cancer rates among "fast " and "slow" metabolizers . A specimen bank will be created to store blood samples for current and future research . The study group will be composed of 1 ,350 women from western New York with breast cancer and 2,030 randomly selected Jo Freudenheim, Ph.D 0 healthy women to serve as controls. Participants will be between the ages of 35 and 79. Researchers theorize that alcohol may influence the development of breast cancer by changing the body's steroid hormone levels or by increasing oxidation. These mechanisms are among those that will be investigated in subgroups of the study population. The research is an offshoot of an $8 million investigation of alcohol and its relationship to chronic diseases being carried out jointly by UB's Center for Preventive Medicine and the Research Institute on Addictions in Buffalo. + L o 5 B A K E R UB liquid ventilation study proves eiTectiveness artial liquid ventilation is safe and effective for premature infants, according to research from UB that appeared as the lead article in theSept.l2 , 1996, issue of the New England journal of Medicine . A five-center trial of partial liquid ventilation to treat lifethreatening respiratory distress syndrome in extremely premature infants has shown that the procedure is safe and effective , and that it improves lung function in some children who failed to respond to conventional treatment, increasing their chances of survival. Corrine Leach, M.D., UB assistant professor of pediatrics , headed the multi-center investiga- a u t t a t a P tion of the procedure, which was developed by Bradley Fuhrman, M.D ., UB professor of pediatrics. Both practice at Children's Hospital of Buffalo. Respiratory distress syndrome , the leading cause of death in premature infants, develops when the lungs of these tiny babies are unable to secrete surfactant to prevent the air sacs from collapsing. Partial liquid ventilation (PLV) involves introducing an oxygen-rich liquid called perflubron into the baby's lungs . The liquid allows the lungs to inflate and permits oxygen and carbon dioxide to pass through the air sacs and into the blood stream more easily and efficiently. "The successful introduction of liquid into the lung and the ability of infants to breathe with liquid allow us to ventilate the lung at lower pressure , which causes less damage ," Leach explains. "If we can decrease the amount of lung injury , we can greatly improve the patient's outcome and perhaps prevent chronic lung disease." The pilot study involved 13 infants born between 24 and 34 weeks of gestation. All had failed to respond to conventional therapy and were at risk of death . Carbon dioxide levels improved in all patients while on PL V; lung functioning improved in 11 infants. Seven of the 13 critically ill infants survived. Of those who died , three succumbed to their acute lung disease, and one to bronchopulmonary dysplasia. Two patients died of nonrespiratory complications of prematurity. Clinical trials using PL V to treat children and adults with severe respiratory distress syndrome are now under way. Results are promising, Leach says. + hysician o L W 5 1 n t 8 e r K A 1 E 9 R 9 7 �- - . - ~ -~ - - . ~. ~ --- ~- - - . .. - - - - -- - - Reorganizing the Human Genome Project Former trooper studies police suicide rates a pretty good indicator of what's going on out there ." Results appeared in the American]our- s part of a nationwide project to combat ethical and image problems with the Human Genome Project, the federal government has given Roswell Park Cancer Institute researchers a grant to build a new human gene library. The same Roswell Park research group , which is led by Pieter Dejong, Ph.D. , also won a grant to begin gene sequencing. They will share the $2 million Department of Energy pilot grant with a team at the University of TexasSouthwestern. The National Center for Human Genome Research decided there was a need for new gene libraries after finding problems with the way researchers had obtained DNA samples in the older libraries. The federal administrators found that most of the DNA in the four best gene libraries (including Dejong's) came from only four people, rather than from a diverse group of donors. They also found that some of the subjects may not have been fully informed of what their donation would be used for, and that several of the donors were known to the researchers and so were not anonymous. Under new ethics guidelines, researchers will recruit a larger pool of donors and follow procedures to ensure donors' anonymity and to obtain their informed consent. They will also follow additional rules to combat image problems. For instance, researchers may not donate their own DNA (because it might appear "elitist") or ask junior lab members to do so . They must also recruit a substantial number of women donors. According to Dejong, a UB associate research professor, sequencers will continue working on the old libraries during the two years it will take to create the new ones. + olice officers are eight times more likely to die by their own hand than by homicide, a study by University at Buffalo epidemiologists has shown. They also take their own lives at a much higher rate than other municipal employees, the findings indicated. The study is one of the few empirical analyses of police officers' risk of suicide, homicide , and accidental death, and the only study to compare their risk to that of other workers. "We are hoping this study will make the police community aware that suicide is a problem, not a myth , not something that should be shrugged aside, " says lead author john M. Violanti, Ph.D., a UB assistant clinical professor who is himself a 23-year veteran of the New York State Police. Violanti, along with john E. Vena , Ph.D. , and other colleagues from the UB Department of Social and Preventive Medicine, analyzed mortality data for the 138 Buffalo police officers and other municipal workers who died between 1950 and 1990 of external causes. According to Violanti, the Buffalo statistics mirror those of police departments around the country. "We looked at five other cities, and all five departments were higher in suicide than other occupations . I think this is The researchers identified a number of potential factors in the police suicide rate, including continuous exposure to human misery, an overbearing police bureaucracy, shift work, social strain, marital difficulties , inconsistencies in the criminal justice system, alcohol problems, physical illness, impending retirement, and lack of control over work and personal life. Easy access to handguns and the lack of confidential counseling may also be factors , says Violanti. "Police officers are even more hesitant than the average citizen to get help for emotional problems," he notes. "Because of their role and their job, they mistrust many things , and they especially mistrust mental health professionals. The other half of the problem is , confidential help isn't always readily available. "Departments should include some sort of suicide awareness training in their stress management program," Violanti adds. "The New York City Police Department has such a program and suicides went down after it was instituted. The Buffalo department now also has a program in place. " The research was supported by a grant from the National Institute of Mental Health. + -JESSICA B u f f a l a ANCKER Physician w 1 n t e r 1 9 9 nal of Industrial Medicine. - 7 L o s B A K E R 0 �Naughton discusses his career from sports writer to cardiac researcher to dean at UB As]OHN NAUGHTON, M.D., 63,stepsdownafter21 eventful years as dean of the medical school, he can be certain he's secured his place in UB history. Conversely, UB can be sure it has secured its place in Naughton's own eventful history, which began far from Buffalo or any other academic center. John Naughton grew up about 80 miles from Oklahoma City in Lawton, OK, at the time a town of 14,000 people. Lawton's business community, including the Naughton family's restaurants, depended on servicemen visiting from the nearby Fort Sill military post and training center. Young jack, as he was called, did well in school and also worked hard at a number of different jobs. Helping out at his father's restaurants , the Chuckwagon and jack's White House Cafe, "taught me just about everything there was to know in the restaurant business." He also worked part time as a sports and news writer for the Lawton Constitution. "I was a good writer-my strong point was writing lead sentences," he remembers with pride. Naughton earned an associate's degree from Cameron State College, a two-year school in Lawton where he was the editor of the student newspaper. But he had higher aspirations: he went on to St. Louis University to earn a B.S. in preparation for medical school. "My interest in medicine, I think, came from my mother. She had been a nurse before she was married, and always wanted to have a doctor in the family," Naughton says. "At the same time , my father , as an independent businessman who was very active in each community he lived in , gave me an appreciation of the importance of community service. That's something I consider to be part of medicine, too. " When he entered college, Naughton found that he was far behind some of his contemporaries in basic science education. "Lawton was a very small community, and we didn't have a lot of kids who went into academic fields. "Looking back on it, I appreciate Lawton, because I grew up among real people who sometimes academics and medical students don't have a chance to know," he says. bx !essica Ancker 0 B u f f o l o P Naughton earned his M.D. from the University of Oklahoma, did a mixed medical internship at George Washington University, and completed a residency and post-doctoral work at the University of Oklahoma Medical Center where he remained until 1968 as an assistant professor. While his early research interest was the effect of emotional stress on the heart, he soon began investigating the effects of physical stress and ways to rehabilitate patients after heart attacks. "In a time of national emphasis on fitness during John F. Kennedy's presidency, we were looking at broad national questions , not just the effects of hysician w I n t e r l 9 9 7 �-- --- tests on individuals. Our question was , in an unfit society, could unfit people be reconditioned and would it improve the quality of life? " a ugh ton then moved to the University of Illinois, where he became an associate professor and the director of the school's Rehabilitation Center. Later, at the George Washington University Medical Center, he became director of both the Division of Rehabilitation Medicine and the Regional Rehabilitation and Training Center. He also directed the ational Exercise and Heart Disease Project, a national study that he continued to head until its final report in 1983. It was at George Washington that B u f f a I a Phys i c - -- - --- Naughton got his first taste of administrative life , becoming dean of academic affairs in 1973. "Even though I loved being a researcher, I had also always been interested in teaching and in broader areas of medical education," he explains. Heremembers being trained to be a first-rate internist, with only secondary emphasis on developing a specialty. By the time he joined the University of Illinois, emphasis on the core of medical education was already disappearing in favor of training specialists. "That alerted me that there were interesting issues in medical education. My interest was in providing a medical Ia w I n t e r 1 9 9 7 - - �''I am lool<ing forward to education that served a broader need in society." Naughton accepted the deanship of UB's School of Medicine and Biomedical Sciences in 1975 at the age of 42. He was eager for the chance to lead a school, and he describes a mix of other reasons that made UB's offer intriguing. First, he says, he wanted to join a public university, with its commitment 0 to serving the people of its state. He also liked the fact that UB was an integral part of the Buffalo community. "Medical education should be serving the community in some way." Also, Naughton said he immediately felt that UB had never taken full advantage of the resources at its fingertips. For example, UB's outstanding faculty weren't getting recognition at the national level, and they were rarely invited to join state Health Department committees. "Things other people saw as disadvantages, I saw as opportunities. That probably comes from my rehabilitation career!" Coming on board at a time of sagging morale, low prestige, limited research funding, and uncertain priorities in the wake of the merger with SUNY, Naughton helped raise the school to national stature. One achievement that will always be linked with Naughton's name is the creation of the Graduate Medical Dental Education Consortium of Buffalo. More than just coordinating resident education, the consortium has become a symbol of the cooperation among the hospitals, which have reduced duplication, saved money, and concentrated their expertise by designating certain hospitals to develop into regional centers of specialty services. Interestingly, Naughton also counts as a success his hospital consolidation study, which stirred public controversy and was never implemented. He had been invited by Buffalo General Hospital, Children's Hospital of Buffalo, and the former E. ] . Meyer and Deaconess hospitals to head a study on the feasibility of mergers. The resulting report recommended a series of consolidations to cut down on unused beds and costly duplication of services. The plan failed by one vote to pass in the Erie County legislature, due to opposition from community groups, politicians, and some parts of the medical community. "However, that study served to create the image of the medical school as a B u f f a l a leader in Buffalo's medical community. It was also the first opportunity to bring people from the different hospitals together in a more cooperative way. It set the stage to found the consortium." Naughton is credited with many other accomplishments at UB, including beginning the Primary Care Resource Center, winning the Robert Wood johnson Generalist Physician Initiative grant, building and renovating university buildings, and establishing a strong affirmative-action policy. The dean is looking forward to returning to research, teaching, and men to ring new generations of students and doctors. "The things I came to UB to accomplish, I think I have accomplished. You get a certain thrill and high out of that," he says. "We now have a sense of institution. We have stature as a medical school, and it's not just dependent on one or two outstanding individuals. "I am looking forward to the next few years as an academic." + Physician w I n t e r 1 9 9 7 �INTERIM DEAN APPOINTED ohn Wright, M.D., will serve as interim dean and vice president for clinical affairs until a new dean is appointed. Wright, the chair of the Departments of Pathology at UB and Buffalo General Hospital, earned his M.D. at the University ofManitoba in 1959. He completed a residency at the Buffalo General Hospital and then held a National Institutes of Health fellowship in endocrinology there. Between 1965 and 1967 he held a Buswell Fellowship at UB. Wright taught at johns Hopkins University School of Medicine before joining the UB faculty in 1974. Among many other appointments, Wright has served as interim director of Roswell Park Cancer Institute and as director of the university pathology residency program. Wright says he hopes to continue john Naughton's initiatives in reorganizing the Faculty Practice Plan, reorienting medical education toward a primary care perspective, and providing support for the student body. He also hopes to keep the medical school involved in the merger negotiations between the Buffalo General, Children's, and Millard Fillmore hospitals. + B u f f o l o Physician w I n t e r 1 9 9 7 �BY JESSICA The managed care revolution goes into high gear in Buffalo lue Cross and Blue Shield of Western New York set off a firestorm of criticism last year when it introduced Community Blue Advantage, a plan that lets patients opt for lower copays and more services in return for a more limited selection of hospitals and doctors. In another city, this might have been accepted as just another insurance option. In Buffalo, it was considered outrageous. One state legislator accused the company of a "callousness" that was "frightening," and the county medical society at one point demanded an immediate halt to the plan's marketing campaign. Reaction might not have been so strong if doctors and hospitals hadn't already been feeling squeezed by fastmoving changes in Buffalo's health-care economy. Two factors here are compressing and accelerating a market evolution that is familiar to much of the rest of the country. First, a statewide Health-Care Reform Act is changing the playing field for New York State hospitals in 1997. New York had been one of two holdout states that still set hospital reimbursement rates for most insurers; now, all 0 insurers are free to negotiate these rates . Second, managed care is rapidly coming of age in Western New York. While about 30 percent of New York State's population is enrolled in managed care plans, the rate is almost 50 percent in Buffalo. The figures will increase, particularly because state officials hope to enroll 2.5 million Medicaid recipients in managed care in the second step of health-care reform. So the state has stripped hospitals of some protected rates at the same time that managed care is driving down hos- Buffalo ANCKER • pitalization rates. And looking ahead, both insurers and providers fear that for-profit companies will soon move into Western New York. These converging forces have produced a burst of competition in the health-care field . Patient care is rapidly moving out of the relatively expensive hospital setting, hospitals are facing low occupancy rates, and insurers are finding new ways to manage care and to share financial risk with doctors. "It took southern California 20 years to be changed by managed care. It took about eight years for Boston. We're going to do it in 18 months ," predicts jack M. Sieber, a health-care consultant at Ernst&: Young, LLP. "I think we're going to leapfrog some of the steps that other regions went through," agrees Robert V. Stanek, chief executive officer of Mercy Health System of Western New York. "That's a double-edged sword. On one hand, we learn from what's happened elsewhere. On the other, the rapidity of the change will be difficult. " These are some of the changes Buffalo will see in the near future : of? A wave of hospital mergers that could consolidate nearly half of the region's hospital beds into two systems; of? Reimbursement systems that split risks between insurers and providers; Physician W 1 n t e r 1 9 9 7 �-- - - - - - - - - - -- - - -- - - 7 Less money for residency training, which may translate into fewer residency slots; t" More interest by doctors in group practices and other sorts of cooperative arrangements that help them provide patient advocacy and negotiate better deals from payers. Stages of economic change The national health-care economy is changing in fits and starts, and it's different in every city. William L. Kissick, M.D., Dr.P.H. , has a unique perspective on the issue. The author of Medicine's Dilemmas: Infinite Needs versus Finite Resources, Kissick is a professor in the University of Pennsylvania Medical Center as well as Penn's Wharton School of Business. In the 1960s, he served as a staff member to the federal task force that created Medicare. In a recent lecture in Buffalo, Kissick outlined four stages of evolution in the health-care market. The first stage is the traditional system as many doctors fondly remember it. Doctors practiced independently or in small groups and were paid by insurers. There was not much push for lower costs on the part of employers. Kissick cites Syracuse, NY, as an example of a community that is still in this early stage of development. The second stage of market evolution begins when managed-care plans attract more enrollment, and hospitals therefore find themselves contending with lower rates of admission. Providers begin affiliating in loose networks, but are often still reimbursed on a discounted fee-for-service basis. According to Kissick, Buffalo is rushing into stage three. Managed-care providers have become larger, hospitals are merging, and integrated systems are beginning to link health-care financing with health-care delivery. Stage four , he predicts, will feature more highly managed care, fully integrated health-care delivery and finance systems, a high demand for primary care doctors, and leaner times for specialists. B u f f a 1 o - - - - ----- - - ---- Merging to save money Western New York's seven Catholic hospitals are well on their way to becoming an integrated system. They are likely to include Niagara Falls Memorial Hospital as an affiliate. In addition, Millard Fillmore Health System, the Buffalo General Hospital, and Children's Hospital of Buffalo are continuing talks toward a merger. They have released few details about the negotiations except to announce that john Friedlander has stepped down from his position as Buffalo General CEO in preparation for leading the new merged entity. "The health-care industry is going down the same path as the banking, railroads, and airline industries-we're undergoing consolidation to provide a better product from cost and quality standpoints," says Stanek, the Mercy Health System CEO. The mergers offer the potential to save money through consolidations and economies of scale. All the players agree that a considerable fraction of the 4,700 hospital beds in the Buffalo area are unnecessary, although estimates of the figure range from 15 to 35 percent. The mergers could also put hospitals in a stronger negotiating position with payers because insurers won't be able pit one hospital against another or ignore a system that serves a crucial geographic region. Erie County Medical Center is pursuing another strategy, expanding to form its own system with a network of community primary-care facilities to attract more insured patients. Creating a system (through mergers or through expansion into the community) puts hospitals in a better position because they can offer payers a full range of services, better geographic coverage, Physician w 1 n t e r 1 9 9 7 -- and more direct control of costs, according to Sieber. Some health-care experts also say that in the future, full-service healthcare systems may contract directly with large employers, bypassing insurers altogether. A more immediate incentive for mergers is a fear that New York State will drop its longstanding ban on for-profit hospitals. "There's a concern that if the law is changed, a big national provider could come in and scoop up whoever's not involved in a system," says Sieber. "Most people here would rather see community involvement and community control of the health-care system." In addition, for-profit insurers from New York City and from other states have been putting out feelers in the region. Increased competition on top of the state deregulation ofhospital rates would have prompted mergers in any case. The process is being speeded up by the fact that managed care in Buffalo is already so strong. "It's a big change, to take away that protection for hospitals at the same time that managed care is mature," says Arthur Goshin , M.D., president of Buffalo's oldest managed care group, HealthCarePlan. "In other states, either there was no regulated reimbursement, or managed care grew slowly." State law changes the rules New York's health-care reform package does more than just deregulate hospital rates. Among other things, it creates new funding pools for graduate medical education (GME) and for charity care. The changes are intended to stop the 0 �common practice of using GME dollars to help support a hospital's charity care and bad debt. They are also an attempt to reduce the number of residents trained in New York and bring the number closer to the national average of30 to 35 residents per 100,000 population. As a result, Western New York hospitals , which train 40 to 45 residents per 100,000 people, will face a $13.9 million loss in GME dollars, according to] ohn P. Naughton, M.D., who recently retired from his position as dean of the School of Medicine and Biomedical Sciences. While there is concern about how the reforms will affect the future of medical education, doctors are welcoming other parts of the health-care reform law that protect patients and doctors . Among the law's provisions: an absolute ban on "gag rules;" guarantees that qualified doctors will be involved in decisions about whether to cover specific procedures; and grievance procedures for patients denied care and for doctors dropped from insurance plans. Doctors share risk in new payment schemes Buffalo's managed care entities-mostly Independent Health Association , HealthCarePlan, and Community Bluetogether enroll almost 50 percent of the area's population (80 percent of the commercially insured population) . But until quite recently, Sieber says, most managed care companies in New York State have operated through discounted fee-for-service systems, so they weren't that different from indemnity companies. "We called it 'managed care lite."' "It's really been 'indemnity in drag,"' agrees UB's chair of family medicine, Thomas Rosenthal, M.D. As the market grows more competitive, managed care groups are altering theirreimbursement plans. For example, Independent Health Association, an independent practitioner association/managed care organization, has introduced a new system of modified capitation (prepayment on a per-patient basis). HealthCarePlan continues to reimburse physicians on a 'withhold' system, in which the insurer prepays doctors up ® to 85 percent of agreed-upon fees , but withholds the remaining 15 percent until the end of the fiscal year. Doctors who worked within their budgets then get the entire 15 percent; higher costs are deducted out of the withheld money. As an additional incentive, says president Arthur Goshin, physicians will be told the rates charged by hospitals. That will give doctors a reason to prefer hospitals where HCP has negotiated low rates. Blue Cross and Blue Shield negotiates different types of reimbursement with different providers, says Nora McGuire, the executive director of Community Blue, the insurer's HMO. Sieber says there is room for a variety of reimbursement systems. "Capitation is the buzz word today, but it's only one form of sharing risk. It's quite possible that no single method will dominate the market. " Companies are also creating new types of plans. HealthCarePlan, originally a staff-model HMO, recently added a preferred-provider network called Choice Care. But for many physicians, it was Blue Cross and Blue Shield's new HMO product that came to symbolize a threatening level of change. In essence, the company divided its HMO, Community Blue, into two parts. One is the traditional HMO in which patients are responsible for copays for a range of services. The alternative, Community Blue Advantage, offers additional dental, optical, and other services, lower copays, and medical care from a subset of the plan's doctors and hospitals. Patients can go to doctors outside the network for an additional fee . McGuire , the plan's executive director, says hospitals were chosen to participate in Advantage based on the rates they negotiated with the plan. The plan selected doctors based on factors that included cost, geographic distribution, and hospital affiliation. The plan resulted in complaints from hospitals and doctors not included in this abridged roster, although Community Blue managed to soften the criticism after adding ECMC to the Advantage plan and holding talks with the Medical Society of Erie County. B u 1 I a l o Best practices Insurers are also doing more to manage care by trying to standardize the way different doctors practice. In part, they do this by providing outcomes data and other research . Doctors and insurers both agree that doctors are eager to help set best-practice guidelines, and that, if they are convinced of the value of the guidelines, they willingly comply. The desire to better serve patients, as well as peer pressure from fellow doctors, can both play a role. "Doctors want to know the data because they want to use it in their decision making," says Gosh in, president of HealthCarePlan. "Physicians are scientists, and if we direct those energies into getting the best practices, we'll get the best outcomes," says Buffalo Medical Group medical director Richard M. Peer, M.D. "If it's imposed upon them, they will rebel. If they understand the process, and have input, they get enthused." But that doesn't mean that insurers and doctors will agree on what the best practices are. Doctors are concerned that insurance companies' business goals will win out over quality concerns. Insurers suspect that doctors don't appreciate the importance of controlling costs. In some cases, physician organizations can give doctors a greater say in how insurers regulate practice. And physician groups can also help doctors negotiate better deals . As a result, Buffalo's doctors are becoming more interested in cooperative arrangements, such as group practices , physicianhospital organizations, and independent practitioner associations. "Physicians in New York haven't been very organized, but we're starting to see more of that," Sieber says. One of the area's largest and oldest multi-specialty group practices is the Buffalo Medical Group. It was formed in 1946 as a way to pool resources and practice in an atmosphere of professional cooperation, but gradually its business role has become more important. The group now handles all billing, negotiates contracts with insurers, and scrutinizes contract language. Physician W I n t e r 1 9 9 7 �- - -~ ---- - -~-- - - ~- -- --~ - - "If we feel it is to our benefit and to care doctors and giving them a strong economy by realizing the possibility of our patients' advantage, we will partici- financial incentive not to use specialty cost savings in insurances. pate in an insurers' plan as an entire care, money is budgeted for primary In 1984, there were 33 hospitals in group," says Peer, a vascular surgeon care and for different types of specialty the Twin Cities. Within four years, eight who serves as the medical director. care based on usage of specialty services hospitals closed and most of the others A different type of physicians' orga- in past years. Additional financial and had merged into three systems. HMOs nization is the University Medical Group, professional incentives are intended to also merged and consolidated, and phyformed to organize UB's 400-plus physi- encourage specialists to follow certain sician groups grew larger in reaction. cian faculty members. Its chief adminis- practice guidelines and to underspend The result is a variety of networks of trative officer, Greg Brodnick, came to their pool's budget. physicians, HMOs, and clinics that have UB after a career with several Blue Cross ''I'm not suggesting this is the perfect shifted the provision of health care from and Blue Shield plans in New York and way to pay doctors, but we also know hospitals into community-based offices Pennsylvania. the pitfalls of the fee-for-service sysand clinics. A new state program, "I certainly know the other side's phi- tem," Tronolone says. "At this point in MinnesotaCare, provides coverage for losophy," says Brodnick. "That's what the health-care system, there is going to the uninsured. makes me valuable in this situation." be an economic policeman. The patients Buffalo may evolve along similar lines, The group's bargaining strength would be best served by having people or it may find its own solutions, Kissick comes from its diversity of generalists with medical knowledge do that, rather says. One of the critical factors is how and specialists. Also, many of the fac- than the 'bean counters."' doctors engage in the process. ulty practice in the downtown hospitals lawrence McCullough, Ph.D., a Baylor that care for most of Buffalo's Medicaid What nowt College ofMedicine professor who spoke patients. This makes the doctors more Minneapolis was one of the first regions at UB's symposium on ethics and values attractive to insurers who enter the Med- where the health-care economy began in health care, urged doctors to be more icaid managed care market, because the to change, and it's one of the few that has assertive in their response to managed insurers have to enroll enough doctors reached Kissick's fourth stage of ecocare. "I refuse to accept the victimology to care for their new subscribers. nomic evolution, managed competition. language. Physicians are the most pow"Whenever you have big numbers, The area has some similarities to erful, well-organized profession in the you have strength," Brodnick says. "Our Buffalo. Like New York State, Minnecountry. It's time to stop complaining goal is to get our doctors signed on with sota prohibits for-profit hospitals. Minand start acting." all the third-party payers. We can say, neapolis' population of 2.6 million is He told doctors to accept the fact that 'Either you take all of us, or you get none about twice that of the Buffalo-Niagara all payment schemes would include fiof us."' County region. However, unlike Bufnancial incentives, but urged them to Another sort of physician group is the falo, Minneapolis has a core of powerful fight to ensure that the incentives do not Independent Practitioners Association of Fortune 500 companies, which spurred cripple clinical judgment, that ethical Western ewYork, which comprises the much of the change in the health-care components are included in quality indoctors who work for Indicators, and that patients dependent Health. The are fully informed about IPA is so integrally contheir insurance plans. nected with Independent Kissick urges providHealth that the insurer ers and insurers to work essentially pays capitatogether to ensure such Carrie B. Frank has been appointed intion money to the docsocietal goods as conterim president and chief executive officer tors' organization, which sumer choice, low-cost of the Buffalo General Health System. then pays physicians. The care, and organized She succeeds John E. Friedlander, who IPA's president, Michael practice. has stepped down to lead the developTronolone, M.D.,says the "To manage or be ment of a merged health care system that IPA gives doctors a strong managed, that is the quesmay include Buffalo General, Children's voice in the plan. tion," he says. "Whether Hospital of Buffalo, and Millard Fillmore Tronolone says the 'tis nobler in the mind to Health System. doctors' group negotisuffer the slings and arFrank had been Buffalo General's exated a form of capitation rows of outrageous forecutive vice president and chief operating Carrie B. Frank that spreads financial tune, or to take up arms officer since March 1993. Before that, she risk among all types of against a sea of troubles, had served in a number of financial roles, including vice president practitioners. Instead of and by opposing end of finance and chief financial officer. capitating the primary them." + New CEO named for the Buffalo General Hospital a u f f a l a Physician w 1 n t e r t 9 9 7 �by Jess ca Ancker B photos u f f a l o P hysici by a n K.C. W Kratt I n t e r 1 9 9 7 �-- - - -- ----- ~ - - - - ·- -- - - - • ____n • the isto~ of medicine In UB\ RoBERT L. BROW\! HISTORY OF MEDICINE COLLECTION HAS BECO:YIE A LITTLE RICHER. A first edition of a 16th-century obstetrical text donated to the collection this fall became the University Libraries' 3 millionth volume. And a $500,000 endowment by the History of Medicine Collection's strongest supporter will enable the library to expand its unique collection. Volume number 3,000,000 is a 1554 first edition of Jakob Rueffs De GALEN PERGAMUM, 0 one of the most famous physicians of antiquity, practiced in Rome in the second century of the Christian era. His texts dominated medicine in Europe , Byzantium, and the Arab countries for more than 1,000 years. This book, Galeni Pergameni omnia, quae extant, in latinum sermonem con versa (The surviving writings of Galen ofPergamum, translated into Latin), is a compilation of his writings published in Basel in 1561. The detailed hand-coloring of the frontispiece evinces the respect accorded to Galen's name even at this date. B u f f a l o conceptu et generatione hominis. The Rueff book was presented to the University Libraries by George M. Ellis, M.D., class of 1945. It builds on the strengths of the collection, which was started by james Platt White, M.D. (1811-1881), a founder of the UB medical school and its first professor of obstetrics. White's collection of more than l ,000 medical texts was bequeathed to the university and became the nucleus of the History of Medicine Collection. The late Robert L. Brown, M.D. '44, was a strong supporter of the History of Medicine Collection throughout his 25-year career in the medical school. Brown, who at one point served as acting dean and later became the school's first associate dean, supervised the merger with the State University of New York. He also served as the medical school archivist, locating and preserving historical records that otherwise would have been lost. In 1985, the year of his retirement, the History of Medicine Collection was named after him. Brown's $500,000 endowment to the collection is one of the largest ever received by the library system. The 12,000-volume History of Medicine Collection already houses a trove of unique books, the oldest dating to 1493. In this issue of Buffalo Physician, we introduce a few of them to readers. Physician W I n t e r 1 9 9 7 �MAKING ANDREAS HISTORY THE HISTORY OF M E D ICI E VESALIUS of Brussels revolutionized the study of anatomy in the 16th century with detailed descriptions and illustrations drawn from his own dissections. He generally suspended his specimens from a pulley, so the organs and tissues in his illustrations often appear to be dangling from the cadaver. Because his observations updated and sometimes contradicted those of the ancient authority Galen, Vesalius came under fire from some critics who accused him of disregarding tradition. While the original sketches may have been made by Vesalius himself, the woodcuts, some of the most famous images in medical history, are thought to have been carved by assistants to the artist Titian. Two hundred seventy-seven wood blocks were created for the 1543 first edition of De Humani Corporis Fabrica (Of the structure of the human body) and an accompanying abridged edition called the Epitome. Some of the original illustrations were replaced by copies in later editions. UB's History of Medicine Collection owns one of these, a fourth edition (the closed book shown above). The original blocks were lost and rediscovered several times over the next few centuries as they passed through the hands of collectors , artists, and librarians. The New York Academy of Medicine and the Library of the University of Munich printed what would become the book' s fin al edition in 1934, a copy of which is shown above and at right. The blocks were destroyed in the Allied bombing of Munich in World War II. B u f f a l o Physi c la W I n t e r 1 9 9 7 �-- - - -- MAKI ~-- ~ - ~ THE G HISTORY DE c 0 N c E PT U ET GENERAT I 0 N E -- ~ ~- - - -- HISTORY OF MEDICI - E H 0 MIN Is (Of the conception and generation of men) was published by Swiss obstetrician Jakob Rueff in 1554. The book's Latin text covers contemporary knowledge about conception, fetal development, uterine anatomy, birth, and care of mother and infant. Rueff is believed to be the first author to recommend the use offorceps in live births . The woodcuts, although in many cases derived from illustrations by Andreas Vesalius, also correct some flaws in Vesalius' representations of the fema le reproductive organs. The woodcuts were carved by Jost Amman, who was also noted for his Biblical scenes. Shown here are depictions of abnormal presentations of the fetus. Presented to UB this year by George M. Ellis, M.D., UB class of 1945, De conceptu became UB 's 3 mill ionth library volume. B u f f o 0 p h y c o n w e 9 9 �MAKING THE HISTORY HISTORY OF MEDICINE SURGEON BRITISH William Cowper published the first edition of his popular Myotomia reformata, or an anatomical treatise on the muscles of the human body only three years after he entered the practice of medicine. The 1724 edition shown here, with its beautiful copperplate illustrations and capital letters, was published posthumously. During his career, Cowper identif ied the bulbourethral gland and the fascia pectinea ligament, both of which are now named after him . He also published other works on hardening of the arteries and surgery of the maxillar sinus. One of Cowper's publications, The Anatomy of Humane Bodies, became the focus of a plagiarism scandal. Scholars believe he bought the copperplates to Anatomia Humani Corporis, published in Amsterdam by Govert Bidloo, and republ ished them with his own English text and a new appendix. Lacking modern copyright protect ions, Bidloo retaliated by publishing a scathing attack calling Cowper a literary crimina l. ® B u f f o l o Phys i cian w I n t e r 1 9 9 7 �- -- -- - MAKI --- - -- G HISTORY WILLIAM HUNTER'S TheAnatomyof - -- - - -- - - - - TH E O F MED I C I erus ex eHum 1 - E ite! in figures reveals both his expertise in medicine and the value he placed on art. Hunter and his artists and engravers worked for 30 years to create this book, which was published in 177 4 by John Baskerville. Born in Scotland , Hunter practiced obstetrics and surgery in London . He opened his own School of Anatomy and lived on its premises , teaching and building his collections of anatomical specimens, rare books , coins , and paintings . B u f f a t o Phys l c l a W I n t e r 9 9 7 �MAKING "LET THERE BE A THE HISTORY T t STD UT ASS I STA HISTORY OF MEDICINE hold the pa ient's head firmly, and let others put their hands on his arms and knees." Such practical advice for surgery before the advent of anesthesia is found in Bell's Great Operations of Surgery, published in 1821 by the British surgeon Sir Charles Bell , who made a special study of the nervous system and was the first to describe Bell 's palsy. In his Great Operations, Bell detailed the tools and procedures used in such operations as trephining the skull, correcting hernias, amputating limbs, and removing bladder stones. An accomplished artist, he also illustrated his own book. In his advice to young surgeons, Bell draws on the experience he earned during his career in London and Edinburgh: "The extraction of the [bladder] stone most requires patience, and a disregard to what spectators are thinking of you, especially fools with watches in their hands." According to an inscription on the flyleaf, this copy of Bell was given to Roswell Park, M.D., in 1882 as a Christmas present. Park's own signature also appears on the title page. ~ I ® 6 u f f 0 l 0 Physlclo w I n t e r 1 9 9 7 �- --- - - ---- - - MAKI -- ~-- -- - - --- ~ G HISTORY - --- - a stonemason , was admitted to the hospital on March 20 , 1854, with debilitating faintness and lack of appetite. He died the next day. This hand-colored lithograph portrait of lveson in Thomas Addison 's 1855 book On the Constitutional and Local Effects of Disease of the Supra-Renal Capsule, illustrates the patient's overall pallor and some smoky skin discolorations on his face and chest. Addison was the first to link the discolorations, the faintness, and the weak pulse with autopsy findings of diseased supra-renal capsules (the adrenal glands). The disorder, called Addison's disease , is now known to occur when tuberculosis or autoimmune problems destroy the adrenal cortex and result in deficiencies of aldosterone and cortisol. This edition of Addison is exceptionally valuable because it was presented to the History of Medicine Collection by George M. Thorn, M.D. , UBclass of1929, who was one of the developers of the treatment for Addison 's disease. The book is inscribed to Thorn by " a grateful patient. " u f f a l a Physician -- - - ~ TH E HISTORY O F ME DI C I IVESDN, e - W i n t e r 9 9 7 - E �• ····· ·· ···························· ···· ······················ · ················ · ········· . I New faculty member is a regular voice on NPR hroughout her career, Miriam Shuchman, M.D., has drawn on her medical expertise to write articles for the popular press and to create broadcast commentaries and documentaries. Today Shuchman, a member of the psychiatry departments at UB and the Erie County Medical Center, is also a regular medical commentator on NPR's "Medical Rounds." A graduate of the University of Connecticut Medical School, she completed her residency in psychiatry at Massachusetts General Hospital and Harvard Medical School. Fellowships at Dartmouth-Hitchcock Medical Center inN ew Hampshire and the Robert Wood johnson Clinical Scholars Program at the University of California at San Francisco allowed her to pursue her interests in consultation psychiatry and medical ethics. She has also worked as a psychiatrist at San Francisco General Hospital. Since moving to Buffalo in 1995, Shuchman has been spending three days a week at ECMC and the rest of the week in Toronto with her husband, Don Redelmeier, a physician on the faculty of the University of Toronto, and their son, 2-year-old Daniel. Some of Shuchman's work for the popular media has been in collaboration with Michael Wilkes, M.D., Ph.D., one of her classmates from both high school and medical school who now teaches at University of California at Los Angeles Medical School. In their first collaboration, an article for the Hartford Courant newspaper written while they were in medical school, they discussed the medical school socialization process that helps turn a student into a doctor. Later, in regular columns for the Los Angeles Times and the New York Times, Shuchman and Wilkes educated readers about such medical issues as clinical depression, back pain, smoking cessation, and vaccines. Their writing caught the attention of a National Public Radio executive, who invited them to create their monthly program for Weekend Edition Sunday. Their close professional relationship shows in the smoothness of their fastpaced discussions on the radio program. One of them may begin an explanation of the day's topic, and hand it over to the other to complete, as in a well-rehearsed duet. They translate medical terms into simpler language that will be familiar to a lay audience. When they disagree, they do so politely but unapologetically. In the week before each broadcast, Shuchman, Wilkes, and NPR host Liane Hansen hold a telephone meeting to choose a headline-grabbing topic. Shuchman then prepares herself with a blitz of research. She combs through professional journals and news clippings and interviews experts around the country. She may ask professional societies, such as the American Psychi- B u f f a I o atricAssociation, to provide background material, or seek the help ofNPRstaffin collecting relevant news articles. On a recent "Medical Rounds ," Wilkes and Shuchman discussed nonsteroidal anti-inflammatory drugs such as Aleve. They pointed out that these drugs can cause serious side-effects, including ulcers. Hansen asked whether self-medication was dangerous. ''I'm not sure that medicating oneself when it's a matter of having pain is such a bad idea," Shuchman said. "You don't want to always have to call your doctor and say, 'I have this pain again, what do you think I should do?' It does make it easier for people that they can walk into the drug store and talk to the pharmacist and say, 'I know that there are a number of these drugs which are over the counter. What do you suggest?"' "I think I've got to disagree, Miriam," Wilkes responded. "I think that few people talk to the pharmacist when they buy over-the-counter drugs. I'm worried about how many people end up in the hospital with serious complications like ulcer disease, etc., and even death, as a result of taking too many of these drugs. " The pair said later that the issue was one on which they have long disagreed. "Michael tends to wear a public health hat, and I tend to wear an individual patient hat," Shuchman said. "I really think there's a limit to how much people want to be protected from thingswhether it's in medicine or in something else, like the speed limit on the highway. We know that a 55 mile-perhour speed limit is safer, but people want to drive faster. " Much of Shuchman's media work focuses on mental health, including such topics as the impact of violence on children who witness it and the value of talk therapy and medication in the treatment of depression. She is working on a radio documentary on schizophrenia for the Canadian Broadcasting Corporation to be aired in spring 1997. Physician W I n t e r 1 9 9 7 �Why Jtay home for the holUJayJ? Tbefront-wbeel orive Infinitt-® /30TM Miriam Shuchman, M.D. Shuchman won the 1996 Media Award from the Northern California Psychiatric Society. It's unusual to get such praise for her journalism work, Shuchman says. "Far more often, you get a letter from someone who disagrees with you or is offended by something you said." But, she says, she appreciates even these letters. She recalls one example, a "Medical Rounds" program on a Supreme Court ruling that protected patient-psychotherapist confidentiality. "It's a stigma for people to find out you've been in therapy. It can often prevent you from being promoted at your job," Shuchmansaid on the air. "So the court was recognizing that people have to know that what they say to a therapist will be confidential in order to feel that they can even go into therapy." Shuchman also pointed out that religious confessions are generally considered privileged, and she described the public outcry over an Oregon case in which prison officials secretly recorded a murder suspect's confession to a priest. Within hours of the broadcast, Weekend Edition Sunday received an e-mail from an Oregonian. "Dr. Shuchman pronounced the name of this beautiful state, Ore-gawn," he wrote. "As every Oregonian knows, and as every easterner who's never been here seems never to know, IT IS PRONOU CED ORYGUN!!! as in 'He may have a knife OR A GUN!! ' Incidentally, people in Eugene are often B u f f a 1 a offended when people say YOU-gene rather than the correct pronunciation: you-GE E. So, let's all say together, 'The taped Catholic confession happened in you-GE E, Orygun."' Although the letter may have been a bit embarrassing, it did turn out to be a learning experience. In a later "Medical Rounds," Shuchman discussed state measures on managed care, including a proposition on the Oregon ballot. "Listeners might not have agreed with me, but at least I pronounced the name of the state correctly! " She adds, "If I get letters that are very moving, where people share their personal stories or have been offended or hurt by something I said, I'll often call back or e-maiL" In one case, after a program on mastectomies and lumpectomies, she spent several hours on the phone with a listener who had lost his wife to breast cancer. Shuchman sees her two careers, medicine and journalism, as closely intertwined. Being a physician gives her the credibility to influence the public's understanding of medical issues. "I keep getting grabbed by stories, coming from my patients, or my students, or the ideas that come up in practice." + "Medical Rounds" is broadcast once a month as part of NPR's Weekend Edition Sunday, which is heard in Buffalo on Sundays from 8 a.m. to noon on WBFO-FM. Physician w I n t e r 1 9 9 7 An interior /TUJre Jpaciou.J than a Rnli.J Royce Sif.,er Spur Ill. An exceptionally genermu lut of JtaniJariJ fu:r:ury featuru A 190-hp V6 capable of out-accelerating mo.ny lu:r:ury V&l. AniJ of courJe, the JtaniJaru-utting performo.na and Javia of 1nfiniti. SJ99 mo. ]6 mo. feaJe 1999.00 dou•n Intro ducing tbe all n ew 97' QX4® f rom 1]5,550.00 In an lnfiniti® QX4®, one of the firJt thingJ you 'll eJcape i.J the mundane. BecaUJe the QX4 i.J not your typical lu.:-cury Jporl utiliiy vehicle. Whdt: it o/ferJ all the verJatility you e:r:pect from a vehicle of itJ l::iniJ, the QX4 offerJ Jomething you IJon 't e.:r:pect: the lu:r:ury of an I nfiniti. I N FIN IT I AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd ., Near Eastern Hills Mall ( 130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage. s.15 per mile' in excess. �Trauma surgeon John R. Border dies ohn R. Border, M.D., an internationally known researcher whose pioneering work continues to save thousands of accident and injury victims from multiple-system organ failure, died on Monday, ov. 11, of a heart attack at his South Wales, NY, home. He was 70. Border, who joined the UB faculty in 1965 as a member of the Department of Surgery, was director of the trauma service at Erie County Medical Center and director of UB's Trauma Research Program from 1968 until his retirement in 1991. In the early I970s, he led nized and treated as soon as a team of UB researchers in possible after the original developing treatment plans trauma," he emphasized. to prevent the stress of seMuch of the lifesaving vere, multiple trauma from research over the years was producing a chain of biofunded through grants chemical events that, if not from the National Institreated with combination tute of General Medical protein and glucose therapy, Services. could lead to death. Although officially retired, Ina 1982 interview, BorBorder continued his work, both locally and internationder explained that when the John R. Border, MD . . body does not receive adally, to improve the treatequate amounts of protein to meet in- ment of trauma patients. Wearing his creased demands to maintain function trademark fire-engine-red suspenders, and begin repair of damaged tissue, it white shirt and tan slacks, he regularly draws on its own resources from muscle visited his office at ECMC. and other vital organs. The modest, soft-spoken Border "The fatal sequence-multiple- trained hundreds of UB medical stusystem organ failure-must be recog- dents and residents during his career, WNY's Largest Volume BMW Dealer THE ULTIMATE DRIVING IF BEING STARED AT MAKES YOU BLUSH, PLEASE CONSIDER YOUR CHOICE OF COLORS ACCORDINGLY. MACHINE~ F. G. DOWNING Towne BMW 3030 Orchard Park Rd . Orchard Park, New York 14224 Phone: 675-2550 $29 320 ' 1996BMWZ3 With a plethora of colors to choose from, you'll want to pick a roadster that goes with the crimson hue you 'll be sporting each time you take it for a spin . Service Loaners Available ... Minutes From Rich Stadium a u f f a l a Physician W I n t e r 1 9 9 7 �- - - --- -----~~- - - --~-- --- - - - HURWITZ & RNE, P.C. [ ATTOR EYS AT LAW I inspiring them by his example to not only be good surgeons, but to practice the art of the profession. It was not unusual for him to sleep overnight in his office at ECMC in case a patient he was especially concerned about needed him during the night. A 1956 graduate of Harvard Medical School, he did his undergraduate work at Harvard College and Indiana University. He served in the U.S. Navy Submarine Service from 1944-48. He and his wife, the former Donna Orvedahl, traveled on the Great Lakes and down the East Coast on their sailboat, Don]on II. + SERVICING THE LEGAL NEEDS OF THE HEALTH SCIENCES C OMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs "It's ok to ploy!" said Ringling Bros. clown John Lynch. Lynch, the son of on endocrinologist, discussed humor in medicine with students in Butler Auditorium while the circus was visiting Buffalo in November. • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 Fourteen physicians have completed UB's first Master's Teaching Fellowships, which offer training in clinical teaching and precepting. Bock row: Thomas Scanlon; Michael Terranova; Jock Coyne; Richard Carlson; Joe Lanigan; Sanford Levy; Anthony Vetrano. Front row: Tim Siepel; Donald Robinson; Colleen Mottimore; C.V.P. Varma; David Novelli; Thomas Gerbasi. Not pictured: Richard Ruh. 6 u f f a l o Phys ician w I n t e r 1 9 9 1300 Liberty Building Buffalo, New York 7 �TAKE TWO. I I AND CALL ME IN THE MORNING! f;"\d ~o..,r OW"\ ro(l[ * Fact: Saab owners have a elebrate the higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. • * According to the Insurance . lfl Marrtott Institute for Highway Safety {IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. SOUTHTOWNS SAAB tyle! 3580 Southwestern Blvd (1 Mile east of Rich Stadium) (716) 662·8008 From elegant parties to informal get-togethers, let the Buffalo Marriott host a celebration filled with warm fellowship and gracious hospitality. TheDollar Doctor... 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BUFFALO.,\\arnott. 1340 Millersport Highway Amherst, NY 14221 (7 16) 689-6900 (800) 334-4040 FAX (7 16) 689-0483 WWKB, 1520 Saturdays 9:05 to 10:00 am ~~P!:,!:~~IJ Member: American Stock Exchange, NASD, SIPC 237 MAIN STREET Tel: 854 -7541 ® 6 u f f 0 l 0 Phys ici an W I n t e r 1 9 9 7 �·--- - - --~ ~ - - TRACING THE MOVEMENTS OF CELLS When walls between research disciplines break down, the change opens up new opportunities and new ways of looking at old problems, according to cell biologistjohn Kolega, Ph.D. B u f f a 1 o muscle cells; specifically, the migration of the endothelial cells that line blood vessels. These cells migrate during normal development when blood vessels are formed, and also during wound healing, tumor growth, and diabetic blindness caused by blood vessels forming in the retina. Kolega is attempting to establish how and when cells organize and distribute the motor protein myosin II, and how cells regulate the function of the protein. To watch cells move in three dimensions, Kolega places them in a collagen gel. Careful observations of moving cells are revealing how this molecule might act to move different parts of a cell as it crawls. A related project that examines how electrical stimuli affect the permeability of a sheet of cells may shed more light on cellular mechanisms of blood vessel leakage. Although some of the molecular structure and mechanisms are beginning to be understood, it's not known how they all work together. Visual imaging may provide some of the answers, Kolega says. For example, he uses fluorescent imaging to examine spe- Physician W I n t e r ~ cific proteins within living cells as they move. "One of the things that is exploding in my field is the imaging technology-the whole battery of different forms of microscopywhich is allowing us to visualize things in the cells that we could never see before. Things that were worked out by biochemists in test tubes are starting to be seen within the living cells. That is going to take the tremendous advances in molecular biology and translate them into real biological behaviors. We can now start to watch these things happening." New discoveries in the field are likely to be applicable to all cells, Kolega says. "I happen to be working on endothelial cells, in part because it's easier to get funding for something with clinical applications, but I like to think that my work will help answer the basic question of how non-muscle cells migrate." + John Kolega, Ph.D. Cell Biologist "It's no longer good enough to know everything about molecules or cells or organisms," he says. "The really interesting things are going on at the interfaces between the old disciplines, where you have people with different expertise looking at a system from different levels." Thanks to this new interdisciplinary emphasis in research and education, Kolega is now delivering human anatomy lectures to firstyear medical students, in addition to working with endothelial cells in the lab. Kolega, 38, earned his doctorate at Yale and held post-doctorate positions at the National Institutes of Health, New York University Medical Center, and Carnegie-Mellon University. Upon joining the Department of Anatomy and Cell Biology at UB, Kolega took a crash course in human anatomy so that he could share the responsibility of teaching basic preclinical courses. He spent virtually every day of his first year at UB in the anatomy lab. "I was just one step ahead of the students," he groans. When not lecturing or supervising dissections, Kolega continues his research into cell migration. His field is the locomotion of non- - - -JESSICA 1 9 9 7 ANCKER �• ............... . ... . ................ . . . ....... ~ I Extemships provide a taste of the real thing ven with today's emphasis on clinical experience in medical education , it's not every second-year student who gets to do an abdominal paracentesis or a flexible sigmoidoscopy. Clayton Polowy did. "I had some serious hands-on experience as far as procedures went," Polowy recalled of his 1996 experience in UB 's Primary Care Summer Externship program. "It's basically primary care medicine and preventive medicine at its highest degree ." Polowy, now a third-year student, was one of 7l first- and second-year students in the program last summer. The externship, which pays students to spend the summer working with a primary care doctor, was developed in 1993. Of the 55 externship participants who have graduated from medical school, more than two-thirds have gone on to residencies in primary care. "It's designed to give students a taste of reality in Geraldine Kelly, M.D., supervises as student extern Mark Oberlies terms of primary care mediexamines a patient. cine," said Kim Crooks, who coordinates the program at UB's Primary Care Resource Center. "A certain. The current budget comes from lot of programs are modeled after this one. a variety of sources, including the mediI get calls from all around the country." cal school, the Robert Wood johnson The six-week externship remains un- Foundation, and the state Department usual in the large number of students it of Health. The Independent Health enrolls and in the stipend it pays: $1 ,200 Foundation has also provided support for first-year students and $2,000 for since 1995, and it recently decided to those in their second year. That helps make a significant contribution for 1997. push the annual cost to $125 ,000, but it "The goal of the foundation is to immakes it possible for more students to prove the quality of health in the combenefit from the full-time externship ex- munity, and we feel strongly that if perience. ''I'm maxing out my loans," there is a large pool of primary care said Polowy. "It was nice to feel that I physicians in the area, we're going to be didn't have to work on top of doing that. " able to accomplish that," said joanne Because it has no guaranteed source Way, the executive director of the founof funding , the program's future is un- dation, which is connected with the ADMISSIONS TEST January 11 and February 8, Upper and Middle Schools March 8 and April 26, Middle School • Exceptional college placement record • Challenging curriculum with the most Advanced Placement courses in Western New York • Average class size of 14 students • More than 60 athletic teams • Comprehensive visual and performing arts program • Financial aid available For further information, call: 875~8212 ICHOLS MIDDLE SCHOOL, 175 Nott ingham Terr. NICHOLS SCHOOL NICHOLS UPPER SCHOOL, 1250 Amherst St. B u f f a l o P hysician w I n t e r 1 9 9 7 �- - - -- ~~-- -· - managed care company Independent Health Association. In addition, the Millard Fillmore Health System, the Millard Fillmore medical staff, and the Howard Wilding Memorial Fund of the Millard Fillmore Health Education and Research Foundation have made donations totaling $30,000. The externship is a way of introducing students to clinical medicine and the Buffalo medical community, said TimothyGabryel, M.D., vicechairmanofmedicine at Millard Fillmore. "It helps them to see that what they went to medical school for really exists," he explained. "The best feedback for us is when we see the enthusiasm in the students," said TonyBarthalomew, M.D., who with his partner, jay Bishop, M.D., has been an externship preceptor since the program started. It was at their Fredonia practice that Polowy got his experience. "In six weeks you really get to see a lot," Polowy said. "One time, I did a joint injection." He recalled how his preceptors would take the time to pull a book off the shelf before discussing a procedure, or would provide an immediate critique of the way he interviewed a patient or made a presentation. "I was always treated by the staff and the physicians as a colleague," the student said. Emily Calkins, another third-year student, was inspired by her 1996 externship with Deborah Richter, M.D. , in Buffalo's Geneva Scruggs and Mercy health centers. "She was just a great role model for me , which I needed during medical school," said Calkins. "You see so many social problems , and she handled them so well. For many of these patients she was the only place they could turn for help. I keep her in the back of my head at all times , wondering, 'What would Dr. Richter do? "' Mark Oberlies, a third-year student who has had two summer externship experiences, said he was already interested in primary care, but he had a nagging uncertainty about whether any B uffalo - - - physician could truly master the scope of practice encountered by generalists. "As a medical student you feel so utterly clueless when there's so much coming at you, " he said. "You just think, 'I've got to get to my little area of medicine and learn everything I can about it. ' At the same time you've got people telling you to be a famil y doc and take care of everything. I needed to see if I could do that. " Oberlies spent the first summer working with geriatric patients under June Chang, M.D., and the second summer with Geraldine Kelley, M.D., at Mercy Hospital. "I take a lot of comfort from the examples of these people," Oberlies concluded. "I have a lot of respect for the people I've met in both externships. The greatest success of the program for me was that it showed me that primary care is doable. People can do it, and do it well. " + - AN DREW D A N Z 0 - & THE ULTIMATE DRIVING MACHINE ~ Checkpoint Foreign Car, Inc. Sales and Service • 487 Kenmore Avenue Buffalo, NY 14223 UB and Buffalo General announce new partnership with Bosnia 836-2033 fficials from UB met at the White House on Oct. 2l for a ceremony to announce a partnership to help Bosnia rebuild its health-care system after years of war. Leaders from UB, the Buffalo General Hospital, and the city of Buffalo were guests of Hillary Rodham Clinton. Buffalo General has had an informal relationship with Tuzla Clinical Center for two years, through the efforts o[Jacob Bergsland, M.D. , a cardiothoracic surgeon and UB associate professor of surgery. The new project, funded by $2 million from the United States Agency for International Development, will offer educational programs and the exchange of clinical personnel. Nearly 120 healthcare professionals have already enrolled in the program at the clinical center in Bosnia-Herzogovina. + Your WNY Leasing Specialist Serving WNY proudly for 33 years Physician W I n t e r 1 9 9 7 • - • ~AR ® �THEN ~~AND~ N 0 W When the germ theory was still atheory BY GEORGE HADDAD, eorge Haddad, M.D. '94, is pursuing a doctorate in the Department of the History of Science and Medicine at Yale University. In his paper "Germ Theories, Scientific Medicine, and the Buffalo Medical Community," Haddad argues that there were numerous kinds of germ theories before Robert Koch's discovery of the tuberculosis bacillus, and that much of the local scientific debate was actually a "fixing of the meaning" of the phrase "germ theory." He also shows that scientific advances did not move, ready packaged,from European and American academic centers to peripheral communities like Buffalo. Instead, these smaller communities underwent their own periods of debate and upheaval before reaching consensus. The following excerpts from Haddad's work focus on the writings of one outspoken opponent to the germ theory. Haddad's full paper, along with other articles on western New York medical history, is being published in Medical History in Buffalo 1846-1996: Collected Essays, by the Friends of the Health Sciences Library and the University at Buffalo School of Medicine and Biomedical Sciences. Copies are available from History of Medicine curator Lilli Sentz at (716) 829-3024. Fighting the new theory F rederick R. Campbell was born in Niagara County in 1860. He graduated from the Buffalo Medical College at age 24 and later joined the medical department of Niagara University, where he taught "Hygiene" and "Materia Medica and Therapeutics." In addition to medical acumen, he had literary and historical interests, and his schol- M D arly output included a book entitled The into a certain lineage of medical theories, Campbell opened the germ theory Language of Medicine. In june of 1885, Campbell wrote an to criticism that other theories also faced. Two years after Robert Koch's discovarticle entitled "Chemical vs. Germ Theories of Disease" in which he offered ery of the tubercle bacillus, Campbell a historical account of the dialectic be- realized that the role of doctors in the new tween the "chemical-humoral" and germ theory world was about to change. "germ-parasitic" theories of disease. just "When the germ theory becomes an esas the history of philosophy had experi- tablished fact," he scoffed, "the true phyenced a dialectic between idealism and sician will become a mere manipulator of materialism, Campbell believed that germicides, and the pathologist a student of microscopic medicine, too , had botany." a specific sort of This did not dialectic between mean Campbell different theories of was opposed to an disease. He wrote: "There was a huideal of scientific progress in medimoral pathology of cine. On the conthe Ancients, estrary, he saw sentially a chemichemical theories cal theory of disof disease and orease, replaced by ganic chemistry as the vegetable parathe legitimate heirs sitic hypothesis of to the scientific traVallisneri, dition. He claimed Hauptmann, and that there were Linaeus. Then "many honest sciStahl proposed a entific men who purely chemical are unwilling to theory of disease, accept, in their but this has been Frederick R. Campbell, M.D., in a portrait present state, the followed by the published posthumously in the BuHalo Medical views of the germ theory, sug- and Surgical Journal. 'bacteriologists.'" gested by the revIn his comparison of chemical and elations of the microscope, and brought to its present stage of development by germ theories, Campbell exploited the such men as Virchow, Pasteur, Tyndall, optical limits of microscopy and offered and Koch. " a large number of well-articulated obBy placing the germ theory within a jections to a germ theory. For example, genealogy of medical theories, Campbell microscopes of the time could not disstressed the contingency and contro- tinguish between bacteria associated versial nature of a germ theory of dis- with very different diseases, and so, as ease. Moreover, by placing a germ theory far as Campbell knew, they were identi- B u f f a 1 o Phys ician w 1 n t e r 1 9 9 7 �- ~ -- - - ~--------, -- - - - - -- T H E N ..A'NDII N 0 w cal to each other. However, Campbell and antisepsis were mediated through thought it was nonsensical to blame chemical processes. The germ theo"identical" bacteria for varying diseases. rists, according to Campbell, had He also asserted that "bacteria and serendipitously, through erroneous theories, fallen micrococci are always found on the upon the proper surfaces of mucous methods of surmembranes and gical antisepsis. these organisms In a translation differ in no respect and commentary from those found in upon a French ardiseases." Moreticle published in over, he denied the the Buffalo Medical clayo al<l, •llowiloc 'I" ...... contagiousness of and Surgical jourtuberculosis and in- This laboratory sketch of cholera germs under the nal, Campbell exsisted that tubercu- microscope was published in the BuHalo Medical pressed his concern losis could be and Surgical Journal by George W. Lewis, M.D., about the social caused by a number a contemporary of Campbell's who defended costs of accepting of different, non- Koch's germ theory. At the time, it was rare for the germ theory of bacterial "irritating the journal to print any drawings or visual aids. disease: substances." "As to the social Campbell's "chemical theory," on the consequences, they have been seen in the other hand, explained infectious dis- recent epidemics in Italy and the south of ease by insisting that the introduction of France, where scenes of barbarism befit"some chemical substance" can result in ting another age were enacted. In Italy, it disease. He believed that chemical poi- appears proprietors demand that persons, just like drugs or bacteria, could sons suspected of having phthisis [tuberhave "selective powers." Moreover, culosis] shall vacate their property." In this piece, Campbell asserted that Campbell believed that chemical theories offered a "more rational basis of laboratory scientists do not do as much treatment than germ theories." Ulti- for practical medicine as "those who mately, Campbell believed that a chemi- pass their lives surrounded by diseases." cal theory of disease would be estab- Campbell's belief that he and the other lished as fact once scientists studied opponents of a germ theory were depathological chemistry as well as patho- fenders of "true clinical medicine" reflects the cleavage in medical identity logical anatomy. Campbell ended his diatribe against that the germ theory controversy progerm theories by rhetorically equating duced. Campbell drew a clear line bebacteriologists with alchemists. Bacteri- tween the practice of traditional bedside ologists "have already given the world medicine and the laboratory dabblings many valuable discoveries," he began. of the new medical scientists. In another Buffalo Medical and Surgi"] ust as the alchemists of old, while seeking the philosopher's stone and the elixir cal journal contribution, Campbell vitae, brought forth what was even more scoffed at bacteriologists for claiming valuable to mankind, modern chemistry, that they had discovered the true nature so the microscopists have paved the way of disease and reminded them that they, for the greatest discovery of modern medi- just as past believers in systems of medicine, were susceptible to new discovercine, surgical antisepsis." By this, Campbell did not suggest ies and revisions: "Were not the astrologists, the that antisepsis relied on a germ theory of disease. He firmly believed that sepsis humoralists, and the solidists of old ----...... ... ...................._ ""'..._·_ B u f f a 1 o PhUSICian W I n I e r 1 9 9 7 equally as certain as the modern bacteriologists, that they had discovered the true nature of diseases? Who can say that some writer in years to come will not ridicule those 19th century doctors who believed that microorganisms, like the demons of old, produced diseases in man?" A laudatory obituary of Campbell appeared in the same issue of the journal. His life ended at age 28. "He fell victim to typhoid fever, after a sickness of over a month," wrote the editors, who then tactfully commented, "Indeed it may be said that his death was the result of overwork enfeebling a physical system not robust and making it an easy prey to disease." Through modern hindsight, Campbell may appear hopelessly unprogressive, but he can also be cast in a sympathetic light. He did not study in Europe, and he, like most other American medical school graduates, did not have extensive training in microbiologic techniques. He saw a germ theory as a threat both to traditional medical practice and to his own sense of professional identity. His opinions did not fall along expected generational lines, nor did his opposition to a germ theory mean that he was against a scientific ideal in medicine. In fact, Campbell repeatedly made the claim that his "chemical theory" was the true heir to the scientific tradition. In addition to his theoretical and practical objections, Campbell saw a germ theory as a threat to traditional sources of professional identity. Campbell believed that true doctors spend their lives surrounded by the sick rather than peering into a microscope. His turn to the analysis of medical history may just have been an idiosyncrasy of his personality. However, it may reflect a greater tendency of physicians to make sense of changing values and meanings by turning to the study of medical history. + �I Achilllce to put idealism into practice BY CHRISTOPHER J. DIMAIO have wanted to become a doctor since I was a child. I did not have any life-altering experiences that led me to choose this career. I simply loved science and wanted to indulge myself in the highest level of science possible- human medicine. Thus I find myself in the middle of my first year of medical school, and I am loving it. But let's face it. My life is not as rosy as I may make it out to be. Ask any medical student, myself included, a seemingly harmless question like, "How's it going? " and you will find that you have just set yourself up for a formidable avalanche of complaints and frustrations about "how much work I have ," "how far behind I am, " and the ever-popular, "I need more sleep! " I can only compare the experience to trying to finish a plate of food only to have the waiter bring out another serving. just when you're wiping your mouth clean with the napkin, two more plates come out. And just when you thought you couldn't eat another crumb, the waiter decides to bring out the main course. Not hungry? Well , too bad, because the chef is just getting started. To be honest, I feel that all of the hard work and sacrifice is worth the effort. My experiences in the past four months have been unlike any others. Every day I get to ask the question , "How does the body work? " and every ® day I get another answer. My experiences go way beyond those in the classroom, though. I will never forget the rush of adrenaline I experienced when I made my first incision on a cadaver, or when I was firs tasked to do a physical examination on a patient. new cases, and how we should learn from the cases we have seen in the past. Most important, we are beginning to learn how to feel like doctors: how, when we are presented with a new case, we realize that this isn't simply patient #6578463, but rather Mr. Thomas O'Donnell who lives around the corner, has a wife and three children, and one day hopes to retire to Florida. The knowledge and information I will have gained from my years at UB will be with me for the rest of my life, and will allow me to carry on a tradition of treating those who are ill, and protecting those who are not. It is a dedication that will allow me to realize my noble thoughts of what a career in medicine should be. In each issue, Buffalo Physician invites a medical student to write a column about a topic of his or her own choice. A member of the Class of 2000, Christopher]. DiMaio is in the middle of his first year of medical school. It is exciting to know that this is only the beginning of my medical career, and that a lifetime of similar experiences awaits me. I stated my idealistic views of medicine in my application essay: "I truly enjoy helping people, and would like to have a career that allows me to make a difference in the lives of those who seek it." Today, my visions are being realized. We are learning how to think like physicians, how we should approach B u f f a l a Physician W I n t e r 1 9 9 7 I �Put tfze.best seat in tfze fwuse myourgarage. UB:MICRO CDMPUIERSALES A Non-Profit UNIVERSnY AT BUFFAIDS Yl PRoGRAM Advertise in one of the finest publications in Western New York ... Call 645-3554 www .computer-store. ubmicro.buffalo.edu Buffalo Physician YOUAREEUCJBTE ~Uff"lj for educationalpricing f " ~ s\ t \ " " DflL•COMPAQ•ZfNIIH APPlE•ACffi llXASINSIRUME\Tf Cl:l!:!!~ HEWIEIT9I(J(ARD - MICROSOFf•CORFl•ADOBFAND MUQI i\Om 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 'ldut7Jau-7Jtdd 1717 Walden Ave., Buffalo, NY Give us a call: (716) 645-6933 Phys APPLE ScHOOL REwARDS Michael J. Baranski Marketing Representative Pun:hase any qualifymg \lacintosh desktop computer, Apple display (if sold separately), and Apple printer through 1119/97 and earn poin~ for any school or your choice (to be redeemed for Apple products) IOMEGA REBATE OFFER Purchase an Iomega Zip Ori\'e, and recei\'e by mail either a $50 rebate, OR more than a $ISO >'alue "Game Pack-to-Go" Pun:hase an Iomega Zip Disk Ill-pack, and =i>< by mail eother a $20 rebaie, OR more than a $6o value "M Stuff Orpnizer". See Iomega maol-m renoCicate at l'BMocro for details. Rebate through 1/31/97. $so HP DEsK}ET 340 sERIEs REBA1EOFFER through 3/31197 See HP mail-on rertiOcaie at UB\Iocro for details CoMPUTER WORKSHOPS Call 645-3560 to have a brochure mailed to you. BARANSKI Open Mon thru Fri 11-5; Wed & T hurs 11-6:30 Coli for curr~nr priCin~ and Q\'(jifabilm·, Pnas subJ~Ct to dmnR~ witlwut noiiCt' ADVERTISING 891-5595 Buffalo Pun:hase any qualifymg Macintosh desktop computer. Apple display (if sold separately), and Apple printer through 1/19197 and rereire a $150 mail-in rebate. ician 146 Stepping Stone Lane Orchard Park, NY 1412 7 W I n I e r 1 9 A non-profit University program for students, faculty & staff The Commons • North Campus • (716) 645· 3554 • Fax: 645-3&84 9 7 �Aman who touched aenerations of students JACK RICHERT , ASSOC IATE DEAN FOR ALUMN I AFFAIRS , RETIRES ack Richert left many in the UB community with fond memories when he retired Nov. l from his position as associate dean for alumni affairs. It's no wonder, because he has touched the lives of hundreds of students- doing everything from helping them finance their education to keeping in touch after graduation. "I've met wonderful people in all my sions, student affairs , curriculum, medidifferentpositionsatUB," he says. "Now, cal school publications, and financial I can go to any major city and look in the aid. He also served as coordinator of Medical Alumni Directory and find post-graduate advisement and director people I know. It's a great feeling ." of the U.S. Foreign Medical Graduate He first came to UB to earn a master's program. In the latter capacity, he won in counseling psychology and a doctor- a $226,000 grant from the U.S . Departate in academic administration. The ment of Health, Education, and Welfare medical school hired him in 1970 as to create a pilot program for these transfer students. registrar and assistant to the dean. Former associate dean Leonard Katz, It was a time of rapid transitions. The dean who had hired him, Leroy A. Pesch, M.D., worked with Richert to bring stuM.D., left in 1971. Clyde L Randall, dent affairs and curriculum together in M.D., and F. CarterPannill, M.D. , served the new Office of Medical Education in as acting deans in quick succession. It 1975. "jack took the lead in student affairs ," Katz rewasnotuntil1975, members . "He with the arrival of was also extrajohn. P. Naughton, " IT'S BEEN GREAT TO SEE ordinary at arM.D ., that the SO MANY STUDENTS WHO school had a perranging events . CAME INTO MY OFFICE ON manent dean. For example, at Naughton credgraduation he THE FIRST DAY OF CLASS its Richert with added color with GROW AND MATURE AND BE helping to shore up a huge UB banthe administration ner , arranged for SUCCESSFUL ." music, and added during this period. other touches to "It was a very tough make ita wonderfew years, and jack was one of three ful pageant and a people who served as the 'glue' to hold great celebration." He took over the alumni affairs office services together for the students," he in 1984, and soon became associate dean says. In 1972, he was promoted to assis- and director of medical alumni affairs. tant dean. At various times in the folHe has had a profound impact on the lowing years , he led the offices of admis- Medical Alumni Association. When he B u f f a l a first became involved with the group , it sponsored only a few activities a year. I oday, as a result of innovations he introduced or facilitated , it is active yearround, offering events, lectures, awards , and educational programs for alumni and current students. He also helped expand the annual Spring Clinical Day program into an entire reunion weekend. The new Distinguished Alumni Awards and Alumni Achievement Awards recognize outstanding accomplishment. Receptions at national medical meetings make UB alumni feel welcome everywhere. The Medical Alumni Association has also become much more active in student life. The association donated money to furnish the medical student lounge, and it participates in student and resident orientations. It also sponsors scholarships, student travel to scientific meetings, and travel to work in developing countries. The association's Community Physician Program invites doctors to give luncheon talks to medical students about career choices, types of practice, and lifestyles. Richert also chaired the Buffalo Physician editorial board, where he helped the dean choose board members that represented the entire UB community, and was sensitive to readers' desires about the look of the magazine , according to fellow board member Bradley Truax, M.D. '74. "jack wanted to make this magazine something that the alumni would enjoy and look forward to getting rather than just throw in the wastebasket," Truax says. One of Richert's accomplishments was the creation of the james Platt White Society, which honors alumni who make annual gifts to the school of $1 ,000 or more. Philanthropy was not the only Physician w I n t e r l 9 9 7 �..L_ - -- - - - -- - - - - - - - - - . . .. .. . . . . . . . . . . . . . . .. -~ • goal of the organization. "My goal in creating the society was to help our alumni reconnect with UB ," he explains. "There had been something of a breach between the people who graduated from the private University of Buffalo and those who graduated from the public University at Buffalo (after the 1962 merger of the university with the SUNY system). We had graduates who lived nearby and had never been back to the school. We needed to bring them back, reconnect them with the school, and show them that they were still part of our community." "None of these good ideas would have come to fruition without jack," says alumni association past president Margaret Paroski, M.D. '80, who met Richert when she was a student and he was assistant dean for student affairs. "He has a real knack for persuading people to participate, take on responsibilities, and get things done, and he's always understood how important volunteerism is to the school and to medical teaching in general. " Richert's engaging manner , good memory for names and faces , and gift for B u f f a l o building friendships have been key to his success at UB---and will make him missed. "I was accepted just four days before school started, so I showed up with no idea about where to stay," recalls jack Coyne, M.D. '85 , Medical Alumni Association president. "jack put together a whole list of possibilities, and found ways for me to fund my education, too. Physician w I n t e r 1 9 9 7 He took a personal interest-it was more than just a job. " In retirement, Richert plans to catch up on reading and research ("There are a lot of libraries I have neglected for too long! ") , get involved with volunteer activities, work on his century-old house in Buffalo, and spend more time with his wife and their daughter. "As I retire, I think what a nice time it was. There were obviously peaks and valleys , but I think the peaks outnumbered the valleys ," he says. "It has been wonderful to watch the school move into national prominence. "I also think about the pleasure I've had in meeting so many fine people who have become my personal friends. And it's been great to see so many students who came into my office on the first day of class grow and mature and achieve and be successful." Recruited by admissions director Thomas]. Guttuso, M.D., Richert will also serve as a volunteer member of the medical admissions committee. And so , even in retirement, he will continue making connections with new members of the UB medical school community.+ -JESSICA A NCKER �Wende W. Logan-Young, M.D. '61 FOUNDER AND DIRECTOR OF THE ELIZABETH WENDE BREAST CLINIC BY ANDREW DANZO ack in the mid-l970s, a diagnostic radiologist had a radical idea. Armed with emerging breakthroughs in imaging technology, Wende W Logan-Young, M.D., felt that radiologists should move out from behind their x-ray viewboxes to play a more central role in the fight against breast cancer. In pursuit of this vision, Logan-Young founded the Elizabeth Wende Breast Clinic in Rochester, NY. Now radiologists at her clinic and similar ones in other cities are giving women more timely and compassionate answers to some of their most fearful questions and reducing the need for surgical biopsies. "Ours was the first clinic where the radiologist intervened and started doing more of what the surgeon did ," ® Logan-Young recalls. "Before, the traditional role of the radiologist was to sit down at the end of the day and look at the image made earlier by a technician. There was no patient contact. " Logan-Young named the clinic after her mother, who taught her the kind of compassion she tries to bring to her own work with patients. "She was my role model , just a fabulous person," Logan-Young says. B u f f a I o P Logan-Young has been a pioneer in the use of a multiprocedural approach that stresses the importance of taking a good patient history and conducting a thorough breast examination, in addition to utilizing ultrasound and 14-gauge needle gun biopsies. With her associate , Nancy Yanes Hoffman , M.S., she published Breast Cancer: A Practical Guide to Diagnosis in 1994. The book is to be the first ofthree volumes; she is currently working on the second. "The book is a distillation of 20 years of what worked best," Logan-Young says. Those years represent a second, perhaps third , career for Logan-Young, who is one of a long line of Buffalo physicians and UB alumni. During her time at UB, she was married to classmate] onathan Logan, M.D. '61, and was called Wende Logan. "It was a hell of a good school," Logan-Young recalls. "I still have very good feelings about the university. " She originally entered internal medicine. After having four children, however, she couldn't keep up with the demands of the practice and switched to radiology. She joined the University of Rochester School of Medicine faculty and got involved in testing new lowdose x-ray films. If it could be perfected, she realized, low-dose mammography could open new doors in breast cancer screening and diagnosis. She also noticed how grateful women were when she told them their results on the same day. "This was considered heresy in 1975," she said. At the time, and not uncommonly even today, radiologists were supposed to report only to the referring physician, a protocol that she said caused delay and anxiety. "It sounds like a small point, but it isn't, " she says. She became convinced that there was a need for radiological practices devoted to breast cancer. "I went around to every group in Rochester and begged them to take me hysician W I n t e r 1 9 9 7 �--- ----- - - - - - -- - - - -- -- - - - -- - "O~RS~IWAS~~ili HE!!IIF.IRSli C l.!! INIC!J,,W8ERE:!!,~ili 8E RADIOI!OGISlijiiiNliERVENED AND STARli ED)~DOING~IMORE O F.: WHAli il'~ili HE S~RGEONn EIDE W. loau·YOUIG, with that concept," she says. "They all said I was crazy. So I opened my own office." As she was setting up, she read an article about using an ophthalmic ultrasound scanner for breast exams. Researchers had reported promising results with ultrasound breast imaging since the 1950s, and by the mid-1970s several physicians around the country were using ultrasound for breast exams, but there was still no commercially available machine designed explicitly for that purpose. Logan-Young bought one of the ophthalmic units. "At that point," she says, "there wasn't a radiologist in the country who was combining ultrasound and radiology." By bringing the best tools for breast cancer detection- clinical examination, ultrasound, and mammography-under one roof, Logan-Young felt that the techniques could complement one another to more accurately identify real cancers and to reduce the number of surgical biopsies on masses that proved benign. But there were problems to be resolved with the low-dose film. LoganYoung organized national meetings on that and related issues at Roswell Park Cancer Institute in 1977 and 1979. "A lot of the equipment changes that came out resulted from those meetings," she recalls. Logan-Young continued publishing her results with low-dose mammography and ultrasound. She also traveled the country demonstrating techniques for clinical breast cancer diagnosis. Her practice, however, was slow to take off. "We spent a lot of time modifying the equipment," she says. B u f f o l o IDID ." M.D. Eventually it paid off. The Elizabeth Wende Breast Clinic now has a staff of 80 and sees 50,000 patients a year, some from as far as Watertown and Binghamton, NY. "They like the ambiance of the office and they like having the results the same day," explains Logan-Young, who took her current name after remarrying six years ago. A major part of her quest to expand the radiologist's role was fulfilled in 1993 when she acquired the first 14gauge needle biopsy unit in western New York. The needle biopsy technique was developed years earlier in Sweden, but it was only recently perfected by a Colorado radiologist who added a new - needle design and computerized guidance that yielded results comparable to surgical biopsy. "The development of the 14-gauge needle was the last step that the radiologist needed to prevent unnecessary surgery, to keep us from doing too many biopsies," Logan-Young says. Nationally, she added, only one out of every five surgical breast biopsies confirms a cancer, while the rate for her patients is one out of 1.3. Equipment and technique are not the entire equation. "This sounds real corny, but from the beginning we tried to make the office look more like a home than an office," Logan-Young says. "I always hated the sterile white jackets. We put in antique chairs and flowered wallpaper. " Three of the 14 chapters in her 1994 book are devoted to interacting with patients. "Once you become the one to make the diagnosis, you do a lot of the counseling that the surgeons would have done." + Grover Wende, Class of 1889 Wende Logan- Young's great-grandfather's brother wrote an early text on dermatology George H. Westinghouse, Class of 1896 Logan- Young's grandfather Walter David Westinghouse, Class of 1931 George Westinghouse's son was Logan- Young's fath er Wende Westinghouse Logan-Young, Class of 1961 Physician Walter David Westinghouse, Class of 1964 Her brother is a San Diego cardiologist Andrea Westinghouse, Class of 1989 Her sister entered medicine as a second career and is now a pediatrician in Eden, NY w I n t e r 1 9 9 7 �• · ··· ·· ···· · · ····· ··· · · · ·· · · · ·· ······ · · ·· ··· ·· · · ·· · ·· ······· ·· ··· · ···· · ···· · · ·· ···· ·· · · · · ·· I 1 9 5 0 s DONALD R . HAULER '57 , of Pensacola, FL, has retired from the U.S. Navy after more than 36 years of active duty. His rank at retirement was captain. He was awarded the Legion of Merit at a Washington Navy Yard retirement ceremony. He moved from McLean, VA, to Pensacola in In April 1997, Jason, along with Edwin Rosinski (Ed.D. '58) and former UB faculty members Stephen Abrahamson and George Miller, will be honored by the UB medical school for their pioneering work in medical education, which began while they were all at UB together. September. 1 JEROME P . KASSIRER '57 , of Weston, MA, was named Distinguished Internist of 1996 by the American Society oflnternal Medicine for contributions to the social and economic environment of the practice of medicine. A kidney specialist at the Tufts University School of Medicine and the New England Medical Center, Kassirer is the editor-in-chief of the New England journal of Medicine. HILLIARD JASON ' 58 , 9 6 s 0 RICHARD H . DAFFNER '67 , of Pittsburgh, PA, writes: "I have just published my fifth textbook, the second edition of Imaging Strong Memorial Hospital in Rochester, NY. He and his wife are both clinical professors of family medicine at the University of Colorado School ofMedicine.Jason is also co-director of the Center for Instructional Support and co-director for education for the Society of Laparoendoscopic Surgeons. ® also serves on the board of the New York State Department of Health's Office of Professional Medical Conduct. He and his wife, Sharon, have two daughters, Gretchen and Julie 1 of Vertebral Trauma . I am currently professor of radiologic sciences at MCP-Hahnemann School of Medicine at Allegheny University. I am based at Allegheny General Hospital in Pittsburgh." ED .D . '62, of Boulder, CO , and his wife, Jane Westberg, Ph.D ., recently published their sixth book, Fostering Learning in Small Groups. It is part of both the Springer Series on Medical Education and the Springer Series on Nursing Education. Jason earned his education doctorate while completing medical school and his residency at director of anesthesia services at Millard Fillmore Suburban Hospital in Buffalo. He is a member of the Millard Fillmore Health System board of directors and president-elect of the system's medical staff. A UB assistant professor, he is also chair of the school's quality assurance committee for anesthesia. Burdick 9 8 s 0 DAVID S . KOUNTZ '85 , of New Brunswick, NJ , has been named associate dean for postgraduate education and chief of the division of primary care at UMDNJ-Robert Wood Johnson Medical School. PEGGY ( MOREY) STAGER of Cleveland Heights, OH, writes that she and her husband, Richard, "announce the birth of our beautiful boy, Samuel Robert, on April 1, 1996." She is practicing adolescent medicine at MetroHealth Medical Center in Cleveland. '88 , 1 9 7 s 0 MICHAEL BARON '71 , of Bristol, TN , writes: "I have relocated to private practice in Bristol in pulmonary critical care medicine. The hospital is two and a half years old and is state of the art, and managed care is just beginning. I am an assistant clinical professor of medicine at East Tennessee State University School of Medicine." JAMES P . BURDICK '75 , of East Amherst, NY, was installed as president of the New York State Society of Anesthesiologists in December. Burdick is B u f f a l o U.S. ArmyinfantryinApril194l. On Dec. 7, when the Japanese attacked Pearl Harbor, Secrist was on guard duty on the island of Oahu, five miles away. In combat duty in Europe, Secrist was wounded in action and received the Purple Heart. He left the Army with the rank of first lieutenant after five years of service. Secrist returned to school on the GI Bill, earning a bachelor of arts degree from Columbia University in 1947 and his M.D. from UB in 1951. Secrist made house calls to patients all over Buffalo and developed a reputation for treating patients regardless of their ability to pay. A member of the Erie County and New York State Medical Societies and the American Medical Association, he was board-certified in internal medicine. He was a member of the American College of Chest Physicians. OBITUARY ROBERT SECRIST '51 , clini- cal associate professor emeritus at the School of Medicine and Biomedical Sciences, died Nov. 5 in his hometown of Lockport. He was 78. Secrist attended Cornell University for three years before leaving to work at Bethlehem Steel. He was drafted into the p h y 9 e a n w n I e 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. • MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356- 4056 in Upstate New York, or 1- 800- ASK- MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ledical ~ Liab1lity :-lutuallnsurance Company guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse. NY 13202 90 Merrick Avenue E. Meadow, NY 11554 el996 Ml"..d ..:.1 L at> ity Mutua! ln~r,gnc~ Company �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No . 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 21 4 'fED.LC L HISTO. IC~ ADDRESS CORRECTION REQUESTED PLAN'fiNG A \3 JT T LldR ~y TREE UNDER WHICH Ll w-~IHLS A Y D-~T You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. Acharitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR ACONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. ESSARY, JR. I Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO U N IVIE: R S I TY AT I!I UFFAl.O SC H OOL O F M ED I CI N E l5~ 1 5 0 YEARS (716) 829-2773 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. 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Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/abe8d2d36bce3f6b3ca187a1f61c17d8.pdf cb90bb359762e6121c6a816e3fd32b20 PDF Text Text L �BUFFALO PHYS I CIAN Volume 31, Number 2 ASSOCIATE V ICE PRESIDENT FOR UN IVERSITY SERVICES Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR jessica Ancker ART DIRECTOR/DESIGNER Alan]. Kegler PRODUCTION MANAGER Ann Raszmann Brown STATE UN IVERSITY OF NEW YORK A T BUFFAL O SCHOOL OF MEDIC INE AND B IOMEDICAL SC IENCES Dr john Wright, lntenm Dean, V1cc President for Clinical Affcurs EDITORIAL BOARD Dr Bertram Portin Dr Martin Brecher Dr. Harold Brody Dr. Richard L. Colhns Dr. Jack F. Coyne Dr. AlanJ Drinnan Brian Duffy Dr James Kanski Dr Barbara MaJeroni Dr. Ehzabeth Olmsted Dr. Charles Paganelh Dr. Stephen Spaulding Dr Bradley T. Truax Dr. Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital .\1icharl Shaw The Children's Hospttal of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Franh Sam Niagara Falls Memorial Medtcal Center Roswell Park Cancer Institute Sisters of Charity Hospital Dear Alumni and Friends, THIS REPRESENTS MY FIRST OPPORTL,NITY as interim dean to communicate with you through the medium of the Buffalo Physician. During my tenure in this position, we will be presented with opportunities to build upon the many accomplishments fashioned in thejohn Naughton era, but we will also need to break new ground as we address new challenges. Managed care will, in whatever form it ultimately takes in Western New York, require significant changes and adaptations not only for the medical school but for the entire health-care delivery system in the Western New York region. Most of you are aware of the merger discussions between the Buffalo General, Children's, and Millard Fillmore Hospitals (see the Winter 1997 Buffalo Physician). As the reorganization unfolds, we may be presented with unique opportunities to reconfigure our programs at these institutions and elsewhere, and, in the process, maximize the distribution of faculty in a way that will enhance not only efficiency but also academic creativity. There is probably no single model that will address these needs. The process will not only be complex but likely driven by considerations beyond our control, and, in some instances, completely unanticipated. Provost Thomas Headrick recently circulated a major discussion document, "Planning UB's Academic Future: A Report to the UB Community," which outlines a number of bold new considerations for the university at large. The document is actually a "work in progress," and during the next few months, the provost and president William Greiner will be meeting with the faculties to discuss some of the concepts and proposals contained therein. Some of the suggestions for the medical school are new to this geographic region, but most are being considered or implemented in many other parts of the country. One of the most challenging ideas involves rethinking the traditional departmental structure and possibly reorganizing at least some of the faculty around interrelated disciplines. UB boasts 28 departments, significantly more than many other schools, including such icons of medical progress as johns Hopkins. Whether other configurations are right for Buffalo remains to be seen, but at the least, they merit our serious consideration and study. All in all, these will be challenging and exciting times. We will keep you updated through the Bllffalo Physician and through our meetings with faculty, alumni, and friends of the university through the months ahead . ~ W right, M.D. lntenm Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dennis ivtcCarthy Veterans Affairs Western New York Healthcare System ©The State Uniwrsity of New York at Buffalo Buffalo Physician is published quarterly by the State Unl\-ersny of New York at Buffalo School of Medtcine and Biomedical Sciences and the Office of Puhhcations. It ts sent, free of charge. to alumni, faculty, students, residents and friends. The staff reserves the right to edn all copy and subm<ssions accepted for publication. Address questtons, comments and submisstons to: The Ednor, Buffalo Physician, State Lmversny of New York at Buffalo, Office of Publtcations. 136 Crofts Hall, Buffalo. N) H260 Send address changes to: Buffalo Physician, H6 CFS '\ddttion, 34 35 Main Street. Buffalo NY l42H Dear Fellow Alumni, As THE SNOW MELTS and the crocuses try to bloom, we find ourselves with new leadership at UB. A towering, gentle man, john Wright, M.D., serves as the interim dean of the School of Medicine and Biomedical Sciences. He is not only blessed with administrative skills, but is also an outstanding teacher. I met him when I was a second-year medical student, and found that he was one of the few teachers who could make medicine come alive. Like many in our class, I was rejuvenated. I wanted to get out there and cure the world, or at least, learn as much as possible now so we could someday make a difference. john generated this enthusiasm in many of us. It's because of role models such as john that UB offers outstanding programs like the Master Clinical Teaching Fellowship, developed by Diane G. Schwartz, Sheila Brodnick, and Richard Sarkin , M.D. As a graduate of this fellowship program, I am excited to share it with you in the pages of Buffalo Physician. l found it an immensely valuable experience for teaching students in my clinical practice. And thank you, Dr. Wright, for your inspiration as a teacher, researcher, and individual. We have exciting, challenging times before us, and no one better to lead us. Sincerely, ~y~DC'~ /'?~ President Med1ca/ Alumn1 Assooat:10n �VOLUME 31 , NUMBER 2 SPRING 8 Teaching on the Fly: US HELPS DOCTORS COMBINE TEACHING WITH 14 OB-GYN today PHYLLIS LEPPERT , M . D ., R . N. , PH . D ., IS THE PRACTICE DEPARTMENT'S INTERDISCI- by Nicole Peradotto PLINARY NEW CHAIR photos by Frank Cesario by Jessica Ancker 18 97 Amedical mission to Kathmandu by Donald P. Copley, M.D. '70 08-GYN yesterday RANDALL AND WINKLER REUNITED A DI V IDED DEPARTMENT New faculty by Ronald E. Batt, M.D. '58 VICTOR .JAMES HERNANDEZ , PH.D ., AND MARIA LAURA A V ANTAGGIATI , M.D. Research news TOSHIBA FOUNDS Astudent's perspective: STROKE RESEARCH MEDICINE IS A CENTER. MILD CONCUS - OF POWER SIONS CAUSE LASTING BY MICHAEL MERRILL , PROBLEMS . SURGERY REMAINS AN OPTION FOR GAME CLASS OF Medical school Alumni WPW SYNDROME. PARENTS ' 1 997 COUNCIL FRANKLYN KNOX SUPPORTS STUDENTS . Hospital news ROSWELL PARK FACES CHANGE. PAROSKI BECOMES ECMC MEDICAL DIRECTOR . HCP REORGANIZES. COMBINES RESEARCH BUCK AND WRIGHT WITH LEADERSHIP. RECEIVE HONORS. TWO HARRINGTON LECTURE ALUMNI GIFTS. NEW FOCUSES ON DEGREE OFFERED. MEL PHYSIOLOGY . DIEDRICK DIES . Classnotes �World-class stroke research center established at UB with $3.6 million gift of Toshiba imaging equipment esearchers are getting down to work in a new world-class stroke research center established at UB with a $3.6 million gift of equipment and services from Toshiba America Medical Systems. Toshiba has donated its most advanced cerebral angiography equipment to help researchers study stroke and perfect new minimally invasive neurovascular surgery techniques. "What's exciting about this center is that it provides researchers with the same kind of super-high-tech equipment that we're using in the hospitals," says L. Nelson Hopkins, M.D., director of the new center and chair of UB's Department of Neurosurgery. "So the research we're doing is only months away from use on patients-not years." Phase one of the project was completed in December with the installation of one of Toshiba's top-of-the-line angiographic x-ray machines in the center on the fourth floor of UB's Biomedical Research Building. The Toshiba machine can show blood vessels as small as a half a millimeter across, and can make video images at a rate of thirty frames per second (about the same speed as a standard video camera). In phase two, Toshiba will donate a model of its next generation of angiographic equipment, which will have three-dimensional capabilities and be able to take even faster images. "We'll have the first one in the world," says Hopkins. That means that UB researchers will be developing the techniques that will be used by physicians around the globe. Such equipment is necessary for some of the newest endovascular surgery techniques, which depend on maneuvering flexible microcatheters through the maze of cerebral blood vessels. The donated angiographic equipment includes positioners and focus tubes, cameras, digital video recorders and interfaces, generators, computer software, and workstations. "Minimally invasive procedures will dominate surgery in the 21st century," Hopkins says. "Tomorrow's neurovascular technology will be developed, tested, and perfected here. We know of no other research center with comparable equipment and capabilities." Installation of the equipment was aided by a grant from the Wendt Foundation, which helped offset the cost of essential structural alterations. Another grant from an anonymous donor will help cover operating expenses. A pioneer in endovascular surgery and chief of neurosurgery for the Millard Fillmore Health System, Hopkins was instrumental in developing the new partnership with Toshiba. He was recently a lead researcher in clinical trials of the Guglielmi Detachable Coil, the first product to receive approval from the U.S. Food and Drug B u f f a l a Phys i Administration for treating intracranial aneurysms considered too high risk for traditional surgery. UB'sstroke researchers at the Toshiba center will have three priorities. One, under the guidance of radiologist Stephen Rudin, Ph.D., is to achieve even better imaging with the lowest possible x-ray dosage. Rudin's new procedures should increase resolution capabilities from half a millimeter to a tenth of a millimeter, Hopkins says. In an unusual collaboration, Barry Lieber, Ph.D., an aerospace engineer who specializes in the dynamics of air cian S p r I n g l 9 9 7 �- ---- - ~-~- - ,~------ ······································ · ····· ·· ············ · ············ · ···· · ········· ··· · m . flow, is working with neurosurgeon Ajay Wakhloo, M.D. , Ph.D. The two scientists are combining their expertise to investigate the dynamics of blood flow, using full-scale models of cerebral blood vessels. Finally, Lee Guterman, M.D., Ph.D., is researching new techniques and de- viding funding to support graduate student stipends and an exchange program between japanese and American researchers. "Further, since any area of the body can be accessed through the vascular system, other departments, such as cardiology, surgery, and radiology, will have the option of conducting studies using the Toshiba angiographic equipment," u.w~ ..... . , . .................... Hopkins says. In addition to research, the center will provide unique educational opportunities. "We currently offer working courses in endovascular techniques for treatment of experimental aneurysms. The Toshiba Stroke Research Center will enable us to expand and diversify our offerings, attracting course participants from around the globe," Hopkins says. "The flow of personnel and information between the center and other international research centers in the U.S. and Asia will offer unique educational opportunities to UB students and faculty and the Western vices to treat and prevent stroke, espe- New York research comcially minimally invasive endovascular munity at large." Toshiba selected UB surgical procedures. Techniques used by UB 's neurosurgeons include because of "the clinical microcatheter injection of thrombolytic expertise, commitment, drugs to break up clots and stents to and research" of Hopprovide permanent support for nar- kins and his colleagues, says Jeffrey T. Dillon, rowed vessels. The Toshiba research facility will sales manager with also be used by researchers developing Toshiba America Medi new treatments for conditions other cal Systems. Toshiba America than stroke, and will serve as an educaMedical Systems, based tional center for students from UB and around the globe. Toshiba is also pro- in Tustin, California, is . _........" / B u f f a 1 a Physician 5 p r I n g 1 9 9 7 .. . .. a subsidiary of the international Toshiba Corp., one of the world's largest manufacturers of electrical and electronic equipment, with annual sales of more than $48 billion. Toshiba America Medical Systems' line of medical imaging systems includes diagnostic x-ray, xray computed tomography, diagnostic ultrasound, and magnetic resonance imaging. "This new stroke research center will capitalize on all the best strengths of UB's School of Medicine and Biomedical Sciences-pioneering research, outstanding clinical care, and exceptional teaching," says UB president William R. Greiner. "We are absolutely delighted to have Toshiba as a partner in this center. With an international corporate leader like Toshiba generously supporting the work of a first-class researcher and surgeon like Dr. Hopkins, we think that's a recipe for success. Most importantly, the creation of this center promises better health and fuller recovery for millions of people. And we think that's the real success." + - LOIS BAKER AND JESSICA ANCKER 0 �11 ............................................................... . . . . . . . . . .. . . . . . . . . . . . . . . . . ' I Surgery remains an option for some with WPW syndrome hree catheter ablations failed to correct Clayton Broussard's WolffParkinson-White syndrome, and he continued to suffer debilitating attacks of tachycardia. So his family brought fourteenyear-old Clayton from Louisiana to Buffalo where he could be operated on by Gerard M. Guiraudon, M.D., a pioneer in the treatment of cardiac arrhythmias and one of the few surgeons in the world who has remained an expert in epicardial surgery for Wolff-Parkinson-White syndrome. The operation was a complete success. "Even the best horse-drawn wagon had to be replaced with a motor car," Guiraudon says. "But once in a while, the horse still works better." In Guiraudon's metaphor, his epicardial surgical approach to arrhythmia is the horse cart, while the newer catheter ablation techniques are the motor cars. Surgery for Wolff-Parkinson-White syndrome was pioneered in 1968. But in the early 1980s, while at the University ofWestern Ontario in London, Ontario, way for a change in technology. By relying on Guiraudon's techniques to pinpoint the accessory pathways, surgeons were able to use catheter radio frequency ablation to fix most Wolff-ParkinsonWhite cases. Guiraudon himself helped train the new generation of catheter surgeons. Since 1990, catheter ablation has become the method of choice for treating Wolff-Parkinson-White syndrome. "I went from 120 of these patients a year to just five or ten," Guiraudon says. Today, he performs the surgery on patients like Clayton, who have undergone catheter ablations without success, or on patients who are scheduled to undergo open-heart surgery for other reasons. In a 1994 review article in the Annals of Thoracic Surgery, Guiraudon lightGuiraudon led an international team of heartedly focused a "retrospectroscope" surgeons in developing safer epicardial on the surgical treatment of Wolffsurgical techniques. Avoiding cardioParkinson-White syndrome. He conpulmonary bypass, they worked on the cluded that "a large body of scientific beating heart using surgical dissection, knowledge and skill was brought to cryoablation, or lasers. light by this experience and, of even For nearly ten years, Guiraudon's apmore importance, passed on for best use proach was the first choice for Wolffto the catheter surgeons." Parkinson-White patients. "Everybody But Guiraudon is not ready to retire visited this man and learned from him, yet. Born and trained in France, he was and everybody sent patients to see him," a professor of surgery in Paris before says Tomas Salerno, M.D., the director accepting a position at the University of of cardiothoracic surgery at the Buffalo Western Ontario and University HospiGeneral Hospital. "Getting Gerard tal in London, Ontario, at age fifty. Now, Guiraudon to come to Buffalo was like at sixty-five, he has become an immiputting a little hook in the ocean and grant again, moving to Buffalo to becatching a huge fish." An accomplished valve surgeon who come UB 's associate chief of developed what has become the stan- cardiothoracic surgery and the chief of dard approach to the mitral valve, cardiovascular and thoracic surgery at Guiraudon has also authored classic pa- Millard Fillmore Health System. His wife, pers on cardiac arrhythmias that are Corette M. Guiraudon, M.D. , remains referenced in such texts as Harrison's in London, Ontario, as the hospital's chief of pathology. Principles of Internal Medicine. "If you move, you do better," he says. Guiraudon and his colleagues also "You look at things in a new way, not in did extensive work in mapping the aca preconceived way. I moved to London cessory pathways that cause Wolffbecause I thought I could have a fruitful Parkinson-White syndrome. "Our goal collaboration with my colleagues there, was not just to do the surgery, but also and I did. Now, I hope I can do someto understand the pathophysiology." That new understanding paved the thing new here." + JESSICA 0 B u f f a l a Physician S p r I n ANCKER g l 9 9 7 �m ·························································································· m .. . ' . Mild concussions can cause lasting abnormalities in brain esearchers at UB have shown that a concussion results in abnormal brain activity that can last for months. This activity correlates with patient complaints of physical and emotional discomfort early on, and with various cognitive impairments later, the researchers found. Richard Linn, Ph.D., assistant professor of rehabilitation medicine, led a multidisciplinary research team which uncovered the abnormal brain activity in a small group of patients with recent concussions, using PET scans taken at the PET Center in the Buffalo Veterans Affairs medical center. The abnormalities were invisible to MRI. "In the first few weeks post-injury, some of these patients may experience headache, irritability, dizziness, or fuzzy thinking," Linn says. "They may have an MRI scan, which typically shows no abnormalities. Many may come away still feeling that their thinking isn't right, but they don't know why. "We now are able to show that these symptoms are related to a definite change in brain activity, and that these patients are not merely imagining their symptoms. The abnormalities in the brain reflected how well patients performed on cognitive tests. The greater the abnormality, the worse the patient's performance." Linn, program director of the UB T raumatic Brain Injury Rehabilitation System, is one of only a few researchers in the country who are using PET to study mild traumatic brain injury. Linn's research is funded by the National Institute of Disability and Rehabilitation Research. PET scans were administered to six victims of concussion two to three weeks after the injury and again three to four months later. The scans revealed small B u f f a I a but significant areas of increased glucose metabolism in the anterior cingulate, more pronounced in the right hemisphere than the left. All the patients had had normal MRis and showed few signs of injury. The increased use of glucose may be a sign that the cells are repairing themselves after injury, or that their ability to function is diminished and they need more energy to perform the same work, Linn says. In the early stages after injury, this abnormal activity correlated with patient complaints, such as headache, irritability, anxiety, depression, dizziness, and lack of concentration-symptoms collectively dubbed post-concussive syndrome. physician 5 p r I n g 9 9 7 ' . The studies showed that after three to four months, the areas of abnormal activity had enlarged somewhat and were correlated with impaired attention span, verbal memory, motor function, and information processing, but not with post-concussion symptoms. "Patients need to know they aren't going crazy, and that what they are experiencing may be a normal part of the recovery process," says Linn, who is now recruiting patients for a larger study. According to Linn, the only treatment for mild traumatic brain injury is patience. "People just have to wait it out. More than 50 percent of them are back to normal by six months; more than 95 percent are fully recovered in a year." + L o 5 B A K E R 0 �~············· · · · ····· · ······· · ···· · ······················ · ··· · ···························· ~ Roswell Park Cancer Institute faces change BY ANDREW DANZO s managed care's relentless expansion forces medical institutions to behave more like businesses, adaptation has become the watchword. At Buffalo's venerable Roswell Park Cancer Institute, however, change doesn't come easily. The 99-year-old institute is part of state government, and that, according to many people inside and outside the institution, has hobbled its ability to compete in the new healthcare marketplace. New York State officials have proposed spinning Roswell Park off as an independent non-profit entity. The plan is greeted enthusiastically by those who believe the institution will benefit from increased flexibility, but it has others worried that Roswell Park may jeopardize its tradition of groundbreaking cancer research in its rush to become self-supporting. Robert Hinckley, public affairs director for the state Health Department, points out that being a part of the state hampers Roswell Park in some of its everyday activities. "They can't develop networks, partnerships, mergers, et cetera, and react quickly to this changing health care environment," Hinkley says. "They can't do a lot of things that the Buffalo General Hospital can do. To get a $5,000 contract approved they have to go through this department, the Division ofBudget, and the Comptroller's Office. 0 CHANGE IF IT IS TO Buffalo General doesn't have to do that." Anderson Cancer Center at the UniverGov. George Pataki this year proposed sity of Texas in Houston. For example, that Roswell Park be allowed to change he would like greater flexibility to creits governance structure, possibly be- ate new types of positions. "We need coming a not-for-profit enterprise or af- managedcare specialists and case manfiliating with another health-care institu- agers," he explains. "The current systion. Approval is required from the state tem takes an enormous amount of time Legislature, and details remain to be and effort when we need to move worked out. One strong supporter of the quickly. This is an institution that needs plan is the institute's new president, David to reinvent itself." C. Hohn, M.D. He succeeds Thomas B. But Pataki's proposal for a governance Tomasi, M.D., who left last year after change has been greeted skeptically by running the institute for a decade. unions. "We think some of the cost "I think Roswell must change if it is to issues can be addressed within the conthrive and survive," says Hohn, who text of a public institution," says Richarrived in February from the M. D. ard E. Casagrande, executive director of B u f f a l a 5 p r I n g 1 9 9 7 �~ ---~== '~-~--- - - - ·································· · ······ · ··········································· · ···· [I I ] ' ' Lll] the Public Employees Federation, which represents 845 physicians, research scientists, nurses, and technicians at Roswell. "We see privatization as being really radical surgery. I think the primary gain, when you cut through the fluff and the sweet talk, is that they think that the public employees make too much." Hinckley says the plan is not an attempt to void state union contracts. "We've told them that we will abide by the collective bargaining agreements they have," he says. "Certainly, because of their expertise, any not-for-profit would need the vast majority of the employees." Some staff members worry nevertheless that Roswell could lose itself in the transition. "Roswell is not simply another hospital," says a senior scientist who asked not to be named. Without financial support from the state, he fears that Roswell will begin to lose research grants and become trapped in a downward spiral. "Roswell was never supposed to compete with a normal hospital, because it doesn't offer the same product," the researcher says. "You don't go to Roswell Park to get the same care as at Buffalo General. You go to Roswell Park because that's where we're developing new treatments that no one in their right mind is paying for." Through the Graduate Medical Dental Education Consortium, Roswell Park trains 26 UB residents. In its capacity as a UB graduate division, the institute also trains about 300 graduate students. The 25-acre Roswell Park campus is in the midst of a $245 million construction project. The institute's fortunes, however, have been slipping in the increasingly competitive health-care industry. Despite its National Cancer Institute designation as one of only 28 comprehensive cancer centers in the nation, Roswell has seen insurers steer many patients B u f f a l o elsewhere, and Buffalo General now handles a greater portion of the region's cancer cases. The institute's deficit is put at about $70 million, and it has been unable to join hospital systems being formed by Buffalo General, Millard Fillmore Health System, and other Western New York institutions. For his part, Hohn says he is dedicated to maintaining Roswell's status as a premier center for research and teaching, as well as for treatment and prevention. "I think acquisition is unlikely and probably not desirable," he adds. "This is not about unloading Roswell on someone else. I would not have come here if that was the intent. It is about the ability to affiliate, because health care is organizing into networks and systems. But the exact governance that would be put into effect has not been established." The governor's proposal also includes an additional $70 million for Roswell Park in each of the next three years. Some of that would be used to begin a 20-year plan to repay the state for the institute's deficit. Roswell Park's new president expects to become a familiar face in Albany over the coming months. ''I'm absolutely committed to building the case for ongoing state support for education and research," Hohn says. He also plans to step up the pursuit of grants and philanthropic support. "My vision of Roswell is for a growing and thriving institution," he adds. "I think we're really talking about building a brighter future." + HealthCarePlan reorganizes ealthCarePlan, Western New York's oldest HMO , is moving away from its roots as a staffmodel HMO. The 90 doctors who work for HealthCarePlan are leaving the HMO to form their own group, Medi- Physician 5 p r I n g 1 9 9 7 cal Partners of Western New York, which will continue to care for HCP's patients as a contractor. Patients will notice little or no change. The decision has been described by both sides as mutually amicable. Richard Battaglia, M.D., who will become medical director of Medical Partners, said the move will benefit the physicians because they will be able to accept payment from other insurers as well as from HCP. Medical Partners, which will be largely primary care doctors, is also exploring the possibility of merging with practices that contain more specialists, including the Buffalo Medical Group, he said. + UB alum appointed ECMC medical director argaret Paroski M.D . '80, of Buffalo, NY, has been appointed medical director of Erie County Medical Center. In this position, she oversees the medical operations of the ECMC Healthcare Network. The network includes the medical center, the Erie County Home, and a growing group of community health centers. Paroski is the former clinical director of ECMCs Department of Neurology. She is also a past president of the UB Medical Alumni Association. In addition to maintaining her Margaret Paroski, M.D. medical practice and her administrative roles, she continues to be an active researcher. + 0 �BY NICOLE PERADOTTO • In e UB HELPS DOCTORS COMBINE TEACHING WITH PRACTICE c E s "Teaching is about being a good role model. Inspiring people is a part of teaching." A R 0 - Pediatrician Richard Sarkin, M.D. 0 B uff al o P hy si cian Spring 1997 �IN THE MIDDLE AGES, teachers were known as "doctors ," a word derived from the Latin verb docere, to teach. By definition, then, a doctor is a teacher. And at clinics, offices, and hospitals around the world, many doctors take that definition very seriously B Take, for example, Kerryann Broderick, M.D., site residency director for emergency medicine at Erie County Medical Center. At 9:00a.m. one weekday, Broderick and fourth-year UB medical student jacqueline Dombrowski interpret a patient's chest x-rays for signs of tuberculosis. At and Biomedical Sciences. Ask students why, in addition to clinical courses, they shadow physicians in their scant free time , and they respond that there's no such thing as too much clinical exposure. Such learning allows them to leave the lecture hall, to leap 9:30, Broderick asks Dombrowski to help document a ninetynine-year-old woman's death, and then ushers her off to the quiet room to watch a resident break the news to the family . Half an hour later, the physician offers the student tips on how to debride a chemical burn and how to present a diabetic patient to the patient's primary care physician. Then Broderick listens to Dombrowski's presentation of a man complaining of intense pain in his left foot. Upon seeing the patient herself, Broderick congratulates her student for correctly diagnosing that the man did not in fact suffer from an infected toe naiL Welcome to "Teaching on the Fly 101 "-clinical instruction. Physicians find many ways of folding the education of students into their own practice of medicine. Under a physician's supervision, students can take histories , diagnose, and even treat patients. Clinical instruction represents more than half of the coursework at UB's School of Medicine from the hypothetical textbook case to a patient on a gurney. For many students, clinical experience helps determine specialties and build confidence. For the preceptors-many of whom volunteer their timethe benefits of teaching may not seem so obvious. Teaching takes time. Balancing patient care with student instruction can be exhausting. Being a preceptor can be demanding in other ways , too; students often expect teachers to serve as career counselors and personal advisors in addition to fulfilling their role as instructors. Yet those who teach insist that its rewards offset its demands. Teaching is as enlightening an experience for them as it is for their charges, and it makes them finer physicians. "Students require a lot of energy," says Broderick, assistant professor of emergency medicine. "They ask tons of questions and need a lot of supervision, especially early on. u f f a I a P hySICia n 5 p r I n g 1 9 9 7 0 �"More and more schools have been expanding their But I get challenged by them, and they're just so eager to learn clinical medicine offerings over the last couple of years and do small things. "They keep me really fresh, particularly at the basic because it is necessary," explains Dennis Nadler, M.D., science level. They'll ofassistant professor of ten ask, 'Why did you do clinical pediatrics and something that way?' associate dean at the "Spending a lot of time in lecture halls and That makes me question medical school. "Spendlaboratories can bring students down. Its why I chose that way and ing a lotoftimein lecture wonder, 'Is there another halls and laboratories can helpful for them to have (clinical) way? Is there a better bring students down. It's way?'" helpful for them to have exposure, to see whats coming down the In the emergency dethis exposure , to see partment, where time is what's coming down the line and to maintain their enthusiasm. " of the essence and line and to maintain their unpredictability is the - UB Associate Dean Dennis Nadler, M.D. enthusiasm." norm, Broderick is well At the clinical level, UB aware that persistent incounts 1,512 volunteer • quisitiveness can be too much of a good thing. In such instances she arms herself with options for students who threaten to slow the pace of operations. "Sometimes I try to sneak in to see a patient before a student does. Then I can come out and set things up that need to be done, like drawing blood. Sometimes, if I don't think they're quite ready to do a certain procedure, I say, 'You have to back off and watch what I do,' or I give them less acute tasks to perform." "You really have to learn how to switch gears very quickly. You have to assess a student's level, get to it, and then explain things at that level." faculty and 807 geographic, full-time faculty. Ehsan Afshani, M.D., clinical associate professor of radiology, falls intaA..he second category.In 1990 and again in 1996, Afshani received a louis A. and Ruth Siegel Teaching Award, an honor based on student nominations. Among the teaching duties Afshani considers most important is fostering critical thought. It's a skill that some students, dazzled by high-tech diagnostic tools and insecure of their own abilities, have a tendency to neglect. "In medicine you don't deal with x-rays alone , and students in radiology must be reminded of that. Sometimes students prefer just looking at x-rays and taking tests instead of what's so important: Talking with patients. Whenever they want to order a test, I say, 'Is it worth doing because it's going to help you come up with a diagnosisor because protocol tells you to do it? '" It's not just that Afshani appreciates the Socratic method. He wants his students to appreciate health-care costs, too. Clinical experience in the curriculum New to UB's curriculum this year is a two-year introductory clinical block that begins during the freshman year. Among the skills taught are history taking, diagnosing, cardiopulmonary recuscitation, and infection control. ® B u f f a l o Physician 5 p r 1 n g 1 9 9 7 �and throat. He organized his fourth-year schedule with a rotation in pediatrics at year's end, recognizing that it would provide him with ample opportunity to examine a host of sore throats, runny noses, and aching ears. "That four-week experience absolutely turned my life around. I had the most wonderful teacher (Mary Cruise, M.D., who is now retired), and she helped me realize that pediatrics was for me. There is no question in my mind that she, more than anybody else, was responsible for my decision. " And that's something preceptors must consider, as well, Nadler emphasizes . "Students take extra time, and at teaching sites, extra time is provided. But managed-care organizations don't want to pay a physician to see twenty patients a day when he or she can see thirty patients a day for the same amount of money. This is something we have to think about, and we'll be discussing it more in the future . And it's not just managed care. If there's a guy in a solo practice, his entire base is the number of patients he sees. But I don't know anyone who has made a conscious decision not to teach because of economics." That's often the case because physicians remember the teachers who nurtured them when they were students and residents, and they want to continue the tradition. When he was a medical student in 1970, Nadler planned to do a residency in surgery followed by one in ear, nose, 0 Consider you r goals and objectives, and communicate them to your learner. 0 Discover enthusiasm for your subject and for you r lea rners. 0 B u f 0 0 Take you r teach ing and their learning seri ously- plan, teach, reflect. 0 0 a l a 0 Get to know your learners as people, not just as learners. @ Promote self-directed learning. Provide frequent, timely, constructive feedback. Consider how you know if your learners are learn ing what you want them to be learning. Make your teaching and their learning fun . From "Sharpeni ng the Saw: Improving Preceptor Teac hing 0 Make you r learners as active as possible. f Becoming a good teacher Not every doctor is a good teacher. Even the best doctors can make simple mistakes when they start teaching. They may be disorganized. They may fail to give students feedback, or be unable to give clear descriptions of protocols and procedures. Some may take students' physician Skills," a handout written by Admit your own limitations. Re-learn how to say, " I don 't know." S p r I n g 1 9 Richard Sarkin, M.D. 9 7 �"The more approachable you are as a teacher, the more abilities for granted; others may underestimate students. comfortable students will be around you, and that's a positive As one doctor puts it, "There are a number of physicians them to learn in," says Sarkin. "I think there's atmosphere for I would want to treat my kid-but not to teach him. " In a very thin line beother words, even a tween a demanding physician esteemed teacher and a teacher by colleagues and "You really have to learn how to switch who intimidates, and liked by patients the latter model is may lack essential gears very quickly. You have to assess a pervasive in medical teaching skills. schools. UB has initiated student~ level, get to it, and then explain "Another problem several programs through the Priis that most people mary Care Resource think that when things at that level." Center to help docthey' re teaching , tors become better they're telling some- Emergency physician Kerryann Broderick, M.D. teachers. The cenbody something. But ter, directed by Riit's questionable chard Sarkin, M.D. , is a joint program of the Departments of Internal Medicine, Family Medicine, Pediatrics, Social and Preventive Medicine, and Obstetrics/Gynecology. One of the center's programs, the Master Clinical Teaching Fellowships, offers selected community physicians a stipend to attend an eight-month workshop series on clinical teaching. A second, the Teaching Effectiveness Program, offers faculty a choice of workshops on specific practical questions, such as, How does a preceptor handle a bright but condescending student? What's the best way to introduce students to patients? How can a preceptor criticize students without disheartening them? Sarkin, a clinical associate professor of pediatrics, teaches many of the workshops. A movie buff, he shows clips from such films as Footloose, Mr. Holland's Opus, and The Paper Chase when discussing the qualities of a capable teacher. ® B u f f a l o whether the person they're talking to is learning or not. We're trying to expand the whole notion that teaching is providing information. Teaching is about being a good role model. Inspiring people is a part of teaching. So is promoting self-directed learning, where students aren't so much provided information but motivated to learn on their own. " At the Children's Hospital Ambulatory Pediatric Clinic, doctors wear animal toys wrapped around stethoscopes, and patients stop by a drawer filled with stickers at the end of their visit. Here, Sarkin practices what he preaches. One afternoon he discusses a hypothetical patient suffering from persistent headaches with a handful of residents and a third-year medical student. Then the group turns their attention to a dozen or so real patients- youngsters sitting in the waiting room suffering from the flu , runny noses, or other winter ailments. After seeing his first patient of the day, medical student Phys icia n 5 p r I n 9 1 9 9 7 �Anand Singh talks with Sarkin. "His mother says he has cold symptoms that are coming and going. The cough is not producing anything, and he's tugging on his ears. I tried looking in his ears, but he started crying." "So, he looked sick and uncooperative?" "Yeah. He stuck his fingers in his ears when I tried to look in them." "Did you make him say 'Ah ?"' "Well, by that time he was crying." "That's an 'Ah,' isn't it?" Doctor and student discuss potential diagnoses and treatments before they walk down the brightly lit hall to room 7. There, a boy no taller than a kitchen stool sits glumly in his mother's lap. As Sarkin turns to address the toddler, his voice changes. Suddenly the fast-talking pediatrician paces his words extra slowly. His tone mellows; the pitch of his voice rises. He sounds like a narrator for a children's movie. "Are these your hands, Taylor? Oh, these are very nice hands. Can the nice doctor see your tummy?" At first the two-year-old doesn't protest when Sarkin pulls up his sweatshirt. When he starts whining, Sarkin encourages him to touch the stethoscope. This holds the boy's interest for a few seconds. Now it's time for the ears. "If I promise not to hurt your ears, can I look at them?" Taylor shakes his head. "OK," Sarkin says as he gently tugs the boy's fingers from his ears, peers inside them, and spots signs of a middle-ear infection. Singh raises his eyebrows and grins. He has learned a skill that no textbook-no matter how comprehensive-can teach. + UB provides support for clinical teaching Because more medical education today takes place in community physicians' offices, UB is placing a greater emphasis on helping doctors become good teachers. UB's Primary Care Resource Center offers a number of programs that promote effective teaching in different ways. Master Clinical Teaching Fellowships pay selected community physicians a stipend to attend an eight-month series of seminars on effective teaching practices. The program carries Category I Continuing Medical Education credits. The next "class" of fellows will start the program in September. The Teaching Effectiveness Program sponsors workshops to provide formal training in effective teaching techniques. These workshops, which generally attract UB's regular clinical faculty and residents, focus on specific teaching issues and carry Category I CME credits. The Master's Degree in Health Professions Education, designed for clinical instructors, combines Graduate School of Education courses with independent study. Community Academic Practice grants support independent medical practices that participate in graduate medical education. Among the activities eligible for funding by the grants: renovations to provide space for students, or the purchase ofjoumals or equipment for students. The program also provides each site with computers and access to electronic resources, such as Medline. For more information about any of these programs, contact the Primary Care Resource Center at (716) 829-3176. B u f f a l o physician S p r I n g l 9 9 7 + �Interdisciplinary Phyllis Leppe rt , R.N ., M.D., Ph.D., is the new department chair BY JESSICA ANCKER PHYLLIS LEPPERT FIGHTS a many-fronted war on behalf of maternal and child health. In the course of the battle, she has acquired an impressive array of academic credentials, published unique research, and worked to build a new ethic of collaboration among different types of health-care professionals. Mecca Cranley, Ph.D., dean of UB's School of Nursing, served on the search committee that recruited Leppert as the new chair of UB's Department of Gynecology and Obstetrics. "My agenda was to get someone committed to interdisciplinary education and practice," Cranley says. "I didn't realize we were going to find someone who was herself so interdisciplinary! That was a bonus." Leppert first trained as a nurse and then became a doctor. But instead of abandoning her first profession in favor of her more prestigious second one, she has worked to break down cultural barriers between the two. Leppert loves lab research and earned a Ph.D. while studying the physiology of the cervix. While committed to what she calls "bench research," she has also continued to work on such medical practice issues as raising health professionals' awareness of cultural differences. "It all comes together when you think that our goal is to reduce the number of low-birthweight babies and problems in pregnancy," Leppert says of her varied career. "We have to work on a number of fronts--biochemical, obstetrical, socialall at the same time." An interdisciplinary career Leppert earned her master's in nursing from Columbia University and practiced as a public health nurse in Harlem before receiving her midwifery certification in 1964. She studied at the Maternity Center Association in New York City, which offers one of the nation's oldest midwifery training programs. ® "I had wanted to be a physician since fifth grade, but it was a time when women weren't encouraged to do that," Leppert recalls. "But when I was in my thirties, I took a look at what I was doing and said, 'Why don't I just go to medical school?"' She did just that, earning her M.D. from Duke University School of Medicine in 1973. Leppert completed residencies in pediatrics and in obstetrics and gynecology and was a Robert Wood johnson Clinical Scholar at Duke before accepting a fellowship in maternal-fetal medicine at Columbia University's College of Physicians and Surgeons. She taught at Columbia for ten years. Though Leppert chose to pursue medicine, she has remained involved with midwifery training and practice and continues to value the knowledge and attitudes she learned as a midwife. For instance, she says, in normal births midwives favor a "high-touch" approach with minimal medical or surgical intervention. Obstetric education focuses on problems in pregnancy and delivery, an essential field of knowledge, but one which sometimes can bias obstetricians to favor a more high-tech, interventionist approach than is necessary for a given situation. "Both approaches are needed, but we're not always very good at figuring out which woman fits in which category," Leppert says. "We need to approach the question scientifically, deter- B u f f a I o mine who needs the interventions, and then make sure they get them." Firm grounding in research Leppert believes that all medical care must be firmly grounded in science-in both laboratory and epidemiological research. Her own love affair with research began in medical school. After a course in immunology, she worked in Duke's Laboratory of Pediatric Endocrinology under Stuart Handwerger. "That is something that really influenced my career," she says. She took advantage of her years at Columbia to do research on the role of cervical elastin in gestation and parturition, obtaining a Ph.D. from the Department of Pathology. She has continued to publish research on the physiology and endocrinology of the cervix and uterus. "It's essential that everyone in medi- Physician S p r I n g I 9 9 7 �cine have a strong grounding in science," Leppert says. "But in this country we have tended to put bench research on a pedestal and pooh-pooh community medicine. My experience has taught me that all of it is important. You can't break these areas apart-you have to be excellent in all areas. "That's one reason I think UB is such a good school-it has shown that primary care is important without neglecting research. " In Rochester, New York, Leppert held positions in obstetrics-gynecology, nursing, and community and preventive medicine at the University of Rochester, and was chief of obstetrics and gynecology at Rochester General Hospital. She has also served as a consultant to the federal Women's Health Initiative and recently completed a Robert Woodjohnson Foundation study aimed at reducing sociocultural barriers to health care. She co-edited a textbook, Primary Care for Women, published this year by Lippincott-Raven Publishers. ("I just had time to call them and change my title on the frontispiece from professor at Rochester to chair of the department at Buffalo! " she says.) The text is designed to provide information for any primary care practitioners who take care of women, including nurse-practitioners, physician-assistants, and physicians in different specialties. The book covers a variety of women's health issues, such as reproductive health, pregnancy and delivery , and menopause. It also provides an introduction to a wide range of primary care issues, such as cardiovascular disease, derma to logic disorders , and psychiatric problems, and describes how these conditions manifest in women and what impact they may have on pregnancy. Other chapters cover social issues, such as "cultural competency," the working knowledge of other cultures needed to care for a broad spectrum of patients. ing that way while they're in training, it might be easier to start working that way in practice. " There are other changes she would like to make. "We have to rethink residency education so it's not so rigid, and incorporate principles of adult learning. We have to do more animal labs and computer simulations and telecommunication. That way, by the time they get to the patient the residents are more polished and prepared." New ideas for medical education Collaborative practice While at Rochester General, Leppert brought together medical and midwifery education by putting student midwives in the same learning situations as medical students and residents. She also helped integrate midwives into the hospital's obstetrics practice. She has similar plans for Buffalo. She is bringing Children's Hospital's four nurse-midwives into University Gynecologists and Obstetricians, the UB practice plan incorporated last year. With Dean Cranley's support, she is also hoping to integrate the education of nursing students and medical students, and to award some of the midwives faculty appointments in the School of Nursing. LuAnne Brown, R.N., believes both doctors and nurses will benefit from Leppert's program. "Her idea is very good," says Brown, the nursing coordinator for maternalneonatal services at Children's Hospital. "It fosters the idea of teamwork. If you get doctors and nurses to start think- Leppert once worked in a neurology rehabilitation unit that provided what she calls an ideal example of collaborative practice. Each patient was cared for by a team of doctors, nurses, nutritionists, occupational therapists, and physical therapists. "The neurologist was about to discharge one patient when the occupational therapist pointed out that the man was still having trouble doing the kinds of everyday activities he would need to live independently. And the physician listened. " Building on this model, Leppert has been involved in collaborative obstetrical practices in which different professionals cooperate to supervise cases, and follow the leadership of whoever is most qualified for each case. High-risk situations may be supervised by a physician; lower-risk ones by a nurse-midwife. "It's sometimes hard for physicians to work this way. We've been taught that we're the king of the hill," she says. "That's an attitude I would like to see changed. We have to respect each other. "+ ...THE CHILDBEARING EXPERIENCE Is an intense, memorable event that lasts at least nine months. The health· care team must provide a nourishing relationship during this time, and because of complex knowledge and the different skills of various professions, a health-care team works best.... 1 believe that no one person should be the "captain" of the team. Leadership is dynamic and fluid and is based on expertise. For instance, in the case of a pregnant woman with Class C diabetes, the matemallfetal medicine specialist is the team leader; in a case of straightforward moderate preeclampsia, the leader might be a family practitioner; In the term twin delivery, the team would be led by an obstetrician; while in a normal birth the team leader could be the nurse-midwife. In the area of discharge planning, the social worker and family are the leaders. Different geographic regions of the U.S.A. could and should develop unique matemlty care Excerpt from "Developteams, just as women and their families should have the right to a team of their choice.... ing sound team relation1believe that the future of matemity care is in a team approach. It will succeed to the extent ships among maternity that we emphasize the positive aspects of the health-care team. Developing sound relation· care professionals," in Prelude to Action II: ships calls for mutual respect, openness, and an absolute refusal to carve out territory. The Reforming Maternity most important feature in the development of sound team relationships on the matemity care Care, 1995, a publication team is a focus on the patient. We always need to ask, "What is best for this particular woman the Maternity Center of and her family?" Only then are team relationships sound and the team approach a success. Association. B u f f a l o Physician 5 P r I n g 1 9 9 7 �OB-GYN yesterday RANDALL AND WINKLER REUNITED A DIVIDED DEPARTMENT AT BY R ON A L D E . BA TT , UB M . D . ' 58 N THE YEARS BEFORE WORLD WAR II, the University of Buffalo's Department of Gynecology and Obstetrics had become divided into an obstetrics department chaired by Francis Goldsborough and a gynecology department headed by James King. This academic division reflected tensions both within the department and within the medical community. But when the two rival chairmen stepped down in 1942, they left heirs who ushered in a new era of cooperation. Clyde L Randall and Edward G. Winkler served as ideal cochairmen of the Department of Gynecology and Obstetrics for eighteen years. They respected each other, and their interests were complementary, benefiting both the department and the practice of obstetrics and gynecology in Buffalo and Western New York. Winkler brings new surgical techniques Edward Godfrey Winkler (1901-1960) went to Georgetown Medical School and did residency training in obstetrics, gynecology, urology, breast surgery, and gynecologic oncology. After returning to his hometown, he honed his skills as a chief resident in obstetrics, gynecology, and urology for two years at the Buffalo City Hospital, under Goldsborough. The two became very close, almost like father and son. Winkler entered practice in 1932 at the depth of the Depression. He ® went to Chicago to learn the Heany technique of vaginal hysterectomy directly from H. P . Heany. He and Robert O'Connor worked night and day to build the obstetric-gynecologic service at Buffalo City Hospital. Winkler introduced low forceps and episiotomy for routine deliveries, and extraperitoneal cesarean section to replace classic cesarean section. Later, he introduced a low-flap- transverse procedure to replace extra peritoneal section, and finally low-segment-vertical cesarean section to reduce the chance of injury to the uterine vessels. Winkler was the first in Buffalo to do total abdominal hysterectomy and introduced the Heany technique of vaginal hysterectomy and repair. In contrast to the teachings of one of their influential predecessors (Irving W. Potter), Winkler and O'Connor taught that no internal podalic version and extraction should be performed until the cervix was fully dilated. 6 u f f 0 l 0 Recognizing the value of breast milk to the survival of premature infants, they introduced frozen breast milk. The breast milk was put into little cake tins, set on dry ice to freeze, and then stored in the refrigerator for use. They reduced premature infant loss from 60 to 10 percent. Randall focuses on research Clyde Lamb Randall (1905-1990) graduated from the University of Kansas Medical School and did residency training in gynecology, general surgery, and pathology. While working together in Buffalo, King and Randall formed a close relationship. Physician 5 p r I n g 1 9 9 7 �THE N "I think that the most important thing I learned from King was to try to be decent to people," Randall said. "He was exceedingly kind to his patients. He liked his patients and he treated them accordingly." However, King's insistence on strict routine irritated Randall. In 194 2, Winkler and Randall declined offers of full-time positions at Buffalo City Hospital and Buffalo General Hospital, respectively. Winkler succeeded Goldsborough as UB professor of obstetrics and gynecology, and Randall succeeded King as professor of gynecology. As co-chairs of the department, they alternated responsibilities on an annual basis. They developed similar but separate three-year residency programs which rotated through the gynecology, gastrointestinal surgery, and breast services at Roswell Park Memorial Institute. Both Randall and Winkler were excellent surgeons, with remarkable respect for tissues. City-wide cooperation During World War II , many physicians were called into the armed forces , and Winkler and Randall experienced huge growth in their clinical practices. They frequently met, often in the middle of the night, while attend- B u f f a I o A N D w _N 0 ing patients in labor. They also met socially in each other's homes to discuss academic matters and curriculum, but never once did they go to each other's hospitals. Out of these meetings they began to hold monthly combined meetings of their residents and attending surgeons at the Park Lane Restaurant on Gates Circle. Soon they added Herbert Burwig's service from the Deaconess Hospital and Louis Mclean's from the Millard Fillmore Hospital. Such collegiality greatly ameliorated the extremes that had marked recent obstetric practice (e.g., the conservative management of natural delivery promoted by Goldsborough, and the routine internal podalic version and extraction practiced by Potter) . The city-wide meetings led directly to the formation of the Buffalo Gynecologic and Obstetric Society in 1946. Different teaching styles Winkler gave medical students and interns a firm grounding in obstetrics and gynecology to prepare them for general practice. Robert Patterson observed: "Dr. Winkler was very demanding of the medical students. We had to sit with the patient during labor with our hand on the abdomen, and we really learned about labor. " Winkler trained his residents as general obstetrician-gynecologists, able to treat all problems encountered , including breast cancer. The large clinics that he and O'Connor had built up at Buffalo City Hospital during the Depression were invaluable for this education. The program was highly structured; residents learned one surgical technique to treat each condition encountered . After mastering the techniques , the residents were encouraged to broaden their experience. Winkler was directly responsible for training ___Q]:)stetrician-gynecologists and then physician 5 p r I n g I 9 9 7 placing the work in their hands by drawing up regulations to limit the privileges of general practitioners doing obstetrics. Randall's residency program was loosely structured. He allegedly never performed an operation the same way twice and encouraged individualized training of his residents so that they could develop and expand their special interests and talents. Complementary interests During the tenure of these men as co-chairmen of the department, the quality of medical education in obstetrics and gynecology for medical students, interns, and residents reached an extremely high level. For example, in the late 1950s, outside examiners of the residency program thought that the medical students were residents. During this period, the University of Buffalo graduated a higher percentage of students into obstetrics and gynecology training programs than most other nonsectarian medical schools in the country. Winkler concentrated on medical student education, standardized resident training, and local medical politics, whereas Randall focused on individualized resident training, the development of subspecialists, and leadership in the National Board of Obstetrics and Gynecology and the American College of Obstetricians and Gynecologists. Together they combined community and university resources for optimal patient care and teaching. When Winkler died in February 1960, Randall became UB's first full-time chairman of obstetrics and gynecology. He later served as the medical school's vice president for health sciences, acting dean, and executive officer, before moving to Maryland as director of education of the johns Hopkins Program in International Education for GynecologyObstetrics. + ® �" BACK IN FAMILIAR SURROUNDINGS, I'M STILL SEElNG THINGS THROUGH A NEPALI TINT ... I CATCH MYSELF PESTERING MY FRIENDS ABOUT HOW LUCKY WE ALL ARE, IN AND OUT OF MEDICINE, WITH SUCH A WEALTHY AND EFFICIENT CIVILIZATION TO GIVE US MORE THAN JUST SURVIVAL." Rmedical mission to BY DONALD P. COPLEY , M.D . ' 70 J l �T MY TWENTY-FIFTH medical school reunion last year, while trading boasts about conquests and crises, I wondered what, after all, is truly meaningful in this life. I turned to a favorite classmate, Brendan Thomson, now a pulmonologist in Phoenix, Arizona, and asked, "What is the most worthwhile thing you've done since graduation?" Without hesitation he answered, "NepaL" Of course I knew that Mount Everest is in Nepal-I'd even day-dreamed of someday seeing the world's tallest mountain-but beyond that I drew a blank. Brendan had traveled to Nepal six times since 1985 on a variety of medical missions. The country, which is the size and population of New York State, is strikingly beautiful from jungle to grand peak, mostly agrarian, and painfully poor. With an average yearly income of only $250 and a literacy rate of about one-third, Nepal needed lots of help, Brendan told me. On his first visit there, Brendan met a young Nepali physician named Buddha Basnyat who was intent on an internal medicine fellowship in the United States. Brendan placed Buddha at a Phoenix hospital and invited the young man to stay at his home during the three-year fellowship. The two have remained close, exchanging visits almost yearly. Since then, Brendan has acted as a travel agent for American students and doctors going to Nepal to study or teach, and he has helped Nepali doctors come to America to take board exams. And when Brendan visits Nepal, he takes other physicians along to teach and practice. ''I'd love to do something like that," I said , with visions of trekking in the Himalayas. "You know what?" said Brendan. "You can!" He needed a cardiologist for an advanced life-support course planned for the next visit. It wasn't long before I was dashing off a check for airfare to the other side of the world. Getting there It took thirty grueling hours for my wife, Andrea , and me to fly from Buffalo to Hong Kong, where we linked up with Brendan's small contingent of American doctors and nurses. After two days of orientation, we flew on to the burgeoning city of Kathmandu, 500,000 people nestled into a story-book valley turned deep green by the recent rainy season. As our jet banked over a shrine to land, I caught a glimpse of a giant figure of Buddha with its life-like tempera eyes squinting through the smog created by cheap Indian gasoline. We headed off in eighty-degree weather on a kamikaze taxi ride into the city, careening crazily on the British side of the road. We passed big-wheeled bicycles piled high with produce, smoky motorcycles buzzing by like mechanized mosquitoes, and little blue vans stuffed with people, like fraternity Volkswagens. The sweet smell of this sewerless city was intermittently obscured by clouds of dense diesel exhaust. At a roadside gutter, a woman washed her family's clothes near an array of fresh vegetables piled on the ground for sale. We were greeted everywhere with the Nepali gesture of "hamaste" (pronounced "hom-a-STAY"), palms together in a prayerful and humble pose, the height of the hands indicating the level of respect. A Nepali hospital About the size of a small community hospital in the U.S., Kathmandu's Patan Hospital was built a decade ago entirely from church donations , and it is still run by missionaries. Chief of Medicine Mark Zimmerman has been there since the day the hospital opened, when he arrived fresh from his U.S. residency. His work has been subsidized every year by a Methodist church in Syracuse, New York. He relishes what would be intolerable to most of us: a smothering rush of seriously ill patients who often arrive too late to be cured, sometimes even dying on the hospital's doorstep. He loves the challenge of functioning with ludicrously limited resources, for next to no pay, with little distinction between work and rest. Smiling and joking gently, he always looked calm and content amidst the hubbub. People, sometimes a thousand in a single day, walk for miles to queue up at an outpatient window. The sickest patients stay in one of Patan's 150 ward beds. We toured the hospital through corridors darkened by J �power outages. Although the hospital was fairly clean, the doors and windows were often left open, without screens, to let the breeze take care of necessary ventilation. Through a door open to an operating room, a smiling patient waved to me as his inguinal hernia was being repaired. Latex gloves , considered disposable in the U.S., were being washed and hung to dry on a large wooden rack, evidence that the Patan staff wastes nothing. The hospital survives on donated medical equipment. Much of it, such as the EKG machines and resuscitation equipment, came from Brendan and his colleagues. As we walked by one of Brendan's old cardiac defribrillators, he whispered, "Think of the lives we've saved by sending this over!" The medical wards bustled with patients and their relatives , the latter providing constant nursing care while the R.N.s attended to technical work. At Patan, the patient's family must purchase all drugs and supplies themselves from a nearby pharmacy. Tuberculosis is the number-one killer in Nepal; pollutioninduced lung disease is the most common non-infectious problem. Exotic infectious diseases abound: leishmaniasis, leprosy, rabies. Many Nepalis smoke-especially the youngsters , who idolize the American Marlboro image-which gives the cigarette industry a chance to "make a killing. " I saw more patients with rheumatic heart disease than with heart attacks , ® B u f f a l a but Nepali physicians expect that increased levels of smoking and urban stress will soon cause a coronary epidemic. Our students, twenty Nepali resident doctors and thirty nurses, were hungry for the critical-care knowledge we taught. We caused some consternation when we challenged traditional Nepali gender roles by putting male doctors and female nurses together in the same room and having them listen to our female nurse lecturers. We taught basic and advanced life support, the mechanics of chest compression and the Heimlich maneuver , cardiac diagnosis and EKG analysis, defibrillation, and drug treatment. Our students asked perceptive questions, the kind that come from people who have seen a lot. They beamed with pride when we handed out diplomas on the last day. Time for touring e made brief excursions into the countryside to learn about its beauty-and its poverty. On a 2,500-foot hike into the foothills of the Himalayas, we puffed like choo-choos while young children hurried past us up the paths, carrying cinder blocks in backpacks supported by forehead straps. Other youngsters begged us for American ballpoint pens to use at school. Finally, Mount Everest! A chartered plane took us northwest from Kathmandu , playing hide and seek with lowhanging clouds. Suddenly, there it was , fully visible from its tropical base at 2,500 feet to its snow-capped peak at 29,000 Physician S p r i n g 1 9 9 7 �The si&fttof a man perusing a newspaper 1s not common, as only about a durd of the Nepali population can read ThiS set of donated equipment 111 a fishing tackle box at Patan Hospital is not fancy, but it IS adequate to handle most emergencies. A father gneves at a child's funeral pyre. Doctors in Singapore work mostly in solo practice, without managed-care headaches, yet they still feel cost-containment pressures directly from their patients. For example, angioplasty is favored over coronary bypass surgery because it's cheaper, and patients are willing to return two or three times a year for repeat procedures. "For my patients, it's like going to the dentist," said one local cardiologist. I found Singapore doctors busy and independent, wealthy and content, with a touch of arrogance-similar in many respects to American doctors of a generation ago. Back in familiar surroundings, I'm still seeing things through a Nepali tint, or what's called "perspective." I catch myself pestering my friends about how lucky we all are, in and out of medicine, with such a wealthy and efficient civilization to give us more than just survival. Now I understand why Brendan keeps going back. He and I are sure to talk about Nepal at our next reunion dinner as we contrive another excuse to return. + ' feet. Microscopic villages were scattered at its toes like the patterns of a fine Tibetan rug. My cherished unlikely dream had become a reality, thanks to Brendan's perseverance. On the way home, we stopped in Singapore, an Oz-like city with gleaming skyscrapers and spotless, antiseptic streets. We had received an invitation from the U.S. Ambassador to Singapore, Timothy Chorba, whose younger brother, Terence, is a 1979 alumnus of UB's School of Medicine and Biomedical Sciences. In Singapore, per-capita income exceeds $16,000, and there is no unemployment. We lectured at Mount Elizabeth Hospital, which is about the same age as Patan Hospital but ages apart in appearance and technology. About the size of the Buffalo General Hospital, Mount Elizabeth sparkles from yearly renovations and is blinking with the latest medical machines and computers. Most patients pay out-of-pocket for their medical services, while those few with limited resources get a lesser level of care at a subsidized government facility. B u f f a l a physician 5 p r Donald P. Copley, M.D., practices cardiology and cardiac rehabilitation in Kenmore, New York. Brendan Thomson, M.D., practices pulmonary care in Phoenix, Arizona. Both are members of UB's Class of 1970. For more information about participating in a Nepal exchange, contact Thomson at 5251 West Campbell, Phoenix, Arizona 85031, (602) 247-7725. I n 9 9 9 7 �............. .. . .. ............. . . . ........ . ................ . ............... Tumor viruses and stressed-out bacterta B Y A N D R E W 0 A N Z 0 or the UB School of Medicine and for a pair of promising researchers at the National Institutes of Health, 1995 was a pivotal year. It was the year that the Lucille P. Markey Charitable Trust awarded $1 million to expand UB's young but already internationally recognized Center for Microbial Pathogenesis. And it was the year that Victor James Hernandez, Ph.D ., and Maria Laura Avantaggiati, M.D., crossed the Atlantic to take their wedding vows in Rome. This year, UB is using part of the Markey grant to bring the couple to Buffalo. "This is, from our point of view, a perfect package," says Microbiology chair Ian Hay, Ph.D. "They both bring to the group expertise that we need, and they're both superb. We consider ourselves very fortunate to have them here." The Center for Microbial Pathogenesis is an interdisciplinary unit with some two dozen investigators who come from both clinical and basic science backgrounds. Formed several years ago out of collaborative efforts that began in the early 1980s, the center has garnered widespread attention for its work in such areas as molecular parasitology, sexually transmitted diseases, and pediatric infectious diseases. Avantaggiati and Hernandez arrived in early February and promptly set up shop in UB's recently opened Biomedical Research Building, where they will continue work they were pursuing at the NIH. Avantaggiati is interested in tumor viruses and cell growth; Hernandez is studying stress response and adaptation in bacteria. "There is no drug that will work against bacteria forever. They will all become ineffective, " says Hernandez. "So our hope is to now find the next generation of antibiotics that will sustain us for the next fifty years. It's my premise that these stressresponse systems within bacteria will be very potent targets for future antibacterial chemotherapeutics." Hernandez, a native ofEl Paso, Texas, received his Ph.D. in cell and molecular biology from the University of Texas at Dallas in 1991. For the next five years, he worked as a postdoctoral fellow in the Laboratory of Molecular Genetics at the National Institute of Child Health and Human Development. Nearby, in the NIH's Laboratory of DNA Replication, Repair, and Mutagenesis, Avantaggiati was studying interactions between viral and cellular proteins. Born in Naples, Italy, she had come to Bethesda after three years as a postdoctoral fellow at the University of Rome, where she had already earned her M.D. "I wanted to do research, " she recalls. "In Italy, it's very good, but it's not the center. Certainly the most important things are going on here." For about three years, Avantaggiati and Hernandez would pass in the hall, exchange a polite hello, and go on to their respective labs. "It had always been a very formal relationship until one day I made a conscious choice to go in and talk to herandget to know her," recounts Hernandez. "We got to know each other better and began dating. It was a whirlwind romance." Onjune 1, 1995, they were married in Italy. "We had a grand party in Rome," Hernandez says. That same year, Avantaggiati moved to the National Cancer Institute, where she focused her work on cellular interactions that appear to have a role in tumor development. Hernandez pressed ahead with efforts to disrupt the ability of bacteria to adapt to stresses. UB, meanwhile, had already begun using the Markey grant to recruit new faculty to the Center for Microbial Pathogenesis. When UB used the grant to make an offer to the pair, they had already received other offers. But they selected UB because they were impressed by both the university and the city. "For us, things like crime are important, because we want to start a family," Hernandez says. Avantagiatti agrees. "The city's very nice. The people are very kind," she says. "The weather I still have to adjust to!" + Physician s p r I n g 1 9 9 7 , �.. . . ...... .. . .. ... .. . . . .. . .. . . . . . .. ... ... . .. . . . . . ......... ... .. . . . ... . ......... • ••••••• •• ~ I Germaine Buck, R.N., Ph.D. Epidemiologist appointed to board of national research agency , ermaine Buck, R.N ., Ph.D., associate professor of social and preventive medicine, has been appointed to a three-year term on the board of the Institute of Medicine's Medical Follow-up Agency, an arm of the National Academy of Sciences. The agency conducts epidemiologic research on the health status of veterans. Founded shortly after World War II to conduct follow-up studies of the wartime experience, the agency now bases its studies on records from the military and the Department of Veterans Affairs . The agency's board is composed of fourteen physicians and researchers from universities and research centers across the country. Buck has won national recognition for her epidemiologic research in human reproduction and fetal and earlychildhood health. In 1995 , she was appointed to a three-year term on the B u f f a 1 o National Research Council Committee on Toxicology , which provides expert advice to government agencies on toxicologic issues and problems. A prolific researcher, she holds a three-year fellowship from the Merck Company Foundation and the Society for Epidemiology Research to conduct a long-term study of the safety and effectiveness of tubal ligation. She holds master's and doctoral degrees in epidemiology from UB. She is a member of the American College of Epidemiology, the Society for Epidemiologic Research , and the Society for Pediatric Epidemiologic Research , and is a fellow of the American Academy of Cerebral Palsy and Developmental Medicine . + Wrtght honored for minortty education achievements aggieS. Wright, Ph.D., assistant dean for minority affairs , has received the Outstanding Contribution to Medical Education Award for 1996 from the National Association of Minority Medical Educators. Wright was assistant Physician 5 p r I n g 1 9 9 7 I dean for student affairs and director of minority programs for the medical school before assuming her current position. During her tenure, she has been director of the Minority High School Research Apprentice Program, the Science and Technology Enrichment Program for talented minority college students, and the Health Careers Opportunity Program. A former teacher, Wright earned master's and doctoral degrees in counseling from UB and worked at the University Counseling Center before taking her position at the medical school. Her recent honors include the Sojourner Truth Award from the National Association of Negro Business and Professional Women's Clubs; the award for leadership in meeting the challenges of children with special needs from the Robert Warner Rehabilitation Center Division of Human Genetics; the award from the Buffalo chapter of the National Medical Association for leadership, commitment, and service; and the award for outstanding contributions to medical minority education from the northeast region of the National Association of Minority Medical Education. + �,. In honor of John Naughton, M.D., the university has installed a bronze bust of the former dean in the Biomedi(al Researth Building. Shown here on the O((asion of its unveiling; UB President William Greiner, Houghton, S(ulptor Jeff Slomba, University Coundl (hair Philip B. Wels, and Provost Thomas E. Headri(k. Museum receives $50,000 gift $50,000 gift from an alumnus will help support UB's Neuroanatomy Museum. Willard H. Bernhoft, M.D. '35, and his wife, Clarice L. Bernhoft, made the gift in honor of Harold Brody, M.D., Ph.D., SUNY Distinguished Teaching Professor in the Department of Anatomy and Cell Biology, who helped establish the museum. "Dr. Brody is a sincere, hardworking gentleman who has been an inspiration to a lot of medical students and colleagues at UB," says Bernhoft, UB emeritus professor of colo rectal surgery. "He devoted much time to this project and even traveled to Denmark to learn how to create a neuroanatomy museum. " After earning his bachelor's and M.D. ® from UB, Bernhoft served from 1942 to will join him in supporting UB. 1946 as a neurosurgeon in the U.S. Army, "New York State doesn't provide the and traveled to the Philippines and Ja- financial resources needed by the unipan. When he returned to Buffalo, he versity. With the right impetus-that opened a private practice in colorectal being support from UB alumni and surgery, from which he retired last year. friends-the university can continue to The Bernhofts hope their gift will be one of the best in the country." + attract similar contributions by other medical alumni to help establish an endowed chair in anatomy in honor of Brody. Bernhoft, who has also been a strong supporter of UB's Willard Bernhoft and Carlo DeSantis Library of Anatomy, Cell Biology, and Neuroanatomy, says he hopes other alumni Clari(e L. Bernhoft and Willard H. Bernhoft, M.D. '35 B u f f a l o P hysician 5 p r I n g l 9 9 7 r �····· · ····· · ····· · ·········· ·· ····· · · · · ··· ················ · ··· ·· ····· · ········ · ··· · ····· • · ~ I ,. r Anesthesiology research to be funded by gift from alumnus Mefford Diedrick UB'sfirst medical illustrator, dies $50,000 gift from Richard]. Nagel, M.D. '53, has established the first endowed fund to support research in UB's Department of Anesthesiology. "Although the university offers excellent clinical experiences for its medical students studying anesthesiology, research in this area is something that I believe requires more attention," says Nagel, UB emeritus professor of anesthesiology. "Supporting research now will allow me to see some results from new UB studies, and it opens up many opportunities for students to Jearn from these experiences. I also hope my gift will encourage others to offer their support to this fund." Nagel joined the medical school faculty in 1955 and retired in 1995 . He also served for four years on the medical school admissions committee. He was chair of the Department of Anesthesiology at Mercy Hospital for fifteen years, and served as chair of anesthesiology at Our Lady of Victory Hospital in Lackawanna, New York. A retired lieutenant colonel of the U.S. Army Reserves, Nagel is the president of the South Towns Tennis Center in Orchard Park, New York. + elford D. Diedrick, UB's first trained medical illustrator , died on January 24, 1997, in Queenstown, Maryland, where he had lived since 1982. He was eighty-four. Diedrick, who was profiled in the fall1996 issue of Buffalo Physician, was the first director ofUB's Department of Medical Illustration. A native of Buffalo , he studied art at the Rochester Athenaeum and Mechanics Institute (now the Rochester Institute ofTechnology) in the early 1930s. Later , he studied at Johns Hopkins University under Max Broedel, who is considered the father of medical illustration in the United States. Upon returning to Buffalo, Diedrick worked in various capacities at area hospitals and at the B u f f a l o Physician 5 p r i n g 1 9 9 7 I medical school until he was hired by UB as a full-time illustrator. With his training in both art and anatomy, Diedrick produced innumerable illustrations for publications and teaching. He also illustrated medical stories for newspapers and television. Among his larger projects~e three surgical atlases. His last major project was the 11lustration o Surgery , by former UB faculty members David H. Nichols, M.D., and Clyde L. Randall , M.D., a text that is now in its fourth edition. Diedrick helped found the nationa l Association of Medical Illustrators in 1945, and served as its president in 1963. The association recently honored him with a Life time Achievement Award. Diedrick, whose wife, Bertha, died in 1995, is survived by his two sons, five grandchildren, and one great-grandson . His remains were donated for medical research. + �• ········································ · ······ · ···· · ·· · ····· · ··········· · ·· · ···· · ·· ···· ~ I Parents'Council aids medical students BY hey drove their children to Little League, checked their homework, and kept them in line. Now that their children have grown, some parents are still finding ways to remain active in their children's lives through the Medical Students Parents' Council, which raises money and provides unique support services to UB's medical students. Robert and Elaine Heichberger, the parents of third-year student Lisa Heichberger, are the council's copresidents. "We both have been teachers all our lives. When teaching is in your blood, this type of thing is a natural progression," Elaine Heichberger says. "We are interested in medical education, have a great deal of pride in UB, and have an interest in our daughter's education." They view the council as a support post for the students. "The support your children feel when you are involved with their medical education, even when they are married, means a great deal to them," Elaine Heichberger says. "That is discussed at the meeting on many occasions, and the students are very appreciative." The council has provided many things to make students' experiences at UB more pleasurable. The parents helped to renovate and furnish the student lounge, supplied the hardware for the electronic mail system, donated a fax machine and a copy machine, and created an annual grant of $5,000 for the computer laboratory. But their assistance is not limited to tangible items. According to associate dean Dennis Nadler, M.D., "the Parents' Council also VICTOR FILADORA provides support for educational missions and activities which benefit the student body as a whole." For example, the group sponsors student travel to national meetings, which Nadler believes has a ripple effect that strengthens the entire class. Also, during every holiday season, council members invite UB students who can't be with their own families into their homes for support and companionship. The council, which is unique among medical schools, was founded ten years ago by former dean john Naughton, M.D., as a way for parents to get involved in their children's education. One of the group's most popular activities is the annual Gala Dinner Dance for the graduating seniors on the evening before graduation. The council pays for dinner, dancing, a boutonniere or corsage, and a gift for each graduate. Parents are recruited during Parents' Weekend, and they receive a directory describing the responsibilities and priorities of the council. During the spring session, the school solicits donations from the members. Between $15,000 and $20,000 is donated annually; these funds go directly to student support. "Reinforcement from the home front gives students the backing they need so that they know they are not alone," says Elaine Heichberger. "The parents realize that it is the little things they can do which provide extras that students would otherwise have to do without. " Although correcting homework and carpooling to sports practices are no longer required, the emotional, educational, and financial support of parents still enriches each medical student's experience and makes medical school at UB much more enjoyable. + Victor Filadora is a fourth-year student at the School of Medicine and Biomedical Sciences. ROBERT AND ELAINE HEICHBERGER, THE PARENTS OF STUDENT LISA HEICHBERGER, ARE THE CQPRESIDENTS OF A UNIQUE PARENTS' GROUP AT UB. B u f f a I o S p r I n g 1 9 9 7 �.......... . .. . . .. ..... ............... ...................... ...... . ..... .. . . . .. . ..... . .. get in the way. But that periphery is made up of human souls, which have a bunch of that subterranean anger, and an agenda. And they are the people who BY M IKE M ERRILL , CLASS OF 1 9 97 pay us . They are trying to get into the examination room, trying to tell us that the ower, says the I Ching, must be fused with justice. same patients who want us to heal them "When one understands this," the 3,000-year-old Chi- also don't want their families hobbled by huge insurance premiums. These nese book says, "one understands the meaning of people are trying to tell us that we need to change the way we do things . everything that happens in heaven and on earth." We ignore them , or fight them , at It's quite a point for contemplation: worker bee in times of layoffs. our peril. They will shape our future , Then I went to medical school, or they will , I think, find someone else power exercised without justice can only lead to instability, in a government or a plunged into an environment of entitle- to do our work. business or a family . It leads in the ment and ego and suffering. The excesses and injustices of the powerless to a subterranean anger that I kept working partadministrative and may build to a destructive explosion. time at HCP, and I noinsurance systems, These thoughts bring a new light to ticed a change, a subtle "LITTLE ACTIONS just like those of evthe hospitals and clinics. It's easy to distance between me erything else, eventuAND WORDS CAN underestimate one's power: watch the and some of my old ally will be blunted patients at Erie County Medical Center acquaintances. I have and balanced. They RESONATE DOWN A deferentially get out of the way of the become one of the obare unstable and so white coats. Little actions and words jects that the anxiety will not last, as the I CHANNEL OF TIME IN can resonate down a channel of time in fixes upon. Ching says. UNFORESEEN WAYS. " But l think the unforeseen ways: one elderly patient I don't like it, but I physician's role will refused CTs because a doctor once said can't undo it. only remain powerful it would "make slices of the stomach." As a doctor, it might to the extent that we In a way, the I Ching is right. What we be easy to forget the learn to incorporate, see going on here in all of human life is fear of losing my job, in a dignified manner, the working out of the correct way to the worry about how the indirect financial to pay for groceries, the exercise power among humans. concerns of the paof unemhorrible maw Nowhere have I seen this so clearly as and the contients , at HealthCarePlan, where I have worked ployment, the anxiety cerns of the adminisof being without for six years. trative environs. I started there in 1991 as, basically, a health insurance. But Medicine now has high-level secretary, continuing as are- these are the fears of powerful enemies. my co-workers. When search assistant for a year, then entering It's the latest incartheir bosses get angry, medical school in 1993. nation of the same old and their world shakes I was of low rank in the Guaranty cycle: power concentrembles. When a secBuilding in downtown Buffalo that around justice, trates retary is fired, it breaks houses HCP's headquarters. I didn't even justice dissipates , and the leg of her family. need to wear a suit; it would have been I know the world of power leaves. + silly. The secretaries and clerks looked the patient will call me. on me as something of an equal, When I'm in the examination room, Mih e Merrill, afonnerj ournali sl, is a fourth-year though a bit of an anomaly. I made a wherever I end up, support staff and medical st udent at UB wlwsecolumns appear regulot of friends , heard the gossip , and insurance companies will seem merely larly in the Buffa lo News. He will begin a resishared the helpless anxiety of the peripheral entities that had better not dency in internal medicin e in Buffalo next year. Medicine is agame of power 8 u f f a 1 o P hysician 5 p r I n g 1 9 9 7 �Aleader in research and in academic administration FRANKLYN KNOX or many academics, stepping into administration means abandoning research. Not for Franklyn Knox. Internationally known for research on the physiology of the kidney (work that he began thirty-five years ago while still a graduate student in UB's Department of Physiology), Knox has also helped lead one of the nation's most highly respected medical institutions through a period of expansion and change. He is a recipient ofUB's Distinguished Medical Alumnus Award, and this February Knox was awarded an honorary degree from UB during the "Kidney Performs Under Pressure" symposium on renal physiology. A native of Rochester, New York, Knox earned his bachelor's degree in pharmacy from UB in 1959. In 1965, he became the first UB student to earn an M.D. and a Ph.D. concurrently. "I had entered medical school with the idea of a career in research and teaching, and it became evident to me that I needed further training in research, so I embarked on the Ph.D.," he recalls. "My decision to pursue renal physiology had more to do with my mentor, Don Rennie, M.D., than with the kidney itself. I first met him when he taught the medical school physiology course, and then I did research in his laboratory in the summers. "One of his many research interests was kidne y function . But under Hermann Rahn's leadership, the Department of Physiology largely focused on respiratory physiology. As a result, we studied respiration of the kidney." Knox worked for three years at the ® ,.. '65 , DISTINGUISHED INVESTIGATOR AT THE MAYO FOUNDATION accomplishment I point to with the greatest degree of pride," Knox says. Before 1982, the Mayo's medical and Ph.D. degrees were granted through the University of Minnesota. Under Knox's leadership, the Mayo became accredited to take full responsibility for both degree programs. "In some sense, the change was a 'truth-in-labeling' issue, because all the medical curriculum was being taught here at the Mayo anyway, " Knox points out. "The decision for us to independently grant Ph.D . degrees, as well as M.D.s, has resulted in much stronger basic science education here." He has also been involved in other major changes at the Mayo. The Mayo established full clinics in jacksonville, Florida, and Scottsdale, Arizona , in order to make its service and reputation more national in scope. It has also instituted a series of changes in response to National Heart Institute's Laboratory of Kidney and Electrolyte Metabolism, moving to the Department of Physiology at the University of Missouri School of Medicine in 1968. Two years later, he joined the Mayo Clinic and entered its Department of Physiology and Biophysics, which he later chaired. He was then appointed Dean of •= the Mayo Medical • School as well as director for education of the Mayo Foundation, with huuu hu responsibility for supervising undergraduate and resident medical education, the Ph.D. programs, and the health-related science programs, as well as continuing medical education. "The establishment of the Mayo as a degree-granting institution in its own right is the Interim medical school dean John Wright, M.D., with Franklyn Knox . B u f f a l a Physician 5 p r I n g 1 9 9 7 �················· · ······································································• James E. Springate; joey P. Granger, of the University ofMississippi; University of Alabama professor james A. Schafer, the president of the American Physiology Society; and the society's president-elect, Allen W. Cowley Jr., of the Medical College of Wisconsin. Knox spoke about his recent research on the kidney's natriuretic response to increased blood pressure. Two observations-that patients who take non-steroidal anti-inflammatory drugs ( SAIDs) over a long time increase their risk of hypertension, and that NSAIDs block prostaglandin synthesis-raised the question of how prostaglandin is involved in natriuresis, Knox said. He traced the sequence of events through which, in healthy individuals, increased blood pressure is reflected in increased renal interstitial pressure, which triggers pressure natriuresis to help lower blood pressure. In hypertension, a number of factors can interfere with this cascade. Knox's experiments showed that lanJESSICA ANCKER thanum ions crossed the epithelium of the proximal tubule via the tight junctions between the epithelial cells. Knox used these findings to argue that prostaglandin helps maintain the permeability of the tight junctions, and D. that this permeability accounts for a he kidney's regulation of blood substantial fraction of the transepithelial pressure relies on the paracellular transport of water and electrolytes. Thus, transport of water and sodium in he said, prostaglandin synthesis amplithe proximal tubules, Franklyn fies the natriuretic effect of increased Knox argued in February's D. W. blood pressure. The D.W. Harrington Lecture series Harrington Lecture. brings distinguished scientific speakers Knox's lecture was the cornerstone UB twice a year. The series is funded to of the "Kidney Performs Under Presendowment created by Harrington, by an sure" renal physiology symposium at a member of UB's class of 1871. + UB's Center for the Arts in February. -].A. The other speakers included UB's managed-care pressures, including developing its primary care network and affiliating with a network of hospitals and clinics. Knox credits the Mayo's strong administrative support structure with allowing him to continue being an active researcher throughout his administrative career. "Also, there's an expectation that administrative responsibilities will rotate, so people are encouraged to maintain their professional research roles throughout different administrative jobs." He now holds the title of Mayo Foundation Distinguished Investigator and Head of the Nephrology Research Unit of the Mayo Clinic and Foundation. He has served on numerous national and international editorial and advisory boards, and is a past president of the American Physiological Society and of the Federation of American Societies for Experimental Biology. His recent research focuses on the regulation of phosphate metabolism and the role of blood pressure in controlling electrolyte and water excretion. + 1kw Y• S Hwl COIIIIIIISSIOII 8arltara A. De8uono, H.D wl be the keylole speaker at DB's 60dl Annual $pMg OilicaJ Day OD April 26, ID a pni&IUI eatided "1lle blienillg of llealdl Care.. The pregnll at tile Buftalo Marriott IS designed to Dlfer physicials ilsigllts and answers to the prolllems ucl epportunltleS of medial practKe, aCtOnllng to program chair Richard Collins. H.D '83. 8 a.m. Welcome and Introduction Jadt f Coyle. H.D '85, presideat. "edial Alumni Association ~ L Wright. M.D., 111ten11 dean. Schoel of ltediCIIe ud lioiiHal Scieltes ' lidtanl L Colas. "0 '83, prop~ dlair Paracellular transport in the kidney: the W. Hanington Lecture B u f f o I o physic i an S p r I n g I 9 9 7 Fw more ln(onnotlon about Sprinc ClniaJI OCiy Gild ocher Alumni Weeltend Cldlwflies, , . _ coneoct die Medical AUnnl Alsodar.ton CJt 7111-129-2778 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] . HURWITZ & RNE, P.C. [ATTORNEYS AT LAW I I 1 S ERVICING T HE L EGAL N EEDS OF THE H EALTH S CIENCES C OMMUNITY • Managed Care 9 JOHN D. 4 s 0 WHITE '40 , of]acksonville, 1 FL, has moved with his wife, Dorothy, to Cypress Village, a retirement community next to the Mayo Clinic. He continues to be active in low-vision counseling and community affairs. He writes: "I would like to know why we don't have news of the '40s classes. I can't believe that they are all dormant. If you get to Florida, I'd like to see any of you!" • Purchase & Sale of Practices THEODORE W . KOSS '41 , of Smithville, • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals TN, has had a good recovery from both a total hip replacement and a coronary occlusion last fall. ''I'm doing exceptionally well, fishing and following the market." 9 6 s 0 MORTON PAUL KLEIN '62 , of Boynton Beach, FL, is retiring from ob/gyn after 28 years. He plans to travel through the United States and Canada in his new motor home. HARVEY LIEBESKIND '63 , of Jackson- ville, FL, writes: "Although I continue to practice psychiatry part-time in Jacksonville, most of my time over the past 20 years has been devoted to the thoroughbred horseracing and breeding industry as an owner. I attend all the major thoroughbred auctions and race principally in New York, Kentucky, and Florida. Two of my three sons are in the business with me. I'm looking forward to our 35-year reunion in 1998." • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716- 849- 8900 HAROLD PESCOVITZ '47 , of Cincinnati, OH, has retired from his practice of surgical oncology. "I winter in Boyton Beach, FL, and summer in Cincinnati, so 1see no snow." of Buffalo, NY, received the Senior Honor Award Cer- ARTHUR J . SCHAEFER '47 , tificate for his many years of service to the American Academy of Ophthalmology and its scientific and continuing education programs. The award was granted at the academy's 100th Anniversary Meeting in Chicago on Oct. 25, 1996. At the meeting, Schaefer was one of five past presidents of the American Society of Ophthalmic Plastic and Reconstructive Surgery who gave a three-hour instruction course, "Refinements in Surgical Techniques in the Treatment of Ptosis, Entropion, and Ectropion of the Eyelids." STEPHEN C . SCHEIBER ' 64 , MARC COEL '68 , of Kailua, HI, is chair of nuclear medicine at the University of Hawaii School of Medicine and director of nuclear medicine at Queens Medical Center. He writes: "I have had a nuclear medicine text (atlas) published by Saunders. 1 would be interested in hearing from members of the class of'68living in Hawaii. I live in Kailua, across the mountains from Honolulu, where I work ... a bit warmer than Buffalo this time of year." s . K. Bosu '69, of Anaheim, CA, has been C .J . PARKER '58, writes that he has moved from Detroit, MI, where he was an associate professor of biochemistry, to Hayes, VA. 1300 Liberty Building Buffalo, New York appointed director of the N.I.C.U. and clinical chief of pediatrics at Southern California Permanente Medical Group in Orange County. He was also recently elected to a two-year term as president of the Association of Nigerian Physicians in the Americas, a 2,000-member professional association. ® of Deerfield, lL, was elected chair of the Committee of Board Executives and Representatives of the American Board of Medical Specialties. He was also approved for membership in the Benjamin Rush Society and the University Club. Scheiber is secretary of the Group for the Advancement of Psychiatry and treasurer of the American College of Psychiatrists. B u a a p 5 c a 5 p n g 9 �.................................................................. I N FIN I T I 1 9 s 0 7 ARTHUR R . GOSH IN THOMAS ARNO '70, of Buffalo, NY, was selected by the Academy for International Health Studies to travel to jerusalem for a '78, of Meadville, PA, was awarded the 1996 D'Angelo Excellence in Heart Care Award by Hamot Medical Center. Arno is medical director and chief of cardiology at Meadville Medical Center. He was honored for improving cardiac care and week of study of the Israeli health-care system. He joined a delegation of 18 American health-care leaders that met with Israeli raising public awareness about heart disease. Among his accomplishments were adding new services at the hospital, writing medical columns for the local newspaper, Minister of Health joseph Matza; members of the Brookdale Institute; the mayor of Jerusalem; and the chair of the board of Israel's largest HMO, which has 3.4 million members. Goshin is president and CEO of Buffalo's oldest HMO, HealthCarePlan. He is also board chair and appearing on the radio to raise awareness of heart disease, and helping in the annual Heart Fund Drive. 1 9 8 s 0 '82, of Los Alamitos, CA, was recently advanced to fellowhip in the American College of Physicians and continues to practice pulmonary and critical care medicine in Orange County, CA. Having '74 , of Seattle, WA, writes: been promoted to the rank of commander in the Navy Reserve Medical Corps, he has attained qualification in surface warfare medicine on the U.S.S. Kitty Hawk and was recently awarded the Navy Commendation Medal. He and his wife, Pina Wong, M.D., have one daughter, Christen Marie, who is experiencing the 'terrible two's. ' "I have joined the Richmond Clinic and am starting an internal medicine practice. I will be living in North Seattle with my wife, Claudia, my daughter, Nicole, and my granddaughter, Samantha." RICHARD AL TESMAN '76 , of White Plains, NY, writes: "After 10 years in the private sector, I've returned to academia as director of the acute division of New York Hospital-Cornell Medical Center in Westchester County. I still maintain my psychiatric consulting practice." TAWNI ANN FRANK '76 ,ofCharlesCity, VA, writes: "After eight years working as a general practitioner and ER doc, I found my true calling in psychiatry. I am now an assistant professor in the Department of Child Psychiatry at the Medical College of Virginia in Richmond." MIKE NEANDER '76 , of Oneonta, NY, is practicing child, adolescent, and adult psychiatry in rural upstate New York, and works monthly in Washington, DC. He works with families with multiply behaviorally challenged children. e 0 0 p y c An interior more Jpaciou,l than a Ro//.1 Royce Silo•er Spur Ill. An e.-cceptionaffy generow liA of ,1tandard Lu.-wry featured. A 190-hp V6 capahle of out-acceleraltizg many Lnxury V8J. And of courJe, !he Jtandard-Jetting performance and Jervice oflnfiniti. $599 mo. 36 mo. LeaJe $999.00 down MARK CHUNG CEO of Vytra Healthcare, a HealthCarePlan subsidiary on Long Island. JOHN J . FIN A The fro nt-wheel drive I nfiniti® /50™ '82, of Grand Island, NY, is director of laboratories and chief of pathology at the Niagara Falls Memorial Medical Center. He has been granted voluntary recertification by the American Board of Pathology. Gioia is board-certified in anatomic and clinical pathology and is a clinical assistant professor at UB. JOSEPH F . GIOIA '83, of Memphis, TN, writes: "After a decade in academic medicine, including the last two years as chief of the division of geriatrics at the University of Tennessee at Memphis, I will begin a new adventure this year. I am joining St.j oseph's Hospital in Memphis to become the medical director of a MedWise Center. MedWise is run by GeriMed of America, a national company providing primary care for older adults throughout the continuum of care. " ROBERT BURNS o n 5 p n 9 9 9 I ntrouucing the all neov 9 7' QX4® from Sj5,550.00 In an ln/inili® QX4®, one of the firJt lhingJ you 'If eJcape iJ the mundane. Beca11Je the QX4 iJ not your typical La.xury .1porl utility l'e!Jicle. While it offet~' all the verJatility you e.-..:pect from a l'ehicle of it,, kino, I he QX4 offeN .wmething you don't e.-..:pect: the Lu.-..:ury of an infiniti. I N F I N IT I AUTO PLACE INFINITI 8129 MAIN ST. , WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall ( 130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage . $.15 per mile in excess. �& WILLIAM J . MAYER '83 , of Portage, MI, was recently appointed president and gen- THE ULTIMATE DRIVING MACHINE= eral manager of the Functional Foods Divi- Advertise in one of the finest publications in Western New York ... Buffalo Physician ~ Uf\"tj v"~ s \ [ \ "" Checkpoint Foreign Car, Inc. sion of Kellogg Company. He also served on an Institute of Medicine study committee that published Improving Health in the Community. He and his wife, Annie Fainsinger, have two sons, joshua (5) and Adam (2). EDWARD A . ZANE '84 , of ew Milford, CT, writes: "After serving as chairman of the Department of Anesthesiology, I have been elected to serve as president of the medical staff of ew Milford Hospital. Our three children-Alexandra (8), Erica (6) , and Mauhew (4)-bring endless joy to Debbie and me." OONNICA L. MOORE '86 , of Sales and Service eshanic Station, NJ, has been elected vice president for membership of the • American Medical Women 's Association. 487 Kenmore Avenue Buffalo, NY 14223 Moore, a gynecologist, has Give us a call: 836-2033 (716) 645-6933 • Michael J. Baranski Marketing Representative also been named president of Sapphire Women 's Health Group, which provides consulting services to companies and organizations interested in enhancing their position in women's Your WNY Leasing Specialist Serving WNY proudly for 33 years health. She will also serve as the program chair for the Fifth Annual Congress on Women's Health in Washington, DC, in june. She writes, "I hope to see many alumni there! " JOHN BARBACCIA '88 and JANET WILLIAMS '88, ofMorgantown, WV, announce the birth of their son, icholas Andrew, on Dec. 31, 1996. He joins three older siblings: Katie (5), Matthew (3), and Thomas (1). 1 BARANSKI ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 14127 ® s u f f a l o P 9 9 s 0 PAMELA A . CLARKE '90, of Prospect, KY, writes: "I finished my pediatric endocrinology fellowship in june 1996 and accepted a position as assistant professor at the University of Louisville in the Division hysician 5 p r I n g 9 9 7 �················ · ······································ · · · ········ · ······················ • II ' of Pediatric Endocrinology. My husband, begin a two-year fellowship in pediatric oto- Mike, and I have been keeping busy build- laryngology at Emory University in Atlanta ing our dream home." this July. GLEN M . GINSBURG '90 , of Omaha, JONATHAN WEINSTEIN I '93, of Alexan- NE, was appointed assistant professor of dria, VA, writes: "I have finished my resi- pediatric orthopedic surgery and clinical dency in pediatrics at Children's director of the Motion Analysis Laboratory Medical Center in Washington, DC, and ational at the University of Nebraska Medical Cen- have joined a large practice in Fairfax ter after completing a fellowship in pediatric County, VA. I love living in this area and orthopedics at the University of Southern California. take advantage of the many sights and activities. I just finished my second Marine Corps Marathon-with my father! Ed Math LINDA D . LORENZANI - FRANCIS '91 , of Washington, NC, writes: "I finished my and I keep in touch frequently and occasionally I hear from Andy Corsello. " psychiatry residency at Sheppart Prall Hospital in Baltimore in 1995, and I've joined RESIDENTS the faculty at East Carolina University School of Medicine's Department of Psychiatric Medicine in Greenville, NC. " W I LLIAM A . PULLEN ( 1982- 85) , of Los Angeles, CA, was chosen as one of the best physicians in Los Angeles by Los-Ange- MATTHEW J . PHILLIPS '91 , of Snyder, NY, writes: "My wife, Toula, and I are proud les Magazine. Pullen is married to JoAnn C. Pullen '83. to announce the birth of our son, Mauhew John Phillips Jr., on Nov. 9, 1996. He joins his brothers James (3) and Michael (2). " of Amherst, NY, is completing the last year of her otolaryngology residency at UB and will PHILOMENA MUFALLI BEHAR '92 , MANDEEP KAUR RAI ( 1992-95), of Chagrin Falls, OH, was awarded an educational grant from the National Foundation for Infectious Diseases to attend the 1996 lnterscience Conference on Antimicrobial Agents and Chemotherapy last fall in ew Orleans. Rai is a fellow in infectious diseases at Prompt Care and the Cleveland Clinic Foundation. NICHOLS MIDDLE SCHOOL • Challenging, mnovative curriculum • Outstanding preparation for high school • Average class size of 14 students • Interscholastic sports • Comprehensive visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: NICHOLS MI DDLE SCHOOL, 175 Nottingham Terr. B f f 0 0 p h y s NICHOLS UPPER SCHOOL, 1250 Amherst St. c 0 5 p 9 875~8212 9 9 ® �• ·············· · ···· · ········· · ····· · ··········· · · · ···· · ············ · ·· · ········ · ······ · ··· I OBITUARIES STEVEN PIERI '36, of Fort Myers, FL, died on Dec. 18, 1996, after a long illness. After graduating from UB, he received further training from the People's Hospital in Akron, OH, and the Belmont Hospital in Chicago. In 1939, he started a group practice in Corning, Y, and worked there until his retirement in 1981. He was also a member of the staff at the Corning Hospital and was active in the Steuben County Medical Society. He is survived by his wife and classmate from UB, Doris Pieri '36. JOHN L. MUSSER '51 , of Orlando, FL, diedjan. 19. He had been battling cancer. He is survived by his wife, Norma. JEFFREY J . SEYMOUR '93 , of Ilion, NY, died jan. 6 as a result of injuries sus- tained in a car accident. He was 31. Seymour was completing his residency in emergency medicine at Albany Medical Center, where he had become chief resident. He earned his bachelor's degree from Cornell University after attending Herkimer County Community College. He graduated from UB School of Medicine and Biomedical Sciences with honors. In 1995, he married Pina Sanelli, UB Class of '94, who is now a resident in radiology at Albany Medi- This photo of Jeffrey Seymour and Pina Sanelli appeared in the 1993 Iris, UB' s medical student yearbook. cal Center. If you come loolring for a car, you'll be awfully disappointed. HoWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who can answer anyof your questions about driving. A4x4, of course. 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) ® a f f a l a P h y s I a n 5 p n 9 9 9 �Put tfte best seat in tfte fwuse myourgarage. 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Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. • These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ \ledJCal uabilit\ \lutual Ins=ie Compan) guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 115S4 Ci1''96M~d allab 1ty M~.Jtuallnt~urance Company �Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLAN'l'ING A TREE UNDER WHICH You WILL NEVER Srr DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships ·to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. Acharitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR ACONfiDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact STEPHEN A. EBSARY, JR. I Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVI!ASITY AT BUFP'ALO SCHOOL OF MI£DICINII!: l50 I 5 0 Y £ A R S 18415-1998 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. 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Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/04b0e3e59d8eb9c6dc6dd52b05eddd9f.pdf 878a086bb473a87802435ea1299cf63e PDF Text Text �Dear Alumni and Friends, BUFFALO PHYSICIAN \ olumr 31 '\umhcr 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr ( ;.uolt "'mlth Pt•tro DIRECTOR OF PUBLICATIONS h.athn n \."a\\ ncr EDITOR Jr ...... ila \n<.:krr ART DIRECTOR \l,m J 1-;egkr PRODUCTION MANAGER \nn Ras::mann Bn)\\ n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. \\ nght lntt:l rru Dnm wul 1·;" Prnulnli{<H Clu1iwl \ffw" EDITORIAL BOARD Dr Bcnram Portm Cha1r Dr Dr Dr Dr Dr Dr Dr Dr Dr Dr Dr \larun Brecher Harold Brod1 R1chard L Coll11" Lmda J. Corder .I ian J Dnnnan James Kansk1 Barhara \laJrrom Llizahrth Ohmtrd Ch.trlrs Paganelli Stephen Spauldmg BradiC\ T Trua"' Roy \ 'ongtama Dr I ranklm Zcplo11 liz THIS I''L r or Bt FHW P11n1c 1.\\ marks a significant change for the school. After nearly two years as editor of Buffalo Phvsician, jessica Ancker has accepted a new opportunity elsewhere. \\"e all wish her well and thank her for her many outstanding contributions to this publication. During our search for her successor. judson Mead, editorial manager of the lJB Publications Office. will sene as interim editor. On May 11 , 1997, we celebrated the medical school's l5lst commencement, graduating l-+6 men and women as doctors of medicine and 37 as doctors of philosophy; four received bo th degrees simultaneously. At the ceremon), an honorary doctor of science degree was awarded to Dr. james Holland. a distinguished former member of the Roswell Park Cancer Institute and of the university. Our incoming medical student class is now complete, and we look forward to greeting this group a few short months hence. \\"e are also welcoming new house officers. many of them our own recent graduates. The new chief residents also begin their final year of residency and, along with the ne\\ residents. will participate in comprehensive orientation programs orgamzed by the Graduate Medical Dental Education Consortium, a legacy of former dean john Naughton ably directed b) associate dean Dr. Roseanne Berger. The introductory programs pro\·ide incoming residents with the latest medical, legal, and administrative updates and teaching! evaluation skills, as well as basic and advanced life-support training. Much credit is due to Dr. Berger for her commitment and dedication to this effort. As we continue to struggle through the fiscal maze so commonplace in today's medical schools and universities, we arc deeply grateful to you, the alumni and friends of this uniwrsity·. for your generous sharing of time, energy, and yes, worldly goods, to this noble cause. Please accept this sincere thank-you for your help. /f John R. Wright, M.D. /ntaim Dean, School of .\lcdic111c and Biomedical Sncncrs lntnim Vice President for Clinical A/fails TEACHING HOSPITALS AND LI A ISONS The Buffalo (,rnrral llospllal \fulwd ~~~"'' The Children's llospnal of Buffalo Ene Counl\ \lrdtcal Center \lerCI llralth ''stem \Iiiiard 1 Hlmore llealth ~ystrm l·ranlz S£1HI '\iagara l·alls \lrmonal \lcd!cal Center Ro~wcll Park ( <.lnccr ln-,ttlutc Sisters of Charll\ llospllal Dntnis \frCatth\ \'eteran!-, .\.ff..l irs \\·estern ~ew York Hcahhcare '-,ystcm ([)The ~tate UniH·rslly of :'\e\\ York at Buffalo Buffalo PI"'""'" IS published quanerh h) the State Lmversilv of ~e" \ork at Buffalo School of \1cdicinc and Biomedical Sucnccs and the Off<ce of Puhhcat10ns. It " sent, free of charge, 10alumni. facultY . students. residents. and friends. The staff reserves the nghtto cdll all cop) and submtssiono.; accepted for publication . .:\ddress questions, comments. and subnu,;10ns to The E:dllor, Bt<{falo Phrskian, State Lmvcrsny of !'Jew York at Buffalo, Office of Puhhcat!Ons. 136 Crofts Hall. Buffalo. '\\ 1-+260 Send address changes Ia: Buffalo Plll\«i<lll 1-+6 CFS .\dduwn H35 Mam Street Buffalo,"' 1-+21-t Greetings! A., THL ~EI\ t 1 LUCTED PRE,IDE"'f of the Medical Alumni Association, I am honored, proud, and humbled when I consider the quality of the individuals this organization represents. The 60th annual alumni weekend and Spring Clinical Day was a resounding success, thanks in no small part to Richard L. Collins, M.D., who put together an outstanding program. New York State commissioner of health Barbara DeBuono, M.D., M.P.H., updated attendees on the political and legislative aspects of managed care in New York State. john Friedlander, president and CEO of CGF Health System, presented the case for mergers. Steven R. Peskin, M.D. , talked about the evolution of managed care across the country. Irene S. Snow, M.D., spoke about practicing medicine under managed care. As a recent past president of the Eric County Medical Society, she has a unique perspective. She emphasized her personal involvement with patients, associates, and local, state, and national medical and specialty societies. Highlighting the program was the induction of two honorary medical alumni-john '\Iaughton, M.D., our recently retired dean of 22 years, and john Richert, Ed. D., our recently retired associate dean for medical alumni affairs. Each of them played a major role in making the school and the alumni association what they are today. There are some special people who deserve recognition for their support of this association: Nancy Druar, our administrative assistant; Bertram Portin, M.D. , our new associate dean of medical alumni affairs; and jack F. Coyne, M.D., our past president. We also wish to thank our interim dean, john R. Wright, M.D., for his support and participation. With the continuing support of these individuals, I am looking forward to a successful and enjoyable year. Sincerely, ~,d::Mf'~ Pres1dcnt, \lediwl Alumni Assocwtion �- --- - -~- -~- -- - ---- - -- -----.--- - VOLUME - - 31, NUMBER 3 S UMMER 1 i i i j Sp~ing 2 Clinical Day THREE PRESENTATIONS LOOK AT DIFFERENT ASPECTS OF CHANGE IN HEALTH CARE. 8 UB's New Specialty Dental Clinics DENTAL MEDICINE AND MEDICINE OFTEN CONVERGE IN St;IUIRE HALL . 10 D~. Cong~essman DAVE WELDON ' 8 1 IN THE HOUSE I S SAYS LIFE LIKE BEING AN INTERN YEAR-ROUND. by Clare O'Shea by Rosemary E. Frei Medical School News MATCH DAY . TWO FORMER FACULTY REMEMBERED. NEW CHA I R OF PEDIATRICS. t-1AMES PLATT WHITE HONOR ROLL. Commencement '97 PIONEERIN G THE Alumni News CLINICAL CURRICULUM. THE PICTURES SAY IT ALL! NEW ALUMNI ASSOCIATION RESIDENCY SLOTS. OFFICERS. HONORS FO R AStudent's Perspective LE ARNING ABOUT ASTHMA FO UR. 60TH ALUMN I WEEKEND. AT STREET LEVEL. by Michael Kane, Class of 1998 Classnotes THE QUOTE ON THE <OVER is hom ·APhysicion'sOoth; odoptedfromonewrittenby louislnsogno, M.D., deon of the Sockler School of Groduote Biomedical Sciences ond deon for ocodemic offoirs of the Tufts University School of Medicine. As port of commencement exerc~es eoch yeor, groduotes of the UB School of Medicine ond Biomedical Sciences rise ond formally sweor to fulfill, to the best of their ability ond judgment, this covenant. In oddiHon, three yeors ogo onew tradition wos born ot the UB medicoIschool: On the first doy of orientoHon eoch yeor, the ooth is reod ond discussed with students os omeons of impressing upon them the full significance of the program they ore obout to undertake. The complete text of the ooth is featured in the Autumn 1996 issue of Buffalo Physician. s 5 J':J~l ~ �SPRING SI X T ANNUAL I ETH ALUMNI WEEKEND CLINICAL DAY'97 Health commissioner discusses state P9licy in B y JESSICA Stockton Kimball Lecture ANCKER are creating tensions between private conscience and public policy, and nowhere are those tensions more obvious than in the office of New York State commissioner of health Barbara A. DeBuono, M.D., M.PH. CHANGES IN AMERICA HEALTH CARE DeBuono, who delivered the annual Stockton Kimball Lecture as part of the 60th Spring Clinical Day on April26 at the Buffalo Marriott hotel , plays a pivotal role in the development of the state's health policy. That often puts her in a tough position, as she illustrated by describing a case that recently reached her desk in Albany, Y. A patient received a diagnosis that indicated a Whipple procedure (pancreaticoduodenectomy), DeBuono said. His insurer, a managed care organization, supplied the names of three surgeons in his city qualified to do the procedure. But the patient, seeking what he felt would be the best possible treatment , underwent surgery at Memorial SloanKettering Cancer Center. His HMO refused to pay the bill or even to cover what the approved doctors would have charged. The patient appealed to the state health commissioner. On the one hand , DeBuono points out, the patient broke the agreement he made when he enrolled in his HMO. That agreement allowed the insurer to control its costs (and his premiums) by controlling where he could seek medical care. On the other, the patient wanted the best possible care. "And why shouldn't he get the best? " DeBuono asked. But there's no concrete evidence that the procedure performed at Sloan-Kettering was of substantially better quality than what the local surgeon would have done. While it is PHOTOGRAPHY 0 universally accepted that surgeons who perform high volumes of cardiac surgery have better outcomes, there is no comparable body of research on Whipples. When it comes, DeBuono's decision may have broad economic and political ramifications. If she decides in the patient's favor , will millions of ew Yorkers get the message that they can go out of plan whenever they want? But if she decides in favor of the insurer, could that lead to further restrictions on care? And how will the patient at the core of the case pay his bill? This case was one of the manypublidprivate health-care issues DeBuono discussed at Spring Clinical Day. DeBuono received her M.D. at the University of Rochester and completed her residency at the ew England Deaconess Hospital in Boston. She then earned a master's degree in public health from Harvard University and served as a fellow in infectious diseases at Brown University Medical School before becoming director of health for the State of Rhode Island. DeBuono was named New York State commissioner of health by Governor George Pataki in 1995 , becoming the first woman to hold the job. During her address at Spring Clinical Day, DeBuono said that the state had balanced cost-cutting with social responsibility in its Health-Care Reform Act of 1996, which deregulated BY DON HEUPEL ---------------------------------------------------------------------------------------B u f f a 1 a Physician Summer 1 9 9 7 �----------------~----- SIXTIETH A NNUAL __ ---- -.-- - - - ALUMNI hospital rates and created unique funding pools for graduate medical education and charity care. However, she noted, there's a lot more for state government to accomplish. As a member of a Republican administration that is in principle dedicated to reducing state regulation, DeBuono sounded reluctant to draft legislation to deal with minute details of health-care delivery. But legislation to cope with the "growing pains" of managed care, such as denials of care and physicians being deselected from networks without good reason, seems inevitable, she said. DeBuono also cited examples of insurers delaying reimbursing hospitals for service worth millions of dollars until the Department of Health intervened. "I don't want to have to legislate that," she added. "I wish the industry would do it voluntarily." The goal is to make sure that medical decisions are made for medical reasons, not economic ones. "The more managed care and indemnity insurance take decisions out of the hands of providers, the more frustrating it is for doctors and patients," DeBuono said. "We've got to fix that problem." An important step, she said, was the state Managed Care Omnibus Act of 1996, which has been praised by the American Medical Association for protecting providers and patients. It bans gag orders; ensures that managed care plans disclose their coverage, referral, and emergency care policies; allows doctors to appeal deselection; and establishes a patient grievance procedure. Legislation alone is unlikely to solve all the problems. DeBuono's story about the Whipple procedure grievance shows that some of the toughest deci ions may continue to be made on a case-by-case basis. "I still haven't decided what to do ," DeBuono confessed about the case. "If anyone has any ideas, let me know." + B u f f a l o Physician summer , 9 9 7 0 ~ �SIXTIETH ANNUAL ALUMNI Practicing medicine under anaged he thoughts I share with you today are mainly personal, and are geared toward our responsibility in patient advocacy and the preservation of our profession in managed care. The failure of managed care When managed care first came into being, it is my understanding that it was supposed to give less expensive care to people who couldn't afford conventional insurance. It is hard to argue that the first goalless expensive care-has indeed been achieved. Health-care premiums have risen at or below the inflation rate for two years, but most industry experts predict more increases. The multifactorial reasons for this include: 1. the need ofHMOs to satisfy stockholders after delivery of low profits last year; 1. the consolidation of HMOs into fewer and larger entities, eliminating competition and allowing prices to rise; 3. more expensive technology and an aging population; 4. demand from consumers for more access to specialists and point-of-service plans; and S. federal and state legislation that make it difficult for managed care to control costs. Managed care has also been a resounding failure in providing coverage to the uninsured and the underinsured. It is estimated that by the year 2002, the number of uninsured will reach 45.6 million, up from 39.5 million in 1995. The health-care reform agenda empowered managed care, and managed care failed to deliver the goods. What is quality care? The most abused and misused phrase of the '90s, in my opinion, has been "quality care." What exactly is quality care? Ask any of the four players in health care-employers, insurers, providers, or patients. Instantly, we have a problem. Patients and health professionals tend to think differently about what constitutes quality of care. Patients judge quality by very personal experiences, such as how long their proBY 0 IRENE B u f 5 f a . l care vider spends with them, how easy it is to access specialty care, and the range of health benefits provided. Professionals, on the other hand, tend to rely on populationbased performance measures, such as outcomes of cancer treatment over time. Employers concern themselves with such data as cost, time lost from work, and employee satisfaction as demonstrated by complaints to their human resources departments. Insurers declare their own quality measures. The ational Committee for Quality Assurance ( CQA) , the organization set up to measure quality of care given by managed care plans, has come under attack for not being independent enough. As of 1996, CQA got 40 percent of its funding from HMOs. The Health Plan Employer Data and Information Set (HEDIS) that CQA uses has been widely criticized by physicians for tallying up easy-to-administer tests rather than getting at core issues of what constitutes quality medical care. HEDIS doesn't measure quality: It measures the number of Pap smears or immunizations given. To confuse this picture even further, the development of quality measures has proven to be philosophically contentious, technically difficult, and politically delicate. Physicians must act Finally, some answers. This is a perfect place for physicians to take a leading-edge position by demanding relevance, objective research, and appropriate application. Physicians and managed care organizations need to work together to establish treatment guidelines patients can trust. Wide-ranging collaborative efforts led by academic researchers would be the most promising in outcomes research and treatment guidelines. And we must be at the table either individually or through our subspecialty societies when outcomes data is analyzed and implemented. just as we must be willing to accept report cards on our performance, we must demand more in-depth surveys of HMOs. Physicians should push for public disclosure and comparisons of HMOs regarding their performance in treating serious or chronic illnesses, how often and why out-ofplan referrals are denied, and ease of access to specialty care, among other things. SNOW o WEEKEND . Phys M . D ici . " 80 an Summer 1 9 9 7 �-~-- - - ----- - - - - - - - -- - - - SIXTIETH ANNUAL --- - --- -- ALUMNI I must admit that when I think of managed care, I feel like Albert Finney in the movie Network when he opens his window and shouts out, "I'm mad as hell and I'm not going to take it anymore!" In my more rational moments, however, I do believe that doctors who fight managed care at every turn will find themselves in a losing battle. We should take the lead in health-care delivery by admitting that we are dealing with finite resources. But physicians need to be a blaring trumpet section in our argument that we are better at making medical decisions and more compassionate than utilization review clerks. Doctors must take a stand against economics driving ethics and insist that ethics drive the economics. While accepting the principlesofpracticingcosteffective medicine , we must be able to challenge certain managed care rules that we feel compromise patient care. While on the topic of ethics and economics, I am philosophically opposed to the concept of capitated agreements. Simply stated, I just wasn't raised to be rewarded for work I haven't done. Under capitation, if you manage patients efficiently and effectively you stand to gain. The potential abuse of this system is glaringly obvious and extremely frightening. As patient advocates, we should not allow a system that poses this kind of potential threat to patient care to gain momentum. Capitation places providers-already in need of tort reform-in legally indefensible positions. In potential errors of omission, it will not take a Perry Mason to ask, "So, Dr. X, did you stand to gain financially by not ordering testY? " Yet capitation is here, thriving, and soon I will find myself practicing within it. However, I hope its prognosis is poor! Capitation in its pure form, without adequate oversight and regulation, is a consumer activist's next cause, and in my opinion, rightfully so. Hold HMOs responsible We must encourage regulators, employers, and consumers to insist on greater public disclosure of HMO financial results. - - - WEEKEND George Anders, a Wall Street journal reporter, said it better than I can in his book Health Against Wealth: HMOs and the Breakdown of Medical Trust. Anders commented that the big profits and compensation packages of some HMO industry executives can be seen as "uncomfortable hypocrisy for an industry that publicly preaches the virtues of austerity." o discussion of how physicians practice in any environment would be complete without mentioning the need for tort reform. In this regard, I mean that HMOs need to be held accountable for their mistakes. HMOs need to be "I question how long I will be able in good conscience o practtce economically driven me 1c1ne." subjected to the same malpractice restitution methods that physicians and other professionals face. Perhaps it is time for us to renew our commitment to the professional oath, ethical principles, and ongoing education process of a vocation that has always been dedicated to the betterment of mankind. The practice of medicine is in a state of unrest, which has the potential to bring out the best or worst in our profession. We must have the courage to speak out against any system that jeopardizes our legal right and moral obligation to practice good medicine. When historians record how we responded to these challenging times, it is my hope that we will be remembered for our commitment to our patients, our colleagues, and our principles. + ~------------------------------------------------------------------------------------------------------~ B u f f a t o P hysician summer 1 9 9 7 0 ~ ��with all of tne diseases of. dentistry, bexond dental caries and tne cracl<s oetween aentistry ommunities extenaing Pennsylvania Alfredo Aaulrre of the Orel Madlall .. Cllnlo (top lettll ......_..A. utlunen of the TeiiiP......,._n......,.Dieor...,.. end OICifacaMI Pain Cllnlo (bottol8 lettll Leurle c.re.r of . . . Orel ..... Me Mai&DIIII Dl&gnaetlo . . . . . . . Cllnlo , ........... ,.,.,,. A d&ld81 X ...... {G&IIIIarltllat •U lllla..e atena&la ln . . . oa:o8d,_D ......... . ., a &Ia , ............ , arrtWWj. in the ��Specia cinic takes haitosis senousy "Some people have joked, 'Maybe you could sell gift certificates,"' says Mirdza Neiders, D.D.S., M.S., head of the Breath Disorders Clinic in UB's Department of Oral Diagnostic Sciences. "Because most of our patients are referred by another person, like their spouse." The Breath Disorders Clinic is one " The best of six Special Care Clinics that specialdetector ize in diagnosing and treating dental or medical difficulties that most pracis still the titioners don't usually treat. They fill human in the gray areas between medicine nose." and dentistry, including psychological and social concerns that affect many Americans. All kidding aside, halitosis is one such serious social problem, as evidenced by the millions of dollars spent in the U.S. and Canada on breath mints, toothpastes, and mouthwashes. Some people are so concerned about their breath that they build their lifestyles around avoiding people. They may be referred to the clinic by someone close to them, or else a physician or dentist. While some cases of halitosis are truly medical, many can be alleviated relatively easily. The first step for patients coming to the Breath Disorders Clinic is for the clinician to determine whether the person truly has bad breath and, if so, to track down the origin of the problem. "The best detector is still the human nose," admits eiders. "If the person does have bad breath, treatments can then be designed to tackle it. If they don't, I sometimes refer them to Dr. Gale to help them overcome their social inhibition." In most cases, bad breath is caused by anaerobic bacteria on the surface of the tongue; these bacteria can simply be scraped away with a flexible, dull object, such as the edge of a plastic spoon. Prescription antiseptic mouthwash can also be helpful in some cases. If the odor is being emitted by an infection under an old crown or between teeth, repair of these defects is the best medicine. + 1 9 9 7 0 �43-year-old physician takes leave for his other calling by CLARE O ' SHEA "Can you hold on a second? " DAVE WELDO '81 PUTS THE PHO E DOW and rushes off again. We had been discussing his neuroanatomy professor at UB, the intense summer he spent immersed in microbiology and pharmacology, the way the snow would settle on the evergreen outside his tiny apartment off Hertel Avenue. But those memories are 15 years old, and right now Weldon doesn't have much more than 15 minutes for nostalgia. Voices on the other end of the line are calling him to the floor of the U.S. House of Representatives. It's time to vote on public housing. ® Buffalo Physician Summer 1 9 9 7 �unruffled, quietly picking up where he left off and continuing his train of thought from the House cloakroom, his refuge between votes. In many ways he sounds less like a doctor than, well, a politicianbut Weldon finds a lot of similarities between the two vocations. "The general skills a physician has transfer well into the political arena," he says. "My background gave me a lot of experience in relating to people, solving problems, and explaining complex issues to people in terms they can understand." While Weldon has become comfortable on Capitol Hill, he remains committed to his first calling. "I don't see myself as a career politician," he says. When he was elected in 1994, he pledged to honor an eight-year term limit. "I definitely identify myself as a doctor-a doctor temporarily on leave to serve Congress." Being on leave has only meant shifting to a higher gear, however. life in Congress, says - - - - - - - - - - - - - - - - - - - - --t"lm--- Weldon, is "like These days Weldon is better known as "Honorable" than "Doctor." For the being an intern "The general skills a physician past three years Weldon, a 1981 graduyear-round." In a has transfer well into the political ate of the UB School of Medicine and sense, Weldon Biomedical Sciences, has been serving arena. My background gave me a lot of has been running as a Republican representative. Instead at that pace since experience in relating to people, oflooking after patients, he's been lookhe left his home ing after the needs of Florida's 15th on long Island solving problems, and explaining Congressional District. Instead of mediand enrolled in complex issues to people in cal cases, he's been caught up in welfare the accelerated reform, balancing the federal budget, terms they can understand." medical program and school-choice legislation. at UB. He had "Okay, now where was I? I was in the accelerated program planned to work his way through medical school, but when at UB, and ... ." We'll be interrupted five times by the end of he realized how demanding the program would be he applied our conversation, but the 43-year-old congressman remains for an Army Health Professions scholarship. Then he got s u f f a l a Physician Summer 1 9 9 7 �''I'm not expecting heaven on earth-there will still be a lot more worl< to do when I leave.'' Weldon also serves on the House Science Committee and engaged to ancy, whom he'd met when they were both the House Banking and Financial Services Committee. And students at the State University of New York at Stony Brook. his commitment to health-care issues has not been forgotten. "l went through this grueling summer curriculum, took my finals, then ran back to Long Island, got married , and went on "We did pass important health insurance reform in the last Congress that will restrict the ability of insurance companies my honeymoon, " he says. "It was a whirlwind, but those were wonderful years. I was newly married , studying like crazy, and to exclude people because of preexisting conditions," Weldon notes. "I was very pleased with that. But I think there's a lot working with some of the finest people I've ever known. " Weldon graduated from UB in 1981 and spent the next more that can be done to make insurance more accessible and three years at the Letterman Army Medical Center in San affordable. l'd also like to see medical malpractice reform, Francisco, where he completed his internship and residency although the President has been an adamant opponent of it. " Because Weldon in internal medicine. He and his family spend was then assigned to a part of every month three-year tour of duty at "I began to become concerned with what I in Washington , it is Winn Army Community saw as a bad direction that we were impossible for him to Hospital in Fort Stewart, GA. The highlight? Workhave regular patients. heading in as a nation. I was particularly ing with General orman But he continues to disturbed by the high degree of family Schwarzkopf. see patients at the "He was the division Melbourne medical breakdown and the general erosion commander when I got group 's Saturday of traditional values." there ," Weldon recalls , walk-in clinic. He "and I was his wife's also is on call on occasional weekends at a community hospital in Melbourne. doctor and a good friend of his aide-de-camp. " "l really did like practicing medicine, and I had reservaBy the end of his army duty in 1987, Weldon and his wife tions about giving it up. That played a strong role in my were in love with the South. They moved to Melbourne , FL, decision to serve only eight years. My plan is to return to where Weldon was in private practice only a few years when he started thinking seriously about getting involved in politics. private practice in 2002. !look forward to that. The pace is so "I began to become concerned with what I saw as a bad much slower than this-can you hold on a second'" direction that we were heading in as a nation ," he explains. "I Weldon puts the phone down again and goes off to cast his was particularly disturbed by the high degree of family breakvote against an amendment (proposed by Rep. joseph down and the general erosion of traditional values. And I Kennedy, D-Mass .) to a bill to repeal the United States thought it was terrible that our congressional leaders in WashHousing Act of 1937 and deregulate the public housing ington were just borrowing money year in and year out. " program. "These are amendments that usually just make it easier for people to get public housing, " Weldon says. "That's First he threw his support behind local candidates whose generally the trend. Mr. Kennedy has a vision that's very vision he shared. Then one day in 1993, a colleague suggested that Weldon would make a better congressman than any of much opposite to what the Republican majority vision is. " the candidates running for election the next year. Coupled Welfare reform and a savings of $50 billion in government with his concern about the Clinton health-care plan-like spending are among the initiatives that Weldon sees as signals of positive change since he went to Washington. ln the next many physicians, Weldon is skeptical about the federal five years, he hopes to contribute to a crackdown on crime and government's ability to run the health-care system drug abuse and to continue to push for a smaller federal efficiently-that suggestion "pushed me over the edge," government and lower levels of taxes. "The process of change he says. Weldon won the election in 1994 and was reelected has been slow," he says, "but I think we're making headway. " to a second term in 1996. And if the world hasn't changed enough by 2002, will Since his district includes the Kennedy Space Center, Weldon be able to give up politics? Weldon devotes substantial time to space issues. His medical ''I'm not expecting heaven on earth-there will still be a lot expertise has proved useful here, as well. "''m a big supporter more work to do when I leave," Weldon says. "But l don't of the space program," he says, "and there's a lot of exciting think l could totally walk away from politics after this. lt's science research that is performed on the shuttle, like gotten into my blood." + microgravity research. " B u f f a 1 a Physician Summer 1 9 9 7 �Sandra A. Block Internal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo , Y Match Day 1997 Adrienne D. Bonham Obstetrics and Gynecology, University of wo-thirds ofUB's graduating medical students were placed Rochester/Strong Memorial Hospital , Rochester, Y in primary care residencies in this spring's Match Day. The Timothy P. Braatz Internal Medicine (prelim ), University of Maryland , Baltimore, MD; Radiology-Diagnostic , University of Maryland , Baltimore, MD ational Residency Matching Program results were announced March 19 by associate dean Dennis Angela M. Camasto Pediatrics, University Hospitals of Cleveland, ' Cleveland, OH adler. Eighty-six percent of the students got their first, second, or third choice of placements. Almost one-third will stay in Buffalo to train in the Graduate Medical Dental Education Consortium, while 48 percent will go out of state. In the primary care specialties, 28 students were placed in internal medicine, 2 7 in pediatrics, 21 in family medicine, and 7 in medicine-pediatrics. This is the first year that ew York State has considered obstetrics-gynecology one of the primary care specialties. Fourteen students were matched to OB-GY residencies. "We're very pleased with the outcome of the match, especially with respect to the number of students who chose residencies in primary care," adler said. "We've worked very hard to achieve this goal." Jared C. Barlow lntemal Medtcine (prelim ), ew Rochelle Hospital , New Rochelle , NY; Anesthesiology, Mount Sinai Hospital , ew York , NY Drew H. Barzman Psychiatry, Duke University Medical Center, Durham , NC Juan P. Abonla Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, NY B u f f a l o p h y s c a S u m Edward L. Chan Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, y Alexander W. Chen Medicine/ Pediatrics, Duke University Medical Center, Durham, C Kristen M. Chimileskl Pediatrics, University of Chicago Hospital, Chicago, IL Ronlka D. Choudhary Family Practi ce, Highland Hospital of Rochester, Rochester, NY Joseph L. Chow Family Practice, Highland Hospital of Rochester, Rochester, NY Gonzalo M. Bearman Intemal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y Ravl K. Desai Internal Medicine, UB Graduate Medical Dental Education Consortium , Buffalo, NY Terl Beers Obstetrics and Gyn ecology, UB Graduate Medical Gregory DIFrancesco Emergency Medicine, UB Graduate Medical Dental Education Consortium , Buffalo, Y Cassann N. Blake Surgery , SU Y Health Science Center, Brooklyn, y m Patricia A. Cawley Pediatrics, Morristown Memorial Hospital , Morristown , J Catherine C. Costello Pediatrics , Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, NY Altagrace Belmar Pediatrics (primary), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY Sharon Baratz Internal Medicine, George Washington University, Washington , DC Jason M. Andrus Psychiatry, University of Hawaii , Honolulu , HI y Kathleen M. Batt Family Practice, Halifax Medical Center, Daytona, FL Dental Education Consortium , Buffalo, NY Jean S. Bae Psychiatry, University of Wisconsin Hospital and Clinics, Madison , WI Jeffrey A. Cassidy Surgery (prelim), UB Graduate Medical Dental Education Consortium , Buffalo, Y; Orthopedics, UB Graduate Medical Dental Education Consortium, Buffalo, e 9 9 Andrew Dmytrljuk lttternal Medicine, George Washington University, Washington , DC Jacqueline A. Dombrowski Medicine/Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, Y �Morris P. Elevado Internal Medicine, University of Massachusetts Medical Center, Worcester, MA Clarlsa R. Gracia Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA Paul J. Kerner Orthopedics, Allegheny University, Central City, PA Thomas R. Elmer Internal Matthew J. Gutierrez Internal Medicine (prelim), Alton Ochsner Medical Foundation, New Orleans, LA; Ophthalmology, Louisiana tate University Eye Center, ew Orleans, LA Medicine, University of Vermont! Fletcher Allen Health Care, Burlington, VT (prelim), University Hospital, Stony Brook, Y; Radiology-Diagnostic, SU Y Health Science Center, Brooklyn, Y Paul A. Guttuso Family Practice, Peter W . Kim Internal Medicine, St. Mary Hospital, Lubbock, TX Simone P. Elvey Internal Medicine Taj A. Hadee Pediatrics, Medical College of Virginia, Richmond, VA (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, NY; Radiology-Diagnostic, University of Rochester/Strong Memorial Hospital, Rochester, NY Children's Memorial Hospital, Chicago, IL Peter S. Ercollno Pediatrics, Asra Khan Internal Medicine Randy S. Fagin Surgery (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, Y Pamela R. Haefner Pediatrics, Electra C. Martin Emergency Mediciue, SUNY Health Science Center, yracuse, Y and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, Y Andrew Klapper Plastic Surgery, Paul J. Mason Orthopedics, Henry Eric J. Hanauer Internal Medicine Benjamin 0 . Koenig Emergency Medicine, William Beaumont Hospital , Royal Oak, Ml Janine M. McAssy Internal Suchltra Koneru Family Practice, M. Angela Mclellan Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, Y ew York University Medial Center, New York, Y Jennifer T. Hanauer Obstetrics (prelim), Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, Y; eurosurgery, Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, NY and Gynecology, Rochester General Hospital, Rochester, NY James B. Gaul Medicine/Pediatrics, University of Minnesota Hospital and Clinic, Minneapolis, M Agnes A. Gelder Family Practice, iagara Falls Memorial Medical Center, Niagara Falls, Y Jennifer P. Gennuso Pediatrics, Kathleen P. Gillan-Lundgren Pediatrics, Children's National Medical Center, Washington, DC Louisiana State University School of Medicine, Shreveport, LA Armond M. Lapine Internal Medicine, niversity of Utah Affiliated Hospitals, Salt Lake City, T Peter M. McNeela Family Practice, Hamot Medical Center, Erie, PA Peter S. McQulller Anesthesiology UB Graduate Medical Dental Education Consortium, Buffalo, NY Manal Hegazy Surgery, ew ew Rochelle, y Research, Buffalo, NY Lisa M . Mendonza Family Practice, UB Graduate Medical Dental Education Consortium Buffalo, NY Janice M . Lee Internal Medicine, Wenchun Hsu Emergency Mediciue, Emory University chool of Medicine, Atlanta, GA t. Louis University School of Medicine, t. Louis, MO Michael D. Merrill Internal Jeffrey M . Legrett Internal Medicine (primary), UB Graduate Medical Dental Education Consortium, Buffalo, NY Mediciue, UB Graduate Medical Dental Education Consortium, Buffalo, NY Daniel C. Metrick lntemal Medicine, Mount Auburn Ho pita!, Cambridge, MA Kenneth A. Levey Obstetrics and Gynecology, George Washington University, Washington, DC Claudia Jaramillo luternal Medicine (primary) , UB Graduate Medical Dental Education Consortium, Buffalo, Y Jennifer A. Meyer Pediatrics, Timothy N. Llesching Internal y Akron General Medical Center/ EOUCOM, Akron , OH; Ophthalmology, Case Western Reserve University, Cleveland, OH Joseph F. Lopes Surgery (prelim), Dartmouth-Hitchcock, Lebanon, NH; Urology, DartmouthHitchcock, Lebanon , NH Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY Loren S. Kane Internal Medicine, Andre L. Lopez Family Practice, University of Medicine East Carolina-Pitt County Memorial Hospital , Greenville, C Stephan J. Mllback Family Practice, aval Hospital, Camp Pendleton , CA Medical University of South Carolina, Charleston, SC Jeannie Kao Physical Medicil1e and Rehabilitation, William Beaumont Hospital, Royal Oak, Ml 0 Alex Mompoint Internal Medicin e (prelim) , Sisters of Charity Hospital , Buffalo, Y; Physical Medicine and Rehabilitation, University of Texas outhwestern Medical Center, Dallas, TX UB Graduate Medical Dental Education Consortium, Buffalo, y Iuternal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y B Lori A . Michael Emergency Andrew J. Luisi Internal Mediciue, Brian M . Karaszewski B Graduate Medical Dental Education Consortium, Buffalo, Medicine, Deaconess Hospital, Boston, MA Thomas J. Joly Transitional, Y Mediciue, University Health Center, Pittsburgh, PA Frank M . Lee Emergency Medicine, Obstetrics and Gynecolog) , Our Lady of Mercy Medical Center, Bronx, NY (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, NY UB Graduate Medical Dental Education Consortium, Buffalo, Thomas E. Hansen Orthopedics, Rochelle Hospital, Ford Health Science Center, Detroit, Ml University of Maryland, Baltimore, MD Ayanna Angela L. James Jennifer L. Geiger Surgery Pathology, UB Graduate Medical Dental Education Consortium, Buffalo, Y University of Wisconsin/St. Mary's Medical Center, Madison, WI Eric I. Finkelstein Surgery University of Rochester/Strong Memorial Hospital, Rochester, NY Dori R. Marshaii-Hobika Gregg E. Kissel Family Practice, Lorna Linda University, Lorna Linda, CA Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY David R. Frels Internal Medicine, Pediatrics, University Health Center, Pittsburgh, PA Akron City HospitaVNEO COM, Akron, OH (prelim), University of Rochester/ Strong Memorial Hospital , Rochester, Y; Neurology, niversity of Rochester/Strong Memorial Hospital, Rochester, Y Michael A. Filice Emergency Alexander Marcus Regina Y. Kim Family Practice, Sabrina R. Hammett Obstetrics University of orth Carolina Hospital, Chapel Hill , C Paul M. Maggio Surgery, Rhode Island Hospi tall Brown University, Providence, Rl Cozzette Lyons Internal Medicine, University Hospitals of Cleveland, Cleveland, OH 0 p y 5 c o n 5 m m e 9 9 �Jonathan A. Morgan Internal Medicine (prelim), Long Island jewish Medical Center, ew Hyde Park, NY; Radiology-Diagnostic, Thomas jefferson University, Philadelphia, PA Christopher M. Pieczonka Surgery (prelim) , UB Graduate Medical Dental Education Consortium, Buffalo, NY; Urology, UB Graduate Medical Dental Education Consortium, Buffalo, Shrini T. Mukkamala Surgery (prelim), B Graduate Medical Dental Education Consortium, Buffalo, Y David M. Pllati Surgery, University of North Carolina Hospital, Chapel Hill , C Tracey L. O'Connor Intemal Medicine, University of Rochester/ Strong Memorial Hospital, Rochester, NY Mount Sinai, Flushing, NY Gina L. Parlato Family Practice, orth Colorado Medical Center, Greeley, CO Emmanuella Paul Family Practice, Emory University School of Medicine, Atlanta, GA Christian W. Rochoii intemal Medicine (prelim), niversity of Vermont/Fletcher Allen Health Care, Burlington, VT Philip S. Piasecki Intemal Medicine (prelim), Sisters of Paul Rosen Pediatrics (pri mmy), Mount Sinai Hospital, ew York, a a Y p Matthew Smith, D.D.S. Surgery (prelim), B Graduate Medical Dental Education Consortium, Buffalo, Y Gavin N. Somersel Obstetrics and Gynecology, Albany Medical Center y 5 c a n s u m Matthew Taberski Internal Medicine, Hospital of the niversity of Pennsylvania, Philadelphia, PA Evan S. Taragano Pediatrics, University Health Center, Pittsburgh, PA Andrea L. Torsone Obstetrics and Gynecolog), University of North Carolina Hospital, Chapel Hill, NC Meryl Y. Tucker Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY Usha Vaidyanathan Internal Medicine, University Hospitals of Cleveland, Cleveland, OH Joseph H. Wandass Ill Medicine/ Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y John J. Welch Pediatrics, Georgetown University Hospital, Washington, DC Dayo N. Wilson Medicine/ Pediatrics, B Graduate Medical Dental Education Consortium, Buffalo, Y Noelle M. Stevens Family Practice, SU Y Health Science Danielle A. Woodall Internal Medicine, Albert Einstein College of Center at Syracuse/St. joseph's Hospital Health Center, Syracuse, y Sarah K. Storm Pediatrics, North Shore University Hospital, Manhasset, Y Gary A. Styn Family Practice, B Graduate Medical Dental Education Consortium, Buffalo, NY m Julie A. Szumigala Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY louise Z. Spierre Pediatrics, University of Cincinnati Hospital , Cincinnati, OH Y y h Nicole L. Symons Family Practice, University of Medicine East Carolina-Pitt County Memorial Hospital , Greenville, C William M. Wind StJrgery (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, Y; Orthopedics, UB Graduate Medical Dental Education Consortium, Buffalo, Y Hospital, Albany, Vitaly Raykhman Surgery (preli m), UB Graduate Medical Dental Education Consortium, Buffalo, Y; Umlog), B Graduate Medical Dental Education Consortium, Buffalo, Y Maryann M. Parietti-Scharf Family Practice, Highland Hospital of Rochester, Rochester, Y u Monica J. Simons Obstetrics and Gynecology, Queens Hospital! Pamela P. Rath Transitional, Hennepin County Medical Center, Minneapolis, M ; Ophthalmology, University of Minnesota, Minneapolis, M John Panagiotopoulos Intemal Medicine, Winthrop-University Hospital , Mineola, Y B Jimmy Y. Sim Pediatrics, Thomas jefferson University/Dupont Institute, Philadelphia, PA Jennifer M. Ragi Intemal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA lesley A. Orman Pediatrics, Eastern Virginia Medical School, orfolk, VA Charity Hospital , Buffalo, Charles M. Severin, Ph.D. faculty, Department of Anatomy and Cell Biology, UB Graduate Medical Dental Education Consortium, Buffalo, Y John C. Radford Emergency Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY Medical Center, Merced , CA Jennifer F. Sussal, M.P.H. Pediatric Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, Y Craig M. Senzon Intenwl Medicine (prelim), Beth Israel Medical Center, New York, Y; Neurology, Albert Emstein Medical Center, Bronx, NY Bobbie l . Pustelny Surgery (preli m), University of California at Los Angeles, Los Angeles, CA Christopher M. Occhino Family Practice, Merced Community Noah D. Sabin Surgery (prelim), Abington Memorial Hospital, Abington, PA; RadiologyDiagnostic, Albert Einstein College of Medicine(Jacobi Medical Center, Bronx, Y y Catherine F. Przystal Medicine/ Pediatrics, University of Rochester/ Strong Memorial Hospital, Rochester, Y David J. Novak Internal Medicine (prelim), Georgetown University Hospital , Washington, DC Paniti Sukumvanich Obstetrics and Gynecology, niversity Health Center, Pittsburgh, PA Tami S. Seaman Family Practice, UB Graduate Medical Dental Education Consortium, Buffalo, Aisha K. Prim Pediatrics, Children's ational Medical Center, Washington, DC Manyan Ng Pediatrics, Thomas jefferson University/Dupont Institute, Philadelphia, PA James J. Runfola Family Practice, West jersey Health System, Trenton, J Patrick V. Scott, D.D.S. Surgery (prelim), UB G•aduate Medical Dental Education Consortium, Buffalo, Y V. Chowdry Pinnameneni Intemal Medicine (prelim), New York Methodist Hospital , Brooklyn. Y Gerardo Negron Internal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y Lisa S. Sufrin Pediatrics, University of Cincinnati Hospital , Cincinnati, OH Thomas E. Schenk Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y y James P. Murray Medicine/ Pediatrics, University of Texas Medical School, Houston , TX Mary E. Ross Pediatrics, St. Louis Children's Hospital , St. Louis, MO e 9 9 7 Medicine(Jacobi Medical Center, Bronx, NY Denise C. Woodall Pediatrics, Eastern Virginia Medical School, orfolk , VA Carolyn M. Young Psychiatry, UB Graduate Medical Dental Education Consortium, Buffalo, Y �.. . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . [1] ~ I Rettred surgery professor dies BY WORTHINGTON G . SCHENK n September 4, 1996, surgery lost an outstanding leader with the death of john D. Stewart, M.D. Stewart earned a B.A. from the University of Virginia and graduated cum laude from Harvard Medical School in 1928. He and Henrietta Rhees were married in 1937 and had two daughters and one son. Their son, David, became a surgeon, but tragically, died quite young of undiagnosed overwhelming sepsis. Stewart completed an internship at the Huntington Memorial Hospital and a residency at Massachusetts General Hospital. He did research and further JR . , M . D . work at Massachusetts General and Harvard before being appointed professor of surgery at UB and chief of surgery at the E. ]. Meyer Hospital (now Erie County Medical Center). In 1943, he was commissioned a major in the U.S. Army Medical Corps and a year later was promoted to lieutenant colonel. He served on several national research committees, including the surgery section of the ationa! Institutes of Health. After serving a term on the American Board of Surgery, he became its chair in 1956. Stewart also Nobelist dies at 94 ir john Carew Eccles, a abel Prize-winning neuro- physiologist and a former member of the UB faculty, died in May at his home in Switzerland, the ew York Times has reported. He was 94. In 1963, Eccles shared the obel Prize for Medicine or Physiology with Alan Hodgkin and Andrew Huxley for describing the electrochemical communication system between nerve cells. Eccles showed that excited nerve cells release a substance (acetylcholine) that enlarges pores in a neighboring cell's membrane, allowing positively charged sodium ions to enter the cell, reverse the polarity of the electric charge in the cell, and transmit the nerve impulse. He also found that in other types of synapses, the excited nerve cell induces the neighboring cell to discharge potas- sium ions, which reinforces its existing polarity and inhibits the transmission of the nerve impulse. Eccles was the author of a number of books, including The Physiology of erve Cells (1957), The Inhibitory Pathways of the Central ervous System (1969) , The Understanding of the Brain (1973), and The Human Psyche (1980). Born in Melbourne, Australia , Eccles earned his bachelor's and medical degrees from Melbourne University, and his master's and doctorate from Oxford University under a Rhodes scholarship. B u f f a l o Phys i served as president of the American Surgical Association and was active in many other professional groups. His interests were not limited to surgery. The family kept cattle and working horses on ranches in South Carolina and Florida. In 1965,john retired from his medical school and hospital positions and moved to Boca Raton, Fl. During his professional career, he trained 20 surgeons, most of whom became chief surgeon at their institutions. Few surgeons made the breadth of contributions to the profession as did john D. Stewart. + Worthmgwn G. Schenh jr., trai ned with Dr. Stewart and later succeeded him as ch1ej of surgery at E.). Meyer Hosp1tal. He conducted the research that led to the obel in the 1950s while at the john Curtin School of Medical Research of the Australian ational University in Canberra. Eccles was knighted by Queen Elizabeth II in 1958. Other honors included membership in the Pontifical Academy of Sciences and a four-year term as president of the Australian Academy of Science. He and his first wife, Irene, had nine children. In 1966, Eccles came to the U.S. to head the American Medical Association's Institute for Biomedical Research in Chicago. Two years later, he moved to Buffalo to direct UB's Center for theStudyof eurobiology. He was named a SU Y Distinguished Professor in 1975. After his retirement in 1975, Eccles and his second wife, Helena, settled in Switzerland. + cian Summer 1 9 9 7 �- - - ------ -~-----~-~ ---- - ~~~- - -= ························································································•· Mlfl I I Morin appointed chair of pediatrics rederick C. Morin III, M.D., has been appointed chair of UB's Department of Pediatrics after serving as interim chair for a year. A UB professor of both pediatrics and physiology, Morin was also appointed pediatrician-in-chief at Children's Hospital of Buffalo. He has been chief of the hospital's Division ofNeonatalogy, which is internationally recognized for its research on treatments for lung failure, including surfactant replacement therapy, inhaled nitric oxide, and liquid ventilation. Morin succeeds F. Bruder Stapleton, M.D., who is now chair of pediatrics at the University of Washington. After earning his M.D. at Yale University, Morin completed his residency at Stanford University and held a research FREDERICK C MORIN Ill fellowship in neonatalogy at the Cardiovascular Research Institute of the University of California at San Francisco. He directed the Intensive Care ursery at the University of Rochester before joining the UB faculty in 1986. He is board certified in both pediatrics and peri nata 1/neona ta 1 medicine. + WNY's Largest Volume BMW Dealer THE ULTIMATE DRIVING MACHINE~ THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. F. G. DOWNING s&99 1997 BMW 740i 27 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. FREE SCHEDULED MAINTENANCE ALL SEASON TRACTION PMT based on 5000 cap cost reduction or trade, 10,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT, taxes and plate fees due at inception. Service Loaners Available ... Minutes From Rich Stadium B u f f a 1 o Physician summer 1 9 9 7 �COMMENI 1 9 9 7 Commencement ceremony honors cancer researcher Internationally hnown cancer researcher James F. Holland, M.D., was awarded a State University of ew York honorary doctorate in science at the 151st commencement of the UB School of Medicine and Biomedical Sciences on May 11. Holland , whose work helped shape modern treatments for leukemia and other cancers , also delivered the annual D. W. Harrington Lecture on May 12, on the topic of "The Search for HMTV, Human Mammary Tumor Virus." Commencement ceremonies were held in the Center for the Arts on the UB orth Campus. SUNY Trustee Edward . elson conferred the honorary degree on Holland. One hundred forty-six students received their M.D.s during the ceremony, and 37 received Ph.D.s. Four received M.D./Ph.D.s. The ceremony served as the conclusion of the university's 18-month sesquicentennial celebration. Holland, CU Y Distinguished Professor and chief of the Division of eoplastic Diseases at Mount Sinai School of Medicine , served as chief of medicine at Roswell Park Cancer Institute for more than 20 years. A graduate of Princeton University and Columbia University College of Physicians and Surgeons, he spent a year at the ational Cancer Institute before coming to UB and Roswell Park Cancer Institute in 1954. He was named chief of medicine at Roswell in 1956, serving until 1973. During much of that time , he also served as director of Roswell's Cancer Clinical Research Center and became a research professor of medicine at UB. In 1972, Holland received the prestigious Lasker Award for his work in chemotherapy. + ® B u f f a l o p h y �-----~-- ---~- - -------- - -~-....--- - - liCE ME NT On with joy to new challenges: Twin sisters Drs. Danielle and Denise Woodall (center); Dr. joseph Lopes with daughter Olivia (top, page 18); UB President William Greiner hooding, then congratulating, Dr. james Holland (below, page 18); Interim Dean john Wright, presiding (top, page 19); Dr. Lisa Mendonza with family friends (above); Dr. Regina Kim signing the Book of Physicians (immediate left); and Class Speaker Dr. Charles Severin (below). ~ �• ··················································· · ···································· ~ I Aword from the director of development BY LINDA J . CORDER. PH . D. , C.F.R.E . n this issue of the Buffalo Physician, the school honors and thanks members of the james Platt White Society. Several times since becoming a development officer in the School of Medicine and Biomedical Sciences, I have been asked about the history and evolution of this honorary recognition organization. The short answer is, it provides a vehicle to thank those who generously contribute their personal resources to enhance and advance the School of Medicine and Biomedical Sciences. Each donor decides where his or her gift will go. Many give to the school's General Fund, which is disbursed at the discretion of the dean. It is not an exaggeration to say that the General Fund is the most important current gift fund. The caliber of our faculty continues to increase, in part, because of the flexibility this fund provides in support of searches and faculty dt.velopment. Other uses for the fund include recruiting promising students, supporting the minority high school research apprentice program, and underwriting the Medical Scientist Training Program seminar series. Some donors choose to designate their gifts for endowed funds, including endowed scholarships and endowed faculty chairs. Others make gifts to special projects, such as UB's euroanatomy Museum, or to departmental funds, which are disbursed at the discretion of the department chair for such uses as research seed money or student medical association activities. Gifts to any of these funds-as well as annuities, charitable trusts, or bequestsqualify a donor for membership in the james Platt White Society. The society offers two types of recognition: annual and lifetime. An annual gift of $1,000 or more results in a year's membership in the society. An individual or a couple is granted lifetime membership in the Founders' Circle of the society when cumulative contributions reach $50,000. Recognition in the james Platt White Society confers recognition in the University's President's Associates (annual) and University Founders (lifetime) honorary organizations. When the james Platt White Society was established in 1986, memberships went to ® B u f f a l o those who donated $10,000 payable over a period of ten years to any fund that benefited the school. Larger gifts guaranteed recognition for a specified number of years. A few "special members" are still recognized, due to those early agreements. Several years ago, the recognition categories were changed to the current annual and lifetime memberships. The category "Special Membership" is no longer offered, and will expire for current members at the end of 1999. The recognition category "In Memoriam" was added to recognize those whose thoughtful foresight included arranging major bequests or gifts from testamentary trusts for the school's enhancement. Individuals and couples who support the medical school at an outstanding level are seen as its closest friends, and so they receive additional information throughout the year, invitations to certain medical school and university events, and special recognition by the school. Best of all, this is an open and expanding group. The more "best friends" the school has, the more excellent it becomes. All are welcome to contribute and be recognized for their support. The entry level for the society has never been raised. In fact, it has actually been lowered for recent graduates. "Graduates of the Last Decade" (GOLD) are recognized for annual contributions of only $500 or more. The Executive Committee wants to encourage all medical alumni, and especially the GOLD graduates, to support their school at a level commensurate with their resources. We are deeply appreciative of all gifts to the medical school, especially those that have the potential to make a transforming difference in the quality of medical education and residency training offered at UB. I invite you to read through the roster of members that follows, and to thank your friends and colleagues listed there for their outstanding support. If you are not yet in this group, please consider increasing your contributions to the school. The executive committee would like to see this honorary group double in size by the end of the century.+ Linda). Corder became the direcror of development for the School of Med1cine and Biomedical Sciences this year. She had previously sen·cd the school as major gifts coordinaror. Physician Summer 1 9 9 7 �- -- --~-----~~~~-- -- - - ---- - - ~~-~ -- -= ·············· · ·········································································• · ~ I Dean ' s Circle james Generous gifts of $25,000 to $49,999 qualify individuals or couples as members of the Dean's Circle. Platt White Society Dr. Kenneth M. and Mrs. joan Alford Chair Buffalo, NY Dr. Charles D. and Mrs. Mary Bauer Byron A. Genner Ill, M.D. Williamsville, NY Potomac, MD I Founders ' Circle Individuals or couples whose cumulative lifetime contributions total $50,000, or whose irrevocable deferred gifts total $100,000 or more, are honored as permanent members of the Founders' Circle. Their names are also repeated in an annual category, at the appropriate level, in any year that they make a new gift to the School of Medicine and Biomedical Sciences. Dr. Elizabeth P. Olmsted Ross Buffalo, I Y Cheste1jield, MO Orchard Park, NY Dr. Orvan W. Hess Dr. Richard B. and Mrs. Ellen Narins North Haven, CT Dr. Richard B. and Mrs. Ellen B. arins Williamsville, NY Philip B. Wels, M.D., and Mrs. Elayne Wels Eggertsville, NY Buffalo, NY I Dr. George M. Ellis Jr. and Mrs. Kelly Ellis Connersville, IN Lakeview, NY Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley Chesterfield, MO p h Annual Members Individuals or couples whose annual gifts total $1,000 or more are honored in the year the gift is made, at the level indicated by the total amount of contributions made during the period specified. The following lists recognize this year's annual members, some of whom are also honored as members of the Founders' Circle. Mrs. Grant (Evelyn) Fisher y 5 c I a n 5 m Circle Gifts of $5,000 to $9,999 are given due recognition in the Professors' Circle. Central to a great university is a strong faculty. Likewise, central to the future of our school is the dedication of a cadre of supporters within the Professors' Circle. Miss Thelma Sanes Dr. Kenneth H. Eckhert Sr. and Mrs. Marjorie Eckhert Dr. Thomas]. Kufel Marilla, Y Dr. Charles]. McAllister Clearwater, FL Buffalo, NY I Scholars ' Circle One strength of an outstanding institution is the caliber of those who study there. Scholars within the james Platt White Society have made gifts to the school totaling $1,000 to $2,499 during the past year. These marked with an asterisk(*) are young scholars, graduates of the past decade who qualified with gifts of $500 to $999. Dr. Bruce M. Abramowitz Glenview, IL Dr. Kenneth Z. Altshuler Dallas, TX Dr. Richard Ament I Professors ' Buffalo, NY Providence, R1 o Longboat, FL Dr. Elizabeth P. Olmsted Ross Snyder, NY l Dr. Benjamin E. Obletz Hilton Head Island, SC Dr. Willard and Mrs. Clarice Bernhoft a East Aurora, NY Dr. Albert C. and Mrs. Linda Rekate Y Chairs ' Circle Dr. Thomas F. Frawley Richard]. Nagel, M.D. and Mrs. Florence Nagel Dr. joseph and Mrs. Helene Chazan Y just as a department chair earns recognition for leadership of an academic program, donors who make leadership gifts in the range of $10,000 to $24,999 are given special recognition by the james Platt White Society. East Aurora, NY Williamsville, Dr. joel M. Bernstein Dr. Richard W. Munschauer Dr. Eugene R. and Mrs. june A. Mindel! Dr. Charles D. and Mrs. Mary Bauer f Dr. Thomas]. and Mrs. Barbara L. Guttuso Mrs. GraceS. Mabie Orlando, FL Buffalo, NY f Buffalo, NY New York, NY Dr. Kenneth M. and Mrs. joan Alford u Buffalo, NY Mrs. Morris Lamer Williamsville, NY B Dr. Eugene R. and Mrs. June A. Mindel! East Amherst, NY Mrs. june M. Alker Circle Fellows within the school are recognized for the added depth they bring to postgraduate study. Within the james Platt White Society, fellows are honored for gifts made during any one year that total $2,500 to $4,999. Williamsville , NY Dr. and Mrs. Pasquale A. Greco Buffalo, I Fellows ' I Dr. William S. Andaloro Caledonia, NY Dr. George Bancroft Hamburg, NY Drs. Kevin and Elizabeth P. Barlog Dr. Willard H. and Mrs. Clarice Bernhoft Amherst, NY Snyder, NY Dr. jared C. and Mrs. Barbara A. Barlow Dr. Harold]. and Mrs. Arlyne Levy Grand Island, NY Amherst, NY Dr. Robert M. Barone Dr. Edward Shanbrom Santa Ana, CA Buffalo, NY e 9 La]olla, CA Dr. Paul D. Barry Dr. and Mrs. james]. White Jr. m Williamsville, NY 9 7 Aiea, HI �• ························································································ Dr. Ronald E. and Mrs. Kathleen Batt Lancaster, NY Dr. Mark and Mrs. Kathleen Comaratta East Amhnsl, ry Gerard T. Guerinot, M.D. , and Mrs. Geri Guerinot Dr. Edwin j. and Mrs. Phyllis E. Manning Rochester, Snyder, NY Y Dr. Ralph T . Behling Dr. Lyn Corder Dr. Eugene J. Hanavan Jr. Dr. Michelle j. Marinello San Mateo, CA Buffalo,, Y Blljfalo, 'Y Williamsville, Y Dr. Richard A. Berkson Dr. and Mrs. Daniel E. Curtin Mrs. Gilda L. Hansen Dr. William L. Marsh Rancho Palos Verdes, CA Orchmd Park, NY Williamsville, NY Bethesda, MD Dr. Theodore . Bistany Mrs. Joan D'A rrigo, in memory of Dr. Pete r . D'A rrigo Dr. Reid R. and Mrs. Elenora M. Heffner Dr. Don L. Maunz Buffalo, NY Dr. john . Bivona Jr. Newbu rgh, NY Dr. Willard H. Boardman Buffalo, Buffalo,, Y Bangor, ME Y Dr. Merrill L. Miller Dr. William j. Hewett Richard H. Daffncr, M.D., and Mrs. Alva K. Daffne r Hamilton, NY West Hartford, CT Mrs. Edwina Mincks in memory of Dr. Charles B. Mincks Jr. Robert M.jaeger, M.D. Winter Park, FL Ptllsbwgh, PA Dr. Dennis L. Bordan Port Washmgton, NY Dr. David R. and Mrs. Sherrye Dantzkcr Dr. Suzanne F. Bradley Roslyn, NY Whitmore Lake, ,\1/ Dr. RogerS . and Mrs. Roberta Dayer Dr. Charles A. joy Dean Mitchell , M.D. Bt;Jfalo, NY fairview, PA Cortla nd, Y Gerard]. Diesfeld , M.D. Dr. Stephen T. Joyce Dr. joseph F. Monte Arcade, NY Buffalo, \JY Buffalo, Dr. Thomas A. Donohue Dr. and Mrs. James R. KanskiJr. Dr. james]. Moran Lexington, KY Eggertsville, Santa Monica, CA Dr. Ronald l. Dozo retz Drs. Julian R. and Mayenne A. Karelitz Dr. Thomas W. Bradley Tonawanda, NY Dr. Martin Brecher Amherst, Y Dr. Harold and Mrs. Anne Brody Amherst, Y Dr. James B. Bronk Napa,CA Dr. Melvin M. and Mrs. Elaine S. Broth man Snyder, NY Dr. August A. Bruno Amherst, NY Dr. William M. Burleigh Rancho Mtrage, CA Dr. Washington Burns Ill Berkeley, CA Drs. Evan and Virginia Calkins Hamburg, l\Y icholas J. Capuana New Hartford, Y Dr. Dr. Nicholas C. Carosella Appleton, Y Dr. Yung C. C han Drapc1, VA Dr. Michael E. Cohen Williammlle, NY Dr. D. Jackson Coleman Ha worth, Nj Allenl01vn, PA Dr. Maynard H. MiresJr. Moun/am Lakes, Nj Norfolk, VA Georgetown, DE Y Dr. Thomas W . Morgan Dr. Robert B. Kaufman North Brunswick, Nj Ontano, Potomac, \tiD Dr. and Mrs. Kenneth K. Kim Roanoke, VA Clinton, Dr. jack C. Fisher Dr. Arthur C. Klein Lajolla, CA Los Angeles, CA Dr. Penny A. Gardner Dr. Robert A. Klocke Los Altos, CA Williamsville, NY Dr. Kenneth L. Gayles Dr. Paul S. Kruger Manhasset , , Y Y Dr. Arthur W Mruczek Sr. Medina, NY Dr. Richard L. Munk Sylvania, OH Dennis A. Dr. Lawrence H. Golden Dr. Paul A. C. Greenberg Y Dr. Kim Griswold Lockport, NY Ri chard]. agel, M.D. and Mrs. Florence agel Dr. Gordon R. Lang Orchard Park, Poestenkill, Dr. Masao 1 Y Eric, PA f f a l o akandakari Drs. Robert G. and Lillian V. jamestown, Carlisle, PA Dr. Robe rt T. Guelcher Y Honolulu, HI Dr. Stanley B. Lewin Fort Myns, FL adler, M.D.* Velvedccr- Tiburo, CA Dr. Andre D. Lascari Dr. Edward F. Gudgel a PaulL. Drs. joseph L. and Marie L. Kunz Chicago, IL Btiffalo, \'Y adler, M.D. East Amherst, NY Watertown, NY Eggertsville, NY Y Dr. John D. Mountain Dr. John A. and Mrs. Karen Feldcnzer Buffalo, NY Y Dr. Philip D. Morey Williams1·illc, Y Los Angeles, CA Dr. Robert Einhorn New York, Mukilteo, WA Dr. Kenneth L. and Mrs. Jane Jewel ey Y Dr. jack and Inez Lippes Dr. Thomas P. and Mrs. Sandy O'Connor Buffalo, Y East Amherst, Y p h y c a n S u m m e 9 9 7 �······················· · ······ · ································· · ······················· · ·' ~ I Mrs. Marguerite T. O'Gorman Dr. Joseph I. Schultz Dr. Bradley Truax Dr. Myron E. Williamsjr. Eden, NY San Pedro, CA Lewiston, Y Batavia, XY Dr. Rudolph Oehm Fred and Peggy Schwarz Dr. Alvin Volkman Dr. Richard G. Williams Walnut Creek, CA Williamsville, NY Greenville, NC Clearfield, PA Drs. Dean E. and Donna W. Orman Roy E. Seibel, M.D. and Mrs. Ruth H. Seibel Dr. Arnold Wax Dr. Lester E. Wolcott Henderson , V Lt1bbock, TX East Amherst, NY Eggertsville, NY Dr. JohnS. and Mrs. Dorris Parker Dr. Molly R. Seidenberg Dr. Harold J. Weinstein Gregory E. Young, M.D. Van Nuys, CA Holland, NY Dr. Arthur M. Seigel Drs. Charlotte C. and Hyman Weiss Ca nandaigua, NY Guilford, CT Highland Park, Dr. Elizabeth G. Serrage Dr. Paul H. Wierzbieniec Dr. Franklin and Mrs. Piera Zeplowitz Portland, ME Amherst, NY Buffalo, NY Dr. John B. Sheffer Dr. Gary J. Wilcox Williamsville, Carlsbad, CA Dr. David C. and Mrs. Susan D. Ziegler Rochester, NY Latrobe, PA Dr. Robert J. Patterson Snyder, NY Dr. Norman L. Paul Lexington, MA Dr. joel H. Paull Buffalo, NY Dr. Victor L. Pellicano Niagara Falls, NY Y Dr. Timothy S. Sievenpiper Dr. Charles E. Wiles East Aurora, NY Ha111es City, FL Dr. A. john Piccoli Drs. RobertJ. Smolinski and Claudia Fosket Fort Myers , FL Orchard Park, NY Dr. and Mrs. Herbert S. Pirson Dr. William L. Sperling Orchard Park, NY San Diego, CA Dr. Cary A. Presant Dr. John E. Spoor San Marino, CA Laurens, NY Dr. Bert W. Rappole JohnJ. Squadrito, M.D. jamestown, NY Troy, NY Dr. Frederic D. Regan Dr. William C. Sternfeld Staten Island, Y Sylvania, OH F. T. Riforgiato, M.D., and Mrs. Mary-Cecina W. Riforgiato Middleport, NY 8 Dr. David W. Butsch Montpelier, VT Eugene M. Sullivan Jr. , M.D. Dr. Richard R. Romanowski Ms. Janet F. Butsch Aurora, CO Boston, NY Williamsville, NY Dr. Michael A. Sullivan Dr. Charles H. Rosenberg Buffalo, NY Mr. Barry Swartz Dr. and Mrs. JeffreyS. Ross Dr. and Mrs. Marvin Z. Kurian Amherst, NY Albany, NY Willtamsville, NY Wayne C. Templer, M.D. Dr. Albert G. Rowe Harry L. Metcalf, M.D. , and KaarenJ. Metcalf, Ph.D. Corning, NY Tonawanda , NY Dr. David M. Rowland Dr. and Mrs. James C. Tibbetts Jr. East Aurora, Y Madison, WI Dr. Eric J. Russell Dr. Charles S. Tirone Chicago, IL Williamsville, NY Dr. Adolphe J. and Mrs. L. SchoepiTin Green Valley , AZ a l o Williamsville, Y Dr. john Naughton Buffalo, Y Mrs. Marvin (Helen) Winer Sarasota, FL Dr. George Toufexis ancy Williamsville, NY p h y 5 a n s In Memoriam - The following individuals left generous bequests or made arrangements for gifts from testamentary trusts to be given to the School of Medicine and Biomedical Sciences during the past year. Dr. Russell F. Brace Randolph, Y Dr. Richard J. Kenline Tonawanda, NY Dr. Thomas A. Rodenberg Hollywood, FL Dr. Mark W. Welch Rochester, :-JY Dr. John L. Butsch Williamsville, NY Stamford, CT ecial Members A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. They will receive special recognition through December 1999. At that time all memberships in the society will be made on an annual basis, including ongoing recognition for Founders' Circle members as they reach 550,000 in cumulative gifts. Elizabeth A. Storch Buffalo, NY f Wa lnut Creek, CA Las Vegas, NV Hamburg, NY f ~ Dr. Wende W. Young Dr. Roger M. Simon Dr. Harry Petzing B I u m m e 9 9 We have made every effort to ensure accuracy in these lists. Please contact Dr. Linda) . Corder, Ms. Catherine Williams, or Mrs. janet Parker in the Medical School Development Office if we have made an error or if you would like your name(s) to be listed differently in fut ure recognition documents. Send mail to: Room 141 Biomedical Education Building, UB School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214-3013. Phone: (716) 829-2773. Fax: ( 716) 829-3395. E-mail: <ljcorder@acsu.buffalo.ed u>. �• ········· · · · ··················································· · · ·· ···· · ··············· Clinical curriculum traces its roots to Buffalo BY S COTT T HOM A S t was half a lifetime ago, at the beginning of their careers . But for five pioneering medica l educators who came together once again to reminisce, the memories remain as sharp as a new scalpel. A "Celebration of Medical Education" honored the five former UB faculty members who created the Project in Medical Education, an innovative effort from 1955 to 1959 to expose beginning medical students to clinical experience and small-group teaching. The project was revolutionary for its time, and not without controversy. Previously, medical students had spent almost all of their first two years in the lecture hall. The Project "we should bring together medical educators and professional educators to see if there was something we could learn from them-and perhaps even they could learn from us." The idea evolved, Miller said, into a series of courses taught jointly by professors in medicine and education, and programs for visiting professors to spend time in both the School of Education and the medical school. 'The colonization began there, but in the course of the next few decades it has spread worldwide," he said. "All these schools have to acknowledge that the seeds of this movement began at the [then] University of Buffalo." Stephen Abrahamson, Ph.D., Ed.D., was on the School of Education faculty at the time; his career has since taken him to the University of Southern CaliLeft to right: Miller, Abrahamson, Rosinski, Jason, and Becker fornia, where he is now professor emeritus. He said he had one proviso when agreeing in Medical Education got them into hospitals and working with patients, an approach that to co-direct the Project in Medical Education: has become the standard for medical educa- " o gross anatomy, and no operating room. " Abrahamson noted the rise of "a bottomtion in the United States. At an April 24 presentation, the five pio- line mentality" with the advent of managed neers shared thoughts on why the project care; he also pointed with hope to the enorsucceeded so thoroughly, and where medical mous amounts of material now widely education might be going in the years ahead. available through the Internet. "In my 35 years of medical education," George E. Miller, M .D., co-director of the project, went on to the University of he added, "''ve tried to learn not a damn Illinois Medical School and is now professor thing about medicine. And the little I have learned has made me pray for health. " emeritus there. Edwin F. Rosinski, Ed.D., earned his docHe spoke of how Stockton Kimball, dean ofUB's medical school at the time, agreed that torate at UB while working on the project. B u f f a l o P Since then, his career has taken him to the Medical College of Virginia; the U.S. Department of Health, Education, and Welfare; the University of Connecticut; and the University of California at San Francisco, where he is now professor emeritus. Rosinski predicted a greater emphasis on outpatient and primary care-the latter a strength ofUB's medical school curriculum, which has become a national model. Hilliard Jason, M .D., Ed.D., earned his medical degree and his doctorate in education from UB. He now directs the Center for Instructional Support, in Boulder, CO, and is clinical professor of family medicine at the University of Colorado Medical School. jason recalled an initial disillusionment with medicine, due to a histology professor who "insisted that we spend hours peering through a microscope at tissues and putting dots on paper to match the shading of what we saw. " That changed with the Project in Medical Education. "I was so excited that there was somebody here who was challenging the status quo. There was this other side of the school that was enormously exciting and enriching." jason sees a plus side to managed care. "The arrival of the bottom-line mentality brings with it the notion of accountability. We have not had that in medical education. " Donald Raymond Becker, M.D., taught surgery at UB until1980, then went to the University of Connecticut at Hartford. ow emeritus there, he teaches at the University of California at Davis. "There have been so many changes in medicine in the past 40 years," he said. "Humanism courses and biomedical ethics committees; AIDS; more women and minorities in the profession. Some say medicine has become too cold, too remote, too impersonal, too unavailable, too money-hungry. "But when students today ask me if I would do it all over again, my answer is still: 'In a flash! ' Why should it matter to me who pays me or how much paperwork I have to do? There will always be the sick who need healing. " hysician + Summer l 9 9 7 B �Put tfze best seat in tfze fwuse myourgarage. ·······················································•· ~ I Residencyslotstobecut by 20 percent overfive years 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 'ldat'JJaff7lllll1 1717 Walden Ave., Buffalo, NY 891-5595 B u f f a l o he number of medical residents trained in Buffalo will be reduced by about 20 percent over the next five years in response to a Medicaid incentive program and cuts at the Veterans Administration. The Graduate Medical Dental Education Consortium of Buffalo had 687 Medicaid-funded residents in training in 1996. That number will be reduced to about 545 by the year 2001 , said Roseanne Berger, M.D., UB associate dean for graduate medical education. The cuts are part of an incentive program for ew York State hospitals offered by the federal Health Care Financing Administration, which runs Medicaid. During the five years of the cuts, HCFA will ease the transition by paying the participating hospitals a percentage of the money they would have received had they continued to train residents at 1996 levels. At the same time, the Veterans Administration is also cutting back on residency training. The Buffalo consortium now trains about 101 VA-funded residents; over five years, this figure will be cut to about 89, according to Gerald Logue, M.D., chief of staff at the Veterans Affairs Western ew York Healthcare System at Buffalo. The result will be a reduction in the number of Buffalo-area medical residents from 788 to 634. Also, a larger percentage of the remaining residencies will be in primary care areas. "Residencies are paid for with public money, so the numbers and types of residents should be driven by what the country needs," Logue said. Nationally, there is a concern that schools are training too many doctors, and specifically, too many specialists. There's also concern about the high cost of medical education, which contrib- Physician summer 1 9 9 7 I utes to the overall expense of health care. For example, federal budget officials have predicted that the Medicare Trust Fund, which is the source of much of the country's GME funding, will have a $600 billion deficit by 2002. As long as residency training provided income for hospitals, there was a strong incentive to create more residency positions and use the residents to take care of indigent patients. Sometimes, residents found themselves performing procedures not because they were required for board certification but because the hospital had no one else to do them. The trend has resulted in many more residency positions than can be filled by graduates of American medical schools, leading hospitals to recruit international medical graduates (IMGs). The changes are likely to start reducing the number of IMGs in the U.S., and Roseanne Berger residents may soon be able to select the types of hospital work they need in order to meet their own educational priorities rather than doing what is needed to care for patients. In addition to the changes in the two federal sources of GME funding, more changes are afoot at the state level due to the ew York State Health-Care Reform Act of 1996. Details remain to be worked out. However, Berger said these changes probably won't result in deeper cuts in Buffalo's programs. The changes provoke a variety of reactions at UB. Some feel that residents will end up better off: "I think this has the potential to strengthen many of our residency programs, " Berger said. "Many of our faculty see it as an opportunity." + - JESSICA ANCKER �_, ............ . . . .................................. . ..................................... . lEI Asthma in the urban community BY MICHAEL CLASS KANE , OF 1998 NOW I KNOW IT'S NOT THAT SIMPLE lenty of studies show that asthma is a growing concern of the inner city. The challenge that I am seeing early in my medical career is making the transition from textbooks, algorithms, and studies to actually helping people with asthma manage their condition outside the physician's office. Over the past two years, I have had the chance to see up close the environIn addition, I learned the importance the opportunity to work with Carlos ments in which Lower West Side asth- of being sensitive to the financial rejaen, M.D., and the Center for Urban matics live. sources of patients. Physicians often tell Research and Primary Care (CURE PC) Of the asthmatics we studied, 80 per- asthmatics to vacuum frequently to reon a comprehensive asthma study done cent were Hispanic, two-thirds received duce the level of dust, or to get rid of in Buffalo's Lower West Side. We iden- public assistance, and more than half cockroaches. But some patients can't tified asthmatics in the community and were exposed directly or indirectly to afford a vacuum cleaner, and they may gathered information about their medi- environmental tobacco smoke. Fewer have no choice but to live in cockroachcal management and knowledge of than half of the adults had a high school infested subsidized housing. asthma, their home environment, their education. More effort has to be put into smokexposure to environmental tobacco My eyes have been opened to many of ing prevention/cessation programs. smoke, and their socioeconomic status. the problems physicians face I joined the research team in per- when treating a chronic disease forming more than 800 home inter- in an urban community. One views in this poor, urban community. I of the most obvious problems became aware of the many sociopolitical was communication. I speak problems of this area, and of many asth- very little Spanish. Sitting in matics' poor understanding and man- patient interviews with a biagement of their condition. lingual researcher, I imagined The a tiona! Asthma Education Pro- what it must be like for a gram publishes guidelines for managing panish-speaking patient who asthma, ranging from the use of corti- enters an emergency room and costeroids, bronchodilators, and peak gets maybe 30 seconds of inflow meters, to the elimination of envi- struction for preventing the ronmental irritants, such as dust, pets, next acute asthma attack- in or tobacco smoke. English. When l first read those guidelines, I gained a better appreciathe management of asthma seemed easy tion of explaining things in enough. I thought that there was noth- plain language. Before I studied ing about asthma that couldn't be ex- asthma, I had no idea what a plained and brought under control after " nocturnal exacerbation " a few 15-minute visits to the clinic. was- it just sounded ow I know it's not that simple. Dr. serious. But that's the kind of term a Almost all the people we interviewed jaen tells his medical students, "In order doctor is Iikely to use when describing a knew that tobacco smoke can make to practice good medicine, you must night-time asthma attack. It's no won- asthma worse , but many still lived in a know the community in which you prac- der some patients-whether they speak smoke-filled environment. One home tice." My experience with him gave me English or not- don't understand. we visited had four children under the ® B u f f a 1 o Physician Summer 1 9 9 7 �UBMICRO COMPUTER SALES A Non-Profit University at Buffalo Se ice Program age of seven with asthma. one of the children were on any sort of treatment plan, and each of the parents smoked two packs of cigarettes a day. I asked what they did when their children had trouble breathing. The parents replied , "Take them to the emergency roomwhat else? " Besides the asthmatics who had no medications to take , there were others who took potentially harmful medications incorrectly. In one home , I interviewed a girl and her grandmother, both with asthma. During the interview , the girl began wheezing. She took an albuterol nebulizer treatment, and when that brought only partial relief, she went to her grandmother's medicine tray and took one of her grandmother's prescription 300 mg theophylline tablets. When I asked about it , the granddaughter explained that she some- Letter to the Editor times had to take her grandmother's medication because it was stronger. I took the opportunity to tell her that these medications-and others-can be dangerous iftaken inappropriately. I urged her to talk to their physician about a medicine review. But even though we both were speaking English , I suddenly got the feeling that I was speaking a foreign language. It is very easy to feel that these sorts of problems are out of the physician's hands, and that people will do whatever they want. However , after working on the CURE PC project, I know that I am going to try my best to confront many of these problems and work with patients for a better quality of life. That, after all , is what the patients really want. + Mi chael Kan e, who wi ll sLa rl hisfatmh yem of medi cal school this f all, is C0 11 sideri11g el!l cringfamil) medi cin e. Buffalo Phys ician received this letter in respo nse to Mike Merrill's www.ubmicro.l)uHalo.edu Call 645· 554 YOU ARE ELIGIBLE for academic pricing on... Acer • Adobe • Apple • Corel • Dell • Hewlett Packard • Microsoft • Texas Instruments & much more ... Delivery &Setup in your home or office available! "A Student's Perspective" column in our Winter 1997 issue. Computer Workshops May 6 , 1997 Call 645-3560 to have a brochure mailed to you. Dear Mike, • On-Site Private Training available. • Scheduled workshops start at $59. • 1/2 day miniclasses target specialized topics. 1 thought you 'd be interested that a guy as far away as Oklahoma really enjoyed your article "Medicine is a Game of Power" in Buffalo Physician. Thirty years ago, I took a watered-down version of the Oath of Hippocrates, which I suppose you will soon do. But keep in mind the spirit of the original . And the violations of it. In my opinion, in spite of "powerful enemies, " the intrinsic value of a good physician is tremendous and will prevail. Water finds its level. Third-party pay is inherently corrupt. You will be more valuable than you think. r Cordially, Summer hours: Mon thru Fri I 1-S Ed Ellis , M . D . Rowland Ellis Flatt Clinic Antlers, Oklahoma A non-profit UnivefSIIy program for students, faculty & staff The Commons • North Campus • (716) 645-3554 • Fax : 645-3884 B u f f a I o P hysician Summer 1 9 9 7 �• · · ··· · · · ·············· · ········ ··· ·· · ······· · ·· · · · ···· · ········ ·· ··· · ·· · ··· · · · ·········· New Alumni Association ollicers elected ared C. Barlow, M.D. , was elected president of the Medical Alumni Association at Spring Clinical Day on April 26. Barlow, an anesthesiologist, is medical director and administrator of the Millard Fillmore Surgery Center in Williamsville, Y, and serves as chair of anesthesiology for the Millard Fillmore Health System. A UB clinical associate professor of anes- Jared C. Barlow thesiology, he graduated from the medical school in 1966. Barlow was recently appointed to a three-year term on the New York State Committee on Quality Measurement, which develops quality measures and promotes research on clinical practice guidelines. He succeeds Jack F. Coyne, M.D ., as president of the Medical Alumni Association. Elizabeth L. Maher, M.D., becomes vice president of the Medical Alumni Association. Maher is a 1985 graduate of the medical school and a UB clinical instructor of medicine. A specialist in family medicine , she is an emergency department Elizabeth L. Moher attending physician at Medina Memorial Hospital. Richard Collins, M.D. , a primary care physician with the Buffalo Medical Group, is the new treasurer of the Medical Alumni Association. He also served as program director for Ri(hord Collins Spring Clinical Day. + Alumni Association honors four our prominent alumni were honored with Lifetime Achievement Awards from the Medical Alumni Association at Spring Clinical Day. Pictured below, from left to right, they are Jack Lippes '4 7, Eugene Marvin Sigman '52, Ross Markello '57, and Richard Ament '42. Of Lippes' research into reproduc- Left to right: Lippes, Sigmon, Morkello, and Ament tion and contraception, his best known work is the invention of the S-shaped intrauterine device known as the Lippes Loop. His biochemical studies of oviductal fluids have also been instrumental in developing treatments for infertility. A UB professor of gynecology and obstet- ® rics , Lippes has served as an international family-planning consultant to the World Health Organization, as well as numerous countries. He serves on the IUD committee of the International Planned Parenthood Federation. Sigman held positions in the Departments of Urology and Surgery at UB, Buffalo General Hospital, and Roswell Park Cancer Institute before moving to the University of Connecticut as professor of surgery and chair of urology. In 1985 , he became dean of the University of Connecticut School of Medicine, a position from which he recently retired. Markello , a former chair of anesthesiology at UB and E. J. Meyer Hospital (now Erie County Medical Center), recently retired as associate medical director of Independent Health of B u f f a I a Western ew York. He served UB as assistant dean for graduate medical education from 1978 to 1981. Markello has held a Sloan Fellowship through the Massachusetts Institute of Technology School of Management's Health Executive Development Program. Among numerous other professional honors and activities , Markello served from 1980 to 1981 as associate project director of the Love Canal Cooperative Health Study for the Centers for Disease Control and Prevention . Ament , a clinical professor of anesthesiology at UB , is a past president of both the American College of Anesthesiologists and the ew York State Society of Anesthesiologists. He also served on the executive committee of the World Federation of Societies of Anesthesiologists and as secretary of the Council of Medical Specialty Societies. An active member of the American Medical Association , he has testified on medical issues before Congress and the U.S. Justice Department. + -J.A. Physician Summer 1 9 9 7 �Reunions at 60th annual Alumni Weekend 1 9 4 7 First row (left to right): Ferdinand Paohm, Hallie Buchanan Mont, Peter Juhan, Robert Ehrenreich Second row (left to right): james Philhps, james Stagg, Arthur Schaefer, Daniel Curtin, Phihp ReitZ, Donald Nuwer, Ste\'en Cline, William Baker, Harold Pescovitz, David ichols, Elbert Hubbard Ill Third row (left to right): Robert jaeger, Robert Segal, Robert Dean, john Sheffer, Hans Kipping, Frederick Whiting, john Waite, john Weiksnar First row (left to right): Oli\·er Steiner, Burton tulberg, Bern1e Dm•1s, Phoebe aturen, Kurt Wegner, james Szabo Second row (left to right): eil Fuhr, Eugene Sigman, Donald Dohn, Victor Panaro, Ralph Obler, joseph Gene\~ich, Melvin Oyster, Alfred Lazarus, Wilbur Schwanz, S. Aaron Simpson, Robert Baumler, Donald Sprecker 1 9 5 7 First row: Roberta Gilbert Second row (left to right): George R. Tzetzo, David Carlson, Anthony Markello, joseph Armenia, Arnold Lubin Third row (left to right): jack Fisher, Sebastian Fasanello, Paul Loree, Owen Bossman, Robert Klocke, john Cudmore, Philip Morey First row (left to right): Charles O'Connor, Gregory Thorsell, Ben Celniker, Bronson Berghorn, Ross Markello, Richard Miller, Hilliard jason Second row (left to right): Bernard Wakefield, james Lasry, Robert Carpenter, Germante Boncaldo, john Parker B u f f a l o p y s c a n 5 u m m e 9 9 7 �[ll 1 9 6 7 First row (left to right): Thomas Augustine, Laird Quenzler, John Treanor Second row (left to right): Margaret Brown, Thomas Sheehan, John Menchini, Douglas Sirkin, Adele Gottschalk, Linda Young, Richard Young, John Anderson, Ronald Josephson, Barry Epstein Third row (left to right): Frank Perlroth, Rocco Venuto, Michael Phillips, William Burleigh, Trevor Robinson, Jonathan Ehrlich, Harvey Schwartz, Alan Saltzman, Arthur Sosis, Donald Miller, Thomas O'Connor, James Giambrone, David Fugazzotto, Anthony LoGalbo First row (left to right): Dennis Gross, Virginia Hawley, Robert Einhorn, Linda Kam, Joseph Oliver Second row (left to right): Alan Ast, Stuart Rubin, Robert Folman, Ian Frankfort, Martin Brecher, Murray Morphy, Richard Rivers, Russell Elwell First row (left to right): Eugene Paul, Thelma Caison-Sorey, lldiko Kondray, Antoinette Wozniak Second row (left to right): Alan Kuritzky, Howard Lippes, Albert Schlisserman, Steven Stone, Helen Marie Findlay, Kevin Greenidge, Nedra Harrison, Gregory Young, Janice Williams, John Norlund, Richard Terry, Michael Kressner First row (left to right): Gerald Harster, Michael Cesar, Joseph Leberer Second row (left to right): Timothy Gee ring, Joseph Gelormini, Mary ® B u a 0 Kelly, Elizabeth Barlog, Kevin Barlog, David Kurss, Michael Bartlett Third row (left to right): Joseph Gioia, R. Scott Crandall, Philip Stegeman, Benjamin Contessa, Joseph Wayne p y a s m m e 9 �First row (left to right): Beth Wutz, Elizabeth Conroy, Katharyne Sullivan, jack Hsrao, Patricia Reddin Vories, Marie Longo, E\·elyn Coggins, Stephanie Fretz Second row (left to right): Randall Loftus, Mark Swetz, Cynthia jensen, George Pancio, Mrchael Longo, Paul Paterson, Atle Skattebol (Identification not ava ilable befo re publication) If you come loolting for a car, you'll be a~vfully disappointed. HoWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who can answer anyof your questions about driving. A4x4, of course . •, Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) B u f f a l o P hysic i an summer 1 9 9 7 �• ......................................... . THE ULTIMATEDRIVING MACHINE: • 9 1 3 0 5 ogy and was named McAllen's of "1996 Honoree. " Kuhl moved Y, writes, "From the to south Texas after complet- forgotten '30s: Last time 1 ing his residency in dermatol- HENRY H . Snyder, HAIN ES ' 33 , checked, there were ten M.D.s ogy and serving in the U .. from 1933. 1 sent a letter to all and was immediately informed Army and the Public Health Service. In addition to his prac- there were nine still alive. Some tice, Kuhl helped found a clinic are still healthy, one with a for Hansen 's disease and Checkpoint Foreign Car, Inc. Sales and Service 487 Kenmore Avenue Buffalo, NY 14223 stroke, me with two bypas es worked in the county venereal and cataracts, but still ambula- disease clinic. A past president tory. I'm still registered, for of the Texas Dermatological Society and a member of the 836-2033 etc.), but retired. 1 turned 90 City Health Authority, he year old on May 4." served as clinical associate pro- Your WNY Leasing Specialist Serving WNY proudly for 33 years convenience (prescriptions, fessor at the University of Texas 1 9 IV A N W. 4 0 K UHL ' 45 , 5 of McAllen , TX, recently retired from his practice of dermatol- Science Center for 17 years. With his wife, Ruth , he raised nine children, two of whom have become physicians. TAKE TWO~ -.. AND CALL ME IN THE MORNING! f;'\d )o ... r OW'\ roaE * Fact: Saab owners have a higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the marl<et. ''The best m a de line in America" since 1913" 300 CRESCENT STREET • JAMESTOWN, N.Y. 716 664-5260 SOUTHTOWNS SAAB -Our Only Location- 3580 Southwestern Blvd (1 Mile east of Rich Stadium) Open Monday - Saturday 10-4 • MasterCard & Visa Accepted Take Thruway Exit 59, then Rt. 60 south to Jamestown. In Jamestown follow Rt. 394 east to Winsor Street; turn left on Crescent. Buy direct from our factory at wholesale prices. Save at least 50%. (?16) 662·800~ 8® 8 u f f 0 l 0 Physician Summer 1 9 9 7 �······································· · ··················································• HI ' 1 9 5 0 5 JAMES E . YOUKER '5 4 , of FRANKLIN ZEPLOWITZ '58 , in May. His new bride, of Buffalo, Margarita (whom he met in medicine.Iwillbeteachingstudents and residents in the ambulatory setting. Y, is the new Hartland, WI, received the president of the Bogota on Project World Gold Medal of the Association Medical Society Health), graduated in 1996. of University Radiologists at its of the County of They matched in Seattle for 45th annual meeting in Dallas, Erie. He suc- neurosurgery and family practice, respectively. David Sherer system chair of pediatrics for Atlantic Health System in annually to an outstanding ceeds Russell Bessette '76. '69 has been hospitality king radiologist for long-term Zeplowitz during the interviews." contributions to education, the TX. The honor is awarded is 1 9 7 0 cago, IL, has been elected vice and is chair of the radiology as a clinical instructor of sur- president of the American Soci- ERIC RUSSELL '74 , gery at UB. Lackawanna, classmate Rasinski julius Jr. '59, of Durango, CO, retired early in 1996 as a family practitioner. He had he will be re- of Chi- Sandra Fernbach, M.D., was el- Victor system chair, sponsible for merging all pediatric care un- ety of euroradiology. His wife, College of Wisconsin. 9 of ], has been named 5 director and chief of staff at 1 FELD '79 , J. As the first Our Lady of Victory Hospital in Lackawanna, NY, and serves of Y, writes: "Our Randolph, medical research, and patient care. DANIEL C . KOZERA '59 , LEONARD G . Florham Park, Youker practices at Froedtert Memorial Lutheran Hospital department at the Medical 6 0 5 evated to the executive council of the American Roentgen Ray WILLIAM E . ABRAMSON '60 , of Baltimore, MD, recently Society. KAREN tification in addiction medicine from the American Society of Addiction Medicine. der one department for the hospitals and the outpatient facilities. Atlantic Health System serves as a major teaching affiliate for both passed the examination forcer- been the team physician for GLASGOW '76 , of ew jersey Medical School and Co- Columbus, OH, writes, '·Re- lumbia University. Feld has been cently, I left a multidisciplinary chief of pediatric nephrology, director of the Children's Kid- group practice to become the the California Angels ever MOIRA J . of assistant program director of ney Center, and professor and since the team was founded. Tampa, FL, writes: "Two new internal medicine at Riverside vice chair of pediatrics at UB and He also served as team physi- physicians have been added to Methodist Hospital in Colum- the Children's Hospital of Buf- bus, where my husband, Pat Hayes '76, practices emergency falo since 1983. cian for the L.A. Rams." BURK E '69 , my family. My son, Brendan, graduates from medical school NICHOLS MIDDLE SCHOOL • Challenging, innovative curriculum • Outstanding preparation for high school • Average class si:e of 14 students • Interscholastic sports • Comprehensi,·e visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: 875--8212 B I u f f a l a p 1 c i a n 5 m m e �• •••••••••••••••••••••••• . HURWITZ & FINE, P.C. I [ 1 EDWARD 9 A. 8 TORIELLO 0 ATTOR EYS AT LAW I I N F I N IT I 5 S ERVICING '80, of Brooklyn, THE L EGAL NY, was appointed to the board of directors of the American Academy of Orthopaedic Surgeons at the organization's 64th annual N EEDS OF THE meeting in February in San Francisco. He is H EALTH S cm cEs chieJ of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, and is attending orthopaedic surgeon at St.john's Queens Hospital , Catholic C OMMU ITY Medical Center, in Queens. Toriello also serves on the board of directors of the New York State Orthopaedic Society and as a • Purchase & Sale of Practices The f ront-wheel Jrive lnj initi® 130n 1 • Managed Care • Business & Tax Planning delegate for the Medical Society of the State of ew York. An titterior more .•paciotM than a Roll• Royce Sil<•er Spur 11!. An e:rceptionally gmmllt.J li.<t of .<fanJard lu.-rury feature,<. A 190-hp V6 mpable 4 out-acceleratin,q many lu.mry v&•. AnJ of cour.<e, the ,</andard-,<elling performance and ,<erl'ict of lnfiniti. • HCFA Safe Harbor Regulations SJ99 mo. 56 mo. lean $999.00 dOII'n and Physician Self-Referrals LYNDA KARIG HOHMANN '81 , of Albany, Y, writes that she joined the Capital Dis- • Contracts with Private trict Physicians Health Plan as associate medical director. Prior to that, she had been & Public Entities medical director of a local addictions pro- • Employee Relations gram for four years. "Heather, my daughter, turns 21th is year and plans to go to medical Counseling school in another year." JANET • Fringe Benefit Programs '84 and JOHN '84 , of Morgantown, WV, WILL I AMS BARBACCIA • Representation Before Government Agencies on announce the birth of their fourth child, Nicholas Andrew. He joins Katie (5), Matthew (3), and Thomas (1).john is residency Audit & Business Issues • Facility Finance director for the Department of Anesthesiology at West Virginia University; janet is research director in the university's Department of Emergency Medicine. and Construction • Credentialing and By-Laws MARTHA PAVLAKIS ln t r ouu cing tbe a ll n ew 97' QX4® f r om SJ5,550. 00 in an lnfiniti® QX-1®, one of tbe fit-.<1 !bing.< you'll e,<cape 1~1 tbe mtmdane. Becau.1e !be QX-1 i.1 not your typical lu.-rury .<portuttlity l'tbicle. lflbi/.e it 1!{/erd all tbe l'tr.latility you e:rpect from a l'ebicle of it.< kint), tbe QX-1 offer.~ .Jome/ bin.9 you Jon 't e.~flecl: tbe lu.~·ury of an lnfiniti. '88 , of Stanford, CA, • Hospital/Medica l Staff Issues is an assistant professor of medicine (nephrology) at Stanford niversity Medical Center. "My clinical work is in kidney and pancreas transplantation, and my research Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 interests are acute rejection and gene expression in transplant dysfunction. " I N F I N IT I AUTO PLACE INFINITI 8129 MAIN ST. , WILLIAMSVILLE 633-9585 '88 and MARY DAVITT Y, write, "We are proud to M ITCHELL TUB LIN '88 , of Albany, East of Transit Rd., Near Eastern Hills Mall announce the birth of our third son, Andrew james Tublin , on October 15 , 1996. Andrew joins Daniel (4) andjoshua (18 months) in ® 1300 Liberty Building Buffalo, New York B u f f a L o ( 130-$450). Bank fee + tax and license due at mception. 12,000 annual mileage. $.15 per m1le in excess. Physician Summer 1 9 9 7 �.........................................................• 11 ' Advertise in one of the finest publications in Western New York ... the Tublin gang! Mitch is assistant professor of radiology at Albany Medical Center; Mary state, and national levels." He had served for four years as the student representative to is practicing pediatrics, also at Albany Medical Center." the medical society's advisory council, and as student councillor to the ew York State Medical Society's governing council. He is CAROL V. R . DECOS T A ' 89 , of Brooklyn, NY, writes, "I was recently promoted to associate director of outpatient rehabilitation at the Staten Island Univer- Buffalo Physician sity Hospital. My practice also includes sports medicine. I was one of the physicians who covered the volleyball players during the Centennial Olympic Games in Atlanta last summer. " RUff"tU f"~S\[\"" 9 9 0 5 MARY RITA MURPHY '90, ofMarshalltown, lA, has moved from Tucson, AZ, to Iowa and will be in private practice with a partner starting in October. She writes that she is happily married and has three sons, ages 5112, Jih, and 18 months. (716) 645-6933 Michael J. Baranski Marketing Representative ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 1412 7 a u t f o 1 o P hysic Levey is starting a residency in obstetrics and gynecology at George Washington University. RESIDENTS A . SWIANTEK ('73-'76), of Williamsville, Y, is in the process of pat- enting an instrument for prostate surgery called the ortech Sled. The instrument allows surgeons to perform electro-surgical vaporization for soft-tissue resection and desiccation. He writes that the procedure resects through soft tissue, prevents postoperative bleeding, and yields high-quality of Vienna, VA, tissue samples for pathological analysis. writes: "I have been appointed to one of the chief resident positions in the Georgetown OBITUARIES CRAIG CHEI FETZ ' 95 , Internal Medicine Program. I have recently won an award as a finalist at the Washington Regional American College of Physicians meeting for a poster presentation on Rhodococcus equi pulmonary infections. I have been elected to serve on the ACP Washington, DC, Regional Associates Council." REGINA Y. K I M '97 . of Akron, OH, is starting her family medicine residency program at Akron City Hospital!NEOUCOM . "I got married on October 12, 1996, in Rochester, NY, to Edward B. Yoon , M.D. , who is a fourth-year OB-GY resident at Akron City Hospital. We have a new yellow Labrador pup named Scout." BARANSKI also an alternate delegate from the AMA Medical Student Section to the American Medical Association's House of Delegates. PHILIP 1 Give us a call : I K E NN ETH L E V E Y '97 , ofBuffalo, Y, was honored by the Medical Society of the County of Erie at its annual meeting in May. He was recognized for "being an enthusiastic representative of organized medicine at the local, o n 5 m m e 9 9 7 ROBERT OEH L ER ' 38 , of Amherst, NY, died May 23 , 1997, after a long illness. The retired surgeon and veteran of World War II was 82. Born in Buffalo, he attended School 53 and was a graduate of East High School. After earning his medical degree, he completed his residency at Buffalo General Hospital. He entered the U.. Army in 1941 , serving until1946. His assignments during the war included duty on the Aleutian islands off Alaska. Oehler returned to Buffalo after the war to open his surgical practice and was on staff at Buffalo General Hospital and Children's Hospital until his retirement in 1979. He was a member of the American College of Surgeons, the American Medical Association, the Buffalo Surgical Society, and the Gross Medical Club. An avid fisherman and hunter, he was also a member of the Buffalo Athletic Club. He is survived by his wife of 4 7 years, the former jean Yeo. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] Magnificent BUILDING LOTS . I of Williamsville, Y, died March 23, 1997. A pioneer in alcohol rehabilitation, he helped the American Urologic Association. Among his honors were election to fellowship in both the American and the Royal Canadian publicize the concept of alcoholi m as a di ease and a public health problem. In Colleges of urgery. He served as president of the iagara County Medical Society and 1948, he started and directed the first alcohol rehabilitation center in ew York State. He also worked with Alcoholics Anonymous in treating patients. Born in Buffalo, the Buffalo Urological Society, and was an enthusiastic teacher as an assistant profes- KENNETH GOLDSTEIN ' 39 , Goldstein was the 1932 Buffalo Evening ews city tennis champion and state doubles champion. After earning his M.D. , he completed a residency at the former E. j. Meyer Memorial Hospital , and served as a major in the Army Medical Corps during World War II. Goldstein practiced internal medicine and gastroenterology in Buffalo, teaching at UB as a clinical professor and serving on the staffs of Millard Fillmore Hospital and E.]. to Tucson . He was hired by THMEP to serve as chief of urology and director of the urology training program at the County and Kino Community Hospitals from 1975 to 1983. After a brief retirement, Baer served eight years as the first urologist of the Salt Lake City FHP Medical Group before re- Medical Alumni Association. He is survived oughly enjoyed his full life with his family, by his wife, Loraine, and a son, Harvey R. his varied medical practice experiences, and his love of golf, traveling, sailing, and skiing. He is survived by his wife of 50 years, Babette; his three children, David (of Pied- BAI SC H '45 , of La jolla, CA, died last year at the age of 74. A surgeon, he was certified by the American Board of Surgery and the American Board of Thoracic Surgery. The Summit at &herff is a truly extraordinary residential development, unrivaled in Western New York. estled in the hills of Orchard Park, this magnificent 81-acres has been subdivided into 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. turning again to Tucson to retire. ever the type to consider retirement an all-ornothing event, Baer then served as a cruise physician for Society Expeditions. He thor- BRUCE F O RDIN G As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western ew York for many years, I've come to understand what members of our profession desire in a home site · privacy, tranquility, fresh air, and pristine surroundings. sor of surgery and urology at the University at Buffalo. In 1975 Baer and his wife moved Meyer. He was a past president of the UB Goldstein, M.D., UB Class of'77. Dear Colleague: Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the Buffalo skyline mont, CA), Laurence (of Laurel, MD), and janet Elisabeth (of Brookline, MA); and his • Mature woods and secluded ravines ten grandchildren; as well as by his brother, Howard (of Plant City, FL). • Quick and easy access to the freeway systems leading to Buffalo and the city's northern suburbs • Oversized lots for your dream house • Privacy, seclusion, and exclusivity R ICHARD A . BAE R '46 , of Saddlebrook, AZ, died March 26, 1997. He was born in iagara Falls, Y, on August 5, 1921. After graduating from the University of Michigan and the University at Buffalo medical school, he served a year's internship at Sisters of Charity Hospital in Buffalo before joining the U.S. Navy. He spent two years on the medical staff of the Great Lakes Training Center Hospital and then completed further training in surgery and urology at Mt. Sinai Hospital , Metropolitan Hospital, and Western Reserve University in Cleveland, OH. Baer then returned to iagara Falls, where he practiced urology for 22 years. He was a diplomate of the American Board ofUrology and a member of ® of Orlando, FL, died injanuary of cancer. Born in J O HN L AWR E N CE MU SSER ' 51 , The Summit promises to be one of the premier areas in Western New York to construct your ltLxury residence. 1 invite you to take a stroll through this picturesque setting. For our detailed brochure or a private shmving please call (716) 667-2237 or Buffalo, Musser served as a sergeant in the .S. Army from 1941 to 1945 in the orth African campaign of World War II before going to medical school. In 1958, he and his family moved to Hawaii , where he practiced (716) 472-3790. at the Hawaiian State Hospital in Paavilo Sincerely yours, and served as chief of psychiatry for Hilo Hospital and Institution of Mental Health. Musser also served in the Peace Corps. After returning to Western ew York in 1965, he Edmond J. Cicewicz, ~1.0. Past President, UB Nl.edical Alumni Association practiced psychiatry in Mayville, Y. He moved to central Florida in 1986 and worked for the Seminole County Public Health Department. He is survived by his wife, orma, THE SUMMIT AT SCHERFF and three daughters. 6 f f 0 l 0 O rcha rd Pa rk, New York p h y s I o n S u m m e 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. • MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. • These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1- 800-ASK- MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ledical ~ Uabinl\ \lutuallnsur.mi't> Company guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 @1996 Me :::.tl abi ty M tual M'!M.Inlr!G'- ..omp•ny �Non-Profit Org. BUFFALO PHYSICIAN U.S. Postage STATE UNIVERSITY OF NEW YORK AT BUFFALO PAID Buffalo, NY 3435 MAIN STREET BUFFALO NEW YORK 14214 Permit No. 311 ADDRESS CORRECTION REQUESTED Planned Giving to UB. Tax deductions and on ncome for l·fe ore only port of the benefits you con receive with planned g;v;ng to the UB School of Medic ne and Biomed·col Sciences. You needn't be wealthy, or a financial genius. All you need is to make a gift. And hove a desire to help today s budding geniuses make the wor 1d o beller place in 50 years For more information, contact Lyn Corder Ph D., CFRE, at (716) 829-2773, or v1o e-mail ot ljcorder@ocsu buffolo.edu. UNIVERSITY AT BUFFALO tate L"niwsity rf.\ ew l iJ1k � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1997 Subject The topic of the resource State University of New York at Buffalo. 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Spring Clinical Day UB's New Specialty Dental Clinics Dr. Congressman Medical School News Commencement '97 A Student's Perspective Alumni News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v31n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LB_HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b3edc60af2be48ce4d345841489ead09.pdf 90507d817819483b3b40c9aa2f51766f PDF Text Text --- - --------- - -- - State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1997 �BUFFALO PHYSICIAN \ olume 31, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole ~m1th Petro DIRECTOR OF PUBLICATIONS Kathryn .-\ Sa\mer EDITOR Judson \1ead (lntenm) ART DIRECTOR/DESIGNER AlanJ Kegler PRODUCTION MANAGER \nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John \\'nght, /ntcmn Dean and V1<r P•cllllrntfor Climwl A{fw11 EDITORIAL BOARD Dr Bertram Partin, Chail Dr \t1artm Brecher Dr llarold Brodv Dr Lmda J . Corder Dr Alan J . Drmnan Dr james Kanski Dr Barbara Majerom Dr Elizabeth Olmsted Dr Charles Paganelli Dr Stephen ~pauldmg Dr Bradley T Trua' Roy Vongtama Dr Frankhn Zeplow 1tz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal .\1iclwcl Sha" The Chlidren·s llospnal of Buffalo Eric County 'Vted1cal Center Mercy Health System Mlila~d Fillmore Health '>ystem Frcmll Sm·a Niagara falls Memonal Med1cal Center Roswell Park Cancer lnsutute ~!Sters of Chanty llospnal Dl'mm .\1cCw thy Veterans Affairs Western New York Heahhcare System The Stale vni\'CrSil\' of New York at Buffalo If) Buf{tdo Pl11 sician IS published quarter\) b\' the State UmverSil)' of Ne" York at Buffalo School of Medicine and Biomedical Sciences and the Office of Pubhcauons. It IS ~cnt , free of charge , to alumni , faculty . students, reSidents, ami fnends . The staff resenes the nghtto ed1t all cop\ and submissions accepted for pubhcauon Address qucsuons. comments , and submisswns to: The Ednor, Buffalo Plnsiciwt, State Lmvcrsity of Nc\\ Y~rk at Buffalo, Office of Publi cations , 136 Crofts Hall , Buffalo, m 14260 Send address changes to: Buffalo Physician , 146 B10med1cal Educauon BuHdmg, H 35 'Vtam ~lreel, Buffalo , NY 14214. Dear Alumni and Friends, As I POI>..;TED OUT TO THIS YEAR's INC0\11NG \1EDICAL STL>DENT'>, these are rapidly changing times, and the task of meshing the art with the science of medicine is becoming ever more challenging. Voltaire is said to have observed, "The art of medicine consists of amusing the patient while nature cures the disease"; yet the scientific basis of medicine continues to expand and now offers glimpses of disease mechanisms and body function that provide new and exciting vistas for the healing arts. But as Victor McKusick noted on a visit to Buffalo, "There is a widening gap between how to diagnose and how to treat, and between what we think we know and what we really know." I suspect that this statement is as valid today as it was just five years ago. We can take solace, however, in the fact that the quality of our entering class has not only been maintained but-no offense, alumni!-actually improved. Our curriculum has also changed: While it still has many of the traditional features familiar to most of our alumni, the new Clinical Practice of Medicine (CPM) and Scientific Basis of Medicine (SBM) courses introduce the art of clinical problem solving through the mechanism of self-directed learning. This should not only add a little excitement to the curriculum but also better equip our students to become "lifelong learners." Finally, we look forward to welcoming Stephanie Unger as the new editor of Buffalo Physician. A senior editor and writer with the City of Hope ational Medical Center/ Beckman Research Institute, in Duarte, CA, Ms. Unger will come on board in October. In the meantime, a very special thanks to Judson Mead, editorial manager of the UB Publications Office, for serving as interim editor. / ~ .127_/ ~f/L~ c:;7' JInterim Wright, M.D. 1~~~;R. Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dear Fellow Alumni, THE CLASS OF 2001, CONSIST\ G OF 135 FRESH\1.\"1 medical students, has embarked on an exciting journey. It is a bit shocking to realize that they will complete their basic medical school education in the next millennium. I'm sure I speak for all alumni in expressing my appreciation for the extensive skills and energy of interim dean Dr.john Wright. I look forward to his continued participation, counsel, and guidance as he works to maintain and improve the quality and status this medical school has achieved over the past two decades under the leadership of former dean Dr. john Naughton. This year we are excited about a new mentoring program, conceived by Dr. Wright, in which interested freshmen will be matched with alumni volunteers who will act as a friend and mentor, as well as serve as a source of information, advice, and assistance. I can't think of a better way for students to get to know the alumni and our association. We already have more than 100 students from the freshman class, and judging by the numbers of alumni volunteers, they seem to be equally enthusiastic. If any alumni who have not been contacted would be interested in participating in the mentoring program, please contact the Medical Alumni Association office. The mentoring program committee is being chaired by past Medical Alumni Association president Dr. jack Coyne. ~.,;;w, ~D~ President, Medical Alumni Association �V OLUME 3 1, N UM B E R 4 A UTUMN 4 Dr. Mahoney Becomes Dr. Mahoney 8 DNA on Ice ROSWELL PARK ' S DNA LIBRARIES-FROM G IVING UP A SILKWORMS TO PLASMODIUM VIVAX. by Jessica Ancker CAREER IN 1 997 "The Woman's Way of Seeing and Doing" 12 PUBLIC HEALTH FOR REFLECTIONS ON MEDICINE. PIONEERING WOMEN I N by Michael Beebe MEDICINE AT UB. by Christopher Densmore Research GAIT-RELATED PROBLEMS. PESTICIDES AND BREAST CANCER. HIGH CHOLES- TEROL AND STRESS . Orientation '97 LET THE HARD WORK BEGIN! Development Medical School News MEDICAL SCHOOL REUNION A Student's Perspective LESSONS FROM THE GIVING PROGRAM. MINI MED SCHOOL. LATE MIDDLE AGES. P AG ANELLI HONORED . PET CENTER GRANT. MAGGIE Alumni News WRIGHT RETIRES. TONE .JOHNSON .JR . DEAN'S ADVISORY COUNCIL. UB COMPLETE S WHI E NROLLMENT . by Judith Toski, Class of 2000 '75 AWARDED BRONZE STAR. 1 9 9 8 SPRING CLINICAL DAY PLAN S. Classnotes �mr· ................................................................................. UB researchers study gait-related problems ALTERED STRIDE MECHANICS MAY LEAD TO SECONDARY INJURIES sing a force-measuring treadmill called the Gaitway, developed by the Kistler Instrument Corp. of Amherst, Y, in conjunction with the UB biomechanics laboratory , UB researchers are looking at two distinct kinds of gait mechanics: running after a leg injury , and walking after hip-replacement surgery. RLN"'ING INJLRIES One area of interest is the relationship between initial and secondary injuries in runne rs . Harold Burton, Ph.D. , UB associate professor of physica l therapy and nutri- ~ tion and exercise science, and his : coinvestigator on the study ,john Leddy, "' M.D., associate director of the UB Sports Medicine Institute, have been able to show that runners who develop a muscle injury in the lower extremities alter their running pallerns unconsciously after an injury. This change in running mechanics causes a deviation in the foot's normal impact and push-off force , which can be measured on the treadmill. A change in running mechanics may affect the way that force is dissipated. As a result , the added or altered forces are absorbed by joints and/or muscles unaccustomed to this stress, which may lead to a secondary injury in areas such as the knee , hip , or lower back. "By getting an idea of how a person with a particular problem changes running strategy, we hope to eventually identify a pattern and predict the risk and location of a secondary injury," 0 Burton says. "If we can predict what's going to happen , intervention with corrective measures , such as an orthotic, can prevent the secondary injury from occurring." The study, which involved 10 male recreational runners , examined the effect of injury to the thigh muscles. After coll ecting baseline measurements during level treadmill running, researchers had the participants induce muscle "injury" by running downhill for two 20minute sessions. Downhill running can cause microscopic muscle-fiber tears. For four consecutive days following the injury session, researchers recorded the walking pallern a patient has developed to cope with the pain of arthritis. According to Scott White , Ph.D., associate professor of physical therapy and nutrition and exercise science, relearning a proper walking pallern helps to prevent injuries after surgery and speeds rehabilitation . White is using a Kistler treadmill equipped with a computer that displays measurements of force for patients to read as they walk. When reinforced by verbal coaching from a physical therapist, the visual aids can help patients see the problems with their gait and get immediate feedback on improvements. vertical foot-ground reaction force generated by each runner during level treadmill running. Results showed that the runners who got sore, or "injured ," after running downhill produced altered forces during the next running session, indicating alterations in running mechanics. "These altered mechanics may predispose the individual to secondary injuries of other structures, such as joints, ligaments, and tendons ," Burton says. Among runners , this is no small problem. According to Burton, 50 percent of the people who run regularly experience some type of injury during any one year and need more education about what can happen as a result. A patient with a pronounced limp , for example, can be shown two rectangles that represent the relative lengths of the strides he makes with his right foot and with his left foot. By trying to make the two rectangles match in size as he walks, the patient learns what the correct, symmetrical walking pattern feels like. The Gaitway system's software also lets researchers record the data and perform a number of different analyses. In a three-year study funded by the Arthritis Foundation, White is testing the technique on a prototype Gaitway machine , working in collaboration with Robert Lifeso , M.D., clinical professor in the Department of Orthopedic Surgery, who performs hipreplacement surgery and often refers his patients to White's group for postoperative therapy. + HlP REPLACEMEt\TS Hip-replacement surgery can take care of the pain and immobility associated with arthritis, but many times it fails to correct a related problem-the cramped B u f f a l o - L OtS physician B AKER AND JESSICA A NCKER Autumn 1 9 9 7 �· · · ···· · · · · · ···· · · · ···· · . ... . . .. . . . . . . . . . ... .. ..... . . .. . m .... . ················· [(1~--~ .. . Study questions breast-cancer High cholesterol boosts blood risk trom pesticides and PCBs for pressure in high-stress situations women who breast-feed eople with normal blood pressure n research involving 154 postmenopausal women with breast cancer and ] 92 healthy \\Omen of similar age selected randomly from the general population, Kirsten Moy ich, Ph.D., research instructor in the UB Department of Social and Prcvcnti,·c Medicine and chief investigator on the study, has found no link between breastcancer risk and exposure to pesticides and PCBs in \Yomcn who breast-fed. Researchers measured blood levels of certain organochlorines-DOE, HCB, mircx, and PCBs. Since these compounds arc stored in body fat and arc not easily broken dm.,n , they accumulate in the body over time. Some of these chemicals ha\ c been shown to increase estrogen activity in animals and consequently have been linked to breast-cancer risk. \\'hen separated into groups according to histor) of breast-feeding, .,.,-omen '" ith breast cancer who had never breastfed had significantly higher levels of organochlorines than healthy women who had nc,·cr breast-fed. "These chemicals arc stored in fatty tissue, including breast tissue ," Moysich savs. "The chief mechanism for climin;ting them from breast tissue is lactation , .,, hich Oushcs them from the svstem." She adds that even though tl1c nursing baby is exposed to these substances, the beneficial effects ofbrcastfccding appear to outw cigh potential risks associated '' ith these organochlorines. The study was p rcsc n ted at the International Socict} for Environmental Epidemiology in Taiwan in August. + --- B u f f 0 I 0 can experience greater increases in blood pressure during stressful situations if they have high cholesterol, according to a study published by Bong Hce Sung, Ph.D., UB associate professor of medicine, in the june issue of the American journal of Hypertension. Conversely , the study found that lowering cholesterol with drugs and diet also lowers stress-related increases in blood pressure. It is the first study showing a link between cholesterol levels and hypertension. "We don't know the cause of high blood pressure in 90 percent of hypertensives," Sung says. "These findings shed some light on the mechanisms that cause high blood pressure, opening up possible new avenues for treatment and prevention. "Our results indicate that lowering cholesterol may have the added benefit of controlling blood pressure better during stress, which will lower the chances of developing hypertension and heart disease." The effect of cholesterol on vasoconstriction has been well documented in isolated peripheral vessels, but until now the o,·erall effect of cholesterol on blood pressure has not been studied. To assess the relationship between high cholesterol and blood pressure, ung and colleagues established a study group composed of 70 people with normal blood pressure, 33 of whom had normal cholesterol and 37 with high cholesterol. Blood pressure was monitored in both groups while they took a mental arithmetic test , a standard method to simulate psychological stress. Physician Autumn 1 9 9 7 ~ Researchers added stress to the equation, Sung says, because a dramatic increase in blood pressure during physical or mental challenges has been shown to be a risk factor for later development of hypertension and cardiovascular disease. Recent evidence also shows that the damage to organs caused by hypertension is more closely linked to blood-pressure response to stress than to "casual" blood pressure. Results showed that during the stress test, systolic blood pressure increased to the hypertension range (greater than 140 mm Hg) in 46 percent of the high-cholesterol group, compared to 18 percent of the normalcholesterol group. Sung says that high cholesterol appears to impair the ability of the endothelium (blood-vessel lining) to relax and constrict normally. The study's second phase was designed to determine if lowering cholesterol lowers blood-pressure response to stress. ln a double-blind design, half of 26 members of the high-cholesterol group took a cholesterol-lowering drug for six weeks, while the other half received a placebo; the protocol were then re,·ersed. Total cholesterol fell 26 percent during drug treatment. Participants repeated the mental arithmetic stress test after both the drug period and the placebo period. Results showed that peak systolic blood pressure during stress dropped from 141 mm Hg without treatment to 133 mm Hg after treatment. Sung's coauthor on the study were joseph L. lzzojr., M.D., UB professor of medicine and professor of pharmacology and toxicology, and Michael F. Wilson, M.D., UB professor of medicine. + L o 5 8 A K E R �~f~HI[~ ~f~f~H~ are key to progress in genetics research If DNA is the book of life , the laboratory of Pieter dejong , Ph.D. , is the printing press . BY JESSICA PHOTOS 0 B u f BY f a K l o He and his colleagues in the Human Genetics Department at Roswell Park Cancer Institute are the world's leading suppliers of the DNA libraries that make genetics research possible. They have supplied the gene libraries in which the two breast-cancer genes (BRCA1 and BRCA2) were identified in 1994 and 1995, as well as a host of less ANCKER famous genes involved in such illnesses as C . KRATT spinal muscular atrophy , pancreatic tumors, and Wilm's tumor. More than 40 research centers in 10 countries are using dejong's libraries to hunt for specific genes , create gene maps , or sequence large stretches of human D A. Their work makes them a crucial participant in the Human Genome Project. They're also applying their methods to a wide variety of other organisms, building libraries of the DNA of mice , rats , baboons , silkworms , the Legionnaire's disease organism Legionella, and the malaria parasite Plasmodi um vivax. They're even working with genetic material from a Doberman pinscher that suffers p hysician A u t v m n 1 9 9 7 �library and its copies occupy three tightly packed seven-foot freezers. "So, clearly, you can see that one of the things we need is technical improvements so the libraries will take up less space," de j ong says. The libraries are shipped to researchers all over the world. One of the biggest advantages of using a standardized library is that it provides a common reference system. lf, for example, a scientist identifies a disease gene made up of several fragments from de jong's DNA library, other researchers anywhere in the world can verify the work by placing an order with de jong for copies of those bacterial colonies. A LTER from narcolepsy, supported in part by a grant from the American Kennel Club. "ln this lab, you get calls from the strangest places," de jong says. CR EAT ING LIBRA RIES ln de jong's lab, human chromosomes are cut into pieces between 100 and 300 kilobases long, and the pieces are linked to fragments of artificially produced bacterial D A. The resulting circular chromosomes are made up of mostly human D A but also include important elements that allow them to "pass" as bacterial chromosomes when they are inserted into bacteria. One of these is a D A sequence that ensures that whenever the bacterium divides, it will produce copies of the artificial chromosome for the daughter bacteria. These bacterial artificial chromosomes, or BACs, are inserted into specially bred strains of the common bacteria E. coli. When the bacteria are properly cultured and separated, the result is an array of hundreds of thousands of separate bacterial colonies. Each colony, which is tagged with a unique identifying number, contains hundreds of copies of a unique fragment of human D A. Together, all the colonies are known as a library. Building the library is tricky work. At each step, many of the bacteria die from the unusual stresses imposed upon them. For example, electric shocks are used to punch holes in bacterial membranes so the BACs can enter-and the shocks are strong enough to kill a substantial portion of the bacteria. "At each step, we have a rather narrow window of opportunity," dejong points out. The library can be stored indefinitely by freezing in glycerol, or it can be copied by a "printing press" that dips a tiny metal spike into each colony, picks up bacteria, and touches a clean well of agar where the bacteria will grow and form a new colony of clones genetically identical to the mother colony. Dejong's lab makes 12 copies of each DNA library in order to accommodate requests from future researchers; a single ATE SYSTE MS IN v ENTED Although there are many ways to build aD A library, most have serious drawbacks. Some techniques package the human D A fragments into viruses, which then infect bacterial cells. But to fit in the viruses, the human DNA has to be cut into very tiny pieces; and since human genes may be as long as 1,000 kilobases, it's not very useful to have to cut the D A into fragments of only 15 kilobases or so. The invention of the yeast artificial chromosome, or YAC, overcame the size problem, but introduced other difficulties. YACs, which are grown in yeast, can be used for fragments of several hundred kilobases-large enough to contain an entire gene, or at least a substantial portion of one. However, up to 60 percent of these fragments are altered in unpredictable ways in the yeast. Sometimes, two or more pieces of human D A become inserted in the same YAC, making unrelated human D A sequences appear to be neighbors. Other times, the YAC D A gets rearranged or combines with other YACs inside the yeast. �~(~[ll[~ ~(~(~H~ Today, de Jong and many other scientists usc a system based on the bacterial artificial chromosome, or BAC. ABA can accept large fragments of human D A, and bacteria faith full} reproduce them without confusing rcarrangemcn ts or recombinations. Dejong also uses a libra[} system he invented several years ago, a variation upon the BAC called a PAC because it uses some fragments from an organism called the rl bacteriophage. His PAC librar) is being used b) researchers all o<.er the world, including the world's largest gene- equencing center, the Wellcome Trust Centre for Human Genetics, in England. "They sequence more than all the other centers put together, and they use our PAC libra[} exclusively," dejong says. ETHICAL TROUBLES RESOLVED The Human Genome Project was in full swing, with research APPLICATIONS I CA CER RESEARCH delving into four major D A libraries (including dejong's), Libraries from Roswell Park haw already been instrumental when an international dispute broke out about ethical probin Identifying the t\\o known breast-cancer genes and in lems involved in the collection of the D A samples. It was studying man} other cancers. discovered that the samples in the libraries were not taken In an example from Roswell Park , dcjong's PAC library is from a cross section of the population, but from a few donors helping to pin down precise information about the chromowho worked in the laboratories, and that these donors had somaltranslocations that cause leukemia. never signed informed-consent releases. Also, no measures Peter D. Aplan, M.D., a member of the Ros\\cll Park had been taken to safeguard their anonymity, leading to the faculty and a B assistant professor of pediatrics and of possibility that they could run into trouble obtaining health microbiology and immunology, says that many research insurance if any genetic anomalies were discovered. methods can provide some information about these transloThese problems arose when the researchers who were cations, but only molecular biology can pinpoint the exact building the libraries treated places where chromosomes the human samples as they break and rejoin. "We want to Some ethicists fear that genetic would samples from other ornarrO\> it down to the precise information will lead to the temptation ganisms. "The focus was not base pair ," he says. on the individual. It was on the Aplan and his colleagues to tinker with the human genome. species," de Jong says. compare D A from leukemia cicntists involved with the patients \l-ith DNA from de Human Genome Project also worried that they would be accused jong's PAC library. B} subjecting both to digestion \\Ith of elitism for studying only the genes of fellow scientists. restriction enzymes , and then comparing the patterns of In response to the findings, the ational Institutes of resulting fragments , the researchers can narro\\ down the Health awarded grants to build a new set of libraries that location of the break-point to a region of less than l ,000 base comply with strict guidelines. Dejong's group was awarded pairs. This region is small enough to be sequenced in an $1 million to build two new libraries, one of DNA from a automatic D A sequencer. woman's white blood cells, the other from a man's. Dozens of "Pieter' Pl clones provide a framework that we usc to volunteer rc ponded to an advertisement in the Buffalo map our findings onto ," Aplan sa)S. cws, and after screening by Roswell Park's genetic counseUsing methods like these, Aplan has identified and charlor, 20 men and20 women were selected as potential donors. acterized a nm·el gene that , when disrupted by translocaThe final selection of blood samples was made on a doubletions, apparently helps to cause T-cell acute lymphoblastic blind basis, so neither the volunteers nor the scientist know leukemia. He has also studied the mechanisms of action of whose genes are in the new library. distorted gene products im olvcd in other leukemias and has The male D A library hasjust been completed; the female proposed an explanation for ho\\ chemotherapy for a prione is next. Meanwhile, the old libraric may still be used mary cancer can trigger therapy-related acute myeloid leukemia many } cars later. because the donors signed consent form , de jong says. 0 B u f f a L 0 Physician A u t u m n 1 9 9 7 I �TH E PROMISE Cancer is not the only target. By studying inheritance patterns in an extended family, researchers at ew York University have narrowed down the location of a potential epilepsy gene to a region of aboutSOO,OOO base pairs on one chromosome. They can go no further with gene mapping, so they have approached dejong about making aD A library from a particular patient thought to have the gene. And many of the world's most prominent genetics research centers, including the Wellcome, the Whitehead Institute/MIT Center for Genome Research, and the Sanger Centre in England, are using dejong's libraries to sequence human D A as part of the Human Genome Project. Each segment of human D A is subdivided until it is small enough to be analyzed by an automated D A sequencer. Some 16,000 of the estimated 50,000 to 100,000 human genes have been mapped, but the function of many of these genes is still unknown. A comprehensive sequence of the human genome will reveal many more unknown genes, so the next step must be to investigate their function through such techniques as comparing them with homologous genes from other organisms. There are many questions about the best uses of the new genetic information. Some ethicists fear that it will lead to the temptation to tinker with the human genome for trivial or monetary reasons. But Thomas Shows, Ph.D., chair of the Department of Human Genetics at Roswell Park, is optimistic that complete information about human genes will focus medicine on what he calls "preventive maintenance." "We could become predictors of disease," he says. "Preventive medicine is so much less expensive than treating disease after the fact. " Prenatal testing can already identify more than 200 genetic disorders. Ultimately, Shows hopes, physicians will be able not only to identify potential problems but to prevent them. "Genetic testing might allow DNA library plates are stored us to find out what cards we're at -85 degrees Celsius. dealt with in the game of life," he says. "Do we have a royal flush , or a couple of two's? Whichever, we need this information to play the game." + For more informoHon obout BACs ond PACs, visit Pieter de Jong's Web site ot http/ jbocpoc.med.buffolo.edu. j essica Ancl1er, a Cleveland-based freelan ce writer, is tlte fann er editor of Buffa lo Physician. 1. Extract DNA Human white blood cells are embedded in agarose, then digested with enzymes, leaving the DNA behind in the agarose gel. How to Build a DNA Library: THE RECIPE 2. Cut up DNA The DNA is incubated with a dilute solution of restriction enzymes, which cut the chromosomes at specific nucleotide sequences, producing a pool of DNA fragments of different lengths. 3. Select fragments In gel electrophoresis, small DNA fragments embedded in a gel move through an electric field at speeds proportional to their size. In order to separate large fragments, the orientation of the electric field is changed every few seconds in a process known as pulsed-field gel electrophoresis. Fragments of the desired size-] 00 to 200 kilobases-can be isolated using this process. 4. Build artificial chromosomes The DNA fragments are linked with the vector DNA to make circular bacterial artificial chromosomes, or BACs. Naturally occurring enzymes are used to seal the pieces of DNA together. S. Insert into bacteria Ashock of a few thousand volts of electricity creates a hole in a bacterium's membrane that lasts long enough for a BAC to squeeze inside, a procedure called electroporation.ln order to create enough holes in enough membranes, the jolt must be strong enough to kill a substantial fraction of the cells. 6. Weed out failures Only a few of the surviving cells will have successfully taken up BACs. Each BAC has been constructed with agene that confers resistance to a particular antibiotic. By exposing the E. coli to that antibiotic, the researchers can kill off any cells that don't have a BAC inside. 7. Grow colonies of clones The surviving bacteria are spread thinly over plates of growing medium and allowed to reproduce. Each colony will be made up of the genetically identical descendants of a single bacterium. 8. Plant colonies Arobot identifies the round white colonies, picks asample from each, and plants the samples in the library plates. Each library plate, which is about the size of a large index card, has 384 tiny wells filled with growing medium and thus can support 384 clones. Each well is identified with a unique address, and each plate is labeled with a bar code. An entire human genome library will contain more than 500,000 clones and fill some l ,500 plates. 9. Store or reproduce The plates can be stored indefinitely at -85 degrees Celsius. The colony-picking robot can also act as a "printing press" to make copies of the plates. �MARTIN MAHOI\L\ \\'.\~ON Ill.,\\;\\ to a stellar career in the field of public health as an epidemiologist whose doctoral dissertation revealed higher-than-expected cancer rates among Seneca Indians and as director of ew York's cancer-surveillance program-all before he reached the age of 30. He also had teaching appointments in the School of Public Health at the State University of ew York at Albany and in the Roswell Park Cancer Institute's graduate division. Arthur Michalek, Ph.D., a leading cancer researcher at Roswell Park who first had Mahoney as a student, then later conducted groundbreaking research with him, recalls that he had the makings of "a leader in the field." So what is Mahoney, now 35, doing with a stethoscope around his neck, checking a youngster's sore throat, asking an elderly patient how that new medication is working, and seeing anyone who comes in the door of the family practice clinic at the relatively low-profile DeGraff Memorial Hospital in orth Tonawanda, ew York? Mahoney, who still carries the oversized shoulders of a competitive swimmer from his undergraduate days at Canisius College, smiles at the question. "It's something I always wanted to do," he says. He obviously wanted to do it pretty badly. 0 e u f f a 1 o phys ici an Autumn 1 9 9 7 �PHOTOS BY FRANK CESARIO �- FROM PUBLIC HEALTH TO PRIMARY CARE ~--------------------------------------~ WHEN HE FIRST APPLIED to the University at Buffalo medical school in 1983, after graduating with honors in history from Canisius, he was not accepted (true of about 90 percent of those who apply). His grades were good, his board scores were okay, and he had taken the necessary science courses despite his history degree. He just wasn't close enough to the front of the line. David Valai k , Ph.D., his history professor as well as his swim coach at Canisius, doesn't think much of a medical school admission committee that would reject Mahoney. Valaik couldn't have asked for a better student or swimmer. Last year Mahoney was the first swimmer since Canisius started its swimming program in the 1960s to be inducted into the college's sports hall of fame. "Martin never needed the lecture 1 give to some students," Valaik says. "He had it. " Without the option of attending medical school, Mahoney decided to study epidemiology, earning both a master of science degree and a doctorate at UB before going to work with the ew York State Health Department in Albany. As director of the state's cancer-surveillance programs, Mahoney found both rewards and frustrations in public health. He suddenly had access to millions of health records and powerful computers to analyze the data . He traveled throughout the state, looking at clusters of cancer and trying to find relationships . But as he discovered in May 1989 , there are limits to what an epidemiologist can do . Mahoney came from Albany to orth Tonawanda with the results of his latest study, a look at cancer cases near a plastics factory. A nine-year survey of local medical records showed cancer was not on the increase. lt was not what the hostile audience wanted to hear . "We are not going to buy that ," said the city's mayor at the time , Elizabeth C. Hoffman , who had ovarian cancer herself. " ot when people see house after house with people with cancer." Mahoney felt the call of medicine and its more immediate results even more strongly after he first gained the confidence of the Seneca Indians and then published his study showing that cancer rates were much higher among that ative American population than expected. The study, and later work by Mahoney , Michalek, and others, showed that while cancer deaths increased by 4 percent in the general population, they jumped by 10 percent among ative Americans, who have the poorest cancer survival rates in the United States. Yet health-care providers to these Indian populations gave cancer a lower priority behind alcoholism, diabetes , injuries , and cardiovascular disease. "As a researcher," Mahoney says, "l thought it would be easy to implement. But I didn't see anyone jumping on it. " So in 1990, Mahoney again applied to medical school and this time , armed with credentials that most medical schools would die for, was easily accepted. B u f f a l a Mahoney's first rejection was reall y not unusual, says Roseanne Berger, M.D., associate dean for graduate medical education at the UB Medical School. "Despite the questions in the press about whether we're training too many physicians or whether income is going down , the number of applications to medical schools continues to increase. The talent pool is really remarkable ." But going to medical school and interrupting a successful career to do so is difficult, as Mahoney found out. He and his wife, Ellen, were expecting their first child (their daughter Christine is now 6), and they had to sell their home in Albany and go apartment hunting in Buffalo. Mahoney also had to give up a good income with the state and face stiff tuition bills again. His wife was behind him all the way. "Why not do it? " he says. "I figured this was always going to haunt me if I didn't." To put it mildly , Mahoney was not your typical medical student. He kept his teaching appointments at SU Y/Albany and Roswell , continued his research with his mentor Michalek, and picked up a part-time job as a medical epidemologist with the Buffalo Otolaryngology Group. "T hey were sitting on a large amount of data from their patients over the years, and I helped set up a database," he recalls. Mahoney, who received one of the public-health industry's most prestigious honors in 1992-thejay S. Drotman Memorial Award-for his pioneering research with the Senecas, also started making a name for himself in national medical circles. He was elected first as a student representative, then later as a resident representative, to the American Academy of Family Physicians' Commission on Public Health. Then this past spring, he received the American Medical Association's Glaxo Wellcome Leadership Award, the resident's award from the ew York State Academy of Family Physicians, and the MeadjohnsonAward for graduate education in family practice. Described by those who know him as soft spoken but vocal when he needs to be , Mahoney seems almost embarrassed by the attention . "I guess I've just been fortunate to be recognized for some of my accomplishments," he says. Mahoney feels that his public-health background is invaluable when searching for the cause of a patient's illness in the clinic. Like epidemiology, he reasons , medicine is a case of examining a problem thoroughly and then reducing the odds. If it's not this, it could be that; if you eliminate this , it might be that. Physician Autumn 1 9 9 7 �FROM PUBLIC HEALTH TO PRIMARY CARE - ~--------------------------------------~ Practicing medicine, in the same way, is helping him with his research. While serving part of his residency in the Deaconess Hospital, where he saw a mostly minority, low-income population, Mahoney noticed that many of the new mothers were not nursing their babies. "Physicians are naturally inquisitive, and would probably notice this and say something about it to their fellow physicians or spouses," says Berger, the associate dean and Mahoney's ultimate boss during his residency. But Mahoney's public-health background gave him the expertise and confidence to follow his curiosity and develop a questionnaire and a database to further study the reasons behind this phenomenon, she says. Noting that the results are still coming in, Mahoney says that it appears that breast-feeding in these women is not something that is passed down from one generation to another, perhaps because they have children at such an early age and the generations pass so quickly. His work at Roswell Park Cancer Institute, where his research partners include Michael Cummings, Ph.D., one of the nation's preeminent antismoking experts, has led him to what he feels is one of his most exciting projects: Tar Wars. Conceived by two Denver physicians and run in past years on a shoestring budget, Tar Wars has been adopted and funded by the American Academy of Family Physicians. Mahoney serves on the Tar Wars board of directors and is its coordinator in Western ew York. ''I've really bought into this," Mahoney says. "I think it's a terrific program. "You can't tell kids that smoking is going to shorten their life and that they may die when they are 40, 50, or 60 years old," he said. "When they're l l or 12, they think they're going to live forever. So we mention the negative effectsbad breath , yellow teeth, smelly clothes. Plus smoking costs a lot of money. It begins to get them to focus on how advertisers set them up. You never see these effects of smoking, or ashtrays or burns in the clothes in the ads. We get them to figure out how much smoking costs, about 60 or $70 a month. That's a small fortune for a kid-that's three CDs and a in tendo game." Mahoney intends to hit the road this year to spread the message of the Tars Wars campaign in classrooms. It's not that he has a lot of free time. In addition to his work , Mahoney and his wife now have two other children, icholas (5) and Madeline (15 months). He also is the medical director for the Cantalician Center for Learning; a board member of the Allegany Regional Development Corporation, which helps serve the Seneca ation of Indians in Salamanca, Y; and a board member for the iagara Frontier Vocational Rehabilitation Services, a group that trains and finds jobs for disabled people. And for the past year, he has served as vice chair of the residents section s u f f a l a Physician representing family physicians on the national Council on Medical Specialty ocieties. He is a founding member and on the steering committee for the etwork for Cancer Control Research in American Indian and Alaska Native Populations. In addition, he serves as a referee for five professional journals, including the Intcmationaljou rnal of Epidemiology, and he i an author, coauthor, or contributor to 57 research projects. "My wife understands my work," he says. "She knows this makes me happy. I'm one of the luckiest people in the world." Mahoney has just completed his residency-he also was chief resident-and signed a contract with the medical school, one that allows him to practice medicine, teach medical students, and continue his research. 'Ttl spend 60 percent of my time in clinical work, supervising residents and seeing patients. Twenty percent of the time I'll teach, 10 percent for administration, and 10 percent for research. That doesn't sound like a lot of research, but right now I'm doing all my research on my own time." It would have been simpler, of course, had Mahoney gotten into medical school the first time. But now that he's completed the training for his dual careers, he wouldn't have it any other way. His former mentor, Michalek, who has developed a deep friendship with Mahoney, says his medical degree helps Mahoney bring a fresh perspective to the public-health field . "I think he'll have the best of both worlds," Michalek says. "An M.D. has a real appreciation for the clinical approach. Most people in public health may have a Ph.D., but they don't have an appreciation for disease. That clinical training gives him the ability to better evaluate the research ." It also has a beneficial side effect for Michalek: After all these years of teaching medical students, Michalek has finally chosen one to serve as his own personal primary-care physician-Or. Martin C. Mahoney, Ph.D., M.D. + .\1ichacl Beebe is a reporter for the Buffalo Autumn l 9 9 7 ews. �MEDICAL STUDENTS �"DOES THE WOMAN'S WAY OF SEEING AND DOING EVER HANDICAP HER?" BY CHRISTOPHER DENSMORE , 'E HtJNDRED YE-\RS> AGO , - on April 27, 1897, Dr. Maude j. Frye addressed the graduating class of the University of Buffalo School of Medicine on the subject of "The Woman's Place in Medicine." An 1892 graduate of the medical school, in 1897 Dr. Frye was on the faculty as a clinical instructor in the diseases of children. I am going to use Dr. Frye's address, along with the recollections of UB's first female medical school graduate, Dr. Mary Blair-Moody, and editorials of Dr. Austin Flint that appeared in the Buffalo Medical]oumal, to illuminate the experience of these pioneering ._. women medical students. I will use, as much as possible, their own words. First, Dr. Frye: "I WISH TO PRESENT to you tonight some thoughts concerning woman's place in medicine; the limit of her work, [and) the line which she will oftenest follow. "Whether we like to confess it or not, woman's physical organization necessarily sets a limitto her achievements ... [Here Dr. Frye refers to the proposal that women serve in the National Guard. She is a bit skeptical.] In reckoning the chances of woman's success when she comes into competition with man, the physical factor has always to be taken into account. That medical work which makes the least demand on woman's physique is, other things being equal, that in which she will best succeed." In looking at the past, it is sometimes apparent that beliefs can change. One of the hot topics of the medical literature of the 1890s was whether women should ride bicycles: Would the exertion harm them? Of possible relevance here is an illustration in the first UB yearbook (the Iris), in 1898, of a woman with a bicycle waving a UB pennant. ow back to Dr. Frye: "IT IS, HOWEVER, concerning a feature of woman's mental equipment for work in medicine that I wish especially to speak. I do not expect many of you to agree with me, yet I ask you to think on these things. We must acknowledge between the average man and the average woman an unlikeness of mental capacity comparable to their physical unlikeness, a sex in mind, if I may use the term. This is not equivalent to saying that man is superior to woman. There is equality with diversity. The elm is not better than the oak, nor the oak than the elm, but each is B u f f a l o Physician good of its kind. There are mental processes which are identical in the sexes, there are others which may oftentimes give advantage to the woman in the work of the physician. Does the woman's way of seeing and doing ever handicap her? Let us try to answer the question." lt was this last sentence that first got my attention. A gendered way of "seeing and doing?" Sounds like Men Are from Mars, Women Are from Venus, and other books of that ilk. The debate about whether men and women are essentially the same, or essentially different, has been going on for some time, with, so far as I can see, little chance of final resolution. But to return to Dr. Frye: "IN THE EARLY DAYS when the woman who began the study of medicine was of heroic type, her success was assured from the beginning, for the courage which dared to commence the struggle was equal to any hardship or any emergency which arose later. She has opened the way for the woman of average ability, the woman who but for her pioneer work would be teacher or nurse. The average woman has not, as a rule, the daring of an Elizabeth Blackwell." Dr. Frye is speaking to us from a century ago, 1897. Fifty years earlier, in the fall of 1847, Elizabeth Blackwell had become the first woman to study medicine in the United States when she entered Geneva Medical College. Or rather, she became the first woman to be recognized by the Autumn 1 9 9 7 �medical profession as a physician. Women have been studying and practicing medicine for a lot longer than 150 years. We are in fact talking about the institutional recognition of women as physicians by the medical profession. Elizabeth Blackwell's story is not unconnected with the history of the University of Buffalo. In 1847, many of the people who taught at Geneva in the fall came to Buffalo in the spring to lecture at the VB medical school. All of the teachers at Geneva mentioned by Elizabeth Blackwell in her autobiography were also on the faculty here at UB. One member of our faculty (who did not teach at Geneva) was Austin Flint, after whom Flint Road on the university's North Campus is named. Dr. Flint was the editor of the Buffalo Medical journal and an early supporter of what was then the novel experiment of educating women to be physicians. ln an editorial published in January 1848, Flint looked forward to seeing women as physicians, even though he also stated that "We should regret to see any innovations tending to lead woman from her appropriate sphere-the domestic hearth and the social circle-but we can perceive no good reasons why females whose duties are not prescribed by domestic or social relation should be denied ... exercising usefully their faculties in the capacity of medical practitioners, under proper limitations." To modern sensibilities, this may seem rather lukewarm support, but Flint did, in my e LimaLion, provide important upport to Blackwell by publishing her dissertation in the pages of the Buffalo Medical journal and by writing approvingly of her progress in the medical profession. But advances are not always sustained. Flint's successor as editor of the Buffalo Medicaljoumal was emphatically opposed to women doctors, and when Elizabeth Blackwell's sister Emily applied for admission to the VB medical school in ovember 1851, her application was rejected by the faculty. Women continued to be educated as physicians, but only in such institutions as the Female Medical College of Philadelphia and the ew England Female Medical College, not at the older male institutions. UB's true pioneer woman medical student was Mary Blair-Moody, whose application for admission to the medical school was accepted in 1874. In 1896 Dr. Blair-Moody's reOections on her own experiences were published in the Buffalo Medicaljoumal: "EARLY IN THE AUTUMN of 1874 the majority of the faculty of the medical department of the University of Buffalo decided to favorably consider an application made some years before by a woman resident of their ® B u f f a I o own city, to pursue the study of medicine in their classes on the same footing as the male students. Sex was to be left out of the question as much as possible. The minority, finding it difficult to wholly approve, yielded with true American spirit and also welcomed the innovator with what grace they could command. My youngest brother, then about passing out of his teens, having just previously decided to pursue the study of medicine in that institution, became a member of my family, and together we went into the search for the precious possibilities of the healing art. Every day we measured our work, not by what was required, but by what was possible to be done, making that also include the required. The personnel of the faculty at that time always recurs to my memory as being of a somewhat unusually high order. There was a keen love of truth among them for its own sake. "Two of them said to me, at different times in the course, 'Do not believe what we tell you in medicine or what anybody says until you prove it.' All did not teach in that way for obvious reasons, especially the demonstrator in anatomy.ltwould be impossible. Professor Hadley's classes in chemistry had been and continued always to be open to women. Not only so, women were cordially welcomed and encouraged to do the best work of which they were capable. Dr. Mason frequently had women visitors in his physiology classes and delighted in enlightening them on such practical points as choice of good respiratory mechanism, effects of certain nervous lesions, and similar branches of the subject. "After being well started in my work, and having become quite enthusiastic over the clearness and elegance with which the professor of surgery, Dr. Moore, instructed his classes, I chanced to be in one of the other professor's rooms when he entered without noticing me and exclaimed: 'How is it that we have a woman here?' Dr. Potter entered at that moment and replied: 'J assume the responsibility.' He was dean at the time, and one of them-1 do not remember whom-remarked: 'If we do not like it when she gets through, we can close the doors.' They have never been closed; but, nevertheless, it is my impression that it is liable to remain what it was in the beginning, a man's college, courteously conceding as a privilege to women advantages not taken into account by its charter members. "This has its uses; chivalry on one side and gratitude on the other are encouraged. It is like a bit of the romance of the Middle Ages dropped into the life of a wide-awake, not to say prosaic, American city. Some of the professors said when they decided to leave the doors open to women: 'It shall never be a woman's college. If they wish to study as the men do, well and good. We shall not advertise it as a college admitting women, nor make special arrangements for them, nor consult their convenience.' One of the professors who took this stand and maintained it expressed at one time a thought which is shared by too many and is Physician Autumn 1 9 9 7 �I = - - - - - -- - - -- - - - ------ - -~~-------~ ~ ~ -- --~----- --- mentioned for that reason: 'No lady will wish to study medicine, with the emphasis on lady.' "It was a question in my mind soon after entering how to manage ... I soon felt that there was a majority of the students that would intelligently sustain fair play in the matter. That was a great help to me. What I would have done had that sentiment not prevailed in the class Ido not know.! am sure that this sentiment also prevailed among the professors. There were a few rough fellows in the class who occasionally called my attention to themselves by cat-calls when I entered, excessive smoking at recess, close to my seat, and other manifestations of ill breeding. The class endured it for a while in silence, simply attempting to frown it down. It happened, however, one day that one of the ringleaders of this movement was discovered in some such trick, I do not know just what, and was doubled up and handed over the tops of the iron seats from one man to another from the back row right down to the desk and rolled over that in no gentle manner to the lecturer's usual place. The quietest, most scholarly, and most gentlemanly men in the class took hold with a will and received him with open arms as he was handed along too rapidly to help himself, starting as he did doubled up like a jackknife. This happened just before lecture time.lt was done quite sternly, almost silently, and ---- = and "Of course," recalled Dr. Blair-Moody, "he would not be just ready when I wanted to go home." " ... At graduation the announcement was received with rather more than the usual cheers and congratulations, six little pairs of hands in the gallery joining in the applause." By the time Dr. Blair-Moody penned her recollections, and when Dr. Frye gave her lecLUre, women medical students at UB were no longer an experiment. In the 1880s and 1890s, women made up as much as 15 percent of the graduating classes. Women would remain a minority until the 1970s, but their fitness to swdy medicine was no longer seriously questioned. On October 17, 1889, the women students at the University of Buffalo met to consider "the advisability of fonning a society of women students of the university." Since the time the college admiued women, and Mrs. Moody became a student, the effort of coeducation had been a success, and the time was now ripe for women to bind themselves to support one another to work, not as a few timorous individuals upon whom the world should frown disapprovingly, but as a sisterhood whose object should be mutual encouragement, support, and aid in matters social, educational, and professional. The organization founded , known only by the initials S.E.V., sponsored lectures, study sessions, and social events. Women were to some degree accepted, but continued to feel the need to create separate organizations for mutual support. Organizations by and for women at the university have now been functioning for more than a century. Returning to the remarks of Dr. Maude Frye in 1897: iiiiiiiiiiiiiiiiiiiiiiiiiiiiii must have noforce, small amount ofrequired muscular as he was not a slight fellow to whom this dose was administered. It amused me greatly, as the man seemed to shrink from attracting attention to himself in any way afterward ... "... John, the janitor, was my faithful friend through it all. He was always interested in my work, kind and helpful. Among the boys he had the reputation of being afraid of nothing, living or dead. He, too, liked to see fair play, at least so far as I was concerned, and occasionally so expressed himself to the students in his own inimitable way. 'She pays her money like the rest,' he said to one rough student one day. 'She has just as good a right here as anyone.' "But there were limits, by common consent apparently, to my privileges. It was to be fair play but no favor on account of sex. Our professor in medicine ... once overstepped the bounds, according to class sentiment. We were studying diseases of the chest under his instruction. A prize had been ... offered for the best report on a certain set of lectures on this subject. Perhaps to try the temper ofthe men and their opinions on the subject, he called me out at several successive clinics to make the chest examination, which was a coveted privilege and could not well be accorded to everyone. About the third time a hiss of disapproval was sufficiently expressive to convey the class sentiment of fair play and no favor ... " Mary Blair-Moody was what we now think of as a "nontraditional" swde nt~older, married , and with children of her own. When she entered the medical school, she was in her late 30s with six children. She doesn't mention her child-care arr;ngcments or support network, but occasionally at the end of a long lecture day her family came down to pick her up, and the children would sit with her in the upper seats of the lecture hall. One of her boys would take off his shoes and stockings, B u f f a 1 a Physician "THERE IS ONE quality which more than any other makes for success in certain lines of medical work. It is the type of courage more or less common to all men, rarely found in women-the courage which dares. It is the courage of the soldier, and the explorer. It is the courage which makes possible the great surgeon." ote here that Dr. Frye is talking about two forms of diversity in the mind: a diversity among women, between the heroic pioneers in the mold of an Elizabeth Blackwell and most women; and a generalized diversity between men and women. "ON THE OTHER HAND, through all time woman's genius has given this character to her work. It has not turned to great deeds but has contented itself with the humbler, often holier, tasks of the home, the school-room, and the sick chamber ... It is the courage whose other name is patient endurance ... "The lack of daring does not make a physician less trustworthy, nay rather she may be more worthy of trust, but the lack does not work to her material advantage. There are departments of medicine, notably bacteriology, for which not only woman's type of courage, but her whole manner of training, from her youth up, should eminently fit her, Autumn l 9 9 7 �and in such work as this I believe she will excel. But the woman who gains wealth and fame in the practice of general medicine or of surgery will be the woman who possesses, without necessarily losing anything of her outward womanliness, the masculine type of courage. She will be the woman who would rather be wrong than not try. The average woman would rather not try than risk being wrong. "There is a special message which I wish to give to the young women receiving their diplomas tonight. It is concerning your work among women. Whether you intend to be a gynecologist or not, every woman who enters your office expects you to be. Setting aside your right to do whatever you can and desire to do, the fact that women wish women physicians is the only reason for your being such. You will come to feel later the great power for good-not altogether in a professional way, but as friend and counselor-which is yours, for the good woman who is a good physician has before her, in teaching to her sex right ways of living and true views of life, a work which will bring satisfaction to herself and blessing to others. "... Except for the woman of unusual talent, wifehood and motherhood are of themselves a vocation. Because of this and because other occupations demanding less of her physically and mentally and offering quicker success are open to woman, the number of women physicians will always be few . Yet whether we ever occupy a great place in medicine or not, a place is ours. We are better women for the knowledge of humanity which our work has given us. May we not hope that humankind will be the better too, for our having wrought!" Dr. Elizabeth Blackwell continued as a pioneer in medical education for women in the United States and also in Britain, where in 1859 she was the first woman to "have her name entered on the Medical Register of the United Kingdom." She died in 1910. Dr. Mary Blair-Moody became the fir t woma n member of the Erie County Medica l Society, a fellow of th e America n Association for th e Advancement of Science, and a fo under of the [Buffalo] Women's Educational and Industrial Union. The union later (in 1916) gave their building to house the new College of Arts and Sciences and provided an endowment for the university. When asked for her opinion about th e uses of the endowment, Dr. BlairMoody recomm ended the establishment of a Departm ent of Preventive Medicine, "wi th a yo ung, able, gifted , and enthusiastic person as leader. Sex should not bar anyo ne fro m this chair. " She died in 1919. Dr. Maude Frye taught briefly at UB, then went on to a large and successful medical practice in Buffa lo. From 1922 to 1940 she also served as Medi ca l Adviso r for Women at th e Uni versity of Buffalo. She died in 1946. Change is so metim es slow. In the co urse of co ll ecting materials for this paper, I checked th e Medentian, a magazine published by the students of medicine and dentistry at UB in the 1940s. I was looking to see if it might have carried an article on Dr. Frye's retirement. Though I didn't find one, there was a regular monthly column written by women in the medical school under the ti tie "Hen-Med. " The first issue of the 1939- 40 school yea r, some 50 yea rs after Dr. Frye ente red the medi cal school, ended with the following observation : "THE SLIGHTING FACT that none of the physical diagnosis instructors at a hospital (quote) wants a woman in his group (unquote) ... The unflattering fact that women are politely excused from certain clinical procedures. The unsurmountable fact that too many hospitals have doors closed to women interns. Take all this, give it a quick glance, and pretend to forget about it. "Pretend. But do your share to prove your worth. Remember that the emancipation of women is still a thing of the future. And here in this school, as liberal and open-minded in its attitude toward women as any school in the country, among a group of genuine good fellows who are learning to accept you in spite of the remnants of their traditional distrust of you, is your chance to play a part in the great emancipation." + Magnificent BUILDING LOTS Dear Colleague: As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western ew York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundi ngs. The Summit at Scherff is a truly extraordinary residential developme nt, un rivaled in Weste rn New York. Nestled in the hills of Orchard Park, this magni fice nt 81-acres has been subdivided into 50 estate-sized buildi ng lots surrounded by Chestnut Ridge Park and euman Creek in a very private enclave. Specifical ly as an escape from the fast- paced everyday life we lead, it's features include: ' Spectacular panoramic views of the Canadian shores, Lake Erie, and the Bulialo skyline ' Mature woods and secluded ravines • Oversized lots for your dream bouse ' Quick and easy access to the freeway systems leading to Bulialo and the city's northern suburbs ' Privacy, seclusion, and exclusivity The Summit promises to be one of the premier areas in Western ew York to construct your luxu ry residence. I invi te you to take a stroll through this picturesq ue setting. For ou r detailed brochure or a private showi ng please call (716) 667-2237 or (716) 472-3790. Sincerely yours, Ed mond J. Gicewicz, M. D. Past President, UB Medical Alumni Association THE Orchard Park, New York CIJristoplt e1 Densmore is tlte University at Buffa lo arcll ivi .st. B u f f a l o Phy si SUMMIT AT SCHERFF c i an Autumn I 9 9 7 �ou and Community Blue - a partnership based on a mutual goal of excellence. Our commitment includes finding solutions to the challenges that we all face in the ever-changing health care arena, and listening to the needs of those we work with and serve. For members, Community Blue offers innovative health coverage that gives members more choices and more flexibility, plus greater and more affordable access to the care they need. PARTNERED FOR EXCELLENCE. Providers benefit from Community Blue's growing enrollment and from the streamlined systems and procedures we're introducing. For employers, we provide a 12-month rate lock that gives rate stability and coverage that matches their business cycle. At Community Blue, we're proud of all we stand for in health care ... our innovative programs, our quality coverage and our financial stability. Most of all, we're proud of the long-standing partnership of excellence we have with the Western ew York medical HMO community. Blue Cross & Blue Shield of Western New York For information, call 887-7921. E .... An loderxn<km LKtnstt of 1he Blue Cross and Blue "'htekl Assoo:.auon The HMO that gives you more Buffalo Phys icia n A utumn 1 9 9 7 ���. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . [1] ~ I Mini med school ahit LAYPERSONS LEARN HOW EX C ITING AND UNDERSTANDABLE SCIENCE AND MEDICINE CAN BE tis 6:30 on an exquisitely beautiful summer evening in late july, and Butler Auditorium is already starting to fill. By 7:00, Alan Reynard, Ph.D., professor of pharmacology and toxicology, is well launched into his description of how R A polymerase forms mR A in order to copy D A. He is squeezing in the last few minutes of a lecture he began two weeks before, working his way to the consequences of mutation" ow, is a protein with an incorrectly placed amino acid a mutation? No." He presents clearly but quickly because Jerrold Winter, Ph.D., professor of pham1acology and toxicology, is waiting to present his scheduled lecture on the chemistry of the brain. Every UB medical school class for the past 30 years has sat in these seats and heard these lectures, although they have usually been given in more detail. But tonight the students are a retired electrician and his wife , a systems analyst, an office manager, a lawyer, 16-year-old Brandon Palumbo, whose grandfather wants him to get a taste of what studying medicine would be like, and 200 other men and women as unlike in their age and backgrounds as traditional medical school students are alike in theirs. This is the final night of the second six-week session of UB's Mini Medical School, developed by Harry Sultz, D.D .S., M.P.H., professor of social and preventive medicine and director of the medical school's Health Services Research Program. When he applied to UB's Office of Public Service and Urban Affairs for a start-up grant, Sultz knew that such programs had been successful elsewhere. The first was offered by the University of Colorado Health Sciences Center in Denver in 1990; since then, more than two dozen institutions have offered similar programs, including a four-week session for members of Congress sponsored by the ational Institutes of Health's Office of Science Education Policy. "The real question in our minds ," Sultz said recently, "was whether Buffalo , with its reputation for blue-collar interests, would respond the way other cities had. " a u f f a 1 o Buffalo and its environs responded. otice of the spring program consisted of one announcement on UB's FM radio station and an article in the Buffalo ews. More than 1,000 people called for the 287 seats. A second program was arranged for June and July to accommodate some of the overflow. A third program will run in September and October, supplemented by additional lectures-on alternative medicine, women's health , preventive medicine , and how to navigate the health-care system, among other topics-for those who have been through the basic course and want more. The curriculum for the basic course consists of two lectures each on the subjects of cardiology, neuroanatomy and neurosurgery , microbiology and infectious diseases , oncology, immunology, and pharmacological therapeutics of the mind. Sultz, who readily characterized the program as "pa rt lecture, part theater, " recruited a luminous faculty of volunteer lecturers . On the night of the last summer session, as Jerrold Winter describes Otto Loewi's discovery of the chemical transmission of impulses in the nerves, the Butler auditorium quiets to a dead hush . "The thing that surprises me the most," Sultz says, "is the interest the people have in pure science. They're fascinated by science, even if it doesn't have immediate practical application to their own health." Sultz set three goals when he proposed the program: to promote good relations between the community and the medical school, to make science and medicine more understandable and exciting to laypersons, and to increase participants' knowledge of health and disease so they could be more competent health-care consumers. Continued demand for the basic course and the interest of"graduates" in additional lectures suggests that he has Physician Autumn 1 9 9 7 �····································· ···· ·······.························· · ··· · ··········• · tM I I THE THING THAT SURPRISES ME THE MOST IS THE INTEREST THE PEOPLE HAVE IN PURE SCIENCE. THEY'RE FASCINATED BY SCIENCE , EVEN IF IT DOESN' T HAVE IMMEDIATE PRACTICAL APPLICATION TO THEIR OWN HEALTH. " met the first goal. "We have a number of science teachers taking the course," Sultz says, "and they've wanted to know if they can bring their students. So we're talking about creating a mini med school for science teachers and their students on a model developed by the University of orth Carolina." For Charles Gorder, a retired electrician from Clarence, NY, the evenings have been a taste of what might have been: "When I was a youngster, I worked as an assistant to a pharmacist. When I got drafted during the war, I hoped to be a corpsman but the avy made me an electrician. I've been an electrician all my life-and that's been good, don't get B u f f a l o me wrong. But I've always had the interest. I've learned more here in six hours than I did in my entire life in school. Look at tonight. Now I know that someone who's depressed may be suffering a chemical imbalance." Bill Kilinskas, a systems analyst from Amherst, Y, came because "at my age you start thinking about health. The knowledge of what a heart attack really is, what a stroke really is, is useful. " And the 16-year-old? "I think it's pretty interesting." During intermission, after Winter has finished diagramming receptors and explaining acetylcholinesterase, serotonin, dopamine, gamma-aminobutyric, and other features Physician Autumn 9 9 7 of brain chemistry, Palumbo buttonholes him at the back of the hall. After the first session, Sultz was approached by a local cable television system with an offer to tape and broadcast the lecture series, but he turned them down. "I don't want people to take this sitting in their living rooms. I want them to go to medical school." And he rounds out the experience with a mini graduation. Led by the traditional bagpiper, the robed faculty march to the well in Bu tier to close the sessions. Participants receive a certificate attesting to the completion of 12 hours of instruction in the medical sciences. + - J U D 5 0 N M E A D �• ·········································· · ···································· · ········ ~ I Paganelli named Distinguished Service Professor harles V. Paganelli, Ph.D., professor of physiology at the University at Buffalo, has been named a SU Y Distinguished Service Professor. A member of the UB faculty since 1958, Paganelli has served as interim chair of physiology since 1991, a position he also held from 1980 to 1982 and in 1986. In addition, he was associate chair of the department from 1976 to 1980 and from 1982 to 1991. Starting in 1970, Paganelli was named to several committees ofUB's Faculty of Health Sciences (made up of all five of the university's medical and health professions schools), in which capacity he helped shape the role of those schools in the university's mission. An active researcher, throughout his career Paganelli has brought more than $5.7 million in awards to the university. His research has taken him to locations that include the Marshall Islands , the Midway Islands , Alaska , and Hawaii. He has presented lectures in Denmark , France , Switzerland, Italy , Israel , Taiwan, Korea , and japan , as well as throughout the United State . Paganelli has published more than 70 articles in professional journals and is coeditor of the book Physiology Function in Special Environments. His professional memberships include the American Physiological Society and the Undersea Medical ociety. In 1995, he received the dean's award of the School of Medicine and Biomedical Sciences and the Student ational Medical Association Award. + try , and Rehabilitation Medicine, and the faculty of Social Sciences. Also participating is the Department of Veterans Affairs through the VA Western ew York Healthcare ystem. "T his award by the Cummings Foundation will allow us to continue mapping the critical pathways by which humans understand language ," says Lockwood. "By studying the links between sound and emotion centers in the brain , we may also be able to better understand hearing loss and disorders such as tinnitus or ringing in the ears, which is associated with adverse psychological symptoms like depression , ~ anxiety, and insomnia." a In addition, the study will examine ~ auditory attention systerns that require ~ more complex processing of aural information and will analyze how the brain handles language , including studies of reading, grammar, and syntax. Such tests have already proved useful in monitoring recovery from concussive brain injuries like the one suffered by former Buffalo Sabres player Pat LaFontaine. Using newly installed M Rl equipment and powerful computers in Buffalo's VA medical center, the researchers will combine the MRI and PET images to map the functions observed in the PET scans onto precise locations in the body indicated by the MRI images. Part of the funds provided by the Cummings Foundation grant will be used to upgrade the computer equipment and software to include this sophisticated image-fusion capability. The james H. Cummings Foundation , located in Buffalo, was established in 1962 through a bequest by james H. Cummings, who was a prominent manufacturer of pharmaceuticals with operations in Buffalo and Toronto, Ontario. The foundation has distributed more than $ 15 million in grants to further medical science, research, and education. + ~ UB medical school receives $107,000 grant from James H. Cummings Foundation he University at Buffalo has received a $107,000 grant from the james H. Cummings Foundation of Buffalo to fund a pioneering research project that will look at how the brain transforms the sounds we hear into information. This three-year study will combine images of brain activity formed using positron emission tomography (PET) scans with images of structures in the brain acquired through magnetic resonance imaging (MRI) to create a unique image that links neural activities to specific brain sites. Through the combined images, researchers hope to gain new insights into how sound relayed by the auditory system are understood. Directed by Alan Lockwood , M.D. , UB professor of neurology , the multidisciplinary project will involve the Departments of uclear Medicine and eurology, Communicative Disorders and Sciences, Linguistics , Psychia- - B u f f a I a Physician PAULA WITHERELL Autumn I 9 9 7 �HURWITZ & RNE, P.C. [ATTORNEYS AT LAW Put the best seat in the fwuse myourgarage. I Maggie Wright med school assistant dean,retires SERYICI G THE LEGAL aggie Saxon Wright, assistant dean for student affairs and director of minority affairs, retired in August 1997. She had served in the medical school's administration since 1981. Wright oversaw the academic and student affairs concerns of first- and second-year medical students and administered the core basic science program, including medical electives, the HLBI Summer Research Program, and the ational Medical Fellowship Program. She also provided support services to all medical student organizations and was advisor to the Minority Undergraduate Pre-health Organization. Active as director or advisor to many local and national programs, Wright has been honored both by medical educators and by the community as the recipient of, among other awards, the State of New York's United University Professions Excellence Award, the ational Medical Association Award, and the NAACP Medgar Evers Award. + NEEDS OF THE HEALTH Scm cEs COMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities 1997 Buick Riviera • Employee Relations Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 1300 Liberty Building 1717 Walden Ave. , Buffalo, NY Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues 'ldut'!Jall7Jlliti Buffalo, 6 u f f a 1 o ew York Physician 891-5595 Autumn 1 9 9 7 �• ······························································· · ······ · ················· ~ I Key issues include relations between the medical school and the local medical community, relations between the BY ANDREW DANZO school and the university as a whole, and changes in patterns of medical practice and teaching. Underlying it all are the economic factors driving much of hey don't do it for the glory-the Dean's Advisory Council is the change-the decline of government a relatively unheralded group that prefers to meet outside the support, the rise of managed care. To preserve an atmosphere in which memspotlight. They certainly don't do it for the money-members bers speak freely, Wright hesitates to relate details of Advisory Council dispay their own way, even if they must take a cross-country cussions, but he will say that recent sessions have touched on such subjects flight to participate. as the importance to the school of its What they do for the chool of Medi- the council after having spent 24 years volunteer faculty and the planned mergcine and Biomedical Sciences, however, as chair of orthopedic surgery at UB. ers among institutions in Buffalo's teachis becoming increasingly valuable. With Bradley Aust, M.D., founding chair ing hospital consortium. a roster of senior alumni and faculty of the Department of Surgery at the Some Advisory Council members members, the Dean's Advisory Council University of Texas at San Antonio have already been through similar issues is helping the school position itself to and a member of the elsewhere. "They can maintain leadership in medical educa- UB Class of 1949, provide us with some DEAN 'S ADVISORY COUNCIL tion, biomedical research , and health- agrees: "We're happy of the scenarios and some of the things we care policy during a period of profound to try and be supJ. Bradley Aust, M.D. national change. need to pay allention Charles D. Bauer, M.D. portive in giving adMichael E. Cohen, M.D. "The Dean's Advisory Council is a vice. One of the to from the perspecS. Max Doubrava, M .D. tive of the medical forum to put forth provocative, poten- advantages of outJock C. Fisher, M.D. schoo I," Wright says. tially controversial ideas; to get a reac- side participation is James R. Konski Jr., M.D. "Experience is a wontion from individuals both inside and that we're at other Jerome P. Kossirer, M.D. outside this community," says interim universities and derful teacher. " (Con sultant ) dean and vice president for clinical af- medical schools: In February of Harry l. Metcalf, M.D. fairs John R. Wright, M.D. "I articulate There are some this year, the group Eugene R. Mindell, M.D. current issues facing the school, warts generic problems met in Boston at the Richard B. Norins, M.D. and all. I don't think I hold anything that cut across uniHoward Hughes Margaret W. Poroski, M.D. back ... and the Advisory Council is not versity boundaries, Medical Institute, Dorothy C. Rosinski-Gregory, M.D. reticent about providing advice." and we can tell [the where the Advisory Albert C. Rekote, M.D. Established two years ago by former dean] about our Robert N. Schnitzler, M.D. Council's honorary George W. Thorn, M.D. dean John P. a ugh ton, M.D., the coun- problems and how chair , UB Class (I lonon11y Clw ir) cil represents a broad range of experi- we solve them. " of 1929 member Philip B. Wels, M.D. ence. Members from the Buffalo area George W. Thorn, Wright sees the Franklin Zeplowitz, M.D. include faculty who are heavily involved council, M.D ., has served as which in the UB medical school and alumni meets three times a research director. who are active in the local medical com- year, as a combina"He talked about his munity. Other council members, many tion of expert panel and sounding board life," recalls Mindel!. "He gave us of whom hold distinguished academic to help the school grow stronger in an some suggestions about how our and research positions, are scallered unpredictable but rapidly evolving en- school can attract outstanding facaround the country. vironment. "It's a given that we're not ulty and how to pursue funding for "We would like to help the UB School going to stand still," he adds. "We're activities we're interested in. " of Medicine to move ahead," says Eu- going to have to think of different ways ext February council members will gene R. Mindel!, M.D., who serves on of doing things." travel to San Diego, where they will be Dean's Advisory Council ® B u f f o l o Physician .A. u t u m n I 9 9 7 �····················· · ·· · ··············· · ··· · ······· · ················· · ···· · ······ · ····· • I • ~ . I hosted by jack C. Fisher, M.D., a UB Class of 1962 member who is among the group's most active participants. A noted professor of surgery at the University of California at San Diego and former head of that school's Division of Plastic and Reconstructive Surgery, Fisher hopes to provide insight for developing strategies in Buffalo. "There are contrasts to what's happening in Buffalo with what I've experienced here in California," Fisher says. ''I'm planning to give [council members] the opportunity to meet with some of the administration from our medical chool and medical center to discuss how managed care has inOuenced our own graduate and undergraduate medical education. It's been hard. " Fisher, who devotes at least several days a year to Advisory Council meetings and preparation , sees it as a way of giving back to his alma mater. "Basically, I'm a graduate, and Buffalo is my home. I was honored to be asked, and I find it interesting." + Andrew Danzo , a Buffalo -based freelan ce writer, is a frcc1uent contributor to Buffalo Phys ician . INFINITI AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall s u f f a 1 o UB first to complete Women's Health Initiative enrollment he University at Buffalo is the first of 40 sites in the nation to meet all its recruitment goals for the $625 million Women's Health Initiative (WHI), the largest clinical trial ever undertaken in the U.S. UB's Department of Social and Preventive Medicine was selected in 1993 to be one of the initiative's 16 Vanguard Clinical Centers. These sites established the study's design and developed the operating procedures for the remaining centers. A total of 4,000 women in Western ew York have volunteered to take part in this landmark study. The WHI's goal is to arrive at definitive answers concerning the relationship of hormone-replacement therapy and various aspects of diet on women's long-term health. A third aspect of the project, the observational study, involves tracking women over the 12year study period to determine lifestyle habits that are beneficial or harmful. Specifically, the study will seek to determine risk factors for heart disease, the largest killer of women; breast, colon, and endometrial cancers; osteoporosis; and Alzheimer's disease. The WHI eventually will involve 163,000 women nationally between the ages of 50 and 79. Karen Falkner, Ph.D., recruitment director for UB's Vanguard Clinical Center, says that being the first to reach its recruitment goals is a significant accomplishment for UB and a testament to the generosity and insight of the women in Western New York. "These volunteers are willing to devote a part of their lives for the next decade to helping improve the health of women for generations to come," she says. "They are part of a history-making adventure." The university's share of the grant forthe WHI study is $11 million spread over l2 years. Co-principal investigators on the trial are Maurizio Trevisan, M.D., professor and chair of the UB Department of Social and Preventive Medicine, andjean Wactawski-Wende, Ph .D. , UB assistant professor of gynecology and obstetrics. The university's recruitment success in this clinical trial will help make it a prime site for future investigations, Falkner says. + When the engineers at lnfiniti set out to create the new flagship Q45, they didn't ask each other, "What does a luxury car owner desire most in a luxury car?" They asked the luxury car owners themselves. In countless interviews, Infiniti asked questions like, "What catches your eye?", "What tickles your fancy?" and "What makes your heart pound?" The result? Styling that's the perfect blend of elegance and sportiness. Physician QX4 Autumn 1 9 9 7 I �• ························································································ Aword from the director of development BY LINDA J . CORDER. PH 0 .. C hanks to many generous medical graduates who celebrated a class reunion this past spring, the Medical School Reunion Giving Program for 1997 received a prestigious award from the SU Y Council on Advancement and Development. I had the felicitous responsibility of accepting this] udges' Citation on behalf of the school during the annual SU Y/CUAD Conference, held in Corning, Y, this pastjune. The entry of the School of Medicine and Biomedical ciences was one of 113 submitted for evaluation of excellence and improvement by a panel of experts. Of the programs or publications evaluated, there were eight recognized as "Best of Category" and 11 that received a "judges' Citation." Our program received a judges' Citation. Last fall , we analyzed the Medical chool Reunion Giving Program by the results it had obtained over the previous six years. The amount of reunion gifts given to the school during that time period wa slightly more than $575,000an average of 92,500 a year, or under $10,000 per class, per year. With the assistance of former dean Dr. john aughton, we recruited reunion gift cochairs for most of the classes celebrating reunions. As far as I have been able to a certain, this year was the first in which most class reunion chairs had a cochair to assist with their class gifts. We extended the definition of "reunion class" to include all living alumni who graduated in years ending in "2" and "7." This added four reunion classes within the "jubilee Emeritus" group. Two-the 55th and 60th year classes-took active roles in this year's reunion celebrations. ® We encouraged class members to make gifts to any fund that would benefit the School of Medicine and Biomedical Sciences. In the past, class members were asked to contribute to a specific reunion account, for a purpose decided by someone else. We also included a one-page survey in the initial mailing. This provided each class member with an opportunity to update the information on file in our office and that of the Medical Alumni Association, to rate their perceptions on various aspects of medical practice, and to s hare per onal information with their classmates. (A t press time, we are still working on the "class booklets" based on these survey . They will be finalized and mailed to each person who made a reunion gift, ca me to reunion weekend, B u f f o 1 o F . R E or took the time to complete and return the survey even if they could not come to the reunion or did not make a reunion gift.) These four program enhancements likely resulted in the increased reunion giving upon which the award was based. Several people made gifts based on Dr. aughton's suggestion of $100 for each year since graduation, and many additional individuals gave contributions of 1,000 or more that will result in their recognition as members of the james Platt White Society for 1997. Overall, reunion class members committed more than $136,000 to the school, with a participation rate of 33 percent. This amount is more than double the total of reunion gifts made in 1996 and it surpasses the average of the previous six years by $44,000-that's an increase of 48 percent!! Twelve additional reunion class members made pledges of unspecified amounts. Depending on the magnitude of these gifts, the percentage of increase may be even more significant. The reunion class with the highest gift total-more than $30,000-was the Class of 1942. This successful effort was led by Richard Ament, who established a Charitable Remainder Unitrust in honor of his 55th reunion . He designated the remainder amount for the Department of Anesthesiology. Two classes shared honors for the highest percentage of participation: More than half-58 percent--of the living class members of the Class of 1937 and the Class of 1947 made a reunion contribution. Above 40 percent were the Classes ofl967 and 1952, with 42 percent and 41 percent participation, respectively. Physician Autumn 1 9 9 7 �··· ··· ··· · ············· · · · ··· · · · ··· · ···· ·· · · · · ··· : ···· ··· ······ · · ···· ··········· · ·· ·· ··· · · · ~ I How does this compare with other academic medical centers? From one perspective, not very well. My evidence is anecdotal , primarily from UB graduates who completed their residencies elsewhere and receive anoth e r institution's alumni publications. A UB alumnus in Arizona told me of a friend from residency whose medical class made reunion gifts totaling more than a million dollars. nearly twice as much as all of our classes combined, over a sixyear period' However, that was a private institution, with a development program that is more than 100 years old. A California surgery professor, also a B alumnus , described a multimillion dollar annual philanthropic program at his university, of which the reunion gifts made up a significant percentage. Like UB , this is a publicly assisted institution , but with a much shorter history than UB's 150+ years. Yet that medical school was established with the knowledge of the need for-and expectation of-significant private contributions. So, what is the "right" perspective by which to assess our program7 For now, l come down on the side of the panel of judges for the SU Y/CUAD awards. We provide our own standard of comparison. In this first year of increased efforts and generosity, the classes celebrating reunions in 1997 made significant progress over previous results . Our improvement earned us a citation of merit. Our efforts this year will provide benchmarks for future years of this program. Over time, reunion gifts have the potential to transform the academic and clinical opportunities currently available to UB's medical students. Over time, more classmates will want to participate and to contribute at levels that will bring them increased personal recognition and enhance their alma mater in significant ways. Who knows? Within the next few years, the certificate earned this past spring may have a companion piecean award of excellence for best program in the development category! + Liuda j. Cordc1 is assist aut dcau aud dirccto1 of dcvclopmcuL Medical School Reunion Giving Program 1997 Class Year 6 u f Number in Class Number Who Gave Gift Amount Number Who Pledged Pledge Amount Total Number of Gifts and Pledges Total Dollar Amount 1937 '42 '47 12 32 48 6 9 26 $6,331 1,910 17,684 1 2 2 (l nspecijied) $28,625 550 7 11 28 $6,331 30,535 18,234 58% 34 58 '52 '57 49 56 19 17 13,735 3,400 1 4 1,650 700 20 21 15,385 4,100 41 38 '62 '67 58 95 20 31 11,343 9,830 2 9 8,650 1,645 22 40 19,993 11,475 38 42 '72 121 26 9,073 7 3,817 33 12,890 27 '77 125 28 5,830 10 1 245 38 7,075 30 '82 121 26 3,950 7 660 33 4,610 27 '87 111 21 3,172 12 1,900 33 5,072 30 '92 119 19 675 7 295 26 970 22 f a l o Phys i cian Class Participation Percentage (I inspecified) (2 Cnspecifled) (2 Cnspecijied) (2 lnspecifled) (2 { nspeci}ied) (I lnspecifled) (I lnspecifled) (I Cmpecijied) Autumn 1 9 9 7 I �.,, ,ar.l"'mllllll':'l '' l711 ~ 11 11~~ · · · · · · • · · · · · · · · • · · · · · · · · · • · · · · · · · · · · · • · · · · · · · · • · · · · · · · · · · · · • · · · · · · · · · · · · • · · • · • · • · • · · · · • · Mandeville's suggested transition-tointerview statement isn't terribly different from the one Dr. Manyon asked us to use in our preceptors' clinics: "So, what brings you to see the doctor today? " While Mandeville certainly doesn't give the patient room to expound upon his BY JUDITH TOSKI . CLASS OF 2 0 0 0 condition (Dr. Manyon would reprimand him for not using an open-ended question), it is noble that Mandeville tis the year 1300, and you are a provincial lord in France. You have and his contemporaries would even been coughing for days, ever since you somehow stumbled into speak to patients. There was little patient-doctor interaction in the earlier, some bad air while hunting your grounds. You send for the local pre-university Middle Ages. Prior to the physician. Along with your messenger you send a flask of your rise of the university system, physicians would instead receive the patient's urine, a you expect the doctor to have formulated an opinion urine and make a diagnosis from it alone, without ever seeing or speaking to regarding your prognosis before he arrives at your bedside. the patient. In medieval European iconography, versibly altered by the innovations of Other aspects of doctor-patient inthe urine flask was the universal science and technology, there is one teraction have also been retained symbol of medicine. It implied element of medical care that has not through the ages. The idea that the great understanding, much like changed quite as drastically: the art patient's trust in the physician is parathe long white coat suggests of doctor-patient interaction. mount is a concept that has been alive Henry de Mandeville, a physi- in some form since antiquity, when the medical expertise of A~~~!!~~ today's attending phycian and surgeon who Greek believers sought healing from sician. While the symwrote around 1315, de- the god Aesculapias. During the 14th bot has changed, the scribed a proper method century, Arabic texts from the early connotation has ofquestioningapatient- Middle Ages came into vogue in not. What imparted onewhich,inmanyways, Europe-including one by Qusta ibn power to the repremirrors the paradigm my Luqa, a writer on psychosomatic medisentation, both in the class was taught in cine. This treatise explained that magic Middle Ages and today, is Clinical Practice of spells and incantations cure illnesses the patient's belief that Medicine during our because patients want to believe in "this doctor is a person first year at UB. In them , and th e mind controls the body who can heal me. " The a descrip- to effect the remedy. The medical intion of the novators of 14th-century Europe took remedies of both eras refleet the scientific underp r o p e r this concep t one step further, indicatstanding of the time, and thus protocol for ing that physicians have the power to would be completely differentbringing in a cure because patients accept that they the provincial doctor would have consultant on have such power. In the absence of applied poultices of mustard and an ongoing case, extensive pharmacopoeia or advanced other materia medica to the lord's M o n d e vi I I e surgical techniques , the patient's beche t, while today's primary-care specified the lief in the ability of the physician to phy ician would most likely language that heal was essentially the only tool that auscultate his lungs and chashould be used with the doctors had available to them. Today, tise the lord for keeping up a patient. He recom- in spite of improvements in medical three-pack-a-day smoking habit. AI- mended that the patient be interviewed, technology and the wide range of drugs though aspects of the treatment and first saying: "Sir, I hope it will not offend available to physicians to help ameliophysical examination have been irre- you if I ask when your illness began?" rate disease, not every illness has been Doctor-Patient Interaction: Lessons from the Late Middle Ages ® B u f f a I o Physician A u t u m n I 9 9 7 �' =-----=---- ~-- --- ------- - ---- -- ----- --~ ------ ··············-·······························-········································· ~:m il Medicine has changed because the world around it has. Advances in scientific thought and innovations in technology have transformed how care is delivered in so many ways that it is inconceivable to us moderns that anything could have remained the same about it. And yet, some similarities do exist between our culture of physicianpatient interactions and that of the Middle Ages. The desire of the patient to have faith in the doctor and his cures has not been modified all that much, and the necessity of open communication between physician and patient is a concept that even today is being taught and reinforced in UB's medical curriculum-to our advantage as future physicians, and to the benefit of our current and future patients. + Details on medieval medical practices taken cured. In such cases we have the same tool available to us that Henry de Mandeville and h is contemporaries had: that is , our patient's belief that we will try to save him if it is at all within our power to do so. This is a skill that transcends wearing a white coat or schlepping a pager around. My mentor, Dr. julian Ambrus , taught me that trust must be earned and reinforced in each encounter with every patient. A physician can only obtain trust when he treats the patients with the honor he would accord a superior. from McVaugh, Michael R. "Bedside Manners in the Middle Ages." Bulletin of the History of Medicine, val. 71, no. 2, johns Hopkins UP, Baltimore, MD. judi tit Toshi It as a B.A. in history of medicine from Thcjoltns Hopllins University. NICHOLS MIDDLE SCHOOL • Challengi ng, innovative curriculum • Outstanding preparation for high school • Average class size of 14 students • Interscholastic sports • Comprehensive visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: HOOL, 175 Nornngham Terr. B u f f a l a Physi NICHOLS UPPER SCHOOL, 1250 Amher>t ci an A utumn L 875,8212 1 9 9 7 NICHOLS SCHOOL --~ �Tone Johnson J[ '75: Alum earns belated decoration for bravery "When 1 got back, the very people I thought 1 was defending didn't like me very well. And that had nothing to do with being black-it was any soldier who was in Vietnam." Johnson said he dealt with the adjustment by disappearing into the colBY VIVIENNE HEINES lege environment. After graduating from Grambling College, earning his M.D. from UB, and completing his residency, uring a three-day period in 1965, a 19-year-old U.S. Army he served two more years in the military private named Tonejohnson found himself in a Vietnam jungle, and two years with the U .. Public Health Service before entering civilian life as a surrounded by dead or dying companions and hostile orth family practitioner. ow married and the father of five, Vietnamese regulars. Johnson runs his own practice and has that it is not uncommon for soldiers to recently opened two drug treatment As the American came under inreceive awards many years after they centers. As a lieutenant colonel in the creasingly heavy mortar fire, they ran out of ammunition and nearly lost any served. Congress also expanded the U.S. Army Reserve Medical Corps, he eligibility hope of surviving. Most didn't. Of the 35 runs a comrules for commen in his unit,Johnson was one of five bat medical ""IT WOULD HAVE BEEN EASY TO JUST bat veterans who lived through what became one of training proGIVE UP. BUT ABOVE ALL. I BELIEVED the worst battles of the Vietnam Warto receive gram to teach THAT MY FELLOW TROOPS WERE GOING TO decorations la Drang Valley, ovember 14- 17, 1965. ordinary solCOME . AND THEY DID ."" in 1996. "We ran out of ammunition at about diers prin one in the morning. We were only saved Johnson ciples of first by what we fondly called 'Puff the Magic attributes the award to the research of war aid and emergency medical care in the Dragon' [rapid-firing gun hip aircraft] correspondentJoseph L. Galloway, who field of combat. and the Air Force," John on recalled. described the horrors of Ia Drang in We ln the la Drang Valley battle,Johnson An American plane arrived, fired nearly Were Soldiers Once ... and Young, the was wounded in several places. An exatop the soldiers, and dropped napalm 1992 book he coauthored with retired plosion gave him a concussion and around them. Lt. Gen. Harold G. Moore . knocked him unconscious. He woke up "That really cleared them out. l was Johnson , now a family practice doc- in the middle of the shooting to find a close enough that 1 could feel the heat tor in Corpus Christi, aid the award is orth Vietnamese soldier sitting on his significant to him. from the names, but it wasn't close chest and eating his C-rations, he once enough to actually burn me," Johnson "lt means my country cares. Above told an interviewer from the ueces all things, it means my country cares," Valley Medical Society newsletter. said. "Frankly, I was glad they did [drop he said. the napalm], because a little longer and "This ticked me off," he said. we would have been goners." Like many Vietnam veterans , WhenJohnson moved, he startled the In ovcmber 1996, the 51-year-old John on returned to an American pub- soldier, who jumped up and shot him in Johnson received the Bronze Star for lic that was neither appreciative nor the armpit before being killed in the meritorious achievement in recognition accepting of the horrors he had experi- intense fire that ensued. Johnson also of his efforts to repulse the enemy durenced. Because of his race, he felt the suffered injuries to the face and knee. ing the bloody battle at la Drang Valley. adjustment even more keen!)'· The scar on his face is barely visible The award was pre en ted at a ce remony "As a black person in the war, it was today, but shrapnel wounds cost him in the ational Guard Armory in Corkind of tortuous. At home , we were the peripheral vision in his right eye. pus Chri ti, T . undergoing racial conOict. Then , in the "As I took care of the other soldiers war, we were undergoing that kind of during the night, a few of them said, A spokeswoman for the Army Personnel Agency, in Alexandria, VA, said armed conOict," Johnson recalled . 'Let's just give up. We're all worn out, B u f f a I a Physician Autumn 1 9 9 7 �we don 't ha\c an\ thing. ' The) had been wounded , and some were blccchng quite badl) and were ma) be a liulc bit delirious," johnson recalled . johnson got through the night b) maimaining his faith in God and in his fellow soldiers. '"A ll I could thmk was, 'The} 'll be here. ' And through the night, as we prayed about it, I knC\\ the) 'cl be here . It would ha\ e been caS) to just give up . But aboYe all, I believed that 111) fcllO\\ troops \\ere going to come. And the) did. " johnson said he has goucn past his nightmares about the \\ar, but it has changed him in other ways. " People ~a) , ''r ou 're so calm.' I sa), 'If you\e been through hell once, it's easy B u f f a I o to li-,:c in America .' Lillie things don't bother me nO\\. " Reprinted b) pctnih>ionfmmtlicCotpus CI111Sli (Tnm) Caller- Times. + ~ 1998 SCD plans I Plans for the 1998 Reunion Weekend and Spring Clinical Day (April25, 1998) are already well under way. This year's program is chaired by Dr. John Bodkin. The following reunion chairs held their organizational meeting September 11 : the 50th Year Class of '48, Dr. Daniel Fahey and Dr. Harold Graff; the Class of '53, Dr. Michael Sullivan; the Class of '58, Dr. Alfred Stein and Dr. Michael Genco; the Class of '63, Dr. Anthony M. Foti; the Class of '68, Dr. Robert Milch and Dr. Thomas Cumbo; the 25th Year Class of '73, Dr. Michael Sansone and Dr. Arthur Mruczek; the Class of '78, Dr. David Marchetti; the Class of '83, Dr. Richard Collins; the Class of '88, Drs. Andrew and Helen Cappuccino; and the 5th Year Class of '93, Dr. Michael Aronica. Physician Autumn 1 9 9 7 0 �• ···· ·· ······· · ·· ·········· ········ ····· ···························· · ······················ I 1 9 4 0 s daring surgery. The idea was to increase the collateral circula- bany, Pensacola, FL, writes: "There's tion to the ischemic cardiac from chair of Dept. of ObGyn, nothing like a sentimental enco- muscle. After a couple of hours Albany Medical Center, after 16 mium to stir fond memories. So of holding retractors, one be- years. iL was when I read of the death of came lax. Dr. Stewart always had and chair the board of Maternal JOSEPH H. MELANT '43 , of M Y R ON G O R DO N '48 , of AI- the same poignant question: Infant etwork of the Capital Re- 4, 1996) in Buffalo Physician. 'Doctor, are you holding those gion, and chair the Committee on Fifty-five years ago I had the retractors, or are those retrac- Medical Schools and Graduate good fortune to assist this gifted tors holding you?' He was the Medical Education of MSS Y. man in the first open-heart sur- embodiment of integrity and the Looking forward to 50th next year. gery performed in Buffalo, at sui generis of his time. " Skip Zola, Bill Bloom , and Dan a senior in medica l school, thus I had the honor of being his fourth assistant (there wasn't room at the table for any more!). It was a period when opening the pericardia! sac and dusting some talcum powder into it was SAMUE L CASSARA Rochester, '44 , of versity of California at Irvine. 1 ow teach, office practice, Dr. John D. Stewart (September Meyer Memorial Hospital. I was (addiction medicine) at the Uni- Y, writes: "Stepped down 9 LANCE 6 s 0 FOGAN ' 65 , of Valencia, CA, writes: "!took full early retirement from the Southern California Permanente Medical Group on July 31, 1997. I spent my entire practice career at the Kaiser Permanente Medical Center in Panorama City, Miller were here in Albany in April CA, beginning in july 1971. My for our son Seta's bar mitzvah. " last 16 years I served as chief of Y, writes that he the eurology Department. I ex- retired May 30, 1997, after 48 MAX A . SCHNE I DER '49 , years of pediatric practice, at the Orange, CA, has been elected pect to pursue my many inter- chair of the board of the ests happily and full time." age of 78 years. ext? "I will of a- write an autobiography of my tiona! Council on Alcoholism life and times. " and Drug Dependence. He is a IRVING S . KOLIN '65 , recently appeared on Channel9 in Miami, clinical professor of psychiatry If you come loolting for a car, you'll be a\vfully disappointed. HOWEVER, there's little chance you'llleave tl1at way. BECAUSE at tl1e Land •, Rover Centre, we have tl1e world's most impressive 4x4s. AND people who can answer any of your questions about driving. A4x4, of course . Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) ® B u f f a l o P hysician A utumn 1 9 9 7 �-- ··················· · · ····· ··· ······· ·········· · ·········· · ···· · ············ ·· ········· ·· ··• • I FL, to discuss psychological trauma in victims of child kid- the Southern California Kaiser publications are Sexual Investi- Permanente Health Care Pro- gation (NYU Press, 1996); Sex, who joins jacqueline (7), Alex (5), and Eric (3). Marc is direc- napping, and ADHD and the Ritalin controversy. gram. The department has a staff Love, and Friendship (Rodop, 1997) ; The Philosophy of Sex thalmology at Florida Health ( Rowman, 1997); and The Pili- Care Plans in Daytona Beach, FL. JOHN E . SHIELDS '68, of Delhi, Y, writes that his son john JOHN E . KNIPP '72 , of Washingtonville, Y, is presi- losoph) of Sex and Love (Paragon House, 1997). JENNIFER L. CADIZ '87 writes: M. Shields has ajD/MBA degree dent and chief of staff of the with honors, and Gregory P. Cornwall Hospital, Cornwall, hields is a freshman at Univer- Y, and president-elect of the of 80 MDs and ER As. sity of Arizona. He adds that he is Orange County Medical Soci- at Russell Sage College in Albany. ety, Orange County, Y. He is in the private practice of internal 1 9 7 0 5 DONALD H . MARCUS '71 , of Sepulveda, CA, has been appointed chief of anesthesiology at the Kaiser Foundation Hospital in Los Angeles. The L.A. Hospital is the tertiary hospital for WNY's medicine and gastroenterology. ALAN S OBLE '72 (M.A. Pharmacology), of ew Orleans, LA, writes: "l have recently been promoted to full professor ( 1990) and to research professor (1994). Among my latest tor of the Department of Oph- ''I've moved to Harrisburg, PA, 1 9 8 0 5 to begin life as a civilian. I'll be practicing with one of the local KEVIN S . F ERENTZ '83 , of hematology/oncology groups." the Pikesville section ofBaltimore, MD, has been installed as the LA URA POST '87, of Saipan, 49th president of the Maryland has been appointed chair of the Academy of Family Physicians (MAFP). Department of Psyc hiatry at Commonwealth Health Center, in Saipan. Her first book, Back- MARC J . KOBLICK '84. of Ormond Beach, FL, and his wife, Helene, announce the birth of stage Pass: Interviews with Women in Music, has just been published by ew Victoria Publishers. their fourth c hild, Reid Jayson , - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.® MSRP s64240 F. G. DOWNING Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 s&99 1998 BMW 740i While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. 30 mo. Lease FREE SCHEDULED MAINTENANCE ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade). 12,000 miles per year. 15 cents charge per mile lor excess miles. First and last PMT, taxes and plate fees due at inception Residual $43040 Service Loaners Available..• Minutes From Rich Stadium s u f f a l o Physician Autumn 1 9 9 7 ® �• ····························· · ···· ·· ····· . I THE ULTIMATE DRIVING MACHINE. JOHN AKER '88 , oflndianapo- ANTH ONY R . RICOTTONE lis, I . writes: "I finally finished '91 , of Cheektowaga. my plastic surgcl) fellowship at " "vly wife, Deborah, and I arc YU, and am now in private practice in Indianapolis. ) . \Hites: pleased to announce the birth of our daughter. Marisa. Our son Kathleen and I were recently Dommie recent!) turned 2. I ha\ e blessed by our second child, recently joined KeY in Barloc, Rt- Zachery Alexander." charJ Gilbcrt,andJohn Gri~wold at Buffalo Medical Group tn the of DEBRA M . OMIATEK '89 , Lewiston, practice of urolog\." Y, is celebrating her first year in private solo prac- CAROL ANN KILLIAN '94 ti ce. She is president of the THOMAS M . BURNETTE '94 , iagara County Chapter of Family Practice (AArP). of Sleep; Hollo"', 9 9 0 5 and GALE of Baltimore, PETEF<BLOOM '90 emergenc\ 111 MD, write that Peter has recently Westchester Count} , ni- Ann has accepted a JOb as an rD versity of Maryland; he i working on research on infectious County Medical Center and Tom dysentery at the Center for Vac- has begun working as an inter- 111 the \ Vestchcstcr cine Development in Baltimore. nist in the Mount Kisco Medtcal Gale just received her master's in Group. The; keep in close con- public health from The Johns tact with Barb Kearnq, \\ ho Hopkins School of Hygiene and married Paul Stcfantck tn '>ep- Johns Hopkins in a CD -funded is finishmg her patholog\ resi- sexuall y transmitted diseases. Gale spent this past spring in tiful bah) girl named South Africa, where she consulted rebruar) 1997. health services. atalt e low to mid 20's; leases starting at $299 per month. MIKE J . PELECHAGY JR . ' 94 , of Orchard Park, ) , \Hites: * According to the Insurance "\\ c've .Just accepted a fellowship position at Roswell Park 111 hema- GULATI '92 announce the birth tology/oncology , starting Juh l , of their son Suneel S. Ram on 1997. Also, '' e had another bah) Feb. 21 , 1997. Ragh u has joined girl, OliYia Paige. We're glad to he Kenmore Family Medicine, a back in the Buffalo area. r or those new group practice in Kenmore, on the Internet, look up m) nc\\ Y. Neeva is completing her rP [-mail address either at ..,,,Itch- niversity at board or 411. Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. SOUTHTOWNS SAAB 3580 Southwestern Blvd (1 Mile east of Rich Stadium) 716) 662·8008 Buffalo this year. ® higher education level than any other car owner group. * Saab purchase prices starting NEEVA re idency at the f;'\d ~01.1r OW'\ road. * Fact: Saab owners have a 111 and RAGHU RAM '90 AND CALL ME IN THE MORNING! tember 1994. Thev continue to dency. Barb and Paul had a beau- develop ado lescent- friend!) TAKE TWO ... reside in Tonawanda while Barb position to conduct research on for a rural district to help them Your WNY Leasing Specialist Serving WNY proudly tor 33 years ) . Carol attending Public Health and is working at 836-2033 respccti\cly, at the L.,niYersit\ of joined the faculty of the Division of Gastroenterology at the 487 Kenmore Avenue Buffalo, NY 14223 medicine and mternalnu·dtctnc, Pittsburgh. The} hm·c mo,·ed back close to thetr families to BURSTEIN '90 , Sales and Service nte that the) ha,·e completed thetr three) car res1denctcs 1 '\J), ' ' and Checkpoint Foreign Car, Inc. B u f f o l o Physician Autumn 1 9 9 7 �... . ..... UBMICRO COMPUTER SALES www.ubmicro.buHalo.edu Call 645· 554 t ..............• 11 . g Out A Non-Profit University at Buffalo Se ice Program - ' OBITUARIES MARTI N A . ANGELO '36 , of Fort Lauder- dale, FL, died May 28, 1997. The retired Advertise in one of the finest publications in Western New York ... Buffalo neurosurgeon was 85. He was on the staff of most area hospitals until retiring in 1976 and moving to Florida. Born in Buffalo, he sold newspapers and shined shoes during the Depression to help support his Buffalo Physician family and pay for his education. In World War II, he was commanding officer of an ~ u~ ~ ~ l~ Army hospital train unit stationed in France. He was a member of the American Medical f" ~ ~ \ t \ "~ Association, the Harvey Cushing Society, the Congress of Neurological Surgeons, and the Baccelli Club of Buffalo. Angelo is sur- YOU ARE ELIGIBLE vived by hi wife of 55 years, Marie Ruth for academic pricing on••. SanFilippo Angelo; a daughter; two sons; a sister; and nine grandchildren. Acer • Adobe • Apple • Corel • Dell • Hewlett Packard • Microsoft • Texas Instruments &much more ... Delivery & Setup in your home or office available! HAROLD Williamsville, BERNHARD ' 49 , of Y, former chief of service and medical director for gastroenterology at Millard Fillmore Health System, died june 19, 1997, at his home. He was 70. He Give us a call: practiced gastroenterology for the past 45 (716) 645-6933 Computer Workshops years and was one of the first physicians here to introduce the technique of gas- Michael J. Baranski trointestinal endoscopy; he was also a clini- Marketms Representative cal associate professor of medicine at UB. Call 645-3560 to have a brochure mailed to you. He recently was named Master of the American College of Gastroenterology, one of the most prestigious awards in his field, in • On-Site Private Training available. • Scheduled workshops start at $59. • 1/2 day miniclasses target specialized topics. recognition of his medical expertise and service to the professional group. He served as a trustee and secretary of the American College of Gastroenterology, governor of the college's orthern ew York chapter, and president of both the GastrointestinalLiver Society of Western Western ew York and the ew York Society for Gastrointes- tinal Endoscopy. Bernhard is survived by his wife of 48 years, the former G loria Summer hours: Mon thru Fri I 1-5 ~~~-·~~.[111'[+] BARANSKI u f f a l o grandchildren. ADVERTISING A non-profit University program tor students_ faculty & staff The commons . North Campus • (1t6) 645· 3554 • Fox: 645-3884 B Grossman; two daughters; and three Physician Due to space collstmillts, some Class11otes recei\ eel forth is issue ofBuffalo Physician will appear i11the next issue. -Eel. 146 Stepping Stone Lane Orchard Park, NY 14127 Autumn 1 9 9 7 �To consult with someone truly concerned with your financial come to KEY PRIVATEBANK Key. Your Key Private Banker heads a team of professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 84 7-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. <>-w Key. For a new America~ ® Buffalo Physician Autumn 1 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1-800- ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ \lt'IKal Uahtlil; \fuluallnsurani,. (ompany guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C1996 MM ca .aPi ty 1nsursnu: Ccmpsny Mutua l �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage PAID 3435 MAIN STREET Buffalo, NY B UFFALO NEW YORK 14214 Permit No. 311 ADDRESS CORRECTION REQUESTED Planned Giving to UB. Tax deduct,ons and on 1ncome for fe ore on'y port ;Jf the benefits you con recetve w th planned g1v1ng to the LB and B omediCOI sc,ences weo 1thy o a School of Med c ne Yot.. needn I be norc1o ger uo All you need s to make a gft And hove o de~ to he1p today s budd,ng gen ses mo e the wor o a better p oc.e n 50 years. For mo e nf Corder PhD mot or contact Ly~ CFRE of 716 8292773 or vo e-mo' of I]C.Order@ocsu buf a o.ed UNIVERSITY AT BUFFALO S!alt l "niz·eni{J' qf . \ i•zt· JiJd, � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1997-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v31n04-1997-Autumn Table Of Contents A list of subunits of the resource. Research DNA on Ice Dr. Mahoney Becomes Dr. Mahoney "The Woman's Way of Seeing and Doing" Orientation '97 Medical School News Development A Student's Perspective Alumni News Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/25d23c235dbdac2e36ce2da1eb43e40f.pdf 6b808860e4c531c12a44d210be2d37cf PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1998 Out with the Rote, -UNDERGRADUATE CURRICULUM RESTRUCTURED TO INCLUDE PROBLEM-BASED LEARNING in with the ew �BUFFALO PHYSICIAN Volume 32, Number I ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephanie A. Lnger ART DIRECTOR/DESIGNER Alanj. Kegler PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john Wnght, lntcrun Dean and Vice PreSident for Clinical Affairs EDITORIAL BOARD Dr. Bertram Portm, Chait Dr. Manm Brecher Dr. Harold Brody Dr. Lmda j. Corder Dr. Alan j. Dnnnan Dr. james Kanski Dr. Barbara MaJerom Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spaulding Dr. Bradley T Truax Roy Vongtama Dr. Franklin Zeplowilz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw The Children's Hospital of Buffalo Erie County Medical Center Mercy Health System Millard Fillmore Health System Franll Sara Niagara Falls Memonal Medical Center Roswell Park Cancer lnsl!lule Sisters of Charity Hospital Dennis McCarthy Veterans Affairs Western New York Healthcare System ©The Stale University of New York al Buffalo Buffalo Physician is published quarterly by the Stale Universny of ew York al Buffalo School of Medicme and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents, and friends. The staff reserves the nght to edit all copy and submissiOns accepted for publication. Dear Alumni and Friends, Nov. THAT 1997 HAS ENDED AND WE BEGIN to contemplate what made this year particularly interesting and challenging, several things come to mind. The rapid changes in the local health-care delivery system represent perhaps the most important of these issues, not only because they affect our primary mission-the education of future physicians-but also because of how the medical school enterprise is currently financed. The state budget provides only 13 tol4 percent of our annual expenditures, matched by approximately the same percentage from extramural-sponsored research programs. Since hospital support, which also includes the residents' salaries, accounts for approximately 23 percent of total expenditures and the practice plan, an additional 41 percent, over 60 percent of our funding is derived through the health-care delivery system. Changes in the financing of this system, together with its overall configuration, are therefore of vital interest to us. As we begin 1998, the merger of Buffalo General, Children's and Millard Fillmore hospitals is poised to occur, yet the consequences of the merger (for us and others) are far from clear. The Catholic system is undergoing similar merger discussions, while Erie County Medical Center and Roswell Park are in the process of determining their respective roles within this rapidly changing environment. As if this were not enough, we are actively engaged in reengineering the residency training programs in response to the well-publicized Medicare Demonstration Project, which calls for a 20 percent reduction in resident training positions over the next five years. This process has been complicated by the fact that most of our programs are dispersed throughout multiple hospital sites and in order to maintain quality (not to mention "accredited") programs, any significant downsizing will undoubtedly require program consolidation to fewer sites. The latter is further complicated by the financial implications to the participating hospitals and the availability of specialized training opportunities for specific program needs. The planning process is moving ahead, but many of the very difficult decisions are yet to come. Against this background, we must continue to develop innovative educational programs for our students, maintain the basic relevance of our curriculum and prepare our students for whatever future medical practice demands. (Fortunately, our students are an adaptable lot and probably better able to manage these changes than some of us older folks.) A number of exciting programs are under development to achieve these goals, some of which are presented in this issue of the Buffalo Physician. Finally, with 1997 having come to a close (and my first year as interim dean), I want to take this opportunity to wish each and every one of you a happy and fulfilling New Year! John R. Wright, MD Interim Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dear Fellow Alumni, Change is definitely the key word and it is currently rapid and aggressive. With winter here, I would advise those physicians who ordinarily choose to hibernate, to forego the temptation and stay alert. If not, they could awake to a considerably different medical environment. The steady advancement and influence of managed care, combined with the merging of health systems and HMOs/insurance companies, is creating a sense of stress. With those thoughts in mind, it is refreshing that I have had the opportunity to reflect on the future of medicine through the eyes and perception of members of the younger generation. First-year student Ryan, who is my mentor partner, and my son jerry, a PGYI resident, visualize their medical careers with joy, anticipation and determination. How nice it would be if that vision could be projected to a number of my colleagues. Attitude is obviously the key to handling the stresses of change. Plans for the 1998 reunion weekend and Spring Clinical Day, April25, 1998, are well under way. Dr. John Bodkin is arranging a program on aging, and the reunion chairs are making arrangements and contacting classmates. An article in the autumn 1997 issue of the Buffalo Physician noted that the reunion class commitments in 1997 were increased by 48 percent. Let us keep up the momentum. It is badly needed in this era of rapid decline in state support. Please plan on joining us in celebrating and supporting your excellent medical school. ~B.c:~.M~~ President, Medical Alumni Association �VOL U ME 32 , NUMBER 1 WINTER Out with the Rote, in with the New 2 CURRICULUM 12 Medical Student Exchange to Bosnia 18 EXPERIENCE BRINGS NEW RESTRUCTURED TO PERSPECTIVE TO U B INCLUDE PROBLEM- STUDENTS BASED LEARNING by Michael Beebe 1998 Communication Skills lor Tom~rrow's Physicians NEW PROJECT TO MORE FORMALLY INTEGRATE TEACHING OF EFFECTIVE by S. A. Unger COMMUNICATION SKILL S photos by Frank Cesario by S. A. Unger Heidi DeBlock, MD, PARLAYS HER FASCINA- TION WITH SPACE INTO REGULAR STINT AT HOUSTON'S LB.J SPACE CENTER New Computer Lab by Nicole Peradotto NEW "E-TECH" COMPUTING LAB GIVES STUDENTS ACCESS 3 Medical School DAVID K. MILLER , MD, "A GIANT IN HIS FIELD," TO STATE-OF-THE ART DIES AT AGE 93. LEARNING TOOLS COLLEAGUES AND by Scott Thomas STUDENTS REMEMBER HIM . Astudent's perspective: THE CHALLENGE TO SUSTAIN THE HUMAN - ITY WITHIN US Department Honored AMERICAN .JOURNAL OF 32 Resemh News EPIDEMIOLOGY DEDI- CATES SPECIAL TO UB' S Alumni ISSUE DEPARTMENT REUNION DAY by F. Michael Elliot OF SOCIAL AND PREFESTIVITIES PLANNED VENTIVE by Lois Baker Cover iiiU>Irolion by Wh~ney Shermon. MEDICINE 38 Class notes �PHOTOGRAPHS BY fRANK CESARIO OuT WITH THE ' IN WITHTHE BY S. A. UNGER -UNDERGRADUATE CuRRicULUM REsTRUCTURED TO INCLUDE PROBLEM- BASED LEARNING Changes are currently taking place in medical school curricula that can only be compared in magnitude to changes that took place more than 30 years ago, when curricula were restructured in response to physician shortages in select specialty areas. Ironically, while the changes several decades ago were fostered by a need to include new, specialized knowledge in the curriculum, today's changes are in large part motivated by an admission that the body of knowledge, especially in the basic sciences, has grown so large and complex that no person can be expected to absorb it all-not in four years of medical school, not even in a lifetime. Enter the concept of lifelong learning. Instead of trying to teach medical students everything they could possibly need to know about a seemingly endless number of subjects, educators at the University at Buffalo School of Medicine and Biomedical Sciences and other institutions worldwide are exploring a new concept: What about teaching students to 0 B u f f a l a master processes whereby they can teach themselves how to learn whatever it is they need to learn-using as their base a strong fundamental knowledge of the basic sciences? As in the real world of medical practice, this new form of learning is necessitated when a case is encountered, along with its specific problems. The method being used to foster learning in this way is called problem-based learning; in a larger context, it is also referred to as case-based learning. At UB's medical school, problem-based learning (PBL) is the foundation upon which the undergraduate curriculum for the basic sciences has been dramatically restructured to include a new two-year course called the Scientific Basis of Physician W I n t e r 1 9 9 8 �It is this rethinking of learning methods that has led medical educators to focus on the development of courses that utilize PBL, which emphasizes learning in small, self-directed, s tuden t-een tered groups. A few schoolsincluding Harvard Medic a l School , Small, self -directed, student-centered groups ore through its New integral to problem-based learning. Pictured ore Pathways Program first-year students with facilitator Joan Boizer, PhD. -have devoted their entire curriculum to a PBL format , but at UB , as in most schools, PBL is used to supplement a scaled-back number of core lecture courses. "At UB, what we're looking for is a balance," explains Dennis A. adler, MD, associate dean of the School of Medicine and Biomedical Sciences. "There is material that we believe is core material and is most effectively taught-and certainly more efficiently presented-through didactic lecture. " To effect this balance, therefore , and to accommodate inclusion of the SBM course, lecture time at UB has been reduced by the equivalent of about a day a week. "We did this because we fully expect about 10 to 15 percent of what is learned through SBM to be new material," Nadler adds. Medicine, or SBM. The course was designed by Alan R. Saltzman, MD , MBA, professor of clinical medicine, clinical director of the Department of Medicine at Erie County Medical Center and former chair of UB's Curriculum Committee; and Murray Ettinger, PhD , Distinguished Teaching Professor of biochemistry. Given that SBM in many ways reflects a paradigm shift in medical education, it seems apt that it was launched at the start of the 1996 school year, with the Class of 2000 the first to be enrolled. While implementation of SBM has involved growing pains on the part of both faculty and students, those who have had firsthand experience with this innovative course agree that it merits close attention and support as it continues to develop. lOOKING FOR A BALANCE At the core of the current changes in medical school curricula is the realization that strictly lecture-based formats may not be the most effective way to teach today's medical students, given the ever-expanding body of knowledge that must be considered. Critics of the traditional, lecture-based curricula have called into question its tendency to emphasize rote learning of facts for multiple-choice examinations, its lack of a meaningful context and its purported failure to provide students with the problem-solving skills they will need throughout their careers. They maintain that what students really should be learning is how to analyze and solve problems; in other words , how to identify what needs to be learned, how to find information that can be used to develop a hypothesis and how to test this hypothesis by acquiring additional, more targeted data. B u f f a l o Physician W I n t e r 1 9 9 8 0 �Is A CouRSE FOR ADULTS the group must expand and refine the learning In their first year in the SBM course, students objectives for the case and agree to a schedule for are presented with five clinical cases their first how these objectives will be covered during the semester and seven, their second semester. In two and a half weeks allotted. their second year, they take on six cases each "The goal of SBM is not diagnosis," emphasemester. A case begins in Butler Auditorium, sizes Ettinger, "although the students do like to where the entire class convenes to participate figure out what's wrong. The goal is to underin its presentation, which involves an actual stand the underlying scientific basis of what's patient who sits in front of the auditorium and happening to the patient: What is the cause of the is interviewed by Saltzman, who takes a hisdisease, and what is its clinical course in relationtory. Students are expected to fully participate ship to anatomy, physiology and biochemistry? in the process, which is punctuated by Saltzman In the second year, the emphasis is on the underprodding them to ask questions of the patient. lying microbiology, immunology, pathology and Behind Saltzman and the patient, Ettinger is at pharmacology of the disease." the chalkboard taking notes under the headutside of these small ingsofQuestions, Hypotheses, Tests and Learngroups, students are ing Issues. At the close of this 90-minute sesexpected to find and sion, the students have an opportunity to talk read full-length pawith the patient or the faculty individually. pers about every This marks the start of their case and in the learning issue, not weeks that follow, the class breaks into 17 limiting themselves groups of eight to nine students, joined by a to medical textfaculty member who serves in a clearly defined books, abstracts or scant role as "facilitator" of the group. Each small summaries from Web sites. To that end, students group meets for two 90-minute sessions a week receive training in how to conduct computer for two and a half weeks, for a total of five searches for medical literature and how to idensessions per case. At the start of the first smalltify papers that are appropriate to the learning group meeting, students are given a written issues for each case. summary of the case, prepared by Saltzman, as In the ensuing small-group discussions, the well as laboratory faculty facilitator tests results from serves as a guidethe patient. With not as a teacherthis information expert-to make in hand, the stusure that each memdents and their faber of the group cilitator embark contributes signifion their journey cantly to all aspects into the new of the discussion world ofPBL and that all the Giving struclearning issues are ture to this procovered in depth. cess are clearly Students are encourdelineated objecaged to facilitate tives for each discussion as well. session as defined During its final in the course outmeeting on the case, line. As a result, the group takes an in the first meeting , DESIGNERS OF THE SCIENTIFIC exam, following the same students know it's improcesses used throughout BASIS OF MEDICINE COURSE. perative that they review the earlier discussions. The MuRRAY ETTINGER, PHD, LEFT: the facts of the case and students are free to refer to AND ALAN SALTZMAN , MD. MBA. any clinical data they their notes throughout the have on the patient. Next, exam and conclude by THIS "lT MAKES THE CASE MUCH MORE MEMORABLE TO HAVE A PATIENT THERE," SAYS MElJI,SA WOlf. A SECOND-YEAR STUDENT. "lT CAN BE VERY EMOTIONAL. I REMEMBER ONE CASE WE HAD WHERE THE PATIENT HAD CYSTIC FIBROSIS AND SHE EXPLAINED TO US ITS IMPACT ON HER LIFE. KNOW I I WOULDN'T HAVE FELT THE SAME IF I HAD JUST READ ABOUT HER CASE." B u f f a l o Phys ic ian W I n t e r 1 9 9 8 �turning in one paper that reflects their combined effort. Grades are based 70 percent on participation and 30 percent on content, using the same grade scale that is used in the core lecture courses. "This is a course for adults ," Ettinger emphasizes. "It's not grade oriented in the traditional sense: The biggest part of the 'grade' students receive is a detailed evaluation of how he or she participated in the group. In essence, the 'exams' are closure exercises that continue the learning process." "Basically, what happens in PBL is that education is no longer controlled by the faculty," says Saltzman. "The education process now becomes much more student-focused and student-driven because the students are really the ones who decide what they need to learn to understand the case." A key to making this process work is the fact that the cases are carefully selected in an attempt to integrate them with the overall curriculum. "We meet with faculty to learn what material won 't be covered in detail-or at all-in the lectures and then we pick cases that represent specific common diseases that correlate with these areas. By selecting cases in this way, we know students will choose the right learning objectives," Saltzman explains. NoBODY ELsE IN THE WoRLD DoEs THIS What makes PBL most effective, its proponents contend , is that it lends relevancy to material by presenting the basic sciences within the context of actual clinical problems, a method that has been shown to improve recall. "Problem-based learning is B u f f a l o Physician really a model that comes from education that says you learn and retain better if you do things in context," adler says. "And there's good evidence that it works; that's why it's used in a wide variety of educational settings now, not just in medicine. " Further impetus for the push toward PBL has come from the Association of American Medical Colleges, the accrediting organization for medical schools . "Since the mid-I980s, the AAMC has been on a push to reduce the amount of curricular time in order to get students involved as more active learners," says Saltzman. "Basically, they've bought into the concept of PBL, so when they come around to accredit schools, one of the things they look at is how much time a school devotes to scheduled activities, such as lectures and labs , versus other learning formats. " PBL has also drawn attention as a means of stimulating students to choose careers in primary care in order to meet physician-supply demands resulting from dramatic changes in the delivery of health care nationwide. "There are different ways of teaching and getting students interested in primary care," says Saltzman, "and one of the ways to do that is to introduce them to patients' experiences early in their medical education." A unique way that the SBM course brings clinical relevancy to PBL is its inclusion of the "real" patient at the start of each case, as opposed to presenting the case on paper. "Dr. Ettinger and I had some things we wanted to do when we designed this course," Saltzman says, "and one of the things we wanted to do is introduce each case with an actual patient. We didn't know at the time that nobody else in the world does this, although I know of one school that brings a patient in at the end of a case to wrap it up. " "It makes the case much more memorable to have a patient there," says Melissa Wolf, a second-year student. "It can be very emotional. I remember one case we had where the patient had cystic fibrosis and she explained its impact on her life. I know I wouldn't have felt the same W I n t e r 1 9 9 8 "T HE BEGINNING WAS PRETTY TOUCH AND GO," SAYS SECONDYEAR STUDENT USLif CHAMBtRLAI '\i . " FoR SOME OF THE CASES, T H E FOCUS WASN'T CLEAR AND WE DIDN'T HAVE THE MED ICAL BACKGROUND TO BASE OUR D ISCUSS IONS ON .. . H owEvER, I ATTRI BUTE T H IS TO T H E COURSE BE I NG NEW LAST YEAR; THIS YEAR JT's IMPROVED TREMENDOUSLY." �if I had just read about her case; I wouldn't have known what was going on inside her and I feel the personal aspects of her disease would have been glossed over. With a real patient, I relate to the person, not just the disease. " ope Cawdery, a second-year student, says she was pleasantly surprised when her preceptor for her externship program last summer said to her, "You know a lot for a first-year student. " She says she told him, "It's all SBM." Cawdery says further that one reason she's learning so much from the course is "I get to pick what I'm interested in." Another key to making the course work, Ettinger feels, is that students are expected to do their own literature searches, as opposed to being told what to read. "I have seen that the real power of this course is that students go out and read different things," he says, "and when they come back the typical student doesn't necessarily have a good grasp of anything, and they know it! But what happens in a very relaxed, fun way-and it's a marvel to witness-is that by having read different papers, the students really complement each other's understanding during the small-group meetings and a whole lot crystallizes. It's incredible what can come out of these discussions; they really put it together. Our medical students are awfully good at this." THE Urs -LEARN! AND DowNs G ALO GSIDE FACLLTY Facilitators for the groups are drawn from both clinical and basic science faculty. "This is a very faculty-intensive course," Saltzman says, "and finding people who want to facilitate has turned out to be one of our biggest challenges-to free up one person from a couple of hours of lecturing doesn't help us come up with the 80 facilitators we need a year. And as the pressure on productivity increases for all faculty- in the lab or in the clinic- the time they feel they can allocate for 'optional' activities diminishes." onetheless, faculty have stepped forward and Saltzman and Ettinger hope interest will con tinue to grow. The first group of facilitators was trained in the fall of 1996, when the course began. "They learned alongside the students," says Saltzman, "and the students were exceptionally patient with the process and helped us out a lot. We were trying some things that just weren't working, so we made many changes to the course based on their input." "The beginning was pretty touch and go," says secondyear student Leslie Chamberlain. "For some of the cases, the focus wasn't clear and we didn't have the medical background to base our discussions on. For example, we had a case on sickle cell, but we didn't yet have a basis for the disease given to us in our biochemistry course. However, I attribute this to the course being new last year; this year it's improved tremendously. " Chamberlain says the facilitators were very receptive to criticism, and that has made all the difference. "They made us appreciate the course and made us feel we had some say in it. They didn't just force it on us," she says. Defining what role the facilitator plays in the group has not been without controversy. "We discussed this ad infinitum when we were developing the course," Ettinger recalls. However, he says several groups independently came to the same conclusion: The facilitator is not an expert in the subject area and is not supposed to supply information to the group. ot all the students agree with this conclusion, however, and the role of the facilitator continues to be a point of discussion for both students and faculty. Second-year studen t Andrew Mayer says, "I think facilitators should be sufficiently conversant with the material we're discussing"; however, he does concur that "they shouldn't dominate the discussion." "They're not the classic teacher," says Saltzman, who , along with Ettinger, also serves as a group facilitator. "Rather, "PBL IS SOMETHING OF A CONTRADICTION,'' SAYS CHARLES LAU, A SECOND-YEAR STUDENT. "ON THE ONE HAND, I'M LEARNING TEAMWORK- HOW TO WORK WITH PEOPLE WITH DIFFERENT PERSONALITIES- YET, ON THE OTHER HAND, I'M BEING PREPARED TO BE A VERY INDEPENDENT PHYSICIAN , CAPABLE OF LEARNING THINGS ON MY OWN , AS NEEDED, FOR THE REST OF MY LIFE." 0 B u f f a 1 o P hys i cian w I n t e r 1 9 9 8 �the job of a facilitator is to help make sure that everybody participates all the time; that the group maintains its focus and that the students go into a decent depth about each issue. They're also supposed to routinely foster a period of open discussion by the group about how the group is working." Midway through the course and again at its conclusion, facilitators complete written evaluations of the students; the students also evaluate their own individual performance, as well as that of the facilitator. When students do voice a concern about the role of the facilitators in SBM, Ettinger says, their concerns tend to focus on whether the small-group, PBL format, in general, is conducive to learning for them as individuals. Roy Vongtama, a second-year student, is a case in point: "In a lecture, material is presented in a systematic way by individuals whose knowledge in their field is recognized. As a result, I think I comprehend the material more, and retain more, and I also am more inclined to accept its veracity-as opposed to discussing the material with classmates and a facilitator whose knowledge base may be limited. However, I know I may be biased in this view because of my years of experience with the lecture format." CoNFRONT! needed, for the rest of my life." For first-year student Marina Zaydman, the small-group format has helped her successfully confront a very personal challenge: "I have always had a major problem with being shy, so being in my group has really helped me open up, mostly because we all respect each other. I'm feeling less and less uncomfortable speaking up, and I'm even noticing a change at my preceptorship because I'm able to talk with the patients quite easily. It's the greatest. Being shy used to hang over my head like a ton of bricks." THE GREATEST CHALLENGE REMAI G AND RrsoLVING PROBLEMS As for day-to-day dynamics within the small groups themselves, students and faculty alike agree that, for the most part, the members get along remarkably well. So well, in fact, that groups are purposely disbanded and reformed with different members at the close of each semester-a tactic designed to help prepare them to interact with the multidisciplinary teams they will be a part of as physicians. Problems, when they do occur, often stem from a group member being either too dominating or too quiet; however, facilitators are trained to motivate the students to confront and resolve any interpersonal problems themselves. "PBL is something of a contradiction," says Charles Lau, a secondyear student. "On the one hand, I'm learning teamworkhow to work with people with different personalities-yet, on the other hand, I'm being prepared to be a very independent physician, capable of learning things on my own, as B u f f a l o Physician W I n INC.. "Probably the greatest challenge remaining," says Ettinger, "is for a reformed curriculum to evolve that optimally integrates the core curriculum with the SBM and CPM [Clinical Practice of Medicine] courses. In order for physicians to provide excellent care for their patients, they need scientific knowledge, clinical skills and compassion, as well as consistent approaches for learning, analyzing and solving clinical problems." As SBM continues to take shape in the years ahead, Saltzman and Ettinger are sure they will continue to have lots of input from students, faculty, facilitators and administrators, and they look forward to further improvements that will come from this process. After all, processes geared to solving problems are what these two educators are primarily interested in, and what they find most rewarding in their work is seeing processes such as PBL translate into learning. "The students are really remarkable," Saltzman says. "It's amazing how quickly they learn right from the start what the process is for PBL; they just run through it: facts , questions, hypotheses, mechanisms, t e r 1 9 9 8 0 �'THE EDUCATION PROCESS NOW BECOMES MUCH MORE STU DENT-FOCUSED AND STUDENT-DRIVEN BECAUSE THE STUDENTS ARE REALLY THE ONES WHO DECIDE WHAT THEY NEED TO LEARN TO UNDERSTAND THE CASE." SALTZMA .MD.MBA learning issues .... That's what Dr. Ettinger and I are really interested in. If they learn that process, they are set to learn for the rest of th eir lives." And the students do seem to be learning the process. "The second-year students are into their third semester of this," says Wolf, "and we're getting to be 'old hands' at it. At the beginning, we had no idea where to go with PBL, but now we really go through the routine fast for each caseit almost gets mechan ica l at times. " Who knows, maybe someday Wolf and her Class of 2000 will be making their own brave attempt to take the rote out of learning. + THE GENESIS OF THE SciENTIFIC BAsis OF MEDICINE CouRSE AT UB he Scientific Basis of Medicine (SBM)course is adirect outcome of a report issued in1991by the UB School of Medicine and Biomedical Sciences' Task Force on Undergraduate Medical Education, cochaired by Charles M. Serverin, MD, PhD, associate professor of anatomy and cell biology; and Avery Ellis, MD, PhD, associate professor of medicine and physiology.ln this report-written by the committee's chairs with assistance from Dennis A. Nadler, MD, associate dean in the Office of Medical Education--<hanges to curriculum were recommended to better "prepare students for the practice of medicine inthe 21st century." Akey objective toward meeting this goal was to stimulate 0 B uffalo students' interests in pursuing primary-care careers by introducing them to clinical experiences in their first two years. To accomplish this, the report in part proposed designing a course in which students could "learn basic medical science in a clinical context that illustrates for every student the importance of basic science knowledge for the clinician." Further impetus for the SBM course also came indirectly from athree-year, $600,000 grant the school received in 1994 from the Robert Wood Johnson Foundation to fund UB's Primary Care Practice Initiative. One of the overall goals of this initiative is to revamp the medical school curriculum to more closely link clinical experiences to the basic sciences, as well as to emphasize problem solving and self-learning, explains Nadler, whose Office of Medical Education provides ongoing support for the multidisciplinary SBM course. + Physician w I n t e r 1 9 9 8 �FACUL1Y EXPERIENCING A LEARNING CURVE l:o! n many ways, the move to- facilitator for SBM, but also helps train the discussion in a different direction." ward problem-based learning new facilitators for the course. He and Another aspect of traditional teaching (PBL) in UB's medical education other faculty work closely with Judith that facilitators must leave behind them, curriculum has been as big a tran- Shipengrover, PhD, a medical education according to Shipengrover, is the familsition for faculty as it has been specialist with the Office of Generalist iar practice of dividing up research tasks for students. Stanley Spurgeon, Initiatives in UB's medical school. Both among group members for the sake of MD, clinical assistant profes- educators agree that faculty who serve as efficiency. "In group sessions this apsor at UB and an emergency facilitators in the SBM course are experi- proach only replaces teacher-delivered room physician for the past 20 encing a paradigm shift in teaching lectures with mini-lectures delivered by years, has had experience both methods as much as the students are the students as they report their findings, as a traditional lecturer and, experiencing a shift in learning methods. while the rest of the group listens," she now, as a facilitator for the "It's really difficult letting loose of says. "Although counterintuitive and .) ......, Scientific Basis of Medi- the 'I'm-the-expert' perspective," says seemingly less efficient, the redundancy cine (SBM) course. "Actually, the role Spurgeon. "I have found that the most and scattershot approach of the PBL of facilitator is probably easier for me important thing a facilitator needs to method, in which all group members than for some because in the clinical learn to do is keep his mouth shut." research every learning issue, fosters realsetting, we frequently teach in small Shipengrover says the paradigm shift time discussion and problem solving as groups," he says. "When attending phy- for faculty involves sevstudents work to sift and sicians, interns and residents do rounds eral key changes in persort what they know or "IN THE PAST in a hospital and come across some- spective related to what don't know about each isFACULTY HAVE BEEN thing involving a patient they're not Spurgeon has experisue based on their collecIN CONTROL OF familiar with, in essence that becomes enced. "Part of it is trust," findings." tive THE DELIVERY defined as a learning issue. Everyone is she says. "In the past facSpurgeon has experiOF INFORMATION enced firsthand all these given the assignment to learn about it ulty have been in control NOT NECESSARILY and give a short summary report the of the delivery of infordilemmas; however, he T HE RECEIVING OF is very motivated to connext day. So the small-group, problem- mation-not necessarily IT- BUT CERTAINLY based, student-directed model for learn- the receiving of it-but tinue along his own learnITS DELIVERY. ing has been used in clinical medicine certainly its delivery, ing curve when he sees WHICH ISNTTHE how well the students for many years." which isn't the case with CASE WITH PBL." In the past, though, Spurgeon says, PBL So at some level you progress within the PBL medical students had to "flounder have to trust that the stuformat. "Most of the along," essentially teaching themselves dents can and will do what it takes to time," he says, "if you allow a group to the processes involved in PBL "By our learn-that's the 'Eureka' moment with attack a concept and go at it, they may third year, we did have the basic build- PBL You let the students confront the not go in a straight line, but almost ing blocks for problem-based learning, problem, realize what they don't know, always they get to where they need to be having picked them up from working then go and find out what they need to going; they get it right." with residents and interns," he says. solve it." Shipengrover, too, sees much merit in "But it would have been helpful if we A second area of transition the PBL format, but feels strongly that had been taught these processes in a Shipengrover has identified is that of facilitators should be encouraged to demore formal way earlier on." knowing when to intervene in a group's vote more attention to working with the Spurgeon says he became interested discussion. "It's a judgment call that students to more clearly define what exin teaching when he was a fourth-year takes a lot of practice," she says. "As an actly the process is that they are experistudent at Indiana University School of expert-turned-facilitator, there's a con- encing in the group. "I feel there should Medicine. "I began teaching the third- stant push and pull about when, for always be a learning objective related to year students," he says, "because I re- example, to speak up and tell the stu- the group process itself," she says. "I membered how helpful the students were dents the answer to an issue they've think we're missing a lot if we don't make who had made the transition ahead of me been struggling with and when to sim- it part of the facilitator's role to help the and I wanted to help in the same way." ply point them toward the solution students see and understand the larger Today, Spurgeon not only serves as a through strategic questions that move framework they're working within." B u f f a 1 o Physician W I n t e r 1 9 9 8 0 J. . . . . . . . . . . . . . . . . . . . . . . . . ._____________________. �APhysician Whose Dreams -and Work-Are WHE her family's home in Elmira, New York , staring up at the stars, as her father discussed the constellations. A pilot during World War II, he was the one who told her about Apollo l3's mishaps after the now-famous warning, "Houston , we have a problem," was uttered from the spacecraft. At an age when many girls are into dolls , DeBlock was caught up with the space race. But back then, the world hadn't met Christa McAuliffe. "The Right Stuff' meant, in no small part, testosterone. Yet no one tried telling DeBlock the stars were no place for a woman. "We didn't have sexual barriers growing up ," she says. "I have an older sister who graduated from college in 1968-she was a dorm-mate of Hillary Clinton at Wellesley-and I thought that she was one of these women who was forging the way for me. So we were talking this summer about that, and I asked her if she found that difficult. Her comment was that she never noticed anything. "There were four girls and one boy in my family, and our parents allowed us to make our mistakes and choose what we wanted to do. And that changed our mind-set 100 percent. "Yes , I notice that I'm the only woman sitting in the room [at the space center]. But I don't let that affect my behavior. " As a teenager, DeBlock's initial exposure to the world of medicine didn't leave her as starry-eyed as space. When she was in high school, her next-door neighbor, a physician, got her a job performing electrocardiograms at the local hospital. "At first I really hated it," she recalls. SHE WAS SIX WEEKS OLD , Heidi DeBlock took her first ride in a glider. When she was six years old, she marveled as Neil Armstrong took "one small step for man, one giant leap for mankind." Her research there focuses on how As a physician, she has parlayed her zero gravity affects astronauts' hearts. fascination with the final frontier into a regular stint at Houston's Lyndon B. The results of her biggest project, in johnson Space Center. "Space is fasci- which she examined the heart rates of nating because it is so vast, and so little seven astronauts who had gone on space is known about it," says DeBlock, Class walks between 1990 and 1993 , were of 1990, a visiting scientist at the center's published in the Apri.l1997 issue of the cardiovascular lab. "I love science, and American]oumal of Cardiology. the science involved in this is And that's just the beginso rich. " ning . Construction of the BY Ironically, DeBlock's NASA space station is scheduled to NICOLE begin next year, and her findconnection with the great unPERADOTTO known began far from it: in the ings will be crucial once it is basement of UB's medical in operation. "The arrhythschool. There, a visiting professor giving mia research is important because we a lecture on a heart drug briefly discussed want to make sure there are no ill her sabbatical at the space center. After effects on the astronauts' heart rhythms the talk, DeBlock, then a second-year when they're up there ," she says. "We student, approached the teacher and have to make absolutely sure that it's asked for names of people she could safe for them. " For now, in-flight data is as close as contact in Houston. She made the calls, had good credentials and, in her fourth DeBlock gets to the launchpad. She was year, was invited for a month-long once invited to watch a liftoff-but she had to scrub when she couldn't find a internship. baby-sitter for her three daughters . "Lo and behold, everything clicked This year she was among close to there," she says. "They just kept inviting me back, and I kept going back." For one 3,000 candidates vying for one of the month every year and a half, DeBlock most elite callings in the world: astrofrees herself of her duties at Albany Medi- naut. Although she didn't get an intercal Center, where she is an intensivist in view, she plans to try again next year. the surgical intensive care unit, and at And if it happens, she would be fulfillAlbany Medical College, where she is ing the dream of a lifetime. director of the second-year cardiovascuAs a chi.ld, DeBlock-then Heidi lar rotation, and travels to Houston. Frutchy-would sit on the front steps of ® B u f f a l o Physic i an w I n t e r 1 9 9 8 �"The environment was scary to me. 1 just didn't like being in a hospital." The next summer she warmed up to the job. And then, a turning point: "l watched open-heart surgery and thought that was the greatest thing." At the University of Rochester, she majored in astrophysics, paying for her education by reading Holter monitors at Strong Memorial Hospital. Both disciplines, huge and unknown in their own ways, intrigued her curious mind. During her senior year, she and a PhD student published an article in an international physics journal on a discovery they had made in the field of chaos. "By that time, I had learned to love medicine more and more. 1 didn't like astrophysics less and less. But after [the article was published] 1 felt 1 had accomplished something in physics, and now it was time to move on to medicine." In the two years before starting medical school, DeBlock worked at Strong as an intensive care unit technician and got married. She entered UB in the fall of 1986. ln space history, it was a signifi- B u f f o l o "lt was very Heidi DeBlock, MD, vying to become on astronaut dramatic. I think everyone held their breath until they heard that the shuttle was into a safe configuration"meaning it was safe for the astronauts to disembark. "And then everyone started hemming and hawing and AT THE UNIVERSITY OF ROCHESTER , SHE MAJORED wondering how long IN ASTROPHYSICS , PAYING FOR HER EDUCATION it was going to be BY READING HOLTER MONITORS AT STRONG delayed. It's only MEMORIAL HOSPITAL. BOTH DISCIPLINES, HUGE then you realize how much of these AND UNKNOWN , INTRIGUED HER CURIOUS MIND . people's lives are on While the world's interest in space that space shuttle, and how much goes has waxed and waned, DeBlock's into it. You can't really realize that until has only grown with her increased you're there. " DeBlock's next trip to Houston is in involvement. She knows that every blastoff means a potential scientific February. Until then, the scientist and breakthrough. "l was in a conference her minister-husband are sure to have room during a launch once, and many an intriguing dinner-table conthere must have been 75 [scientists] versation about the world "out there." "That's always interesting," she notes, watching it on a closed-circuit TV. laughing. "We never argue, though. " Two of the three engines ignited and Between her hectic schedule and varithe one did not. So they had to shut down the shuttle and abort the ous professional duties, DeBlock relies on her family to keep her grounded. + mission immediately. cant year. Early in it-on january 28the Challenger burst into Games 73 seconds after liftoff. "1 was 23," she remembers with the instant recall you would expect of a space buff. "I had just moved from Rochester to Holland, Michigan, where my husband, Scott, was starting seminary." Physician w I n t e r l 9 9 8 ��MEDICAL STUDENT EXCHANGE TO BY MICHAEL BEEBE BRINGS NEW PERSPECTIVE VERY PHYSICIAN HAS A HORROR STORY about getting through medical school. Few ring as true as those of Maida Secerbegovic, MD , a 1997 graduate of the University of Tuzla Clinical Medical Center. That's Tuzla, as in Bosnia, the war-torn former Yugoslav Republic whose people-let alone its medical care-have been turned upside down by ethnic fighting. Secerbegovic, whose medical studies took seven years to complete due to the constant shelling of her city and hospital by Bosnian Serbs, just completed a five-week exchange at Children's Hospital of Buffalo as part of a medical partnership between Buffalo and the Bosnian city. Earlier last summer, three students from the University at Buffalo's When they first arrived at the hospital. the UB students were shocked by the damage they saw, which had b een caused by hundreds of shells landing on the hospital grounds. School of Medicine and Biomedical Sciences made the journey to Tuzla, where they saw how a hospital staff missing one-third of its physicians has been handling the medical care of a city whose population more than doubled to nearly one million during the war. This was the first time it was deemed safe enough for an exchange of medical students through a partnership called International Medical Relief of Western New York. Begun by jacob Bergsland, MD, a Buffalo General Hospital heart surgeon who went to Bosnia in 1994 to work in a United Nations field hospital, the alliance is the first hospital partnership in Bosnia supported by the American International Health Association. It was honored by First Lady Hillary Rodham Clinton in a October 1996 White House ceremony. P H 0 6 u f f 0 l 0 Physician T 0 w B y G R A P H S 1 n t e r 1 9 9 8 L I S A A P F E L �T he exchange of medical students almost never happened. The relief organization did not want to dilute any of its already scarce resources, which were needed to help Tuzla's physicians rebuild their medical system. The immensity of the job and the dearth of available funding seemed to make an exchange of students a costly extra. But after hearing how their professors were helping people who truly needed it, and after becoming acquainted with some of the Bosnian physicians and nurses who have come to Buffalo for training, the students didn't think so.(Recently, the U.S. government renewed a $2 million grant that, along with local contributions and donations from the medical school and Buffalo hospitals, will be used to assist Bosnia.) "This program was generated by the students," says Dennis A. adler, MD, associate dean at the UB medical school and a clinical assistant professor of pediatrics. "They decided to do their own fund-raising. Without that kind of initiative, we could not have done it. " The only restriction the medical school put on the students was that the program would have to be a true exchange program, with Tuzla students coming to Buffalo to study as well as UB medical school students spending time in Bosnia. The student exchange started last summer when the first group from UB-Lisa Apfel, a second-year student from Hyde Park, NY; Daniel Avosso , a second-year student from Long Island, Y; and Won Hee Kim, a thirdyear student from New York City- traveled to Tuzla. A Muslim-held industrial community about 50 miles north of Sarajevo, Tuzla suffered considerably during the war, when it served as a key distribution center for humanitarian aid. To bring in even more supplies, the United Nations wanted to open the city's airport. The Serbs responded by shelling the city. 6 u f f 0 l 0 When they first arrived at the hospital, the UB students were shocked by the damage they saw, which had been caused by hundreds of shells landing on the hospital grounds during the war. Clinic walls are still pockmarked by shrapnel. Less immediately obvious was the effect that years of fighting and treating war victims had had on the hospital staff and on the community it served. During the worst of the fighting in 1992, there was power only two hours a day, no telephone service, little or no pay for doctors for their long hours and no public transportation. urses sometimes had to walk three hours just to start their shifts. Some of the doctors who were able to leave did; others were pressed into service in field hospitals at the front. During the interruption in her studies, Secerbegovic helped give immunizations in the war zone and was nearly hit by artillery shells. A medical-surgical resident at the hospital suddenly became the hospital's chief of surgery when the chief left. There was no more heart surgery, let alone elective surgery. When they ran out of supplies and drugs or equipment, the staff had to make do . Apfel experienced a telling example of this the first time she walked into the hospital and saw the long line of patients waiting outside a clinic. There are no longer any hospital gowns in Tuzla, so men and women alike stood outside the clinic stripped to the waist. o one complained. It was just part oflife. At least they had some hope of treatment now. Riyaz Hassanali, MD, a Buffalo physician specializing in reconstructive plastic surgery and an advisor to the program, was stunned when he first went to Bosnia. Because everyone in the medical community had to concentrate on treating war injuries, no one was caring for the health needs of the civilian population. "Minor problems became major problems because they had not been treated," he says. "One of the national journals published the pictures we took of patients with untreated tumors because they could not believe the tumors had progressed to that point." Apfel and her fellow students were shocked at how little equipment was left. The nearest MRI machine was in Budapest, Hungary. There was a CT scanner at the hospital, but it was Physician W 1 n t e r 1 9 9 8 �thousands of hours past its intended lifetime. Last summer a Buffalo physician packed a neonatal ventilator into three suitcases and took it to the Tuzla hospital, where 7,000 babies a year were being delivered with no ventilator available. Contrast that with the experience Secerbegovic had coming to the Children's Hospital of Buffalo. In one of the most advanced pediatric hospitals in the country, she spent a majority of her time helping administer gastrointestinal tests with equipment not available in her homeland. She says she asked as often as she could how the American physicians would handle procedures if they didn't have the benefit of such advanced technology and equipment. "This was a great experience. I feel like I can help our younger students now," she says, in nearly flawless English. (She did not need tutoring from the UB English professors who go to Bosnia to help physicians with their language prior to their coming to the United States.) Hassanali says that Bosnia's lack of resources brings an interesting twist to the medical education of the American students who visit: "The students who go there learn more about the practice of medicine than about the practice of technology." They also learn how difficult-and potentially costlyit can be to practice medicine without even the rudiments of technology. Apfel notes, for example, how Bosnian physicians looking for blood in stool samples sometimes miss it because they have to rely on visual examinations, while American doctors use a simple chemical strip costing a few cents, with near-perfect results. "The resources are severely limited in Bosnia," she says. "It was amazing to see how the staff dealt with it; how they would devise things while a physician here would order several tests." Students from both countries also spent time together outside the hospitals. 1 Secerbegovic, whose parent? took Apfel into their home in Bosnia, visited her host's home in Hyde Park and made a trip to Niagara Falls during her time in the rotations at the Tuzla hospital-pediatrics, surgery or internal medicine-and spent their off-hours exploring the city and countryside. They included a trip to Sarajevo, a once breathtakingingly beautiful city that was heavily damaged during the war. The medical student exchange program, once thought to be an expensive extra, is bringing unforeseen benefits, as the students are bringing to their studies a different perspective from their visits, viewing the problems and challenges in both countries with fresh eyes. ew approaches are going to be needed, notes Hassanali, since Bosnia is being forced to not only rebuild its health system, but also to abolish the former centrally controlled economy of communist Yugoslavia. Every specialty in the Tuzla Clinic, for example, was once its own fiefdom , with everything separate-from medical journals to operating theaters. Daniel Avosso, who, like most Americans, followed the war on television and in newspapers, began to see Bosnia in a different light after his stay there. As he walked through Tuzla, he saw numerous churches, temples and synagogues as evidence ofa diversity far wider than the media's portrayal of only three groups: Serbs, Croats and Muslims. "I was impressed by the diversity in Tuzla, the various religions and cultures," he says. "It was something I thought only existed in America, not in a country that I thought was not accepting of other cultures." Hassanali, himselfa refugee from Uganda, believes other UB medical students who travel to Bosnia will come to the same conclusions he has about his practice here: "I realizes how lucky I am to be in the United States, practicing in Buffalo, with the tremendous resources we have available." + u.s. Apfel, Avosso and Kim were given their choice of B u f f a l o Physician w I n t e r 1 9 9 8 �Communication E for Tomorrow's Physicians stablishing a pattern of open and trusting communication between physician and patient is more than a perfunctory gesture of goodwill at the outset of a professional relationship; it's the foundation for every measure of success in a clinical practice. How well a physician communicates with patients affects accuracy of diagnosis, adherence to treatment plans, patient and physician satisfaction and-increasingly-incidence of malpractice suits. Despite this fact, a focus on technology in medicine over the past four decades and a subsequent drive to train "scientific physicians" have tended to erode awareness of the need for clinicians to have and cultivate effective interpersonal skills. In more recent years, however, the emphasis on technological innovation has been eclipsed by managed care and its focus on cost effectiveness, which has dramatically changed how health care is delivered. This, in turn, has provoked unprecedented criticism from patients about how they perceive they are being treated. More often than not, the focus of their attention-or contention-is on how well they feel their doctor communicates with them. In an effort to ensure that medical students acquire the communication skills they will need in their future practices-and to help bring the "art" of medicine back into balance with the science-a new project is under way at ® the University at Buffalo to more formally integrate the teaching of effective communication skills into the medical school's curriculum. The projectwhich will complement existing efforts at the undergraduate and residency levels at UB-is being led by Frank Schimpfhauser, PhD, assistant dean for educational evaluation and research. Funding for the project is being provided by a $50,000 grant from the Medical Liability Mutual Insurance Company and the Medical Society of the State of New York. L!STE lNG AND RESPONDING TO CALLS FOR CHANGE The new communication project is a direct outgrowth of the Standardized a u f f a 1 o BY 5 . A . UNGER Patient Clinical Competency Program established at UB's medical school in 1992 with grants from the Macy Foundation and the National Board of Medical Examiners. In large part, this program was begun in response to concerns that thirdand fourth-year students and faculty expressed about the curriculum, which they felt did little to ensure that students had minimal competencies in a wide range of clinical practice areas, according to Schimpfhauser. More than 90 percent of the students surveyed over two classes felt their opportunities to observe or be observed in a standard way were less than adequate. Students felt that they had not observed enough physician-patient interactions, that they did not have enough structured feedback on their own interactions and that their clinical skills training lacked consistency and quality. This sentiment was paralleled by faculty interest at the national and local level to develop more effective and consistent approaches to assessing students' progress and performance in areas of history taking, physical examination and patient communication. "We realized that we could no longer just assume that over the course of their first two or three years in medical school, students will uniformly acquire basic clinical practice skills, and we saw that we needed to develop more consistent ways to teach and objectively assess the skills relevant to these Physician W I n t e r 1 9 9 8 �instructors who will demonstrate positive modeling, continued practice with and feedback from standardized patients and, finally, application of the acquired skills in a clinical setting. Performance reports will be given to students, summarizing their attainment of skill, and plans for the future include making communication skills a part of UB's annual " I ALWAYS TELL MY STUDENTS THAT NO PATIENT WILL EVER competency exams. COME TO YOUR OFFICE WITH A WRITTEN TEST SAYING . 'I SEE "Working with standardized patients YOU PASSED THIS TEST, SO YOU CAN BE MY DOCTOR ,' INwill provide stuSTEAD, THEY ARE GOING TO JUDGE YOU BY SUCH THINGS AS dents with an opporYOUR EYE CONTACT, HOW WELL YOU LISTEN AND WHAT tunity to perfect their communicaQUESTIONS YOU ASK . PATIENTS WILL MAKE THESE TYPES OF tions skills without JUDGMENTS ABOUT YOU EVERY DAY" - JAMES HASSETT, MD embarrassment a wide range of clinical procedures and about their lack of experience and withprovide structured feedback in years out consequence to patients," explains two, three and four, using "report cards" Harry Sultz, DDS, MPH, professor of and faculty presentations. Expectations Social and Preventive Medicine, and and performance scoring are based on coinvestigator for the project. faculty-developed criteria. "Rather than focus on history tak- WoRKING TO OvERCOME ing, the physical exam or other specific "PROBLEMS OF PERCEP'fi0:\1" clinical problems, this project is in- The foremost goal of the new project is to tended to place a primary focus on give students the interpersonal skills they students' communication skills within will need to deal sensitively and effecthe context of common, yet sensitive tivelywitha wide range of situations they and difficult clinical topics and issues," will encounter in their everyday practices, especially situations that can be says Schimpfhauser. Currently, Schimpfhauser and his value laden, such as teen pregnancy, coinvestigators on the project are work- alcoholism or risk of HIV infection. ing with faculty teams to identify and Studies have consistently shown that develop appropriate problems and patients' criticisms of physicians-and checklists, as well as clinical scenarios approximately 75 percent of all medical that will be implemented using stan- malpractice suits-can be traced to probdardized patients. Topics and issues will lems of perception about how well painclude, but not be limited to, advanced tients feel their doctors communicate directives; informed consent; HIV risk; with them, not how well they feel their Do ot Resuscitate orders; the presen- illness was treated. Specifically, these tation of bad news; sexually transmitted studies show that patients focus on such disease; obesity and nutrition; substance concerns as how comfortable the physiabuse; and domestic violence. cian made them feel, whether they unThe training-set to begin in the spring derstood their treatment options, whether of 1998-will initially involve medical the physician gave the impression that he students and residents in the depart- or she listened and truly cared, and ments of Surgery and Medicine. Their whether the physician explained things interactions with the standardized pa- in a way that gave them hope. James Hassett, MD, also a project tients will be videotaped and critiqued. If deficiencies are identified, the students coinvestigator, is associate program diwill participate in a five-step remedial rector for residency training in the Deprocess that will include working with partment of Surgery at UB and chair of areas- including communication skills," says Schimpfhauser. Through the program, "standardized patients"-persons trained to portray patients and specific scenarios-are first used to complement preceptor instruction in the Clinical Practice of Medicine Program for first- and second-year medical students. They are also used to assess 6 u f f a l o Physician W I n t e r 9 9 8 the Program Director's Committee, a consortium of committees for all of the medical school's residency programs. He works every day with residents as they learn to interact with patients, and he feels strongly that communication skills are the single-most important determinant of success at this level of training. "For residents in training," he says, "how well they do depends on how well they communicate with their peers, with other professional staff, with patients and with attending staff. Communication in those four areas becomes the most crucial factor in whether or not they're going to do well in a residency program. "Residents are almost never stressed by knowledge limitations; rarely does anything happen to their patients where just pure knowledge will make a difference," he adds. "There's not that kind of urgency in the work. However, what does matter is how well the students can talk with a patient and find out what's wrong and how well they can talk with the patient's family and explain treatment options. I always tell my students that no patient will ever come to your office with a written test saying, 'I see you passed this test, so you can be my doctor.' Instead, they are going to judge you by such things as your eye contact, CONTINUED ON PAGE 19 COMMUNICATION SKILLS [oinvestigotors working to develop the new communications skills training program and to plan the conference ore: LISA BENSON, MD, clinical assistant professor of medicine and consultant; TIMOTHY GABRYEL, MD, clinical assistant professor of medicine and director of the Internal Medicine Residency Program at Millard Fillmore Hospital; JAMES HASSETT, MD, professor of surgery and associate director of the Surgical Residency Program; DENNIS A. NADLER, MD, associate dean for curriculum and student affairs, Office of Medical Education; STANLEY SPURGEON, MD, clinical assistant professor of emergency medicine and medical director for the Standardized Patient Clinical Competency Program; HARRY Sum, DDS, MPH, professor of social and preventive medicine and director of Health Services Research; KAREN ZINNER STROM, PHD, trainer/ evaluator, for the Standardized Patient Clinical Competency Program. �The Challenge to Sustain the Humanity Within Us BY F . MICHAEL ELLIOT last June gave me a sense of accomplishment and brought closure to a period of exploration and growth. The transition to medical school represented a deliberate and refreshing step into a world of new experiences, ideas and people. RADUATI G FROM COLLEGE The past few months have been a period of intellectual discovery and personal introspection. The adjustment to the faster pace and greater expectations of medical school has been difficult, as I believe it has been for many. What is most challenging, however, is the confrontation each of us must undergo with our own limitations despite our desire for perfection. The pressure to master knowledge becomes the crucible through which our perseverance is tested, strained and strengthened. Although tedious and consuming, the process of learning inscribes within us the vocabulary through which we will communicate as future teachers, scholars and healers. As we prepare to become witnesses to the suffering of people, students must also confront and accept the limitations of medicine. Our knowledge of the human body and the causes of its pathologies has always been, and will certainly continue to be, incomplete. As science provides medicine with new routes of observing and deconstructing the mechanisms within our cells and organs , new questions will overshadow the past discoveries. Advances in biotechnology conquer yesterday's diseases only to be rendered impotent by the ® emergent pathogens of tomorrow. The search for the breakthrough is over: Victories over disease are now measured in cautious, incremental steps. Bold efforts to cure cancer and AIDS are now directed toward attempts to manage these diseases as chronic, long-term conditions. Economic forces now significantly influence the direction of biomedical research and public health policy. Escalating health-care costs have invited and indefinitely ensured the fu- spite these obstacles, the art of medicine perseveres as the means through which human suffering is understood and alleviated. Because those who suffer most acutely are often the least spoken for and soonest forgotten, it is often the physician who must act as sole witness , advocate and healer. Although the progression of a disease and the inevitability of death may be beyond a physician's THE INTERACTION BETWEEN DOCTOR AND PATIENT IS MORE FRAGILE AND INTIMATE THAN I HAD IMAGINED : IT IS A PRECIOUS FORM OF COMMUNICATION THAT SELDOM OCCURS BETWEEN HUMAN BEINGS . ture dominance of managed care. The consequent loss of physician autonomy has forced doctors to reexamine and possibly redefine the relationships they share with their patients. It is what the field of medicine aspires to accomplish that continues to compel students to become doctors in this increasingly arduous social landscape. De- B u f f a l a control, his capacity to address pain may not. What seems to distinguish the physician from other vocations is his consciousness of this pain and his willingness to alleviate the consequent suffering. It is through communication that this healing occurs, as the patient's vulnerability and uncertainty is abated by an understanding of what afflicts him. Physician W i n t e r 1 9 9 8 �The clinical experiences during this first semester have been a fulfilling opportunity for me to experience medicine beyond the basic sciences. The very act of taking a history with a patient is profound for a student, now entrusted with the private pain and frailties of others. The interaction between doctor and patient is more fragile and intimate than I had imagined: It is a precious form of communication that seldom occurs between human beings. While shadowing a doctor during a preceptorship, I found myself an observer of two worlds, remembering myself once as a patient but now projecting myself as a future doctor. Before I am fully equipped with this new medical education, these few visits have allowed me to see patients from the uncomfortable perspective of someone who is helpless to heal them. Although I cannot discern them yet, these patients have symptoms I will soon recognize and diseases I will one day diagnose. Until then, however, I am grateful for their kind patience as I fumble with my stethoscope. The frenetic pace of this first semester has increased my appreciation for the occasional moment of casual diversion or personal introspection. I have looked forward to seeing my family during the holidays and breaks, more acutely aware of the brisk passage of time. It is paradoxical that this education through which we seek the ability to heal others requires that we devote so much time away from people, immersed in study. We have chosen to devote our lives to the rigorous study of medicine, a pursuit demanding personal sacrifice for what we believe is a noble end. The challenge is to accomplish this task while nurturing and sustaining the humanity within us that has compelled us from the beginning. + COMMUNICATION SKILLS (FROM PG 17) how well you listen and what questions you ask. Patients will make these types of judgments about you every day. " The only way students are going to learn these skills, Hassett says, is through practice and appropriate feedback. "This is what Dr. Schimpfhauser is doing with standardized patients. The reiteration of a format in a standardized way is critical to training; it's the concept of 'practice makes perfect."' TooLs FOR ToMORRow In addition to training students, the methods developed in this project will provide faculty with objective and systematic means of assessing performance in the area of interpersonal skills. "In medical school you have a variety of very good evaluation tools to test cognitive competencies," Hassett says. "However, there are few tools to evaluate skills. You have a history of how well the student performed in college, but we are finding that these records are not always predictive, so really there currently are no methods of testing how well students will be able to interact with patients. With this project, Dr. Schimpfhauser is working to develop this type of tool. Once it's completed, it will be very helpful for faculty because it will allow us to train against a precise standard, a standard that will help us make sure students are acquiring the skills they will need to become better doctors-and better people." + A final outcome of the projecl ru•i/1 be to hold a bes/pmclices confermce in Buffalo in the fall of / 998 in '"'-'hich teaching techniques, diniml simulation packages and assessment tools developedfor the project rmd in use at other medical school.r u::iH br.rhored 11:irh eiluca7orsinvitedfrom mediml schools throughout Nt'"'-• Yori.'Siale. O NLY O NE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement courses • tate of the art visual and performing arts center • More than 60 interscholastic sports team • Comprehensive community service projects • Average class size is 15 • Financial aid avai lable Admissions tests on these Saturdays at 9:00 a. m.: January 24, February 28 To reserve a place for testing or for additional information, please call: ICHOLS MIDDLESCHOOL, 175 Nottingham Terr., NICHOLS UPPER SCHOOL, 1250 Amherst St. 875--8212 Acceptance 1s granted to qualified students w1thout regard to race, color, rehg1on or nanonal ongm. B u f f a l a Physician w I n t e r 1 9 9 8 NICHOLS SCHOOL �New Medical Computing Lab Opens medical student peers intently at the computer screen, working her way through a histology tutorial program. Layer by layer, the structure of a tissue section reveals itself-accompanied by review questions, gentle corrections and the kind of patience only a machine can muster. In a thousand variations, that's the worked to each other and ready to go scene being replayed in the new Medical to work with quick Internet connecComputing Lab that opened in August tions and access to Medline, Hubnet 1997 at the University at Buffalo's School and other medical databases. of Medicine and Biomedical The lab is open 8 a.m. to BY Sciences. Combining a new age 10 p .m. , weekdays, and dayof computer technology with light hours on the weekSCOTT the accumulated knowledge of ends-plenty of time for harTHO AS centuries of study, the lab is ried students to fit in one last making medical education Internet search for a missing more accessible to the first generation of citation, or to type that paper that's due students who've grown up with the desk- tomorrow. top computer. Primarily, however, the lab is a place From such mundane necessities as for teaching and for learning. word processing to exciting advances in Dannenhoffer refers to it as an "e-tech" database searching, all the possibilities classroom, in which a professor can work of computer-assisted learning (and even- at a central station and direct computer, tually medical practice) are being played VCR and other electronic images to apout in the Cary Hall lab. pear on students' individual monitors, or "This has been in the planning for project them on a screen using one of two three or four years, " says Ray projectors and an audio system. The arDannenhoffer, PhD, director of the rangement allows the professor the flexschool's Office of Medical Computing ibility to move back and forth in his and faculty member in the Department presentation at the click of a mouse, for of Anatomy and Cell Biology. "I under- example, or the ability to quickly access estimated how much the students would appreciate it: The feeling is, 'The school has really invested something in my education. They've put up an infrastructure I can really use."' The project involved major renovations to the second floor of Cary Hall, including the removal of walls to create a wide-open room, then a series of improvements-carpeting, paint, new furnishings, such as comfortable ergonomic chairs and computer desks and Laser]et printers-and about 70 Gateway 200 MHz computers, all net- e u f f a 1 o a related image when a class discussion takes an unexpected turn. What's different about the e-tech classroom is that the students, too , are given the tools and the responsibility for managing their own learning. This is especially evident in a series of tutorials, such as the histology tutorialdeveloped by John Cotter , PhD , professor of anatomical sciences and opthalmology at UB's medical schoolthat allow students to immerse themselves in a body of information until they're satisfied that they've mastered it. There's also a computer sound system with headphones- useful in a cardiology session, for example, in which the student learns to identify normal and abnormal heart sounds by listening in a controlled environment. The medical school's new focus on problem-based learning, as in the Scientific Basis of Medicine course for firstand second-year students, would be much more difficult to carry out without this computer support. For one thing, problem-based learning demands that students search out, sort and evaluate information on their own- something that computers make exponentially more efficient than walking through a labyrinth of library stacks. "It saves a tremendous amount of time," says Amy Van de Water, a second-year student who's now taking her third semester of Scientific Basis of Medicine. "Because we're first- and second-year medical students, our medical background Physician W I n t e r 1 9 9 8 �\ I is very limited, so you really have no idea and the students can search those for a interactive teachers of diagnostics, even sometimes what to make of the symptoms particular article and either save it or as general-reference textbooks. [presented by the class's designated pa- print it out." "These students are either working tient]. There are a number of medical This sort of information manage- directly with the diagnostic programs, textbooks on-line, so that's a good starting ment is crucial to the emerging field of or logging onto the World Wide Web point. In some programs you can get a medical informatics, a field that the and looking at particular sites, or logwhole article on-line, rather than trying to next generation of physicians will find ging onto the university library facilifind it in the literature in the library-if themselves encountering every day. ties, looking at papers with regard to you can find it at all on new findings .... Many of the shelves." the students have had a THE EMERGENCE OF PRACTICAL APPLICATIONS IN First-year student great deal of computer exRob Collard agrees: perience through the colMEDICAL INFORMATICS MAKES . .. FAMILIARITY "Here you can go off lege years. But surpris[WITH COMPUTERS] CRUCIAL TO THE STUDENTS" and find reliable ingly, there's a section of sources of information the class that is fairly naSUCCESS AS PHYSICIANS. to attempt to bring ive as far as computer usdepth to the issues age is concerned. It's very raised in class. It's a team approach, and From computerized patient records important that they be given the opporhopefully it leads to a synthesis of is- and billing, to new ways of presenting tunity to begin to use this technology sues." and sharing data about patients, to keep- and get some idea of how it all works As for the amenities of the new com- ing current with the tremendous growth and to overcome their fears. " puter lab, Van de Water says it's a sig- of medical knowledge, physicians will The emergence of practical applicanificant improvement over the previous increasingly find the keyboard as tions in medical informatics makes that lab. "There are more computers avail- necessary as the stethoscope. familiarity crucial to the students' sucThat's the focus of a course in medi- cess as physicians. As an example, able to students, so you don't have to wait," she says. "There are faster and cal informatics for second-year students Spangler points to the Visual Chart, a better printers here. And the old lab was taught by Robert A. Spangler, MD, an method of presenting patient informanot temperature-controlled, so we were associate professor and director of gradu- tion visually that was developed by always opening the windows because it ate studies in the Department of Physi- former UB medical school professorjohn was sweltering." ology and Biophysics. "We go through Loonsk, now at the University of North "Because the computer lab is in the things like the structure of databases Carolina. "It's a Windows-based probuilding where teaching takes place, and how to conduct effective searches, a gram that tackles individual patient data students don't have to go to the library little bit about the Internet as a resource, and displays it in a graphical fashion , so if they need to do a search in between and then we talk about expert systems," one can, at a glance, get a feeling for the classes and have only a little bit of time," he says. Those systems include such nature of the problem," Spangler says of Dannenhoffer says. "And besides the programs as QMR and Iliad, which can the program, which is undergoing field medical databases that are available, a act as consultants in diagnosing a condi- tests. "It's not just a chart hanging on lot of the medical journals are on-line tion based on a set of symptoms, as the end of the bed anymore." + B u f f a l o Physician W I n t e r 1 9 9 8 �Journal Celebrates Innovative UB Research acuity in the Department of Social and Preventive Medicine at t "Consumption ofPCB-Contaminated Fresh Water Fish and Shortened Menthe University at Buffalo School of Medicine and Biomedical strual Cycle Length"- Pauline Mendola, Sciences have trained some of the most respected epidemiolo- PhD, formerly of UB, now of the EPA t "Gender Differences in the Relationgists in the United States and produced significant and innova- ship Between Depressive Symptoms and tive research in cancer, occupational, environmental, nutritional, Alcohol Problems: A Longitudinal Perspective"-Beth Steger Moscato, PhD, reproductive and cardiovascular epidemiology. research assistant professor tionship of alcohol and breast cancer, In recognition of the department's t "Physical Activity, Obesity and Diabecontributions to the field , the December and relationship of gum disease and tes"-Timothy D. Dye, PhD, a 1990 2, 1997, issue of the American journal of heart disease. graduate of the department, now BY Epidemiology is dedicated to research by t Trevisan was the first to show at the University of Rochester. the beneficial dietary effects of its faculty members and graduates. The issue begins with hisLOIS "The publication of this issue cel- olive oil in population-based torical overviews of the UB ebrates the rich legacy of the depart- studies. medical school (which marked ment and the School of Medicine and t John Vena, PhD, professor its sesquicentennial in 1996), Biomedical Sciences," says Maurizio and associate chair, has defined several the department, as well as epidemiolTrevisan, MD, professor and chair of the nutritional and environmental factors ogy in Western ew York, dating back department. "It affirms the important that influence the risk of bladder to 1843. Graduate Philip C. asca, PhD, contribution that our training programs cancer. professor of epidemiology at the Unihave made to the field of epidemiology t Germaine M. Buck, PhD, associate versity of Massachusetts at Amherst, and prevention." professor and one of the nation's most writes on current problems and future Saxon Graham, PhD, one of the pio- respected specialists in epidemiology of opportunities in the field and graduate neers in the study of the relationship of infertility, in 1994 received one of two Christine B. Ambrosone, PhD, discdiet and disease, spent his career at UB, research fellowships awarded in the usses the new field of mol ecular where he conducted some of the earliest United States by the Merck Company epidemiology. studies in the United States on the health foundation and the Society for EpidemiThe final two studies concern the benefits of a diet high in vegetables ology Research. She is conducting a reliability of study participants' reports containing beta carotene, now shown to long-term study of tubal ligation. of lifetime drinking histories (by Marcia The issue's lead article, "Body Mass Russell, PhD, clinical professor) and of lower the risk of certain cancers. Jo L. Freudenheim, PhD, associate Index and Mortality in a General Popu- reports of pap smears, breast exams and professor, has continued that research lation Sample of Men and Women," mammograms (by Richard B. Warnecke, and in the past decade has earned a written by Joan M. Dorn, PhD, assistant PhD, formerly ofUB, now of the Univerreputation as one of the nation's leading professor, reports that being overweight sity of Illinois at Chicago). is a significant mortality risk factor for nutritional epidemiologists. Graduates of the department include women and men less than 65 years old. top officials and/or researchers at the Other research highlights follow: Other articles and lead authors int The department was designated as one ational Cancer Institute, Monsanto of 15 vanguard centers for the ational clude: Company, the ational Center for Institutes of Health's Women's Health t "Lactation History and Breast Cancer Toxicological Research, ewYorkState Department of Health, Roswell Park Initiative, one of the largest clinical tri- Risk"-Jo L. Freudenheim, PhD t "OxidativeStressandLungFunction"als ever assembled, focusing on diseases Cancer Institute, Centers for Disease Holger ]. Schunemann, MD , research Control and Prevention, Illinois Despecific to women. t More than $12 million in funded re- assistant professor partment of Public Health , University search is currently under way, includ- t "Consumption of Contaminated Sport of Massachusetts at Amherst, Univering studies of the effects of lifestyle on Fish from Lake Ontario and Time-to- sity of Iowa and orthern California lung cancer and heart disease, health Pregnancy, ewYorkAnglerCohort"Cancer Center. + effects of eating Lake Ontario fish , rela- Germaine M. Buck, PhD ® s u f f a l o Phys i cian w I n t e r 1 9 9 8 �Magnificent BUILDING LOTS l Dear Colleague: As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western New York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundings. THE CARJTAS The Summit at Scherff is a truly extraordinary residential development, unrivaled in Western New York. Nestled in the hills of Orchard Park, this magnificent 81-acres offers 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. MEDICAL AitTS BUILDING Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the BuiTalo skyline A Unique Partnership with St. Joseph Hospital • Mature woods and secluded ravines • Oversized lots for your dream house • Quick and easy access to the freeway systems leading to BuiTalo and the city's northern suburbs • Privacy, seclusion, and exclusivity Harlem Road, Cheektowaga The Summit promises to be one of the premier areas in Western New York to construct your luxury residence. I invite you to take a stroll through this picturesque setting. For our detailed brochure or a private showing please call (716) 667-2237 or (716) 472-3790. (connected via enclosed walkway to St. Joseph Hospital) 500- 8,000 Sq. Ft. Medical Office Suites Now Available Sincerely yours, For More Information Edmond J. Gicewicz, M.D. Past President, UB Medical Alumni Association Ciminelli Development Company, Inc. Centerpointe Corporate Park 350 Essjay Road Williamsville, NY 14221 _j 716/631-8000 B u f f a l a Physician W I n t e SUMMIT AT SCHERFF Orchard Park, New York A development by Falcon Land Corp. - --- THE r 1 9 9 8 ® �~ ········· · ·············································· · ··················· · · ······· · ·· El the world. Later, in 1963 , he was a senior member of the team that performed the first kidney transplant at that same institution. After his training was completed, Aust stayed on the faculty as a scholar of the American Cancer Society, beginning in J. BRADLEY AUST LOOKS BACK 1957. "At the University of Minnesota ," he recalls , "I worked for Dr. Owen Harding Wangensteen, who, over the Bradley Aust, MD, was recognized as University at course of his career, trained 30 chairs of Buffalo Distinguished Medical Alumnus at a dinner held surgery around the country, including Dr. Randolph Paine, cochair of surgery in his honor on September 25, 1997, in Buffalo . A 1949 at UB. " Discussing trends in medicine that I graduate of the UB medical school, Aust retired in 1996 influenced career options for physicians as chair of the Department of Surgery at the University of starting out in the 1950s, Austsays, "My whole generation went into cardiac surTexas Health Science Center at San Antonio, a position he gery. " However, his plans to do just this held for 30 years. In a recent interview from his home in changed suddenly one day, when his mentor and "boss ," Dr. Wangensteen , Texas, he shared highlights of his long and eventful career, stopped him in the hallway and engaged attributing much of his success to exceptional mentoring, him in a conversation in which he strongly encouraged the young surgeon collegial teamwork and simply "being in the right place at to pursue oncologic surgery. "It was clear that if I wanted a job on the right time ." staff, I should become a cancer "The 1950s were a very intersurgeon," Aust says with a esting time to enter medicine ," chuckle. As is often the case, this Aust says. Indeed, as his career unexpected change was positook shape, the young Buffalo native found he had the good tive and over time led to new and unexpected opportunities. fortune of being able to play an active-sometimes pioneeringIn 1966, Aust was selected to role in the unfolding of medical be the first chair of the Department of Surgery at the Univerhistory. After finishing his studies at UB, Aust went to the Unisity of Texas Health Science Center at San Antonio. Earlier versity of Minnesota to serve his surgical residency, during which in his career, while at the University of Minnesota , he time he discovered an interest in research and an academic caconducted research related to studies on endotoxin shock and reer. His surgical training was interrupted by two years of ser- J. Bradley Aust, MD, left, receiving Distinguished Medical Alumnus award fromJohn the application of immune R.Wright, MD, interim dean, UBSchool of Medicine and Biomedical Sciences, center, tolerance to transplantation. vice as a surgeon during the Koand Jared C. Barlow, MD, president, Medical Alumni Association. Later, he began to gain national rean War. Returning to school in In 1955 , Aust had his first brush recognition through his pioneering clini1952, Aust completed his residency and fellowships in physiology, oncology and with medical history , when he served cal work in oncologic, vascular and transsurgery, and earned an MS degree in as a junior member of the team at the plantation surgery. Once in Texas, he physiology and a PhD in surgery as part University ofMinnesota that performed concentrated his efforts on the many one of the first open-heart surgeries in challenges inherent in building a new of his research training. 1997 UB Distinguished Medical Alumnus Named ® B u f f o l o P hysician w I n t e r 1 9 9 8 �···· ·· · ·· · ··· · ···· · ··· ····· ···· · department, the practice of oncologic surgery and the development of improved ways to administer adjuvant chemotherapy. Aust's move to San Antonio was literally a "ground floor" opportunity, as the school was in the process of being established. Looking back, he feels this time and the years that followed were the most rewarding of his career. "just the germination of the idea that I could run a department of surgery was very exciting," he says. "These were heady times. I had an opportunity to help design the curriculum, establish a new department in a new school and train surgeons according to my own model. " In addition to his administrative responsibilities at the Health Science Center, Aust continued to explore his clinical research interests and pioneered isolated perfusion, the administering of ·· · · · ········ · · · ······ · ··· · · ·· ············ ·· ····· high doses of chemotherapy locally as a means to overcome systemic toxicities. He also found time to serve as president of a number of medical and surgical societies, including the Society of Surgical Oncology, and the Association for Cancer Education, and served as chair of the Board of Governors of the American College of Surgeons. Aust is reflective about progress in the field of oncology, having spent the last several decades of his career treating cancer patients. "People often ask me where I think we stand now in our attempts to treat cancer more effectively, " he says. "I often compare the conquest of cancer to the conquest of the atom bomb. When we developed the atom bomb, we knew all we needed to know to develop it; we just had to do the engineering. When we started out to conquer cancer, we didn't have the basic · ·· · · · · ~ • understanding to do the engineering; we didn't have the basic science. " Today, progress is being made in our understanding of the basic biological processes underlying the genesis of cancer; that's the understanding from which progress in the future will stem, he adds. In retirement, Aust is avidly pursuing one of his favorite hobbies-surgical history-and is hard at work writing a chronicle of the Health Science Center at San Antonio. He also remains dedicated to his alma mater by volunteering his time to serve as a member of the Dean's Advisory Council for the UB medical school, traveling to Buffalo three times a year to meet with the group. He says being named UB's Distinguished Medical Alumnus is something he didn't anticipate and states simply, ''I'm really honored. " + -S.A . UNGER If you come looking for a car, you'll be awfully disappointed. HOWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who answer any of your questions about driving. A4x4, of course. &JjS Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) Buffalo Physician w i n t e r 1 9 9 8 ® �• ···· ·· ········ · · · ······························································· ······· · ~ I Primary Care Extemsbip Program Receives $150,000 Grant n innovative program providing real-life clinical learning opportunities in primary care for University at Buffalo medical students has received a three-year, $150,237 grant from the Charles E. Culpeper Foundation of Stamford, Connecticut. Physician in Training Initiative. The paid externship exposes first- and second-year medical students to the practice of primary care medicine in community-based settings throughout Western New York. Administered by UB's Primary Care Resource Center, the six-week Medical Student Summer Externship Program is recognized as the largest of its kind in the nation by the American Medical Student Association 's Generalist Diane Schwartz, executive director of the Primary Care Resource Center, says the Culpeper Foundation grant will help fund an assessment of ways to retain UB medical students to practice primary care in Western New York. "Our numbers are showing that 50 percent of UB medical school graduates are entering primary care ," Schwartz says. "However , the significant issue is retention. With more analysis and evaluation of the primary care externship program, we will have valuable information on how we can retain the medical students entering primary care in Buffalo and the surrounding areas." Gathering this information, explains Schwartz, could have a significant impact in areas with a health-care shortage designation , a federal term to identify areas with too few medical THE SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES WISHES TO EXTEND ITS THANKS TO THE FOLLOWING PHYSICIANS WHO SERVED AS PRECEPTORS FOR THE PRIMARY (ARE SUMMER EXTERN SHIP PROGRAM IN 1997. EXTERN PRECEPTOR FIELD EXTERN PRECEPTOR FI ELD Renee Abderhalden Bettina Ackerman Tomaro Alberti Ben Alderfer Romone Alexander Steve Ambruski Jell Amodeo Joyce Anderson Lynn-Marie Aronico Stephanie Babcock Lynn Barnhard Florence Bero Anthony J. Caprio Thomas V. Caprio Hope Cowdery Patrick D'Abbracci Ann DeNordin Porn Diomontis Melissa Dilanni Melissa Dilonni Louis Domenico Jr. Holly Drexler Notosho Frongopolous Jennifer Griffith Molly Harrington Chuck Howorth Shannon Howe Shirley Huang Rashma Katira Thomas S. Scanlon, MD Evelyn Hurvitz, MD, FAAP Ganesh N. Deshponde, MD Thomas F. Cozza, MD David Holmes, MD G. Lawrence McNally, MD Mork R. Klocke, MD lone M. Pormington, MD Nicholas Aquino, MD Chelikoni VP Varma, MD Geoffrey Markowski, MD Geoffrey Markowski, MD Pat Collins, MD Donald Robinson, MD Richard Schifeling, MD John Fudymo, MD Geraldine Kelley, MD Sanford Levy, MD Anthony 0. Bartholomew, MD G. Joy Bishop, MD Shawn Cotton, MD Mork Swetz, MD Geoffrey Markowski, MD Paul Lecat, MD Theodore Putnam, MD Richard Schifeling, MD Margo Krasnoff, MD Gregory Synder, MD S. T. Pavon, MD Internal Medicine Pediatrics Pediatrics Pediatrics Family Medicine Pediatrics Pediatrics Pediatrics Medicine/Pediatrics Pediatrics Family Medicine Family Medicine Family Medicine Family Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Family Medicine Family Medicine Family Medicine Medicine/Pediatrics Pediatrics Internal Medicine Internal Medicine Family Medicine Family Medicine Margaret Lafferty Charles Lou Karen Lee Judy Lettmon Jason Lorenc Rosemarie Mannino Andrew Moyer Kara McCunn Hasit Mehta Donna J. Peace Jesenia Pena Stephen Przynosch Mory Rose Puthiyomodam Kevin Robillard Gretchen Schueckler Morsilio Seiwell Tracey Shanahan Natalie Sikka Marissa Stumpf Britto Svoren Priyo Tahilioni Roque! Thomas Judith Toski Amy Van de Water Rosalia Viterbo Michelle Watson Ryan White Melissa Wolf Nora Yip Barbara Stouter, MD David Milling, MD Raphael Wang, MD Dona Drummond, MD James Wild, MD Ellen Rich, MD Timothy F. Gabryel, MD Thomas R. Gerbasi, MD Harry Metcalf, MD Ellis Gomez, MD Peter Kowalski, MD Fronk C. Mezzadri, MD Colin McMahon, MD David Thomas, MD Jack P. Freer, MD Brian Connolly, MD Emily Frieden, MD Jack F. Coyne, MD Deborah Richter, MD Peter Kowalski, MD Colleen Mattimore, MD Anthony F. Oliva, DO Leonard Katz, MD Robert Berke, MD Peter Winkelstein, MD Geraldine Kelley, MD Howard Sperry, MD, MPH Leonard Katz, MD Anthony Vetrano, MD Pediatrics Medicine Pediatrics Family Medicine Family Medicine Internal Medicine Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Medicine/Pediatrics Medicine/Pediatrics Family Medicine Internal Medicine Family Medicine Pediatrics Pediatrics Family Medicine Family Medicine Pediatrics Family Medicine Medicine Family Medicine Pediatrics Internal Medicine Internal Medicine Medicine Pediatrics B u f f a l o Phys i cian w I n t e r 9 9 8 �professionals available. "It is important to attract students to practice primary care in these areas," Schwartz says. "Developing long-term relationships with patients and the community through the externship program, we believe, provides the impetus for the medical students to continue practicing medicine here." The Culpeper Foundation grant also will fund stipends for 20 medical students per year to participate in the externship program, as well as provide partial funding for an associate director of the program. The Charles E. Culpeper Foundation is a private, nonprofit charitable foundation established by the late Charles E. Culpeper, one of the early pioneers in the bottling and marketing of Coca-Cola. The foundation provides approximately $7 million per year in support of activities in health, education, arts and culture, and the administration of justice. + Journal Dedicated to Dr. Helm he ovember 1997 issueoftheDer- matologic Surgery journal has been dedicated to Frederick Helm, MD, emeritus professor and former chair, Department of Dermatology, UB School of Medicine and Biomedical Sciences, on the occasion of his 70th birthday. In an editorial comment, Robert A. Schwartz, MD, of The University of Medicine and Dentistry of ew jersey, says of Dr. Helm: "His work since the early 1960s with professors Edmund Klein, Halina Milgram and Howard L. Stoll Jr. on skin cancer and its immunotherapy is of extraordinary merit. His book, Cancer Dermatology, is a first-rate accomplishment, as are the large number of book chapters and articles he has written .... The work of Professor Helm and his colleagues has led to the present era of unprecedented advances in the study of etiology, recognition and management of skin cancer symbolized by the superb articles in this Special Issue." + inda Duffy, PhD, associate professor ters, insurance providers and school and of pediatrics, and scientific director public health officials," she says. "I look of the Women and Children's Health forward to serving the children of ew Research Foundation (WCHRF) at York State and intend to promote public the University at Buffalo School of policy that supports initiatives that help Medicine and Biomedical Sciences us achieve Health 2000 objectives for and the Children's Hospital of Buffalo, immunizations." + has been appointed to New York State Governor George Pataki's Advisory Council on Immunizations. According to Duffy, the appointment provides a vital opportunity to impact immunization compliance for the children of Western ewYorkand ewYork State. "Immunization surveillance depends on integrated, cooperaLinda Duffy, PhD, associate professor of pediatrics and scientific tive efforts between primary-care director of the Women and Children's Health Research Foundation physicians, regional referral cen- u f f a l o Physician W I n t e Buffalo Physician ~Uff"tj f "~ s \ t \ " " Giv e us a call: (716) 645-6933 Michael J. Baranski Marketing Representative Linda Duffy,PhD,Named to Governor'sAdvisory Council B Advertise in one of the finest publications in Western New York ... r 1 9 9 8 BARANSKI ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 1412 7 �• ································· · ··············································· · ······ . I fallacy .... Everyone has a will. The real question is "Who wrote it? " If an individual, for whatever reason, doesn't take the time to write a personal will, the author becomes "the politicians." All states, as well as the m Co•o•• PHD " ' " ' federal government, have laws that govern what happens to a person's ast fall, I had the opportunity to represent the School of Medicine assets if he or she dies without a valid will or other estate plan. One reason and Biomedical Sciences at the 17th International Fund Raising there are so few "public service" proWorkshop. It was held near Amsterdam, outside the village of grams promoting the writing of wills may stem from the government's inNoordwijkerhout, on the North Sea, in a former monastery. terest in the resources of those who die intestate. Some people are also Thirty-four countries were represented by a total of 689 delegates. content with this arrangement. (I once There were 18 of us from the United States. What a novel experience heard of an immigrant and naturalized citizen of the United States who to be in such a distinct minority-and yet at the same time, to feel was so happy with the life he had made here that he wanted his accumulated totally at home among my peers. wealth to go to our government.) Most Participating in this workshop was laws therein. The overwhelming mes- of us, however, prefer to have a more an adventure I will treasure all my life. sage was that those who included edu- active voice in how our hard-earned It reinforced my commitment to this cational and charitable organizations resources are used after we are finnoble vocation of institutional advance- in their estate plans did so more for the ished with them. Recently, I had the privilege of readment, and at least equally important, love of their families and their organimy decision to work on behalf of this zations than for tax benefits. To pro- ing an expertly crafted will. It was excellent medical school. Together with vide for their families and to direct beautiful, thoughtful and complete. It fully utilized the gift exDr. Wright, the departclusion amount of ment chairs and fac" WHERE THERE' S A WILL , YOU HAVE A SAY ." YOU MAY HAVE $600,000, currently in ulty, with alumni and effect, as legacies to friends of this instituHEARD IT REPORTED THAT ONLY FOUR IN TEN OF ADULT children and grandchiltion, I am delighted to dren. The remainder be involved in helping AMERICANS HAVE VALID AND UP-TO- DATE WILLS. FROM ONE was divided among to weave the future of educational and charithis school. It is alPERSPECTIVE . THAT STATEMENT IS A FALLACY . . . . EVERYONE table organizations, ready outstanding; fuHAS A WILL. THE REAL QUESTION IS " WHO WROTE IT?" leaving no taxes of any ture philanthropy sort to "Uncle Sam" or holds the potential to "Cousin Gov." One of enhance and expand the opportunities available to students, resources to nonprofit organizations, the beneficiaries was the University at alumni, fellows, faculty and friends. there has to be an official document Buffalo. The six-figure gift will initiate Three of the small-group sessions in that governmental authorities recog- a scholarship endowment in memory which I participated focused on lega- nize. In this country, the document of the individual's daughter. Forever after, outstanding students at UB will cies, and how, at their deaths, indi- is a will. viduals in many different countries "Where there's a will, you have a benefit from the thoughtful foresight make gifts to their favorite organiza- say." You may have heard it reported of this individual and those who helped tions. There are, of course, more simi- that only four in ten of adult Americans to structure the will to meet his wide larities than differences in these have valid and up-to-date wills. From variety of objectives. In our office, we frequently receive prgrams, regardless of country or tax one perspective, that statement is a AWord from the Director of Development "' ® B u f f a 1 o Physician w I n t e r 1 9 9 8 �requests for assistance in crafting wills and other estate plans . For general questions, I have a variety of booklets that present overviews of ways to give, what is essential to include in a will and what types of gifts bring with them lifetime benefits to donors. One even focuses on "Estate Planning for Today's Woman." All of them include information regarding the changes made in the tax laws during the 1997 Congressional Session. The school is also fortunate to be a part of a university-wide development operation, with a planned giving staff available to assist in specific aspects of planning one's estate. Each situation is different; each plan becomes a tapestry, the design of which rests with the individual and what he or she wants to accomplish with the resources available. lf you have questions , our conversations are confidential. Give me a call. Linda]. (Lyn ) Corder is th e associate dean and direc tor of development for the School of Medicin e and Bi omedical Sciences. She previously serv ed the sc hool as maj or gifts coordinator and assi stant dean . + INFINITI tal in Little Rock and served as assistant professor and associate professor of ophthalmology at the University of Arkansas for Medical Sciences. Reynolds returned to Buffalo in 1988, when he was named chief of pediatric ophthalmology at Children's Hospital. Currently, Reynolds is the recipient of a two-year, $436,000 grant from the National Eye Institute to investigate a treatment that could prevent retinopathy of prematurity. Characterized by excessive growth of retinal blood vessels in extremely premature infants, the condition can cause vision degeneration and blindness. + James Reynolds,MD, Named Interim Chair, UB'sDepartment of Ophthalmology ames Reynolds, MD , has been appointed interim chair of the Department of Ophthalmology at the University at Buffalo School of Medicine and Biomedical Sciences. Reynolds, who is an associate professor at the medical school, also serves as chief of pediatric ophthalmology at the Children's Hospital of Buffalo. A graduate ofUB's school of medicine, Class of1978, Reynolds completed his ophthalmology residency in Buffalo and fellowship training in Pittsburgh, after which he became a clinical instructor and staff surgeon at the Eye and Ear Hospital, the Children's Hospital of Pittsburgh and the University of Pittsburgh SchoolofMedicine.ln 1983, he became the chief of pediatric ophthalmology at the Arkansas Children's Hospi- James Reynolds, MD I ntroducing your way to escape. lnfiniti's luxury sport AUTO PLACE INFINITI Unlike most luxury sport 8129 MAIN ST. , WILLIAMSVILLE escape for the weekend, it has all the comforts and luxuries you East of Transit Rd. , Near Eastern Hills Mall u f f a I o MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 B utility vehicle : the QX4. need to escape life's daily stresses. Physician W i n t e r 1 9 QX4 9 8 �• ··········· · ··········· · ············ · ······················· · ··· · ······················ · ~ . I He Was aGiant in His Field -DAVID KIMBALL MILLER , MD , DIES AT AGE 93 avid Kimball Miller, MD, professor emeritus at University at Buffalo School of Medicine and Biomedical Sciences, died in his sleep at age 93 on October 25, 1997, at the home of his son, David Rush Miller, in Hilo , Hawaii, where he had lived since 1993. A native of Bloomington, Il, Miller graduated from Illinois Wesleyan University in 1925 and Harvard Medical School in 1929. He then served a twoyear internship at Boston City Hospital, after which he completed a residency at Rockefeller Institute for Medical Research in ew York City from 1931-1937. Miller came to Buffalo's Edward ] . Meyer Memorial Hospital (now Erie County Medical Center) in 1937 as director of laboratories, and two years later he became director of the Department of Medicine at the hospital , a position he held until1967. Also in 1937, he accepted a teaching position at the University at Buffalo medical school, becoming the first full-time faculty member in medicine at the school. "Because he was the first full-time faculty member in the department, which had a very strong clinical faculty , it was critical that he be a master clinician, and this was a role Dr. Miller fulfilled in a very amazing way," says james olan, MD, professor of medicine at UB's School of Medicine and Biomedical Sciences and chair of its Department ofMedicine from 1978 to 1995. "Dr. Miller was recognized by both academic and volunteer faculty as being the most superb bedside clinician and teacher in Western ew York," olan adds. "He had an encyclopedic knowledge of medicine , but more importantly, he could assemble small clues about a patient's illness and arrive at an accurate diagnosis and effective management plan. Dr. Miller trained a generation of internists who are among the best clinicians in this region and throughout the nation. To this day, many of these physicians still revere him as the greatest clinician they've ever encountered. " From 193 7 to 1968, Miller also served as cochair of the Department of Medicine at UB 's medical school, a responsibility that was shared with the chief of medicine at the Buffalo General Hospital. For many years, the two hospital-based departments operated largely independently; however, with the arrival of Evan Calkins, MD , in 1961 , as head of medicine at the Buffalo General Hospital, and the incorporation of the then-University of Buffalo into the State University of New York system, he and Miller began to work together closely to develop a university-wide department. In 1968, Miller volunteered to step down as cochair of the department in order for the university to further develop the concept of a single department, according to Calkins. "Dr. Miller realized the importance of combining the two departments into a single, unified department and was very supportive of me," says Calkins, who , following a national search, was selected to serve as its chair. "Dr. Miller was 100 percent supportive of this transition," he adds. "He was a very generous man and had a great capacity for seeing the whole picture." Miller remained active as a professor of medicine at UB until his retirement in 1974, at which time the university hon- ® a u f t a l o ored him with the title of emeritus professor of medicine. In 1984, in further recognition of his skill as a medical diagnostician and for his commitment to patient care and clinical instruction in medicine, he was honored on his 80th birthday with the dedication of the David K. Miller Wing of the Erie County Medical Center. orman Chassin, MD , completed his residency training with Miller in 1951 and remained a lifelong colleague and friend. "Dr. Miller was not only a teacher, but he was an example for us, " Chassin says. "He was known as a counselor to his trainees. I still see some of these physicians at meetings and they tell me the most important time they spent in their professional life was the three to five years they spent with Dr. Miller. " "He was a tremendous clinician who ran a very tight ship and really challenged young people," Calkins recalls. "He had a wonderful way with those he trained and they, in turn, loved him tenaciously. " "The thing I remember most about Dr. Miller," Chassin says, "is that, as a teacher, he never stopped taking care of patients. He never turned down a referral from a colleague. If you had a tough case, you'd tell him you needed his help and he was there, even if it meant making a house call along with you. Sometimes he'd add an important but subtle observation; other times, he just gave you and the patient confidence by being there because he was a giant in his field, and his greatness touched the patients. " + Amemorial service will be held for Or. Miller on Friday, April 24, 1998, at 1 p.m. at the Bernard Smith Amphitheater, Erie County Medical Center, in conjunction with Spring Clinical Day. Physician W ; n t e r l 9 9 8 �When w-as the last tin1e you w-ere rew-arded for being you? Don't you think it's tin1e ... D IS C 0 U N T P R 0 G RA M S You're a doctor. You're committed to helping people. The last thing you should have to worry about is liability insurance. Nobody knows that better than we do. We're MedPro/Frontier, a recognized leader in Professional Liability Insurance. We reward doctors with comprehensive plans and discounts including part-time and new doctor discounts, and risk management credits. And doctors reward us: 18,000 practitioners are protected by MedPro/Frontier. We've also earned the exclusive Part Time 50% Nevv Doctor 50% Annual Pre-payment 3% Risk Management 5% endorsements of many medical societies including the New York State Society of Internal Medicine. MedPro/Frontier has an (A-) rating by A.M. Best Company, and an (A+) by Standard & Poor's. Our in-house claims department plus a staff of insurance, legal and medical professionals are readily available to answer any questions you may have. Call now. Don't you think it's time? 1-800-822-8260, Ext. 616. MedPro. Protecting You and Your Future B u f f a 1 o Physician w I n t e r 1 9 9 8 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] '' ' " . Noise-Induced Hearing Loss Partially Rescued sensory cells express a rush of glutathione, an antioxidant that absorbs free radicals. R-PIA was found to increase the activity of glutathione, thus oise-induced hearing loss may be providing enhanced protection from caused partly by free-radical oxi- free-radical damage. dative damage to sensory cells in To test the effect of the drug on hearthe inner ear, and laboratory stud- ing loss, researchers applied R-PIA topiies of a drug called R-PIA have cally to the inner-ear membrane of one shown that it can lessen the ex- group of animals and applied a saline solution as a control in a tent of damage by ensecond group. The anihancing antioxidant activity, researchers at mals then were exposed to mid-frequency noise the University at for four hours at levels Buffalo's Center for high enough to cause Hearing and Deafness temporary deafness . have found. Donald Henderson, The loss of hearing was verified by monitoring PhD, UB professor of brain waves in the hearcommunicative disoring center in the cortex. ders and sciences, says The lack of brain activthe action of R-PIA " IN THE FUTURE, WE MAY likely would be similar ity in response to normal BE ABLE TO RESCUE THE in the human ear. "In the sound indicated complete hearing loss. HEARING LOSS OF future, we may be able to Brain-wave activity rescue the hearing loss PERSONS INADVERTENTLY was measured again at one of persons inadvertently EXPOSED TO LARGE day, four days, and 20 days exposed to large amounts AMOUNTS OF NOISE. " following noise exposure. of n'"'ic;e, such as those Results showed that the near an explosion, for example, through the use of this drug. " animals treated with R-PIA recovered Noise-induced hearing loss, a major their hearing faster and more completely health problem in industrialized societ- than those treated with saline. "The R-PIA-treated animals also ies, is a primary research focus of UB's Center for Hearing and Deafness, which showed less damage and loss of senHenderson codirects with fellow scientist sory cells than control animals," Henderson says. + Richard]. Salvi, PhD. The new study, conducted by L 0 I S B A K E R Henderson and colleagues Sandra Mcfadden, PhD, and Bo-Hua Hu, PhD, along with Richard Kopke, PhD, of the U.S. Army, documents the action of R-PIA on noise-induced hearing loss in chinchillas, a mammal with an auditory husband-and-wife team of psychiarange similar to that of humans. trists at the University at Buffalo In earlier work, the researchers has received a $2.6 million grant showed that the stress of loud noises from the National Institute ofMencauses an increase in free radicals in the tal Health to conduct one of the inner ear, which can damage or kill first major population-based studsensory cells. To defend themselves, Searching for Genes Linked to Schizophrenia ® B u f f a I o ies aimed at finding the gene or genes that may be linked to schizophrenia. Carlos N. Pato, MD, and Michele T. Pato, MD, UB associate professors of psychiatry, are principal and coprincipal investigators, respectively, on the project. They have been building the project for seven years in the Azores, a group of nine islands located off the coast of Portugal that make up a Portuguese state and where most inhabitants are descended from a few families. "Psychosis is a complex syndrome, the most common form of which is schizophrenia," Carlos Pato says. "In at least 20 percent of cases of schizophrenia, other family members are also affected with the illness, but genetics may play a role in an even greater percentage. Our study will try to determine how often the illness and a particular gene, or genes, are seen together. If we can find the gene that causes the illness and then find the product of that gene, we can begin to design more effective treatment." About one percent of the world's population is afflicted with schizophrenia, a mental illness characterized by symptoms such as deterioration of personality, disordered thinking, delusions, hallucinations, paranoia or catatonia. The main form of treatment is antipsychotic drugs, which must be taken regularly and continually to control symptoms. The five-year study will be carried out in the Azores and in a population group on the Portuguese mainland. "The Azores are ideal for a genetic analysis," Pato says, "because the country is small and its population has been relatively genetically isolated, with most inhabitants descended from a few families. The Azores have a centralized health system, and all 10 psychiatrists on the islands are collaborating on the project." The researchers will look for genetic links using a variety of approaches. "We will select genetic markers and look at how the markers behave in well families compared to a family where the illness Physician W I n t e r I 9 9 8 �······· · · ·· · · ········· · ···· · ·· · ···· ·· ···· ···· ···· · ·· ·· ········ ·· · · · · ····· · ·· ·· ···· ·· · ·· ··· m ·'S~ '· ..~.. '-· . Why Are Blacks More Prone to shows up several times ," Pato says. "We'll look to see if illness and genetic markers exist together, and we'll analyze genetic patterns from ill person to cardiology researcher at the Uniill person. We'll develop a description versity at Buffalo may have found of each suspect gene and determine one answer to the question of why how often it occurs with illness. " more blacks than whites have high An important aspect of the study will blood pressure. be a Haplotype Relative Risk analysis. The answer appears to lie in the Using this approach , researchers will way the lining of blood vessels , the analyze the set of genes from a patient's parents that were not passed on to that endothelium, responds to certain sigpatient, Pato explains. The noninherited nals telling it to dilate. Bong Hee Sung, PhD, UB associate professor of mediset then acts as a control. A field team is already in place in the cine, has shown that in some blacks, Azores. The UB researchers travel there blood vessels didn't relax and widen as frequently to maintain close ties with the they should in response to a normal project. Meanwhile, they are setting up a blood-vessel dilator. Dilation of blood genetics research program and labora- vessels is one of the body's natural tory at UB that ultimately will be mechanisms for easing blood flow , thus lowering prescapable of performing sure. genetic analyses of any Sung prepotentially inheritable disthe sen ted ease, the researchers say. study results Both Carlos and Michele recently at the Pato hold adjunct appoint12th Internaments with the Center for tional InterNeuroscience at the disciplinar y University of Coimbra in Conference on Portugal, which is collaboHypertension rating on the project. Also in Blacks in involved are james L. London. Kennedy, MD , head of the THE FINDING REIN · Why the blood neurogenetics section at Clark FORCES THE RELATION · vessels don't relax Institute of Psychiatry, UniverSHIP BETWEEN and widen as exsity of Toronto , who is a pected remains unHYPERTENSION AND coprincipal investigator, and clear, Sung says. Eric Lander, PhD , of the WhiteDIABETES , TWO "Th ese are all head/MIT Center for Genome DISEASES THAT ARE healthy people, " Research, who will perform a MORE PREVALENT she adds. "They genome-wide scan and collaboAMONG BLACKS THAN had normal glurate on all data analyses. WHITES . cose and cholesM. Helena Azevedo , MD , proterollevels, and are fessor of psychiatry at the University of Coimbra, is the principal in- not obese.There was no apparent reavestigator for the Portuguese team, and son for them to have endothelium dysCarlos Paz Ferreira, MD , director of psy- function . Where this comes from , we chiatry at Psychiatric HospitalS. Miguel, don't know . We can't really say what the pathway is yet. " Azores, is directing the fieldwork. + Sung and colleagues studied the High Blood Pressure Than Whites? - B u f f a L I 0 o I S 8 A K E R Physician w I n t e r 1 9 9 8 ' . blood-vessel response in a group of l2 healthy African-Americans and l l Caucasians, all of whom had normal blood pressure. They also showed normal fasting cholesterol levels, glucose levels and other parameters known to affect blood pressure. The researchers measured the diameter of a vein in the left hand of all participants and then introduced the vasoconstrictor norepinephrine into the vein to cause it to narrow. Veins of participants in both groups narrowed similarly. Insulin, a vasodilator that acts on the endothelium in addition to regulating blood glucose, was added to the norepinephrine, and the vein diameter was measured again. Results showed that veins remained narrowed in five , or 42 percent, of the l2 African-Americans, indicating they did not respond normally to insulin as a vasodilator. Sung says the blunted response may be one of the mechanisms underlying the increased prevalence of hypertension in some blacks. "This subgroup of African-Americans was resistant to the vasodilatory action of insulin. Nothing happened to their blood pressure when insulin was infused." Sung said the finding reinforces the relationship between hypertension and diabetes , two diseases that are more prevalent among blacks than whites. Insulin resistance is a risk factor for adult-onset, or type II , diabetes. The question Sung and colleagues now are trying to answer is why an apparently healthy subgroup of blacks is not responding normally to insulin. She said the condition has important health consequences, and that once scientists know what causes it, they can work to prevent it. Additional researchers on the study were Marilou Ching, MD; Surendra G. Gudapati , MD ; and Michael F. Wilson , MD , all of the UB Department of Medicine. + L 0 I S 8 A K E R �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . [1] ' , ' "' . lesser-known functions include activating the immune system in response to stress; it also plays a role in fertility. It is another of prolactin's lesserUniversity at Buffalo neuroendo- known effects-its role in regulating crinologist is providing new in- the seasonal molting cycle in such anisights into the cause of changes in mals as the Siberian hamster-thatdrives blood levels of the hormone Badura's research. Siberian hamsters prolactin, which plays a role in turn from brown to white in winter and regulating many vital human experience a corresponding drop in prolactin levels. Badura is attempting to physiological functions. Supported by a grant from the Na- identify the brain chemical that triggers tional Science Foundation (NSF), Lori this change. Once identified, the chemiBadura, PhD, assistant professor of psy- cal could be manipulated to correct an chology, is attempting to identify the existing hormonal imbalance. The Siberian hamster is a convenient neurotransmitter that signals those model for studying prolactin regulation changes. If successful, her research could lead to interventions to keep the because its hormonal variation is photosensitive-triggered naturally by seasonal hormone at optimum levels. "Some medications-ones that in- changes in amount of daylight- and crease dopamine, for example- requires no chemical manipulation. "A number of faccan cause prolactin tors can affect prolevels to be low," she lactin release," says. "Too much or Badurasays. "Ifthere too little prolactin are big changes, a can cause infertility. number of factors It is important to may be involved. At know what neurothe basal level, the chemicals are affectchanges are small ing any system and easier to because a change in control." one causes a change One of the neusomewhere else. rotransmitters that "We already know "TOO MUCH OR TOO Badura and colleagues prolactin's effects, but we are looking at is norepiLITTLE PROLACTIN CAN don't know what causes nephrine because its levthe brain to regulate its CAUSE INFERTILITY. els also appear to change production. If we can find IT'S IMPORTANT TO under different light conthe chemical signals that KNOW WHAT ditions and it is known cause these changes, we NEUROCHEMICAL$ ARE to be involved in prolaccan design a drug to reguAFFECTING ANY SYSTEM tin release. late them. Knowing the BECAUSE A CHANGE IN "We don't know if this chemical neurotransmitis coincidental, if other ONE CAUSES A CHANGE ters that underlie each factors are involved or if system would allow us to SOMEWHERE ELSE. " there is a real cause and compensate for problems effect," she says. "Once in any of them." we establish a relationship, we can maProlactin is perhaps best known as the hormone responsible for stimulat- nipulate norepinephrine and see ifprolacing mammalian milk production. Its tin changes. No one has done that yet." Study Seeks to Identify Brain Chemical Regulating Prolactin ® B u f f a l o Before Badura can move into that realm ofdiscovery, however, she and her graduate students must master the delicate and difficult technique of implanting the necessary microinstruments in the mousesized hamsters so that any physiological changes can be measured. "If this technique becomes viable," she says, "it would permit a new direction in research that is very attractive to granting agencies. This will allow us to document any kind of physiological activity and physical state minute by minute. We will be able to answer many questions that we haven't been able to answer before." Badura's work has been funded by the NSF since 1993, when she was a postdoctoral fellow at the University of Connecticut. + - L 0 I B A K E 5 R Link between Heart Disease and Gum Disease trange as it may seem, taking care of your teeth and gums may also protect your heart. Funded by a $1.2 million grant from the National Institutes of Health, University at Buffalo dental researchers and preventive medicine specialists are beginning a fiveyear study of the relationship between periodontal disease and heart attacks. The study and the size of the award reflect a growing interest in new evidence suggesting that infections in the oral cavity may trigger disease elsewhere in the body. UB dental researchers are in the forefront of this field, with several preliminary studies showing that persons with gum disease are at high risk of developing heart disease. The oral bacteria that cause gum disease appear to be the culprit, says Robert Genco, DDS, PhD, SUNY Dis- Physician w I n t e r 1 9 9 8 �••••••••••••••• • • 0 •••• 0 •••••••••••••• 0 •••• 0 •••• 0 •••• 0 •• 0 . 0 •• 0. 0 •••• - ~~~~~~~~ HURWITZ & FiNE, P.C. [ATTORNEYS AT LAW tinguished Professor, chair of the UB problems, eliminating the influence of Department of Oral Biology and princi- other factors that contribute to heart disease, such as smoking or obesity, to pal investigator on the new study. "Oral bacteria enter the bloodstream determine the extent to which gum via small ulcers that develop in the gum disease is an independent risk factor for heart disease in tissue of persons with both men and periodontal disease. women. These bacteria conThe participants tribute to plaque forwill be followed to mation and increase determine the incithe chance of clots dence of second forming. Clots can heart attacks among also accumulate the heart patients around damaged tiswith and withou t sue, such as a lesion periodontal disease. in the blood vessel or Researchers also a replaced heart valve. will collect data on These accumulations UB DEN T AL the number of first heart can narrow blood vessels. attacks in a control The bacteria also cause RESEARC HERS ARE IN group and assess their platelets to aggregate and THE F O REFRONT OF can increase the chances relationship to periof clots forming. Clots in a odontal disease. TH IS FI ELD, W ITH If periodontal disease narrowed blood vessel can S E V E RAL PRE LIMINARY is found to be a true risk cause a myocardial infarcfactor for heart attack, tion, or heart attack. STUDI ES SHOWING "We've known for the next step will be to THAT PERSONS WITH find out if treating the some time that oral bacteria can precipitate these disease reduces that GUM DISEASE ARE AT kinds of reactions," risk, Genco says. BeHIGH RI S K OF cause cardiovascular Genco says. "We just redisease remains a leadcently put these findings DEV ELOPING H E ART ing cause of death in together as a possible most developed counexplanation of how D I SEASE. tries, the answer to that bacteria that cause gum question could have a disease can also increase major impact on public health. the risk for heart disease. " "Although we know much about the The new study will involve 1,000 people who have survived a first heart risk factors for heart disease, there is attack, and 2,250 people who have not still much unexplained risk to be ashad a heart attack. A complete health sessed," he notes. Coinvestigators on the study are history will be compiled on all particiMaurizio Trevisan, MD, and Karen pants, and all will be given a dental exam with X-rays to determine the ex- Falkner, of the UB Department of Soistence and extent of periodontal dis- cial and Preventive Medicine; and Sara ease. Blood samples also will be taken Grossi, DDS, Ernest Hausmann, DMD, PhD ,Juan Loza, DDS, PhD, andjoseph and cholesterol profiles determined. Researchers then will analyze rates Zambon, DDS, PhD, all of the UB School of periodontal disease among heart- of Dental Medicine. + attack patients and those with no heart L 0 I S 8 A K E R B u f f a L o Physician w I n t e r 1 9 9 8 S ERVICING T HE L EGAL N EEDS OF THE H EALTH S ciENCEs CoMMUNITY • Managed Care • Purchase & Sale of Practice • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence Mo Ross at 716-849-8900 1300 Liberty Building Buffalo, New York I �~ -······················································································· El CLASS OF 1 958 Reunion Chairs Prepare for Reunion Weekend Festivities Allred M. Stein (pictured) Dear Classmate-Fifty Eight-Can you believe it? Forty years since you became an MD. Our reunion will take place on April 25. Save the date. We have the place. We will celebrate. Michael Genco t's not too early to plan for the 1998 Spring Clinical Day and Reunion Weekend. A cocktail reception will be held on Friday, April24, 1998. The 61st Spring Clinical Day andReunion Dinners will be on Saturday, April25. For more information, call the Medical Alumni Association at (716)829-2778. The reunion classes are of 1948, 1953, 1958, 1963, 1968, 1973, 1978, 1983, 1988, and 1993. Here's what your reunion chair has to say to you! Mickey Stein and l are putting together the usual celebration. lt won't be the same unless you are there! CLASS OF 1 963 Anthony M. Foti We traveled life's path together for a meaningful period. lt would be fun to see how we, the school and Buffalo have changed in 35 years. Please plan to attend our reunion. We hope to see you there. CLASS OF 1948 CLASS OF 1968 Harold l. Graff Daniel J. Fahey It's hard to believe that it has been 50 years since graduation. Please reserve Reunion Weekend of April 24-26. Hope everyone will be here. Great expectations! Looking forward to renewed friendships of the Class of '48. Thomas J. (umbo Robert A. Milch Dear Classmates, lt's 30 years for us. Please come back on April25 to celebrate and reminisce together. We are all looking forward to seeing you again for our 30th. CLASS OF 1 973 CLASS OF 1953 Michael A. Sullivan Arthur W. Mruczek (pidurec/) Next April 25, imagine you're at our 45th reunion. Like Marv Levy says, "Where would you rather be than right here, right now?" We are looking forward to seeing you at the 25th-Year Reunion Weekend. Please plan to join your classmates for this special quarter century of memories. Michael A. Sansone Come back to your roots for the 25th reunion. We need you to make it a success! ® B u f f a l o Physician w I n t e r 1 9 9 8 �··················· · · · · · ···· · ··· ·· ······· · ···· ······ ··· ·· ····························· ·· ~ • CLASS OF 1 988 CLASS OF 1978 Helen (Hess) and Andy Cappuccino David L. Marchetti The clock is ticking! Our 20th reunion (our "Distant Replay"). Please find the time to attend. "Collagen Superstar"; "Insulin Superstar"; Who really ca res? Who really remembers? But memory of the parties will last forever. Come celebrate lOyears out of med school. April25. Save the date! CLASS OF 1 993 CLASS OF 1 983 Michael J. Aronico Richard L. Collins Dear Class of 1993, Can you believe it's been five yea rs since med school graduation? Why don't you book April 24 for our five-year reunion weekend and Spring Clinical days. Look forward to partying and catching up with all of you . Let's ge t together and have some fun at our 15th. & THE ULTIMATEDRIVINGMACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. Sales and Service Comprehensive Cost-Effective Receivables Management 487 Kenmore Avenue Buffalo, NY 14223 836-2033 Your WNY Leasing Specialist Serving WNY proudly tor 33 years ~ . ' Amana Capital Corporation Buffalo, New York 716-852-3500 800-441-6925 B u f f a I o Phys ici an w I n t e r I 9 9 8 �• ........ . ........... . ... .. ... . ........ . . . . .. .. . ...... . ..... . .......... . ..... . . .. . . ........ I 1 9 4 0 5 writes from her home in Hillsdale, NY: "At age 72 , I'm still working. Retired from my solo family practice after 35 years , but the retirement didn't take , so I'm doing school health. I'm the medical director of Columbia and also of Green Counties' outpatient Alcohol and Drug IRMA M . WALDO , ' 49 , Treatment Services. And after years of seeing young'uns and their families , I now am seeing the pathology of medical school days , as an attending at the Pine Haven Nursing Home for 40 of my dear little old folks! John is retired , and we both ski all winter. " 1 9 6 0 5 JOHN J . LAMAR , JR ., '63 , retired in September 1997 after 30 years of solo pediatric practice. He now spends much of his time visiting his grandchildren, Garrett, age five , and Skyler, age three, in Ft. Hood, TX. IRA H I NDEN , '65 , says, "I'm very pleased to announce that the Wooster Clinic, a 31-physician multispecialty group, of which I am a member, has merged with the Cleveland Clinic. I will continue to practice in the Family Practice Department of the Cleveland Clinic's Division of Regional Medical Services. BARRY A . WEINSTE I N , ' 69 , has been elected to the Erie County Legislature, representing most of Amherst, NY. His twoyear term began January 1, 1998. He continues in family practice in Amherst, in his 24th year. 1 9 7 0 5 V . SZEKERES , '71 , AGNES writes , "I was selected Internist of the Year" in 1997 in our Kaiser Facility in Bellflower, CA. I was proud to be the only lady to be honored by my colleagues after six years of well-deserving male internists. We have 65 internists in our group. " of Toledo , OH , has been honored by the Vitreous Society, the world's largest organization of vitro-retinal surgeons , with a named lecture in recognition of his contributions to the society and to the advancement of vi.treoretinal surgery. The "Founder's Lecture" award wi.ll fund internationally renowned speakers and support vision research for the society, which Dr. Bovino cofounded and of which he is past president. JERALD A . BOVINO , '71 , has accepted a position as associate professor in the Department of Otolaryngology at Case Western Reserve School of Medicine and Metro Health Medical Center in Cleveland, OH. GREGORY ANTOINE , '76 , ® MELINDA AQU I NO , '92 , says , "I finished my pain management fellowship at Montefiore Medical Center and joined the faculty there as a full-time attending in both anesthesiology and pain management. I am currently studying to become a licensed acupuncturist to enhance my pain management practice. " KRISTINE TENEBRUSO , '93 , of Honeoye Falls, Y, and Todd Blalock announce the birth of their first baby, Lauren Marisa Blalock, on July 14, 1997. Kristine is an attending physician in emergency medicine at Rochester General Hospital, Rochester, NY. of ew Orleans , LA, has begun his residency in ophthalmology at the Ochner Medical Foundation and Louisiana State University Hospital in ew Orleans. "Ever the boater," he writes, "I have chosen to live and spend what little free time I have on my 3 7foot sailboat, Yank ee." THOMAS R . ELMER , '97 , OBITUARIES COL. HERBERT BERWALD , '27 , of Napa , CA , died on Octo- JOHN R . ANDERSON , '67 , writes from DePew, NY: "I retired as medical director at Brothers of Mercy Nursing and Rehabilitation Center on December 31 , 1997." 1997. Mary writes, "Our son , Sam, is now two. Joe has joined a group of otolaryngologists in Bayshore, Y, after completing a head and neck and microvascular surgery fellowship . I completed a fellowship in pediatric infectious diseases and am in private practice. " 1 MARY 9 9 0 5 ( CAPPUCCINO) AND BONAFEDE , ' 91 , announce the birth of their second child , Ella , on June 30, JOE B f f a l o ber 10, 1997. Following graduation from UB, Dr. Berwald was commissioned in the U.S. Army and received his surgical training at Walter Reed General Hos- p h s c a n pita!. During World War II, he was commanding officer of the 217th General Hospital in England and France , the largest general hospital in the European theater. Following the war, he was chief of the surgical service at Percy Jones General Hospital in Battle Creek, MI , and at the 343rd General Hospital in Osaka, Japan . During the Korean War, he was surgical consultant to the Republic of Korea , after which he served as chief of the Departm ent of Surgery at Letterman General Hospital in San Francisco, where he retired from the Army in 1957. Following his military retirement, Dr. Berwald became chief of surgery at the Veterans Home in Yountville, CA , retiring from the state in 1972. He then joined Kaiser Permanen te Medical Group , retiring from medical practice in 1982. He is survived by his wife of 67 years, Victorine Cherney Berwald; his daughter, Arley Hulstrand, of Denton, TX; and his son, Col. Herbert T. Berwald,Jr. , of Fairfax, VA ; and eight grandchildren and two great-grandchildren. PATR ICIA A . MEYER , '50 , died on August 27 , 1997. CARL LOUIS EVANS GRANT , '83 , chair of the medical staff at Sheehan Memorial Hospital and clinical instructor in medicine at University at Buffalo School of Medicine and Biomedical Sciences, died Sunday, October 5, 1997, after a brief illness. He was 46 . Born in Manhattan , Grant attended Marist College and completed his pre-med studies at Harvard University prior to w n I e 8 �........................... ............. • TAKE TWO ... AND CALL ME IN THE MORNING! ~'\d ~014r OW'\ earning his medical degree at UB. In addition to Sheehan Memorial rottd: * Fact:Saabownershavea higher education level than anyothercarownergroup. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. Hospital, he practiced internal medicine at Buffalo General Hos- Millard Fillmore Hospital's Resident Physician Program 1950-52 and a former research staff physician of the Millard Research Insti- pital and Erie County Medical Center. In 1992, he received the UB Biomedical Sciences Commendation for Teaching Excellence. cochair of an International Study on Toxic Inhalation Programs of the National Toxic Inhalation Surviving are his wife, the former Lachele Clemons; four sons, Khori Group, headquartered in Milwaukee, WI, and Cleveland, OH. At ofBuffalo and CarlJr., Adrian and Trevor, of Grand Island; and six present, Dr. Cordasco is affiliated with the St. Luke's Hospital Medical Center and affiliate clinical professor of medicine at Case Western Reserve University. He is also an emeritus (retired) of the Cleveland Clinic Foundation and presently works in the Department of uclear Medicine as a research associate. daughters, Christian of New Britian, CT, Kahlia and Lauran, of Buffalo; and Maria, LaShae and SOUTHTOWNS SAAB Cheynae, of Grand Island. 3580 Southwestern Blvd RESIDENTS (1 Mile east of Rich Stadium) EDWARD M . CORDASCO ' 50, (716) 662·8008 WNY's of Cleveland, OH, an alumnus of tute 1970-75, has been appointed - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.e MSRP s64240 F. G. DOWNING s&99 1998 BMW 740i 30 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. FREE SCHEDU LED MAI NTENANCE ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade), 12,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT. taxes and plate fees due at inception. Residual $43040 Service Loaners Available •.• Minutes From Rich Stadium B u f f a I 0 P hysician W I n t e r 1 9 9 8 �Planned Giving to UB. A tax deduction and income lor life are two of the benefits you may receive with planned giving to the UB School of Medicine and Biomedical Sciences. You needn't be wealthy, or a financial genius. All you need to do is make a gilt- and hove a desire to help today's budding geniuses make the world a better place in 50 years. For more information, contact Lyn Corder, Ph.D, CFRE, at (716) 829-2773, or via e-mail at ljcorder@acsu.buflalo.edu UNIVERSITY AT BUFFALO State Universiry ifNew York http: // www . buffalo .e du �Who says there's nothing good on TV? 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To find out more, call1-800-356-4056 in Upstate New York, or 1-800- ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ :.ledteal Liability \lutuaJ ln,urance Company guide for office practices. • Our defense never rests. 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C>l996 Me,J cal LIB~• ity Mutual ln5Urana C )mpany �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED To consult with someone truly concerned with your financial health, come to Key Your Key Private Banker heads a team of KEY PRIVATEBANK professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For anew America~ f � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v32n01-1988-Winter Table Of Contents A list of subunits of the resource. Out with the Rote, in with the New Heidi DeBlock, MD Medical Student Exchange to Bosnia Communication Skills for Tomorrow's Physicians A student's perspective New Computer Lab Department Honored Medical School Research News Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/6ceb59dbd454b2d5b3e613a94a5285ee.pdf 9ea5f35b4b64afd726bc4aa06cfe7a53 PDF Text Text J J ] �BUFFALO PHYSICIAN Volume 32 , Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Sm1th Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephamc A. Unger ART DIRECTOR/DESIGNER Alan j. Kegler ASSISTANT DESIGNER Lynda Harmel PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. John Wright, Interim Dean EDITORIAL BOARD Dr. Bertram Portm , Chair Dr. Marun Brecher Dr. Harold Brody Dr. Linda j. Corder Dr. Alan J. Dnnnan Dr. James Kansk1 Dr. Barbara Maj eroni Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spauldong Dr. Bradley T. Truax Roy Vongtama Dr Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital M1chael Shaw The Children's Hosp1tal of Buffalo Erie County Medical Center Mercy Health System Mollard Fillmore Health System Frank Sava Niagara Falls Me mona! Medical Center Roswell Park Cancer lnstnute Sisters of Chanty Hosp1tal Dennis McCanhy Veterans AffaiTS Western ew Yo rk Healthcare System © The State Umversity of New York at Buffalo Buffalo Physi cian IS publi s h ed quarterly by the State Umversity of New York at Buffalo School of Medicone and Biomedical Sciences and th e Offoce of Publications. ll1s sent, free of charge, toalumm , faculty , students, res1dents, and fnends . The staff reserves the right to edn all copy and submissiOns accept ed for publication. Dear Alumni and Friends, of our major hospital affiliatesthe Children's Hospital of Buffalo, Buffalo General Health System and Millard Fillmore Health System-is fast approaching. At the same time, the Catholic Hospital System is moving toward a different and more integrated configuration, and the U.S. DepartmentofVeterans Affairs Medical Center is being molded into the evolving VA Integrated Network (VISN#2). Within this flurry of mergers and reorganizations, the Erie County Medical Center is struggling to establish its essential niche in this community's health-care delivery system, and Roswell Park Cancer Institute is experiencing a "rebirth" of sorts. Not only will each of these dynamics significantly change the nature of health care within the greater Western ew York area but, as noted in previous Buffalo Physician messages, they also present a variety of important challenges for the university and, in particular, for the School of Medicine and Biomedical Sciences. My message in the last issue of Buffalo Physician outlined a few of these challenges, and while we cannot report much externally visible progress, some progress has been made, at least in terms of "establishing a direction" as distinct from "arriving at a destination. " I am therefore particularly pleased to report that Dr. Michael Bernardino, from Emory University, accepted the important position of vice president for health affairs and came "on board" Aprill , 1998. Dr. Bernardino, an academic radiologist by training who is well versed in the ways of managed care and practice plans, brings much-needed expertise to the university. The circumstances described above underscore the wisdom of separating the dean of medicine function from that of the vice president for health affairs. Although there will continue to be significant overlap in responsibility, each position is sufficiently different in today's new world of changing education focus , research direction , practice configurations, mergers and managed care that differing skill sets need to be employed-and applied on a full-time , concentrated basis. Mike's arrival should not only herald the development of a more coherent strategy for the medical school-and for the other health science schools-in dealing with the rapidly changing environment, it should also greatly increase the school's "negotiating strength. " The interests of the community, in the broadest sense, represent those of the medical school and of the larger university. Hopefully, your school can serve as a catalyst to bring some rationality to the present turmoil. In the meantime, it is clear that our destiny will be to work side by side, and in collaboration, with our community physicians and volunteer faculty. The commitment is to be inclusive, not exclusive, and to work with the various players in as collaborative a fashion as possible. It won't be easy, but I think you will agree: It's the only logical way for us to go! THE ANTICIPATED MERGER DATE FORTH REE John R. Wright, MD Interim Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, lT S EEMS LIKE TH E SC HOOL YEAR IS FLY! G BY. I have the feeling that it just began. However, here we are looking down the homestretch, with Match Day (March 18) and Senior Reception (March 21) behind us, and Alumni Reunion Weekend and Spring Clinical Day (April24-25) upon us. I hope that many of you were/are able to join us for some of these activities. We are happy to announce that Dr. Nancy Nielsen will be joining the Medical Alumni Association Board of Governors. A past recipient of the prestigious Samuel P. Capen Alumni Award, she currently holds the position of assistant dean for thirdand fourth-yearmedicalstudents. We look forward to her participation and counsel. I wish to advise you that the Medical Alumni Association will no longer be able to offer a joint membership with the general University at Buffalo Alumni Association. That association has decided to solicit your membership separately. I will give a more detailed explanation in the next issue of the Buffalo Physician. Dr. john Bodkin has put together an excellent program on the "Aging American" for our Spring Clinical Day, April 25. This year's recipient of the Stockton Kimball Memorial Award , Edward H. Wagner, MD '65, MPH, will deliver a lecture at the annual Medical Alumni Association luncheon tha} day. He is professor of medicine at the University of orth Carolina and at the Umversny o Washington , and also director of the W. A. MacColl Institute for Health Care Innovation, in Seattle. I am looking forward to seeing you at the Alumni Weekend and Spring Clinical Day. With warm regards, ~B"~~.M~~ President, Medical Alumni Association m.o, �------ ~--- ~ -- ~---- ~~ ------ VOLUME 32 , -- ----- NUMBER 2 SPRING The Sounds of Science Focusing AUention on ADHD Northern Exposure RESEARCHERS FIND COMPREHENSIVE A SloE IN BRAIN APPROACH TAKES LEAVE OF RESPONSIBLE TO TREATMENT ABSENCE TO FOR TINNITUS by S. A. Unger WORK IN ALASKA 1998 MEDICAL STUDENT by Bretton Newman by S. A. Unger photos by K.C. Kratt 1 U 8 ALUM THRIVES IN THE BIOTECH INDUSTRY by Betsy Sawyer 1 FDA APPROVES NEW DRUG FOR 2 3 1 COLLABORATIVE EFFORT WITH PRESIDENT UB, THE UNIVERSITY AT NAMED FOR ALBANY AND HEALTH AFFAIRS ROSWELL PARK by Arthur Page by Jessica Ancker Research ews Cl tP. FOUR U 8 A udent's pe spec ive: THE BEGINNING TREATMENT OF OF MY QUEST LUNG CANCER by Pamela Crowell ~--- ALUMNI PRESENTED AMA LEADERSHIP AWARD -- �Sof c1e RESEARCHERS FIND SITE IN BRAIN RESPONSIBLE FOR TINNITUS ICHAEL D EAKI RECALLS the exact moment in his life when he first experienced tinnitus, the constant ringing in the ears that affects an estimated 50 million Americans. "I remember waking up on the morning of Aprill2, 1994, with a high-pitched squealing in my ears. I thought the microwave was going off downstairs but I wasn't able to find the sound anywhere," he says. Recently, For many people who experience tinnitus, the condition represents a nag- Deakin found ging bother in their lives, but one they something else manage to cope with reasonably well. to keep him For others, however, like Deakin, tinni- going: the retus is a debilitating condition because it sults of a study affects them emotionally, to an extent published in Using positron emission tomography, Alan Lockwood, MD, (/eft}, and Richard Salvi, PhD, have that their lives are severely disrupted. "I the january localized the spontaneous neural activity associated with tinnitus to the brain's temporal lobe. went into a state of depression and wasn't 1998 issue of Neurology in which researcheven able to work," says the "Tinnitus will affect 30 to 40 percent ers using positron emission of all people by the time they reach age 56-year-old CPA and BufB y falo businessman. "I have tomography (PET) have for 60, and these numbers are expected to S . A spent the past four years the first time pinpointed the increase as the baby-boomer population looking for help, but I've specific regions of the brain ages," lockwood says. "People with seU N G E R been told this is something l responsible for tinnitus.The vere tinnitus, which is currently about 10 will have to learn to live with study was conducted at the percent of elderly Americans, often sufbecause there is no known treatment. University at Buffalo School of Medicine fer depression, anxiety, sleep disruption "l have friends and know people who and Biomedical Sciences and the U.S. and other symptoms that have a major have tinnitus, and they're not that dis- Department of Veterans Affairs Medical impact on their quality of life. Without tressed by it, but for me, it has seriously Center in Buffalo by lead researchers objective information on how and where affected my life. I can't read, and I can't do Alan Lockwood , MD , and Richard the condition originates, developing efmuch that involves significant concen- Salvi, PhD, who have since received a fective treatments has been difficult. By tration. I have good days and I have bad $1.5 million grant from the IH to identifying the sites in the brain that days; what keeps me going is knowing conduct a major investigation of tinnitus mediate tinnitus, we have taken a critical that I will have some good days. " and hearing loss using PET scanning. step down the road toward a cure 0 B u f f a l a Phys i cian S p r 1 n g 1 9 9 8 �-~ ~~.~---------- ------~ -- ----- TINNITUS . ,_,_ < ~ u ~ for this disabling condition. " Lockwood, a professor of neurology, nuclear medicine and communicative disorders and sciences at UB , is director of the Center for Positron Emission Tomography at the Buffalo VA medical center, a joint venture with UB , where the research was conducted. He and Salvi, who is codirector of the UB Center for Hearing and Deafness, studied tinnitus patients who have the unusual ability to control the loudness of the ringing by clenching their jaws. "We went to a tinnitus support group here in Buffalo," Salvi recounts, "and during conversations with the participants, we learned that some of them could modulate their tinnitus: They could make it louder or quieter by pressing or touching their face around the mouth or jaw, clenching their teeth or sometimes pressing on a tooth. This was a real breakthrough in the project because it meant we could look at the brain in two different states: when the tinnitus was at its normal level and when it was louder or quieter. We used this quite effectively to design the brain-imaging study." The study involved four tinnitus patients, all of whom had mild to severe hearing loss, and six persons with normal hearing and no tinnitus who served as controls. All participants took standard hearing tests before the PET scanning began. By working with these participants , the researchers were able to track fluctuations in cerebral blood flow through PET scans taken while the patients manipulated their symptoms, creating a map of the brain site responsible for tinnitus activity. "We have four major findings in this study," Lockwood says. "The most important is that we were able to localize the spontaneous neural activity associated with tinnitus to the temporal lobe of the brain, which is the most important auditory region of the brain. " The researchers then included another step in the design of their study: They compared the phantom sounds of tinnitus with activity that was produced in the brain by real sounds. In so doing , they narrowed down the population of patients in the study to include only B u f f a l o those people who experienced tinnitus in one ear-and what they found was that most had tinnitus only in their right ear. lt was these two factors-the unilateral expression of the phenomenon and the ability to control the loudness by a voluntary means-Lockwood says, that enabled the researchers to next compare the brain region associated with spontaneous neural activity of tinnitus in the right ear only, with the brain regions activated by playing a real sound in the ear. '' T I hat we found was that the real sounds caused bilateral neural activity, whereas the phantom sounds of tinnitu~ were associated with unilateral "TINNITUS WILL AFFECT 30 THE TIME THEY REACH AGE TO the limbic system, the part of the brain that, among other things, controls emotion. "Our third finding, therefore, was that in tinnitus patients, but not in normal controls, there is this crossover between the auditory system and the limbic system. We now think this is the pathway through which the phantom sounds are conveyed that impact adversely on emotions," Lockwood says. "An important aspect of the clinical manifestation of tinnitus is that it's extraordinarily distressing to many people, and we think this aberrant link between the auditory and the limbic systems is the means by which this information gets transferred. " The fourth finding of the study resulted from a strategy whereby the re- 40 PERCENT OF ALL PEOPLE BY 60, AND THESE NUMBERS ARE EXPECTED TO INCREASE AS THE BABY-BOOMER POPULATION AGES," LOCKWOOD SAYS. activity," says Salvi. "This told us several important things , the most important of which is that the source of this neural activity had to be in the brain. The unilateral delivery of sound to just one ear activates just one cochlea. And if the cochlea had been the site of the spontaneous neural activity that causes tinnitus, we would have seen bilateral activation just as we saw when we played real sounds. So this comparison between phantom sounds and real sounds enabled us to arrive at our second major finding , which was to localize the source of the phantom sounds to the brain, instead of the cochlea, where many investigators have believed tinnitus was originating. " Through comparison of this sound activation in the patients, the researchers made two further significant observations. By playing the sounds into the ears of the patients who also had sensory neural hearing loss , they found activation of the hippocampus region of Physlcia 5 p r I n g 9 9 8 searchers subtracted the areas of activation caused by real sounds in the controls from the areas of activation caused by real sounds in tinnitus patients. What they found was that there is a much larger area of the brain activated in tinnitus patients than in the control group. "This finding indicates that the circuitry of the auditory system has been changed in some way in the patients with tinnitus, " Salvi notes. "It's much larger than in the controls, and we think that's important because we surmise that some of these new connections are the ones responsible for causing the phantomsound sensations. " According to Lockwood and Salvi, other studies have been conducted using functional imaging techniques , such as MRl, in which results have clearly shown that the distress of phantomlimb sensation is associated with the degree to which the brain manifests this TINNITUS CONTINUED ON PAGE 15 0 �William E. Pelham, Jr, PhD, working with a young participant in the Summer Treatment Program. �--- --~-~--------- - - - - - - - - - - - - - - - - - - -- Focusio Atteotion on I n ~ TTE TION DEFICIT HYPERACTIVITY DISORDER (ADHD) is the most commonly diagnosed disorder of childhood. Boys and girls with classic symptoms of ADHD have diffi.culty with attention, impulse control and modulation of activity levels. In recent years, ADHD and its prescribed treatments have swept into the medta spotlight, grabbing the attention of the public with a fervor unrivaled at times by even the most hyperactive of children. At the heart of this national discourse are questions about the number of children being diagnosed with ADHD and the drugs with which they are being medicated-most notably Ritalin, a central nervous system (CNS) stimulant less well known by its generic name methylphenidate. ' At the University at Buffalo, William E. Pelham Jr., PhD, one of the leading ADHD researchers in the United States, is conducting ongoing studies on how best to manage this disorder through a combination of behavioral modification techniques and medication. As a result of his studies and the innovative treatment programs he has developed over the past two decades, Pelham has gained widespread recognition as a researcher who has helped to bring rigorous scientific inquiry to bear on many of the con troverB Y S A . U N G E R siessurrounding the treatment of ADHD. Recently, he was selected as one of a handful of experts to plan and address a ~ational Institutes of Health Consensus Statement Conference on ADHD, to be held in November 1998. CLINICAL TRIALS AIMED AT IMPROVING MEDICATION CoMPLIANCE Medication compliance problems severely hamper treatment of children withADHD, in large part because there currently is no effective long-acting medication available for treatment of the disorder. Ritalin, for example, which has long been considered the "gold standard" for ADHD medicaB u f f a I a tion, lasts only three and a half to four hours so must be given three times a day if it is to be effective. "The schools are then faced with the dilemma of how to give medications to these kids and since there are fewer and fewer school nurses, most schools don't have a person to do that," explains Pelham, who came to UBin 1996asa professor and director of clinical training in the DepartmentofPsychology. "As a result, teachers, secretaries, principals and guidance counselors-people who have lots of other things going on in their workdays-are trying to give the kids their medications during school hours. And some schools are so averse to this that they don't prompt the child, which causes further compliance problems because kids with ADHD have difficulty with organization in the first place, so they don't remember to take their medication." Currently, Pelham is working with coinvestigators at UB's School of Medicine and Biomedical Sciences to conduct two clinical trials, the goals of which are to examine drug delivery systems that would overcome the need for children to take ADHD medications more than once a day. In the first trial, Pelham has received $1.5 million from ALZA Corp. to study the effectiveness of a 12-hour formulation Physician 5 p r I n g 1 9 9 8 of methylphenidate (Ritalin). His coinvestigators on the study are Martin Hoffman, MD, clinical associate professor, and Thomas Lock, MD, assistant professor of clinical pediatrics, in the Department of Pediatrics; and Eugene Morse, professor and chair, Department of Pharmacy Practice, UB School of Pharmacy. In the study, which will conclude in mid-May, participants must already be receiving methylphenidate and responding well to it. Once enrolled, they are randomly assigned to either continuing their normal Ritalin regimen, taking a comparable dose of the new long-acting formula or taking a placebo for one week each in a threeweek period, during which time their regular classroom teachers and their parents rate their behavior. Each Saturday they come to UB and spend the day in a laboratory classroom, participating in recreational activities, schoolwork and meals. Throughout the day, their behavior is observed and measured by researchers viewing them from behind a one-way window and by the teachers in the classroom, with the objective being to track the onset and offset of the medication. "We are measuring the things that you want to know Ritalin affects," 0 �Pelham explains. "For example, in the classroom, we want to see how the drug affects their academic work. So we have them spend lO minutes doing a timed math or reading test and we track their behavior while they work. " Prior to the start of the study, all the families receive psychosocial therapy. Parents attend six training sessions to learn about appropriate behavioral intervention techniques , and the children's teachers attend four similar sessions geared toward classroom interventions. nee this small, tightly controlled study is completed, a second trial with this same design will be conducted by researchers at the University of California at Irvine. Then, in September 1998, UB and 10 other sites across the nation will participate in a large-scale randomized Phase III study of the new longacting version of the drug. Children are currently being accrued for this trial, which will last a year. In a second drug trial, Pelham has received $250,000 from Bristol-Myers Squibb to study the effectiveness of a 24hour skin-patch version of the drug Buspar, an antianxiety agent that has been used for years with adults. His coinvestigators on this study are Helen Aronoff, MD, assistant professor of clinical psychiatry, and Michelle Pato, MD, associate professor of psychiatry, Department of Psychiatry. "Bus par, while not a CNS stimulant, is a drug that preliminary trials show may be efficacious for children who do not respond to Ritalin," Pelham explains. In this multisite trial, the participants-who cannot currently be taking any medication for ADHD-are assigned either a placebo or a lower or higher dose of Buspar in the patch form, which they take for six weeks. The children come to UB once a week to be checked by physicians and research associates; at the end of six weeks their teachers rate their behavior using the Conners Rating Scale. "At the end of the trial, if the doctors think the child is doing well, he is entered into the longer-term safety phase of the study," Pelham says. SUMMER TREATMENT PROGRAM FocusEs oN BEHAVIOR WITH PEERs Pelham's research into ADHD extends beyond drug intervention to include behavior modification, as well. A disadvantage to giving Ritalin is that when children with ADHD stop taking the drug, they revert to former patterns of behavior, and research shows many people affected by this disorder do stop taking the drug when they become teenagers or young adults. "We know that medication, when stopped, has no long-term effect," he says. "Furthermore, research over the past few years suggests that by combining medication and behavioral treatments, significant incremental benefits are gained beyond either treatment alone. Therefore, it's this combined approach that's becoming the treatment of choice for ADHD. " To that end, Pelham has worked since 1980 to develop a Summer Treatment Program that integrates behavior modification therapy with activities normally associated with summer camp. Last summer, the program accommodated 36 children, ages 7 to 12, who stayed together for eight weeks, from 8 a.m. to 5 p.m. each day. The program will be offered at UB again in the summer of 1998. • The activities are largely sports-oriented and provide a highly interactive setting in which behavior problems can easily arise, especially those that pertain to peer relationships, a key area of focus for ADHD researchers. "Negative perception by childhood peers is the single best predictor of adult maladjustment," says Pelham. "This is something we've known in the field of child psychology for years. And surveys show that children with ADHD are often uni- formly disliked by their peers. " Despite knowing that this problem is predictive of poor outcomes in a whole host of measures in children withADHD, researchers have been frustrated in their attempts to find treatment approaches that have proven successful in managing peer relationship difficulties. "Peer relationships are very resistant to change," Pelham says, "and one of the reasons why there has been failure is that it's difficult to work on peer relationships in the office or the classroom, the two locations where standard outpatient treatments are provided. " Overcoming the limitations of these traditional treatment venues is a key objective of the Summer Treatment Program. Another limitation to existing interventions that the program is structured to overcome is the fact that although children are more available for mental health services during the summer months than they are during the school year, most mental health centers and professionals cut back on or eliminate services for children with ADHD during the summer. "A child with ADHD spends as much time awake and interacting with others during the summer months as he or she does in school during the entire rest of the year ," Pelham notes, "yet treatment programs for most children with ADHD are suspended during this time, leaving the kids to engage in what are often unstructured acttvttles. Summers , therefore, represent an untapped time for treatment." In the Summer Treatment Program, children are placed in age-matched groups of l2 children, and treatments are implemented by teams of five clinical �----~---------- staff members who are student interns. Key behavior modification goals of the program pertain to improving the children's social interactions, academic performance and self-esteem, as well as increasing their ability to follow directions and complete tasks. The children spend three hours a day in classroom sessions conducted by special education teachers and aides, who use behavioral modification techniques designed to treat the children's problems in a classroom context. Of these three sessions, one is modeled after an academic special education classroom, a second involves computer-assisted instruction and a third, art therapy. The remainder of the day consists of recreationally based group activities. Treatment throughout the program also includes teaching the children social skills necessary for them to function effectively with their peers in a group setting. These skills are introduced in 10-minute sessions that include role modeling, instruction and practice, after which they are reinforced through the assignment of group tasks designed to promote cooperation. In addition to social skills, an important aspect of peer relationships is a child's performance in group recreational activities, according to Pelham. "In the program, therefore, we strongly emphasize teaching sports skills and knowledge as a way to improve the children's status among their peers and to also improve their own self-esteem." A major component of the program's interventional goals takes the form of a "report card" that is given to the children each day. Points are awarded for appropriate behavior, such as listening and paying attention, following the rules and showing good sportsmanship, or subtracted for inappropriate behavior, such as talking out of turn, aggressiveness, not staying in line and swearing. The children exchange their points for daily and weekly privileges, - - - - - - - --- - social honors and home-based rewards. If the standard interventions provided by the program are insufficient or inappropriate, clinical staff members develop individualized strategies to deal more effectively with a child's behavior. To ensure that what the children learn transfers to their time outside the program, parents receive training one evening a week in how to implement behavioral modification techniques at home, a strategy Pelham says is key to the success of the program. ased on a variety of measuresfrom parent, counselor and teacher improvement ratings, to child self-perception ratings- the Summer Treatment Program has proven to be a very promising form of treatment. In recent years the program has been replicated by the Departments of Psychiatry in the medical schools at Emory University, Case Western Reserve and New York University, as well as by the Department of Pediatrics in the medical school at Vanderbilt University. In addition, the program was adopted as the child-based treatment component of the psychological treatment arms in the National Institute of Mental Health's (NIMH) Multimodal Treatment clinical trial for ADHD and was implemented at seven national medical centers as a part of that trial. However, because treatment programs-even those as intensive at the Summer Treatment Program-have not been shown to have long-term effects without appropriate follow-up, Pelham has developed a Saturday Treatment Program, booster parent training and school interventions. The Saturday Treatment Program, which takes place each Saturday from September to May, places an emphasis on maintenance and generalization -~-­ - --- -------------- of behavior modification. Booster parent training consists of biweekly or monthly sessions to help parents learn how to communicate with their children's teachers and how to continue working on home-based programs. In follow-up interventions, program therapists work with teachers to help them develop detailed classroom management strategies that will provide effective, consistent intervention for children with ADHD. CLINICAL TREATMENT SETTINGS PRO• VIDE BASE FOR ONGOING RESEARCH In addition to providing effective treatment and training, both the Summer Treatment Program and the Saturday Treatment Program are designed to facilitate ongoing clinical research. Over the years, Pelham and his coinvestigators have conducted numerous double-blind, placebo-controlled evaluations of stimulant medications within both these settings. For example, he and his colleagues published a paper in 1990 in Pediatrics (1990. 86, 226-37) in which they described the first study ever done to compare the efficacy oflong-acting drugs for ADHD, including standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline. "This study resulted in an increase in the number of people using long-acting stimulants because it showed that they all work about as well as Ritalin," says Pelham. "So, despite the fact that there are problems with these drugs, this research showed that they are viable medications, worth using and worth further development for treatment of ADHD. " In another study done in the context of the Summer Treatment Program, Pelham looked at the controversial question of whether Ritalin gives children a sense that they need the drug to solve their problems. In this NIMH-funded study- the first balanced-placebo design study ever done in children-the AOHO CONTINUED ON PAGE 31 �rJ 1 I 1 J .':J ! L! C_. 8 SJ. ! ;:) �-------~ ------ - --- -~- --------- ---------- -~-----~----- Breech babies, blueberries and icebergs TWAS NEARING MIDNIGHT , IT WAS GOING TO SHAPE ME IN A WAY :-.:0 OTHER PLACE HAD BEFORE. -- �U ays later, on August 17, 1997, I began my descent who had been authorized to fly into Nome (by a physician via through thick, gray clouds on an Alaskan Airradio call). She had been thrown from her four-wheeler while lines flight. Having made the decision to take a moose hunting and was medically stable, except that her nose leave of absence from my fourth year of medical was lacerated and separated from her face. It was my job to school at the University at Buffalo, I was ready to stitch it back into place. At home, I thought, a plastic surgeon begin a two-monthstayinNome, working alongwould have been called. Here, I was the person available to do side local physicians and other health-care providers. the job and I went to work. Nome, population 4,500, is situated on the isolated coast of the Bering Sea in the northwest region of Alaska, some 161 miles from Siberia, and is not connected by roads to any outside community. Completely surrounded by water or stretches of unpopulated land in every direction, the region boasts a history rich in Inupiaq and Yupik Eskimo tradition, as well as a Caucasian LEFT TO RIGHT· MOTHER HOLDING BABY influence that has persisted since whaling times. Every fourth DELIVERED BY NEWMAN; RESPECTED VILLAGE orne is also famed for its 1899 gold rush and night, I took inas the terminus for the annualiditarod dogsled ELDER IN NOME FOR A CHECKUP YOUNG BOY FOR house call at the race, held in March, which traverses 1,049 WHOM NEWMAN PERFORMED A SCHOOL PHYSICAL. hospital. After miles offrozen tundra from Anchorage toN orne. 6 p.m. there were I arrived in orne in a drenching downpour and was told that no physicians on duty at the hospital (they were on call from it had been raining for weeks and would likely continue to for home). I took the calls first and had the incredible opportumany more days. The unpaved streets ran thick with mud in nity to see patients in the ER with no residents or attendings front of small, colorful, boxy houses sitting on gravel plots with present to direct me. When I needed help , I called for it, but sparse lawns. This place was very different from any I had ever in the meantime I learned to trust myself, to be calm and to seen before, with severely limited opportunities for dining, think about medical problems on my own for the first time. entertainment or shopping. The focus instead is on the landAfter a few weeks in orne I had the opportunity to fly via the berries in season, the whales and walrus, the salmon runs, bush plane to the tiny Eskimo village of Unalakleet, for a the hours of daylight, the whereabouts of the moose, and the "village visit" with a doctor to see patients who had been simple richness and variety afforded by the changing seasons. waiting for months for medical attention (unless it's an The Seward Peninsula, the great landmass supporting Nome emergency, patients wait for a doctor to visit their village) . and the many smaller surrounding villages, provides a natural The villages are primitive when compared to Nome. Many subsistence harvest rich enough to feed and fully support its residents do not have running water in their homes, and there limited human population. A mixed economy has taken hold, is usually only one store to supply all needs. The schools are split between the influences of "the lower 48" (which has gained well built, and the homes are small and winter-tight. Life here entrance via the telephone, satellite TV and the Internet) and the is even less dollar-driven; instead, it is highly focused on the ever-present, inescapable influence of the bountiful land. hard work of "subsistence living," earning a living from the The town of Nome is the most developed community for land. I treasure memories of the days I walked out into the miles around, and it is clearly the center of medical progress on tundra to pick fat blueberries until my hands were purple the Seward Peninsula. The hospital houses a 21-bed inpatient with the delicious juices. I would return home with a full sack unit, an outpatient clinic and a two-bed emergency room. Norne and can berries as jam, bake fresh pies, and store the juices for provides health care for its own population and for an additional pancake syrup. The pride I felt in collecting my own food was population of 5,000 spread throughout 17 rural villages, accespowerful, and I was blessed to share this experience many sible only by bush plane or boat (the health-care region encomtimes over, thanks to the incredible generosity of those I met. passes an area of some 23,000 square miles). Since the populaOne such kind and generous Eskimo woman was a "health tion is not large enough to support full-time specialty medicine, aide" at the Euksavik Health Clinic in the Unalakleet Village. the physicians who reside in Nome practice as family physiShe invited me and the doctor I was accompanying into her cians. The doctors in this remote area must each be willing and home for dinner with her family, and we shared a "subsistence able to handle the full gamut of medical problems. meal" consisting of a fresh-picked salad from her garden, My first week at the hospital was a busy one. On my first day newly caught salmon from a nearby river, and home-baked I was asked to see a young girl from one of the outlying villages bread served with home-jarred jams. Our hostess , who was 10 �: EXPOSURE raised in the village and is intimately familiar with traditional village life and subsistence living, has taken classes to achieve a minimal level of medical training approximately equivalent to that of an EMT in the lower 48 states. With very little formal training, these brave health aides, as they are called, are responsible for managing the health needs of the entire community: They coordinate prenatal OB care, complete such procedures as blood draws and preventive pap smears, deliver a healthy baby after cutting a fourth-degree episiotomy. This was not the optimal situation: This young woman, who was late in her pregnancy and had had minimal prenatal care, had arrived in Nome on a village Oight that same day. She presented to the clinic in active labor, and at that point our choices were few. We did what we had to do to deliver that baby-and we spent all night repairing that episiotomy. The very next day another woman 35 weeks pregnant with She had been thrown from her four-wheeler while moose hunting and was medically stable, except that her nose was lacerated and separated from her face. It was my job to stitch it back into place. twins was "authorized in" to orne from a village. When she and then radio-call the physicians in Nome with accurate, arrived, we found her four centimeters dilated and opted to pertinent information regarding their patients, on whom they medivac her to Anchorage (500 miles and a few hours by keep updated medical records. medically equipped bush plane). It was clear that this situation This arrangement, unique to Alaska, of health aides procalled for a medivac; however, not all tough situations warviding first-line care to villagers and physicians backing them ranted such an expensive Oight, and we were often faced with up by radio-call from a hub, is important because it allows the difficult decisions about the limits of what we could and could health care of the village to be ministered to by members of not handle safely in Nome. the community. If an emergency arises that is beyond the The system of health care on the Seward Peninsula abilities of the health aides, then a "medivac" is called and the is a fantastic endeavor dictated very much by the expanse patient is retrieved by plane and Oown to orne for care. The and challenge of the land. The isolation between villages is health aides I met are a true inspiration. They embody an extreme, as is the isolation between Nome and Anchorage, institution that has grown out of the special needs arising which adds yet another significant obstacle. I was touched from Alaska's isolation. by the ability of the health aides to take such an active role I returned to orne at an extremely busy time to realize in the care of their community members , and by the that, although health care in Nome was more sophisticated willingness of doctors to give up some autonomy to than village health care, there were still many patients for allow the Alaskan h ealth-care whom we were not able to provide system to exist as it does. appropriate care. For example, at GOLOVIN, A TRADITIONAL ESKIMO VILLAGE ON I was amazed and moved by the THE BERING SEA VISITED BY NEWMAN. orne's hospital, the Norton Sound effect the land had on evRegional Hospital, we had ery aspect oflife in Alaska, a fully-stocked pharmacy, from the gathering of food, an X-ray department with to the establishment of sonogram,and a laboratory; communities, to the prachowever, we had no CT, tice of medicine. I wish all no official OR and inadof us could know the equate space for certain and beauty of napower procedures or emergencies. on a daily basis as I ture Late one night I was did for a while in Alaskacalled in from my stuexperiencing the strength dent apartment in orne of character that is built in because one of my favorstocking a freezer for winite family doctors found ter with salmon, moose himself in the challengand in letting the land meat and hand-gathered blueberries, ing position of delivering a footling breech baby. I had + shape who we are. never seen such a thing, because at home this presentation would have gone to an obstetrician for a cesarean delivery. Bretton Newman returned to the University at Buffalo School of Medicine a nd Biomedica l Sciences in january 1998 and expects to graduate in May 1999. In time, however, my fri end managed to su ccessfully II �Merging Medicine with Business UB ALUMNUS CRAIG SMITH THRIVES N THE B OTECH OLOG c DUSTRY s MD the journey from medical school graduate to founder and leader of a promising new biopharmaceutical company was not as great a leap as one might imagine. In fact, Smith says, his career path has consisted of a progressive series of steps , "each one logically leading to the next and not at all hard to take. " Smith-who spent 16 years junior faculty position there in academic medicine before as an instructor and assistant B y chief of service in the Departstepping into the corporate B E T S Y world-is president and CEO ment of Medicine. He was SAWYER of Guilford Pharmaceuticals, subsequently invited to stay a company he established in on as a faculty member at the university and became an 1993 to discover and develop drugs for the diagnosis, treatment and assistant professor in medicine in 1976. Along the way, Smith says, "I found prevention of brain cancer and other neurological diseases. From his current myself consistently drawn to issues surrounding drugs and vantage point as the therapeutics. Early in leader of a pacesetting my career I won a pharmaceutical busiGUADEL Wafer (polileprosan 20 w1th fellowship that allowed ness, he looks back on carmustine implant) me to complete a yearan unusual and rewardlong sabbatical at the ing career, first in Qohns Hopkins] School academic medicine and Public Health and of then in business. Hygiene , studying Born and reared in Orchard Park, New York, epidemiology and Smith graduated from statistics, and I Nichols School in became interested in Buffalo in 1964. He applying the principles left the area briefly to I learned in those complete undergradufields to the study ate studies in biology at of new drugs." The University of the South in Smith was also beginSewanee, Tenning to realize The GLIADEL®wafer, for treatment of brain cancer. nessee, and then that he had talreturned in 1968 ent as an orgato attend medical school at the Univer- nizer, as well as a flare for building sity at Buffalo School of Medicine and programs and inspiring teamwork. "I've Biomedical Sciences. always gotten enjoyment from the Followinggraduationfrom UBin 1972, process of doing things that perhaps Smith completed an internship and resi- aren't popular, but that are important dency atjohns Hopkins University School for the achievement of a valuable goal ," of Medicine and, in 1975, was offered a he says. "I believe that more is ® a u 1 I a l a accomplished when people work together toward a common purpose ." It was atjohns Hopkins in the mid-1970s that Smith first tasted the satisfaction that comes from building an organization from scratch. Under his direction, the Division of General Internal Medicine grew from a one-man operation-with Smith as its sole member-to the third largest division in the Department of Medicine in terms of National Institutes of Health (NIH) funding, patient care revenues and teaching responsibilities. In 1985, with funding from the Burroughs-Wellcome Foundation , Smith was able to begin his second major building effort-the development of a research program devoted to the thenfledgling field of pharmacoepidemiology. Under his guidance, the program grew to include an interdisciplinary team of two MDs , one PhD epidemiologist and four support staff. Through the program, which still exists atjohns Hopkins, clinical research projects were funded by the Food and Drug Administration (FDA) , the NIH and numerous pharmaceutical companies. In 1988, Smith was courted and eventually hired by Centocor, a biotechnology company in Pennsylvania. As vice president, he led the company's worldwide clinical research programs, initially directing a staff of 24. By 1992 he administered a budget of $30 million, oversaw more than 50 active clinical protocols and supervised a staff that had grown to 126. He was made a corporate officer and as a member of the senior management team, he began to play a key role in the formulation of Centocor's business strategy. Working closely with Centocor's CEO, CFO and legal department, he helped develop the company's partnering strategies. At Centocor, Smith was also charged with identifying key barriers to the company's long-term success. One of Physician S p r I n g 1 9 9 8 �came the first employee of the new corporation. After writing most of the business plan in his home office, Smith moved back to Baltimore from Philadelphia. In September 1993, he hired a secretary, a financial officer, and his wife, Susan, who is now the company's director of project management and, together, the small group formed the core of Guilford Pharmaceuticals. Scios Nova had been working on a drug-delivery system, known as the GLIADEL ®wafer, for treatment ofbrain cancer. Although clinical testing of the product had been completed, the results had not yet been analyzed. Because "I BELIEVE THAT MORE IS ACCOMPLISHED WHEN PEOPLE WORK TOGETHER TOWARD A COMMON PURPOSE ." Craig Smith, MD, president and CEO of Guilford Pharmaceuticals,which develops drug-delivery and neurological products. the problems he identified was that his own role consisted of functions normally carried out by the CEO. Thus, when the company downsized-from almost 1,500 employees to about 500Smith found himself among those looking for other opportunities. In retrospect, Smith says, the dead end at Centocor turned out to be a very good thing, as it cleared the way for his fourth organization-building venture: Guilford Pharmaceuticals. During the last few weeks of his tenure at Centocor, Smith was contacted by a recruiter who was looking for someone to start a new companywithSolomonSnyder, MD , a world-renowned neuroscientist whom Smith had known from his days at 8 u f f a I a Phy johns Hopkins. It was from Snyder that Smith learned of an exceptional opportunity to start a company from scratch with promising intellectual property and technology that was being spun off another company. Originally a small neuroscience company based in Baltimore, Nova had been purchased by the California biotechnology firm Scios, and had its name changed to Scios Nova. The parent companywanted to keep theScios Nova products and research efforts that were complementary to its own efforts, while selling the neuroscience work in progress. Snyder believed the purchase ofScios ova's products and technology would form a sound basis for a new company. Smith agreed and, in July 1993, he be- sician S p r I n g 1 9 9 8 Scios Nova did not want to focus on neurological research or drug delivery, the wafer was included in Guilford Pharmaceuticals' initial capitalization. Smith's team spent their first year of business involved in an intensive search for funding. Much of the company's originally planned financing had fallen through, and instead of the $27.5 million that Smith had expected, Guilford had only $2 million to establish the new company. Adding to this problem was the prevailing financial climate in which investment bankers simply weren't interested in underwriting start-up biotech companies. Consequently, the company remained at four employees, as Snyder and Smith scrambled to find funding. Because Scios Nova owned 80 percent of the company, venture capital firms were not interested in investing: They wanted to own 80 percent of the company. late in 1993 , Smith and Snyder invested their own savings in the company (a combined total of $750,000). This convinced Scios Nova to invest another $1 million in Guilford's future. �Then, in june 1994, the company went public, raising $15 million in an initial public stock offering. This much-needed infusion allowed Guilford to begin to expand its manufacturing capabilities as it filed a new drug application for GLIADEL with the FDA. y 1995, the company was firmly launched. A follow-on public stock offering directed toward institutional investors raised an additional $19.5 million. By the end of the year, the company had increased to nearly 40 employees, whose primary focus was commercializing GLIADEL. A third growth spurt the following year came about as the company evolved from a one-product company (GUADEL) to a company with multiple drug development capabilities. Today, Guilford employs nearly 200 people and is involved in the development of a variety of drugdelivery and neurological products. ministration of chemotherapy drugs . Through a marketing agreement with Rhone-Poulenc Rorer (RPR) , Guilford began marketing GUADEL in February 1997. This event was a major breakthrough for Guilford. No longer considered a development-stage company, Guilford became one of only a handful of biotechnology businesses that have a marketed product. PREPARATION FOR SuccEss ife as a CEO really isn't all that different from life as a physician, says Craig Smith, MD. The founder, [ president and CEO of Guilford Pharmaceuticals recently was asked by a group of Robert Wood Johnson clinical scholars how difficult a transition it was for him to leave academic medicine for the business world. lJ Success in either world, Smith says, is very much a product of good judgment. "Physicians are constantly taking disparate bits of information and synthesizing them into a plan of action, atherapeutic plan. At times, this is simple; at other times, we make decisions in consultation with others whose judgment we trust. With a CEO, it's the same." In medical school, men and women ore trained to work hard and to put in long hours. The some is required of oCEO. Physicians must continually renew their fund of knowledge. likewise, the technical aspects of being o CEO require constant upgrading of skills and acquisition of new information. Guilford's lead product, the GUADEL wafer, gained final federal approval in September 1996, becoming the first brain cancer treatment to be cleared by the FDA for marketing in more than 20 years. The wafer, which is made of a biodegradable polymer, contains BCNU, or carmustine, a cancer chemotherapy drug used in the treatment of glioblastoma multiforme, a particularly virulent form of brain cancer. Approved for patients undergoing surgery for recurrent brain cancer, GLIADEL wafers are packed into the cavity created when a tumor is excised from the brain. Once implanted, the wafers degrade over several months , allowing for the extended delivery of high concentrations of BCNU directly to the tumor site. In addition to permitting site-specific and controlled delivery of the drug, the new product eliminates the toxic and debilitating side effects that accompany systemic ad- ® Under the agreement, RPR holds the rights to market GLIADEL globally, except in Scandinavia; RPR also has the exclusive right of first offer on other polymer oncology products developed by Guilford. In return, Guilford shares in profits from GLIADEL sales and receives other payments from RPR as various regulatory hurdles are cleared in the U.S. and abroad . Additionally, RPR is "Renewing, retooling- these come very naturally to me," Smith says. "We didn't receive training in balance sheets and public stock offerings in medical school, but with the way health-core delivery is changing, that might not be such o bod ideo." Academic medicine is really very entrepreneurial, according to Smith, who compares it to o franchise operation. Faculty and researchers get into business by being accepted by a larger institution with a big nome. Johns Hopkins didn't give himo budget to start o new division in the Deportment of Medicine: it gave him use of its nome. With that nome, he raised funds and leased space in the institution. The institution took 15 percent off the top of his earnings, and he was required to follow the rules of the "franchise." It's up to the choir, program director or principal investigator to keep the franchise running, Smith says. If he or she does poorly, the franchise doses and the space is leased to someone else to develop another research program. Smith was successful of this mode of operation when he was in academic medicine, and he enjoyed the challenge of building his franchise. Today, as a CEO, one of his greatest challenges still is to find the resources to expand the company. Afundamental contrast between business-at leas! business al Guilford-and academic medicine is the emphasis on teamwork versus individual achievement, Smith says. "In the academic setting, the focus is on who's bringing in the mosl money and who's work is being published in which journals. This approach promotes individual achievement that often discourages collaboration," he says. "In a company like Guilford, working in teams for a larger purpose is o way of life." B u f f a l o Physician 5 p r I n g 1 9 9 8 �- - ---~-- --------------- ~ --~- - -~-- ·········· · ·············· · ······························ · ························· · · · · · · [ ! ] IN ANIMAL STUDIES, THE GUILFORD COMPOUNDS HAVE BEEN SHOWN TO REGENERATE NERVE TERMINALS LOST IN PARKINSON'S DISEASE AND TO REVERSE THE FUNCTIONAL ABNORMALITIES ASSOCIATED WITH THIS LOSS. financing clinical studies of GLIADEL for metastatic brain cancer and pediatric brain cancer. Although Smith acknowledges that Guilford has some distance to go before its stockholders can expect the company's products to generate healthy profits, he is excited about Guilford's future. Part of Smith's enthusiasm is based on achievements in the company's neuroscience program, including the completion of Phase II clinical trials of the company's diagnostic test for Parkinson's disease. The new product promises to improve detection and monitoring of the condition, which currently afflicts more than 1.5 million Americans. P arkinson's disease is caused by the loss of dopamine neurons in the area of the brain that controls muscle tone and movement. It is one of the most common of the neurodegenerative conditions affecting older adults, but it is difficult to diagnose in its early stages and impossible to monitor using current methods. Guilford scientists, however, have developed an imaging technique to measure the density of dopamine neurons in the brain. The new product, DOPASCAN Injection, has recently completed a multicenter Phase lib study with the Parkinson's Study Group. Additionally, Guilford's research and development team is concentrating on developing drugs that may someday reverse the effects of Parkinson's disease, as well as those of stroke, spinal cord injury and other serious neurological conditions. Researchers' efforts are centered around the new compounds, called neuroimmunophilin ligands, through B u f f a l o which nerve regrowth can be induced. Building on findings by researchers at johns Hopkins, scientists at Guilford demonstrated in laboratory experiments that low concentrations of certain immunosuppressive drugs can be used to stimulate nerve regrowth. After discovering that the neurotrophic activity of these compounds can be isolated from their immunosuppressive properties, the Guilford team developed a series of compounds with neurotrophic capabilities, but without the immunosuppressive effects. In animal studies, the Guilford compounds have been shown to regenerate nerve terminals lost in Parkinson's disease and to reverse the functional abnormalities associated with this loss. Smith is unaware of any similar studies with such dramatic results. "If anyone had told me 10 years ago that it was possible to make damaged nerves regrow and regenerate, I would have said, 'So what? They won't know what connections to make,"' he says. "But that's what appears to be happening. If the damaged nerves can be stimulated to regrow, they seem to 'know' how to make the right connections on their own." In March 1997, Guilford was granted a U.S. patent covering the neurotrophic applications of neuroimmunophilin ligands, and the company hopes to begin clinical studies of the compounds within the year. Researchers at Guilford are also involved in neuroprotective research, which focuses on preventing nerve cell damage resulting from stroke and head trauma, and in addiction research, which focuses on developing nerve inhibitors to block the pleasure effects of drugs Physician S p r I n g l 9 9 8 such as cocaine, alcohol and nicotine. Smith's ambition for Guilford is to build it into a multibillion dollar concern-an aspiration that is not at all antithetical to his desire to make the world a better place. "Our company does well by doing good," he says. "Our mission is to become a world leader in the discovery and development of drugs to improve human health care and enhance quality of life. We're also in business to build value for our shareholders. While it's true that our industry is competitive, we don't have to conduct business in a way that is at odds with our goal of improving the lives of individuals confronted with life-threatening diseases. " + TINNITUS CONTINUED FROM PAGE 3 plastic transformation of its circuitry. "So we think tinnitus is the auditory system's analog to the phantom-limb sensation experienced by some amputees or people with peripheral nerve damage," explains Lockwood. "This is of much interest to us because we think it provides a target for future research. Understanding the mechanisms that cause plasticity may provide a method for preventing or treating tinnitus in the future." For Michael Deakin, who was a participant in the study, these results and their potential for clinical applications provide him with much hope for a future life in which he can once again enjoy the quiet that normally accompanies times of relaxation, rest or concentrated absorption in a task. "To me," he says, "this study is very, very significant." Seed money for th e research described in this article was provided by the UB Offi ce of Research, with additional f unding from the UB Center for Hearing and Deafness, the American Tinnitus Association, the j ames H. Cummings Foundation of Buffalo and th e National Institute on Deafn ess and Oth er Communication Disorders, of the National Institu tes of Health . �the health sciences at UB. As director of managed care with the Emory University System of Health Care, Bernardino oversaw sales, marketing, contracting, medical management and community relations for a health-care system with net revenues BY A RTHUR P AGE of more than $1 billion. One of the projects he oversaw was the consolidation of multiple system laboratories 1 ( l-f .\ ~ 1 F D t n r ' \If D has been named vice president into a single laboratory system . Prior to for health affairs at the University at Buffalo, effective Aprill, becoming director of managed care, he was associate clinic director in this same as announced by President William R. Greiner. Prior to coming area with the Emory Clinic. Bernardino has been affiliated with to UB, Bernardino served as director of managed care with the the Emory University School of MediEmory University System of Health Care, in Atlanta, and was a cine since 1982. He has served as direcprofessor of radiology in the Emory University School of Medicine. tor of magnetic resonance imaging and director of abdominal radiology at At UB , he has assumed responsibility health sciences," he adds. "Western New Emory University Hospital and as a as the chief officer overseeing the clini- York is very fortunate to have someone of professor in the Winship Cancer Cencal and collaborative activities of the his caliber become a part of our commu- ter. Before joining Emory, he was affiliuniversity's five health sciences nity. His joining us bespeaks the strength ated with the University of Texas Sysschools-medicine and biomedical sci- and potential not only of health sciences tem Cancer Center and ences, dental medicine, health related at UB, but also the excelM. D. Anderson Hospiprofessions, nursing and pharmacy. He lence of the region's healthtal and Tumor Institute is also overseeing the university's rela- care community. " in Houston , and with Provost Thomas E. tions with its affiliated teaching hospiEverett General HospiHeadrick, who tal in Everett, WA. HE WILL BE A FIRM LEADER WITH A CLE"AR headed the A graduate of Case search commitSENSE. OF ~·~E~T'~ ' .-~D TH HE, ' ~u Western Reserve Unitee that recomSCIENCES. - PROVOS T THOMAS E . HEADRICK versity in Cleveland , mended BerBernardino earned his tals and Roswell Park Cancer Institute. nardino , says he "blends an medical degree in 1973 In addition , he is serving as leader for understanding and commitfrom Ohio State Univerthe health-science deans in planning ment to academic medicine sity and completed his and executingjoint and cooperative pro- with health-care business experience. residency in diagnostic radiology at grams of teaching and research and is a He will be a firm leader with a clear George Washington University Hospikey member of the president's cabinet. sense of direction for the health sci- tal in Washington, D.C. In 1996, he John R. Wright, MD , is continuing as ences. His leadership and decision- received an MBA degree from Roberto interim dean of the UB medical school, making styles emphasize listening and C. Goizueta Business School at Emory a position he assumed in january 1997 learning from his faculty members and University. following the resignation of john P. the health and medical community, and Certified by the American Board Naughton, MD. bringing people together for shared goals of Radiology, he is a past president Greiner describes Bernardino's ap- and common benefits." of the Society of Computer Body pointment as "a historic win for UB. " Headrick notes that among Tomography and has been active in "His leadership experience and his Bernardino's charges will be develop- medical organizations, including the vision for the place of medical education ing a five-year academic and financial Society of Magnetic Resonance in the rapidly changing health-care field plan for the medical school and, more in Medicine and the Society of will help bring focus and strength to the generally, guiding the planning for Gastrointestinal Radiologists. + New Vice President Named for Health Affairs ® B u f f a l o P hysician 5 p r I n g 1 9 9 8 �------------------~~---------~- - ----- ····················· · ·································· ·· ······························• · ~ I Nancy Nielsen, MD,PhD,Named Associate Dean for Student Affairs ancy H. Nielsen, MD , PhD, has been named assistant dean for Student Affairs at University at Buffalo School of Medicine and Biomedical Sciences. In this capacity, she will be responsible for overseeing the academic and student affairs of third- and fourth-year medical students. ielsen, who earned her medical degree from UB in 1976, is a clinical associate professor of medicine at UB, with teaching responsibilities at the Buffalo General Hospital. She is also in private practice in internal medicine. Since 1995, ielsen has served as Speaker of the House of Delegates for the Medical Society of the ew York (MSS Y) and has served on MSSNY's state and federal legislation committees and on the Task Force on Health Care System Reform. A frequent lecturer and radio and INFINITI television host on topics relating to health, nutrition, infectious diseases and women's health concerns, ielsen is currently a ew York State delegate to the American Medical Association (AMA) , member of the AMA's Council on Scientific Affairs and a member of the board of directors of the ational Patient Safety Foundation, an AMA initiative formed this year. She is also past president of the Eric County Medical Society and the first woman elected president of The Buffalo General Hospital staff, a position she held from 19961997. In 1996, ielsen was named recipient of the Samuel P. Capen Award, the UB Alumni Association's most prestigious award. + James P. Nolan Receives Alfred Stengel Memorial Award ames P. olan, MD, Distinguished Service Professor and former chair of the Department of Medicine at the University at Buffalo School of Medicine and Biomedical Sciences for 16 years , has been named recipient of the Alfred Stengel Memorial Award for outstanding service to the American College of Physicians. Selection is "based upon unusual loyalty and exceptional contributions to the aims and purposes of the college, as well as the recipient's outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research, " according to information provided by the college. olan, an internationally recognized expert in endotoxins and liver function, disease and injury, is also well known for his leadership in the areas of affirmative action and minority recruitment in medical education. As a Master of the American College of Physicians, he has served the college as governor, regent and chair of the board of regents. olan received the Stengel Award on April20, during the college's 79th annual session in San Diego. + 0~~ f ntroduc;ng your way to escape. \\~ Infiniti's luxury sport AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 u f f a l a MSRD 36,045. 00 utility vehicles, the QX4 not on ly features everything you need to escape for the weekend, it has a ll the comforts and luxu ries you East of Transit Rd., Near Eastern Hills Mall B uti lity vehicle: the QX4. Unlike most luxury sport need to escape life's dai ly stresses. Physician 5 p r i n g 1 9 QX4 9 8 I �• ' ··· ····· ············· · ········ · ····· ·········· ·· · ······································· ~ 0 I New, Uniquely Collaborative MPH Degree Program Established BY JESSICA ANCKER OR YI:.ARS PAIRICK A orRs had been thinking about earning a master's degree in public health (MPH), but he never found an opportunity. After he earned his DDS from the University at Buffalo School of Dental Medicine in 1986, he operated a busy private practice and then joined the staff of the Buffalo graduates will be better qualified to respond in a more informed way to changes in health care and to take a more proactive role in helping to define workable solutions to health-care problems. A second advantage, he says, is that "by understanding the determinants of health and disease in our society, practitioners will be better able to help prevent disease and to contribute to the public debate influencing our health policy, making them not only better health-care professionals, but better citizens, too." REFLECTING A NEW REALITY IN THE ECONOMICS OF MEDICAL EDUCATION While the course content for the collaborative MPH program addresses the new economic realities facing medical practices, the administrative structure of the program reflects the new economic realities facing medical educa- General Hospital. His training prepared him well for treating individual patients, but, Anders says, he found himself encountering situations where more knowledge about public health, health policy and healthcare administration would have been helpful. Rapidly changing health-care reimbursement structures and the Buffalo hospital mergers made him want to learn more about administrative and fiscal issues. In addition, Anders developed a subspecialty in treating developmentally disabled patients, a population whose dental needs are not unique but whose cases may pose special management problems. Nevertheless, there was no MPH program in Buffalo where Anders could study the issues that interested him. The closest equivalent was the master of science degree in epidemiology offered by the University at Buffalo School of Medicine and Biomedical Sciences, but Anders felt that the degree was too research oriented for his needs. This year that has changed. Anders has a chance to study for his MPH and he doesn't even have to leave the area. A groundbreaking agreement between the University at Buffalo, the State University of New York at Albany and Roswell Park Cancer Institute, will allow physi- cians and dentists in Buffalo to earn advanced degrees in public health from the University at Albany's School of Public Health. The collaboration is sponsored by the Department of Social "OUR MPH DEGREE IS INTENDED TO GIVE PRACTICAL and Preventive RELEVANCY TO PUBLIC HEALTH-A PROGRAM WHERE Medicine at UB's THE STUDENTS CAN GO OUT AND WALK AROUND AND School of MediSEE HOW EVERYTHING WORKS IN REAL LIFE." cine and Biomedical Sciences and Roswell Park Cancer Institute. tion. After several years of tight state "With the changes in health-care de- budgets, SUNY medical schools generlivery today-including a growing em- ally find it hard to win money for expanphasis on prevention-knowledge ofpub- sion. Instead, they can enter into interlic health issues has become increasingly campus cooperative arrangements to desirable for physicians and other health- share existing resources. care practitioners," says Maurizio Trevisan, "This joint program will benefit both MD, chair of UB's Department of Social of our institutions," says David C. Carand Preventive Medicine. penter, MD, former dean of the Univer"A better understanding of the social, sity at Albany's School of Public Health. public health and policy side of medicine "UB gains access to our nationally acwill greatly benefit physicians and other credited MPH and DrPH programs with health practitioners," he says. "The a minimal investment, while the Uniknowledge acquired in the MPH pro- versity at Albany is able to help set the gram will not only prepare health practi- standard of public health education and tioners for a career in public health and expand its student base." administration, but it will also equip a 'This is a concrete example of collabobroader range of these professionals with ration between SUNY units," Trevisan tools that will enable them to better prac- adds. "It's an example of how things will tice medicine." According to Trevisan, be in the future, with teleconferencing one advantage of the program is that and cross-offerings. This collaboration ® B u f f a l a Physician s p r 1 n g 1 9 9 8 �------------- I - -------------- -- ... . . . ............ .. ........ . ... . . . . ... . . ............... . ........ . . . . . ....... . ----- - -- ........... . ' ~ I represents a significant opportunity in a time of shrinking resources. " W ithout a collaboration with Albany, it's unlikely that UB could have created a new degree-granting program without hiring more faculty, according to Arthur Michalek, PhD, associate director for the Department of Educational Affairs at Roswell Park Cancer Institute and dean of the institute's graduate division, SUNYatBuffalo. "In the present economic climate, we have to be fairly innovative. If we want new programs, we have to fashion them so they aren't going to require a great number of new faculty, " he says. The schools are implementing several innovative teaching techniques to make a success of this joint venture between two campuses that are separated by some 300 miles. UB already offers many relevant courses through the Department of Social and Preventive Medicine and as part of the master of science program in epidemiology. Through teleconferencing, additional instruction will be offered at a special facility at UB. In addition, Roswell Park is expected to have a teleconferencing facility of its own in the near future. Externship opportunities will be provided for students in settings that are expected to range from the Erie County Department of Health to the administrative offices of a health maintenance organization (HMO). Most students will be able to earn credit for B u f f a l o relevant courses they took while earning their primary degrees. UB is implementing the program gradually to ensure a smooth and cohesive transition, and only a few students will be admitted initially, each of whom must already have earned their MD or DDS. Eventually, the MPH program may also be opened to individuals from other health professions. As the program expands, Trevisan hopes to create a dual-degree program that would allow medical students to earn an MD and an MPH simultaneously in a four- or five-year program. THE "BASIC SCIE CE" ARM OF PREVE TIVE MEDICINE The MPH degree integrates well with UB'semphasis on primary care, and it is expected to help UBattract students with a public health perspective. The course requirements for the MPH will be similar to those already in place for the MS in epidemiology; however, MPH students will focus more on public health issues and will not complete a research thesis, but instead will complete internships in the community. "Someone from the 'ivory tower' might get tongue-tied when faced with real public health situations in the field, " Michalek says. "Our MPH degree is intended to give practical relevancy to public health-a program where the students can go out and walk around and see how everything works in real life. " Flexibility has been built in to the Physic/on 5 p r I n g 1 9 9 8 I MPH program to accommodate as many learning needs as possible, so students can focus on specific areas of interest. Citing an example about the importance of this flexibility, Trevisan explains that one of the requirements for completing the three-year residency program in preventive medicine at UB is that students earn an academic degree in either public health or epidemiology. "This is training that is seen as imperative for anyone pursuing a career in preventive medicine. In a sense, public health and epidemiology represent the basic science arm of preventive medicine. Therefore, it's important that we allow students to tailor the MPH program to their specific career goals and interests." Trevisan is already receiving anumber of inquiries about the program. Potential students are interested, he says, because they recognize that public health training will help expand their perspective from individuals to populations, and from treatment to prevention. They also recognize that training in the fiscal and administrative aspects of medicine can enhance their professional careers and their attractiveness to managed care organizations , hospitals and universities. Anders applied for the MPH program as soon as he heard about it, and became the program's first student. He has already begun a course in cancer epidemiology. While in school, he will continue to work nearly full time, so he expects it will take several years to complete his master's degree. "I really think this makes a lot of sense with what I've been doing professionally, " Anders says. Of course, he adds, there are a few disadvantages to being the first: "I have no one to study with!" + For more information on the MPH program, contact Dr. j ohn Vena, acting director of graduate studies, Department of Social and Preventive Medi cin e, Univ ersity at Buffalo, 270 Farber Hall , Buffalo, NY, 14214. Phon e: (716) 829-29 75. �~ · ................ . ..... . ........................................... . . . .. .. .............. ceptional for her maturity and composure. "I was with her when she received a call of congratulations from the Secretary of State and she was very poised. MONICA SPAULDING , MD , A LEAD MED I CAL OFF ICER AT There's something about her; she just NAGANO' S SKATING EVENTS has that little extra spark," she notes. Spaulding spends most days as chief HF T -\;;'-\ LIPI Sl\.1 glided off the ice after her gold medal- of oncology at the U.S. Department of winning figure-skating performance at the 1998 Winter Olym- Veterans Affairs Medical Center in Buffalo , but her avocation takes her to compics in Nagano, japan, she had a mandatory appointment petitions all over the East. In recent months , she supervised drug testing at with Monica Spaulding, MD, professor of medicine at the the World Cup Free Style Skiing team University at Buffalo School of Medicine and Biomedical Sciences. competition in Sugar Loaf, Maine, and the Olympic short-track skating trials in Spaulding, one of four U.S. physi- Olympics in Atlanta, an offer she couldn't Lake Placid. Her venues also have incians in Nagano participating in drug refuse. There she met Carl Lewis,jackie cluded the 1997 Boston Marathon, the testing, was lead medical ofJoyner and Michael] ohnson, 1997 U.S. Track and Field Championficer for the women's figure chatted with 15-year-old ships in Indianapolis and the World B y skating, short-track skating swimming phenomenon Cup water polo competition and the L 0 I S and long-track skating and Brook Bennett, and got to 0 lympic track and field trials , both held 8 A K E R some skiing events. know the entire women's in Atlanta prior to the Olympics. This was Spaulding's secswim team. Those Summer Games-her first ond Olympic experience. She At Nagano, Spaulding Olympic experience-were unquestionwas lead medical officer in Atlanta in worked closely with the American and ably the pinnacle. Spaulding recounts 161996 for two hugely popular competi- Canadian women figure skaters and hour days, subsisting on turkey sandtions: track and field and the aquatic speed skaters. Her impressions of many wiches and the occasional Big Mac, and events, including swimming, diving, of the athletes are memorable, both on loving it. "After the first week, we were all water polo and synchronized swimming. and off the "stage." Spaulding says she exhausted," she says. "I don't think I've The job is a gift from the gods for the very much enjoyed working with worked that hard since I was an intern." avid sports fan and mother of two daugh- Lipinski. "She is a really neat kid. l had agano wasn't much easier, as most of her ters who are competitive athletes. "It's seen her around the games quite a bit events took place in the evening, with the one of the greatest experiences I've ever and she was very easygoing, always mix- athletes often not arriving for testing until ing with people and joking. She had in my life," she says. after midnight. "I usually got back to Nagano is far removed from the lo- seemed to be having a very good my room at two or three in the cal competition in 1990, where time. And in the drug testing morning, sometimes as late as Spaulding's adventure began. She vol- area, she was a delight to work four," she says. unteered to do the drug testing for her with and just so excited to Spaulding's job as lead daughter's swim meet and found the have won the medal," she says. medical ofexperience fascinating. Spaulding reSpaulding adds that she has ficer was to ceived her training and certification in worked with other young make sure time to handle testing for swimming Olympic athletes, all test and track and field for the 1993 World but feels that samples University Games in Buffalo. Lipinski is exwere Because she was certified to conduct drug testing by the U.S. Olympic Committee (USOC) and the National Colle- At the dose of the Olympic;, giate Athletic Association, Spaulding was Spaulding and contacted by the USOC and asked if she Lipinski again would be interested in working at the crossed paths. Keeping the Olympics on Track ® �---------------~--- - --- -- - - -~ --~----- - ---~- ·························································· · ······ ··· ········ ··········· a notified of their secollected and lection and must packaged withsign a form certifyout tampering, ing the time of notiand that each fication. They then athlete certified have an hour to apin writing that pear for testing. If the process was they don't, a posiconducted tive result is autoproperly. The matically registered, ingenuity of usSpaulding says. ers, combined Most competiwith the develtors appear as reopmentof everquested, however , more-advanced and their main task performanceis to produce a urine enhancing drugs , has Spaulding enjoyed the unique cultural events at the Olympics such as this drum performance at the moguls venue in Hakuba. sample while being observed, a predicatransformed what should be a simple matter of letes' safety," she emphasizes, explain- ment that can give even a champion collecting a urine sample into a closely ing that there have been several deaths pause. "Some athletes are around for in cycling in recent years. "The problem hours because they are either dehydrated monitored, painstaking procedure. "No matter what you do with innova- with having a high red blood cell mass is or over-hydrated," Spaulding says. It's tive drug testing, they are one step ahead your viscosity goes up and you can have under these circumstances that she meets the big names who come accomof you," Spaulding says. She tells of a major stroke," she says. Urine is analyzed for evidence of ste- panied by their managers, as well as the athletes using catheters to fill the bladder with "clean " urine, strapping a con- roids, human growth factor and diuret- unheralded , and often more endearing, tainer of urine to the body or hiding a ics, which can mask the presence of champions of lesser-known contests. Once samples are procured, athletes urine bag in the vaginal cavity. Athletes some performance-enhancing drugs , as select a testing kit, certify its pristine selected for testing now are observed well as flush evidence of illegal drugs condition, divide the sample between constantly from start to finish to pre- from the system, Spaulding says. Tests two bottles, label and seal the bottles, also look for stimulants, narcotics and vent such transgressions. The new drug of choice, particularly beta blockers , sometimes taken by place them in the packing kit , seal the kit for distance events, is erythropoietin, marksmen to slow the heartbeat and and testify in writing that all procedures used to stimulate red blood cell produc- gain an extra moment of dead calm in were followed properly. One sample is tested, the other is frozen. If sample A is tion and boost the amount of oxygen which to take aim and shoot. positive, sample B also is tested. If both available to muscles , Spaulding says. Drug testing is conducted on all medal results are positive, appropriate sancNot long ago, this effect was accom- winners and world-record setters, as tions are imposed. Labs were set up in plished more crudely by transfusing red well as randomly selected athletes. Comagano to conduct the testing, which cells, a·process referred to as blood dop- petitors who set a record for their counhad to be completed within 24 hours. ing. "In Nagano, the drug testers weren't try also may ask to be tested to validate Nagano was a very unique experireally confident in their ability to test for their performance. ence for Spaulding when compared to the hormone, so instead they checked hile drug testing was instituted to her other sporting venues, in large part the hematocrit prior to the event and if protect athletes from dangerous due to the unbuffered exposure she had it was past a certain level, the plan was substances as much as to maintain to japanese culture. "I was housed in a to not let the athlete compete because it a level playing field , the process small room, furnished with a tatami was a health risk, " Spaulding explains. This test was only done in the biathlon itself is designed to insure a reliable mat, futon and low table. A communal and cross-country events, and to the result that will withstand legal chal- sink and bathroom were down the hall ," best of Spaulding's knowledge, no one lenges. Athletes selected for testing are O LY MP ICS CONTINUED ON PAGE 22 was excluded. "This test is for the ath- escorted off the field of competition, W f f a l o Physician S p r I n g 1 9 9 8 �• · · ········ · ·· ··· ··· ···················· ·················· Magnificent BUILDING LOTS ~ e I OLYMPICS CONT ' D FROM PAGE 21 she explains, adding that women and men's quarters were completely segregated. "I was surrounded by Japanese women from all walks of life, and it really was a wonderful experience. They helped me improve my Japanese a lot. " Other cultural highlights included a two-day trip to Kyoto with her fellow medical officers and the many hours she spent exploring Nagano on foot. During one such walk, she came upon police officers roping off the street and waited patiently with a gathering crowd to see the emperor and his wife stroll past her. "He was a kindly looking man and his wife was probably one of the loveliest older women I've ever seen," she says. When she wasn't working her events or spending time deciphering the sched- ule for her daily bus rides to the venues, Spaulding made good use of her "Infiniti" pass, which gave her access (not necessarily a seat) to any Olympic event she wished to attend. This enabled her to take in a whirlwind of drama , from Jonny Moseley's gold-medal performance on the moguls, to the U.S.-Canadian men's hockey game, the subsequent Czechoslovakian-Canadian match (with tickets selling for more than $300), and the women's Chinese-Finn hockey match in which the Finns won a bronze medal. Now back into her normal routine of work, Spaulding has had time to reflect on her two-week experience in Nagano and admits to looking forward to an opportunity to participate in future Olympics. "It was an adventure," she says. + TAKE TW ••• AND CALL ME IN THE MORNING! f;'\d ~o~r OW'\ ro(ld: * Fact: Saab owners have a higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. As a former president of the University at Buffalo medical school Alumni Association and a practici ng surgeon in Western New York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundings. The Summit at Scherff is a truly extraordinary residential development, unrivaled in Western New York. Nestled in the hills of Orchard Park, this magnificent 81-acres offers 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the BuiTalo skyline • 11-lature woods and secluded ravines 1 Oversized lots for your dream house • Quick and easy access to the freeway systems leading to BuiTalo and the city's northern suburbs 1 Privacy, seclusion, and exclusivity The Summit promises to be one of the premier areas in Western New York to construct your luxury residence. I invite you to take a stroll through this picturesque setting. For our detailed brochure or a private showing please call (716) 667-2237 or (71 6) 472-3790. Sincerely yours, Edmond J. Gicewicz, M.D. Past President, UB Medical Alumni Association SOUTHTOWNS SAAB 3580 Southwestern Blvd (1 Mile east of Rich Stadium) (716) 662·8008 B u f f a l o THE SUMMIT AT SCHERFF Orchard Park, New York A development by Falcon Land Corp. Physician S p r i n g 1 9 9 8 �-- --------~---------- - --- ~ - -~-- - ~--- ---- ·· · ··· · · · ········ ··· ···· · · · ············ · · · · · ·························· · · · · · ·· · ·········· • ~ ··.· ~ I Laboratory and Fellowship Named in Honor of Louis Bakay, MD he Louis Bakay Neurosciences Laboratory for Surgical Anatomy and Neuropathology at Buffalo General Hospital was opened in December 1997. The lab is named in honor of Dr. Bakay, head of the hospital's Department of Neurosurgery from 1961 until his retirement in 1985 and emeritus professor of neurosurgery at UB. In addition, the Louis Bakay Fellowship has been established in the hospital's Department of Neurosurgery. "Dr. Bakay has done pioneering laboratory research on the specialized nature of the blood-brain barrier and on radioactive nuclear scanning of the brain. He has contributed significantly to various areas of research pertaining to metabolism of the brain," says Walter Grand, MD , clinical head of the Department of Neurosurgery at Buffalo General Hospital (BGH) and clinical professor of neurosurgery at UB, who worked closely with Bakay for more than 10 years. According to Grand, Bakay was the first to introduce electron microscopy to Western New York, having brought the and gentle person and exemplary scholar first such microscope with him when he who is not in the least bit bitter toward came to Buffalo General Hospital in 1961 . his fellowman. These are wonderful qualiIn addition to his medical research ties that came out of his terrible ordeal. accomplishments, Bakay is also known It's for all these reasons, both his pioneeras a medical-history scholar and as an ing research, as well as the stature of the author of several books, one of which is man himself, that we felt it fitting to his autobiography, titled Gallery ofGhosts. dedicate the laboratory and fellowship to "In this book he recounts the trials and him at Buffalo General. " Th e Louis Bakay tribulations he encounLaboratory , which is tered in his homeland of codirected by Grand and Hungary during WWII Peter Ostrow, MD , of the and his escape to Sweden through Nazi- and Department of NeuropaRussian-occupied territhology at BGH, is detory, " says Grand , who voted to training neuroadds that Bakay speaks surgical residents in new five languages and is a surgical techniques usmaster editor in English ing laboratory anatomiDr. Wolter Grand and Dr. louis Bakay and a notably accomcalspecimens. Residents , plished translator of medical archival fellows and attending physicians corredocuments from Latin to English. late surgical anatomy with surgical pro"This is a man who has led a very cedures, and also design and refine new special life," says Grand. "He came to this procedures. The lab is also available for country late in life and had to repeat his use by other surgical subspecialties and entire training at Harvard before he could for training pathology residents. A private dedication for the laboraresume his work. Yet what I find most remarkable about him is that despite all tory was held on December 9, 1997, the horror and deprivation he experi- with Bakay, who is now 80, in attenenced in his life, he grew to be such a kind dance with his wife , Nancy. + ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional coll ege placement recorJ • Challenging curriculum with I4 Advanced Place ment courses • State of the art visual and performing arts center • More than 60 interscholastic sports teams • Comprehensive community service projects • Average class size is 15 • Financial aid available Ad missions tests on these Saturdays at 9:00 a. m.: January 24, February 28 To reserve a place for testing or for aJJitional information, please call: ICHOLS MI DDLE SCHOOL, 175 Nottingham Terr. , NICHOLS UPPER SCHOOL, I250 Amherst St. Acceptance is granted to qua lified students without regard to race, color, rel!gam or national origin. e u f f a l a P I hysician S p r i n g 1 9 NICHOLS SCHOOL 9 8 �~····· ········ · ······················································ · ····················· Shedding Light on Treatment of Lung Cancer FDA APPROVES NEW PHOTOSENSITIVE DRUG 1 • • • ~ · -, IS R T U S Food and Drug Administra- tion approved the use ofPhotofrin®, a light-activated drug used in photodynamic therapy (PDT), for treatment of patients with early-stage lung cancer. PDT is a multistep process in which a harmless drug absorbed by body tissues is activated by light and releases cytotoxic substances inside tumors. This new modality of cancer treatment has been pioneered over the past three decades by Thomas J. Dougherty, PhD, chief of the Department of Radiation Biology/Photodynamic Therapy at Roswell Park Cancer Institute and professor of radiation oncology at the University at Buffalo School of Medicine and Biomedical Sciences. The use ofPhotofrin in PDT Photofrin is injected intraBY is an option for people diagvenously into the patient, a KEVIN nosed with early-stage lung procedure that is sometimes cancer who are not eligible done in an outpatient setCRAIG for surgery and radiotherapy. ting. Within approximately LOIS "In clinical trials, approxitwo days, the drug concenBAKER & mately three-quarters of the trates in cancer cells, and S .A . patients had a complete rephysicians can then deliver a sponse following treatment of light to the tumor beam UNGER and about half of them are using a fiberoptic and an cancer free in long-term argon-driven laser. When the follow-up," says Stephen Lam, MD, head Photofrin absorbs energy from the light, of the bronchoscopy program at British it produces a molecule called singlet Columbia Cancer Agency ofVancouver, oxygen, an active form of oxygen Canada, and a clinical trial investigator derived from endogenous oxygen. Durfor the new drug. QLT Photo Therapeu- ing its one-millionth-of-a-second life tics, a Canadian biotechnology span, this highly reactive molecule oxicompany, has exclusive license to the dizes anything it touches, killing the Photofrin patent, which is held by cancer cells but sparing surrounding Roswell Park Cancer Institute. tissue. In some cases, necrotic tissue "This is the very first approval for this and exudate are removed through a bronnew therapy in North America for which choscope two days after the initial the intention is to cure the patient. Some procedure. Principal side effects of the patients in the trial are still free of drug include skin sensitivity to light for disease 10 years after PDT treatment," four to six weeks; some patients also says Dougherty. experience inflammation at the treatln photodynamic cancer therapy, ment site, causing varying degrees of ® B u f f a l o shortness of breath and coughing. Lung cancer remains the number-one cause of death by cancer in the United States for both men and women. Currently, the five-year survival rate for Physician 5 p r 1 n g 1 9 9 8 �----~~- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · a I • ' ~ found out, as early as the 1930s and again in the 1960s, but was discontinued due the unavailability of technically advanced equipment. The big leap in technology came in the 1980s, when lasers that could focus light at precisely correct wavelengths through endoscopes were developed. Since that time, scientists around the world have used PDT successfully on esophageal, bladder, stomach, oral and cervical cancers, and Photofrin-PDT is currently approved for use in Canada, japan and several Euro"TO ME , THE GREATEST VALUE OF PHOTOFRIN IS THAT pean countries. Prior IT HAS THE 'MAGIC BULLET' PROPERTIES THAT HAVE to january of this year, BEEN TALKED ABOUT IN ONCOLOGIC RESEARCH FOR SO Photofrin and the LONG," LIEBOW SAYS . REFERRING TO PDT'S ABILITY TO PDT laser equipment had only been apIMAGE AND TREAT AFFECTED CELLS WITHOUT DAMAGE proved by the FDA for TO SURROUNDING TISSUE. treating late-stage esophageal cancer. Because light doesn't penetrate far Building on the success of Dougherty's into tissue, PDT can only be used on work, Buffalo General Hospital opened a tumors that are on or near the surface of Photodynamic Therapy Center in March organs, accessible by an endoscope or 1995 , under the direction of exposed surgically. Also, because it is a ThomasS. Mang, PhD, former director of local therapy, it is not appropriate to Roswell Park's PDT center and research blood-borne cancers. Although not associate professor of oral and maxillofatherapeutic for all cancers, PDT is less cial surgery at UB. In addition to patient expensive, quicker and safer than many treatment, the Buffalo General center is conventional cancer therapies. Under conducting Phase II and III trials on two Dougherty, Roswell Park's Photody- other photosensitive drugs, tin ethyl namic Therapy Center is continuing to etiopurpurin and Foscan, the latter of develop new and improved PDT drugs, which is being studied for its efficacy in participating in clinical trials of new treating recurrent oral cancers. In the fall of 1997, Mang and his drugs and therapies and investigating the mechanisms that make PDT work. colleagues Ronald Allison, MD, and Dougherty began his innovative work Vitune Vongtama, MD, of the UB Departwith PDT in the early 1970s, following ment of Radiation Oncology, and B. Dale a serendipitous discovery in his lab in- Wilson, MD, of Roswell Park and UB dicating that a chemical being used to Department of Dermatology, announced identify live cells in culture could kill preliminary results from an FDA trial the cells if they were exposed to light. In they were conducting on PDT for use in the years that followed, he and his col- treating Kaposi's sarcoma, as well as leagues began experimenting with pho- external chest-wall lesions from recurthe 178,000 Americans diagnosed with tosensitive chemicals in combination rent breast cancer. Presenting at the lung cancer every year is 14 percent, with conventional lamps to kill tumors European Cancer Conference in Hamaccording to the American Cancer Society. "This new drug approval is particu- that had spread to the skin. Work of this burg, Germany, they announced that 75 larly significant since it is now possible type had been attempted, they later percent of the Kaposi's sarcoma lesions to detect early-stage lung cancer much more successfully than has been the case in the past," says Dougherty. Roswell Park is now planning to combine early detection and appropriate treatment with PDT as a new option for lung cancer patients. This work, according to Dougherty, will be available through Roswell's Division of Surgery under john Urschel, MD, and Timothy Anderson, MD, and through the Division of Medicine under Gregory Loewen, DO. B u f f a l o Physician 5 p r I n g 1 9 9 8 �~·· · · · ········· ······ ············· ······· ·················· ~ HURWITZ & FINE, P.C. I [ATTORNEYS AT LAW were reversed completely and another 19 percent showed partial reversal. Also, 92 percent of the chest-wall lesions associated with breast cancer were completely reversed and the remaining 8 percent showed partial reversal. The only adverse reactions experienced by subjects were due to sun exposure while the photoreactive agent used was still active, a period of several weeks. Mang, who has done extensive research with PDT and is a longtime colleague of Dougherty's, says these results support earlier findings indicating that photodynamic therapy holds great promise for treating cancerous lesions of the skin and that, in general, it appears to be most effective when used to treat small tumors that are discovered early. "Compared to other treatments for Kaposi's sarcomas, PDT is easier on the patient, you can treat large numbers oflesions at one time and the cosmetic results are very good," he says. "Also, PDT doesn't interfere with HIV status and any other treatment patients may be receiving. " Results with recurrent breast cancer of the chest wall were equally exciting, Mang says. "PDT is a very localized treatment that does not interfere with chemotherapy, and there are none of the usual side effects of cancer therapy. Many lesions can be treated in one session, and the therapy is repeatable if the response isn't complete." In yet another research endeavor related to Dougherty's original work, scientists in the Great Lakes Biomedical Laser Institute-a comprehensive, multifacility "laser center without walls," headquartered at US-scientists and clinicians are further exploring the use of the laser as a tool in the diagnosis and treatment of cancers, both alone and in conjunction with drug sensitizers, such as Photofrin. The center is directed by Charles Liebow, DMD, PhD, professor of oral and maxillofacial surgery in the UB School of Dental Medicine, who is na- tionally recognized for his research and treatment of precancerous and malignant lesions of the oral cavity, as well as at other sites, including the pancreas. Liebow, who works closely with Mang, notes that it is only within the past 30 years that lasers have gained acceptance in the medical and dental professions as a means of safely removing lesions from the body. Over the past few years, researchers at several member centers of the laser institute have used the combined laser-Photofrin therapy under special license both experimentally and clinically for other animal and human malignancies. "To me, the greatest value of Photofrin is that it has the 'magic bullet' properties that have been talked about in oncologic research for so long," Liebow says, referring to PDT's ability to image and treat affected cells without damage to surrounding tissue. Liebow further points out that Photofrin combined with PDT is also proving to be a highly precise method for staging cancer. "Photofrin is absorbed by premalignant cells in a way that is directly proportionate to the transformation of the cell from a premalignancy to a malignancy. By taking a fluorescent reading of the cell and measuring the intensity of the fluorescence, we can measure in a very exact way how far the cell has evolved toward cancer, so this has the potential to become a very powerful staging tool," explains Liebow, who, along with Mang, has published studies on this area of research. "Anytime you have a site where there is a transformation of cells going on and you don't know which specific area is further progressed than another, you can find the spot with Photofrin and use it to guide a biopsy. When working with premalignant cells, you then have the ability to provide treatment that is preventive by selectively destroying lesions before they become cancerous. This, to me, is the greatest hope for this new drug and PDT in oncology research." + ® B u f f a l o SERVICING THE LEGAL NEEDS OF THE HEALTH SciENCEs CoMMUNITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations Physician and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Faci lity Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 1300 Liberty Building Buffalo, New York 5 p r I n g 1 9 9 8 �------------~----~-----~-- THE CARITAS MEDICAL ARTS BUILDING A Unique Partnership with St. Joseph Hospital Harlem Road, Cheektowaga (connected via enclosed walkway to St. joseph Hospital) 500 - 8,000 Sq. Ft. Medical Office Suites Now Available For More Information Ciminelli Development Company, Inc. Centerpointe Corporate Park 350 Essjay Road Williamsville, NY 14221 716/631-8000 B uf fa lo P hysici an S p ri ng 1 9 9 8 �~·················· · ············· · ························································· Image of Neural Activity Provides Objective Measure of Attention it takes longer than without the distractions. When the brain is forced to divide its attention, however, as in processing two cocktail-party conypical scenario: You're at a party, versations at once, it flounders. listening to your friend's vaca"The brain can only divide up its tion plans, while straining to over- resources so much," says David hear the gossipy conversation Shucard, PhD, a coinvestigator on the nearby. Your brain, meanwhile, research. Ralph Benedict, PhD, assisis mustering its neuronal re- tant professor of neurology; Alan sources to allow you to concentrate on Lockwood , MD, professor of neurolboth conversations at once. ogy; and Danielle McCabe, psycholeuroscientists at the University ogy graduate student, complete the at Buffalo have been able to produce research team. Results of their work an image of this were presented at neural activity in the Society for one of the few euroscience studies using meeting in New positron emisOrleans in Octosion tomography ber 1997. (PET) and elecKnowledge trophysiology about the neurosimultaneously physiology of atto study brain tention will infunction. Their crease underfindings may standing and improvide new inprove treatment of sight into the basuch attention sis of many_ attendisorders as attention disorders. tion deficits and hyper"WE'RE LEARNING "We're learning how vigilance, a symptom of the brain attends to imposttraumatic stress HOW THE BRAIN portant information disorder in which perand screens out what sons are unable to ATTENDS TO is not important," says screen out irrelevant JanetShucard, PhD, UB stimuli, Janet Shucard IMPORTANT INFORMAassistant professor of says. It also provides neurology and a lead information about the T ION AND SCREENS researcher on the neural demands of any study. "Using electrojob that commands OUT WHAT IS NOT physiology and PET, intense concentration. we can identify how reThe team collected its IMPORTANT." sources are allocated. electrophysiology data What we end up with via electrodes attached is an objective measure to the scalp while study of attention. " subjects wearing earphones identiTheir findings showed that the fied a specific syllable-in this case, brain can successfully complete a the syllable "ba"-from a sequence task requiring focused attention even of syllables . Neural actions generin the presence of distractions, but ated in response to this task, or B u f f a l o event-related potentials, appear on a computer-generated map that reflects the pattern of electrical responses from the brain. The amplitude of a specific point on this wave, called the P300, indicates the acuteness of the brain's response to the relevant stimuli. The P300 was recorded under three conditions: Sustained attention-detecting the target syllable without any auditory interference Focused attention-detecting the target while ignoring distracting stories played simultaneously Divided attention-detecting the target and also paying attention to the content of the stories "We found a huge reduction in the P300 in response to the dividedattention task," says David Shucard. "These findings are relevant to any activity that demands constant attention, such as piloting an aircraft or monitoring sensitive instruments. This is one of the major causes of 'human error'-people get off target. " Simultaneous PET scanning pinpointed areas in the brain responsible for auditory attention tasks by recording the areas of increased cerebral blood flow during the tests. "By combining PET and electrophysiology , we are able to determine the location of major brain areas that are responsible for these different types of attention processes, as well as the time it takes the brain to process information when there are different demands on attention," Janet Shucard says. The researchers are applying their findings to persons with attention deficit disorder and posttraumatic stress disorder, as well as persons with sleep disorders, some of whom have trouble concentrating on tasks. + Physician - 5 p r I LOIS n g BAKER 9 9 8 �~~------- ········· · ······· · · · ······ · ························· · ···· · · · · · · · ·········· · · · ············ · a .. '.·~ . of chemicals obtained from ginkgo leaves-to treat age-related deterioration in brain function. Several human trials there have shown positive reinkgo biloba, prescribed widely in sults, but little research has been done Europe to improve brain function, to replicate these findings in animals, appears to improve learning and according to Winter. memory in rats and prolong their Winter's earlier research with rats life, a study at the University at showed that a set of tasks performed in Buffalo has shown. The unexpected an apparatus called the radial maze could reliably detect positive effect on longevdeficiencies in learning ity has surfaced in re" THAT FINDING and memory related to search to determine age. In the current ginkgo biloba's effect on LEADS US TO study, Winter used 20age-related cognitive SPECULATE THAT deficits, using rats as an month-old rats, which IN ADDITION TO animal model. were assigned a diet "At a certain point in GINKGO BILOBA'S that included either our analysis, we realized ginkgo biloba extract PURPORTED that the rats who were or no extract. Over sevBENEFICIAL EFFECTS receiving ginkgo biloba eral weeks, the animals ON BRAIN FUNCTION , were living substantially performed tasks in the longer than those who radial maze that reTHE EXTRACT were not receiving the quired them to master MAY ALSO HAVE A extract," says Jerrold C. new challenges andrePOSITIVE EFFECT ON Winter, PhD, professor of tain learned informapharmacology and toxition over time. LONGEVITY," Results cology in UB's School showed that rats of Medicine and Bioreceiving ginkgo medical Sciences and biloba extract author of the study. learned more "That finding quickly and made leads us to specufewer errors than late that in addition control animals to ginkgo biloba's and-unexpectpurported beneficial edly-that they effects on brain lived an average function, which our of five months study supports, the longer. Winter extract may also found a significant have a positive effect positive relationship beon longevity. " Results of tween the amount of active ingredient the study appear in the January 1998 and the degree of learning. The standard issue of Physiology and Behavior. dose during most of the study was 50 Ginkgo biloba is available in the U.S. mglkg. However, one subgroup of anias a dietary supplement but is not apmals was assigned to receive EGb 761 in proved by the FDA as a medical treatdoses of 100 mg/kg followed by 200 mgl ment. It is prescribed widely by physikg, interspersed with periods when they cians in Germany and France in the performed tasks while receiving no exform of EGb 761-a complex mixture Ginkgo Biloba Study Indicates Po~tive Effect on Longevity a u f f a l o Physic i an l 9 9 8 ' ' tract. Results showed that at the highest dose, errors declined by 50 percent. "Despite the urgent need to discover drugs able to prevent, delay , ameliorate or cure age-related memory impairment and the degenerative dementias, progress has been slow," Winter states in the article. Two major reasons for this, he notes, are a lack of agreement on appropriate animal models and on their applicability to humans when memory and cognition are concerned, and the absence of a drug proven to work in humans that could serve as a standard in animal tests. "The present demonstration of positive effects of EGb 761 in animals, a substance for which abundant evidence exists of at least a modestly beneficial clinical effect in humans, is encouraging on both points," Winter says. "The challenge now is to identify, from this mix of perhaps 200 chemicals, which chemical or chemicals are producing these pharmacologic effects. " This study was supported in part by Dr. Willmar Schwabe Gmbh & Co. of Karlsruhe, Germany, manufacturer of EGb 761. B A K E R L 0 I 5 Saliva Shown to Be as Reliable as Blood forDNA Screening a!iva appears to be as good as blood as a source of genetic material needed to screen people for inherited diseases, a University at Buffalo oral biologist has shown. The discovery could simplify the screening process enormously, eliminating the risks and complications of handling, storing and transporting blood, including the risk of contact with blood-borne viruses. It also would allow persons who cannot or will not give blood to be screened, and would be a boon to the needle-phobic. �[1] . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . "This is such a clean, reliable, quick, was conducting a major research easy test," says Rob van Schie, PhD, a project involving genetic screening of children for potential UB postdoctoral associrisk factors for juvenile ate in the Department of "SOME PATIENTS periodontal disease, a Oral Biology and lead reMAY BE RELUCTANT particularly aggressive searcher on the discovTO SUBMIT TO form of gum disease that ery. "There are no PHLEBOTOMY tends to run in families. needles. Samples can be PROCEDURES ON Mark Wilson, PhD , forcollected by untrained RELIGIOUS OR merly of the UB School personnel. And it's great CULTURAL GROUNDS, of Dentistry , is the for children, because WHILE OTHERS MAY project leader on that they love to spit." SIMPLY BE APPREHEN· research . Forensic scientists Excited by the possiSIVE; HENCE, AN have used many materibility of having his als as a source for DNA ALTERNATIVE TO THE young research subjects evidence, but blood is USE OF BLOOD FOR spit into a test tube incurrently the most comGENETIC STUDIES MAY stead of being stuck with monly used source of BE DESIRABLE." a needle , van Schie DNA for genetic testing, both for clinitested the salivary :t.. DNA theory using cal use and for basaliva and blood sic research, van from himself and Schie notes. Unforhis wife. Finding tunately, the use of the genetic material blood has many in the blood and sapractical disadvanliva samples indistages and inherent tinguishable , he limitations. collected blood "Blood sampling is invasive and -..~_...,, and saliva samples from 69 adult volpainful, and it inunteers to test the volves a potential theory further. risk of contamination Using polymerase chain reaction, he with hepatitis and the human immunodeficiency virus," he states in his study, was able to show that DNA from saliva published in the October 1997 issue of was as precise as that from blood in revealing polymorphisms in two genes the journal of Immunological Methods. "Some patients may be reluctant to thought to play a role in the developsubmit to phlebotomy procedures on ment of juvenile periodontal disease. The results pertain to only two genes religious or cultural grounds, while others may simply be apprehensive; whose sequence is known, van Schie hence , an alternative to the us e cautions, and although its potential of blood for genetic studies may be appears very promising, the method desirable." has not been proved universally. Like Van Schie was struck with the idea others, he predicts that genetic screenfor the study after hearing a news ing for disease-the subject of a recent report on the Unabomber investiga- editorial in the journal of the American tion telling of successful DNA analy- Medica/Association-will become rousis of dried saliva from a stamp used tine in the near future . by the suspect. At the same time, he Van Schie's findings could increase ~lE~~~~~::;, ® a u I I a t o this momentum, and make genetic testing easily available to populations presently outside the medical mainstream. The research was supported by the ationallnstitute of Dental Research. + -LOIS B AKER Nitric Oxide for Treatment of Aspiration Pneumonia May Do More Harm than Good ohn Belushi, Janis Joplin , Jimi Hendrix and several other pop icons are believed to have died due to regurgitation of stomach contents into the lungs while they were unconscious, an event that precipitates aspiration pneumonia. Aspiration pneumonia also is one of the leading causes of death in pregnant women, who are at risk of developing the condition when they give birth under general anesthesia or undergo other surgery. Researchers in the University at Buffalo's Department of Anesthesiology have found that inhaled nitric oxide, a new therapy being tested to treat serious respiratory ailments, may do more harm than good if used for aspiration pneumonia. They have reported new information about the progression of this potentially fatal form of lung inflammation. Results of their studies were presented recently at the American Society of Anesthesiologists annual meeting in San Diego in November 1997. "We're looking at the mechanisms involved in aspiration-induced lung injury, how we can treat this disease, and how to avoid things that make the injury worse," says Paul Knight, MD, professor and chair of the UB Department of Anesthesiology and senior researcher on the studies. Physician 5 p r I n g 1 9 9 8 �- ~~~ --·---------- --~------ ·----- .................................................................................. -- - - ········ ~ ~ ,,,~WI ' Aspiration of stomach contents oc- synergistically to produce an increase in curs during unconsciousness brought reactive nitrogen species that are toxic on by anesthesia, trauma, drug over- to lung tissue. There was no effect of the dose or other circumstances. When un- combined therapies on lung injury from conscious, a person loses the natural aspiration of gastric particles. Knight reflexes that prevent food particles and! says these two etiologic agents have or stomach juices from entering the been shown to use different pathways in respiratory system. Stomach contents producing inflammatory lung injury. "This observaoften are highly acidic. tion, along with our When acidic matter previous findings comes in contact with of microvascular tissue lining the air and functional passages of the lungs, changes with exa cascade of events reposure to nitric sults that can lead to a oxide and oxygen, decreased ability of the llii!IIIIP:!~~"l suggests that caulungs to transport oxytion should be gen. Even when the taken in using process is internitric oxide in rupted , the initial acute inflammatory damage inflicted may lung injuries that eventually prove fatal also require oxygen due to later-occurring reac"WE'RE LOOKING AT therapy," he says. tions, Knight says. THE MECHANISMS Another study by the One of the newest therasame team centered on pies for treating inflammaINVOLVED IN the relationship of the tory lung injury is inhaled ASPIRATION-INDUCED concentration of food nitric oxide, which can bring LUNG INJURY. HOW particles aspirated to the dramatic improvement in severity of lung damage WE CAN TREAT THIS oxygenation in some paand the progression of tients. Giving supplemental DISEASE. AND HOW the damage. Results oxygen also is a standard TO AVOID THINGS showed that most of the therapy to improve oxidadamage occurred durTHAT MAKE THE tion during lung injury. ing the first five hours Knight and colleagues exINJURY WORSE. " after aspiration and amined administration of remained unchanged oxygen and nitric oxide toafter 15 days. " ot surprisingly," Knight gether in acid-injured and normal lungs, using rats as an animal model. They says, "the higher the concentration of administered nitric oxide at the rate of particles, the greater the damage." Researchers on the studies, in 80 parts per million for five hours to addition to Knight, were ader lung-injured animals, while the animals ader-Djalal, MD, Bruce A. Davidson, also received either 90 percent oxygen or 20 percent oxygen. Lung injury was and J erzy C ios, MD , of th e UB caused either by acidic liquid or gastric Department of Anesthesiology; David particles. A control group with normal Steinhorn, MD, of the UB Department of Pediatrics; and Kent Johnson , MD, lungs also was examined. Results showed that when lung injury of the University of Michigan Departwas caused by aspiration of acidic liq- ment of Pathology. + - uid, nitric oxide and oxygen worked B u f f c l o 5 p r I L n o g 8 l 5 1 A K E R 9 9 8 A D H D c 0 N T '0 F R 0 M ' ' p A G E 7 researchers were able to devise a way to "tease out" what the children expected to happen due to the Ritalin versus how the drug actually affected them. Published last year in Experimental and Clinical Psychopharmacology (1997. Vol. 5, o. l. 3-13), the study took more than five years to complete and involved four consecutive cohorts of 40 children each, with follow-up studies conducted in regular school classes and laboratory settings. "Across all those cohorts, all those settings, all those kids, we found no evidence that expectancy does anything. It makes no difference whether a child with ADHD thinks he took a regular pill or a placebo," reports Pelham. "So all those people arguing over the years, saying that these kids would learn to attribute their successes to taking a pill, turned out to have unfounded concerns." The drug study Pelham is currently conducting on the long-acting version of Ritalin is being done within the context of the Saturday Treatment Program. He is planning other, ongoing studies to take place within the settings of both it and the Summer Treatment Program. Despite the many successes of his programs and studies, Pelham is the first to admit that much work still needs to be done to better understand this complex disorder. "Right now there is no single effective, comprehensive treatment program for ADHD; it hasn't been discovered." But the high societal cost of juvenile delinquency, adult incarceration, alcohol and drug abuse and mental health services reminds him and his colleagues every day how critical it is to continue to search for effective treatments for children with ADHD before their lives spin out of control in ways that even the most organized and focused of individuals would have difficulty overcoming. For more infonnalion on the summe1 treatment program 01 the upcoming clinical oial of long-acting methylphenidate, call (716) 645-3650, ext. 373. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 I I AWord from the Dtrector of Development B Y L I N D A J . C 0 R D E R , P H 0, C F R E to the many people who supported the School of Medicine and Biomedical Sciences a tan exemplary level in 1997.Inso doing, they became members of the Class of 1997 of the school's esteemed james Platt White Society. Since its founding in 1986, the society has grown from a small group of dedicated alumni to an organization of more than 200 alumni and friends, who are generous investors in the future of medical education and training at UB. An executive committee of active society members works with the development staff to increase philanthropy to the school and plan recognition events for members. Publishing this list of the school's most generous donors gives Dr. Wright and the executive committee, as well as all of us who work daily on behalf of the school, an opportunity to show our appreciation. The society currently offers two types of recognition: annual and lifetime. A gift within any year confers an annual membership for the following year. Honorary lifetime society membership is granted when cumulative contributions of a couple or an individual reach $50,000. There are also a few "special" members who received "term memberships"for a specified time frame. Although no new special memberships have been granted since 1992, we honor those earlier commitments. Most special memberships will expire at the end of 1999. Historically, the society held a recognition event in the fall, retroactively compiling a list of those whose gifts had been received from November 1 of the previous year through October 31 of that year. Last year, the society (by a mail vote) decided to migrate to a calendar year. Thus, this year's Honor Roll includes donors of contributions received from November 1, 1996, through December 31 , 1997. For a variety of reasons, the james Platt White Society Class of 1997 is the largest and most prestigious in the history of the organization. These individuals and couples who support the medical school at an outstanding level are seen as its closest friends. They receive additional information throughout the year and invitations to certain medical school and university events. Best of all, this group keeps expanding. It is a welcom- ® B u f f a l o ing and inclusive organization, since the more "best friends" the school has, the more excellent it becomes. Many donors made year-end gifts in both 1996 and 1997; our overall total gift amount is higher than it would have been in twelve months. Others made only one gift during the 14 months. Some made gifts in honor of a class reunion; thus, the current list includes gifts from two sets of reunion classes. There are several individuals and couples who are in the society for the first time, based on two or more gifts made at different times during the 14-month year. Finally, those marked with an asterisk (*) are GOLD members of the societyGraduates of the Last Decade-whose gifts during this time frame totaled between $500 and $999. The lower entry level for more recent graduates was instituted during 1996 to encourage newer alumni to take their place in this society. Most gifts were designated for the school's General Fund, disbursed at the dean's discretion. A few gifts were designated for special projects, such as the Neuroanatomy Museum, or as contributions to departmental funds, which are disbursed at the discretion of the chair for such uses as research seed money or student medical association activities. Donors designated most of the larger gifts for a particular purpose, generally for named endowments. Living donors listed in this Honor Roll collectively contributed $997,429 to theschool.In addition, the school received more than $130,000 from testamentary trusts and bequests during this time frame. We are deeply grateful for all gifts to the medical school, especially those that have the potential to make a transforming difference in the quality of medical education and residency training offered at UB. Read through the roster of members. Thank your friends and colleagues listed here for their outstanding support. If you are not yet in this group, please consider increasing your contributions to the school. The executive committee would like to see this group continue to grow, and increase its significant impact on the academic environment of the UB School of Medicine and Biomedical Sciences. + Linda]. Corder (Ly n) is associate dean and director of development. She may be reac hed by phone at (7 16) 829·2773 or by E- mail at ljcorder@acsu.buffa lo.edu Phys i cian 5 p r I n g 1 9 9 8 �----~= ---~- ------~~ · .~ - - - - - - - - - - - - - - - - - - - - ---- - ~----- ························································································a · '~ I The James Platt White Society I . . '. Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the society. ames of Founders are repeated in an annual category when they make a new gift. Mrs. Catherine Fix Dr. Eugene]. Hanavan] r. Martinsburg, WV Buffalo, NY Dr. JohnS. &: Mrs. Doris M. Parker-Latrobe, PA Dr. Thomas F. Frawley Chesterfield, MO Richard]. agel, M.D.,&: Mrs. Florence Nagel Dr. &: Mrs. Edward Shanbrom Santa Ana, CA Mrs. Christina Gretschel Genner Orchard Park, NY Ms. Pamela F. Skaper Potomac, MD Dr. Elizabeth P. Olmsted Ross Hamburg, NY Dr. &: Mrs. Pasquale A. Greco Buffalo, NY Dr. and Mrs. James]. White] r. Buffalo, NY Buffalo, NY Dr. Glen E. &: Mrs. Phyllis K. Gresham-Snyder, NY Dr. Syeda F. Zafar &: Ms. Mona S. Zafar Dr. Thomas]. & Mrs. Barbara L Guttuso-East Amherst, NY UB's founders envisioned a school to train students for service to the community. The society's Founders help to actualize that vision by providing support for programs that enrich the academic environment and enhance medical training. Dr. Kenneth M. &: Mrs. joan Alford-Buffalo, NY Mrs. June M. Alker Williamsville, NY Buffalo, NY Mrs. Morris Lamer New York, NY Mrs. GraceS. Mabie Orlando, FL Dr. Charles D. Bauer &: Mrs. Mary A. Bauer Dr. Eugene R. &: Mrs. june A. Williamsville, NY Dr. Joseph &: Mrs. Helene Chazan-Providence, RI Richard]. agel, M.D.,&: Mrs. Florence Nagel Dr. Philip D. &: Mrs. Colleen Morey-Williamsville, NY Orchard Park, NY I Professors ' Hilton Head Island, SC Buffalo, NY Miss Thelma Sanes Williamsville, NY Dr. Kenneth M. &: Mrs. Joan Philip B. Wels, M.D.,&: Mrs. Elayne Wets-Buffalo, NY ALford-Buffalo, NY Buffalo, NY Dr. joel M. Bernstein MEMBERS Dr. joseph G. Cardamone Eden, NY I Dean ' s Circle Dr. Thomas F. Frawley Chesterfield, MO Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more. Dr. Richard Ament Dr. George MEllis Jr.&: Mrs. Kelly Ellis-Connersville, IN Williamsville, NY Mrs. Grant (Evelyn) Fisher Lakeview, NY Ms. Rose M. Ellerbrock a l o Physician s n East Amherst, NY Dr. Richard B. &: Mrs. Ellen B. Narins-East Aurora, NY Dr. Bernice W. oble Amherst, NY Dr. james&: Mrs. Marcella Phillips-Buffalo, NY Dr. Seth A. Resnicoff Concord, NH Mr. Eugene M. &: Mrs. Susan W . Setel- Buffalo, NY Lewiston, NY I Mr. W. Russell Hurd Sun City, AZ Buffalo, NY r Albany, NY Mr. Arthur H . Judelsohn Dr. John C. Newman p Buffalo, NY Dr. Myron Gordon Tonawanda, ,'JY Dr. Warren R. Montgomery Jr. Amherst, NY Dr. Robert]. Gillespie Dr. Albert G. Rowe Dr. Earl S. Gilbert Buffalo, NY Dr. Willard &: Mrs. Clarice Bemhoft-Snyder, NY f Circle A strong faculty is central to a great university as are the supporters whose annual gifts range from $5,000 to $9,999. Dr. Elizabeth P. Olmsted Ross Buffalo, NY f Dallas, TX Dr. Jack C. &: Mrs. Patricia Fisher-Lajolla, CA Williamsville, NY Dr. Kenneth H. Eckhert Sr. &: Mrs. Marjorie Eckhert Dr. Kenneth Z. Altshuler Dr. Albert C. &: Mrs. Linda Rekate ANNUAL Dr. joseph &: Mrs. Helene Chazan-Providence, RI Fellows within the school bring added depth to postgraduate study. Within the society, Fellows are honored for gifts that total $2,500 to $4,999. Dr. Harold &: Mrs. Anne Brody Amherst, NY Mr. Sheldon Berlow Dr. Willard &: Mrs. Clarice Bemhoft-Snyder, NY Fellows' Circle Dr. Richard B. &: Mrs. Ellen Narins-East Aurora, NY Williamsville, NY u Circle Just as a department chair leads a program , donors of leadership gifts in the range of $10,000 to $24,999 are given special recognition. Dr. Eugene]. Hanavanjr. Dr. Charles D. Bauer&: Mrs. Mary A. Bauer B East Amherst, NY I Chairs ' Mindell-Buffalo, NY Founders' Circle I g 1 9 9 8 Drs. Robert &: Claudia Smolinski-Orchard Park, NY �· · · ·· · · · ·· · · · · · · · · · · · · · · · ·· · · · ·· · ·· · · · · · ·· · · · · · · · · · · · [!] l ~ 0 I Scholars ' Circle Scholars within the society made gifts to the school totaling $1,000 to $2,499 during the past year. Young Scholars (*) are graduates of the last decade who qualified with gifts of $500 to $999. Drs. Evan & Virginia Calkins Dr. Penny A. Gardner Los Altos, CA Hamburg. NY Drs. Andrew & Helen M. Cappuccino*-Lockport, NY Dr. icholas C. Carosella Dr. Arthur C. & Mrs. Klein Los Angeles, CA Dr. Ronald F. Garvey Dr. Robert A. Klocke Dallas, TX Williamsville, NY Dr. Kenneth L. Gayles Dr. & Mrs. Franklyn G. Knox Rochester, MN Appleton, NY Buffalo, NY Dr. Yung C. Chan Dr. Lawrence H. & Mrs. ancy Golden-Eggertsville, NY Dr. Jacob S. Kriteman Draper, VA Dr. William S. Andaloro Dr. & Mrs. Norman Chassin Dr. Peter H. Greenman Dr. Paul S. Kruger Caledonia, NY Williamsville, NY Fairfax Station, VA Watertown, NY Dr. Salvatore Aquilina Dr. Michael E. & Mrs. Joan Cohen-Williamsville, NY Dr. Glen E. & Mrs. Phyllis K. Gresham-Snyder, NY Dr. Thomas]. Kufel Lockport, NY Dr. George & Mrs. Susan Bancroft-Hamburg, NY Dr. Mark & Mrs. Kathleen Comaratta-East Amherst, NY Dr. Robert T. Guelcher Dr. Ivan W . Kuhl Erie, PA Wimberley, TX Drs. Kevin & Elizabeth P. Barlog-Amherst, NY Lyn Corder, Ph.D. Gerard T. Guerinot, M.D., & Mrs. Geri Guerinot Drs. Joseph L. & Marie L. Kunz Buffalo, NY Dr. Charles A. Bauda Dr. & Mrs. Daniel E. Curtin Rochester, NY Boynton Beach, FL Orchard Park, NY Dr. Mala R. Gupta Dr. Ralph T. & Mrs. Rita Behling- San Mateo, CA Richard H. Daffner, M.D., & Mrs. Alva K. Daffner Rochester, NY Dr. Richard A. Berkson Pittsburgh, PA Williamsville, NY Dr. Stanley B. Lewin Rancho Palos Verdes, CA Dr. Nedra]. Harrison Carlisle, PA Dr. Harold Bernhard Dr. David R. & Mrs. Sherrye Dantzker-Ros1yn, NY Buffalo, NY Drs. Roger S. & Roberta A. Dr. Donald R. Hauler Buffalo, NY Dr. Theodore S. Bistany Dayer- Buffalo, NY Pensacola, FL Dr. David L. Marchetti Buffalo, NY Dr. Robert]. Dean Kinston, NC Dr. Reid R. & Mrs. Elenora M. Heffner- Buffalo, NY Dr. Willard H. Boardman Winter Park, FL Danvers, MA Marilla, NY Lockport, NY Dr. Andre D. Lascari Poestenkill, NY Dr. Harold]. & Mrs. Arlyne Levy- Amherst, NY Mrs. Gilda L. Hansen Buffalo, NY Dr. Jack & Mrs. Inez Lippes Buffa lo, NY Dr. Michael A. & Mrs. Glenda Mazza-Spencerport, NY Gerard]. Diesfeld, M.D. Dr. Orvan W. Hess Dr. Dennis L. Bordan Port Washington, NY Arcade, NY North Haven, CT Dr. Melvin B. Oyster Dr. William]. Hewett Harry L. Metcalf, M.D. , & Kaaren]. Metcalf, Ph.D. Dr. Suzanne F . Bradley Niagara Falls, NY West Hartford, CT Williamsville, NY Whitmore Lake, Ml Dr. Robert Einhorn Dr. John M. Hodson Dr. Merrill L. Miller Dr. Martin Brecher North Brunswick, Nj Williamsville, NY Hamilton, NY Amherst, NY Dr. & Mrs. Russell Elwell Dr. James B. Bronk Napa, CA Mayville, NY Dr. Dennis C. & Mrs. Suzette HoUins*-Greer, SC Dr. Maynard H. Mires Jr. Georgetown, DE Dr. Melvin M. Brothman Snyder, NY Dr. Domonic F. & Mrs. Margaret E. Falsetti Lewiston, NY Robert M. Jaeger, M.D. Dean Mitchell , M.D. Allentown, PA Cortland, NY Dr. Kenneth L. & Mrs. Jane Jewel- Mountain Lakes, NY Satellite Beach, FL Dr. Stephen T. & Mrs. Mary Dr. Joseph F. Monte Dr. George H. Mix New York, NY Dr. John A. & Mrs. Karen Feldenzer- Roanoke, VA Dr. August A. Bruno Dr. Helen MarieS. Findlay Joyce-Buffalo, NY Buffalo, NY Buffalo, NY Eggertsville, NY Dr. John D. Mountain Dr. William M. Bukowski Drs. Susan Fischbeck & Patrick T. Hurley- East Concord, NY Drs. James R. KanskiJr., & Genevieve Kanski Eggertsville, NY Dr. Arthur W . Mruczek Sr. Dr. Thomas D. & Mrs. Grace A. Flanagan- Williamsville, NY Dr. Paul B. Karas* Medina, NY Rancho Mirage, CA Buffalo, NY Dr. Dr. Jennifer L. Cadiz Dr. Neal W . Fuhr Getzville, NY Mechanicsburg, PA Williamsville, NY Dr. & Mrs. Kenneth Kim Clinton, NY Dr. Hans F. Kipping Sylvania, OH Ms. Deborah Elliott Brown Buffalo, NY Dr. William M. Burleigh Manhasset, NY irrnala A. Mudaliar Dr. Richard L. Munk Williamsville, NY ® a u f f a 1 a Physician 5 p r I n g 1 9 9 8 �········· · ··············································································a · \ ... I Dr. Masao Nakandakari Honolulu, HI Dr. Edwin A. Salsitz ew York, NY Dr. Charles S. &: Mrs. Anne R. Tirone-Williamsville, NY Dr. &: Mrs. Marvin Z. Kurian Williamsville, NY Dr. Nancy H. Nielsen Orchard Park, NY Dr. Arthur]. &: Mrs. Elizabeth Schaefer- nyder, NY Dr. Bradley Truax Lewiston, NY Dr. Timothy T. &: Mrs. Cynthia ostrant-Saline, Ml Dr. james N. Schmitt Kenmore, NY Dr. joan A. Vivona&: Mr. Robert L. DeiszJr.*-Elma, NY Harry L. Metcalf, M.D., &: Kaaren]. Metcalf, Ph. D. Williamsville, NY Dr. john&: Mrs. Michelle M. O'Brien*-Pinellas Park, FL Dr. Robert . Schnitzler San Antonio, TX Dr. Coolidge S. &: Mrs. Edith Y. Wakai-Honolulu, HI Dr. Thomas P. &: Mrs. Sandy O'Connor-East Amherst, NY Dr. Adolphe].&: Mrs. ancy L. SchoepOin-Tucson, AZ Dr. Arnold Wax Henderson , NV Mrs. Marguerite T. O'Gorman Eden, NY Dr. joseph I. Schultz Harbor City, CA Drs. Charlotte C. &: Hyman Weiss-Highland Park, Nj Dr. Kathleen A. O'Leary &: Mr. Michael]. Collins* Buffalo, NY Roy E. Seibel, M.D. , &: Mrs. Ruth H. Seibel-Eggertsville, NY Dr. Frederick D. Whiting Vestal, NY Dr. Molly R. Seidenberg Rochester, NY Dr. Gary J. Wilcox Carlsbad, CA Dr. Arthur M. eigel Guilford, CT Dr. Richard G. Williams Clearfield, PA Dr. john B. Sheffer Williamsville, NY Dr. John R. &: Mrs. Deanna P. Wright-Williamsville, NY Dr. Timothy S. &: Mrs. Karen S. Sievenpiper-East Aurora, NY Dr. Gregory E. Young Holland, NY Dr. Byron A. Genner Ill Potomac, MD Dr. james A. Smith Orchard Park, NY Dr. Wende W. &: Mr. W illiam]. Young Ill-Canandaigua, NY Dr. Charles D. Kimball Bellevue, WA Dr. Robert G. Smith Savannah, GA Dr. Franklin&: Mrs. Piera Zeplowitz-Buffalo, NY Dr. Clara A. March Buffalo, NY Dr. Donald H. Sprecker Leeds, MA Dr. David C. &: Mrs. Susan D. Ziegler-Walnut Creek, CA Dr. Mark W. Welch Rochester, NY Dr. Ralph M. &: Mrs. june M. Obler-Los Angeles, CA Dr. joseph]. O liver Jr. Rock Springs, WY Drs. Dean E. &: Donna W. Orman-East Amherst, NY Dr. Victor A. &: Mrs. Virginia Panaro-Snyder, Y Dr. Margaret W. Paroski Buffalo, NY Dr. Robert]. &: Mrs. Patricia M. Patterson-Snyder, NY Dr. Norman L. Paul Lexington, MA Dr. Clayton A. &: Mrs. Susan Peimer- Eggertsville, NY Dr. Victor L. Pellicano Niagara Falls, NY john]. Squadrito, M.D. Troy, Y Special Members A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. For most, special recognition will be granted through December 1999. All membersh ips in the society are now made only on an ann ual basis. Dr. james M. &: Mrs. Margo W . Strosberg-Schenectady, NY Dr. Bert W. Rappole jamestown, NY F. T. Riforgiato, M.D.,&: Mrs. Mary-Cecina W. Riforgiato Buffalo, NY Dr. Richard R. Romanowski Williamsville, NY Dr. Burton &: Mrs. Gloria Stulberg-Buffalo, NY Dr. Michael A. Sullivan Williamsville, NY Dr. David W. Butsch Montpelier, VT Dr. MichaelS. Taxier Worthington, OH Dr. Charles H. Rosenberg Stamford, CT Ms. janet F. Butsch Aurora, CO Dr. Wayne C. Templer Corning, NY Dr. Thomas C. &: Mrs. Georgia L. Rosenthal-Orchard Park, NY Mrs. Marvin (Helen) Winer Sarasota, FL In Memoriam The fo llowing individuals left generous bequests or made arrangements for gifts from testamentary trusts to be given to the School of Medicine and Biomedical Sciences during the past year. to ensure accuracy in these Elizabeth A. Storch Middleport, NY Dr. john Y. Ranchoff Fairview Park, OH Dr. john Naughton Buffalo, NY every effort Dr. james F. &: Mrs. Lillian Stagg-Tucson, AZ Dr. William C. Sternfeld Sylvania, OH Dr. Harold Pescovitz Cincinnati, OH Dr. John L. Butsch Buffalo, NY Dr. &: Mrs. James C. Tibbetts Madison, WI lists. Please contact Mrs. Mary Glenn in the Medical School Development Office if we have made an error or if you would like your name(s) to be listed differently in future recognition documents. Send mail to: UB Medical School Development Office, 3435 Main Street, Building #22, Buffalo, NY 14214-3013. Phone: (716) 829-2773. Fax: (716) 829-3395. B u f f a l o P hysician 5 p I r I n g 1 9 9 8 �[5;] . . . . . . .... . . . . . . . . . . . . . . . . . . . . .... ...... . . .... ... . . . . The Beginning of My Ouest BY P A M E L A C R 0 W E L L AST SPRING I HAD THE OPPORTUNITY to hear Dr. Carlos Roberto jaen deliver a lecture on smoking cessation during our third-year clerkship in family medicine. In that 60minute lecture, he opened my eyes to the serious side effects that tobacco use can have on a patient's health and the important role physicians can play in helping a Pam ela Crowell is a fourth -year patient to quit. His lecture was very motivating, and after class I found myself asking him how I could learn more about the topic. He had made me suddenly aware of how little I knew about smoking cessation and how ill prepared I felt as a future family physician. This was the beginning of my quest to become a smoking cessation specialist. I did not want to follow in the footsteps of so many clinicians who ignore the problem of tobacco use because of patient resistance and lack of time. I wanted to learn how to discuss tobacco use with my patients and how to avoid alienating them in the process. In subsequent discussions I had with Dr. jaen, we decided that I would gain the most valuable experience from direct interaction with both the patients and their physicians. As a result, we chose an inner-city primary-care facility, the Deaconess Family Medicine Center, as my primary work site. Our goals at the family medicine center were twofold: (l) to increase the identification of smokers, and (2) to improve the amount and quality of smoking cessation counseling offered to patients at the center. We attacked our first goal by devising a new charting system. We added smoking status to the vital signs and problem list and designed a separate smoking cesstudent at the University at Buffalo School sation progress note that was added to of Mcdicint• and Biomedical Sciences. each smoker's chart. My second role was to provide more intensive smoking cessa- stand my ground instead of running in tion counseling. This sometimes meant the opposite direction. I would inquire as simply talking with the patient about rea- to how much they knew about the effects sons why he or she should consider quit- of smoking on their body. "It's my body. ting. Other times, it entailed assisting the I can do what I want with it," I was told. patient in finding alternative activities to I would try a different angle. "Do you lighting up a cigarette during times of have children?" I asked. I wasn't always stress. Over the course of four weeks, I able to get the patient to admit to the talked with several hundred patients. It importance of cutting back on his or her did not take long to realHE HAD MADE ME SUDDENLY AWARE OF HOW LITTLE I ize that the best way to KNEW ABOUT SMOKING CESSATION AND HOW ILL learn about smoking cesPREPARED I FELT AS A FUTURE FAMILY PHYSICIAN. sation was through the patient's own experiences and attitudes. tobacco use, but I was often surprised at I would often take the opportunity to the number of positive responses I retalk with patients as they sat in the exam ceived from simply initiating an open room waiting patiently to be seen by their conversation. The patients themselves physician. I introduced myself as a medi- began to approach me, saying, "I've been cal student and mentioned that I was trying to cut back on my cigarettes for trying to learn more about smoking. Each years. Do you know anything that may patient reacted in a different way, and I be able to help me?" tried to cater my approach to each one's Whenever I encountered patients who response. Some patients resisted vehe- had successfully quit smoking, I enthusimently. "I'm not interested in quitting," astically asked how they accomplished it. they would tell me. I learned quickly to Some gave credit to their own willpower, ® B u f f a l o Physician 5 p r I n g l 9 9 8 �------- ------------~ -- -----~-- - ------------- --- - ---- ········································································· · ············· a others to a change in daily routine, or hypnosis or prayer. I discovered that the process was a very individual one but also one with great rewards. Another valuable learning experience was my participation in a Stop Smoking Clinic at the Roswell Park Cancer Institute. There was a wide variety of participants, ranging from young to old, first-time quitters to relapsers, and smokers to nonsmokers. The class was taught by Dr. K. Michael Cummings, a nationally recognized tobacco expert. He talked about all aspects of smoking, from the history of the tobacco industry, to the ingredients of cigarettes, to the effects of nicotine on the body, to various behavioral modification techniques. At the end of the sessions, I was thankful to have taken the class and was once again reminded that the best teachers WNY's of all were the participants themselves. One gentleman had returned to smoking after quitting for five years. "The first time I was able to do it cold turkey, right after I was hospitalized for a heart attack. I didn't touch them after that. I didn't even crave them, but then life started to get the best of me. Stress, you know? I was worrying about paying the bills all the time and the next thing you know I was lighting up a cigarette again, not even thinking about how much extra money each pack was costing me," he explained. It was a serious addiction, both physically and psychologically. Dr. Cummings listened to each story intently, then offered his own best anecdotes. One participant said, "I've tried everything: the patch, the gum, walking, drinking water. I just can't stand to go without them. Giving up cigarettes is like losing my best friend." Hearing these words, I wondered, "What could Dr. Cummings possibly say to that?" He always came up with something else that the person could try, a new way to think about the problem or a new behavioral modification technique. One day, at the end of the month , I was talking with Dr. Cummings and sharing with him how impressed I was with his ability to help so many people quit smoking. A smile crept across his face as he peered over his desk and replied, "Pam, I've never been able to make even one patient quit smoking. The patient doesn't quit smoking because of anything I tell her to try. The patient quits smoking because she is ready to quit herself." I walked out of the room adequately mystified, once again humbled by the oft-forgotten role that the patient plays in her own health. + - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.e MSRP s64240 F. G. DOWNING s&99 1998 BMW 740i While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. 30 mo. Lease FREE SCHEDULED MAINTENANCE Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade), 12,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT. taxes and plate fees due at inception. Residual $43040 Service Loaners Available ••. Minutes From Rich Stadium a u f f a 1 o P hysician 5 p r I n g 1 9 9 8 �l!!l. ................................... . ......... . .................... . ..... scrub in on the consummate ousopportunitytoobserveand psychiatrist, part general medical doctor and part law- have been retired 11 years and surgeon's cases. One day , my yer. I am enjoying my work founder, president and CEO of am enjoying it. I'm still active good friend and classmate, Dr. as well as enjoying traveling HealthCare Plan , has been and doing well with my tita- Ferdinand Paolini, and I were and playing tennis. elected board chairman of the nium right hip and post-myocardial infarction, both in 1996. !live one-half mile from Marine co-retractor holders on a thowas non-profit and provider-based on Lesterhill Lake and fish a lot, very slow but meticulous sur- recently certified in medical di- health plans. The December 15, take care of my home and small gery, Dr. Stewart paused and rection for long-term care by 1997, issue of Newsweek maga- garden. My grandson is enter- the American Medical Direc- zine listed the highest rated ing his MD residency this spring. asked," eed to rest your arms 'Dr. Pawlini'7" Ferd replied ,"! don 't know Dr. Stewart, they've tors Association. Rosemarie Santora Lamm, his wife, re- HMOs in the U.S. and THMOG member plans accounted for the writes: been completely numb for the ceived her PhD in Applied top five-scoring health plans, and Thought you'd all like to see last 30 minutes. " The surgical team all relaxed a bit and even Medical Anthropology in De- 11 of the top 18. HealthCare cember 1997. Plan, under Goshin's direction, THEODORE W . BOB COLLINS , Koss , ' 43 , ' 41 , ] three of the class of March ARTHUR EDW I N R. LA MM, ' 60, Stewart "The Superb" chuckled a little. A great man could show a little humanity at times. has MAX A. S C HNEIDER , ' 49 , been elected chair of the a- tiona! Council on Alcoholism 1943. On the left is JOHN M ARA N T Z , ' 65 , of the Pathology Department Center in Corona, CA. Ambulatory and Community effective january 1, 1998. He Ml: In September 1996, I be- has served on the NCADD came corporate chairman of Di- FLET C HER , has been appointed vice-chair of Gardens, Florida; in the middle RICHARD KE N NETH BROMBE R G , ' 75, at Corona Regional Medical and Drug Dependence ( CADD) for a two -year term, iS ' 70 , was a founding member of THMOG. has accepted a new position as chair CA L VI N of Palm Beach Do N oHu E GOS HIN, The HMO Group (THMOG), a national alliance of integrated, racic sympathectomy case. After about 1 and l/2 hours of R . K E NN ET H M A TASAR , Pediatrics at the SUNY Health Sciences Center/Brooklyn (downstate). ' 68 , writes from Bloomfield Hills, Tequesta, Florida; and to his board since 1983. Widely agnostic of William Beaumont right is me, (lOO Waterway Rd, known in the field of alcohol- Hospital, a 930-bed teaching R O BERTS BU R N S, ' 8 3, Apt. 201A, Tequesta, FL ism and other drug addictions hospital , as well as a 190-bed ated from the University of Mem- 33469). I think it is great we as a teacher, author, lecture satellite hospital. We perform phis in December 1997 with a live together, play golf together and film producer, Schneider nearly 400,000 imaging stud- master's degree in playwriting. is the director of education for ies annually and have 35 radi- His play "Zen and the Fear of the Positive Action Center at ologists, 24 residents and 11 Flying" was produced in Pitts- Chapman Medical Center in Orange County, CA. He is a fellows. Judi and I have two sons. Our younger son is in his burgh this year. recipient of UB's Alumni Life second year of medical school and associate together all the time and are well. We go out to dinner all the time, which is great. We would love to hear from any of you and have you come and see us. We will have Achievement Award. attorney in 1 9 5 0 W ILLIAM S ULLI V A N , '55, writes: After 35 years of gen- bad . The best to all. eral psychiatry and psycho' 47 , analysis, I have changed my writes: Another Dr . john Stewart memory. In 1948, I was professional work to forensic psychiatry. I find this new an intern at M.M.H. on the sur- work interesting and demanding . One must be part CHARLES D . ROSS, gical service. l had the marvel- B f f recently, I heard a familiar voice ew York City. His from the past. Looking up, I wife is a third-year medical stu- much medicine has changed. We are glad we are retired. Too a l o SaW PAU L dent at Columbia University College of Physicians and Sur- practice at St. joseph Mercy Hospital in Ann Arbor. (I'm in in orthopedic surgery. PM&R.) As it turns out, Paul and his family live around the corner! Two '85ers on the has been promoted to captain in the U.S. Naval Reserve Medical Corps. p S HIELDS , y s c B E R KOW I TZ, ' 85 , who has joined a nephrology geons who is planning a career J O HN reports: While making the rounds at Harvard. Our older son is an a good time together. Can't believe its been 55 years and how JON WAR D N E R , '85, gradu- ' 68 , a n same block-there goes the neighborhood! 5 p 9 9 �········ ······· · ················ ·········· ····················· ·················· ······ ·[! ] THOMAs P. SMITH , JR. ' 87 , Washington Residency Pro- promoted to assistant profes- Langone, '96, is enjoying her pe- has been appointed medical di- gram in Rehabilitation Medi- sor and am now the director of diatric residency atthe University rector of Erie County Medical cine in 1995. Presently, he is obstetrical anesthesia at the of Texas and will stan in terview- Center's ca rdiac care and telem- an associate medical director University of New Mexico . etryunits. Heisa lsoanassistant professor of medicine, division at Whittier Rehabilitation Hospital in Westborough , MA. of cardiology, at UB. In this ca- He and his wife, Kathleen , pacity, Smith is clinical precep- ing soon for a general pediatric position in ANTHONY LANGONE , ashvi lle, TN. ' 96 , proudly announced the birth writes: I am currently in my second year of my interna l MOR G AN tor for third-y ea r medical of their son, Marc Daniel medicine residency at Baylor alumnus of UBs orthopedic students and lectures exten- Liguori , in july 1997. College of Medicine. After being residency, hand and spine accepted by l2 nephrology fellowship , is back home in Cajun CYNTHIA LEBER MAN JENSON , programs, 1 have accepted a po- country in private practice, hav- writes: Mark and 1 had sition at Vanderbilt University- ing successfully completed two our second child, Erica, on a three-year fellowship with international adoptions (one girl january 16 , 1998. She joins special certification in renal from China and one from Viet- transplantation. My wife, Susan nam) and planning more. sively on topics related to cardiovascular disease. ' 92 , 1 9 9 0 PAUL A . LIGUORI , ' 91 , gradu- ated from the University of Alexandra, now three . 1 was P. LORIO, ' 88 , Four UB Alumni Presented AMA/GlaxoWellcome Leadership Award skills, and the Allegheny Regional resident at the State University of New F Development Corporation, which York at Buffalo School of Medicine and our alumni of the UniHrsity at Buffalo School of Medicine and Biomedical Sc1ences were presented the AMNGlaxo Wellcome Leadership Award at the AMA's interim meeting held in Dallas in December 1997 . The award, which was given to only 40 recipients nationwide this year , acknowledges resident physicians and fellows who have demonstrated a strong commitment to their civic or medical community through volunteer activities. Recipients arc given the opportunity to participate in the Am erican Med1cal Association's policy-making process by attending two meetings of the AMA Resident Physicians Sec tion (AMA-RPS ). The obJeCtive of the program is to encourage involvement among community-oriented physicians 8 u f f a I a P and to develop the skills of potential leaders of orgamzed medicine . Award recipients have their expenses paid to attend one annual and one intenm meeting of the AMARPS and the opening session of the AMA house of delegates. The four UB alumni receiving this award , and their contributions as described b) the AMA, are as follows: Biomedicol Sciences. Stephen J. Kimatian, MD '92, cochaired ofund· raising event for the Children's Hospital of Buffalo during medico\ school. Then while in the U.S. Air Force, he served as ofacilitator for teen and family support groups and coordinated school physico\ examinations and immunization reviews. Kimotion is on anesthesia resident at the Hershey Medico\ Center of the Pennsylvania State University. Kim S. Griswold, MD '94, volunteered os o clinician and on the board of directors of Conoon House, a home for women who ore reconstructing their lives after incarceration, where she developed o program to provide the women with health education and initiated o program to recruit other medico\ residents to volunteer. In 1989, she co-coordinated La Clinico Suyo, o free medico\ clinic for refugees and the uninsured. Griswold is o family medicine hyslcla 5 p r Martin C. Mahoney, PhD, MD '95, serves on the board of directors of the Contolicion Center, which provides health and education services to people with disabilities. He also volunteers with the Niagara Fron~er Vocational Rehobilito~on Center, which helps the disabled acquire and maintain voco~onol I n g I 9 9 8 provides health core to Native Americans with disabilities. Mahoney is a family medicine resident at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. Andrew Sherman, MD '93, volunteers at two local boys and girls clubs in Seattle that serve under· privileged innercity youth. He coaches basketball year-round, providing leadership and o positive role model to 12-14-yeoriJ\d boys. He is ovolunteer physician for o loco\ high school team and provides physicals, game coverage and acute core of injuries. He also provides acute-core coverage for the spinal cord-injured patients at the Veterans Administro~on games. Sherman is o physical medicine and rehabilitation resident at the University of Washington Hospital in Seattle. an �& THE ULTIMATE DRIVING MACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. 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Ask for free copies of our risk management \ l.i.Jbilill ' lutual In-ur.mrr Company guide for office practices. • Our defense never rests. a u f f a l 0 Ph ys i cia n 5 p r I n g 1 9 9 8 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C1996 Medical lial7ility Mutoallrtf1urance Company �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage 3435 MAIN ST . PAID Buffalo, NY Permit No. 311 BLDG. 22 BUFFALO NEW YORK 14214-3013 C"t ISC E~IC~L 219t. HISTO !- L ~!­ A3 30TT LI Q~~y SER!~LS ADDRESS SERVICE RY -;:> ... ::. I REQUESTED To consult with someone truly concerned with your financial health, come to Key Your Key Private Banker heads a team of KEY PRIVATEBANK professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For a new America~ BP 1002-98 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v32n02-1998-Spring Table Of Contents A list of subunits of the resource. The Sounds of Science Focusing Attention on ADHD Northern Exposure Merging Medicine with Business Medical School MPH Program Established Hospital News Research News A student's perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1024134183ada70f0ec4c6c8afd2d9c8.pdf e60f0f944e59001172da7272b38184f0 PDF Text Text �BUFFALO PHYSICIAN Volume 33, Number 1 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole Smnh Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR StephaniC A. Linger ART DIRECTORIDESIGNER Alan J. Kegler ASSISTANT DESIGNER Lynda IIanne! PRODUCTION MANAGER Ann Raszmann Brov.-n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. Wnght, Intcnm Dean EDITORIAL BOARD Dr Bertram Portm, Chair Dr Martin Brecher Dr Harold Brod\ Dr Linda J. Corder Dr Alan J. Drinnan Dr James Kanskt Dr Barbara MaJCront Dr Eltzabeth Ohmted Dr Chari" Pagancllt Dr Stephen Spauldtng Dr Bradlq T. Tru"' Chr"topher Adams Dr Frankltn Zeplownz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal .\ftdtacl Shaw The Chtldren"s Hospnal of Buffalo Eric Coullly Medical Center \<!ern Health Svstem Mtlla~d Fillmor~ llcahh System franll Sma :-.:iagam Falls Memorial Medical Cemer Ro~wcll Park Cancer Institute Ststers of Chanty Hospnal Dennis .\1rCwcln Veterans Affatr'-. \\'estern :\cw York Hcahhcarc System (()The State Cnt\Crslly of :-.:ew York at Buffalo Buffalo PltyStctan is publtshed quarterly by the State umversit' of "'ew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publtcatwns. It is >ent, free of charge,toalumnt, faculty, students, resident.<., and friends. The staff reserves the right to edn all cop) and submissions accepted for publtcauon. Letters to the editor, address changes or other correspondence should be addressed to: The Editor, Buffalo Physician, Stale University of New York at Buffalo, Office of Publications, 136 (rafts Hall, Buffalo, NY 14260. We can also be reached by phone at (716) 645-6969; by lax at (716) 645-2313; or by E-mail at bpnoles@pub.buffalo.edu neaP Alumni and FPiends, As "'OTED I'\ THE LAST IS UE OF THE BUFFALO PHYSICIAN, on April1 we welcomed to the university our new vice president for Health Affairs, Dr. Michael Bernardino. Michael's experience in Atlanta in the managed care environment will be invaluable as we face the evolving challenges within the Western New York community. Coupled with the recently consummated merger of Buffalo General Hospital, Children's Hospital of Buffalo and Millard Fillmore Hospital, it is a certainty that these challenges will multiply over the months ahead. Spring Clinical Day has come and gone for another year and, as usual, the event was an unqualified success. On Thursday night, the Dean's Advisory Council joined the james Platt White Society at the society's annual dinner, which, this year, was convened at the Center for Tomorrow. The various reunion class alumni met at several different venues around the city and congregated at a reception Friday evening, and again at the Saturday morning scientific program, The Aging American. On May 22, 1998, we graduated 138 new physicians and 37 new PhD scientists at the Center for the Arts building on the orth Campus. David Hohn, MD, president and CEO of Roswell Park Cancer Center, spoke on the Problems, Solutions and Challenges for clinical practice and medical research. Although many of our graduates will remain in Western ew York, even more will continue their training elsewhere, and no doubt establish their professional "roots" in other places around the country. Included in this issue of the Buffalo Physician is a Match Day 1998 list of where our graduates were placed in their residency programs. I encourage you to review this list and to contact and welcome your fellow UB graduates who are moving into your community. A focused visit from the LCME was completed in April and, although we have yet to hear any official pronouncements, we believe we are on the right track. The LCME has been concerned about implementation of several new small-group course offerings and the density of the curriculum, particularly in the first year. Two other areas of concern were financial aid and general student advisement. Progress has been made on all fronts (except, perhaps, for the first-year curriculum density issue) and the alumni advisement program was recognized as a major advancement for the school. The Alumni Association has agreed to expand the advisement system to encompass all four years. The school budget continues to represent a challenge, particularly as the changing practice environment impacts on revenues centrally available for operating the school. Philanthropy has become even more important to us and you will no doubt have already gotten a sense of this through the various mailings you have been receiving. I hope to continue meeting alumni "on the road,'' as it were, and taking advantage of those opportunities whenever they arise. One purpose of these meetings is to reconnect alumni with the school. This is more than just an effort to increase philanthropy, although many of our alumni are actually looking for opportunities to "reinvest" in the school that gave them so much. We also have a great deal of "expertise" among our alumni, who can be of immense help in providing advice and counsel as we move ahead into the next millennium. 0 t/~?w:"', .i,~~~~m MD Dean School of Medicine and Biomedical Sciences Cover I LLUSTR ·ITIO--: B\ MICHAEL GELEN �Dear Fellow Alumni, A s THE :-.:EW PRESI DE"T O F TH E M EDI CAL A UJ M:-JI A SSOC IA TI O , I plan to continue the good work started by our previous presidents. Thanks to the leadership and direction from our past president, Jared Barlow, and the hard .. work of john Bodkin, this ........ year's Spring Clinical Day, titled The Aging American, was a tremendous success. This issue of the Buffalo Phy sician contains an article on this year's Stockton Kimball lecturer, Edward H. Wagner, MD , '65. Already, plans are under way for next year's event, with . . . . . -. . . -. D.K. M i ller about the death of Dr. David K. Miller (Winter 1998, Buffalo Physician). He was a great teacher and clinician. l would like to relate to you an incident that happened to me as a junior medical student while on my internal medicine rotation at [the E. ]. Meyer] Memorial Hospital in 1965. Dr. Miller was the attending on the medical service at that time. Internal medicine was my second clinical rotation. During one of the first days on the rotation, I was told by the a his and physical on a patient resident to for renal failure (prethe bedside, introduced was going to perform a me that I was about the a history and physical on UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES and none yet had found an d me to proceed. Being a , l performed a complete I WISH TO NOMINATE (print) - - - -- - - - -- - - - - - - - - - - - - - - -- 1ation of the nares l found AS A DISTINGUISHED MEDICAL ALUMNUS/A. septum. With this findi ng had revealed granulomas, COMMENTS (required)-- - - -- -- - -- - - - - - - - - - - - - - - - - - - ent possibly had Wegener's .. WAS SORRY TO READ .. Distinguished Medical Alumnus/a Award Nomination rounds, I told the chief tative diagnosis and that I ained for possible biopsy. 1as ordered, nor did any of patient's nose. ;ervice three weeks, but in YOUR NAME - - -- - - -- - - - - - - -- -DEGREE/YEAR - - - -- - l made weekly attending ~- Miller always treated the SIGNATURE _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ Attach separate sheet if more space is needed fo r comments. medical team. He asked Please respond by March 1 of the current academic year. ominations are rev1ewed annually . tg you think and challeng~ was tough but honest and wa" ~:,c:Hc:• auy uiL<::Ic:,Lc:u 111 u•c. pau.:nt's welfare. During those three weeks, this patien t was never presented to him because the patien t has been presented so many times in the past. Shortly after my third attending round with Dr. Miller, I passed him in the hall and he stopped to talk to me about how my rotation was going. I told him fine and then proceeded to tell Medical Alumni Association him of my findings in the patient with the nasal lesion and my tentative diagnosis. He thanked me for telling him this and proceeded down the hall. Figuring that my comments had again fallen on deaf ears, l felt that I had done about as much as l could do to convey my concerns about this particular patient. Unbeknownst to me, Dr. Miller had immediately proceeded to the ward, demanded the chief resident come with him, took an otoscope and performed a nasal exam. He observed CONTINUED ON PAGE 2 �first year of medical school, in 1976, I attended the graduation ceremonies.! was appalled that the graduates, after four very difficult years of medical school training, wore basic black gowns and the "square hats." I had imagined that the graduates would be attired in very elaborate gowns, befitting their acwhat I had described on my physical exam and he personally complishments-a gown similar to the one the dean wore. called theE T attending and requested an immediate biopsy During my fourth year of medical school, I pursued the of the lesion. A biopsy was performed that day which of a more elaborate graduation gown. The dean's gown idea revealed granulomatous inflammation, with necrosis, comstood out in my mind. After receiving permission from the patible with Wegener's granulomatosis. dean' office to investigate the matter, I contacted several othing more was ever said to me about this, since I had gown companies and obtained several different designs and rotated to a different service. Over two months later I was prices, the most beautiful design being the replica of the asked to attend the Medical Grand Rounds. At the grand dean's gown. The class of 1979 met and voted to make the rounds a case of Wegener's granulomatosis was presented. dean's gown the official gown of graduation. After the presentation, Dr. Miller stood up and stated that The company hired to produce all the necnumerous physical exams had been performed essary gowns, completed the order in time for on this patient over the previous six months Your letters are our graduation. I had fulfilled my dream. The prior to his diagnosis and that the patient had welcome. Please submit excitement and anticipation of wearing these gone undiagnosed until a junior medical student to Editor, Bullalo elaborate gowns permeated the entire class. had made the diagnosis by noting the nasal Physician, 136 Crofts However, the week the gowns were to be lesion. l was then introduced as the person who Hall, University at delivered for our ceremony, the nation's truck had made the diagno is. Buffalo, Buffalo, NY, drivers decided to strike. The gowns were rell did not choose to go into internal medicine, 14260; fax: 716-645egated to a warehouse until the strike ended. although Dr. Miller tried hard to convince me to Ironically, my classmates and I graduated in 2313; or E-mail: choose a career in this discipline. l chose a career the same basic black gowns and "square hats" of bpnotes@pub.buffalo.edu. in surgery and did a general surgery residency and our predecessors. However, the fact that future We reserve the right to then a fellowship in surgical oncology at the classes wear the gown that eluded my classmates University oflllinois Hospital in Chicago, Illinois. edit letters for length and me makes me somewhat envious, but also I cannot tell you what effect this incident had and style. very glad the issue was pursued. It is a gown on my medical career. However, it instilled treof the wearer and the ceremony. worthy mendous confidence and taught me that we should stand by our convictions and not just accept the status quo. As a clinical professor and practicing physician, I have tried to emulate Dr. Miller's skills as a teacher and clinician, and I will never forget him. The medical community has lost a stellar physician and colleague. ROBERT M. BARONE, MD, '66, FAC San Diego, California . jOSEPH GAGLIARDI, MD, MA, '79 Columbia, Maryland Editor's Note The dean's gown described by Dr. Gagliardi was originally designed in 1971 by the late Robert L. Brown, MD, '44, to commemorate the 125tll annivers01y of the founding of the school of medicine. Dr. Brown was associate dean of UB's school of medicine, as well as medical school archivist and associate professor ofmedicine emeritus. Seams from the Past Due to the efforts GRAD ATED FROM the University at Buffalo School of Medicine in 1979. Every year I read with interest your review of the medical school's graduation. l would like to share with you the origin of that very handsome graduation gown. At the conclusion of my of the Class of 1979, all students graduating since 1980 have worn the "dean's gown." Pictured is Joell. Sebastien, Class of 1998. J "' :> "'z ~ z 0 0 �VOLUME 33 , NUMBER 1 SUMMER Elegant Solution to a Complex Problem Merger Final 4 8 NEWLY MERGED HEALTH SYSTEM- 20 1998 Physicians Reaching Out to Students UB ALUM AND PROFESSOR U B MEDICAL ALUM I INVENT LASER TARGETING ASSOCIATION BEGINS SYSTEM USED WORLDWIDE NEW MENTORING PRO- by S. A. Unger GRAM FOR STUDENTS Photo by K. C. Kratt by Nicole Peradotto CHALLENGES AND OPPORTUNITIES FOR UB by S. A. Unger Illustrated by Michael Gelen Alumni Medical School SPRING CLINICAL NATIONAL RESIDENCY DAY , "THE AGING MATCHING PROGRAM AMERICAN" RESULTS LISTED EDWARD H. WAGNER, photos by Frank Cesario Research STOCKTON KIMBALL * REDUCING MULTIPLE LECTURER COMMENCEMENT 1 9 9 8 , A BIRTHS by Scott Thomas TIME TO CELEBRATE * PROSTATE CANCER , photos by Don Heupel ESTROGEN LINK Class Reunions * HYPOXIA STUDIED * TALLER, P HOTO BY NOT HAPP IER �Newly Merged Regional Health System Presents Challenges and Opportunities for UB . - - - - - - . HE LO 'G-A:"\TlC IPATED MERGER OF Buffalo General Health System, Children's Hospital of Buffalo and Millard Fillmore Health System was announced on Aprill, 1998. After nearly two years of extensive study, planning, legal work and governmental reviews, the merger came to fruition, significantly reconfiguring the Western ew York health-care delivery system. Making the announcement was john E. Friedlander, president and chief executive officer of the newly merged regional health system, which has temporarily been named CGF Health System. "Thanks to the efforts, spirit of cooperation and commitment by a great many people in all of the involved organizations, we have made history today because the face of health care in Western ew York has been changed forever in a very positive way," he said. ILLUSTRATION BY MIKE GELEN �BY Friedlander also paid special tribute to the boards, physicians and internal leadership of Millard Fillmore, Children's and Buffalo General for their "extraordinary vision and strong desire to work together to create a dynamic , new , value-driven health-care system for the community and region. " Facilities included in the merger are Buffalo General, Millard Fillmore Gates, Millard Fillmore Suburban, Children's and DeGraff; four longterm care facilities; a number of home care services and approximately 50 service locations in five of Western ew York's eight counties. In all, the merger brings together 2,200 physi- S . A . UNGER cians and 12,000 employees under the CGF Health System. "As an organization, CGF is committed to assuming a leadership role to promote the health of our community and, in doing so, improve the overall quality of life for everyone we serve," said Friedlander, who emphasized that as part of its mission, CGF is committed to excellence not only in service, but in education and research , as well. The UB Connection Because all three of the larger hospitals involved in the merger-Buffalo General, Millard Fillmore and Children 'shave teaching and residency programs with the University at Buffalo's School of Medicine and Biomedical Sciences, the future place of academic medicine within the CGF Health System has been the focus of much attention and concern within the UB community. In addition to ways in which the new merger will affect the school of medicine's primary mission of educating future physicians, there is also a complex financial relationship between the school and the hospitals involved in the merger. As john R. Wright, MD , interim dean for UB's School of Medicine and Biomedical Sciences, explained last winter in a message to Buffalo Physician readers, "The state budget provides only 13 to 14 percent of [the medical school's] annual ex- �Newly Merged Regional Health System penditures, matched by approximately school," he adds. "It would not be in by university administrators, led by the same percentage from extramural- our best interests to be dealing with a Michael Bernardino, MD, the Universponsored research programs. Since weak, floundering, constantly volatile sity at Buffalo's new vice president for hospital support, which also includes delivery system." Health Affairs. the residents' salaries, accounts for apost of these prinThis is a perspective shared by the proximately 23 percent of total expen- business community at-large, Wright ciples are not conditures and the practice plan, an addi- feels. "I think the business community tentious, but reflect tional 41 percent, over 60 percent of sees health care as playing a major role in mutual goals the our funding is derived through the the rebirth of the Western ew York university would health-care delivery system." support, according economy. The University at Buffalo is ln an interview several weeks after arguably the largest employer in the reto Wright. "However, there are some principles that the merger was announced, Wright ex- gion and probably represents--if you may not completely or accurately deplained that while the merger does included faculty, staff and students-the present clear-cut challenges for the uni- largest group of health-care consumers. fine the university's position on what should be included or excluded in an versity and the medical school, it pro- And recently, a number of health-care affiliation agreement. It will be over vides significant opportunities, as well. manufacturing companies have sprung those issues that the agreement, in its In order to effectively balance the up in the region and, although it's not present form, will be subject to negothreat of challenges with the promise often a well-appreciated fact, this is a very tiation as we begin this process," he of opportunities, Wright feels it's im- promising local industry. So, there's an remarks. portant to step back and view the opportunity at this time for the univerWright outlined four benchmark merger in a context that includes as sity, the health-delivery system and priconcerns the medical school will put broad a vision as possible for the future vate industry to work together to improve of health care in our region. forth in its negotiations with CGF. The the economic climate of this region." first, he says, is that "We need to be "I think it could be said that the ln addition, Wright foresees impliable to control the educational envidriving forces behind the formation of cations of the merger that could ronment for our students and resithe CGF Health System have been com- provide other, more specific opportudents, and that level of control clearly munity leaders as much as the individual nities for the medical school. "We will overlaps with CGF's equal desire to hospitals themselves. This merger is an have a chance to consolidate the medihave control over the medical services effort for our community to determine cal school's programs and to develop a it provides and the physicians who its own future bymaintainingsome local more focused, less distributed clinical provide them." programs," he explains. base for these control over the provision of health-care Secondly, he says, "We are a comservices in an environment where com- "There will also be opportunities to munity-based medical school and there mercial enterprises from outside our re- organize our clinical faculty and pracis the desirability, in fact necessity, for gion could come in and determine it for tice plans into a more cohesive, cenus," he says. ew York State is cur"I think the business community sees health care as playing rently not a particularly full-time faculty to work side-by-side hospitable environment for for-profit tralized operation-something that has with volunteer faculty. " As a result, he hospitals, according to Wright, who been missing in the very distributed, adds, "There needs to be different insays that could change. "Clearly, this community-based medical system that reorganization of health care in our has been in place in Buffalo." centives and constructs for each group, community is a proactive commitment and it is critical that CGF be able to to plan for the future and to gain con- Challenges and Obligations create an environment that fosters coltrol over costs and administrativestruc- Following announcement of the laboration among physicians. " ture now. merger, CGF presented the medical Thirdly, the medical school has a And of course what's healthy for the school with a Principles of Affiliation need, as well as an obligation, to concommunity is healthy for the medical Agreement, which is being reviewed tinue its relationship with health- a �delivery systems not included in the CGF system, and the affiliation agreement cannot in anyway jeopardize these long-standing relationships. "We have an important working relationship with Roswell Park [Cancer Institute], Erie County Medical Center, the Veteran's Administration system and the Catholic system that we simply cannot and will not abandon ," Wright states. "We cannot work exclusively with the CGF Health System. That would not be good for us , nor for the community. " And, finally , "The relationship between the university and CGF must be financially sound, " Wright says. "So , it's a symbiotic relationship in which the health and well-being of both entities is absolutely essential to the entire process. " "Roswell Park is clearly one of the centers of excellence that is already established in Buffalo and, therefore, is key to the goal of having other such centers because it already has as its mission the cultivating of a referral base beyond this region, more so than any other facility in our area ," Wright explains. This interest in drawing individuals from outside the region to a center of excellence relates back to the business community's goal of ensuring that health care in Western ew York remains a viable economic force and one that can form a base for revitalization, explains Wright, who emphasizes the integral role academic medicine would play in the development of such centers. "I am convinced, " he says, "that in most, if not all , centers of excellence , an academic presence ensures that the center is going to continue to grow and develop more innovative approaches to treatments compared to a facility that is simply a highly skilled practice site that does not have the constant influx of new information that an academic affiliation provides. " that we have a full-time vice president with expertise in these various areas ," he adds , referring to Bernardino, "we feel dialogue will open up and the faculty's comfort level will increase." Wright emphasizes, too , that how the health-care delivery system in Buffalo takes shape in the months and years ahead will involve choices the community will need to make, as well , and will not be limited to what the university, area hospital systems and physicians determine to be the best course. '·For example," he says, "the question could be asked of the community: 'Do you want a medical school? And if you want a medical school, do you want a good, bad or indifferent school?' I would assume the answer is 'Yes, we want a medical school, and we want it to be an excellent school."' iven the current comCenters of Excellence plexity of Buffalo's The ultimate goal of such a symbiotic health-care delivery sysrelationship between the university and tem, finding a middle CGF is the development of "centers of ground that best repreexcellence" that would not only serve sents the collective needs the Buffalo community, but would result of the population of our in a referral base from outside the region, region-not just the needs of the varaccording to Wright. The idea of estabied entities that provide the care-will lishing a network of centers of excel- Opening up Dialogue be a challenging process but one Wright lence has been repeatedly floated about Wright acknowledges that the prois optimistic about. "Working out how the Buffalo medical community over longed merger process has been very health care will be best delivered in our the past few decades, but has gained stressful for medical school faculty, but community will not be a slam dunk; there is a lot of work to be major role in the rebirth of the Western New York economy... done," heconI cedes. "We're . !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .~ going to go momentum in recent years as a result of also points out that it has been difficult through some pain, we're going to have market pressures leading to , among for the university to take a proactive differences of opinion, and we will have other things, the CGF merger. Under role in clarifying the ramifications of to work things out over time. For the the centers-of-excellence model , a such a merger until the merger itself long run, we need to look at how we can particular facility would complete a was formally in place. 'The university deliver health care in our community in high volume of specific procedures for couldn't hammer out an affiliation a way that not only helps assure the treatment of defined conditions, such as agreement with a merging system while viability of the medical school, the unicancer or heart disease, in order to con- there was still a possibility it would versity, and area hospitals, but in a way trol costs and assure the highest possible fail ," he explains. "However, now that that helps ensure the viability of our quality due to its focused expertise. the merger has in fact occurred and now entire community." + �MICHAEL K . LANDI , MD , LEFT, AND ROBERT M . LIFESO , MD , WITH DUAL TARGETING RADIATION SYSTEM THEY INVENTED . �8 Y 5. A. U N G E R --------' .L4n UB ALUM AND PROFESSOR INVENT LASER TARGETING SYSTEM �"T ilE 1-1 n r l'llOTIITYI'E ",~ \1 \DE 1 'il\ 1, , .\IIHiw n Fil ii \[ .\ Bllw ,·.\l ;r·: .\\'ll PIPE FHI I\1 \ II \IW\1'\HI: '\TII HE ... L\\ Il l HEI .\LL.' . ".\ :\ [)Til E 'i Et:O \Il Pre \I OilEL \\".\ .' lll"ILT I-.;[\(;.\ FL.\ IILII ;/IT Ifill I\(; .\\'ll \ ll E.\ T\L \llllllOH . Today, the product they developed, called the DRTSTM Platform (for Dual Radiation Targeting System), is being manufactured in Orchard Park, ew York, and sold throughout most of the world. While application for the DRTS Platform was initially aimed at the orthopedic field, other uses for it are rapidly becoming apparent as the innovative tool makes its way into the hands of skilled clinicians in other fields , from oncology to neurology. The system, which received Food and Drug Administration approval in September 1997, is being marketed by Ml RAD Inc. , whose chief executive officer, William Burns, was named Inc. magazine's 1993 Entrepreneur of the Year in ew York State. Fl\lll\1 a research project to find a better way to do this. " This was a project for which Landi was ideally suited. Prior to entering medical school to pursue an interest in biomedical engineering, he had completed a degree in electrical engineering at the University at Buffalo. Before coming to UB , he worked for several years at a company in Los Angeles that developed software for projects requiring advanced radar systems. Earlier, he had served in the U.S. avy, working with guided missile weapon systems on board a destroyer. Lifeso, who is director of the Spinal Cord Injury Unit at Erie County Medical Center and clinical professor of orthopedic surgery at UB's school of medicine, did not have Landi's engineering background; however, he did have a strong interest in laser technology and its potential application to medicine. When Landi approached Lifeso about working on the research project he had proposed, Lifeso was excited to learn of the young medical student's training in engineering and immediately saw the fit. "He talked to me about a concept he had of combining X-ray with laser light and how that might provide a sort of guidance system for surgical procedures," Landi says. After further discussions, Landi decided this was a concept well worth pursuing and he went to work for Lifeso during the summer between his first and second year of medical chool, devoting himself to taking a roughly formulated idea and turning it into a marketable product. "Once I fully understood the problem, I saw that what you needed was a way to mark a surface point of entry that would not interfere with the operant field and give an axial alignment to intersect with a subsurface target. And a laser pointer made the most logical sense," says Landi, who today is a neurosurgery resi- \ BITTI· Ii \\'\)Til Dll Tiii'- The story of how the careers of these three men converged at the point of a laser beam began in the fall of 1990, when Landi was a first-year student at the University at Buffalo School of Medicine and Biomedical Sciences. "I was assigned Dr. Lifeso, an orthopedic surgeon, as a preceptor," he recalls. "The first time I met him was at a morbidity and mortality conference where the previous month's cases and complications were presented. One complication discussed involved a nun who had fallen out of bed and fractured her femur after an intermedullary rod placement in which the distal-locking screws were inserted incorrectly. Dr. Lifeso explained that this was a common problem-that external targeting devices that are supposed to point you toward the region where you need to make the incision and place the screws, weren't that accurate and when done under X-ray imaging required excessive radiation exposure to the patient and surgeon. He then asked if anybody was interested in doing a u f f o 1 o P hysician Summer 1 9 9 8 �I - -- --- ~--~~~ dent and a research instructor in UB's Department of Cn \"II jl B.\ C1111l E Electrical and Computer Engineering. "The most diffiWilliam Bums was the former president and chief execucult problem was developing a way to make the laser rive officer ofMatrx Medical Inc., North America's largest light coincide with the image that you saw from the manufacturer and distributor of emergency medical prodX-ray. Once I figured out how to do that, the device ucts. "Bill Burns provided the entrepreneurial brain came together very rapidly ," he says. power we needed," says Lifeso, who describes his first Figuring out how to do this "just required a lot of few years working with Burns as "a crash MBA course." geometry," according to Landi. "Basically, what I came up Securing the intellectual property rights for the dewith was a system that identifies a line of radiation from vice was obviously a high priority and little time was the X-ray source to the detector; positions a laser beam so wasted. In May 1993, the first patent for the device was that it's co-linear with that line of radiation; and puts a awarded to Lifeso and Landi and assigned to the Reradiopaque target symbol- a cross hair- on that same search Foundation, State University of ew York at line of radiation so that its image on the TV monitor Buffalo. In May 1996, Burns and the two inventors represents a point on the line that the laser indicates." formed a company called MI RAD (minimum radia"Once Mike began building prototypes," Lifeso says, tion) to market the DRTS "it became clear to us that the real problem we were facing Platform and today the was finding the center of the X-ray beam, and that's where BH( l.\ll .\PPLH:.\Tit~~~ company employs 25 his expertise came in. He designed a collator that is key people, including six .\cno~~ jf.\:-~r to the device being able to correlate the flu oro image of engineers, regulatory exthe screw placement site, as viewed on the TV monitor, , 'PECL\LTIE:-perts and two patent with a precise point on the patient's anatomy. '' Throughout the summer, Landi worked on the project at home with materials he and Lifeso were able to obtain using their own resources. "The first prototype was made using a mirror from a bird cage and PVC pipe from a hardware store," Landi recalls. "And the second model was built using a flashlight housing and a dental mirror. " By the end of the summer, Targeting brain tumors during perioperative localization. Landi had designed and built a device that was remarkably sophisticated and someattorneys. In late 1997, thing the two inventors were fairly confident was a the University at valuable innovation if they could get it in the hands of Buffalo invested in someone who knew how to market it. Essentially what MINRAD , taking up the they had developed was a system that would allow a largest equity position it surgeon to use the fluoroscope to visualize and locate a has ever held in a startdeep structure, turn off the X-ray radiation and still have up company. accurate guidance and position information relative to "This was an opporthat deep structure. Using their device, a surgeon would tunity for the universimply place his or her drill tip on a patient at the precise sity to invest in a strong spot indicated by the laser (e. g. , as pointing to the hole start-up company, bein the intermedullary rod) and drill along the axis ing led by an excellent indicated by the beam. entrepreneur with an "Once we had gotten that far with the device, we started exceptionally good to realize how little we truly knew about what to do with technology in a promthe thing," Lifeso says. "Because we were both affiliated ising market, " says with the university, we went to the Office of Technology Daniel Massing, former Transfer, and they put us in touch with Bill Burns." B u f f a I o P hysician Summer 1 9 9 8 �director of UB's Office of Technology Transfer. dent and general manager. "The technology patented In cases where UB has patent rights on a technology, by Drs. Lifeso and Landi is a very elegant solution to the the university traditionally receives an up-front licenscomplex problem of aligning a visible laser guidance ing fee from the company commercializing the techwith a selected portion of the X-ray beam of a fluoronology , according to Massing. In this instance, in lieu scope. The simplicity of the solution they came up with of the licensing fee , the university will receive equity in means that it is inherently less expensive to manufacMI RAD based on its interest, which consists of foundture and less costly and complex to maintain after ing shares and subsequent stock purchases equal to 4. 7 installation. You can't help but feel good about a project percent of the fully diluted interest. In turn, UB's that is this straightforward to design and manufacture," license and patents on the DRTS were beneficial to the Me eirney says. "After 30 years' experience with simicompany as components of the prospectus document lar projects, I've seen both sweet and sour solutions. for raising funds , Massing explains. "The opportunity This is a sweet one. " to take equity in a start-up company that is commerll11 \II\ 1, I\ II\ ~ f.\1 ,\I' I' L II \Till\" cializing research developed in our own laboratories is consistent with a national trend by universities," he Sweet also is the fact that other applications for this notes. "Once the stock is sold, the return to the univerdevice are rapidly developing, which make it more sity of an equity position can be significant, often versatile than its inventors originally intended it to be. exceeding what would result from the license income In oncology, the device is proving to be ideal for generated by royalties. " performing minimally invasive biopsies oflesions than And the return to all investors does indeed look can be visualized with X-rays. This use of the system promising. According to Burns, surgical procedures could also translate into significant improvements in guided by fluoroscopy account for about 10 percent of the accuracy of deep tissue biopsies done on breasts, all operations performed worldwide. "There are about livers or spleens, some 20 percent of which currently 90,000 fluoroscopes currently in use around the world, " produce false negative readings. " ot only will you be he says, "and I think the market potential for the able to improve accuracy, but you will also be able to MI RAD device could reach $130 million, plus anreduce the patient's exposure to radiation as well as his other million for disposable accessories , such as surgior her discomfort because you can hit the target on your cal drapes and biopsy needles. first attempt, without having to manipulate the needle On September 24, 1997, two weeks after it received under fluoro , something that can be especially painful a notice of approval from the FDA for the DRTS, during bone or vertebral biopsies," explains Landi. MI RAD launched Other promisthe device at the ing applications for annual Meeting and the system are in Exhibition of the neurosurgery , ·To! C.\'i.T IIELI' BI'T FEEL mon \Bili"T ,\ l'!lO.JECT TIL\T I. British Orthopaewhich especially dic Association in interests Landi Cardiff, Wales. Earsince this is the lier, the DRTS had field he chose to .\HEll :~1) YL\H< E\I'EHIE'if:E \\ITII SI\IIL.\Ill'llii.Ji':CT:--. I\ E been approved for pursue following sale by Europe 's his graduation 'EE'i BoTH s\\EET \'ill ·,wn 'ilLlllil:\ . Tm·.; '"' .\ s\\"EET ti:\L.". FDA counterpart, from medical and MI RAD has school in 1994. since signed a 10"We're using the year $83 million DRTS to target agreement with Atmos Healthcare, to distribute the intercraniallesions prior to brain surgery. We use it as DRTS in 16 countries in Europe. Recently, a 34 a frameless stereotactic system to localize lesions in a million contract was signed with an Asian distributor. 3-D space, as opposed to the system currently in place," Currently, MINRAD i hoping to produce 400 syshe explains, referring to the standard stereotactic protems a month at its Orchard Park facility, with a sale cedure that involves bolting a rigid frame onto a patient's price of $4,000 for each. The only other systems that head, then placing him in a CT scanner to obtain a come close to competing with the DRTS are priced at three-dimensional picture of a lesion. "What most about $300,000 and are much less accurate than it, neurosurgeons will tell you is 'get me there and I can according to john Me eirney, MI RAD's vice presiCONTINUED ON PAGE 31 6 u f f a I o P hysician Summer 1 9 9 8 �BY LINDA J. CORDER. PHD, CFRE Dreams Woi1h Weaving CREAT I NG A TAPESTRY FOR THE SCHOOL O F MED I C I N E A N D B IOMED ICAL S CIENCES ' HY DEVELOPMENT?" This is a frequent question, especially when I first meet someone unfamiliar with the day-to-day work of a medical school development officer. Weaving is my favorite metaphor for development. In weaving a tapestry or a rug, the details of the background work are invisible, yet a successful outcome is impossible \Vithout careful attention to preparing the loom, securing the strands of the wrap, filling and threading the shuttle and deciding on a general pattern. Similarly, in coordinating development efforts for the School of Medicine and Biomedical Sciences, m; background activities are largely invisible. However, planning, setting priorities and having sufficient resources to support the development program are as important as the loom, which provides the mechanism that makes weaving possible. Maintaining good records and the systematic gathering of additional information on alumni and friends are analogous to the warp, as appropriate research supports all productive development. Consistent and thoughtful communications become the weft, the strands or threads by which all other elements are linked together. In addition, it is necessary for the development officer to review constantly the current dreams and priorities of the institution, always in light of its stated mission. By talking with individuals within the school, who guide key aspects of the academic environment, I can begin to conceptualize proposals. At the same time, I identify prospects who might be interested in contributing to the realization of those dreams. In this manner, general patterns for the desired institutional outcomes are determined; case statements for specific projects can then be written. Patience is paramount. On some days, no visible progress is made. On others, it is necessary to alter the pattern as the fabric takes shape. Occasionally, and with great patience, rows of weft must be carefully undone in order to accommodate changes in the original plan. Colors must be matched and complemented and, at times, a different yarn or thread is necessary, requiring skill in integrating loose ends into the overall design. A development officer's efforts call for the same type of sensitivity and flexibility as specific fund-raising projects evolve. The interests and dreams of individual prospects B u f f a l o Physician need to be melded with institutional priorities. Sometimes, potential donors will have another (or little) philanthropic interest or the timing is not quite right. Some reworking of original designs or finding other donors for a particular purpose then becomes necessary. Picking up and weaving in loose threads- by being aware of prospects' family situations, responsibilities and goals-arc integral to assisting others in their creative gift planning. Both weaving and institutional development involve longterm commitment. Woven fabrics take shape slowly. The matching of donor interests with specific programs or individuals on campus (along with ascertaining '·the best" overall gift planning) is a time-consuming activity. As with all relationships, this type of involvement requires nurturing and the time to grow. In both development and weaving, some motifs may appear repeatedly (i.e., scholarship endowments or endowed chairs, funded by bequests or with trust proceeds). Occasionally, a truly unique design emerges (perhaps a new interdisciplinary research center, complete with "cutting edge" technology). Variations are constrained only by the limits of human imagination and the resources and materials at hand. Not only is considerable time required for the process, but many results are primarily for posterity, lasting long beyond the lifetimes of those from whom the funds and ideas flowed. Thus, in some sense, each completed gift to the school is like a work of art. It is meant to inspire-and to be used and valued by-future generations as well as by those present!) living. As a development officer, 1 remain essentially invisible to the vast majority of people who -..viii ultimately benefit from my work. Nevertheless, I am content to recognize "my mark" in the "final product," just as weavers feel a close affinity with the pieces they have created. It is the "dream become real" that remains long after each item becomes a part of the total fabric of the institution. I chose to be a development officer because it satisfies me to be a weaver of dreams-especially when they come true. 1 chose UB because of its unique history-and because it has dreams worth weaving . . . + Summer Lyn Corder, PhD, CFRE, is associate dean and director of Development. She can be contacted at 716-829-2 773, by fax at 716-829-3395 or on E-mail: ljcordn@buffalo.edu 1 9 9 8 �. . . . . . .. . . . . . . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . .. . . .. . .. . . [1] ~ I PH O T O S B Y FRAN K CESARI O Carol Chen lntcma/ Medicine, Loyola Um,·ersit) Medical Center, Maywood, IL Connie H. Chen Internal Medicine, Barnes-jewish Hospital , St. Louis , MO Bonnie Cheng Internal Medicine, Hospital of the Uni\ ersity of Pennsylvania, Philadelphia, PA Peter Cobb Family Practice, Columbus Family Practi ce Cem er, Columbus, GA Seth Cohen Internal Medicine, UMDNj-R.W . johnson , Piscataway, J Jeanine Cooley Pediatrics, Children's Hospital , Philadelphia, PA Pamela Crowell Family Practice, niversity• of Southern Florida , College of Medicine, Tampa, FL Michael Cummings Psycltially , S l\Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY April Cyr Family Practice, Memorial Hospital , Pawtucket, Rl Gul Dadlani Pediatrics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium , Buffalo, f\iY Emily Aguilar Pediatrics, Orlando Region Healthcare System , Orlando. rL Eric Bonenberger Ortltopedics, St. Luke's Medical Center, C leve land, OH Kristen Andresen internal Medicin e, Unt\ ersity of Rochester, Strong Memorial Hospital, Rochester, l'\Y Lori Bowman Pediatrics, SUNY! Buffalo Graduate MedicalDental Education Consortium, Buffalo, ·y Luna D. Bailey Sw·ge•y (Prelim. ), S NY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, NY; O!ola•yngolog) , SUNY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, '\JY Leslie Barr FamiiJ Praclice, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo. :\JY Stephen Bekanich Fami!J Practice, University of lJtah Affiliated Hospnals, Health SCience Center, Salt Lake City , UT Eric Bluman Orllwpedics , Rhode Island Hospital, Brown University, Providence , Rl Yvonne Bobek Pediallics, Medical College of Virginia , Richmond, VA Richard Bremer Internal Medicine, Medical College of Virginia , Richmond , VA Jennifer Bulger Family Praclice, St. Vincent Health Center, Ene , PA Robert Burns Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, '\'Y Therese Caligiuri Internal Medicine, S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Jonathan Pediatrics, SU Buffalo Graduate Medical-Dental Education �························································································• · ~ I I .. r Left to right. Jeanine M. Cooley congrotuloted; Christopher P. Schaeffer gets o big hug of support; Nnenno Okereke, Luno D. Bailey, Sophia Streete ond Jonathon Daniels shore results. MaryAnn Dean Psychiatr), SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Claudia Deyoung Intemal Medicine, orth Shore University Hospital, Manhasset, Y Stacey Dimartino Psychiatry, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Vamil Divan Internal Medicine, Mt. Sinai Hospital, Elmhurst, Y Jane Dopkins Obstetrics and Gynecolog}, University Hospital, Cincinnati, OH Jason Ehrlich Intenral Medicine, North Shore Universit) Hospital, Manhasset, Y Andrew Esch Internal Medicine (Prelim .), isters of Charity Hospital, Buffalo, NY; Physical Medicine and Rehabilitation, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Timothy Fallon Surge') (Prelim.), SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y John Fanton Pediatr-ic Psychiatr) , Rhode Island Hospital, Brown University, Providence, Rl Left to right: Jeffrey Richman, Mei Y. Wong, Jose Macedo, on enthusiastic guest ond Li Zeng celebrate their future. Charles J. Fetterman Internal Medicine (Prelim .), S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Ophthalmology, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, . Y Donald Flihan urgery (Prelim.) , SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Richard Gayle Psychiatry, Long Island Jewish Medical Center, New Hyde Park, Y Thomas Gergel Famil) Practice, Hinsdale Hospital , Hinsdale, IL Robert E. Gerstenbluth Urology, Case Western Reserve University, Cleveland, OH Youssef Ghaly Family Practice, Mountainside Hospital, Montclair, "lJ Hari Gopal intemal Medicine (Prelim .), Wilson Memorial Regional Medical Center, United Health Services, Binghamton, Y; Diagnostic Radiology, SU Y Syracuse Health Science Center, Syracuse, NY Christine Gordon Pediatrics, St. Luke's-Roosevelt Hospital Center, New York, Y Lisa Green Medicine/Pediatrics, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo,. Y Carrie Greenberg AncsthesiolOg)-, The New York Hospital , ew York, Y Alejandro Gruneiro Surgery , Southern Illinois Uni,·ersity, School of Medicine, Springfield, IL Rachna Gupta Internal Medicine, Uninrsity of Maryland Medical Center, Baltimore, MD Bryan Hanypsiak Orthopedics, George Washington University, Washington, DC Michael Hassett lntemal Medicine, University of Rochester, Strong Memorial Hospital, Rochester, NY Lisa Heichberger Family Practice, Hamot Medical Center, Erie, PA Scott Helsley lntemal Medicine (Prelim.), SU!'\Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Anesthesiolog_\ , Duke University Medical Center, Durham, C Michael Herbowy Internal Medicine, SU. Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Aaron Hoffman urgery , ew York Methodist Hospital , Brooklyn, 'Y Steven Horn Internal Medicine, SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY Calogero Ippolito lntenral Medicine, SU 'Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Dana Jandzinski Surgery (Prelim) , St. Joseph Hospital, Denver, CO Peter Janes Medicine/Pediatrics, S "JY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Theresa M. Jarmuz Otolar)ngology, Emory University, Atlanta, GA Michael Kane famil) Practice, U Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY Lawrence Kanner Internal Medicine, orth Shore University Hospital, Manhasset, Y ® �. . . [1] " ~ I encourage you to review this list and to contact and welcome your fellow UB Judith Kim Pediatrics, SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Paula Kocialski Psychiatry , SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo , Y David Montesanti Internal Medicitre (Prelim .), S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Ophthalmology , SUNY/Buffalo Graduate Medical-Dental Education Consortium , Buffalo, NY Colin Powers Surgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Anne Marie Reynolds Pediatrics, S NY/Buffalo Graduate MedicalDental Education Consortium , Buffalo , Y Jennifer Lee lntenwl Medicine, niversity of Rochester, Strong Memorial Hospital , Rochester, Y Bennett Myers lntenwl Medicine (Prelim.), Duke University Medical Center, Durham, NC; eurology , Duke University, Durham , NC Anthony K. Rice Family Practice, Womack Army Medical Center, Ft. Bragg, NC Sandra Leni Internal Medicine, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo , Y Kristin Nesbitt Orthopedics, Henry Ford Health Science Center, Detroit, Ml David Lin Internal Medicine, niversity of Michigan Hospital , Ann Arbor, Ml Neil Lipke Surgery (Prelim .), ew York University Medical Center, New York, Y; Anesthesiology, ew York University Medical Center, ew York , Y Jose Maceda Obstetrics and Gynecology, Thomas jefferson University , Philadelphia, PA Patrick Mahar Medicine/ Pediatrics, S Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Thomas Malinich Medicine/ Pediatrics , outhern Illinois University , chool of Medicine, Springfield, IL Michelle Mang family Practice, Highland Hospital , Rochester, NY Jeffrey Marchant Internal Medicine, Medical College of Virginia , Richmond, VA Michael Markham Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo , Y Amy McGarry Pediatrics, Georgetown Unive rsity Hospital , Washington , DC Thomas McTernan Internal Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Sumit Mehta Transitional , Chestnut Hill Hospital, Philadelphia , PA; Diagnostic Radiology , Stonybrook Teaching Hospitals , Stonybrook , Y Mark Oberlies Internal Medicine, Loyola University Medical Center, Maywood , IL moving into your Joseph Rebhan Family Practice, Wausau Family Practice, Wausau, WI George T. Moynihan Otolaryngology , Loyola University Medical Center, Maywood , IL Lori Kwan Internal Medicine, Yale- ew Haven Hospital , New Haven , CT graduates who ore community." John R. Wright, MD INTERIM DEAN Jeffrey Richman lntenwl Medicine (Prelim. ), Mercy Medical Center, Baltimore, MD; Anesthesiology , Johns Hopkins Hospital , Baltimore , MD Joseph Sheehan Pediatrics, University of North Carolina Hospital , Chapel Hill, C A. MacDuff Sheehy lntemal Medicine, Einstein/Montefiore Hospital, Bronx, NY Jenny Oh Internal Medicine, LAC-USC Medical Center, Los Angeles, CA Marc N. Richman Surgery (Prelim .), niversity of orth Carolina Hospital , Chapel Hill, C; Urology , University of North Carolina, Chapel Hill , C Nnenna Okereke Intemal Medicine, Yale-New Haven Hospital , ew Haven , CT Jayson Roland Pediatrics, S Y/ Buffalo Graduate Medical-Dental Education Consortium , Buffalo, Y Dawn Simon Pediatrics, SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Tamera Paczos Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA Neha Sangwan Internal Medicine, Temple University Hospital, Philadelphia, PA Prashant Parashurama Internal Medicine (Prelim .) , Long Island Jewish Medical Center, ew Hyde Park , Y; Diagnostic Radiology, The ew York Hospital , ew York, Y Jennifer Scarozza Medicine/ Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Anand Singh Surgery (Prelim .), SUNY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, Y Kathleen Pastore Emergency Medicine, Brigham and Women's Hospital , Boston , MA a Andrew Stoeckl Surgery (Prelim .), SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, ; Orthopedics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Joel Sebastien Surgery , Westchester County Medical Center, Valhalla , Y Joseph Stowell Transitional, Shadyside Hospital, UPMC, Pittsburgh, PA; Emergency Medicine, Long Island Jewish Medical Center, ew Hyde Park, l\lY Carl Seon Orthopedics, Hamot Medical Center, Erie , PA Clayton Polowy Internal Medicine, Rush-Presbyterian , St. Luke's Hospital , Chicago, IL f Hans Stelmach Psychiatry, niversity of North Carolina Hospital , Chapel Hill , NC Matthew Scozzaro lntenwl Medicine, University of Florida Program , Shands Hospital , Gainesville , FL Christine Pluviose Family Practice, Albany Medical Center Hospital , Albany , NY f Sunil K. Srivastava lntenwl Medi cine (Prelim .), St. Vincent's Hospital, ew York , NY ; Ophthalmology, Emory University , Atlanta , GA Medical-Dental Education Consortium, Buffalo, NY Achini Perera Internal Medicine, University Health Center, Pittsburgh , PA 0 David Serra Obstetrics and Gynecology, SUNY/Buffalo Graduate Sophia Streete Family Practice, Jamaica Hospital Medical Center, Jamaica, Y Medical-Dental Education Consortium, Buffalo, p 5 c o n Y J. William Sparks Transitional, San Diego aval Hospital, San Diego, CA Christopher Schaeffer lntemal Medicine, University of Rochester , Strong Memorial Hospital , Rochester, Y Mary Scott Obstetrics and Gynecology, SUNY/Buffalo Graduate Nicole Pazzaglini Obstetrics and Gynecology , Abington Memorial Hospital , Abington , PA u Lily Snyder Family Practice, Highland Hospital , Rochester, Michael Scharf Psychiatry, University of Rochester, Strong Memorial Hospital , Rochester, Y Viresh Patel Surgery (Prelim .), nion Memorial Hospital , Baltimore, MD ; Orthopedics, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo, Y B Anthony Shih lntemal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 5 m m e 9 9 8 �······· ···················· ·············•g··· I Jeffrey Visco Surgery , SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Gordon Wingard Emergency Medicin e, Maricopa Medical Center, Phoenix , AZ Keith Volmar Patholog), johns Hopkins Hospital, Baltimore, MD Mei Y. Wong Surgery (Prelim .), SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY; Neurosurgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Andrew A. Wagner Urology , niversity of Massachusetts, Worcester, MA Jenny S. Oh, left, and Doris Vanderpool share Match Day results. Jennifer Walsh Intemal Medicine, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Thomas Trevett Obstetrics and Gynecology , University of California at San Diego Medical Center, San Diego , CA Garin Tomaszewski Intenwl Medicine (Prelim .), Loyola University Medical Center, Maywood , IL; Diagnostic Radiolog) , University of Colorado, School of Medicine, Denver, CO Colleen Weber Obstetrics and Gynecology, University of Rochester, Strong Memorial Hospital, Rochester , Y Edna Valdes Surgery , New York Hospital , Medical Center at Queens, Queens, Y Angela Weirich Family Practice, Carilion Health System, Roanoke , VA Doris Vanderpool lntemal Medicine, St. Mary's Medical Center, San Francisco, CA Hannah Toon Intemal Medicine (Prelim ), Mt. Auburn Hospital , Cambridge, MA; Anestllesiolog), Massachusetts General Hospital, Boston , MA Mark Weirich Family Practice, Carilion Health System, Roanoke , VA Anthony Villani Pathology, University Health Center, Pittsburgh , PA Linda Van Intemal Medicin e, Stonybrook Teaching Hospitals , Stonybrook, Y Daniel Yawman Pediatrics, University of Rochester, Strong Memorial Hospital, Rochester, 1Y Li Zeng lntemal Medicin e (Prelim .), Lankenau Hospital , Wynnewood , PA; Anesthesiolog) , Hospital of the University of Pennsylvania, Philadelphia , PA Michael Zionts Family Practice, S NY/Buffalo Graduate Medi calDental Education Consortium , Buffalo, Y 0. \}\~e a mistake. But not from the inside. The roof looks funny, odd, strange, a\~ 'Ilwwa~· we sec it, wh~· build a ~traight roof when can build a perfect!~- ,good crooked one ·~ It's something up to sc,·en passenger~ in the Land Rm·cr Disco,·ery will truly appreciate . \\'ith the clc,·atcd roof and stadiumlike seating. passengers in the rear ha,·e ample headroom. \\'hich means the~· can look at more than the back of the fro nt seat. ~luch more. in fact. Because the Land Ro\'er Disco\·er,· has more \\·indows than an~· other -lx.t. \\'h" not take one out for a test dri\'e ·~ .\nd instead of just lookjng into it. look out of it. YOU Gf* DISCOVERY Land Rover Amherst A NORTHTOWN AIJTOMOTM C~/IM 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com B f f a I o p h 5 c a 5 m m e I 9 9 8 �• ···················· · ······ ·· ···················································· · ······ ~ ' �• • • • • • • • • • • • • • • • • • •• • ~ I Commencement for the School of Medicine and Biomedical Sciences at the Stole Unive~ of New York at Buffalo wos held on May 22, 1998, at the Center for the Arts on the North Campus. On that day, the school graduated 138 new physicians and 37 new PhD scientists. Pictured clockwise from below: 1 Therese Caligiuri and one-year-old Willy; 2 Moster's degree candidates; 3 Closs Speaker Sunil K. Srivastava; 4 Nnenno Okereke receiving diploma from UB President William R. Greiner, School of Medicine's Interim Dean John R. Wright, MD, leh, and Vice President for Heohh Affairs Michael Bernardino, MD, center; 5 Rochno Gupta, leh, and Nicole Kerner; 6 Students entering the auditorium; 7 Christopher P. Schaeffer. I �Physicians Reaching Out to Students -NEW PHYSICIAN-STUDENT MENTORING PROGRAM ED! CAL ~CHOOL IS THE TOGGHEST CHALLE'\GE many students have ever faced. The pressure to achieve is intense; the work, grueling. When a problem arises, where do they turn? How do they cope? The University at Buffalo School of Medicine and Biomedical Sciences is offering help in the form of a new Physician-Student Mentoring Program that links first-year students with physician mentors in the community "Medical school is a parochial system, and students can feel so lost in it," says jack Coyne, MD, past president of the UB's Medical Alumni Association, who helped spearhead the program. "You lose contact with the world around you. During the first two years you don't even have time to read the newspaper. When yo u' re they're struggling in a class and don't know where to find help. Maybe they're homesick and could use an empathetic conversation over a hot meal. Perhaps their troubles run deeper. "When I was a student, a number of my classmates had concerns and problems and they didn't know where to go with them ," recalls Coyne, who graduated from UB's school of medicine in "STUDENTS WHO EXPERIENCE STRESSFUL SITUATIONS, WHETHER THEY RESULT FROM REAL-LIFE TRAGEDIES OR THE EVERYDAY CHALLENGES OF LIFE AND MEDICAL SCHOOL, NEED TO FEEL THAT THEY HAVE SOMEONE TO TALK TO, SOMEONE WHO IS INTERESTED IN THEM AND WILL TRY TO HELP." - 1N T E R I M being pushed to the limit in that setting, you can easily feel overwhelmed." In the program, which was begun last fall , the mentoring physicians act as confidantes, friends and sounding boards for students, who can call on them under any circumstances. Maybe ® 0 EA N J 0 HN R.W RIGHT 1985 and today is medical director of child advocacy centers for Erie and iagara counties and for pediatrics at Mercy Hospital. "It can be difficult for a student to share things with people in the administration. With this program, students have an opportunity to B u f f a l o Phys ici meet physicians who can help them or who know people who can help them without having to go 'on the record."' As a student Coyne watched classmates grapple with depression and drug problems. One, overwhelmed by his struggle and unable to talk about his despair, committed suicide, he says. Mentoring may be a way to help, by providing students with a safe haven whenever they need it. "In that case we're talking about a very serious situation , but more often it will be the case of a student who's feeling stress during final exams or who maybe wants a physician to open up his office so he can see the clinical side of things," says Coyne. The new mentoring program is informally structured. At the beginning of the 1997-98 school year, physicians who volunteered to participate received a letter with the name and telephone number of the student with whom they had been matched. Student participants received the physician's name and home and office telephone numbers. Physicians have been encouraged to initiate contact to overcome any hesitations first-year students may have due to shyness, intimidation or worry that they will be a bother. When the program was announced at the beginning of the year, 107 of the medical school's 135 members of the class of 2001 signed up. A survey conducted in early 1998 revealed that of the participants, 29 had been in contact with their mentors, and of that number, 22 described the relationship as helpful. In the survey responses , the program was described by students as "sup portive," "reassuring," "informative" and "friendly, " with several adding that they received "good pointers" from their mentors. an Summer 1 9 9 8 �············ · ·················· · ·············· · · ·· ·· · ··········· · ····· · · · ······· · · · ·····~ Such feedback, says medical school interim dean john R. Wright, MD, indicates that the men to ring program is reaching out to students in need, which is its goal. Wright recalls past situations where he has helped students get through difficult times. One particularly difficult case that stands out in his mind was that of a distraught first-year student whose sibling had been murdered. "There is a real need for this kind of program," Wright emphasizes. "But in the past, attempts to provide such assistance had been somewhat haphazard , so we thought it would be beneficial to the students to have a more organized effort in place. Students who experience stressful situations , whether they result from real-life tragedies or the everyday challenges of life and medical school, need to feel that they have someone to talk to, someone who is interested in them and will try to help. " The idea for the new PhysicianStudent Mentoring Program was brainstormed at an alumni executive committee meeting last year. Once the program was established and an- nounced , area physicians were quick to respond to the call for volunteers , with 75 immediately signing up and a few dozen more coming on board since that time. "Advisement is something that all medical schools struggle with, " Wright says. "Often it's not done particularly successfully. It requires a certain degree of organization because you want to make sure students know these services are available , yet you don't want to meddle in people's lives, and you don't want to be intrusive. From a different perspective, however, it's a good way for medical students to see how a doctor actually practices medicine." But the student isn't the only one who benefits from the rapport. It also allows physicians to reconnect with their past, Coyne says , and to take a look into the future of medicine. "I get a sense of belonging. We as physicians lose touch with what the students are going through. It helps us stay in touch with the system and , more importantly, with the problems students are having as they go through the system ." • PHYSICIANS NEEDED The Physician-Student Menloring Program has met with an overwhelmingly positive response from students; however, more physicians are needed. To volunteer, please call the UB Medical Alumni Association Office at 829-2778. Earlier in the year , Coyne received a call from one of the two students he mentors. Her grandmother died , and she just needed someone to talk to . When he received the call , Coyne realized how useful-and necessarythe program was . Then she told him about a friend of hers who was interested in a mentor. ow he's a mentor to three students . + INFINITI I ntroducing your way to escape . lnfiniti's luxury sport AUTO PLACE INFINITI 8129 MAIN ST . WILLIAMSVILLE ) 1 utility vehicle: the QX4. Unlike most luxury sport MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 escape for the weekend, it has all the comforts and luxuries you East of Transit Rd. , Near Eastern Hills Mall a u f f a I o need to escape life's daily stresses. Physician Summer 1 9 QX4 9 8 ® �B Y S COTT T HOM EDWARD H . WAGNER , A S MD '65 , STOCKTON K I MBALL LECTURER The patient wAs A wiDow, ss YEARs oLD . D ESPITE A HALF CENTURY OF CIGARETTE SMOKING, SHE WAS DOING QUITE WELL . Then, from the tiniest hint of trouble, began a slippery slope of debilities. Her legs had been feeling weak; a lifelong walker, she was moving more slowly. Her family physician could detect no pulse in her feet and diagnosed intermittent claudication. Then a series of upperrespiratory infections buffeted her lungs and she began to develop wheezing. The physician searched for a carotid pulse and found none; he prescribed aspirin. He referred her to a vascular surgeon, who examined her and concluded she was not a candidate for surgery. She was at very high risk for stroke, he said, and would benefit from taking it easy. She did, and got weaker. She entered a skilled nursing facility for a while. And B u f f a ! a when she went home, it was, for the first time, with a cane. Now this previously vital womanwho used to take long walks, do her own shopping and maintain an active social life-is largely confined to walking to the bus stop and back. "This is not an uncommon story,'' says Edward H. Wagner, MD '65, MPH, who delivered the Stockton Kimball Memorial Lecture at the University at Buffalo School of Medicine and Biomedical Science's 6lst annual Spring Clinical Day, on April 25. "And it illustrates the difficulties she is faced with in trying to deal not only with these illnesses, but with their impact on her ability to function." The good news, he went on to say, is that Physician Summer 1 9 9 8 �this impact can be managed and mitigatedif the physician intervenes, and if, in the long run, we design a health-care system that goes beyond acute care and supports older people's efforts to take control of their own health. can they communicate and collaborate with their medical providers-often a bevy of specialists in addition to their primary physician-to devise a treatment plan. A STRUGGLE ON BOTH SIDES Wagner says the health-care system, as currently configured, is oriented toward acute care, addressing the presenting complaint without necessarily delving into the underlying health factors in the patienfs life. "But when illness plays itself out over years or decades, the patient's needs change, and a reactive system may not be as relevant as it was in ASTHEAVERAGEAGEOF the past,·· he says. Using the 85-year-old AMERICANS CONTINUES TO CLIMB, widow to illustrate the point, he adds: "She THERE WILL BE MORE DEMAND FOR wanted to walk, to play PHYSICIANS WHO CAN DEAL bridge, to go downtown shopping. The system EFFECTIVELY WITH THE ISSUES OF wanted to know what her presenting complaint was OLDER PATIENTS. that day. This was a clear mismatch between what was important to her and what was important to her health-care provider." The current medical system, he says, focuses on the short term. It pays little attention to delegating health-promoting tasks to the patient, to issuing reminders over months or years that would promote good health and to helping patients educate themselves about their condition. "The older patient," Wagner says, "needs a different system: one that takes a prospective view and looks down the road to next month, next year, a few years from now." A SYSTEM BUILT BACKWARDS Wagner, who spoke to a large luncheon audience at the Buffalo Marriott, has made a career of thinking about the public policy aspects of medicine. A general internist and epidemiologist, he directs the Center for Health Studies and the MacColl Institute for Healthcare Innovation at the Group Health Cooperative of Puget Sound in Seattle, Washington. He also teaches at the University of Washington School of Public Health and Community Medicine, where he is a professor of health services. His research interests include the care of geriatric patients. As part of a Spring Clinical Day focused on '"The Aging American," Wagner pain ted a broad picture of how practitioners tend to treat their older patients-and where they fall short. "The older patient is a struggle for physicians,'· he notes, "but it's also a struggle for the patient to deal with the physician. The patient needs to be an effective, educated manager of his or her own health. So the question becomes, what kind of health-care system do we need to support this?" Wagner says patients themselves must address several issues: what activities can they pursue that would promote good health; what skills can they learn to monitor their illnesses and adapt to changes in their bodies; how can they manage the effects of those illnesses on their ability to function; how can they manage the emotional impact, such as their ability to be a "social animal"; and how a u f f a 1 o Physlclon CONTINUED Summer I ON 9 9 PAGE 8 24 ® �'' THE OLDER PATIENT NEEDS A DIFFERE T SYSTEM: ONE THAT ... LOOKS DO\VNTHEROADTONEXTMONTH,NEXTYEAR,AFEWYEARSFROM TOW. C O N T I NUED FROM PAGE 23 It's not that individual physicians don't recognize these needs and try to meet them, Wagner adds. "But providers are working in a system that doesn't help them do this." The older patient's priorities, he says, generally are twofold: preventing disability and falls, as well as "the potentially devastating impact of the fear of falling"; and managing the chronic illnesses that most older people have. From 75 to 80 percent of older people have at least one chronic illness, he says, and about half struggle with two or more. Do NOT Go GENTLY The encouraging news,Wagner says, is something that has become a fundamental tenet of geriatric medicine: THE PATIENT NEEDS "The deleterious effects of aging may TO BE AN EFFECnot be inevitable." He displayed a TIVE, EDUCATED chart that seemed to prove a piece of common wisdom: Be it MANAGER OF HIS OR pulmonary function or muscle strength, HER OWN HEALTH. oxygen-uptake capacity or endurance, a human being's physiological capacity declines with age. But, Wagner says, that truism applies to the population as a whole; it's a mistake to assume that each individual will follow that path. The challenge for each individual patient is to buck the trend and resist the declines of age-a concept known as "successful aging." ''We're now beginning to understand the factors that lead to successful aging," Wagner says. "Physical activity is probably the most important. Individuals who become sedentary probably will have an increased decline." He points to the concept of"deconditioning" -the idea that with disuse, any physiological system will weaken. "This," he says, "is an enormously powerful tool for understanding decline." SOME PRACTICAL APPROACHES So how can physicians work with their elderly patients to maintain a good quality of life B u f f a l o ' ' despite the chronic conditions that often come \Vith advancing years? Wagner again suggests that we focus on patients' functional abilities and their ability to manage their own health care. For example, to avoid often-debilitating falls, patients might be encouraged to practice tai chi, or pursue endurance and strength training. To reduce incontinence, they can do Kegel exercises or consider pharmaceutical remedies. And to help patients in managing their own care, he says, the key concept is empowerment. "Handing them a book is not useful,"' Wagner says. '·Providing them with organized problem-solving help is"-such as suggesting sources of information, connecting a patient with support organizations, and, in general, treating the patient as an equal partner in health-care decisions that affect his or her life. For the physician trying to better organize his practice, Wagner suggests thinking about how we accomplish six tasks or roles: + Responding effectively to the acute problem. + Making sure the patient's overall status is assessed accurately. + Providing first-class self-management and support. + Finding ways to communicate and coordinate among the primary physician and specialists. + Advocating for patients in the community so that they receive the care they need. + Using data systems and technologies, such as registries and reminder systems, so longterm patient care doesn't depend entirely on the memory of the physician. Physicians don't necessarily have to accomplish all these tasks, Wagner says. They can be delegated to people on their staff or elsewhere who are trained for those roles. As the average age of Americans continues to climb, there will be more demand for physicians who can deal effectively with the issues of older patients. Fortunately, Wagner says, the science of treating older people is starting to come together. "I think this is an exciting time. For the first time we're moving beyond philosophy to evidence," he says. "There's clear evidence out there that we can improve outcomes, and I look forward to working with you on this in the future." + Physician Summer 1 9 9 8 �• ~ --¥" •Sprin~gaClinrcall•Dao/•Gatherimgs........._ Lehto right: Jared C. Barlow, outgoing president of Medical Alumni Association; Bertram A. Portin, assistant dean for Alumni Affairs; and Elizabeth L. Maher, president of Medical Alumni Association . Class of 1973 at Stockton Kimball Lecture. Lehto right:John J. Bodkin and Jared C. Barlow with Edward H. Wagner, Stockton Kimball lecturer. .110 Class of 1948 (pictured) shared the attendance trophy with Class of 1953. Fifty-year reunion doss at Saturday's luncheon. John R. Wright at Saturday's luncheon activities. Class of 1988 at Friday evening reception. B u f f a I o Phys i c i an Summer I 9 9 8 �Medical Alumni Achievement Awards ~FE r!VIE ME Die \l Atl 1 1 Ac HIE\ E \H· I A" on" were presented to the following four University at Buffalo alumni at Spring Clinical Day, April 25, 1998, at the Buffalo Marriott Hotel. RONALD BATT MD CLASS OF 1 958 -Introduced by Dr. Richard Romanowslli "Throughout his career, Dr. Batt has been an innovator in obstetrics and gynecology and an outstanding teacher and superb clinician with special expertise in endometriosis and microsurgery," Romanowski said. "He has been a pioneer in encouraging the use of laparoscopy in his field and, along with his colleague Dr. aples, has been recognized for his research in infertility and for his efforts to find more conservative measures of treating pelvic endometriosis." A prolific writer and medical historian, Batt has published some 20 peerreviewed articles and more than 25 book chapters and monographs. He was a coauthor of Another Era: A Pictotial History of the School of Medicine and Biomedical Sciences, State University of Ne~~ Yorh at Buffalo, published in 1996. In addition, he has also produced a number of audiovisual programs used in teaching. "I see residents and students helped by his work with these programs," Romanowski noted, "and that's very gratifying.'' In recognition of his contribution as a teacher, Batt received the 1995 Chief Residents Teaching Award, which is inscribed: Some men lift the age they inhabit until other men walll on higher ground during that lifetime. A leader in his community, Batt has organized many medical missions overseas to places such as the Ukraine in an effort to help his colleagues in less advantaged countries update their skills. "So for these contributions-for his ongoing patient care, his teaching and his B u f f a l o research, I thank him on behalf of us all for the work he's done throughout his career, day by day," Romanowski concluded. RONALD "SKIP" GARVEY. MD CLASS OF 1953 -Introduced b) Dr.]. Bradley Aust Ronald "Skip" Garvey is an accomplished surgeon, professor and health-care administrator, Aust said. A native of Olean, Garvey was a scholar athlete who attended Harvard College, where he played football. After medical school, Garvey completed his internship and residency at Parkland Memorial Hospital in Dallas, Texas, and a fellowship at the IH. From 1961 to 1983, he was in private practice as a surgeon, and for nine of those years was also team physician for the Dallas Cowboys. "In 1983, he went to Southwestern Medical School as a professor of surgery," Aust said. "Going from practice into an academic medical center is really quite a change and he felt academic medical centers were ill-prepared to deal with the problems that they faced, so he took time out to earn an MBA in Hospital Administration in 1986. At that time, the university was about to build a hospital at Southwestern and they looked around for someone to spearhead the effort and they picked Skip, so he shepherded through the building of the [Zale Lipshy l University Hospital and became its first president and CEO, from 1987 to 1991." Gan•ey then returned to teaching until last year, when the university asked him to accept a position as director and chief administrative officer for its Health Center in Tyler, Texas. "Scholar-athlete, practicing physician, Physician Summer l 9 9 8 �dedicated family man, academic surgeon and administrator-Skip Garvey is truly a 'man for all seasons'," Aust said. MILFORD MALONEY . MD CLASS OF 1 953 -Introduced by Dr. Michael Sullivan "I am honored to be able to present this award to my classmate, Milford, who has led an active career in academic medicine as a teacher, researcher and administrator, while simultaneously maintaining a busy private practice," said Sullivan. After a rotating internship, Maloney completed residencies in both internal medicine and cardiology. Following two years in the U.S. Army Medical Corps., and another two years as a part-time senior cancer research physician at Roswell Park Cancer Institute, he entered into private practice in 1964. In 1968, he was named president of the Western ew York Society of Internal Medicine, and in 1969, became president of the Heart Association of Western New York. Also in 1969, he was appointed chair of the Department of Medicine at Buffalo Mercy Hospital, a position he held until1994. During these years-from 1972 to 1989-he also directed the American Board of Internal Medicine's Medical Residency Training Program affiliated with UB. In 1976, he was named to the Steering Committee for the ational Association of Program Directors in Internal Medicine and a year later, was appointed to the Council of the National Association of Program Directors in Internal Medicine. In 1974, he was named president of the ew York State Society of Internal Medicine and in 1981, served as president of the Medical Society of Erie County. Also in 1981 , he was appointed clinical professor of medicine at UB, after having served as associate clinical professor since 1972. In 1990, Maloney was inaugurated as president of the American Society of Internal Medicine. "I cannot imagine how he managed to do all this in his career," Sullivan noted, "but it's for accomplishments such as these that we present this award." KENNETH R. NISWANDER , MD CLASS OF 1 948 -Introduced by his son Philip N. Niswander, MD "I am honored to introduce my father. It's particularly easy to sing his praises as a colleague because he has so many outstanding achievements, '' said Philip iswander, who gave a brief overview of his father's career. After completing a rotating and a surgical internship and residency training in obstetrics and gynecology, Niswander entered into private practice in Buffalo from 1953 to 1964, during which time he was an assistant clinical professor at UB. In 1964, he was made an assistant professor; and in 1965, an associate professor. From 1963 to 1967, he worked as an obstetrician in the Child Development Program at Children's Hospital in Buffalo, and for three years-from 1966 to 1969-he also served as chief of Obstetrics and Gynecology at the hospitaL In 1969, he accepted a position as professor of Obstetrics and Gynecology at the University of California at Davis, where he also served as chair of Obstetrics and Gynecology from 1969-1982. Speaking of his father's accomplishments, Niswander said, "During this time he published over 150 articles, as well as a textbook on obstetrics, which is currently in its fifth edition. otable among his research accomplishments, in my opinion, is his work showing that obstetric factors have little or nothing to do with brain injury among infants or with the development of cerebral palsy. This research is noteworthy economically as well as medically since it has contributed to the limiting of medical malpractice awards against obstetricians, who were previously found at fault for misconduct for any baby born malformed." In concluding his remarks, Niswander joked that, after consulting with his brothers, it "was difficult to find a single redeeming defect in our father." On a more serious note, he added, "Instead, as time passes, we notice that his reputation is enhanced and that his abilities are sustained, and, for this, we are very proud of him." + New Alumni Association Officers Elected B u f f a l o Physician Summer 1 9 9 8 ® �~············· ··················································· ················· · ······ ltlil CLASS REUNIONS First row: Darwin Moore, Norman Minde, \Villiam Bloom; second row: Raphael Good, Harold Graff, Kenneth 1\Jiswander, Raymond Moffitt, orman Paul, Lester Schiff; third row: Daniel G. Miller, Ansel Martin, Francis Peisel, Vernon Lubs, Daniel Fahey, Michael Dzubaty; fourth row: Robert]. Hall, Alfred Shapiro, S. Paul Zola, Myron Gordon, jasper Van Avery, Richard Proplesch, \Varren Hollis, Glenn Doan. First row: Thomas Geoghegan, Richard Nagel, David Batt, joseph Ruh, Samuel Galeota,W. Ransom Kelley; second row: john Strachan, Donald Ehrenreich, \-til ford \-Ialone\, jack Gold, Herbert Constantine, john Handel, Molly Seidcnbcrg,Jacob Shammash, Thomas Comerford, Ronald Garve}; third row: Marvin Wadler, Bertram Port in, Donald Rachow, Michael Sullivan, Harold ·mulvan, Harle) Lindquist, Herbert Simpkins, Howard Smith, James Orr, James Carlin, John Fenger. First row: ~orton Spivack, Robert Perez, Michael Mazza, William Glazier, jacques Lipson, Carl Contino, Richard Romanowski; second row: joseph Bellanti, Bernice Comfort, john Float, Richard Rahner, Samuel Shatkin, Gary Cohen; third row: jason Reder, Melvin Broth man, Eugene Friedberg, Michael Genco, Alfred Stein, Franklyn Campagna, Richard Wasson, joseph Zizzi, Robert Dickson, Richard Boyle, James Williams, Franklin Zeplowitz, Thomas Cummiske), Marie Leyden Kunz, Harold Zimmerman, jerr) Weisberg. First row: john Schriver, \Villiam Heyden; second row: Stephen joyce, E. Michael ulli\ an, David Malinov, Richard arins, Frank DeLaus,jason Rudisill; third row: john Wadsworth, Thomas Reagan, Joseph Tutton, Ernest Fatta, Robert Hamilton, Charles Tirone, Anthony Foti, George Steiner. First row: Leonard Argentine, Bruce ~toesser, Robert Rosen, Robert \filch, Sara '>trkm, Thomas Cumbo, Ronald Friedman second row: Ehas Rosenblatt, Jonathan Rcynhout, Kenneth \1atasar. Jean Dwyer \\!I hams, Lesbia Fcmande:: mith Le,in, Kenneth Eckhcrt, 1artial Knicser, Harold Kulman, Rtchard Stamile, Barry Shult::. B u f f a l o p h 5 I a n 5 m m e 9 9 8 �CLASS REUNIONS First row: Thomas Dwyer, Charles Anderson, Kenneth Gayles,jeremy Cole, Fredric Hirsh, Robert Lamantia; second row: James Marks, Demetrius Ellis, Paul Kuritzky, Timothy ostrant, Sharon Kuritzky, Reta Floyd, Lynda Sorrenti, Barry Sanders, john Przylucki, Daniel Pietro, Frederick Beck, Michael Haberman; third row: Arthur Mruczek, Patrick O'Connor, Da\·id Breen, Frederick Buchwald, Robert Fugitt, Thomas Lombardo, Michael Sansone, john Klimas, Gary Palys, Daniel First row: :-..1ark Kramer, Barry Rosenberg, :-\elson lsada, Alan Kosk•\\; second row: Louise Barbieri, Clifton Pea), Ronald Somogyi, Cheryl Aldrich, Rondie Emn jones, Linda :-.!orris, Elizabeth Doherty, Iris Buchanan; third row: Paul \\'opperer, Richard Elman, tephen Gawronski, Henry Wilamowski, Dand Sangster, Gregory Bennett, Simon Shaham, Richard Busch, ~!atthe\\ O'Bnen, Angelo DelBalso, David ~!archetti. First row: Catherine Goodfellow, Leslie Doolittle, Younghee Limb, Patricia Flanagan, Suzanne Meyers-Tanbakuchi, Melinda Cameron, Cynthia Pristach; second row: \ u-Fei Wu, Barbara Ostrov, Richard Collins, Charles Niles, Allen Rosen, Neal Smith, Robert Stall, Gah;n Anderson, Robert Rosen, Kenneth Murra), Andrea Man yon-Wild, Renata Wajsman, Mark Schwager; third row: Francis Mezzadri, Peter Accetta, James Wild, Kenneth Zimmerman,Jonathan Graff, Frederick McAdam. First row: Ann Marie LeVine, Margaret Morey-Stager, Stephanie Christensen, Mary Davill, Norah Lincoff, Andv Cappuccino, Lisa Benson, Helen Cappuccino; second row: Sandra Everett, Constance Greene Klocke, janet Flier Sundqmst, Dawn Hrab, Nicole Sasson; third row: Richard Gilbert, Thomas Bellomo, Lori Luzi, Frank Luzi,Jeffrey Steinig, Stephen Hughes, james Schlehr, Charles Everett, David Pochatko,John Dusse, Kathleen O'Leary, Anthony Bartholomew, Mark Klocke, Kevin Kopera, Brad Shumcl, john Barbaccia, janet Williams. First row: Kevin Kelleher ,Jennifer ordby, Paul Fa\·orito, Honora Heffner Favorito, Michael Aronica, Gill Farkash, Richard Hall; second row: Brian Szymanski, jeffrey Senall, Michael Sweeney, Jeffrey Parnell. B u f f a 1 o Physician Summer 1 9 9 8 �Harry Bergman, '34, Special Recognition Award Recipient has received an Award of Special Recognition from the Dean's Advisory Council of the University at Buffalo School of Medicine and Biomedical Sciences for his life's work in urology. When he heard news of the award in April, Bergman, 87, who lives in Hollywood, Florida, said, "I never expected anything like this. My work has been out there for so many years, this is beyond me." The award recognizes that, in 194 7, Bergman devised an instrument capable of obtaining an early neoplastic degeneration inside an apparent benign tumor, an accomplishment for which he received a national award from the American Cancer Society in 1948. lt also acknowledges Bergman's discovery of a radiological sign for ARRY BERGMAN . ' 34, cancer of the ureter, named "Bergman's ign" in his honor by john Emmett, professor of urology at the Mayo Clinic, and first catalogued in Dorland's Medical Dictionary in 1981. Also noted in the award is Bergman's work as a writer and editor of many publications and books, including his highly respected text, The Ureter, which he published in 1960 and revised in 1981. Bergman graduated at the top of his class at UB in 1934 at age 21, making him the youngest graduate of the school. He established a successful practice as a urologist and surgeon in Manhattan and the Bronx. ln 1978, he semi-retired in Florida, where for the next decade he served as a professor of urology at the University of Miami's Medical School and clinical professor at jackson Memorial Hospital in Miami. In presenting Bergman with the award, the Dean's Council states its resolve "to recognize him for his outstanding career contributions to medicine, especially for furthering the knowledge of cancer of the ureter." + Rob Bakshi, '91,Wins National Neuroimaging Award BAKSHI , MD . has been awarded the prestigious Oldendorf Award by the American Society of euroimaging (AS ) . Bakshi was cited for research he did in collaboration with his colleagues at the Lucy Dent Imaging Center and Millard Fillmore Hospital that involved the use of brain positron emission tomography (PET) in the study of multiple sclerosis (MS). The award, named in honor of Dr. William H. Oldendorf, a pioneer in the field of neuroimaging, is presented to a young investigator for outstanding neuroimaging research. Bakshi, a Buffalo native, graduated from UB in 1991 and completed postgraduate training at Harvard and the University of California at Los Angles. He returned to Buffalo in 1995 for a neuroimaging fellowhip and subsequently joined the Dent eurologic Institute and UB's Department of eurology. OB ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement courses • tate of the art visual and performing arts center • More than 60 interscholastic sports teams • Comprehensive communn:y sel'"\'tce proJects • Average class si:e is IS • Financial atd available Admissions tests on these Saturdays at 9:00 a.m.: January 24, February 2 To resel"'e a place for testmg or for addtttonal mfom1atton, please call: ® B u f f a l o Phys ician Summer l 9 9 8 �Bakshi received the award on February 27, 1998, at the national AS convention, during which time he presented a lecture detailing the findings of his research work. The effect ofMS on brain functioning may play an important role in the progression of the disease , but has previously been poorly understood, he reported. Using fluorodeox yglucose (FDG ) as a tracer to measure brain metabolism by PET, widespread global and specific regional hypometabolism was noted in MS patients as compared to healthy subjects. This effect of reduced metabolism and consequently reduced function was most profound in the frontal and occipital gray matter, and in the white matter. These findings suggest that FDG-PET may be a useful tool to improve the understanding of the pathophysiology ofMS and track the response of these patients to new therapies. Other aspects of brain mapping studying specific clinical MS protocols have been completed and were presented by Bakshi and his Dent colleagues in April 1998 at the annual meeting of the American Academy of eurology. The work presented by Bakshi Rob Bakshi, MD in Orlando was co-authored by RobertS. Miletich, MD , PhD ; Peter R. Kinkel , MD; Mari Emmet and William R. Kinkel , MD , '54. The PET research of the lucy Dent Imaging Center is being supported , in part, by the Dent Family Foundation and is performed in collaboration with UB's Department of uclear Medicine. eurologists at the Dent Institute are also using PET scanning to improve the understanding of other neurologic diseases such as Alzheimer's disease , epilepsy and brain tumors. + B u f f a l o Phys i Nedra J. Harrison, 'Tl,New President Medical Society EDRA J. HARRISON. 77. is the new president of the Medical Society of the County of Erie. A practicing general surgeon with Delaware Surgical Group , P.C. , in Buffalo , Y, Harrison was installed at the society's annual meeting May 12, 1998. A native of Buffalo, she earned her undergraduate degree at Rosary Hill College (now Daemen College) in Amherst, Y. After earning her medical degree, she completed her internship and residency training at Millard Fillmore Hospital in Buffalo. She was in solo practice in general surgery for a number of years following her postgraduate training before joining her present group in 1994. LASER SYSTEM CONTINUED take out the tumor. I don't need an expensive system to help me do that. ' This system is making it much easier and simpler for a physician to find , biopsy or excise a brain tumor," Landi says. Another neurologic procedure DRTS is greatly improving is the percutaneous procedure for trigeminal neuralgia. Treatment of this condition involves placing a needle up through the patient's face via a hole in the bottom of the skull and either burningorinjectingamedicationaround the affected nerve. "What the DRTS system allows you to do is target a neural foramen and place a needle directly into it as opposed to how we do it now, which is walking a needle along the base of the skull until you pop through. This can be very painful for the patients because they need to be awake to tell you if you've hit the right spot in the right part of the nerve," landi explains. In addition , the DRTS has also found a broad application to spine procedures, from guiding the placement of instrumentation to percutaneous procedures for pain relief. cian Summer Harrison, who is a past president of UB's Medical Alumni Association , is also a voluntary clinical assistant professor in general surgery at UB, where she Nedra J. Harrison, MD serves as a preceptor for senior medical students. Harrison is a diplomate of the ational Medical Board and the American Board of Surgery and is a fellow of the American College of Surgeons. Currently, she is a delegate from Erie County to the House of Delegates of the Medical Society of the State of ew York. She is also a member and past president of the Buffalo Surgical Society, where she was the first woman to serve as president. + 1 9 9 8 FROM PAGE 12 Given the success of the DRTS to date , both Landi and lifeso would not be surprised if other, yet-to-be discovered, applications are found for the system they invented. For each physician, it's tremendously rewarding to see how use of the DRTS is contributing to improvements in diagnosis , treatment, pain control and protection from radiation exposure. 'There's no substitute for the satisfaction you get from the people you meet every day when you know you've helped take away some of their pain or contributed to their being treated in a better way," Landi says. lifeso, too, says he derives much satisfaction from seeing the benefits the DRTS brings to his patients, a satisfaction compounded by the work he continues to do with young medical students. "I still do a lot of work with students," he says, "and I encourage them to explore their ideas. If they have something they want to talk about, I tell them to come on in and we'll sketch it out." + Ellt•n liolr/luntuli'OI//rillll!l'll/o this arlitlt•. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · IJ ----------------------~- '' - ' / ' Reducing Multiple Births RELI\IINAR't RF'>LARC II by a fertility specialist at the University at Buffalo School of Medicine and Biomedical Sciences shows for the first time that a hormone whose role in fertility was thought to be limited to triggering ovulation may also support growth of a developing egg follicle during fertility treatment. The findings suggest thatlutenizing hormone (LH), a hormone present in the second half of the menstrual cycle, may perform the critical task of ustaining the growth of egg follicles until ovulation, said Michael W. Sullivan, MD, VB assistant professor of gynecology and obstetrics and lead researcher on the study. They have important implications for women undergoing fertility treatments, Sullivan says, because specialists formerly thought the only way to keep a developing egg growing was to administer follicle stimulating hormone (FSH), which also causes multiple eggs to mature. By manipulating LH and FSH, Sullivan says it could be possible to sustain the growth and development of one or two follicles in women undergoing fertility treatment while preventing multiple ovulations, thus decreasing the risk of multiple births. " obody has looked at this before, because it wasn't possible until the development of the recombinant form of the two hormones, which happened very recently," he says. "The finding is very preliminary, but it is promising. " The results are based on a prospective trial involving 24 women that Sullivan ® led while a fellow at the University of Pittsburgh School of Medicine. Successful infertility treatment depends on the ability to manipulate precisely the essential hormones involved, which requires their clear identification. Infertility specialists strive for a single birth; however, a stumbling block to this end has been identifying a way to limit the number of eggs that mature during fertility treatment while keeping at least one egg developing. During a normal menstrual cycle, FSH stimulates egg follicles to develop. At a certain point in the cycle, estrogen signals the pituitary to stop producing FSH, a signal that at least one egg follicle is well and being nurtured. The drop in FSH stops more follicles from developing, all immature follicles die, but the "recruited" follicle lives. " obody knew why the follicle continued to thrive in the face of decreased FSH ," Sullivan says. "We thought that FSH was required all the way along, even at low levels. So stan- B u f f a l o dard procedure during fertility treatment has been to continue FSH, which keeps follicles growing, but also may stimulate too many to develop. "We've now shown that FSH is not essential during the entire first half of the cycle. We've discovered that LH can make up for the deficiency ofFSH as the follicle grows." ullivan and colleagues stopped production of fertility hormones artificially in the study group, and then stimulated follicle development in all the women with recombinant human FSH. When a 14-mm follicle was identified by ultrasound, the women were randomized to one of four groups: continued FSH treatment; FSH replaced with saline; FSH replaced with high dose of recombinant LH, and FSH replaced with low dose of recombinant LH. After two days of treatment, researchers measured blood levels of estrogen, the sign that a follicle is healthy and developing normally. Estrogen levels dropped in the saline group, indicating the maturing follicle had ceased to thrive in the absence of FSH or LH. In all three remaining groups, estrogen levels continued to rise and pregnancies resulted in all three groups. "This suggests that if you administer FSH until one follicle matures, then limit FSH and substitute LH, you can support the growth of the maturing follicle, but won't recruit any more follicles," Sullivan says. Also participating in the study were A. Stewart-Akers, ]. S. Krasnow, S. L. Berga and A.]. Zeleznik of the departments of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh School of Medicine. Funding came from the IH and TAP Pharmaceuticals. + Physician - LOIS Summer BAKER l 9 9 8 �m ·· ···· · ···· · · · · ·· ······· · ········ ··· · ·· · · ········ · ······ · · · · · ················ · ···· · ······ · m .. . . Blood-Brain Barrier Disruption and Hypoxia HE LA TEST HIGH- TECH GEAR can't protect climbers on Mount Everest from one of the hazards feared most by those who spend time at extreme heightsoxygen deprivation , or hypoxia , resulting in the potentially lethal brain swelling known as high-altitude cerebral edema. Research conducted at the University at Buffalo School of Medicine and Biomedical Sciences suggests that highaltitude cerebral edema is caused by a disruption in the blood-brain barrier. john A. Krasney, PhD , UB professor of physiology and a specialist in hypoxia, presented these findings on April28 , 1998, at the 66th annual meeting of the American Association of eurological Surgeons in Philadelphia. Krasney and colleagues in UB 's Hermann Rahn laboratory of Environmental Physiology have developed an animal model using sheep for studying hypoxia and cerebral edema in an effort to learn more about how and why these conditions develop and their effect on cognitive function. "Brain swelling, and also pulmonary edema, is one of the major problems at high altitude and we don' t really know the cause of either," Krasney says. "It is not lack of oxygen , per se. At high altitude , the brain has an adequate supply of oxygen, because blood flow increases to compensate for the lower concentration of oxygen in the air. Yet people still get sick. " In its mildest form, swelling of the brain brings on the headaches and nausea characteristic of acute mountain sickness. In its most severe form, B u f f a l o unrelieved by retreat to lower elevations , brain swelling advances to highaltitude cerebral edema, which causes disorientation, impaired mental function and death. Information gained from the study of high-altitude cerebral edema and hypoxia is relevant to many people other than those wealthy enough to afford an Everest trek , Krasney notes. "Thirteen million people go to Colorado every year to ski and 65 percent develop at least a headache, " he says . "Twenty-five percent develop acute mountain sickness , and l to 2 percent develop highaltitude cerebral edema. " Hypoxia also is associated with obstructive lung diseases , sleep apnea and other disorders. Krasney's research using sheep has shown that the symptoms of highaltitude cerebral edema are not caused by an inadequate supply of oxygen or glucose to the brain. Rather , it appears that an accumulation of malfunctions creates enough cerebral blood pressure to force apart cells of Physician Summer 1 9 9 8 . . the blood-brain barrier and allow fluids to accumulate in and around brain tissues. They theorize that acute hypoxia may allow a decline in cyclic adenosine monophosphate (cAMP) , a chemical messenger involved in regulating capillary permeability. The decrease in cAMP may allow the cerebral capillaries to leak. In addition , Krasney said, it is possible that , in the presence of hypoxia , another chemical messenger , cyclic guanosine monophosphate (cGMP), acts with nitric oxide , a vasodilator, to promote and sustain permeability of the blood-brain barrier. The combined influence of actions could allow fluid to accumulate in the intracellular spaces, he says. Yet another mechanism that may be at work involves eleva ted levels of leukocytes that may cling to the lining of cerebral blood vessels and cause leaks in the blood-brain barrier. Krasney and colleagues are attempting to clarify further the importance of these mechanisms in the development of acute mountain sickness and highaltitude cerebral edema. Their research is supported by the ational Heart, lung and Blood Institute. + -LOIS BAKER ® �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · 11 -- ' ------ - - ' / . HURWITZ & RNE, P.C . [ ATTOR Link between Prostate Cancer and Estrogen Studied u f f a l a Ph AT LAW I SERVICI G THE LEGAL NEEDS OF THE HEALTH Scm cEs CoMMU ITY HE FIR<, T 1 \ E~ TIC, -\TIO of the been studied in men , especially in rerole of estrogen metabolism in lation to prostate-cancer risk," Muti the development of prostate can- says. "Yet, men also produce estrogen, cer will begin at the University at and we know that estrogen plays a role Buffalo chool of Medicine and in the development of cancers in Biomedical Sciences in October women. There is evidence also that 1998, funded by a $450,000 grant from androgens are increased in women who the U.S. Army's Medical Research and develop brea t cancer later in life. " Muti's goal is to determine if estroMaterial Command. The 30-month study will determine gen metabolism is influenced by enviif differences in estrogen metabolism ronment and lifestyle in a way that exist between healthy men and men increases prostate-cancer risk. The inwho develop prostate cancer. Infor- crease in prostate-cancer deaths among mation on lifestyle habits also will be men who emigrate from countries with low rates to the collected to deterUnited States, where mine if, as suspected, rates are high , sugthese habits affect "ESTROGEN METABOgests that environwhether estrogen LISM HAS NEVER BEEN mental factors play breaks down into a a dominate role in potent product that STUDIED IN MEN, the disease, she says. may induce prostateESPECIALLY IN RELA"There is evice ll division , or a TION TO PROSTATEdence that a sedenweak version that tary lifestyle and acts to discourage it. CANCER RISK .. . YET , high-fat diet influThis never-beforeMEN ALSO PRODUCE ence estrogen meexamined mechaESTROGEN , AND WE tabolism to produce nism represents a a potent estrogen , potential new avKNOW THAT ESTROGEN while an active lifeenue of s trategies to PLAYS A ROLE IN. THE style and low-fat diet prevent this imporDEVELOPMENT OF induce production tant disease, said of a weak estrogen. Paola Muti , MD, UB CANCERS IN WOMEN ." Potent estrogens assistant professor of may increase prossocia l and preventate cell division and tive medicine and lead investigator on the research. increase cancer risk. It's possible that Prostate cancer is the second lead- the influence of these lifestyle factors ing cause of cancer deaths among men , on hormone metabolism, especially and the American Cancer Society esti- estrogen metabolism, could be the link mates that39,200 men will die of the between environment and prostatecancer risk." + disease in 1998 in the U.S. "Estrogen metabolism has never L OIS BAKER B EYS • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations ysician and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849 -8900 1300 Liberty Building Buffalo. ew York Summer l 9 9 8 �· ···· · ··· ·· ·· ·· ··· · ·· · ·· · · · ·· ··· · · ·· ··· ·· · · ·· · ······· ····· · · ··· · · · · · ··· · ···· · · ···· · ·· ··· ·· m ·~!tl ~. ,;. . Taller, but Not Necessarily Happier con- into changes in quality of life. "If adult quality of life is what we're tinues to presume that height is a measure of personal satisfaction concerned with , then we should probin life, a new study by a team of ably be looking at factors in addition to researchers at the University at height. Maybe we should take into acBuffalo refutes the idea that taller count experiences related to having a is necessarily better. The study, which chronic medical problem in general, compared the quality of life of adults and how this might affect adult adaptawho were treated for growth-hormone tion, " Sandberg says , stressing that the deficiency as children with their healthy findings do not suggest that growthsame-sex siblings who experienced nor- hormone treatment has no benefit mal growth, appears in a recent issue of for patients' quality of life as adults. the journal of Clinical Endocrinology and Metabolism (Vol. 83, pp. 1134-1142.) The researchers, led by UB pediatric psychologist David Sandberg, PhD , a specialist in the psychological aspects of growth-hormone The study involved 140 former deficiency, found that as adults , chil- patients- 117 males and 23 dren who were treated were as well- females- and 53 siblings, all over adjusted as their physically healthy the age of 18. The mean age of the brothers and sisters . They also were treatment group at the time of the study doing much better as adults than previ- was 26. Information on several qualityous studies using non-sibling control of-life measures was collected by telegroups or norms from questionnaires phone interviews. The treatment and follow-up study were conducted at had indicated. Results showed, unexpectedly, that Children's Hospital of Buffalo. there was little or no relationship beBoth the data-gathering method and tween the former patients' adult height the relatively large and complete study or how much they grew over the course population give the findings special of therapy and their reports of psycho- credence , Sandberg says. "Most studies logical and social functioning. An im- use self-administered questionnaires , portant difference that did emerge was which are mailed to patients, giving in marital rates: Siblings were twice as you limited control over the process. likely to be married as former patients. Also , by using same-sex siblings, we "This study questions whether there is account as much as possible for particia direct relationship between how tall pants' genetic and social backgrounds. " The results showed no significant difyou are as an adult and how satisfied you are with your daily life experi- ferences between the formerpatientsand ences," Sandberg says. "Changes in their same-sex siblings in educational height brought about by growth hor- attainment, gainful employment, the likemone do not automatically translate lihood they were living independently, LTHOLGH POPCLAR CCLTLRE a u 1 1 o 1 o P hysic i an Summer 1 9 9 8 '"· .. and social support or adjustment, which involved aspects such as one's network of friends and social activities. There were slight differences between the groups on a measure of general health. Former patients reported more health problems, and those missing other hormones experienced more health and social difficulties , a predictable outcome in light of the fact that some patients still have health problems, notes Sandberg, who adds that he has no explanation for the differences in marital rates. The study places in perspective the relationship between height and happiness . "We shouldn't get caught up in the idea that making someone taller as adults will necessarily improve their quality of life," Sandberg says. "Our goal is to allow each person to reach the normal range so his or her short stature doesn't constitute a physical disability. Maybe beyond that we aren't going to find benefits. Quality oflife is an enormously complex concept. " Also participating in the study were Margaret H. MacGillivray, Richard R. Clopper, Caroline Fung, Linda LeRoux and Dana E. Alliger , all of UB and Children's Hospital of Buffalo . The study was supported in part by grants from Genentech . + - L OIS B AKER �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ----' / ' - -- ~~~- ' ""' . "It has taken 30 years from the discovery of these animal models to finding out the true cause of these anemias ," comments Michael Garrick. Recent efforts to map the rat genome gave a boost to the anemia research by providing enough markers to enable researchers to begin mapping the Belgrade rat and tists describe as a stunning example of conducting the D A analysis to find the biological conservatism: The same gene that encoded the critical protein. amino-acid change in the same gene in "The publication in 1995 of the rat the same protein is responsible for iron- genome inspired us to get together with deficiency anemia in two different ani- the Harvard group to map the Belgrade mal models. The details of iron metabo- rat, " says Garrick. Meanwhile, the Boslism-particularly the question of which ton Children's Hospital researchers were proteins are responsible for iron attempting to map the microcytic mouse. absorption in the intestine and for iron What the two groups found was akin to traffic within cells-have lightning striking long eluded researchers. twice, he says. "We The UB-Boston team has were looking at two . . . THE PROTEIN concluded that it is different models. We ramp2that actually takes APPEARS TO BE didn't know we'd up iron in the gastrointesfind the same thing. INVOLVED IN NOT tinal tract. Later, when Not only is it the iron is absorbed into cells JUST ONE , BUT same gene encoding in the body, it must be the same protein in SEVERAL CRITICAL delivered to the mitochonboth animals , but it dria. "This protein also is ROLES IN IRON is the same aminothe major one involved in acid change that METABOLISM . this critical, intercellular distinguishes the traffic step," says Garrick. normal animal from The current results, says the mutant. " Laura Garrick, as well as recent research A group at Brigham and Women's conducted elsewhere, suggest that the pro- Hospital in Boston independently found tein also may be implicated in a third the same protein; however, they did not type of iron transport, called nontransferrinhave a mutant animal that could help bound iron transport, which comes into play identify its role. "They did find that when there is excess iron in the body. ramp2 also transports lead, manganese, The findings of the UB and Boston cadmium, zinc, cobalt, nickel and copChildren's Hospital researchers build per. Thus the Belgrade rat could be defion decades of work at UB led by the late cient in some of these metals and thereRobin Bannerman, MD , and colleagues, fore may help us to understand human includingjohn Edwards , MD, that re- variability in response to toxic material," sulted in the characterization of animal Garrick says. models of two types of iron-deficiency "However, this protein doesn't ananemia: the Belgrade rat and the micro- swer all the questions in iron transport, " cytic mouse. Both animals are unable to he cautions. "What's remarkable, absorb iron properly in the gastrointes- though , is that it shows up in so many tinal tract or take it up sufficiently at the ways. It's a fantastic coincidence. " + cellular level. -ELLEN GOLDBAUM Major Step in Understandina Iron Metabolism, Iron-Deficiency cientists at the University at Buffalo and Children's Hospital in Boston (affiliated with Harvard University) have identified and characterized a protein that is the single most critical known element in iron metabolism. The first protein to be identified as essential for normal intestinal iron absorption and the first mammalian iron transporter to be characterized at the molecular level, the protein appears to be involved in not just one, but several critical roles in iron metabolism. The research, supported by the ational Institutes of Health, was published in the February 5, 1998, issue of the Proceedings of the ational Academy of Sciences and highlighted in the March 25 , 1998, issue ofjAMA. 'This finding allows us to take a major step forward in our understanding of iron metabolism," says Michael Garrick, PhD, professor of pediatrics and biochemistry at UB and a coauthor of the paper. Other UB coauthors are Laura M. Garrick , PhD, clinical assistant professor of biochemistry, and Michelle A. Romano, research technician. The discovery of the protein, called ramp2, will allow researchers to increase their understanding of iron-deficiency anemia; it could also lead to improved treatments for hemochromatosis and help manage exposure to toxic metals. For example, the potential role of ramp2 in hemochromatosis was a main topic of discussion in a symposium titled "Molecular Medicine and Hemochromatosis-At the Cro roads ," heldinBethe da , MD,May14-15 , 1998. The work highlights what the scien- e u f f a 1 o Physician Summer 1 9 9 8 �.........................................• • • 1 9 4 s 0 1 9 8 s 0 W ILLI AM MALONEY, '41 , wrties: EDWARD A . TOR IELLO , '80 , Good to read about Ted Ross. I'm glad some of the '41ers are still alive. The war was rough on been named to the board of directors of the American Academy of Orthopaedic Surgeons. our class. I've retired from anes- His election took place at the 65th annual meeting of the academyMarch 19-23,1998, in New thesia and live in Maine, near the shore. My health is fair. I do a little fishing and go to the Carribean most winters. 1 9 7 s 0 has Orleans. Toriello is chief of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, Y, and GLENN L. POST , '72 , writes: "I am currently working and attending orthopaedic surgeon at St. John's Queens Hospital, enjoying life in Kathmandu, Catholic Medical Center, Queens , Y. A member of the Nepal, with my wife , May, a Burmese physician. I am chief of the health E-maJU5 program at the U.S. agency for International Development You've done all you can for your patient. .. now what? I Classnotes tan also be submitted by E-mail at: ew York State Orthopaedic Society, he currently serves on its board of di- rectors. He is also a delegate of the House of Delegates for the Medical So- here. Our program has an anbpnotes@pub.buffalo.edu. nual budget of 17 million for ciety of the activities in maternal and child health, HIV/AIDS, family plan- State of New York. ning and infectious diseases. ROSLY N ROMANOWSK I, '86 , epa! is a wonderful country writes: ''I'm practicing hematolwith a rich and diverse culture, ogy/oncology with Century spectacular countryside and Medical Associates in friendly people. I was a Peace Williamsville, NY. My husband, Corps volunteer here from Bob Campo, and I are enjoying 1977-1979 , during which time our first child, Richard Joseph, I completed a preventive mediborn January 1, 1998." cine residency with a specialty in international health at Johns 1 9 9 0 s Hopkins. Suggest Hospice support and care. Explain how Hospice also helps the whole family. Remind them that you 'II be there with Hospice, still directing care. Tell your patient that you and Hospice together can help make the remaining time more meaningful, more dignified and more comfortable. JONATHAN is now at the University of Florida M ICHAEL J . p~~ 686.8077 5ALZLER ,'79 , at Gainesville, where he works in research. HOSPICE BUFFALO • HOME CARE BUFFALO • KRESGE RESIDENCE LIFE TRANSITIONS CENTER • HOSPICE FOUNDATION WE I NSTEIN , '93 , writes, "I am working in a private pediatrics practice in orthern Virginia, just outside Washington, DC. I got married in August 1997; my wife's name is Sandra. I keep in touch with B u f f a l a p s i c a 5 u m m e 9 8 �I -~-- • ·· · ········· ···· · · · ·· ········· ····· ···· ···· ···· ·· ·· ····· ··· ·· ·· ·· ·· ·· ····· ····· ·· ········· I Edward Math '93 (he was my best man). He will be doing a one-year fellowship in mary for 17 years and completed his career with the ew York thesiologists from 1984-1992. He also served as a certification examiner for the American Board ROBERT J . EHRENREICH , '47 , died on April3, 1998, in a Philadelphia nursing home after suffering a stroke. Ehrenreich, who fought a long battle with State Health Department. Survivors include his wife of 56 years, the former Marjorie Thomas. of Anesthesiology for 25 years. ThisJuly, I will begin my second year of residency in dermatology at SUNY Stony Brook. Also, died March 19 while visiting relatives in Evanston, IL. Ament, January 28, 1998, in Wanakah, Y, at the age of 88. Saab, a surgeon, maintained a practice in a pediatrician, allergist and clinical assistant professor in UB's my wife, Kimberly, and I would like to announce the birth of our who was 79, was a clinical professor of anesthesiology and vice Lackawanna, Y, for more than 50 years. He was also a taff phy- School ofMedicine and Biomedical Sciences. In his 43-year prac- first child, Danielle Leigh, on May 23, 1998. She was one chairman for educational affairs for the anesthesiology resident program at UB. During his long sician at Our Lady ofVictory Hospital and Mercy Hospital in that tice of medicine, he was on the staffs of Children's, Millard community. Survivors include his Fillmore, Sisters, Kenmore Mercy career as an anesthesiologist at Buffalo General Hospital (BGH) wife, the former Jane Daley. and DeGraff Memorial hospitals. Ehrenreich, known as "Dr. Bob," Charlouesville, VA, next year. SCOTT FLUGMAN , '96. writes: month early (surprise!) , but baby and mom are doing well. MARTIN C. MAHONEY , "95, has received the fir t-place award in the 1998 American Academy of Family Physicians Resident JOSEPH R . SAAB , '43, RICHARD AMENT , '42 , and Children's Hospital, Ament introduced new anesthesia techniques and developed the anesthesia resident program at BGH. The author of numerous pub- Scholars Competition. The award was given for his paper, lications, Ament was an expert in "Correlates of Anticipated Infant Feeding in an Urban , Indigent Family Practice Setting." the development of academic anesthesiology in the U.S. and, in recent years, became involved The AAFP respresents nearly 84,000 family physicians, fam- with the Wood Library Museum of the American Society of Anes- ily practice residents and medical students nationwide. thesiologists in Chicago. In 1986, he received the Distinguished Service Award, the most presti- OBITUARIES died December l l , 1997, in his Buf- gious award of the American Society of Ane the iologists, which he had served as president in 1977. Ament also was honored with the dean's award for outstanding service from the UB medical school in 1986, and in falo home after a lengthy illness. He was 81. rban, an internist, 1996, he received the OutstandingAiumnu AwardfromtheUB was a former track star at UB who once ran again Jesse Owens. Alumni Association. A member of many medical In addition to maintaining a private practice in his residence, he was a member of the medical organizations, Ament was president of the ew York Society of CARMELO E . PATTI , '32 , died December 7, 1997, in Hornell, Y. He was 89. STANLEY T . URBAN. '40 , staff of Millard Fillmore Hospital for more than 50 years. He was also medical director of the Erie County Home and lnfir- Anesthesiologists in 1967, a governor of the American College of Anesthesiologists from 197577, and treasurer of the World Federation of Societies of Anes- died on Parkinson's disease, which forced him to retire three years ago, was VINCENT J . CAPRARO , '45 , died continued the practice of house calls long after many physicians had abandoned them, and often on February 2, 1998, in Lorain Community Hospital, Lorain, OH, after a lengthy illness. Capraro, a retired professor and he called his patients if he went out for the night. An early advo- associatechairofthe Department cate of parent-effectivness train- of Gynecology and Obstetrics at UB, was an internationally known specialist in adolescent gynecol- ing, he taught parenting sessions in his office. After traveling to tournaments with his tennis-playing ogy and corrective surgery. He establi hed a private practice in daughter, Amy, Ehrenreich be- 1950 and joined the staff of Millard Fillmore Hospital in 1951, later serving as chair of the hospital's Department of Obstetrics and Gynecology and director of the training program for residents and medical students at UB. He was also chief of the Division of Adolescent and Pediatric Gynecology and Corrective came a chair umpire with the United States Tennis Association and officiated at matches in many locations, including Madison quare Garden and Forest Hills. During those years, he had several encounters with the former tennis "bad boy," John McEnroe. He is survived by his wife, Miriam; his daughter,Amy Haller Surgery at Millard Fillmore Hos- of Penn Valley, PA; two sons, Richard A. of Potomac, MD, and David B. of Wynnewood, PA; a pital and chief of the Division of Adolescent and Pediatric Gynecology at Children's Hospital. In brother, Harold M; a sister, Annette Irwin ofPembroke Pines, 1971 , he received the B Senior Medical tudents' Award for out- FL; and four grandchildren. standing teacher, and in 1990 a lectureship was established in his honor by the UB Medical School JAMES G . ROB I LOTTO , '48 , died November 25, 1997, at age 74, in Orchard Park, NY. After com- Alumni Association class of 1945. He retired in 1976 and moved to pleting his residency at the old Avon Lake, OH, in 1988. 6 f f a I o p s I c a 5 m m e 9 9 �................................................................. . ....... . ... . . . . . . . . . . . . ·· ~ - • E.]. Meyer Memorial Hospital in 1950, Robilotto established a general practice in Williamsville, NY, which he maintained until 1999 Class Reunion Preview I The following is o profile of John H. Remington, MD, Closs of 1939, which will be celebrating its 60th reunion next Moy. 1958. He was on staff of Sisters Hospital and served his anesthesia residency at Veterans Hospital from 1958 to 1960, after JOHN H . REMINGTON , MD After completing his internship at St. Mary's Hospital in president of the American College of Surgeons Upstate which he was a member of St. Joseph Hospital in Cheektowaga, Y, from 1960-1970. He was on Rochester, New York, John H. Remington entered gen- New York Chapter and the American Society of Colon and eral practice for two years with his father, the late Alvah Rectal Surgeons, and was on honorary fellow of the the staff at our Lady of Victory C. Remington, University of Buffalo medical school1897, Royal Society of Medicine of london and Royal Austra- Hospital, Lackawanna, NY, from 1970 to 1974. From 1974, until after which he spent a year in the Pathology Deportment lian College of Surgeons. He served as on examiner for at the University of Rochester, conducting research with the American Boord of Colon and Rectal Surgery and was Nobel Laureate George Hoyt Whipple. He was subse- on American Medical Association program director for quently granted a three-year fellowship in surgery at the the Section on Colon and Rectal Surgery. In addition, he Mayo Clinic, where for one year he was first surgical was founder of the Rochester Surgical Society and presi- his retirement in 1981 , he was a physician for ew York State. Survivors include his wife of 49 years, the former Helen Reyda. EDWARD A . PENN , '51 , died in assistant to Charles W. Mayo. While at Mayo, dent of the Research Society of the he developed and described two new surgi- American Proctological Society. Remington after a brief illness. After gradu- cal procedures and designed on instrument received two awards from the Rochester ating from UB and completing his training in Boston , Penn es- for performing bowel resections. Following Academy of Medicine and was elected to the fellowship, he was assistant surgeon to Sigma Xi, the notional honorary research the staff of the clinic and went on to earn on society. He was also a trustee of the MS degree in surgery from the University of Hochstein Music School and the Allendale Minnesota in 194 7. He then returned to School and was president of the Genesee December 1997 at his home in Yarmouthport, MA, at age 71 , tablished a pediatric practice in Fall River, MA, and served that community for more than 39 years. He moved to Yarmouthport in 1992 and retired from medicine in 1994. Dr. Penn was the former chief of pediatrics at St. Anne's Hospital in Fall River during the early 1970s and was Emeritus Fellow of the American Academy of Pediatrics and past president of the Massachusetts Chapter of the Academy of Pediatrics. He was also an associate professor of Pediatrics at Tufts University School of Medicine and a member of the Health and Finance Committee for the National Academy of Pediatrics. Surviving are his wife , Eileen + (Simon)and three sons. B u f f a l a P Volley Antique Automobile Society. Rochester, where he practiced in his specialty of colon Today, Remington, who retired in 1979, is enjoy- and rectal surgery. During the course of his career, Remington was a ing studying history, reading biographies and travel- clinical associate professor of surgery ott he University of ing with his wife, the former Katherine Weber, RN, who Rochester, choir of the Deportment of Surgery at St. formerly was a surgical nurse at the Buffalo General Mary's Hospital, attending surgeon at Highland Hospital Hospital. There, she worked with the late Marshall and consulting surgeon at Rochester General and Genesee Clinton, Herbert Smith, Thew Wright, Elmer Milch, Hospitals. He has been in all 50 states and in 38 foreign Wallace Hamby and others. The Remingtons (who countries, serving as a lecturer or visiting professor in 14 reside on Old Mill Rood, Rochester, NY 14618), hove of those countries. three children: John Alvah, PhD, University at Buffalo '66, oflucson, AZ; William Frederick, MD, of Pittsford, Remington has published 52 articles, including NY; and Susan Ann, MA, of Ann Arbor, MI. three chapters in surgical texts. He has served as hysician Summer 1 9 9 8 + I �THE ULTIMATE DRIVING MACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. Sales and Service 487 Kenmore Avenue Buffalo, NY 14223 Comprehensive Cost-Effective Receivables Management 836-2033 Your WNYLeasing Specialist Serving WNYproudly for 33 years ~ Amana Capital Corporation Buffalo. New York 716-852-3500 800-44 1-6925 WNY's- Exclusive - BMW Retailer THE ULTIMATE DRIVING MACHINE.® THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. F. G. 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Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1998 Subject The topic of the resource State University of New York at Buffalo. 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Merger Final Elegant Solution to a Complex Problem Medical School Physicians Reaching Out to Students Alumni Class Reunions Research Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b53d99c6138cd19deb31dbe3a690439b.pdf 52e6b38e2dd07f9baeee38b2e0427e88 PDF Text Text AN OPENING TO A NEW PER ECTIVE �Dear Alumni and Friends, BUFFALO PHYSICIAN \'olumc "3"3. '\lumhcr 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. s~1wncr EDITOR Stephanie -\. L'nger ART DIRECTOR/DESIGNER \Ian J Kegler ASSISTANT DESIGNER lynda Harmel PRODUCTION MANAGER \nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. Wright, /ntmm Dea11 EDITORIAL BOARD Dr Bertram Portin, Chai1 Dr Martin Brecher Dr. Harold Brody Dr lmda J Corder Dr. ,\Jan J Drinnan Dr. Jamc~ Kanski Dr. Barbara \1ajeroni Dr Elt;:abeth Oltmted Dr Charles Paganelli Dr Stephen Spaulding Dr Brad lev T frua., Christoph~r .-\dam ... Dr 1-'rankhn Zeplownz TEACHING HOSPITALS AND LIAISONS The Buffalo General Ho;pital \hcharl H Slum The Children\ Ho,pllal of Buffalo [ne County Medical Center MerC\ Health Svstem \1tlla;·d rillmor~ Gates Hospital t-1IIIard Fillmore Suburban Hosp11al ~Iagara !'alb \lcmorial \ledtcal Center Ro~\vcll Park Cancer In~titutc '>tster- of Chanty Hospital Dnmis .\fcCarth\ \'ctcran'-. Affa1rs v\·cstcrn :'\C\\ York Healthcare System ©The State Lmn·r~nv of '\;cw York at Buffalo ' Buffalo Phnician is puhhshed quarterly by the State LnivcrSity of ~ew York at Buffalo School of Mcdicme and Biomedical Sciences and the Office of Pubhcallons. It one of the best of times for those privileged to be part of the medical teaching profession. New students-be they undergraduate medical students, basic science graduate students, or house officers-serve to energize the faculty. At the end of june, Incoming Residents' Week and a day-long training program for chief residents marked the beginning of the 1998-99 Graduate Medical Education curriculum. Associate Dean Roseanne Berger and her staff organized each of these highly successful and well-received programs. As a practical topic for those destined to be the next chief residents, the program theme was Tools for Leadership. Incoming Residents' \Veek was designed to prepare incoming house staff for the transition from medical student to house officer, and more direct (albeit carefully supervised) responsibility for patient care. In addition to learning more about how the health-care system functions and the various regulations under which it operates (including the infamous NYS "405" variety), the resident's role as teacher was emphasized. Indeed, by the end of the week, each of the incoming residents had been provided with some very basic, small-group teaching principles and an opportunity to apply these skills in a simulated ward-like environment. During a White Coat Ceremony, convened on the first day of their orientation week in mid-August. incoming first-year medical students were welcomed officially into the medical profession (see article on page 22 of this issue). Traditionally, our medical students have taken either the Hippocratic Oatlt. the Charge ofMainwnides, or what is locally referred to as the Physician's Oath at the time of graduation. It occurred to some of our faculty that this might be "a little late" in their evolution as physicians and the suggestion was made to have a ceremony at the vel) beginning of their preparation for the profession. Accordingly, Assistant Dean for Students Dr. Tom Flanagan organized the White Coat Ceremony, the high point of which is reciting the Physician's Oath. At this year's ceremony, introductory remarks described what being a member of the medical profession entails, particularly the obligations that come with the privilege. The fact that some aspects of medical ethics tend to evolve with time was underscored by reference to Jerome Kassirer's (a distinguished UB grad) editorial in the August 6, 1998, issu~ of the New England]oumal of Medicine. On the other hand, it was noted that some ethtcal pnnctples have not changed since the days of Hippocrates, including those embodied in our own Physician's Oath. The students were reminded that when faced with ethical decisions, one's own ingrained value system often becomes invaluable; i.e., "Sometimes one has to set aside principles and do what is 'right."' Following an address by Dr. Margaret Paroski, members of the senior faculty then provided each student with a white coat in what was very much a graduation-like hooding ceremony, foiiO\ved b) group recitation of the Physician's Oath. Smce It may have been some time since any of you attended a graduation ceremony, particularly atUB, yo.u may want to read the oath, which is printed on pages 22 and 23 along w~ a descripuon of Its ongms. Please let us know what you think! f.\11 IILR.\I D'> Tm Blc.l;-.;:--.1;-.;r. Of A NE\\ \L\DI\tK YLAR, IS sent, free of charge, to alumni, faculty, srudents, residents and friends. The staff reserves the right to edit all cop} and submisswns accepted for publication. ~~ hN R. W"G"', MD Interim Dean Sclwol of Mcdicirtc and Biomedical Sciences Dear Fellow Alumni, THE 11 u~t:-<l \\HO YOLL'HFER THEIR Tl\tF to serve on the Governing Board of the Medical Alumni Association do so for a variet; of reasons. One of my main motivations is to improve the medical school experience. )-along with many of my fellow classmates-was one who complained in the early 1980s about a torn-up Main Street, outdated anatomy labs and lectures m a drab G-26 lecture hall with its equally drab "student lounge" across the basement hallway. The present medical student lounge is a far cry from that basement lounge of the past. I am proud to be a part of the Alumni Association's effort to furnish the student lounge (see related article on page 28 of this issue). In the last issue of the Buffalo Physician, I mentioned some recent problems with the Medical Alumni Scholarship Fund. I am happy to announce that the scholarship has been awarded this year and the recipient, chosen by the Admissions Office, is Mr. jesse Cone, a 1998 graduate of the University at Buffalo. Since the Governing Board of the Medical Alumni Association is committed to the future of this scholarship fund, it \\<ill be the subject of an article in a future issue of the Buffalo Physician. I am tremendously grateful and happy to report that more than 150 busy physicians in the Buffalo community have volunteered to serve as mentors for the new Physician-Student Mcntoring Program. The students were equally enthusiastic, and the program is off to a great start. From the profile of the first-yearstudcnts in this issue (sec page 22), I am sure you will agree that despite all the recent changes in medicine, its future IS looking good. ~ E LIZABETH L. MAHER, MD President Medical Alumni Association �VOLUME 33 , NUMBER 2 AUTUMN 1998 4 1 NOV 1 3 1998 2 China Rotation FOURTH-YEAR STUDENTS TAKE A NEW 8 vt APaUrough an 4H Unexplored Field • • EUGENE M. FARBER, The Strengths of Children LUTHER ROBINSON , MD, LOOK AT ANCIENT DERMATOLOGY PIONEER, WORKS IN THE U.S. AND RECEIVES UB ALUMNI AWARD ABROAD TO TREAT AND by S. A. Unger PREVENT FETAL HEALTH-CARE PRACTICES IN BEI..JING ALCOHOL SYDNROME Medical School by Jessica Ancker BIOGEN ENDOWS Research NEUROLOGY CHAIR AT u B-LAWRENCE .JACOBS BODY SHAPE AND NAMED FIRST HOLDER BREAST CANCER by Lois Baker THE ARTFUL DOCTOR - CHARLES V. U 8 PROFESSOR PURSUES 40 AND LOW PREGNANCY PAGANELLI, PASSION FOR PAINTING PHD, SPERM ABNORMALITIES RATES RETIRES AFTER by Lois Baker YEARS OF SERVICE TO UB STUDENT LOUNGE A Class Notes SOCIAL HAVEN FOR MORE CLASS REUNION MEDICAL STUDENTS PHOTOGRAPHS AND by Mara McGinnis MEMORIES Student Perspective SECOND-YEAR STUDENT NEVA DALEY INAUGURAL WHITE COAT CEREMONY FOR INCOMING LEARNS ABOUT THE REALITIES OF CANCER CARE MEDICAL STUDENTS by Mara McGinnis CO\ ER PHOTO B\ jA'>E ELLERY 00PKIKS. Case presentation of two-year-old bor with hypothyroidism. Preventing fetal alcohol syndrome. Story on page 14. �US ' S FAMILY MEDICINE • ROTATION CHINA IN �-- - --- ach spring, fourth-year students at the University at Buffalo School of Medicine and Biomedical Sciences have an opportunity to participate in UB's Cross Cultural Medicine Program, which includes a three-week clinical rotation at various ..--....-• medical facilities in Beijing, China. During their stay in China, students gain knowledge about the structure and financing of the country's health-care system, as well as about its medical education. They also learn about the role of traditional healing practices such as massage, herbs and acupuncture, and have an opportunity to hone their physical-examination skills by taking part in hospital rounds, case presentations and various meetings (see following article by jane Dophins, Class of 1998). The Cross Cultural Medicine Program, which is partially underwritten by Millard Fillmore Hospital, was begun in 1990, when a working relationship between the medical school and Beijing's Capital Medical Hospital was first established. "The goal of the program is for the students to learn about another health-care system and to consider health and illness from a different cultural perspective," explains S. Ramalingam, MD, director of Cross Cultural Medicine and International Health at UB, and clinical assistant professor in the Department of Family Medicine and associate residency director. Ramalingam is convinced that the opportunity for American medical students to collaborate with their peers from another culture and health system fosters an openness to different perspectives on health, education and society. He also believes that by observing a different culture and its medical treatment of patients, students can take an important step in furthering their understanding of the nature of disease. "I want students to understand that medicine is more than just interpreting lab tests. With all of our modern technology, I sometimes think we've forgotten the primary focus of medicine- treating the patient. " A unique aspect of the rotation in China is the exposure students gain to Traditional Chinese Medicine LEFT: PEDIATRIC PHYSICA L (TCM) and the ways in THERAPY SESSION AT A which it is collaboratively integrated with Western, FAMILY MEDICINE HOSPITAL allopathic methods. AlIN BEIJING THAT PROVIDES though this type of colINTEGRATED , HOLISTIC CARE . laboration seldom exiStS between American phy- s u f f 0 l 0 P hysici a n A sicians and alternative medicine practitioners, there are indications that the role of alternative medicine in Western culture is being reconsidered, not only in the clinic, but in the classrooms as welL ationally, the Society of Teachers of Family Medicine has established a Subcommittee on Integrative Medicine charged with developing the first curricular guidelines for the teaching of alternative medicine in U.S. medical schools. (The phrase "integrative medicine" has begun to supplant the phrase "alternative medicine" when describing such studies.) Ramalingam is one of five individuals selected from across the nation to sit on the subcommittee. He reports that after two years' work, the group has completed its recommendations and has submitted the proposed guidelines to the society for consideration, after which they will be presented to the Association of American Medical Colleges. Also, in 1992, the Office of Alternative Medicine (OAM) was established through a Congressional mandate under a ational Institutes of Health appropriations bill to scientifically study the results of TCM. In its first year, the OAM was budgeted $2 million to analyze, interpret and acknowledge what effective therapeutic regimes exist in various alternative practices. By 1997, that figure had risen to $12 million. _" _ Despite governmental encouragement and attempts by such educators as Ramalingam to explore the role of alternative healing methods , the historic lack of scientific rigor-as defined by double-blind studies-is responsible for many of the reservations Western-trained clinicians hold about the efficacy of alternative medicine. A significant benefit medical students enjoy during UB's China rotation, therefore, is the opportunity to observe for themselves the positive results of alternative medicine in a culture where TCM and Western medical practices seem to peacefully coexist. Summarizing what he feels are the benefits of the program, Ramalingam says, "The excitement of a different culture fills students with curiosity and enthusiasm to be inquisitive as well as open-minded- attributes that will serve them well throughout their careers as physicians. " utumn 1 9 9 8 0 �BY JANE ELLERY DOPKINS • cnve THE OST VALU BLE EXPERIENCE OF MY MEDICAL EDUCATION ditor's note: In March 1998,]ane Dophins, afourth-yearstudent at the Universit) at Buffalo's School of Medicine and Biomedical Sciences, participated in the Cross Cultural Medicine Program and its famil_v medicine rotation in China. In the following article, Dophins-n lw is cw rent!) a resident in obstetrics and gynecology at Univcrsil) Hospital in Cincinnati, Ohiogi\ es a fi 1 stlumd account of her unique opportunit) to stuch abroad through L B~'l program The thickly polluted Beijing air was chilly at 6:30a.m. as six of us from the University at Buffalo School of Medicine and Biomedical Sciences assembled in the courtyard of Capital University in Beijing to meet our tai chi instructor for our first lesson. As a participant in UB's three-week Family Medicine rotation in China, I had not expected daily tai chi lessons to be part of the program. To be honest, I had very little knowledge of China prior to participating in this rotation, so I really didn't know what to expect. What I soon realized was that! had been given a remarkable opportunity not only to learn about medicine in China, but also to witness, firsthand, some of the changes the country is experiencing politically, technologically and economically. Beijing, a City of Contrasts Over the course of the rotation, the students and teachers at Capital University of Medical Sciences became wonderful friends to us, and our conversations with them gave us unique insights into Chinese life and culture. The medical studen ts told us about political changes occurring in China and spoke with great excitement about the local elections taking place for the first time. Even though many students we met said they were eager for greater freedoms in China, including greater economic freedom , all but a few were planning to apply for Communist Party 0 membership in order to secure jobs in well-respected hospitals. Without party membership, we were told, a young physician was sure to be sent to a remote rural province after graduation. Many of these young men and women also told us they are in favor of the one-child law as an essential element for China's future success. The economic and technological transitions were apparent in the construction of new apartment buildings to provide better housing for the 11.2 million people who live in Beijing. While shiny skyscrapers funded by rich companies based in Hong Kong were sprouting up, Chinese street workers continued to dig sewer lines and build new roads using hand shovels and pure manpower. We visited several new department stores very much like those in the U.S., but only one of them accepted MasterCard or Visa. BMWs shared the crowded roads with oxen-drawn carts and men riding large tricycles laden with pineapples. During our rotation, we stayed in comfortable hotel-like accommodations on the university grounds, but discovered that young teachers at the university live in small university-owned apartments that have no running water. Beijing is a city of technological contrasts. Modem Tools and Modest Facilities Changes in the economy and advances in technology have influenced the practice of medicine in Beijing. We visited many teachB u f f a l o Phy sician A utumn 1 9 9 8 �ing hospitals in Beijing offering the best tertiary care available in the country. ew technology is a priority for the doctors, but many of the buildings and their grounds are poorly maintained; for example, one day we saw a patient on a stretcher being rolled through rubble to get to a brand-new MRl machine. Although some buildings were modern , most appeared to be very old. ln one hospital, paint was peeling from the walls in a room where we examined patients who were recovering well from kidney transplants. Also, the telephone systems were not elaborate in any of the hospitals we visited. In one facility, we noted that when a surgeon wanted to get results from the pathology lab, he or she would simply walk over to the lab and talk with the staff. Communication, we learned, was often delayed. Case Presentations and Hands-On Learning Attending physicians and residents who spoke near-perfect English escorted us on tours through their wards, stopping at the bedsides of their most interesting patients to give case presentations and teach physical examination. As the weeks passed, we had CLASS OF 1998, DURING an increasing number of ROTATION IN CHINA . excellent hands-on experiences. For example, LEFT: HERBAL we heard the murmur of a mild tetralogy of PRESCRIPTIONS BEING Fallot in a nine-yearPREPARED IN TRADITIONAL old boy. We palpated metastatic cancer in the CHINESE PHARMACY. nodes of a cheerful elderly man who had learned laryngeal speech after his tracheotomy but who had never been told he had cancer. We also saw the butterfly rash on the face of a beautiful 12-year-old girl with Lupus, observed a retinal detachment for the first time, and palpated large spleens. lt was thrilling to have the opportunity to feel with my own hands or hear with my own ears physical findings l had never experienced before as a medical student. After the instruction ABOVE: JANE DOPKINS . ""' z " X u . " 0 < u ~ 0 X ~ �L received in Beijing, l feel much more confident in my examination of the heart and abdomen. We also toured operating rooms where barefooted surgeons routinely perform delicate eye and open-heart surgeries, or relieve bowel obstructions. A world-famous cardiologist showed us his state-of-the art cardiac care unit while lamenting the incredibly high rate of untreated hypertension in China. In talking with obs tetricians, we learned that the cesarean section rate is much higher for boys than for girls, and that infanticide of female babies is uncommon in Beijing. After completing a case presentation and an examination of a patient, we often gathered in a conference room to discuss the case and exchange information. Sometimes the Chinese doctors taught us about a case they were particularly proud of managing; at other times, they asked us for our expertise. Usually the learning was mutual, and we finished our days with a sense that we had exchanged medical knowledge as well as shared our unique cultural perspectives. J Learning about Traditional Chinese Medicine In the U.S., allopathic doctors know very little about herbal medicine , and most herbal preparations are sold as food supplements with very little regulation YANG GUANG DEMONSTRATES or knowledge of their HOW MOXIBUSTION SUCTION , use . In China, the use of herbs in Traditional CREATED WHEN FIRE UNDER Chinese Medicine THE GLASS BALL BURNS OFF (TCM) dates back many millennia. OXYGEN , IS USED FOR During our visit, TREATMENT OF PAIN . we had glimpses of TCM being practiced RIGHT: WILLIAM J . MEDWID , as adjunctive therapy CLASS OF 1996 , PERFORMS to allopathic treatments and were able PERCUSSION EXAM . to observe how herbal prescriptions are used to counteract the side effects of immunosuppressants in transplant patients. At a well-run psychiatric hospital, we learned that TCM is used with great efficacy in preventing the movement disorders produced by antipsychotic medication. Also, at the Children's Hospital we saw the TCM pharmacist mix a treatment for the common cold. One day was entirely devoted to visiting aT raditional Chinese Medicine hospital where TCM is the first-line treatment and 0 B u f f a l o allopathic medicine is used to assist treatment. While we were there, our hosts demonstrated acupuncture on a man with Bell's palsy and on a child with an Erb's palsy. Also, a Traditional Chinese Medicine doctor demonstrated his special method for palpation of the pulse and examination of the tongue. He examined a woman with all the signs and symptoms of hyperthyroidism , and demonstrated that after two weeks of herbal medicine her pulse had fallen from 120 to 85. The patient told us she felt much less anxious and her heart seemed less jumpy. One of the most successful wards in the Traditional Chinese Medicine hospital is the vascular ward, where physicians use salves and systemic medicine to heal diabetic foot ulcers with incredible limb-sparing success. We were awed and amazed by it all. Phys ician A utumn 1 9 9 8 �-- -- - - - Reflecting on Similarities and Differences ln the U.S. , we worry about the politics and controversy surrounding managed-care reimbursement and Medicaid. To our surprise, we found that similar medical coverage problems exist in China. For example, we were told that a person employed by a large company typically has medical coverage, but others pay out of pocket for their care. The friendships l made with our Chinese hosts were one of We also learned that medical care in the country prov- the most meaningful aspects of my experience in Beijing. The inces is difficult to obtain and of very poor quality; often president of Capital University of Medical Sciences, Mr. Shu, patients have advanced disease by the time they are re- hosted us at a welcome banquet and then at a farewell dinner. ferred to the large hospitals in Beijing for treatment. The He was well spoken, entertaining and easy to talk to. We got to philosophy of care for the terminally ill is quite different in know several of the medical students during evening parties China . Few heroics are employed for a terminally ill they arranged for us. On one occasion, the UB physicians patient, and special hospitals, perhaps a bit like Hospice, teamed up against the Chinese medical students in a basketball provide assistance for the dying and their families. game in the center of the university compound. Also , despite At the end of each day spent in the hospitals, we were the unexpected novelty of our first lesson , we enjoyed getting exhausted, both emotionally and physically. Most of the time to know our tai chi instructor during our daily lessons, and we we were impressed with how well patients were cared for , but developed a true fondness for the man who drove our bus to there were a few times when we felt patients were not being the hospitals. treated appropriately. Although we were amazed with the Dai, a 26-year-old science instructor and graduate student modern intensive care units and the great strides being made at the university, served as our facilitator for all our hospital in cardiology, the realities of an overpopulated country with trips and, quite naturally, became our friend. She was eager to very limited resources often weighed heavily on our minds as learn about our life in the U .5. and was willing to tell us of her we rode in our minibus through the crowded streets ofBeijing experiences growing up in China. As we became better back to our luxurious hotel for dinner. acquainted , she told us about her dream of coming to study Over wonderful meals , we had the opportunity to discuss in the U.S. but also helped us understand why she was very among ourselves the many things we had seen and done fond of her life in China. Dai not only talked to us about her life, but shared it with during the day. Because our group of six consisted of two us, as well. She showed us her apartment, took us to the open students, one nurse and three physicians, we often had a great deal to teach each other. We became good friends , shared the Chinese markets and introduced us to her friends. l was very fun of exploring the city of Beijing and helped each other sad to say good-bye to her at the end of our three weeks, but we are keeping in touch through letters. through moments of homesickness. New Sights, Learning and Maturing Our three weeks in Beijing were not spent entirely in hospitals. Our itinerary included several days of structured excursions to such places as the Great Wall and the Summer Palace, as well as a few afternoons of free time for shopping or relaxing. We saw the old-style Beijing Zoo on a Saturday morning, when it was filled with children eager to see the pandas. We spent several evenings getting to know the city of Beijing by hailing a tiny taxi, pointing to where we wanted to go on a map , and then praying the taxi driver would take us where we had asked. As we drove through the city, we saw evidence of the fact that nightclubs and bars are becoming more popular now that there is a little more freedom in China. One evening, we visited Tianamann Square, which was even more impressive by night than during the day. On one of the last days of our visit to China, l sat with two other members of our group, Pam Warner and Carol Chen, in one of the university-run restaurants , eating a delicious dumpling soup that had been boiled over a coal fire. We reflected on all that we had learned of Chinese culture, medicine and human nature. lt had been an exhausting three weeks, with moments of joy and excitement mixed at times with confusion and questioning when we felt that our fundamental values had been profoundly challenged by the way things are done in China compared to the U.S. Each of us learned different lessons and matured in different ways. The three weeks I spent on this rotation in China were thought provoking and mind broadening and were, without a doubt, the most valuable experience of my medical education. + in Different Ways Sounds and Friends B u f f a L a Physician A . u t u m n 1 9 9 8 0 �............................................... .. .... . .. .. . .......... ............. . ... ................. EUGENE M . FARBER , DERMATOLOGY PIONEER , RECEIVES UB ALUMNI AWARD . . . . . .. .. . .. . . . . . . . . . OR EL c,F F M. FARBI R, medicine was more than a calling; it was a fait accompli. By the time he entered medical school at the University at Buffalo in 1939, three of his older brothers-Sidney, Seymour and jason-had preceded him in choosing medicine as a profession and were embarking on careers that, collectively, would make the Farber name one of BY 5 . A . UNGER the more well known in science in the latter half of the 20th century. "I was preconditioned to choosing medicine as a career. Because of my brothers, I was surrounded by medical books at an early age, and I never thought of doing anything else," says Farber, who returned to Buffalo this spring to be honored at the VB Alumni Association's annual awards dinner. . ........ ..... . . .. . .......... ....... . . ........ .......... .... .. .. ........ .. ........... .. ... . . ........ ..... 0 Buffalo Phys ici an Autumn l 9 9 8 �In 1959. when Stanford•s medical school a leader in research to promote lthough he followed of the etiology and understanding in his brothers' foottreatment of psoriasis. steps, Farber was moved to Palo Alto, quick to discover his own path, The Support of choosing in 1946 to pursue what a Close-Knit Family was then an unexplored area of Born the 11th of 14 children, six medicine: diseases of the skin. of whom graduated from the UniThe research contributions he at Buffalo, Farber says versity made over the next four .. . was selected as the first that despite the size of his famdecades-especially with regard chair of lhe school's newly ily, there was always time for to psoriasis-gave significant books and learning-pursuits impetus to the development of formed Department of that were cultivated by his pardermatology as a medical speDermatology. a position ents, Simon and Matilda Farber. cialty. As a professor and chair of "My father came to Buffalo from the Department of Dermatology h e held until 1986. when he was 17. The first Austria at Stanford University's School job he took was as a stevedore on of Medicine from 1959 to 1986, he further contributed to his field as an academic clinician a barge on the Erie Canal, and from that start he went on to build a very successful insurance business," says Farber. and teacher. Today, Farber is president and chief execuDespite the press of maintaining a growing business and tive officer of the Psoriasis Research Institute (which he cofounded in 1986) in Palo Alto, CA, and continues to be raising a large family, both parents spent every spare Farber ••••••••••••••••••••••• e u f f a 1 o • •••• Phys 0 •••••••• ici • 0 an ••••••••••• • •• ••••••• Autumn ••• 1 9 • ••••••••• 9 8 ••••••• • • •••••• ••••••••••• 0 ••• 0 �....................................................................................................... A Path through an Unexplored Field ........ . ........ . ........................................ moment they had reading, so a love of learning came naturally to Farber and his siblings. "My mother was amazing. She had so much work to do all the time around the house, but at night she never rested without her book, and my father read whenever he could, too. Our house was full of books-well over a thousand, I'm sure. There was no TV, so on cold winter nights in Buffalo, there was great pleasure in getting into bed and reading and talking about books, which we would hand down and recommend to each other." sa young teen, Farber was nurtured and strongly influenced by his older brothers d their love of medicine. With their help, he was able to observe operations and tag along on hospital rounds while they were interns. "They liked what they were doing o much and were doing so well, it just seemed natural for me to do it, too. I never thought otherwise," he says. Passing On the Knowledge, One to Another In 1935, Farber departed for Oberlin College in Ohio, where he earned an A.B. degree in premed studies, after which he returned to Buffalo to enter UB's medical . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . school. Several of his brothers had attended Harvard, but Farber decided to return home. "UB was one of the best medical schools in the country, even then, " he says, adding that he has never regretted his decision, as there were a number of professors at the school who not only greatly influenced him as a medical student, but who served as models he would strive to emulate over the course of his career. "Guy Youngburg [then professor and head of the Department of Biological Chemistry] was very inspiring because he gave more than didactic lectures," he recalls. "He was innovative in his teaching and taught by posing problems instead of presenting repetitious lectures from one year to the next. He encouraged me to think of research in relationship to disease. " In his preclinical years, Farber says Oliver P. jones was his very memorable professor of anatomy. "He was a kick. He was an old shoe with the students, who, as a group, were then as they are today-very insecure, very tense and overtired. And 1939 was a desolate year to enter medical school because it was such a stressful time financially; but 0. P. jones had a way with the students that eased some of their burden . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . a u f f a 1 a Physician Autumn 1 9 9 8 �"Then there was Earnest Witebsky," he continues, the Compassion respect he had for his professor of immunology still and Commitment evident in his voice. "He was a German-jewish refugee While Professor Osborne may have strongly influenced Farber to consider choosing dermatology as an area of who spoke with a slight accent. He had piercing blue eyes and a kindly way. He's renowned for isolating the Bstudy to focus on in his career, the final push came from antigen found in human blood, his older brother Sidney. Already which made blood transfusions a distinguished pathologist well safer. It was a big lift for the on his way toward making dishis war effort. And what was so coveries in cancer chemotherapy unusual-especially today-was that would result in the Dana preclinical that even though he was a proFarber Cancer Institute in Bosfessor and head of a whole imton being named in his honor, years. Farber says Sidney had words of advice and munology program, he was in encouragement for Eugene once the lab walking around from stuhe had graduated from medical dent to student three afternoons school and was in training, casta week from l p.m. to 5 p.m. " ................... ing about for a direction to take. Another UB professor Farber "Sidney said to me, 'Why don't recalls as clearly as if it were you go into dermatology-there's yesterday is Abraham Aaron, his so much to learn, so much to do; professor of clinical medicine, it's a field that hasn ' t been who "was feared and respected. was his very memorable explored yet. All medical research He asked tough questions at the professor of anatomy. has largely been done on the bedside, and one of his adages ••He was a kick. He was heart, lungs and kidneys, but the that l remember to this day was an old shoe with the skin has been mostly ignored. 'Use a peashooter instead of a students. who. as a There's an opportunity for somecannon with respect to drug group. were then as one with a scientific bent to make therapy. ' In other words, start a contribution."' they are today-very cautiously." With a chuckle, With those words, Farber and Farber adds, "I used that same insecure. very tense and his wife of two years, Ruth Seiffert, quotation with my students for overtired.•• were soon on their way to Minne35 years, and l imagine some of sota. "I was an assistant resident them who are now professors are in medicine at Buffalo General at repeating it." the time and was to be chief medical resident, but I made The UB professor who inOuenced Farber the most is the decision to leave for the Mayo Clinic and to move clearly Earl D. Osborne, who was head of the Departahead with dermatology. " ment of Dermatology and Syphilology. "He was voted While at the Mayo Clinic, the best teacher of the year for Farber pursued his scholastic 30 consecutive years; he was interests, earning a master of scidynamic and exciting," he reence degree at the University of calls with an enthusiasm that Minnesota in 1946. He completed hasn't dampened over the years. a thesis on the blood vessels in "Osborne had received his trainthe skin of the essential hypering in dermatology at the Mayo tensive and immediately made a Clinic, and he inOuenced me to contribution to his newly chosen choose dermatology because I field by being the first to describe was so impressed with how he what is now known as hypertencorrelated clinical changes with sive ischemic leg ulcer. biochemical and immunologiThe four years Farber spent at cal events. That type of apthe Mayo Clinic not only conproach to the largest organ of firmed his desire to pursue academic medicine, but also the body had a great deal of appeal to me." provided him with an opportunity to gain insight into the Pausing, Farber observes, "Teachers, you know, can lives of the patients whose suffering he hoped to someday have a tremendous influence on three or four generations alleviate through his research. by virtue of passing on their knowledge, one to another." In Oliver P. Jones B u f f a l o Physician Autumn 1 9 9 8 �••••••••••••••••••••••• 0 •• •••••••••••• • •• •• •••• ••• •••••••••••••••• 0 ••••••••••••••••••••• 0 ••• 0 •••••••••• A Path through an Unexplored Field ..................... "The Mayo Clinic was the only center in the world found that Stanford Medical School, which at the time where they had a program for the treatment for psoriasis; was in San Francisco, would provide me with a small they called it the Goeckerman treatment. This involved lab for dermatopathology research." covering the patients with black tar from head to foot and So, in 1950, he headed West, with the promise of a keeping them in the hospital for a month, giving them lab , a salary of $2,400 a year and an annual research ultraviolet light every day and special baths. This caused budget totaling $50. " obody had any money in those the disease to go into remission for six months to a year, days , including the schools; you had to get your own," but then it would come back. l was on the hospital service he explains. where we had 30 to 40 psoriatic patients who were But moving west of the Mississippi had its benefits, as suffering terribly-they were at the 'bottom of the barrel' he would soon find out. The post-World War II economy as far as their advanced disease was concerned. When I was picking up steam and the ational Institutes of had that experience of taking care of all those patients who Health ( lH) began to have dollars available to funnel were suffering so badly, I figured this is what I'm going to into dermatology research . "There was no research being do with my research , and that's why I chose to concentrate done in dermatology in the Western United tates," on psoriasis. " he recalls, "so a representative Farber says that while working from the IH came out and with the patients during this time, offered me an opportunity to have mindhe also gained a deep appreciaa very large grant for research in tion for the psychological impact skin dermatology, if we could provide of dermatologic disease. "Visible the labs. " As a result, several thoudisease is the cause of great sufferrelationship is very sand square feet oflab space were ing, and diseases of the skin built and "from then on, we were require great compassion and funded generously, not only by attention to the psyche because of the IH , but by foundations and the mind-skin relationship. The other sources." mind-skin relationship is very ln 1959, when Stanford's medistrong, and the morbidity of most and the morbidity of cal school moved to Palo Alto, skin disease is accentuated when Farber-who had been serving as most skin diseases is acthere is distress-and I say a clinical professor and director of distress , not stress. That is what centuated when there is dermatology since 1950-was the patients experience." selected as the first chair of the Fortunately, Farber was able to school's newly formed Department play a role in mitigating the sufferof Dermatology, a position he ing of patients sooner rather than held until1986. Under his leaderlater. While at Mayo, he had the ship, the department grew to -and I say distress. not opportunity to work with his chief, include 11 full-time faculty memDr. Paul O'Leary, to test the effistress. That is what the bers and achieved international cacy of the first antihistaminerecognition for its research and patients experience. •• Benadryl-for which Parke-Davis innovative treatment. had just received the rights folDuring his long career, Farber lowing its synthesis in Paris. O'Leary and Farber evaluated has published more than 250 papers, the majority of which the compound in acute and chronic urticaria and published focus on elucidating the natural history of psoriasis and the first paper reporting the clinical application of the defining the pathogenesis of the disease. While he was at antihistamine. "It's been a popular treatment for hives ever Stanford, the Department of Dermatology sponsored four since," Farber says. international conferences on psoriasis, each of which attracted 300 to 500 dermatologists and basic Research Opportunities "Out West" scientists from around the world. Also, in 1967, as chair of Once his studies at the Mayo Clinic were completed, the Task Force on Psoriasis for the Academy of DermatolFarber set his sights on winning an academic job in ogy, Farber and his fellow task force members helped dermatology. "I was looking for an opportunity to do standardize treatment of the disease by fulfilling their scholarly work, but there wasn't anything. Finally, I charge to evaluate a wide range of treatment modalities in The strong. distress • • ••••• •••••••••• •••••••••••••••••••••••• B u f f 0 a •••••••••••••••••••••••••• I a 0 ••••••••••••••••••••••••••••••• Physician A. u t u m n 1 9 9 8 �use at the time and to establish criteria for the indications for the different therapies. During his busy and productive years at Stanford, Farber also found time to teach, training over 180 residents and taking pride in the fact that, despite dermatology being an elective, 90 percent of all students signed up to take the class "because we made it interesting and they were able to have a close personal relationship with our faculty," he says. ln looking back on his role as teacher, he acknowledges his good fortune to be in academic medicine at a time when teaching medical students wasn't circumscribed by economic forces like those at work in today's health-care market. "We didn't have any of the pressures on us then that managed care imposes today on faculty , who must see more and more patients, which means they have less and less time for teaching residents and students," he says. "And teaching in medical schools all over the country is suffering because of this. " When he left Stanford in 1986, Farber moved across the street from the school and opened the nonprofit Psoriasis INFINITI Research Institute. Today he maintains a strong interest in ongoing research at the institute, including a large-scale study under way to find the gene(s) that predispose individuals to psoriasis. ever one to retire, he continues to see patients two halfdays a week because, he says, "I still enjoy helping people. " He also enjoys spending time with his grandchildren and following the careers of his three children, Charlotte, an attorney; ancy, a hospital CEO; and Donald, a financial consultant. When he learned that he had been invited to return to UB this spring to be recognized by the university's Alumni Association , Farber says he was "honored and absolutely delighted ," but in recalling his feelings, he is quick to add that this is an honor he cannot accept just for himself: "I have five siblings who graduated from UB. l'm very happy with this honor because I'm thinking of this not so much for me, but for them, as well. I only wish they could have been here to share in this, because they certainly deserved it far more than l." + I ntroducing your way to escape. lnfiniti's luxury sport AUTO PLACE INFINITI Unlike most luxury sport 8129 MAIN ST. , WILLIAMSVILLE escape for the weekend, it has all the comforts and luxuries you East of Transit Rd., Near Eastern Hi lls Mall u f f 0 l 0 MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 8 utility vehicle: the QX4. need to escape life's daily stresses. Physician Autumn l 9 QX4 9 8 ��DNG ~OUT THE SSTRENGTHSS OF CHDLDRIEN Luther Knox Robinson'swork to prevent birth defects BY JESSICA ANCKER HEK LUTHER ROBI SO , MD, traveled to South Africa last year to study fetal alcohol syndrome (FAS), he heard local people -.-...-... using the word Ubuntu. They told him it meant "I am because we are," a powerful expression of the vital importance of the community to the individual, and of the individual to the community. The word stuck in his mind because it perfectly conveyed a philosophy that he had long admired. "Each of us has a role to play in meeting societal challenges," explains the associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences. "Each of us is successful if the entire group is successful." Buffalo Physician Autumn I 9 9 8 �obinson, who specializes in clinical services for and research on birth defects, !!opes to draw upon the philosophy expressed b) ubwzlu to lower the incidence of preventable birth defects like fetal alcoholS) ndrome. In his view, F AS is not merely a medical condition; it's a sign of trouble at the heart of a community. "FAS calls attention to the real challenges \\e have relative to women's health, and indeed to men's health," Robinson says. "An entire famil) is affected by alcohol abuse. We need to learn ho\\ to strengthen women who are involved in substance abuse, and how to help men to resist substance abuse or rehabilitate themselves." Public education is one of the most important ways to fight preventable birth defects. "One cannot guarantee a perfeel baby, but a beller-informed public can make the types of choices that improve outcomes," he says. "We know that folic acid is a means oflowering the risk of spina bifida, and that avoiding alcohol in pregnancy is a means of preventing FAS. These are public information issues. " But with alcohol, education is not always enough. Society must find ways to prevent and reduce adolescent entry into alcohol use and binge drinking, as research has demonstrated that they are or will be at high risk for alcohol abuse. Resources are needed to provide early intervention counseling, spiritual support or community safe havens to reduce environmental risk factors. "We've known about the dangers of alcohol to the developing fetus for 20 or 30 years now, but the problem of alcohol abuse is so insidious that it's hard to reach the people who are involved," he says. "just telling them something is not going to get them to stop drinking. That's part of the challenge we have to meet in our civic lives. " Robinson tries to put his ideas into practice not only through teaching, but also through community leadership and involvement in local birth-defect infor- ® mation and monitoring projects. "I am a believer that one's intellectual work is enhanced if one can make a link with one's community. ''I'm not unique in that, in any way," he is quick to add. "Most of us at UB feel that way. " native of Ohio, Robinson attended Oberlin College and .._..o;;...,......-...- earned his medical degree from the University of Cincinnati College of Medicine in 1974, after which he completed a residency in pediatrics at the University of California/San Diego (UCSD) Medical Center. It was at UCSD that Robinson met the physician and scientist who would set the course of his future career. Kenneth Lyons jones , MD , professor of pediatrics and dysmorphology, is one of the first researchers to have identified and described fetal alcohol syndrome. jones's 1973 paper in the Lancet, "Recognition of the Fetal Alcohol Syndrome in Early Infancy," described a cohort of high-risk children in Seaule and confirmed long-standing suspicions that alcohol consumed during pregnancy could cause serious problems, including growth retardation and mental deficiencies. (A French physician had published similar findings a short time earlier, but because his paper was not in English, it hadn't been noticed by the worldwide medical community.) Robinson worked with jones for two years as a postdoctoral fellow in dysmorphology. ln addition to learning about and extending the research on FAS , he also studied birth defects linked to genetic factors , nutrition, and chemicals or medications. Following this experience, he returned to general pediatrics during a stint as a general medical officer with the U.S. Public Health Service, and then served as- an associate professor of pediatrics at the University of Texas Medical School in Houston before joining the UB faculty and Children's Hospital of Buffalo in 1987. Robinson , who is board certified in both pediatrics and medical genetics, is director of clinical genetics at Children's Hospital and serves as part of the teamteaching faculty for the first-year genetics course at UB. He also supervises residents and fourth-year medical students doing rotations in the field of genetics and dysmorphology. South African child with fetal alcohol syndrome. Her country has the highest incidence of FAS in the world, according to a NIAAA study. �IfF AS is a tragedy, Robinson is a at least public educahighly regarded tion and other social teacher who has and medical methods earned awards for offer some hope of preteaching both basic venting it. With many science and clinical of the other types of subjects at his birth defects that academic posts in Robinson studies, the Houston and at UB. In path to prevention is 1995, he was given the still uncharted. johnS. ParoskiAward Yet Robinson says for Outstanding Athe does not find his tending Physician work disheartening. Teacher at Children's Luther Robinson, MD, oHrocts o crowd of children during his visit too village ou~ide Cope Town, South Africa. First, he says, there is Hospital. He is a regular attending physician Infant Home in the form of the Father the intellectual challenge of trying to at the Buffalo Institute of Fetal Baker Service to Youth Award in 1991. understand what has happened, a challenge that may someday lead to a cure or Therapy, the Children's Hospitalobinson's expertise in FAS method of prevention. based clinic that specializes in detecearned him a place in the For example, Robinson has been able tion and treatment (where possible) ational Institute on Alcohol show that facial asymmetry in infants to of birth defects in utero. At the instiAbuse and Alcoholism ( IAAA) delis linked to poor facial blood flow durtute, Robinson supervises collection egation that made two trips to South ing development. While it's not yet clear of data for a new birth-defect registry being created in collaboration with Africa last year. The joint South African how to prevent the problem, the finding the federal Centers for Disease Con- and American team was studying a re- suggests further areas of research and trol and Prevention and the ew York gion settled by French wine makers implicates drugs that are known to cause who for the past 200 years have partici- vascular spasms, such as cocaine, toState Department of Health. Robinson also serves as medical pated in the "DOP" system, which pays bacco and nicotine. Robinson also finds director of the Western ew York Tera- their African and "colored" or mixed- satisfaction and inspiration in working tology Information Service, an organi- race workers with both money and alco- with children. "l am impressed time and again with zation he helped found with his wife , hol. The DOP system gives workers wine jan, a nurse who has long-standing in- two to three times a day, five to seven the strength of children and their famiterests in public health, the prevention days a week, from age 14. This practice lies," he marvels. "They sort of develop of birth defects and service to the minor- has resulted in the highest incidence of their own realities in the way they deal ity community. The information service F AS known in the world today, a finding with disability. " Recently, he saw a former patient, a answers the questions of pregnant confirmed by the preliminary results of boy born with limb deficiencies, playing women who suspect they might have the IAAA's study. While in South Africa with the hockey. Some of his other patients, been exposed to a possible teratogen, provides examinations for their babies delegation, Dr. Robinson examined women who went through high-risk pregchildren from the farm communities nancies as teenagers, are pulling their and collects data. The Robinsons founded a similar outside of Cape Town and trained local lives together, caring for their children, information service in Texas during pediatricians on how to use specific working, or returning to school. "My work is personally rewarding and their time in Houston. Both organiza- measurements to identify FAS. "In South of materAfrica, we find the same types intellectually stimulating," Robinson tions are modeled after a California service established by Kenneth Lyons nal risk factors we find anywhere- says. "I often say children don't outgrow jones. The Robinsons' work with the poverty, undereducation, social and their conditions-they outgrow their peWestern New York Teratology Infor- medical problems," he says. "The result diatricians. I look forward to that. I look mation Service won them recognition is that it is the people with the least forward to working with a second generation of children." + from Buffalo's Our Lady of Victory resources who are most affected." �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . [1] ~ I Biogen Endows Chair in Neurology at UB LAWRENCE D . JACOBS , MD , PROFESSOR OF NEUROLOGY , TO BE FIRST HOLDER biotechnology company headquartered in Cambridge, Massachusetts, has established the Irvin and Rosemary Smith Chair in Neurology in the University at Buffalo School of Medicine and Biomedical Sciences through an endowment of 1.5 million. IOC.I \ L r \DI ' G I TER 1 -\TIO 1 A. I The sponsorship of the endowed chair-which is in conjunction with Biogen 's 20th anniversary celebrationwas announced by UB president William R. Greiner at a pres conference at the university in june. Lawrence D. jacobs, MD, UB professor of neurology and an internationally recognized authority on the treatment of multiple sclerosis (MS), will be the first holder of the chair (see article number of MS-related brain lesions and the number of clinical flare-ups. The drug , known by the brand name Avonex®, wa approved by the FDA in 1996 and is now the world's leading treatment for patients with relapsing forms of the disease. In announcing the endowment, Greiner said, "It is especially gratifying to have the breakthrough work of one of our most distinguished faculty memopposite). bers, Dr. Larry jacobs, lead to the Currently, MS affects 250,000 to creation of a chair in neurology that 300,000 people in the U.S., with 200 recognizes and supports his work and new patients diagnosed every week. For provides UB with a permanent legacy. reasons that are not fully understood, "Larry's path breaking research, teachpeople who live between the 38th and ing, service and leadership have elevated 52nd northern latitudes on the globe- significantly the national and internaWestern ew York is located at about tional reputation of our Department of the 43rd northern latitude-a re eurology and the UB medical school. particularly susceptible. We are very grateful to jacob was the first Biogen for recognizing researcher to show that Larry's work through this interferon beta was an generous gift to UB." effective treatment in some james L. Vincent, forms of the disease. Over Biogen's chair of the board, the past two decades, his said, "Biogen is proud to pioneering work has been supported by endow thi chair, which honors three private foundations and the ational individuals who repre ent the fine t Institutes of Health, with funding for ideals of science. l have been closely clinical trials provided by Biogen. associated with lrv and Rosemary mith Ultimately, jacob's research showed for more than 30 years. They demonthat Biogen's genetically engineered strate the highest standards of courage, interferon beta-la slowed the accumu- ethical behavior and integrity-values lation of physical disability in MS pa- that are fundamental to Biogen's corpotients, making it the first treatment ever rate philosophy. to exert such a benefit for this disease. In "We are delighted that Dr. Larry addition, the treatment reduced the jacobs is the first person to hold this B u f f a I o chair," Vincent added. "His belief in the potential of interferon beta-la as a treatment for multiple sclerosis was vital to the successful development of Avonex®, which has brought new hope toMS patients throughout the world." jacobs said he was "very honored" to be selected to hold the new Irvin and Rosemary Smith Chair in eurology. "The endowment demonstrates Biogen's commitment to the work we are doing here, and it's coming at an age when I still have plenty of time left to continue that work. "But the chair isn't forme," he added. "It's for progres in treating patients with multiple sclerosis. It will allow us to do so much, and it will ensure that the work can continue uninterrupted. " john R. Wright, MD, interim dean of the UB medical school, thanked Biogen for its generosity in endowing the chair and termed jacobs' appointment as its first holder "a well-deserved honor. ' ' T h e medical school is proud and pleased that Biogen has chosen to recognize an individual who has contributed so much to the field of neurology and to the community. Dr. jacobs has spent more than 20 years helping people who are living with this debilitating disease. His work is a great credit to himself, the UB medical school and all of the people and organizations who have believed in him and supported his research." Physician Autumn 1 9 9 8 �owrence D. Jacobs, MD, credits his involvement with the treatment and prevention of multiple sclerosis-the interest that has become his life's work-to serendipity. Anative of Buffalo, Jacobs graduated from Niagara University and earned his medical degree from St. louis University. In 1973, he joined the University at Buffalo faculty as a clinical assistant professor of neurology. Through on early affiliation with Roswell Pork Cancer Institute, where he worked as a consultant, Jacobs developed a professional relationship with Arnold Freemon, MD, and several other scientists who were conducting innovative clinical trials of interferon as a possible cancer treatment. It was Freemon who initially urged Jacobs to begin working with natural interferon, suggesting that he test it to determine its antiviral and immune-modifying properties in appropriate neurologic patients. In response to this suggestion, Jacobs decided to concentrate his interferon research on multiple sclerosis. "We asked ourselves, What ore the neurologic diseases of viral and dysimmune etiologies that might be appropriate for trials of interferon therapy?" Jacobs explains. "We first considered lou Gehrig'sdisease, but ultimately we decided on MS because Buffalo happens to be in a geographic region where MS occurs with high frequency and there were so many patients in Western New York with MS. It was just luck. As it turned out, interferon beto was not effective in treating lou Gehrig's disease, but it was effective in MS." Supported by local funding from the Baird Foundation, Delaware North and UB, Jacobs began his research. His early results, published in Science in 1981 , reported that interferon injected into the spinal fluid appeared to stop or reduce MS flare-ups. This led to another, larger multicenter doubleblind study that was supported in port by ogrant from the Notional Institutes of Health (NIH). The positive results of that trial, confirming those of the earlier study, were published in Lancet in 1986. By then Jacobs hod the full attention of the NIH; however, in order to secure funding for on even larger multicenter definitive trial, he knew he hod to show there was o possibility that, in addition to reducing the number of flare-ups, the drug could slow the accumulation of physical disability naturally associated with untreated MS. Jacobs was able to put together o research proposal that satisfied the NIH's stringent requirements regarding disability, and in 1990 he received $4.5 million over four years to conduct a Iorge study of interferon's effectiveness in slowing or reversing the accumulation of physical disability in MS patients. "Biogen then come in to support the Phose Ill trial expenses, as well as the cost of the interferon," Jacobs says. "We developed o wonderful relationship over the years." The company provided substantial monetary support and a supply of genetically engineered interferon called recombinant interferon beta-] o needed to complete the Phose Ill trial. Results of the trial showed that the drug significantly slowed the progression of disability, decreased the relapse rote and reduced the number of MS-reloted brain lesions, compared with the placebo group. Avonex®, Biogen's brand nome for the drug, was approved by the FDA in 1996. Currently, Jacobs is the principal investigator of o$12 million, 50-center study being conducted in the U.S. and Canada on the potential efficacy of the drug in preventing the development of clinical multiple sclerosis in patients who ore at high risk for the disease, such as those with optic neuritis. + -lois Boker ~LVIO.I~ ~~ MD, pioneer in the fight against multiple sderosis In addition to his professorship in neurology , Jacobs holds appointments in the UB Departments of Ophthalmology, Physiology, and Communicative Disorders and Sciences. He is head of neurology at the Buffalo General Hospital and chief of neurology at the William C. Baird Multiple Sclerosis Research Center at Millard Fillmore Hospital. He has won numerous awards and honors for his work, including the Stockton Kimball Award in 1996, and has a lengthy publication record. Irvin Smith, PhD , for whom the chair is named , is a biochemist by trammg whose career in health care and biotechnology spanned nearly 40 years. Prior to his retirement from Biogen in 1996, he served as the company's vice president for development operations and was responsible for managing the Phase Ill trial of Avonex® and for shepherding it through the lengthy FDA approval process. Biogen was established in 1978 by a group of academic researchers, including two obel Prize winners, interested in genetic engineering and its potential to improve health care. Discoveries by Biogen scientists have included the alpha interferon gene and hepati tis B antigens. In addition to Avonex®, the company's discoveries have resulted in the development of Intron® A, a leading treatment for hepatitis Band C and various cancers, and of vaccines for hepatitis B. + B u f f a l a P hysici ' a n A. u t u m n l 9 9 8 �Refiecting on 40 Years of Service CHARLES PAGANELLI, DISTINGUISHED SERVICE PROFESSOR, RETIRES HA.RLES V. P A.GA ELL!, PHD, Distinguished Service Professor, and interim chair of the Department of Physiology since 1991, retired September 1, 1998, after 40 years of service to the University at Buffalo School of Medicine and Biomedical Sciences. "For the past four decades, Charlie has been a consistently productive and extremely dedicated member and leader within this medical school's faculty, " says Interim Dean john R. Wright , MD. "His recent elevation to Distinguished Service Professor rank attests to the many contributions he has made to the university community and to the esteem in which his academic colleagues hold him. As interim chair of the Department of Physiology, and the newly created/merged Department of Physiology and Biophysics since 1997, Charlie has demonstrated extraordinary leadership, patience and vision-qualities we will surely miss as he enters retirement. " leon Farhi, MD, Distinguished Professor of Physiology and Biophysics, says, "Dr. Paganelli's retirement is a great loss for the university. He has been a most faithful servant, and his recently being named a Distinguished Service Professor was longdeserved recognition of his many superb qualities. " Paganelli came to UB in 1958 after completing his PhD in physiology at Harvard University and a two-year postdoctoral fellowship sponsored by the ational Foundation for Infantile Paralysis at the University of Copenhagen in Denmark. In the late 1950s, Hermann Rahn (chair of physiology at UB from 1956 to 1972) was in the process of building a department that was to become internationally recognized for its researchand teaching excellence. Toward this end, he knew he needed to recruit promising young faculty and so contacted friends and colleagues at Harvard and the University of Pennsylvania, including A. K. Solomon, john Pappenheimer and Robert Forster, each of whom recommended Paganelli. Rahn then wrote to Paganelli, offering him a job at the then University of Buffalo. a u f f a 1 o "My wife and I and our two young children were living in Denmark at the time, and l accepted the job sight unseen ," recalls Paganelli, who adds that he had other interesting offers but wanted to return home to ew York. A native of Brooklyn , Paganelli had moved with his family to Albion , Y, when he was 12. In 1958 his parents were still living there , which was one of the factors that turned the tide in his decision to come to UB. The other was his opportunity to join Hermann Rahn in a new and developing department. As a student and fellow , Paganelli had focused his research on examining the permeability properties of red blood cell membranes. "When I got to UB , my research interests shifted somewhat, and I became interested in transport in epithelial cells; for example, in the kidney and in amphibian skin," he says. Later, Rahn interested Paganelli in studying the permeability properties of avian eggshells, which then became his primary focus of research throughout the remainder of his career. This research, much of which was funded by the National Institutes of Health and the ational Science Foundation, provided a model for studying how gases are exchanged by diffusion in the lung. Paganelli credits Rahn with creating a work environment in the Department of Physiology that was conducive to creativity, collegiality and stability-factors, he says, that led him to stay at UB for four decades. "The department Dr. Rahn built here was very lively. It was an interesting Physician Autumn 1 9 9 8 ) �u actually been able to introduce them to something they hadn't thought of before." ln the mid-1960s, Paganelli began his long and notable career of service to the university by participating in a number of medical school committees. By the 1970s he was an active member of several committees for UB's faculty ofhealth sciences, which comprised all five ofUB's medical and health professions schools. Later he began serving on campuswide committees and was a member of the Faculty ) place and he was an extraordinary man. He had a breadth of interests that was remarkable, and because his interests were so broad, he always wanted to share ideas with you. That's how I got involved in research with bird eggs. One day he pulled me aside and said, 'Oh, I have this project l want to talk to you about,' and we went from there. He could get you interested in things." In addition to Rahn, Paganelli speaks fondly of his many colleagues in the department over the years, including Don Rennie, Suk-ki Hong and Leon Farhi. Upon arriving at UB, Paganelli was also given the customary load of teaching responsibilities, something which he says he wasn't quite prepared for at the time. "When l came to UB, I had only done a minimal amount of teaching, so l sort of got thrown into it," he recalls with a smile. Today, with four decades of experience behind him, he says without hesitation that he has very much enjoyed teaching. "What I have liked about it is the idea that you can convey concepts to students and you can see their eyes suddenly open up. It's a very satisfying feeling to think you've 6 u f f a l a Senate , which included a one-year term on the Executive Committee and seven consecutive years on the Budget Committee. He also was a member of the steering committee for the self-study that led to UB's 1982 Middle States accreditation. Paganelli says that perhaps his most memorable campus-wide assignment was his chairing of the President's Review Board on Appointments, Promotions and Tenure (PRB) in the mid1980s. ln a 1997 letter in which he nominated Paganelli to the rank of Distinguished Service Professor, UB president William R. Greiner wrote: Physician Autumn 1 9 9 8 "Service on this board demands an extensive commitment of time, as well as a commitment to the university's highest ideals. One colleague notes that Professor Paganelli was 'an exceedingly effective [PRB] chair who dealt diplomatically but incisively with very sensitive matters."' ln addition to his research, teaching and service responsibilities, Paganelli was also given demanding administrative responsibilities. From 1991 until his retirement, he served as interim chair of physiology, a role he also fulfilled from 1980 to 1982 and again in 1986. He was also associate chair of the department from 1976 to 1980 and again from 1982 to 1991. Paganelli, who is 69, says he and his wife, Barbara, plan to travel in retirement, as well as spend more time with their five children and eight grandchildren. Their eventual plans include living in Italy for an extended period of time and visiting Hawaii to renew friendships they made in 1974 while on sabbatical at the University of Hawaii. When asked what he feels about retiring after 40 years of service to UB, Paganelli says, 'This has been a very good place to work. I've had wonderful colleagues and very good students, and I've been proud to be affiliated with this university. "However, I don't have mixed feelings about retiring," he adds. "It's time." + - 5 . A U N G E R �. . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . [1] ~ I Inaugural White Coat Ceremony CLASS OF 2002 REMINDED THAT THEIR MEDICAL CAREERS HAVE BEGUN swear to fulfill, to the best r recited the Class of 2002 as they began the "Physician's Oath" at the inaugural White Coat Ceremony held in August to welcome the school's newest medical students. tremely competitive academic environments where the element of humanism is often missing, Flanagan adds. p s he expansion of my knowl· edge throughout my life for the benefit of my p The greatest challenge for medical ln the presence of faculty, staff, peers, experienced kidney failure a week bestudents today is that they cannot family and friends, members of the fore finals as a junior at the University of school's l52nd class were "cloaked" with California at los Angeles. anticipate what the their first white coats to mark the begin- He says he was inspired medical field will be like because it is constantly ning of a new UB tradition that empha- to pursue a career in sizes the importance of physicians medicine by the compaschanging and evolving, serving with compassion as well as skill. sion and encouragement according to Flanagan . The Arnold P. Gold Foundation, an shown to him by one of He says that one of the organization dedicated to fostering hu- the doctors during his hospital stay. strengths of this year's manism in medicine , conceptualized the I ri r me e a t e e s o and class is the diversity of their academic ceremony, which reminds new doctors s(e e o die e and cultural backgrounds , which Teaching the more personal, psycho- he feels will contribute in a positive of their responsibility to 'care' as well as 'cure' by endorsing a psychological con- logical aspects of medicine has always way to their ability to adapt to change tract for professionalism and empathy been a challenge for medical educators, and to continue learning throughout at the start of their medical catheir careers. reers. Today, about 85 medical This year UB received " WHEN YOU HAVE THIS COAT ON , WHETHER schools nationwide hold similar 2,500 applications, or about initiation ceremonies for incom19 applicants per slot. YOU ARE A STUDENT OR A PRACTICING ing students. Thomas Guttuso, MD , assisDOCTOR , YOU ARE EXPECTED TO UPHOLD . . . I will respect the scientific gains tant dean and director of CERTAIN IDEALS . THE CEREMONY REMINDED of those physicians and scientists in admissions, says motivation, whose steps Iwallc, and gladly share empathy and social awareness US ALL THAT OUR CAREER STARTS NOW AND such knowledge as is mine with those are the qualities that are most NOT IN FOUR YEARS ." who are to follow ... closely evaluated in the The White Coat Ceremony Class of 2002 applicants. A was an extraordinary way to Guttuso adds that this begin medical school, says firstclass, which has 70 women year student Morcos Morcos. " Reading according to Tom Flanagan, MD , assis- and 65 men , is the first in the school's the oath reminded us that we're not here tant dean for student and curricular history to have a greater number of just to pass a class." Marcos adds that he affairs, who organized the White Coat female students. The students range appreciates the advice he received from Ceremony. "Educators in the medical from age 23 to 35, with the majority a second-year student who told him that field have done a really good job of of the class between 23 and 26 years of it's as important to share knowledge in teaching the technology , science and age. Most students majored in science medical school as it is in medical prac- even the economical aspects of medi- as undergraduates but a substantial4l tice , and who warned him to be wary of cine; teaching the art of medicine , how- students were non-science majors. The overly competitive students. ever, is more difficult. " mean undergraduate grade point Morcos, who recently celebrated his This challenge is compounded by the average of the class is 3.55 overall and th ird anniversary of a kidney transplant, fact that many students come from ex- 3.5 in science courses. a u f f a I a P hysician Autumn 1 9 9 8 �I ----- --- ························································································• · ~ I I ••. I will practice medicine with conscience potential partnership in Georgia at the several times in several ways to accomand d1gn f last minute to pursue her dream of at- modate changes in the medical field, Margaret Paroski, associate profes- tending medical school. explains Flanagan. sor of clinical neurology at UB and the A few years ago Dennis adler, MD, e f my patient featured speaker at the ceremony, told a associate dean of the medical school, the students to be proud of their accomAccording to first-year student requested that a student committee be plishments in making it to medical Antoinette Alonzo, there are very few oc- formed to review several existing verschool, but to be careful not to become cupationswithasmanyrights. "Wehaveto sions of the oath and to decide on their arrogant. "The higher the pedestal you're remember that people are entrusting us. own UB version to reflect the modern on, the harder people try to knock you They are telling us things that they wouldn't world of medicine. The students seoff it," she warned. lected a brief version of an oath by tell anyone else." First-year student Louis Lasagna, MD, Deana Savage felt of Tufts University Paroski's best advice was School of Medicine, to live for today because which was then tomorrow is not promadopted as UB's ised. "Life is today, life "Physician's Oath." is now. Don't feel you ... Most especially I have to wait to start livwill tread with care in matters of life and ing until you have finished medical school," death. If it be merely advised Paroski. "Try to within my abilities to help ease suffering at enjoy these next four the end of a life, may I years and don' t feel face this awesome reguilty if you take time to sponsibility with hudo something you really mility and awareness want to do." of my own frailty ... The mother of a twoyear-old son, Savage can- Peter Ostrow, MD, associate professor of pathology, helps first-year student Jundo Woo of Brooklyn don her white coot. ew student not put life on hold for Steven Weitzman four years. "He is actually going to help Alonzo was in dental school at the Uni- realizes the value of humanism in me," she says about her son. "lf I ever versity of Pennsylvania when she realized medicine after battling lymphoma while think about putting off studying, I will she was trying to make dentistry a substi- pursuing his master's degree in just look at him." tute for her real passion to study medicine. counseling psychology. Throughout Savage, originally from Buffalo, is "It gives me a sense of relief and peace of chemotherapy, Weitzman continued one of 23 UB graduates in this year's mind to be here after having gone through working part-time toward his degree class and proved her loyalty by submit- something that l knew in my heart wasn't and today is in full remission. Although ting only one medical school applica- really for me." he has considered pursuing oncology, tion. "When I read the acceptance letter, For Alonzo , the white coat is a mean- Weitzman thinks he may try child I think everyone in my neighborhood ingful symbol. "When you have this psychiatry since it will not hold such heard me screaming," she laughs. "The coat on, whether you are a student or a personal relevance. practicing doctor, you are expected to excitement still hasn't worn off." The high point of the White Coat Of the 139 new students, four are uphold certain ideals. The ceremony Ceremony for Weitzman, he says, was MD/PhD candidates, three have reminded us all that our career starts when Guttuso read his name and called already earned doctoral degrees and now and not in four years." him 'Dr. ' "It made me feel so privier Ican; for leged to be here." another 14 hold master's degrees in 1e prev I vow always to act to preserve the business administration. finest traditions of my calling and may /long Savage is among those embarking on The ancient Hippocratic Oath no a second career. Previously a resident longer accurately reflects what physi- experience the joy of healing those who podiatrist in Maryland, she gave up a cians do today and has been altered seek my help. + B u f f a l o Physician A. u t u m n 1 9 9 8 �WITH HIS ARTIST AT WORK , SELF-PORTRAIT 24 B u f Q 0 p h w • c a n Jl. u u m n 9 9 8 �························································································• · ~ I The Artful Doctor US PROFESSOR ' S PAINTINGS SELECTED FOR INTERNATIONAL JURIED SHOW E I '> B f R T R \ \! -physician, public health specialist and accomplished scientist at the University at Buffalo-is ready to give it all up for art. Three years ago, the clinical assistant professor in the Department of Social and Preventive Medicine rekindled a love of painting he had abandoned decades earlier. When one of his new works was accepted into an international juried show earlier this year, there was no turning back. "If I could, I would do nothing but paint," says Bertram, sitting in the living room of his tum-ofthe-century orth Buffalo home, where his canvases cover the walls and cluster in the corners. "But I can't afford to." Thus, as with physiciansturned-painters-or - poets throughout history, science subsidizes art. Bertram spends mornings at the School of Medicine and Biomedical Sciences, helping direct the school's new Master of Public Health Program and its preventive-medicine residency. In the afternoons and evenings he takes classes, paints and applies to art shows. "My wife tells me l'm catching up, keeping up and going ahead all at the same time," he notes. Bertram's divergence from art early on is a telling example of environment subverting genetics. "Art is something I wanted to do when I was a kid," he says. "I was the one who did the illustrations for the school newspaper and painted the stage sets in high school. I even won an art contest. s u f f a 1 o "But there was no art education in my grade school or high school. There were no role models and I had no encouragement. I was raised to believe in self-sacrifice, to live life for the betterment of others. To go into art would have seemed selfish. "But there was lots of encouragement to go into science," he says. "Lots of role models, and science offered lots of opportunity. And I was good at it." Consequently, Bertram majored in zoology, no tart, at Indiana University and earned a medical degree from Washington University. He investigatedartschoolsaftergraduating from medical school, but didn't have the courage then to make a major career change, he says. Instead, he went to the johns Hopkins University and earned a master's degree in public health and a doctorate in science. For nine years, he was an assistant professor of social and preventive medicine at UB, conducting health-services research and publishing papers in scien- Physician Autumn 1 9 9 8 I tific journals. Injanuary 1995, he left UB to manage the technical-information program locally for The HMO Group, where he assessed the scientific merit and effectiveness of medical techniques. Bertram's wife, Peggy Brooks-Bertram, assistant to the vice president in the UB Office of Public Service and Urban Affairs, inadvertently pointed him back to art. "It was around Christmas in 1995, and my wife wanted to do something different in the foyer for the holidays, so she dragged out the drawings l did in medical school. I didn't realize they were still around. l looked at them and thought, 'Hey! l wasn't so bad! Let merethink this."' When Bertram left The HMO Group in 1996 to work as a consultant, the less-rigid schedule allowed him time to paint. He enrolled in art classes at Buffalo State College and began to draw and paint again. This time around, there was plenty of encouragement: He submitted works to an amateur art show at the Erie County Fair, winning ribbons and recognition that spurred him on. When his painting "At Ease" (pictured left) was one of 116 pieces out of l ,500 submissions accepted into the ew jersey Center for the Visual Arts' 12th IntemationaljuriedShow, he was thrilled. The show was juried by an Rosentha, consultant in 20th-century art to the Metropolitan Museum of Art, and ran from February 15 through March 29, 1998. Bertram was e pecially pleased that his very traditional piece, influenced by Winslow Homer and Andrew Wyeth, was selected, despite fitting into neither of the two movements Rosentha said characterized most of the selections: collage and assemblage, and surrealism. With his talent affirmed, Bertram now presses on fearlessly. "I no longer have doubts, as I did when I was younger, that lam able to do it," he says." ow all I need is time." + �• . ·········· ··· ······ · ······· · ······················ · ···························· ·· ······· l I "Wimpy"Parents Take Note inconvenience and failure." The results: children who often are inconsiderate, unpleasant, demanding and unhappy. UB PROFESSOR ' S BOOK ON PARENTING GAINS ATTENTION Although the rules and relationships invariably change between parent and child through the stages that lead to adulthood, Condrell says underlying HI- PROC Rf SSI\ f, CHILD-CE TE RED parenting movement, goals should not. "Early on, it's vital that popular during the past two decades, has given rise to a youngsters learn to respect authority, the rights of others and the consequences national epidemic of families in which children are "running" of their actions. " Even the very young can learn the the show, according to child psychologist and family therapist meaning of the word "no" and that misbehavior, lying, cheatKenneth . Condrell, PhD. ing , bullying, whining, Condrell, a clinical assistant professor putting these misobstinance and tantrums in the Department of Psychiatry at the guided, tired, loving parlead to age-appropriate punUniversity at Buffalo, is coauthor with en ts back in charge of ishment. Loss of privileges, Linda Lee Small of a new book, Wimpy their children, their toys , television, trips or Parents, From Toddler to Teen: How NOT families and their lives. games for a predetermined From fodd. r to Teento Raise a Brat, published recently by Wimpy Parents, From HO\\ time carries the message to Rue Warner Books. He notes that parents have Toddler to Teen: How when applied consistently, a Brat been encouraged by the "self-esteem moveOT to Raise a Brat he notes. ment" to not be strict or bossy with their provides parents with Condrell stresses that it's offspring. Instead of being strong family examples and anecalso important to complileaders, he adds, they have become dotes on how to be ment and reward good "wimpy" parents, raising kids who are loving and successful paren ts and behavior so a child gets in the habit of selfish, demanding and disrespectful. enjoy their children into adulthood. behaving at home and elsewhere. The theory followed by these parents The goal of parents should be to teach Bratty behavior, if not altered at some their children a strong point, returns again and again once the sense of responsibility, children become adults. "They are usu• worth and values, which ally the adults who will later inconsiderprepares them for the chal- ately drop off their children with lenge ahead in an often- grandma and grandpa with little or no changing, demanding, warning to baby-sit, borrow money when stressful wor ld , says they find themselves in preventable Condrell. Otherwise, they financial predicaments or expect to will not grow up prepared routinely be bailed out of self-created for the real world, where messes," Condrell observes. proposes that by promoting youngsters' sel [-centered, insensitive, irresponsible Parents, he says, need to teach their self-esteem and turning the family into behavior leads to unhappy relationships, children moral values and responsibila democracy, children will grow up to as well as serious and often grave, life- ity through discipline and example, and be confident, competent, successful threatening consequences. be firm and loving in doing so. "If they adults. "Wimpy parents find it difficult to be don't learn these lessons when they're "The theory looked good on paper, in charge," Condrell emphasizes. "They growing up, they'll learn them later from but in reality, it was awful," says Condrell, are too loving, too patient, take too the real world, which won't be as loving, who founded and directs a large group much abuse and are wishy-washy where forgiving or supportive," he adds. practice specializing in family therapy. discipline and enforcing house rules are Condrell has appeared on national teleow he and other clinical psycholo- concerned because they want to save vision, including CN and BC-TV's gists find themselves spending more time their children from unhappiness, Today show. + Parents . ® B u f f a I o - BY MARY BETH Au tumn SPINA 1 9 9 8 �·····················································································• · ~ . . ~. e I s d 0 g ', s e t s ., r j e s :l f Innovative Partnership Brings Gamma Knife to Buffalo n August 4, 1998, David C. Hahn, MD , president and chief executive officer of Roswell Park Cancer Institute (RPCI), announced the formation of an innovative partnership with Buffalo eurosurgery Group, the University at Buffalo's Department of Neurology and the Roswell Park Alliance Foundation to bring to Western ew York a Leksell Gamma Knife, which he called "one of the most groundbreaking medical advances of recent years. " In announcing acquisition of the gamma knife, which will be operational this fall, RPCI becomes the only facility in Western ew York-and one of only 47 facilities in orth America-to offer this tool for noninvasive brain radiosurgery. The purchase of the gamma knife was made possible through a $3.6 million grant from the Roswell Park Alliance Foundation, chaired by the Han. Nancy aples. "This type of cooperative venture between private practice, university neurosurgeons and Roswell Park Cancer Institute Will be the hallmark of health care in the 21st century," says L. elson Hopkins, MD, professor and chair of neurosurgery, and professor of radiology and director of the Toshiba Stroke Research Center at the University at Buffalo. The gamma knife delivers a single, high dose of ionizing radiation from 20 l intersecting beams to a target previously defined by advanced imaging techniques. It offers the precision of surgery Without a scalpel and without the usual risks associated with surgery, while pro- viding enough radiation to destroy a lesion. This form of radiosurgery has proven successful as a treatment for benign and malignant tumors and vascular malformations located in critical, difficult-to-access areas of the brain. "The gamma knife represents a major technological advance toward noninvasive treatment, which is rapidly becoming the standard of care for some of these conditions," says Douglas B. Moreland, MD , director of Buffalo eurosurgery Group and chief of neurosurgery at Sisters Hospital. For brain tumor patients who are not good surgical candidates due to age, health status , or the inability to tolerate anesthesia , the gamma knife may be an alternative to conventional surgery. For others, it may be used as an adjunct to conventional surgery. Following treatment with this state-ofthe-an radiosurgical tool, patients can usually return to their normal routines within a day, allowing them to maintain good quality of life while eliminating costly hospital stays. Between 1988and 1997, the number of gamma knife sites worldwide has grown from five to 112. Over the same period , the number of patients treated has increased each year from 2,190 in 1988 to 80,000 by 1997. Gary M. Proulx, MD, radiotherapy codirector of the Gamma Knife Center, says, "The gamma knife and other improvements planned for the Brain Tumor Treatment Center at Roswell Park Cancer Institute will make the newest and best treatment modalities available to patients with malignant and certain benign diseases of the central nervous system." + Physician A. u t u m n 1 9 9 8 In Memoriam I �~ -······················································································· ~ Student Lounge aSocial Haven SUPPORT O F MED ICA L A L UMN I A SSO CIATION A PPR ECIATED hile physicians often prescribe rest and relaxation for stressprone patients, future doctors are experiencing the true value of the therapy in the UB medical school's student lounge. Opened in 1993 with the help of the Medical Alumni Association, what was once a medical conference room in 133 Cary Hall is now home to the hustle and bustle of busy medical students who depend on the room's comforting features to accommodate their hectic lifestyle. Visitors to the lounge shouldn't expect to encounter discussions of gross anatomy or cell biology so much as heated foosball games between medical and dental students or a game of pool in which first-year medical students have challenged more experienced 'second-years.' Air-conditioned and furnished with a full-size refrigerator , microwave , VCR, televi ion , copier machine, pool table, two foosball machines , soda machines , couches, and tables and chairs, the lounge provides a recreational retreat for hard-working medical students, who have access to the room 24 hours a day with a 4-digit security access code. Second-year students Tom Zajac and Hugh Bui say they visit the student lounge to work on their foosball skills. "lt helps hand-eye coordination in case you want to go into surgery," jokes Zajac. Bui sums up what he thinks about the lounge in three words: fridge , food and foos. Cheryl Taurassi, a third-year student, frequents the lounge mostly to use the refrigerator and microwave. "The majority of us use it as a place to eat lunch, ® hang out and take a break, or in some cases to nap on the couch," she says. "It's also great in between classes if you only have 15 minutes or a half hour unUlyournext c~ss." The lounge is currently maintained by POLITY, the medical student governing alumni affairs in the medical school. ow retired, Richert recalls when the lounge area also was the Lippschutz conference room, which relocated to the Biomedical Education Building. Before the lounge was created, he remembers , the only place students .. WITH SO MuCH EMPHASIS BEING PLACED ON EDUCA· body, whose -ION IN A STRICT SENSE offices, along -HE LOUNGE IS A SOCIAL with those for the 1ris, HAVEN THAT ENABLES US the medical TO COMPLETE OUR student yearT0GETHER book, are located -CHRIS ADAMS within th e POLJJY P1rsidrnt lounge. The governing board of the UB Medical Alumni Association played a primary role in furnishing the lounge , with the help ofjohn Richert , EdD, former associate dean for Dl'~A~ION B u f f a l o Phys ici could hangout socially was in the atrium in the Biomedical Education Building. "The students felt the atrium area was too public , and they wanted something more private that they could call their own," he recalls. "l agreed, and POLITY submitted budget proposals two years in a row to the governing board of directors. Both yea rs we designated money to help students furnish the lounge. " With the generous donation from the alumni association, students were able to purchase couches, tables , chairs, a television and a VCR. Bertram Portin , MD , current assistant dean for alumni affairs, adds that an A. u t u m n I 9 9 8 �················· · · · ···· · ······························································· ~ the alumni association is studentoriented and supportive of enhancing the quality of student life. "Members of the association have a genuine concern for the students' needs and fee l very strongly that the students should be taken care of. l was glad to play a part in making such resources avai lable," he says. The lounge is especially important to students because it allows them a diversion from the pressures of school. "It gives us an opportunity to get away from school work," says third -year student jason Lake, who was a regular at the pool table his first two years, when he participated in organized lounge pool tournaments. "If we had no escape , life would get pretty dull." To offset the seriousness of their studies with a little humor, other students turn to television. Popular programs include stand-up shows of comedian Chris Rock and reruns of South Parh, says second-year student Charmaine Gregory. Some students, however, use the television as a learning tool. Gregory notes that she has seen students taking advantage of the VCR to study histology slides on videotape. As second-year student Debbie Ogie busily makes copies, she explains the convenience the lounge offers students who want to stay in the building to make a few copies or to look over material. "In the winter, people don't like to have to walk over to Harriman or the library," she says. "It's also really nice because it is a place where I can relax with friends.·· • According to POLITY president Chris Adams, the lounge gives students an opportunity to enjoy each other's company in a relaxed environment. He explains that the friendly atmosphere of the lounge helps foster the development of interpersonal skills, which are important to being a good physician. "I feel that the lounge is an integral part of our experience here at UB. With so much emphasis being placed on education in a strict sense, the lounge is a social haven that enables us to complete our education together .., Adams adds, "It's great to see the dedication of the school's graduates to the needs of current students. I think I speak for all of the students who use the lounge in saying that the efforts of the alumni are greatly appreciated." + \ \}\~c a mistake . But not from the inside . The roof looks funny, odd, strange, n\\~ 1.l1e wa\" IH' sec il. 11 h~· build a >otraight roof 11 hen ~·<nl ean build a perfeetl1· good erooked one'c It·, something up to se1·en passengers in the Land l{o,·er llisem·er1· 11ill trul1· appreeiare. \\"ith the elenlted roof and stadiumlikc sea tin(\. passen(\ers in the rear ha1·e ample headroom. \\' hieh means the~· ean look at more than the hack of the front seal. ~luch more. in fac1. Beeause the Land Ro1·er Dbe01·ery ha>o more 11indows than an1· other 4x4 . \\'h~· no~ take _one out for a test dril·e'c .\nd instead ot just looking into it. look out of i!. 48 DISCOVERY Land Rover Amherst ANORTHTOWN AIJTOMOlM COWAN'f 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com L B u f f a l o P hysician Autumn I 9 9 8 �r ! J ··· · ·················· · ····················· · ····· ·· ····················· · ··· · ·· · ······· Learning about the Realities of Cancer Care caring for the patients. My interactions with the patients became close, and my with long hours in the lecture halls and laboratories and late concern for each of them deepened. The nights of study, I eagerly looked forward to summer vacation. Y~t patients' openness with me made me feel even more concern and sympathy my eagerness to see summer arrive was not for the typical for their situations. reasons, since what I was excited about was beginning a clinical Full of optimism for each of them, it shocked me when I would learn from research program at Roswell Park Cancer Institute. the attending that a patient's cancer was The disease of cancer has intrigued Park, my views about quality of life progressing and we had no cure. I would me since my junior year as an under- have been challenged and redefined. think to myself, "How will we tell the graduate, when I worked at Yale Cancer In my formerly naive view, I felt that patient? What do we say? " When I observed Dr. Lawrence Center. Since that time, my apprecia- when patients or physicians Leichman talking with pation for oncology has only deepened, in decided to stop treatment or tients, it was consoling to large part due to my having had an to not undergo experimental see how he would indicate to opportunity to work with two medical therapy at all, they were givthem, either verbally or by oncologists, Dr. Amy Early and Dr. Meir ing up too ea ily or accepting his demeanor, that what he Wetzler, during the past school year. defeat before even trying. owl understand why somewas about to say would not Gradually, the field started to have times it may not be worth much to be easy. In fact, he said that if telling meaning to me beyond the complexities people such bad news ever becomes of cancer biology or the therapeutic "fight" anymore, or even try at all. On most GI clinic days there were easy, it's time to do something else. And regimen : l began to realize that it's the end-of-life issues that pose the greatest between 25 and 30 patients. Although he is right. Patients deserve someone there was a fellow and a resident to who empathizes and is fully supporting challenge to an oncologist. Textbooks and manuals will tell you make preliminary assessments of the them during this time. If therapy does about staging and chemotherapy, but patients, the large number of patients work, the oncologist's care and support how do you tell omeone that there is no meant that I, too, had an opportunity to may be all the medical hope they have. It was a challenging summer to cure for his or her disease? How do you take historic and perform physical exadvise a patient on whether to use ag- aminations. l built confidence and soon face life and death issue so frequently. gressive treatment or to enjoy his or her felt like an important part of the team On one occasion, l watch ed Dr. last months in a Leichman tell a mother that her 23healthier, asymp tomatic state? There year-old son might TEXTBOOKS AND MANUALS WILL TELL YOU ABOUT live only a few more arenorightorwrong answer , nor will it months. The doctor STAGING AND CHEMOTHERAPY, BUT HOW DO YOU TELL told her what she be the same in every SOMEONE THAT THERE IS NO CURE FOR HIS OR HER probabl y already situation. knew, but now it After working for DISEASE? HOW DO YOU ADVISE A PATIENT ON WHETHER TO had been confirmed eight weeks under that things were not the direction of Drs. USE AGGRESSIVE TREATMENT OR TO ENJOY HIS OR HER going to improve. Lawrence and Gail In another case, Leichman in the LAST MONTHS IN A HEALTHIER. ASYMPTOMATIC STATE? a woman who had gastrointestinal received secondservice at Roswell pn1 r" ', r.;mc::,T YEA.R OF MEDICAL SCHOOL filled B u f f a l o Phys i cian Autumn 1 9 9 8 �• • • • • • 0 • 0 • 0 • • • • • • • • • • 0 • 0 • • • • • 0 • • • • • • • • • • • • 0 • 0 • • • 0 • • • • • • • • • 0 • • • • • • • ~~~~~~~~ HURWITZ & RNE, P.C. [ line treatment for her colorectal cancer was told it was not shrinking the tumor and that there were no more reasonable options. Sh e could not appreciate the implications of having failed the second-line regimen, and her response to the poor results was that everything was going to be okay and the physician would just find another type of chemotherapy that would eventually work. But her husband, who was in the hospital room at the time, understood perfectly. As we left the room, he followed us out and asked with uneasiness, "What do I say to my wife when we get home? " He did not know how to cope with the next few days or the next few months. We had no answers for him except that we would try to find another treatment for which she might be eligible, but explained it was B u f f o l o Phy highly unlikely that it would work. It is not common to tell someone how long they have to live, but certain circumstances require it. Patients need to be aware of what is happening to them so they can prepare accordingly. It is usually done out of respect for the patients and their families. However, discussing how long a patient has to live may not be appropriate because one may not know the efficacy of treatment or how fast the cancer will progress to making a significant systemic impact. Also, one may unfairly take away hope for a patient's survival and cause him or her to worsen more quickly due to psychological debilitation. Sometimes l would stand in the clinic and wonder, "What are we accomplishing in oncology? Are we really helping anyone? " But then I remember the many faces we see each day and feel satisfied because I know that regardless of the outcome, we are supporting these patients through what may be the most difficult and scary ordeal that they will encounter. We see the trusting eyes peering at the doctor, who may give a glimmer of hope. We also see the insecurity, not knowing if and when the cancer will come back now that therapy has been successful. Every day may bring smiles of denial, euphoric laughs to cover the hurt, angry outbursts, silent acceptance or slow tears. Although oncology is challenging, we help people to cope. And that may be all that is needed to say that it is worth it in the end. + sician Autumn l 9 9 8 ATTOR EYS AT LAW SERVICI G THE LEGAL NEEDS OF THE H EALTH Scm cEs CoMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referral • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • C redentialing and By-Laws • Hospitai!Medical Staff Issues Please contact Robert P. Fine or Lawrence Mo Ross at 716-849-8900 1300 Liberty Building Buffalo. New York I �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] '' ... ' ' Body Shape May Indicate Increased Risk of Breast Cancer omen who display certain physical characteristics, such as abundant body hair, excessively oily skin and an apple-shaped physique, may have a greater risk of developing breast cancer than other women, researchers at the University at Buffalo have found. Results of the research were presented in june by Paula Muti, MD , UB assistant professor of social and preventive medicine, at the annual meeting of the Society for Epidemiologic Research . The finding comes from an analysis of women who took part in a study in orthern Italy called ORDETHORmone and Diet Etiology of Breast Cancer. Muti says blood levels of male sexual hormones , called androgens , produced in women in small amounts by the ovaries and the adrenal glands, have been positively associated with the risk of developing breast cancer in several prospective studies. The most active androgen is testosterone. The current study sought to determine if external signs of high androgen levels in women could be associated with brea t cancer risk. A positive finding would mean that these traits could be used as a screening tool. "lf these characteristics are linked to an increased risk , women with these traits could be referred for closer screening, or could receive treatment to lower the androgen level," she says. "There are hormone-lowering drugs available, and there are also indications that a diet high in vegetables, fruits and fiber can lower testosterone levels." Muti followed a group of pre- andpostmenopausal women in the Italian study for three years. At the beginning of the study, the women were assigned a score based on an assessment of the amount of body hair. Researchers also assessed sebum production-the output of the skin's oil- and waxproducing sebaceous glands-and body-fat distribution, based on the ratio of waist-to-hip measurements. At the end of three years, 36 premenopausal and 26 postmenopausal women had developed breast cancer. The remaining participants-136 premenopausal and 99 postmenopausal women-served as controls. Analysis of androgenic traits in women with breast cancer and in those free of the disease showed that: • Postmenopausal women with excess body hair had a 33 percent increase in risk of developing breast cancer versus their counterparts with no excess body hair. There was no relationship bet\>\oeen body hair and breast cancer risk in premenopausal women. • Excess sebum production was a significant risk factor for premenopausal women , but not for postmenopausal women. Premenopausal women with the highest levels of sebum production had 2 lf2 times the risk of developing breast cancer compared to those at the lowest level. • Premenopausal women with the stereotypical "apple" shape, in which the waist is bigger than the hips , had a 2112 times greater risk of developing breast cancer than their counterparts with "pear" shapes, in which the hips are bigger than the waist. o signifi- B u f f a l o ., < 0 X . ~ > 0 ~ cant relationship was found between waist-to-hip ratio and breast cancer risk in postmenopausal women. The results, Muti says, provide more evidence that androgens play a role in the development of breast cancer and show that outward signs of high androgen levels could be a useful screening tool for the disease . Martin Stanulla, MD , a visiting researcher from the Medical School of Hannover, Germany, also participated in the study. + Physician - L 0 I 5 Autumn 8 A K E R 1 9 9 8 �··········································· · ·················· · ························· ·· a ' '<~~ . Two Sperm Abnormalities Linked to Low Pregnancy Rates link between specific clinical pregnancies and very low levels of two sperm abnormalities has been found by fertility researchers at the University at Buffalo School of Medicine and Biomedical Sciences. The two abnormalities-premature acrosome reaction and premature chromosomal decondensation-are overlooked in a standard semen analysis and had never been linked to low pregnancy rates, says Lani]. Burkman, PhD, UB assistant professor of gynecology and obstetrics, and urology, and head of the Andrology Section of the UB Department of Gynecology-Obstetrics. By analyzing hundreds of semen samples and comparing them with subsequent pregnancies in the couples studied, Burkman and colleagues determined that samples showing more than 7 percent premature acrosome reaction or more than 14 percent premature chromosomal decondensation had only a slim chance of leading to a pregnancy. "We were surprised to see that these two factors related to pregnancy so clearly," says Burkman, lead researcher on the study. "This is a new finding, and it's impressive because the test is so simple." The acrosome is an enzyme-filled cap covering half the sperm head. Just before fertilization, enzymes from the acrosome, activated at the proper time, soften the egg's covering, or zona, and allow the sperm head with its genetic material to fertilize the egg. If the enzymes are released too soon (a process called premature acrosome reaction) , the sperm is rendered useless. Premature chromosomal decondensation refers to the untimely unraveling of the sperm's tightly packed genetic cargo. lf this begins before the sperm has penetrated the egg, the sperm head swells and fertilization becomes impossible. "ln our study, when pregnancy occurred, we knew that the partner's sperm were capable of fertilizing the egg," Burkman says. "When pregnancy did not occur, the possibility existed that the sperm failed at one or more points in the fertilization process." For this study, the results of which were presented at a meeting of the American Urology Association in June, researchers analyzed semen samples from 250 consecutive patients who came to their andrology laboratory at the Children's Hospital of Buffalo. Samples were rejected if the male did not follow instructions carefully or if the samples were more than one hour old. Each sperm slide was scored for percentage of sperm showing the premature acrosome reaction or evidence of chromosomal decondensation. These scores were then correlated with the couples' pregnancy results, which were grouped as natural pregnancies, intrauterine inseminations and in vitro fertilizations, or no pregnancies. Results showed a very low incidence of acrosome reaction or chromosomal decondensation in the natural pregnancy group, while in the no-pregnancy group, the rates for both errors were significantly higher. Based on these data, the researchers established fertility thresholds of 7 percent premature acrosome reaction and 14 percent chromosomal decondensation, then tested their criteria on sub- e an u f f a 1 o Physic i Autumn 1 9 9 8 ·~ '· ' . sequent new pregnancies. They found that of the 29 couples who later achieved a pregnancy, 82 percent fit the new semen criteria. "Eighty percent of what we guessed would happen, happened," Burkman says. 'This also means that only 20 percent of the problem semen cases could be linked to a pregnancy. So couples with either of these errors have greatly reduced pregnancy potential. "Fifteen years ago, we knew so little about the human sperm that we couldn' t come close to models for predicting pregnancy," she says. "We know much more now." Also participating in the study were Kent Crickard, MD, Frank Gonzalez, MD, and Hemlata Bhakoo, PhD, all ofUB and Children's Hospital, and MaryLou M. Bodziak of Children's Hospital. + -LOIS BAKER ., < 0 '> . 1- 0 1- �BY J . LINDA CORDER . PHD , CFRE AHelpful Guide for Planning ISITS, PHONE CALLS AND MAIL-these provide much of the communication between the development office and those who are interested in contributing money, appreciated stock, real estate or other personal property to the University at Buffalo School of Medicine and Biomedical Sciences. Incoming and outgoing communication is rather even. I enjoy learning from those who love the school as much as providing information for those who request it. Recently, one of the school's generous donors passed along a worksheet on appreciated stock with an example. I had the occasion to share it with others during the summer. Nov,.·, once or twice a week, I receive a nev,. request to send it to someone's friend or classmate, or I am asked for "another copy since I gave mine away." Something with such widespread interest deserves a broader audience, so I decided to share it through this column. What follows is a summary narrative of the procedure, and then a story. It is offered merely as a guide for planning and for your enjoyment. As always, when you are ready to make decisions affecting your taxes, talk with your tax professional. If you would like more details, please contact me at the office. Income tax charitable deductions may be claimed for gifts of intangible capital gain property contributed to the school. The amount claimed is the fair market value on the date the assets arc transferred from the donor to the UB foundation for the school. The overall deduction of such property is limited to 30 percent of the donor's adJUSted gross income for that tax year. To compute an "approximate maximum" deduction, note your adjusted gross income from the prior year (assuming no drastic changes in circumstances), and multiply b) 30 percent ('·x 0.3"). This will give you the maximum allowable deduction for your annual income. To determine the tax benefit of a proposed contribution, multipl) the deduction by your marginal tax rate to compute your tax savings. Marginal rates range from 15 percent for incomes under $41,200 to nearly 40 percent for incomes over $2 71,050. Most ® a u f f a 1 o of the donors with whom I have worked recently have tax rates of 31 percent or 36 percent. If you have a reason to liquidate stock and would like to be philanthropic rather than pay capital gains taxes, you take the amount of tax savings on your gift and multiply it by 5. (The "tax savings" represents the 20 percent figure you would pay in capital gains taxes.) This number will give you the amount of personal gain you can obtain using the tax savings from a gift to offset capital gains taxes you would otherwise pay. Let's look at Dr. G. I. Feelgood's situation. In 1997, he had an adjusted gross income of $270,000. Dr. Feelgood also owns 5,400 shares of stock in Small Biotech Laboratories, Inc., which he acquired over the years with an average cost basis of $3 per share. SBL never paid a dividend. Currently, it sells for $44 per share. Dr. Feelgood's holdings are worth $23 7,600-a potential gainof$221,400. Dr. Fcelgood wouldfeeleven betterifhecould sell the stock and use the proceeds to pay off his condo in Arizona. In addition, Dr. Feelgood would feel terrific if he could use part of the "gains" to benefit good ole' UB medical school, and at the same time reduce his tax burden. Dr. Fcelgood figures that he could give a maximum of $81,000 in stock ($270,000 adjusted gross income x 30 percent) and save $29,160 in taxes ($81,000 x 36 percent). With the tax savings and a capital gains rate of20percent, he could also realize againof$145,800 ($29,160x 5), in essence, tax-free. A gain of $41 per share is equal to 3,556 shares ($145,800 di\i.ded by $41) for $156,484. So, the good doctor gives 1,841 shares to UBF for "alma mater" for a contribution totaling $80,004. He sells 3,556 shares for $156,464 and pays off his condo. He is left with three shares of SBL. He will probably sell them, too, pay Uncle Sam the designated amount and feel ecstatic! If you have a story, pass it along; or if you have any reason to sell some of your highly appreciated stock and would like to contribute an appropriate amount to offset capital gains taxes, let's talk. + Linda] Corcle1, PhD, CFRE, is an associate dean in the School of Medicine and Biomedical Sciences at the Unnerslly at Buffalo She can be contacted b~ phone at (716) 829-2776; toll free at 1-877-826-3246; by fax at (716) 829-3395; or by E-mail, at ljcordcr@acsu.buffalo.cdu. Physician A. u t u m n 1 9 9 8 �........................................................ . ........ ..... . .. ........ 1 LASS OF 9 4 0 s was a guest speaker at the 24th Annual University of Wisconsin Spring Sympo iumsponsored by the Department of Ophthalmology and Visual SciARTHUR J . SCHAEFER '47 1953 REUNION ences April 1718, 1998,inMadison, WI. His lecture, titled "Reflections on the Complications of Ptosis Surgery Yesterday and Today," was given as a tribute to Dr. Richard K. Dortzbach, retiring professor of Cloclmise: Patricia and Harley lindquist, Jack and Maxine Gold, John Handel, Betty and Samuel Galeota ophthalmology and director of the Oculoplastic Service. Dr. Schaefer is a long-time friend and colleague of Dr. Dortzbach. Also, on May 24, 1998, Schaefer was conferred an honorary degree of Doctor of Humane Letters by Canisius College, whence he graduated in 1943. In honoring him at this year's commencement exercises, the college cited Schaefer's "contributions to the field of ophthalmology, his support for aspiring physicians, his contributions to church and community, and his outsta nding Left to right: John B. Fenger, Michael A. Sullivan, Joseph F. Ruh service to his Alma Mater, Canisius College." 1 9 7 0 s • peripheral arterial vascular testing and peripheral venous vascular testing. Gage is a fellow of the American College of Surgeons and serves as a clinical assistant professor at UB. JAMES G . EGNATCHIK '79 has joined Buffalo eurosurgery Group. He is currently clinical assistant professor of neurosurgery at UB and a member of the Executive Committee of the CGF Health System. 1 DANIEL is a gen- eral surgeon and director of the Main Vascular Laboratory in Williamsville, NY, which was recently reaccredited by the lntersocietal Commission for the Accreditation of Vascular Laboratories. Areas included within this accreditation are extra- Left to right: Donald Ehrenreich, James Carlin, Mrs. John Fenger, Thomas Geoghegan, Rivone Ehrenreich cranial cerebrovascular testing, e u f f a l 0 p y 5 c a n A. u t u m 9 8 8 P . 0 SCHAEFER s ' 81 authored three chapters in the textbook Second Edition of Ophthalmic Plastic and RecotJstructive Surge1y, published by C. v. Mosby earlier this year. The textbook, which covers ophthalmic plastic, reconstructive and orbital surgery, is widely read and referenced in the United States, as well as internationally. Schaefer was the primary author of the chapter on enucleation and the solo author of the chapters on evisceration, anophthalmic socket and socket reconstruction. 1 9 9 0 s ' 90 writes: and j would like to announce the birth of our first child, Zachary Alexander Bloom, born on August 4, 1998. GALE ANDREW B . GAGE '76 9 BURSTE IN PETER BLOOM ' 90 Peter is a gastroenterologist at the University ofMaryland. 1am a pediatrician specializing in adolescent medicine atthejohns CONTINUED ON PAGE 36 �• ··········································· · ··· · ······· · ············ ···· ···· · ············· . ' Hopkins School of Hygiene and Public Health. I recent!) had a paper published in )AMA (the lead article, August 12) titled "Incident CIJ/a111ydia traclw111atis infections among inner city adolescent females." I received a great deal of media publicity about the findings of this paper, including national (C , CB ), interna- tional (CBC), and local TV coverage, as we ll as in magazines (Time, cwswee/1) and newspapers (Washington Post, Boston Globe). WILLIAM CHLOSTA '93 will The combined SUNYAB 14th Annual Research Day and Buffalo Otolaryngological Society Meeting was held on June 18, 1998, at the University Inn and Conference Center in Amherst, NY. Pictured ore Buffalo-area physicians honored for their distinguished contributions in the field of otolaryngology over the post 40 years. Standing, left to right: Frederick K. Neuburger, MD; William Hildebrand Jr., MD '40; William Mcintosh, MD '45. Seale~ left to right: Irwin A. Ginsberg, MD '44; Fronk Marchetta, MD '44. begin his fellowship in cardiathoracic urgery at Yale University/ Yale ew Haven Hospital injuly 1999. He can be reached a t chlosta@biomed.med.yale.edu. APRIL CYR '98's husband, Kris , writes: Aidan Campbell was born 10 ounces. He is already living up surgeons, practicing at Buffalo to his name (Aidan means "little General Hospital, CGF Health partner of Buffalo Heart Surgical fiery one" in Irish Gaelic). He System. A grad uate of the Associates in 1983. does tend to sleep quite a bit, so University of the West lndes, we're starting to get some sleep Lewin completed residencies in ourselves and recover. general surgery at Buffalo. He was a founding IN MEMORIAM WALTER L. SYDORIAK '38. on july 1, 1998, at 4:05a.m. April and bravely endured eight hours of thoracic surgery WILLIAM has been and a fellowship August 23, 1998, in St. Mary's elected president of the Buffalo in pcdiatriccardio- Hospital, West Palm Beach, thoracic surgery FL. after a long illness. He at the University was 78. labor at Millard Fillmore Hospital. he i doing fine now. Aidan NORMAN A . LEWIN was pronounced a beautiful baby Heart boy and weighed 7 pounds and specialty of cardiothoracic urgical Associates, a cardiaC . NIESEN '43 died ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement course • tate of the art visual and performing arts center • More than 60 inter:,cholasnc sports team:, • Comprehensive community service project:, • Average class size i:, 15 • Financial aid available Admissions tests on these Saturdays at 9:00 a.m.: January 24, February ZS To reserve a place for testing or for additional information, pleaoe call: NlCHl1LS MIPPLE CIIOOL, 175 ottmgham Terr., NllHnL~ UrrER SCIIlX1L, 1250 AmheN St. Accepwnce I> gr.mtd to quo~!.heJ >tuJent> without regarJ to race, C<>i<lr, rchgHm nr mnnn.1! nngm. 6 u f f o I o p h c 0 )l, u u m 9 8 �· ········ · ···················································· · ···························• 11 ' I After graduating from UB, iesen served as a major in the Army during WWII. He was chief of urology at Buffalo Veterans Hospital before entering private practice in iagara Falls. Later, he was chief of the medical staff ichard F. Mayer '54, professor of neurology Through I997, Moyer held responsibilities for varied at the University of Maryland School of Medi- lengths of lime as director of the Resident Training Program, cine, was promoted to Professor Emeritus in acting choir, and director of the EMG and Nerve Conduction and Mt. St. Mary's Hospital and I997. On May 9, I998, in celebration of laboratories and Neuromuscular and Myasthenia Gravis served as an assistant clinical Dr. Mayer's long and dedicated career in neurology, Clinics at the University of Maryland Hospital. He has also professor of urology at UB. A member of the Royal Col- the university held a symposium named in his honor. published many papers and articles and has participated in lege of Surgeons of the United After graduating from medical school at the Univer- numerous national and international symposia on neuro- Kingdom, and chief of urology at Falls Memorial Medical Center iesen also main- tained a practice in sity at Buffalo, Mayer completed a summer fellowship muscular disease and neurophysiology. iagara iagara Falls, Ont. He was a past president of the Buffalo Urology with noted neuroanatomist Grant Over the course of his long career, Mayer Rasmussen, PhD, who inspired his growing has been involved in the training of approxi- Society and the Health Association of iagara County. He fascination with the field of neurology. In mately I00 neurology residents and 35 moved Florida 10 years ago. I 954, Mayer made the decision to go to fellows in neuromuscular disease and Survivors include his wife, Boston to serve a medical internship at the research. His leaching responsibilities have jean; a daughter, ancy Eddy of Palm Beach Gardens, FL; and a Boston City Hospital. He remained in brought him great satisfaction, and he enjoys granddaughter. Boston for his training in neurology at the keeping in touch with his former residents Massochusells General Hospital, with the Richard F. Moyer, MD and fellows, who now live and work in locations throughout the United Stales and in exception of a year when he completed a to SIDNEY M. SCHAER '44. WILLIAM M. BUKOWSKI '47 died july 28, 1998, after a long baule fellowship at the Mayo Clinic in Rochester, MN, and many foreign countries. His travels as visiting professor of another year when he served as assistant in neurology have Ioken him to medical centers in Sweden, research at the Notional Hospital at Queen Square Denmark, Germany, Taiwan, Great Britain and Columbia. he had beenastaffmember for44 in london. From I960 through I964, he woso research For the past eight years, he has made annual trips to Japan, years. Bukowski, who was an internist and cardiologist, was along- fellow in neurology at the Harvard Neurological Unit at where he has served as visiting professor in the department time clinical assistant professor the Boston City Hospital and held appointments in of neurology at Nora Medical University and in more recent of medicine at UB. He was 76. neurology ol Harvard Medical School. years in northern Japan at the University of Hokkaido. with amyotrophic lateral sclerosis, in Sisters of Charity Hospital, where After earning his medical degree, Bukowski entered the U.S. In I 966, Moyer accepted a position as associate As Professor Emeritus, Mayer will continue to leach and Army Medical Corps as a captain professor of neurology within the newly organized consult in the University of Maryland's medical school. Department of Neurology at the University of Mary- However, his lighter responsibilities will allow him more lime and served as commanding officer of the 57th Field Hospital land School of Medicine in Baltimore, where he was for his family and for his weekend retreats on the eastern in internal medicine and cardiol- appointed professor of neurology in I 968. shore of Maryland. ogy, establishing a private practice following his military service. in Toul, France. He specialized CONTINUED ON PAGE 38 S u f f a l o Physic i an Autumn l 9 9 8 �• ············ ····· · ·· ·· ·· · ········· ···· ··· I An attending physician in medi- A professor of gynecology and cine and electrocardiography at obstetrics at UB from 1971 to Sisters Hospital, he was president 1979, Nichols left Buffalo in of the medical staff there in the early 1980 to become chair of the 1970sand served on the hospital's Department of Obstetrics and boardofuusteesfromthemid-1970s Gynecology at Brown University to 198l.ln April, he was honored in Providence. He also served as as Man of the Year by the Sisters obstetrician-gynecologist-in-chief Hospital Past Presidents Club. at Women and Infants' Hospital of Survivors include his wife, Rhode Island. ichols is credited Marguerite; five daughters,joan, with building Brown's academic Barbara, Kate, Beth ofWashington, department into a nationally rec- D.C., and Martha Thomson of ognized program and for creal- Devon, PA; two sons, William Jr. of ing an integrated center for Montreal and Peter; two brothers, women's health care throughout Thomas of Alexandria, VA, and Rhode Island and surrounding Stan ley; and eight grandchildren. states. In 1990, he received the Distinguished Medical Alumnus D AVID H . N ICHOLS '47 died in AMANA COLLECTS Comprehensive Cost-Effective Receivables Management ~ Amana Capital Corporation Buffalo, ew York 716-852-3500 800-441-6925 AwardfromUB'sSchoolofMedi- Providence, Rl, on July 15 , CONTINUED ON PAGE 40 1998, of heart failure at age 72. 300MHz Pentium II· Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Dnve • Iomega Z1p Dnve atap1 • 17" 27NI SVGA D1g1tal Color Mon1tor • 8 MB AGP Graphic Accelerator • 56K V90 PCI Fax/Modem • 36x IDE CD·ROM Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! • Sound Blaster 128 PCI Stereo Sound Card • Sound1mage Subwoofer System • 3.5" H1gh Dens1ty Floppy Drive • M1crosoH Wmdows· 98 • Corel Wordperfect SUite 8 (Includes, Word· perfect 8 . Ouanro Pro 8 . Presentations 8•) • Zod1ac 1000 CD Bundle 1·716 ·743 ·0195 TECHNOLOGY DISTRIBUTION NETWORK www.tdn.net 1000 Young Street. Suite 270. Tonawanda NY 14150. Fax: (716) 743.0198 B f 0 0 p h y 5 c o n A u m 9 9 8 �We Get Rehab Results! Cost Effective! Superior FJM1'M hnprovement Vs. National and Northeastem Regional Subacute Facilities 34% GREATER FIM'M increase vs. the nation for all admissions. • Stroke • Pain Management • Orthopedic • Medically Complex • Cardiac • Infections • Joint Replacement • Cancer • Amputee The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from the Wall Street Journal and the American Health Care Association. - The Ticket Home! A greater percentage of our patients return home vs. the national and northeastern regional Subacute averages. Our goal is to prepare you to return home as soon as possible. Ftve Star Care To<let T"""'u Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FIM score- 72.5; discharge FIM score- 97.6; FlM change25.1 points; length of stay efficiency- 1.40; onset time - 17; discharge disposition - 80% to community. Based on 12 months ending March 31, 1998. The McGuire Rehabilitation Centers rely on the national leading measurement tool for documenting patients rehabilitative outcomes. This tool is lmown as FIM 5 "~ Instrument; Functional independence Measure, developed by the UB School of Medicine along with the Center for Functional Assessment Research. it's used along with the Uniform Data System for Medical Rehabilitation (UDSMR5 " ) to establish rehab outcomes that can be measured and calculated to document successful results. Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. The results are in. The McGuire Rehabilitation Centers have the clear advantage over other regional facilities based on FiM 5 " improvement, discharge to home, and cost effectiveness. Our successful rehab program delivers results because of our superior staff, state-of-the-art equipment, and specialized rehab facilities. Choose The McGuire Rehabilitation Centers for five-star rehabilitation services. THE UJtiCGUIRE llEHABILITATI(9.1\T . Call 1-888-POSTACUTE. .&~ CENT~ c Copyright 1998 Uniform Data System for Medical Rehabilitation, a diVISIOn L -- B u f f a l o Phys ician Autumn ~" . of UB Foundation Act:IVlties, Inc. All rights reseiVed. 1 9 9 8 �• ·························································································· I cine and Biomedical Sciences. director of the cardiovascular MICHAEL MEENAGHAN '71, From 1991 to 1997, Nichols was laboratory at Memorial Hospi- fessor the ing his career at the University a visiting professor of obstetrics- University at Buffalo School of at Buffalo, he served as direc- gynecology at liarvard Medical tal and later became chief of cardiology. Dental Medicine and a dental tor of the dental school's Elec- School and chief of pelvic Kucinski was recognized researcher whose work over two tron Microscope Laboratories as a pio- decades significantly contrib- and professor and chair of the former Department of Stoma- reconstructive surgery emeritus in pro- Oral Diagnostic Sciences. Dur- at neering uted to the use and safety of Massachusetts h ear t implants in the human body, tology and Interdisciplinary surgeon died August 31, 1998, in his Sciences. and in- home in Amherst following a nova tor. lengthy illness. He was 62. s General Hospital , returning to Brown in 1997 as a From 1971to 1989, he served as director of UB's Surface He was While many of Meenaghan's first studies focused on the design of until his retirement he was an cardiologist dental in Colorado Springs to implant a biocompatibility of various materials with oral tissue , he active member of the Council on International Studies and also was involved in evaluating Meenaghan retired in 1996 as pacemaker techniques for "supercleaning" a Lt. Colonel with the U.S. Army and to perform heart various implants for use in the Reserves , 338th General Hospi- human body, as well as the 1998, after a six-month battle tal, Niagara Falls. A graduate of catheterization and balloon long-term effects of umbilical- with lung cancer. He was 61. American International College angioplasty; he also invented a cord vein grafts. in Springfield, MA, he earned professor of obstet- the lies and gynecology. CHESTER 5. KUCINSKI ' 60 died in his Colo- : submitted by E-mail at: bpnates@pub.buffalo.edu. rado prings home on April 5, After completing an internship and residency in internal medicine at the University of Minnesota Hospitals , Kucinski served as a captain in the Army Reserves on active duty France 111 from 1962 to 1964. He then completed his residency in internal medicine at Washington University in St. Louis , MO, in1965 and a fellowship in clinical cardiology at the University of Colorado Medical Center in Denver in 1967. Kucinski then taught for two years at Yale University Medical School before becoming director of cardiology at St. Joseph' Hospital in Orange, heart catheter. implants and Science Center, and from 1991 the Programs. As an educator, he had su- his dental degree and a doctoral In addition, he established pervised postgraduate students degree in anatomical sciences Flight for Life programs for ru- and presented lectures in from UB. ral areas, conducted cardiology anatomy for medical and dental clinics throughout his region students. Meenaghan was a diplomate and past president of the and recruited the first pediatric A former chair of the UB den- American Society of Osseo- cardiologist to Colorado Springs. Kucinski started a vol- tal school's cultural exchange integration, and a member of committee and a member of the the International Congress of unteer service program that u ni ve rsi t y-wide Provost 's Oral Implantologists , as well obtained donations of medical Council on International Stud- as several professional orga- equipment. He also traveled to ies and Programs , Meenaghan nizations. Kenya , Morocco , India and promoted exchange programs In addition, he was a member Guatemala to teach modern with more than 10 foreign den- of the American Dental Associa- cardiology practices to medical tal schools, including those in tion, the American Association personnel there. Thailand, Korea, Japan, China of Anatomists, the International! American Association of Dental Kucinski is survived by and Mexico. During his career, his wife, Doris ; two sons, he was a consultant to more Research and Omicron Kappa Bridger of Denver and than 20 corporate, federal and Upsilon. of Colorado icholas prings; a daugh- university agencies, including Meenaghan is survived by ter, Megan Guiterrez of Gilroy, the U.S. Food and Drug Administration. his wife, Barbara; four sons, CA; his mother, Frances of Buffalo; a brother, Edward Meenaghan joined the john B and Michael of Williamsville , Kevin of Fort of Buffalo; two sisters, Sylvia dental faculty in 1971 in the Mill, Krayna of Buffalo and Audrey lished his practice in Colorado former Department of Oral Pa- Lockport; a sister, Kathleen Tumbarello of thology . He retired last year as Springs, where he served as a Meenaghan of Springfield, MA; and three grandchildren. professor in the Department of and six grandchildren. CA, in 1971. Inl975 , he estab- B ew York City; f f a I a p h 5 c a A C, and joseph m 9 of 9 8 �No one knows better than medical professionals the importance of teamwork to get things done. That is why most New York physicians and surgeons choose MLMIC as their professional liability insurer. MLMIC's responsive team of underwriters, claims personnel, policyholder services representatives, risk management consultants, medical experts, and defense attorneys provides our insureds with the best liability protection and the highest level of personalized service available. Owned and operated by its policyholders, MLMIC has successfully defended more New York physicians than all other insurers combined. With one of t he country's largest and most experienced claims departments, MLMIC also offers the State's only true peer review of claims experience. These are just a few of the reasons why MLMIC is the only medical liability insurer endorsed by the Medical Society of the State of New York. 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We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For a new America~ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n02-1998-Autumn Table Of Contents A list of subunits of the resource. China Rotation A Path through an Unexplored Field The Strengths of Children Medical School Student Perspective Research Class Notes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n02 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/efe69a80ce3df399dd1c791c99e45540.pdf 6de97f45c87624fd0643e32c40a70c32 PDF Text Text �BUFFALO PH Y SICIAN Volume 33, Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSIT Y SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephanie A. Unger ART D IRECTOR/ DESIGNER Alan j. Kegler STATE UNIVERSITY OF NEW Y ORK AT BUFFALO SCHOOL OF MEDIC INE AND BIOMEDICA L SCIENCES Dr. john Wright, Dean EDITORIAL BOARD Dr. Bertram Portm, Chai• Dr. 'VIartin Brecher Dr. Harold Brody Dr. Lmda j. Corder Dr. Alan j. Drinnan Dr. james Kanski Dr. Barbara MaJeroni Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Christopher Adams Dr. Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal Michael Slww The Children's Hospnal of Buffalo Erie County Medical Center Mercy Health System Millard fillmore Gates Hospital Millard fillmore Suburban Hospital Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospnal Dennis McCarthy Veterans Affairs Western New York Healthcare System Dear Alumni and Friends, Buffalo Physician message, sans the "interim" title. Although I really don't feel much change, it does seem to make a difference to others in terms of moving things ahead, and that is what is important. I know that more than a few of you had been urging for a more permanent solution to the dean's position, and I certainly appreciate the confidence, support and notes of congratulations that have been expressed. The dean's office moved in December, to the second floor of the new medical education building known previously as Cary-Farber-Sherman and now as the Biomedical Education Building (BEB). The office will be located just off the BEB atrium, where it will be much more accessible to students. Being tucked back in the corner of the administrative wing has made it difficult to visit with students on a regular basis. Indeed, I am in the process of setting up regular lunches with small groups of medical students (twice a week, God willing) to track how they are doing, on a more personal level. This move will also bring the dean's office, the Admissions and Medical Education offices into closer proximity. Speaking of medical education, a special task force has been appointed to look at all four years of the curriculum. Although this project is expected to take at least two years to complete, we anticipate some "deliverables" for falll999 implementation and, hopefully, at least, a few "mid-course corrections" this next semester. I talk about these and others changes affecting the medical school in an indepth interview published in this issue of Buffalo Physician (see page 4). Our Dean's Advisory Council (DAC) recently concluded its fall meeting and the input was most helpful. As with any medical school in today's turbulent environment, we face a wide variety of challenges and the DAC has proven to be an invaluable method of reviewing issues and ideas with informed alumni who are dedicated to the mission of the school. We are also interested in obtaining input from other alumni and I am making an effort to visit with alumni groups wherever possible. Indeed, at the recent AAMC meeting in New Orleans, we cohosted a reception (with the other SUNY schools) in an effort to reach out to alumni in that particular region, as well as to attendees at this national meeting. Unfortunately, we did not see many alumni who were not also attending the meeting. We shall keep trying, however. Finally, Dr. Harold Strauss, formerly the Edward 5. Orgain Professor of Cardiology and professor of medicine and pharmacology at the Duke University Medical Center, arrived at UB on ovember l, 1998, to assume the chair of physiology and biophysics (see related announcement on page 27 of this issue). This represents a pivotal recruitment, in my opinion, given the importance and stature of this department within the medical school. Please join me in welcoming Dr. Strauss to our medical school community. You will learn more about his accomplishments and his plans for the department's future in upcoming issues of Buffalo Physician. THIS WILL CONSTITUTE MY FIRST ---; (_ I &~ ~N ~ ~~~~' School of Medicine and Biomedical Sciences R. W "'G"', MD ©The State University of 'lew York at Buffalo Buffalo Physician is published quarterly by the Stale University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Dear Fellow Alumni, THIS PAST FALL, the Western New York medical community received much attention due to the murder of Dr. Barnett Slepian. Although I did not know Dr. Slepian personally, he serves as a role model for me and, I am sure, for many other physicians, as well. He was a man of much integrity and compassion who provided a wide range of medical services for women in this area. Regardless of each of our personal opinions regarding abortion, the medical community has a responsibility to provide safe and compassionate care. Medicine has never seemed like a dangerous profession, yet Dr. Slepian's death reminds us of our vulnerability. The Medical Alumni Association has chosen "Women's Health Issues" as the ,-(,::, topic for Spring Clinical Day, May l, 1999 . Mark your calendars now. Thanks to Dr. Patty Duffner, a dynamic event is anticipated. Treatment advances in the areas of breast and ovarian cancers will be highlighted. The author and activist Betty Friedan will be the Stockton Kimball lecturer. Don't miss the opportunity! Congratulations to our dean, john Wright! Moving the offices of dean within the medical school walls in order to be closer to where the students are is indicative of his known talent for and interest in improving the medical school experience here at UB. My confidence in the medical school, and in the quality of our future graduates, is heightened with Dr. Wright at the helm. L. M AHER, MD President, Medical Alumni Association E LIZABETH �33, 3 W - 1 _N _T _E_ R_ NUMBER 1_ 9_ 9 _9 '1 'I FEB 2 2 1999 LlunAHY Steady Leadership in Changing ~mes 2 A CONVERSATION WITH .JOHN R. WRIGHT, 12 Managing Mental Health with Care RONALD I. MD, MD '62, DOZORETZ, DEVELOPS LARGEST Harold Varmus Delivers Cori Lecture IN RECOGNITION OF ROSWELL PARK CANCER NAMED DEAN IN PRIVATE OCTOBER HEALTH SERVICES COMPANY ANNIVERSARY by Scott Thomas by Catherine Donnelly 1 998 photos by K. C. Kratt BEHAVIORAL 18 INSTITUTE'S 1 DOTH Major Health-Care lntitiative U 8 PART OF FEDERAL PROGRAM TO BRING HEALTH-CARE PROVIDERS TO UNDERSERVED AREAS Medical School Town Hall Meeting • DIRECTOR OF NATIONAL • PRIMARY CARE EXTERNSHIP / INSTITUTE ON PRECEPTORS LISTING ADDICTION, ALAN INTERNET ACCESS FOR LESHNER, RURAL COMMUNITIES AStudent's Perspective: Alumni SEXUAL IDENTITY • .JEROME KASSIRER ' 5 7 HONORED CLINICAL PRACTICE SETTING PHD, • by Frank P. Carnevale, MD '95 .JOSEPH A. B ELLANTI ' 5 8 NAMED D ISTIN- GUISHED ALUMNUS • REUNION WEEKEND! I. SPEAKS AT UNIVERSITY AT BUFFALO ISSUES IN A DRUG �zn NGINGTIMES P H 0 T 0 G R A P H Y B Y K. C. K R A T T JOHN R. WRIGHT, MD, INTERIM DEAN FOR THE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES SINCE JANUARY 1, 1997, AND CHAIR OF ITS DEPARTMENT OF PATHOLOGY FOR 23 YEARS, WAS NAMED DEAN OF THE SCHOOL IN OCTOBER 1998. IN ANNOUNCING THE APPOINTMENT, UB PROVOST THOMAS E. HEADRICK PRAISED WRIGHT'S CONTRIBUTIONS AS INTERIM DEAN, CITING HIS "EXTRAORDINARY PERFORMANCE IN THE MOST CHALLENGING OF TIMES FOR MEDICAL SCHOOLS AND HEALTH CARE IN GENERAL." 0 Buffalo Phy sici an W i n t e r 1999 �JoHN R. WRIGHT, MD, 24TH DEAN OF THE UNIVERSITY AT BuFFALO ScHoOL OF MEDICINE AND BIOMEDICAL SciENCES. Michael E. Bernardino, MD, vice president for health affairs, praised Wright, as well. "john Wright demonstrated his devotion to the medical school by serving as interim dean during a very turbulent time. His wisdom, thoughtfulness, and honest and focused leadership enhanced my transition to the university, and !look forward to working with him as we strive to fulfill the mission of the medical school and the university." • perceptive understanding, openness and resoluteness have made it possible for the university and the medical school to move for\\·ard toward fundamental changes during a difficult period,·· Headrick added, lauding Wright's equanimity, determination and sense of purpose. "I look forward to his continued help and guidance through the thicket of concerns affecting health care and medical schools." B u f f a l o Physician w i n t e r I 9 9 9 �L STEADY - I N LEADERSHIP ---- CHANGING T I M E S ----- A CONVERSATION WITH DEAN JOHN R. WRIGHT s Wright embarks on his tenure as dean, he confronts unprecedented business and fiscal challenges that are inextricably tied to his ability to successfully further the school's primary mission of educating future physicians and research scientists. In early November, he took time out of his busy schedule to talk with Buffalo Physician about some of these challenges and to describe strategies being explored to meet them. With his long history of leadership at UB in many areas of endeavor, from teaching and clinical practice to administration and volunteer service, Dean Wright clearly draws on his deep affection for the school as he strives to provide steady leadership in these changing times. 1In April of last year, Dr. Michael Bernardino assumed the role of vice president for health affairs at UB. What is the scope of his responsibilities in relation to yours as dean of the medical school? SA UNGER with the school's immediate environment, specifically its education and research missions. Obviously, l too am concerned with the practice plan since it affects these two school missions and our overall financial viability. So , there are certain aspects of my job that are very closely intertwined with those of the vice president, and we work together on these issues. Until April of last year, the vice president and dean positions were combined, which is the trend in medical schools today, particularly in those that own their own hospital. Our situation, however, is different and probably more complex than most medical schools. Dr. Bernardino's primary mission will be to work with our affiliated hospital institutions and managed-care organizations to develop productive working relationships with them and- interwoven with that mission-to develop a viable practice plan for the faculty. ln addition , he is also the vice president for the university's four other health-science schools and so he must look after their best interests, as well. The medical school dean, on the other hand, will be more concerned Why is the Clinical Practice Plan as it involves medical school faculty being reorganized? We have a practice plan that has been very difficult to operate and oversee for a reason that is fairly simple: lt was designed as a one-size-fits-all plan for all four of the state's medical schools. However, the other three SU Y schools have their own university hospital, and we do not. And this situation has made it very difficult for Buffalo to develop its own workable practice plan. What has happened is that rather than a single, centralized plan, we have a practice plan within each clinical department, and in some departments there are even additional subdivisions. So we have roughly 22 different practice plans, each with its own separate corporation, business manager, billing system, rules and bylaws and so on. In this milieu, how can the university know what's going on, or negotiate managed-care contracts? How can we monitor the entirety of the practice plan to ensure that we comply with the various regulatory agencies; and if we are asked for an accounting of the plan, how can we respond to that request in a timely and effective way? Surprisingly, despite this lack of central Dean Wright (right) works closely with Michael Bernardino, MD, vice president lor health affairs. organization, the practice plan has worked 0 6 u f f a l a P hysici a n W I n t e r 1 9 9 9 �Ever the professor, Wright lectures on several topics in the General and Systemic Pathology course and says he hopes to continue to be involved in resident education in pathology. measure of accountability, but we should be able to operate in a much more efficient way. In order to be able to contract with the MSO, which is called UB Associates (UBA) , the departments will all have to become not-for-profit, "1412," state corporations. Some already qualify as this kind of entity, but there are other configurations out there that don't conform and so will have to change. rather well over the past decade. But in our particular environment, the departments have had to be entrepreneurial to a degree that has increased plan variability from department to department. And, with managed care, new Medicare regulations, and federal oversight of Medicare dollars, our system has been stressed enormously. So, where it perhaps wasn't necessary before, it now becomes imperative that we develop a more centralized system. Is there a concern that our practice plan could be subjected to a federal audit? What changes are being proposed to the plan? The federal audit that is of most concern to us and to every other medical school in this country is the PATH"physicians at teaching hospitals"audit, which a number of medical schools and medical centers have already undergone. Basically, these audits grew out of issues surrounding Medicare billing for physician services and such questions as who provided the service-residents, who are Medicare supported; or a supervising physician. One of the major issues has been whether or not the supervising physician was physically present when a critical part of the service was rendered. If the physician was not present, then Medicare contends that he or she should not submit a bill for these services since Medicare has already paid for the service through their support of the resident physician. The problem is that, for a long time, Medicare was not at all clear about what "present" actually meant. This has since been clarified, in a way, but PATH audits are retroactive in nature and extend back to when the rules were not clear. Essentially, what is being proposed is the establishment of a medical service organization, an MSO, which will not be involved in the practice of medicinethat's going to be left up to the individual departments and their corporations. What the MSO will do is provide certain services for the departments, such as centralized accounting and, hopefully, over time, centralized billing, although the actual preparation of the bills will probably remain decentralized in the departments. But all the revenues will come in to a central repository so that they can be accounted for and appropriately credited and then redirected back to the departments. The MSO will also provide centralized legal services. Currently, each of the practice plans has its own legal representation, which has been an enormous expense for the overall plan, as have been all the other decentralized services. By forming an MSO, therefore, we will not only be able to provide some B u f f a l o Physician w I n t e r 1 9 9 9 0 �S T E A D Y LE::ADE::RSHIP One of the ways to monitor these patterns of Medicare billing is to have more centralized accountability within the clinical practice plan. In a recent message in Buffalo Physician, you sa id that the medical school' s budget continues to represent a challenge, especially in terms of revenues that are centrally available to operate the school. Could you elaborate on this? This concern is not unique to our medical school. ationwide, managed care has stressed the clinical side of many, if not all, medical schools. In some instances, the financial support of the entire enterprise is challenged. In our case, the state provides roughly l3 percent of our expenditures, and the practice plan between 35 and 40 percent, with research grants and endowments making up much of the remainder. One of the things we have struggled with in our clinical enterprise at UB is the fact that we don't have a university hospital while the other universities in the SUNY system not only have a hospital that they control, but they are also subsidized for this facility. In turn, they control their graduate medical education [GME] dollars, which are significant. The GME dollars in our system go to the affiliated hospitals that participate in the GME consortium. We manage some of these funds through our consortium, but by no means all of them-or even most of them. As a result, one of the things UB is known for is that it costs less for us to educate a medical student than it does for any of the other state schools. The reason for this is simple: We do it with fewer resources. One of the ways the whole thing could be equalized, of course, would be for us to receive a portion of the subsidy that the other state schools receive for their hospitals. If we received just a small fraction of that subsidy and/or had greater control over GME dollars, we would be in a much better, much stronger, position in dealing with our affiliated hospitals and in controlling our educational programs. Is the medical school looking to obtain that subsidy? It's been talked about for a number of years. I don't want to say that we'll never get it, as I'd like to think it's a reasonable request. If we did get that money, I think we could be a model for 0 B u f f a l o As choir of the Deportment of Pathology at the University ol Buffalo for 23 years and immediate post-president of the Association of Pathology Choirs, Dean Wright (pictured here with graduate student Amy Renauld in the pathology laboratory of Robert Spengler, PhD) maintains o strong interest in his area of specialty. the rest of the state-that the state could end up devolving their university hospitals, which is something they've talked about; and for a good deal less money than they're spending now, they could develop a truly excellent medical education system. Are there advantages to our not having a university-owned hospital? ln today's world, it's considered disadvantageous to own one's own hospital, chiefly because of the financial liability involved. Also, as medical education and medical practice become less hospital-bound, the value of a highly specialized tertiary-care facility to a medical school's mission diminishes significantly. The strength of having had, or having come from , a university-owned hospital, however, is the "faculty culture" such arrangements facilitate. Without Physician W I n t e r 1 9 9 9 �S T E A D Y I LEADERSHIP that "culture," the full-time faculty do not tend to practice as a cohesive group and may not identify themselves as readily with "the university. " Well, [laughs] we're working through that. It's a major work in progress and one that's complicated by the fact that we have affiliated institutions in the process of undergoing significant mergers and/or other versions of reorganization. Traditionally, there's been a very competitive spirit among these institutions, and in today's health-care environment, that competition has only intensified. One result is the desire, in some instances, to develop more exclusive relationships with the university. For example, the CFG system has been seeking and in fact has publicly pronounced that it wants a more exclusive relationship with the university, yet we at the university also recognize our other obligations-to Erie County Medical Center, Roswell Park [Cancer Institute], the VA [Veterans Affairs medical center] and the Catholic Health System-which we're not going to walk away from. So, we will have to maintain a delicate balance in terms of exclusivity. That said, however, I think it's a certainty that we're going to have a very strong relationship with CGF, but something short of an exclusive one. Another very important issue we must address with our affiliated hospitals is the university's desire, and indeed need, to control the educational environment for our students and residents. This, of course, presents a challenge because the hospitals have an equally strong desire to control the medical services they provide as well as those who provide them. f a I o Physician w I n I M E S In selecting these centers, we're building on our strengths. In other words, we're looking at the areas in which we already have a national reputation and then proceeding to capitalize on these. The pediatrics and oncology selections clearly fit this stipulation and are areas that we thought, right from the beginning, could be established as Centers of Excellence. As for when the other centers will be named, I anticipate that this will take place once the configuration of the medical school with its affiliated hospitals becomes better defined. What is the state' s new resource allocation methodology, RAM, and how does it affect UB' s research efforts? RAM is a more precise way of allocating resources and reflects upon what you do and how successfully you do it. It's an opportunity for UB to garner more resources from the state, particularly in relationship to new research dollars. There's a sort of premium applied from the state to research dollars . By that l mean, for every new dollar that's brought in to the university, the state has promised to provide us with 20 cents, which is obviously a very attractive proposition. The problem , as I understand it, is that this is a zero-sum game. In For us, a Center of Excellence will be nationally and internationally recognized for its clinical services and research expertise in a specific area of medicine. The medical school, the clinical centers with which we are affiliated, and the entire geographic region will share in this recognition. f T Two of the Centers of Excellence at UB have been determined to be pediatrics and oncology (specifically Roswell Park Cancer Institute). What are the criteria for selecting these centers, and when will the other centers be determined? It has been announced that UB plans to establish four Centers of Excellence. What is a Center of Excellence, and what roles do research, clinical practice and medical education play in these centers? u CHANGING To develop the type of clinical expertise required for a Center of Excellence, you need to recruit physicians and develop programs that have a national reputation and be able to draw patients from well beyond this region. To maintain a Center of Excellence, you have to move forward; you can't simply stand still. You have to generate new ideas and new knowledge, and to do that, you have to be engaged in research, both clinical and basic. From the educational standpoint, nothing stimulates the development of new knowledge better than questions. And anyone working with medical students or residents knows that they make you think about things differently; they keep you from doing something a certain way simply because that's how you've always done it. So, in this way, clinical expertise, research, and medical education all fit into a common purpose when your goal is to develop and maintain a Center of Excellence. How would you describe the present relationship between the medical school and its affiliated hospitals? What changes do you foresee? B N t e r 1 9 9 9 0 �S T E A D Y LEADERSHIP I N CHANGING T I M E S and we need to recognize that these faculty members are absolutely essential to the educational programs of the school. But we also need to energetically protect programs that make us a good medical school. What are some of the issues volunteer faculty have with the university? One of the main issues is that volunteer faculty feel university faculty have an unfair advantage because they are "paid by the university." As I said earlier, only 13 percent of our budget comes from the state, and that is distributed almost equally between the basic sciences and the clinical departments. Because the clinical departments are so large, the money available for salaries is diluted rather rapidly. Also, our fulltime faculty are taxed on their clinical income, which volunteer faculty are not, and our full-time faculty are expected to teach and engage in research. Frankly, I see no such advantage; it's much more of an even playing field than is generally imagined. One advantage that I think the university does have-and, again, this gets back to all of us reading from the same page as far as the clinical practice plan is concerned-is that we represent a significant number of physicians in this community and we should be able to apply that strength to managedcare contract negotiations. If we do get our act together and do function as a group, we'd be a significant presence in this community and we'd be in a position to provide a conduit through which volunteer faculty could also benefit from these contracting relationships. In fact, right now we have a committee of the Governing Board looking at how we might integrate volunteer faculty who wish to be integrated into the system so that they can derive additional benefit from a relationship with the university. As another example, fulltime university faculty can generally obtain malpractice insurance at a much better rate than can the volunteer faculty. This is an advantage that might also be shared. Representatives from the Office of Medicol Educotion meeting recently with Dean Wright include (/eft to right) Fronk Schimpfhouser, PhD, Dennis Nadler, MD, ond Thomas GuHuso, MD. certain respects, RAM is more a shifting of resources than a source of much new money. For example, if our productivity goes up in a certain area and another school's productivity falls , the resources from that declining institution will be transferred to us, and vice versa. If everybody's productivity goes up in a certain area, there might be little shift in funds-or new funding. There' s been some discussion about university-based physicians establishing clinics in the community. Is this being considered and, if so, how do you see this affecting the "towngown " relationship? Part of the concern about the campusbased University Physicians Offices [UPO), of course, revolved around the so-called "towngown" relationship. In some ways, the very existence of physician offices on campus bordered on a tightly held secret; these were not advertised and there was no large signage on campus, presumably to avoid some of the inevitable town-gown issues. But these are issues that are not going to go away; they're part of the territory for our medical school, and for most other medical schools. What we would like to do, however-and I think this is possible-is to collaborate with volunteer faculty in a community effort to better distribute our geographic fulltime faculty. These faculty might have office hours at practice sites that aren't owned by the university, perhaps in rented space where they could make themselves available to patients and to those volunteer faculty members involved in our teaching mission. I feel that this could be a win-win situation for both the university and the town and an arrangement that could mute some of the town-gown tensions. After all, we are a community medical school. We need volunteer faculty 0 B u f f a l How would the university benefit from being in the community? We need to have a more decentralized educational system. The number of hospital beds is shrinking and the push, particularly in primary care, is to have students educated where primary care takes place-and o P hysician w I n I e r l 9 9 9 �5 T E A D Y LEADERSHIP I N CHANGING T I M E 5 Medical informatics is also an important part of modern curriculum development. We have an outstanding new computer lab available to our students, and we need to ensure that they have "free time" available to use it. Currently, we are charging a task force to look at the curriculum for all four years, but with a "deliverable" part that can be implemented next fall . Stan Spurgeon, a faculty member in the Department of Emergency Medicine with a strong commitment to education, is chairing that committee. that isn't in a hospital intensive care unit. We're shifting from a paradigm in which virtually all medical education took place in a hospital environment, which is a very artificial environment for primary care, to a more balanced situation where a good deal of education occurs in the office practice. So there is definitely an advantage for us to have our geographic full-time faculty distributed in the community, with closer working relationships with volunteer faculty. What is the status of the medical school's curriculum? Can faculty and students anticipate changes? Yes, they can. We have a fairly traditional curriculum in this medical school. Recently, we've added some innovations, such as problem-based learning [PBL]-the current rage in medical schools-but our core remains traditional. A number of schools around the country have revised their curriculum to introduce PBL either in toto or in part. We're pretty well convinced that there are some very significant merits to both the PBL approach and the traditional approach, so we're striving to develop a hybrid. A major problem is that by introducing PBL into the first and second years, we now have a very crowded curriculum. This is particularly true for first-year students, who are in class more than they should be. So we need to have a more coordinated/integrated curriculum. Dr. and Mrs. Robert Smolinski, MD, clinical assistant professor of orthopaedics and medical director of UB' Sports Medicine Institute, enjoy an informal moment with Dean Wright. BIOGRAPHICAL BACKGROUND ------ ~----- Monitobo, Conodo, John R. Wright received his medical degree from the University of Monitobo in 1959. He then served his internship ond o resident yeor in internal medicine ot Winnipeg General Hospital ond in pathology of Baltimore City Hospitals. In 1964, he completed his residency in pathology of the Buffalo General Hospital (BGH). Wright olso wos oNotionollnstitutes of Health fellow in endocrinology ot BGH ond in 1965 received o two-yeor Buswell Fellowship, which he spent teaching ond conducting research. From 1967 to 197 4, Wright served os on ossistont professor of pathology ond oncology ot the Johns Hopkins School of Medicine. In 1974, he returned to UB to choir its Deportment of Pathology, o position B u f f a l o Physician w I n he held until being nomed interim deon ot UB in Jonuory 1997. During his 23-yeor tenure os choir of pathology, he olso headed the Deportment of Pathology of BGH. Wright hos olso enjoyed o long offiliotion with Roswell Pork Cancer Institute. From July 1985 through October 1986, he served os interim director of the institute; he wos olso o member ond long-time choir of its boord of visitors until it disbanded in1997. Todoy, he remains on the boord of the Roswell Pork Cancer Institute Alliance Foundation. Notionally, Wright is immediate post-president of the Association of Pathology Choirs ond o former member of the Notional Caucus of Bosic Biomedical Science Choirs ond of the administrative boord of the Council of Academic Societies of the American Association of Medico I Colleges. + t e r l 9 9 9 0 �5 T E A D Y CHANGING T I M E 5 James Plott White Society Executive Committee members hosting o congratulatory dinner. Lehto right ore Or. Charles ond Anne Tirone, Oeon Wright ond his wife, Oeonno. What are some of the attributes you would like to see in a physician who his or her medical education Obviously we would like to make certain that the individual becomes a competent physician with the knowledge base to enter into whatever postgraduate training program he or she chooses and the skills, or sense of curiosity, to continue as a lifetime learner. We would also like to train physicians who think beyond the pure science of medicine, who are imbued with the art of medicine and who view individuals as people first and patients with diseases second. I think our students tend to come to medical school very people oriented but somehow we manage to beat it out of them in the first two years, and maybe in the clinical environment, as well! We need to pay more attention to nurturing the attributes they come to us with and to see that these are not only preserved, but reinforced. whom I knew quite well, I recall that he was a pretty relaxed individual [laughs). There were few of the challenges then that face the deanship today: He was able to go on rounds with students and we would almost never talk about the economics of medicine or fiscal or legal oversight. Those weren't the sorts of things he had to contend with. On the other hand, medicine itself has advanced enormously, and we now enjoy the opportunity to teach students many more exciting things. In my view, one of the most frustrating parts of medicine today is the conflict between having the ability to successfully treat a great number of conditions, yet not having enough resources to provide these treatments to every citizen in need of them. As dean of a medical school, you must ask, How will we apportion these gifts, and how do we fit them into the fabric of our health-care environment and the bureaucracy within which our graduates will need to function? Such ethical considerations were not things that really concerned my dean. Much of this conversation has been about change. What is your overall impression of the health of UB' s medical school and its future? What are the most pressing challenges you face as dean, and do you feel this is a particularly diHicult time to lead a medical school? I'm an optimist. I think we're going to go through some difficult times, though. The construct of the practice plan in Absolutely! When I think about my own medical school days and my dean, a u f f o 1 o Phys ician w 1 n t e r 1 9 9 9 �S T E A 0 Y I LEADERSHIP CHANGING N T I M E S There's going to be a good deal of work ah ead, but we have the matrix here for success. First of all, we are the only medical school in the immediate region, which is not a situation shared by all medical schools. Also, we are a community-based medical school and I think the larger community- not just the hospitals but the business community, as well- recognizes the importance of the university and the medical school to Buffalo. And that's a pretty good asset to have when you're trying to resolve difficult and contentious issues. + this medical school never really fit the environment, and getting that corrected is going to be a challenge. But I believe it's a very do-able goal. The competition that is driving the hospitals to change their configurations is-from the standpoint of progressvery healthy but, on the other hand, we don't want to get caught in the middle of that competition. The medical school needs to pursue its own goals and objectives independently while being aware of and sensitive to the pressures being felt by our affiliated institutions. MICHAEL BERNARDINO , MD , DISCUSSES COPING 1111 CHAOTIC ENVIRONMENT GOALS FOR UB' S MEDICAL SCHOOL • R 0 0 UB'svice president for health affairs, presented areality check on the changes in store for the medical school and its teaching hospitals in the years ahead at the October 13, 1998, "UB at Sunrise" program. The inevitable pain that will accompany the changes, he assured the audience of 170, will be worth the eventual gain. "Ithink if we con get through the next two to three years, the people of this community will look bock at the changes and be very, very proud," Bernardino said. "If we can accomplish even half of our goals, we will hove significantly improved the quality of care in this community." Bernardino, whose topic was "How on Academic Health Center Copes in a Chaotic Environment," took office as vice president for health affairs on April1 , 1998. He come to UB from Atlanta, where he was director of managed core with the Emory University System of Health Care, Inc., and professor of radiology at Emory University School of Medicine. Bernardino said he has set out to achieve three goals lor the UB School of Medicine and Biomedical Sciences: (l) sort out the graduate medical education puzzle with affiliated hospitals to increase benefits to the public and improve residency programs; (2) increase development and research revenue; and (3) stabilize clinical revenue. UB and its teaching hospitals, he added, ore in the process of signing affiliation agreements, the heart of which pertain to residency traininggraduate medical education-and ownership of the reimbursements-from insurance providers that fund the training. As the provider of residents to hospitals and source of a major revenue stream, UB must play a larger role with the hospitals than in the post, Bernardino contended. "In the future, we need to be general partners, not a limited partner," he said. Bernardino predicted that some area hospitals will dose because Western New York has lor too many beds lor the population, and that the closings will hove a sizable economic effect. The imperative during these changes, he stressed, will be to maintain quality of core. L. B IC' 6 u f f a l o P hysici a n w I n "UB should serve as a conscience," he said. In terms of quality of care, he added, "UB physicians should strive to achieve maximal outcomes in 60 to 75 percent of patients, rather than the 50 percent national norm." In an effort to increase revenue from research and development sources, Bernardino said the UB School of Medicine and Biomedical Sciences in the future will locus its clinical and basic research on lour national centers of excellence.Two obvious areas, he said, are pediatrics and cancer; the remaining two are still open for discussion. Noting that stabilizing clinical revenue has been his major locus, Bernor· dina said that government intervention will be on ever-larger force as increasing numbers of patients ore covered by Medicare and Medicaid. Greater government involvement, he added, will bring closer scrutiny, in the form of audits of the medical school's practice plan. The practice plan is the mechanism by which university-affiliated physicians, under contract with the university, agree to return a certain portion of their clinical practice revenues to the university to support essential, but nonrevenue producing, aspects of the medical school, such as basic -science education. In the past, each clinical deportment maintained its own practice plan. "In this environment, we can't operate a practice plan in a decentralized manner with decentralized authority," Bernardino stated. Underscoring the need to introduce sound-business management, he added, "We need a corporate mentality rather than a cottage industry mentality. We must emphasize the group needs rather than individual needs." In the current chaotic health-core environment, Bernardino said, the medical school must constantly question conventional wisdom and determine its own path to a new level of stability and excellence. "I hove no question about our surviving," he said. "I hove no question about our thriving." BY t e r 1 9 9 9 LOIS BAKER - �Managing Mental Health with UB ALUM DEVELOPS LARGEST PR I VATE BEHAVIORAL HEALTH SERVICES COMPANY C r j OR R ONALD l. DOZORETZ, MD, CLASS OF IJ HAPPEN: ~ BECAME THE LARGEST I 1962, IT ALMOST DID 'T OT THE THRIVI G PSYCHIATRY PRACTICE HE FORMED, WHICH VIRGINIA, A D OT THE ME TAL HEALTH MA AGED-CARE COMPA Y HE FOUNDED, WHICH GREW I TO A MULTIMILLIO - DOLLAR ENTERPRISE ACROSS THE In fact, if it weren't for the timely intercession of a caring professor at the University at Buffalo's school of meaicine, Dozoretz might not even have had the privilege of becoming a physician. But that's leaping ahead. To fully appreciate Dozoretz's faltering start to a stellar career in health care, it's important to go back to the beginning, to a little fruit market in Buffalo's Riverside neighborhood. There, as a boy, he worked for his parents-his father, an immigrant from Russia, and his mother, a lifelong Buffalonian-from a very B u f f a 1 a Ph U !TED STATES. young age. Later, he helped out at the small supermarket his family opened off Sheridan Drive. Work was part of the Dozoretz way of life, and that ethic extended to education, as well. Throughout his elementary school years, Dozoretz attended parochial schools and did well; however, when he entered public school, he discovered he was a grade behind. Determined to catch up to his peers, he succeeded in graduating from Bennett High School in three years. He then pursued studies in biology at the Uni- ysician w 1 n t e r 1 9 9 9 �versity at Buffalo, earning his bachelor's degree in 1958. "For kids of that generation who were smart and really fortunate, medical school was the best opportunity," Dozoretz recalls today. "There was dentistry and pharmacy, too, or maybe even law school," he adds, "but nobody talked about going into business. It just wasn't a consideration in those days the way it is now." -lJ ozoretz chose medicine. At about the same time he entered UB's medical school, however, he also chose to get married to Marilyn Bass, and the combined stresses of adjusting to married life and absorbing the enormous amount of material presented to first-year students almost proved too much for him to handle. "With school and marriage, I got stressed out and started falling behind," he says. Finally, at the end of that academic year, three professors-Mouchly Small, Harold Brody and 0. P. Jones- called him in and had a candid talk with him: He would have to get his life in order, they told him, and repeat his first year of studies. "It was a great gift. They could have thrown me out in a second," Dozoretz remembers. "But Dr. Small felt that I was very bright and able to handle the work, so he gave me another chance. As it turned out, I went on to finish, and I think I came out pretty high up in my class. This clearly had a major impact on my life-one that I still remember. " The medical degree Dozoretz earned at UB opened the door to a remarkable transformation from doctor to businessman. First came the clinical studies he conducted with Dr. Julian Ambrose at what was then Roswell Park Memorial Institute in Buffalo. Dozoretz had developed a strong interest in hematology, and at Roswell Park he studied clotting disorders, work that won him a rotating internship at Case Western Reserve University in Cleveland. It was there that he discovered what would become his lifelong calling-psychiatry. B u f f a l o . c c < z m 0 m Ronald I. Dozoretz, MD '62, is chief executive officer, chair and founder of FHC Health Systems. "I loved the medical part of it," he says, "and I felt that with psychiatry I was able to do the medical things that I was interested in, particularly neurology. And the people in the department Physician there were very, very capable. So I switched specialties." After three years as a psychiatric resident at Case Western, Dozoretz served two years as a lieutenant com- DESPITE THE CONTINUING SUCCESS OF FHC HEALTH SYSTEMS, OOZORETZ STILL MANAGES TO FIND TIME TO TURN HIS ATTENTION TO CHARITABLE AND PUBLIC-SERVICE CAUSES . HE'S ESPECIALLY PROUD OF A PROGRAM FOR MINORITY STUDENTS HE HELPED DEVELOP AT NORFOLK STATE UNIVERSITY. W I n t e r 1 9 9 9 �In 1982, he sold the company and began creating what has since become a sprawling, full-service behavioral health-care and managed-care company, FHC Health Systems, headquartered in orfolk, Virginia. Today, FHC-which Dozoretz heads as CEO and chair-is the largest privately held company providing behavioral health services throughout the United States and Canada. With the completion of a recent acquisition , it's also the secondlargest mental health managed-care company in the nation. Injune 1998 the company acquired Value Behavioral Health Inc. and created ValueOptions Inc., which covers more than 20 million people through contracts with over 900 customers and a network of 60,000 providers nationwide. ValueOptions, which operates as a subsidiary of FHC Health Systems, manages behavioral and psychiatric land United States, but to Puerto Rico and the U.S. Virgin Islands, as well. FirstLab is the company's international drug and alcohol testing division, serving corporate clients , state and municipal governments, and even several professional sports teams. RX Innovations is a pharmacy benefits management company with a focus on behavioral health drug management. With the creation of ValueOptions, FHC now employs about 6,000 people. The company's growth record is a source of great satisfaction for Dozoretz, but he prefers to emphasize FHC's goal of becoming better , not necessarily bigger. It's this ongoing emphasis on costr~ omething else he "had" at that effective, quality care that has helped time was the realization that FHC to form alliances with the Univerhis small practice in Portssity of Virginia and the johns Hopkins " Jmouth was hamstrung by a University to conduct outcomes research ........,/ lack of proper facilities for for treatment of psychiatric illnesses. his patients. "We basically had a few "For the past 50 or 60 years, mental health care has been rooms in the basement of one of the provided virtually FOR MANY, THAT WOULD HAVE BEEN THE HAPPY DENOUEMENT hospitals ," he rewithout data ," calls. "There was Dozoretz notes. "It TO A LONG-SOUGHT-AFTER GOAL, BUT FOR DOZORETZ, IT WAS no occupational was conducted in this ONLY THE BEGINNING . THE ROAD LAY AHEAD, AND IT WAS WIDE therapy , no recreoffice or that hospiational therapy, no tal, and maybe thereOPEN. "I'VE ALWAYS HAD AN ENTREPRENEURIAL SPIRIT IN ME. art therapy and no sults were published I JUST THINK YOU EITHER HAVE IT OR YOU DON'T. " group therapy room. in a journal article, It was very difficult but practitioners to treat patients. " rarely spoke with Dozoretz's solution was to broker a health care in two arenas: in the public each other. There was no one who would deal with the developer of a nearby sector, through the federal Medicaid compile the data to find out what really nursing home to establish a psychiatric program and with military contracts; worked in mental health care. unit in the building. The developer built and in the private sector, through indi"At FHC, we have a significant volit, then leased it back to him. From vidual contracts with dozens of compa- ume of data that allows us to define and there , Dozoretz expanded the practice nies , including some of the largest in determine what the best treatment plan to over 125 practitioners in more than the United States. is for certain types of ailments . With While ValueOptions is FHC's newest this data , we can help practitioners 10 offices throughout Virginia and became founder and medical director of initiative, the company's other subsidiar- know how to help patients to get better Portsmouth Psychiatric Center, one of ies have been just as ambitious and just as faster. We also have an extensive inforthe first private psychiatric hospitals in successful. Alternative Behavioral Ser- mation management service division ; vices manages a wide range of programs it forms the basis of what we do, beeastern Virginia. Seeing the potential for providing for troubled young people, including al- cause we pay claims to millions of psychiatric services and facilities , ternative schools, outpatient services, patients and take millions of phone Dozoretz then founded a company called home and community programs, group calls every day. " American Medical Centers Inc., and his homes , alternative living programs, teen By using its vast stores of data to career as a developer was born. "We "boot camps," secure facilities , residen- structure treatment plans that have built and developed more than 30 hos- tial centers and acute inpatient facilities. proven, measurable outcomes, FHC has pitals around the country," he says. Its reach extends not only to the main- been able to sustain its mission of pro- mander at the U.S. aval Hospital in Portsmouth, Virginia , where he treated inpatient and outpatient service members at the height of the Vietnam War. "We had two kids , a rented house and a lot of debt, " he remembers. But he and his family loved Portsmouth, so when his time in the service ended, he established a practice there. For many, that would have been the happy denouement to a long-soughtafter goal, but for Dozoretz, it was only the beginning. The road lay ahead, and it was wide open. "I've always had an entrepreneurial spirit in me. I just think you either have it or you don't. " ® B u f f a L o Physician w I n t e r 1 9 9 9 �viding patient-centered care. "We focus on taking care of patients; this is the most important thing we do," Dozoretz stresses. "We don't look at it as a business as much as a service. We're trying to help people to get better care in a more organized, cost-effective way. "Mental health services today are much more acceptable than they ever were before," he continues. "If a person needs help, or his or her daughter, son, aunt or uncle need it, I think they're very comfortable asking for it. And the new medications, such as Prozac and Clozeril, are extremely effective. They have changed lives and the way mental health care is provided. People spend less time in hospitals now." Despite the continuing success ofFHC Health Systems, Dozoretz still manages to find time to turn his attention to charitable and public-service causes. He's especially proud of a program for minority students that he helped develop at or- folk State University. His theory, he says, is that many minority students are highly capable of succeeding in the sciences at the college level, but they may be put off by the prospect of entering a big college. At orfolk State, for about a dozen years now, the Dozoretz ationallnstitute for Minorities inAppliedSciences has helped support 20 minority students each academic year. "We've graduated many hundreds," hesayswith pride. "About half go into medicine and dentistry, half into other sciences. " Dozoretz also has instituted a mentoring program throughout FHC, in which students at the company's various offices learn about the healthcare business and receive support and encouragement from company employees. The program was featured in President Clinton's recent summit in Philadelphia, with General Colin Powell promoting volunteerism in American life. $1 399 Enterprise Series 300MHz Pentium II• Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Drive • Iomega Zip Drive atap1 • 17" .27NI SVGA Digital Color Monitor • 8MB AGP Graphic Accelerator • 56K V.90 PCI Fax/Modem • 36x IDE CD-ROM B u f f a I o Physic Dozoretz's public involvement also has included serving on the White House Health Reform Task Force, as vice chair of the Reduction of Bureaucracy Group. He also serves on the board of trustees of the Kennedy Center and is a board member of the National Health Policy Council, where he is active in the restructuring of the nation's health-care policies. Dozoretz's home life is full of hopes and plans for the future, as well. He and his wife, Beth, have two small children: four-year-old Josh, and their newly adopted daughter, Melanne Rose. His two daughters-Shari and Reneefrom his previous marriage both live close by. Acquisitions, outcomes, policies, panels and philanthropy: It all seems like a long way from the family fruit market on the West Side of Buffalo. But Dozoretz still remembers that it almost didn't happen-except for a second chance that turned out to be a first-rate decision. + Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! • Sound Blaster 128 PCI Stereo Sound Card • Sound1mage Subwoofer System • 3.5" High Density Floppy Drive • Microsoft Windows• 98 • Corel• Wordperfect Suite 8 (includes; Wordperfect 8•, Quattro Pro 8•, Presentations 8· ) • Zodiac 1000 CD Bundle 1·716 ·'743 ·0195 TECHNOLOGY DI S TRIBUTION NETWORK www.tdn.net 1000 Young Street . Suite 270 . Tonawanda NY 14150 . Fax: (716) 743 .0198 Ia W I n t e r 1 9 9 9 �r \ 11 c~r c. (_ was the focus of the 30th annual Cori Lecture presented at Roswell Park Cancer Institute (RPCI) on0ctober20, 1998, by Harold Varmus, MD, director of the National Institutes of Health. This year's lecture was held in conjunction with an ongoing series of symposia and special events at RPCI in celebration of the institute's lOOth anniversary (see article on pages 18- 19). In discussing the future of cancer care, Varmus predicted that "it's quite likely we will learn HE QCEST FOR! D \ D' AI I T"\ I to tailor cancer therapies to the lesions at the genetic level. Our immediate future will be to create treatments that target the cellular level of cancer and are widely available to all cancer patients." He then talked specifically about research he is currently conducting on gliomas, one of the most common forms of cancer of the central nervous system. seen in patients with the most aggressive form of the cancer. "In the initial study Varmus, who shared the we found that introduc1989 Nobel Prize in ing mutant bFGF inPhysiology and Medicine duced proliferation and with Dr. Michael Bishop migration of glial cells for demonstrating that without the induction of oncogenes can arise from tumors. So, we went back normal cellular genes, exto the beginning and inplained that glioblastoma troduced mutant VEGF. multiforme is of particular ::r Subsequent analysis of interest to him today. This the brain tissue found a poorly differentiated, rapglioma forming in the idly growing tumor is one brain," Varmus said. that occurs most often in The mice with glioNIH DIRECTOR SPEAKS AT adults and was the cause of mas developed hydroROSWELL PARK IN CELEBRATION death for a colleague of his. cephalus ; this proOF INSTITU T E ' S 1 00T H "It has been shown that nounced swelling of the 15 to 20 percent of paANNIV E RSARY head will help identify tients with gliomas reanimals with successful spond to the conventional tumor development. A combination treatment of magnetic resonance imBY CATHERINE DONNELLY surgery, radiotherapy and age (MRI) of the mice chemotherapy. It is not with hydrocephalus clear, however, why some patients respond and the rest also detected the tumor. These clinical observations will do not. We decided to seek the combination of genes allow animals suspected of having a glioma to mature, that control the mutations seen in these cancer pawhich in turn will enable researchers to study more tients," he explained. advanced tumor development. In order to study the gene mutations ofgliomas, Varmus's "Our studies matched some of the clinical progreslaboratory used an avian virus-based retroviral vector sion seen in human patients. It would appear that system to implant suspected genes into mice. Two genes in combinations of oncogenes are necessary to create the particular were studied: basic fibroblast growth factor migratory gliomas, but this is a good first step. We now (bFGF) and vascular endothelial growth factor (VEGF). can move toward the question of where to attack this More than 90 percent of glioma patients have an abnonnal disease and which genes consistently cause this canexpression of these genes, and they are predominantly cer," Varmus reported. Seeking Genes That Control Mutations B u f f a I a Physician w I n t e r I 9 9 9 �. . . LL . < Harold Varmus, MD, director of the Nationallnstitues of Health, at Roswell Park Cancer Institute. Future studies in oncology will not only continue to expand the list of genetic determinants of cancer but also explain the function of these oncogenes and their roles in the process of tumor development. In tum, physicians will be able to identify the gene causing a tumor and treat it appropriately, according to Varmus. "We will continue to build models of human cancer in animals and determine the genetic changes that cause tumors. It is reasonable to expect that we will learn the pattern of mutations and gene expression in cancer and create remedies to cure those tumors," he predicted. For the majority of their careers, Carl and Gerty Cori collaborated on the chemistry of the glycogen-glucose cycle, work that earned them the 1947 Nobel Prize in Physiology and Medicine, which they shared with Dr. Bernardo Houssay of Argentina. With this honor, Dr. Gerty Cori became the first American woman and the third woman in the world to be awarded the Nobel Prize. "The work that Carl and Gerty Cori performed resonates in the scientific community today," Varmus stated. "They helped us to understand sugar metabolism and its effect on tumor development, as well as to elucidate the mystery of diabetes. But, a greater message from their lives is the need to encourage women in the field and the incredible results obtained from collaborative efforts. " Varmus also pointed to an ongoing conflict in the scientific community between clinical researchers who need and want to work together on a project and the tendency in the field to reward independent efforts. "Teamwork," he emphasized, "is the way we need to go." + The Cort Legacy of Collaboration In addition to discussing cancer research, Varmus also stressed the need for collaboration in the scientific field and recognized the exemplary work of Drs. Carl and Gerty Cori, who held positions at Roswell Park Cancer Institute from 1922 to 1933 and for whom the Cori Lecture is named. B u f f a l o Ph ysici an w I n t e r 1 9 9 9 �BY CATHERINE • DONNELLY .. University of Buffalo, so a new building was constructed through fund-raising efforts and the generosity of Mrs. William Gratwick. In 1901 the Gratwick Research laboratory of the University of Buffalo was opened. In 1904, Harvey Gaylord, MD, was named the second director of the institute when Dr. Park stepped down. As part of this transition, Drs. Park and Gaylord determined that the laboratory should be owned and managed by New York State, rather than jointly by the state and the university, as had been the case since its founding. "The laboratory was maintained by an annual grant from New York State, but the state owned neither the land nor the building-these were owned by the University of Buffalo. Dr. Park, Dr. Gaylord and other influential administrators persuaded everyone involved to transform Gratwick Research Laboratory into a state institute," explains Mirand. The legislation to transfer the facility was signed on May 10, 1911. The University of Buffalo's Council subsequently passed a resolution, signed by 14 of its 22 members, agreeing to transfer the Gratwick Research laboratory to the people of ew York State on February 29, 1912. The university received no compensation for the transfer, and the laboratory was renamed the ew York State Institute for the Study of Malignant Diseases. The next step in the evolution of the institute came on March 7, 1912, when a grant of land and monies was provided for construction of a hospital on High and Oak Streets, near the current site of Roswell Park Cancer Institute. "The time has come when the State Cancer laboratory should have hospital facilities for research purposes. All the great modern institutions of medical research are so equipped," stated Gaylord, referring to the fact that the institute had been using the Buffalo General Hospital for its patient care. In 1913, construction was com- world's first institute dedicated to cancer research, is celebrating its lOOth anniversary this year. Since its establishment in 1898 by Dr. Roswell Park, RPCI has maintained a close relationship with the University at Buffalo, which played an integral role in its early development. Park, a world-renowned surgeon, had the prescience to realize that cancer would become one of the most common diseases to plague mankind. To confront this challenge, he proposed the concept of a multidisciplinary institution that would include research, treatment, follow-up care and education. Soon thereafter, he went in search of funds to launch his institute, which was destined to become a prototype for today's comprehensive cancer center. With the help of Buffalo Evening News editor Edward H. Butler Sr., Park began by requesting a $10,000 grant from the New York State legislature. "Dr. Park pioneered the modernday structure of government funding. He believed that New York State should fund biomedical research and cancer investigations, in particular, although monies for biomedical research had never before been received from a government source," explains Edwin A. Mirand, PhD, DSc, emeritus vice president for educational affairs at Roswell Park Cancer Institute and author of The Legacy and History of Roswell Park Cancer Institute. It took two attempts and an election year to pressure Governor Frank S. Black to finally approve the funding from the legislature on April 29, 1898. The facility, which opened shortly thereafter, was named the New York State Pathological laboratory of the University ofBuffalo and was housed on a floor of the University ofBuffalo, then located at High and Elm Streets. Its mission, as stated at the time, was to focus on "defining cancer, its causes and cures." Two years after the laboratory was founded, it outgrew its floor at the B u f f a I o Phys i cian W I n t e r 1 9 9 9 �...... --~ the New York Pathological Laboratory of the University of Buffalo was founded. Its first home wos on the first floor of the university, then located at High and Elm Streets (/eft).ln 1901, a separate facility wos built and named the Gratwick Research Laboratory (below). In 1946, the laboratory was renamed in honor of Dr. Pork. passage of the National Cancer Act of 1971 by testifying at congressional hearings held at the institute to outline the need for significant and continued support of cancer research. Roswell Park Cancer Institute's relationship with the University of Buffalo was strengthened again in 1955 under George Moore, MD , its fifth director, who believed that a comprehensive cancer center should be involved in education, particularly graduate education. Moore was joined in promoting this concept by UB president Clifford Furnas; john Payne, MD, professor of surgery; and Henry Woodburn, PhD, dean of the Graduate School, who helped to found the Roswell Park Graduate Division by charter in 1955. "ln addition, in 1983, RPCI and UB created the Graduate Medical Dental Education Consortium of Buffalo to jointly train residents and fellows interested in oncology. Originally, RPCI had established separate residency and fellow programs, but it later transferred the programs to the university to maintain their quality and consolidate appointments. To date, RPCI has helped to train more than 4,000 residents and fellows who now work throughout the world, and many of the oncologists in ew York learned from this partnership," says Mirand. ln May 1998, RPCI unveiled its new Diagnostic Treatment Center and Inpatient Tower. This facility is the cornerstone of the $241.5 million Major Modernization Project to renovate the institute's 25-acre campus and provide a foundation for state-of-the-art cancer treatment and research into the 21st century. pleted and Cary Pavilion, a 30-bed hospital, opened at the institute. Around the tum of the century, work at the NewYorkState Institute for the Study of Malignant Diseases was recognized worldwide and served as a model for cancer research and treatment across the globe. lts accomplishments influenced President William Taft, who visited the institute in 1910, to urge support of a federal cancer program; however, efforts to .. - establish a federal cancer program did not gain momentum again until President Franklin D. Roosevelt was in the White House. Roosevelt, who understood the goals and programs of the New York State Institute for the Study of Malignant Diseases from his years as New York State governor, signed the first National Cancer Act in 1937, which also established the ational Cancer Institute. Almost a decade later, in 1946, the ew York State Institute for the Study of Malignant Diseases was renamed Roswell Park Memoriallnstitute in honor of Dr. Park. (In the early 1990s, its name was again changed to Roswell Park Cancer Institute.) The institute's influence on national cancer legislation remained strong, and its leaders played an instrumental role in B u f f o l o Physic i an W I n t e r 1 9 9 9 �• · · ··········· · · · ··················· ...... .............. ...... . . . . . ... . .... . ...... . ... Initiative to Bring Health-Care Providers to Underserved Areas UB HEADS FEDERAL EFFORT I N NEW YORK 2 0 ew York State ranks sixth in the nation in the number of people living in areas with fewer than 150 residents per square mile. Unfortunately, only about one in 3,000 of those persons is a physician, and the ratio is worse in the state's inner cities. To help alleviate this shortage of health professionals in the state's underserved communities, the School ofMedicine and Biomedical Sciences at the University at Buffalo is teaming up with the State University of New York Health Science Center at Syracuse and other ew York professional schools. The effort is being aided by a three-year, $3 million grant from the U.S. Department of Health and Human Services that funds the first cycle of a 12-year program with a potential for $22 million in federal funding. With the UB medical school as lead institution, the grant will fund the start-up of an Area Health Education Center (AHEC) program in New York State. The ew York program is part of a nationwide effort launched in 1972, based on the 1970 Carnegie Commission's "Report on Higher • Education and the Nation's Health. " AHEC programs now operate in 41 states. (An earlier effort in ew York State failed due to lack of institutional support.) The goal of the initiative is to bring more health-care providers into the underserved areas by establishing clinical teaching l!Jl~·ml-mlrlJi·mJ•~ . • and practice sites in these outlying communities or B u f f o l o urban settings. Each AHEC site will be managed by a locally appointed director and advisory board and will be linked with a medical school. Through these sites, students from medicine, pharmacy, nursing, allied health, dentistry and social work will get firsthand experience living among and caring for patients in underserved areas. "We urbanize most of our medical students during their training," says Thomas C. Rosenthal, MD, professor and chair of UB's Department of Family Medicine, who will oversee the initiative. "The high-profile urban medical setting is whatyoungphysicians are comfortable with, so that is where they tend to practice. "They cluster in prosperous areas of cities and suburbs for personal reasons, also. Most want to raise families where they will have the greatest opportunities, so it is difficult to retain providers in underserved rural communities, in particular. It requires a person who understands and values rural America. The only way they will see themselves in those communities, is to be in those communities. " During the program's first three years , UB will set up a statewide administrative office in its Department of Family Medicine and help establish regional offices at the SUNY Health Sciences Center at Syracuse and Albany Medical College/State University of ew York at Albany School of Public Health. During subsequent funding cycles, center staff will help establish AHEC regional centers at SUNY at Stony Brook Health Sciences Center and SUNY Health Sciences Center at Brooklyn. Each regional center will be responsible for Physician w 1 n t e r l 9 9 9 \ �······ ·· · · ··· · ·········· ·· ······· · ······· · ··· · · · · · ·· ··· ·· · ··· · · · · · · · ·· · ········ ·· ··· · ··· 2 E , ~~ e I setting up two community-based AHEC sites in underserved areas by the end of the 12-year federal funding cycle. ew York State is required to begin funding the AHEC program in its sixth year and eventually to assume full financial responsibility. Diane G. Schwartz, director of special projects for the UB medical school, will be deputy director of the statewide program office. During the first year, the UB office will establish a communitybasedAHEC site in the 14-countyWestern New York region. According to Rosenthal , each community-based AHEC will function as an arm of a SU Y health sciences center, providing teleconferencing links back to the main campus, a setting for meetings with faculty members, and support services to students and residents living in the rural communities during their rotations. Site directors and community clinicians who will act as preceptors will be trained on-site by UB faculty . "The overall objective is to attract and keep more health-care workers in underserved areas, both by linking medical residents and third- and fourth-year medical students to these communities, and by helping local practitioners feel more connected to the SU Y medical schools," Schwartz says. + Consortium Effort Looks to Improve Family Practice he Department of Family Medicine in the University at Buffalo School of Medicine and Biomedical Sciences is part of a university consortium that has been awarded $900,000 over four years to participate in a new research initiative to change the way primarycare services are delivered and assessed. The grant from the American Academy of Family Physicians was awarded to the Center for the Value of Family Practice, which includes, in addition to UB, Case Western Reserve University in Cleveland, University ofN ebraska Medical Center in Omaha and Lehigh Valley Hospital in Allentown, Pennsylvania. The Center for the Value of Family Practice was one of three centers funded out of 65 applicants. The award is part of an $8 million effort undertaken by the academy to provide a new level of scientific evidence about the importance of an integrated, whole-health approach to the practice of family medicine. "Everyone knows intuitively that family medicine is highly health-effective and cost-effective," stated eil Brooks, MD , president of the academy , in announcing the initiative. "Countless stories from the 85,000 members of the academy confirm that. But a doctor's anecdotes are not enough. " This effort, he adds , will lay the groundwork for evidence-based , outcomes-oriented research in primary care. Carlosjaen, MD , associate professor of family medicine and director of UB's Center for Urban Research in Primary Care, is UB's codirector of the project. "This is very exciting for us ," he says. "The competition was quite stiff. This initiative will give us a chance to help make family practice better for all physicians and patients. " jaen and his fellow codirectors will develop a detailed map of the core structures and processes of family practice. Their center will address five priorities: • Managing chronic diseases within the context of each patient's needs and priorities; • Increasing the ability of family practice to serve as an outlet for applying new technologies; • Integrating mental-health care into comprehensive medical care; • Developing practice-tailored systems to deliver preventive service; • Increasing the community focus of family practice. + Perez Selected to Serve as Liaison to AAFP each medical school in the United States to serve as student membership liaison for his or her campus. The AAFP, a national medical organization for the specialty of family practice, represents 85,000 family physicians, family-practice residents and medical students nationwide. renda L. Perez of Buffalo, a second-year student in the University at Buffalo School of Medicine and Biomedical Sciences, has been selected to serve as student membership liaison for the American Academy of Family Physicians (AAFP) for the 199899 academic year. As the AAFP's official UB representative, Perez is responsible for working directly with other medical students who have an interest in family practice, as well as promoting the specialty of family practice to fellow students. Each year the AAFP selects one student from \ I B u f f c I o Physician W I n t e r 1 9 9 9 I -LOIS B AKER �a · · ······················································································ Physician Preceptors Appreciated SUMMER 1998 PRIMARY CARE EXTERNSHIP PROGRAM is an innovative program that provides real-life clinical learning opportunities for students at the University at Buffalo School of Medicine and Biomedical Sciences who are interested in pursuing careers in primary care. Started in 1993 by the Primary Care Resource Center, the externship is now administered through the Office of Graduate Medical Education. The program is recognized as the largest of its kind in the nation by the American Medical Student Association's Generalist Physician in Training Initiative. The paid six-week externship, completed during the summer months, exposes both first- and second-year medical students to the true continuity of primary care. Placements are arranged in the offices of generalist physicians throughout the Western ewYork area. Students enjoy varying degrees of interaction with patients, including taking histories and performing physicals, while becoming part of the daily operation of an office. In 1998, newly defined goals and objectives, along with more detailed and frequent assessment of the program at various stages, have helped to strengthen the program by providing a consistent set of expectations for everyone involved. The School of Medicine and Biomedical Sciences wishes to extend its thanks to the following physicians who served as preceptors for the Primary Care Externship Program in 1998: STUDENT PRECEPTOR(S) Dorothy Adler Sleven J. Ambrusko Jeffrey L. Amodeo Lynn M. Barnhard David Holmes, MD Jock F. Coyne, MD Mark R. Klocke, MD Anthony Vetrano, MD, lynda S~dhom, MD, & Josey Welliver, MD Amy E. Braun Chelikani V. P. Varma, MD laura E. Cancilla Catherine O'Neil, MD, & Janet Sundquist, MD Anthony J. Caprio Richard Ruh, MD, & Mark Swetz, MD Shawn Cotton, MD Thomas V. Caprio leslie A. Chamberlain Herbert Joyce, MD J. Thomas Reagan, MD Jeffrey Chung Andrea Manyon, MD Kristin L. Clark Timothy F. Corvino Herbert Joyce, MD Jessica L. Dolewilz Charles Hershey, MD Raphael Wang, MD Sorabh Dhar Holly J. Drexler lorne Campbell, MD Ani J. Fleisig Donald Robinson, MD, & Emily Freidan, MD Jeremy J. Flood Brian Connolly, MD Madhuri Guntupalli Gregory Snyder, MD Brigid M. Hannohoe Jock P. Freer, MD Ann Marie Hedges Colleen Mattimore, MD, & Mary E. Schamann, MD Alissa J. Huston Chester Fox, MD Gregory A. Jobes David Milling, MD Christopher W. Kling William Kuehnling, MD ® STUDENT Family Medicine Pediatrics Pediatrics Morto C. Kalthoff Pediatrics Pediatrics Internal Medicine Family Medicine Family Medicine Independent Health Admin. Family Medicine Family Medicine Independent Health Admin. Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Family Medicine Internal Medicine Pediatrics Family Medicine Internal Medicine Family Medicine a PRECEPTOR(S) SPECIALTY u f f a 1 o SPECIALTY Ashok Noik, MD, & Suwarna Naik, MD Internal Medicine Pat Collins, MD Family Medicine Eileen W. Lou Jennifer I. Lee Peter Kowalski, MD Family Medicine Peter Winkelstein, MD Sabina lim Pediatrics John Thompson, MD Family Medicine Andrew G. Moyer leah S. Millstein Howard Sperry, MD, MPH, FACP Internal Medicine lorne Campbell, MD Family Medicine Dhruli Naik Nicholas Aquino, MD Debra M. Ogie Medicine/Pediatrics Bernadette J. Pasamba Geraldine Kelley, MD Internal Medicine Peter Kowalski, MD Family Medicine Jesenia Pena Herbert Joyce, MD Independent Health Admin. Brenda L. Perez Elysso R. Peters Ashok Naik, MD, & Suwarna Naik, MD Internal Medicine Gaurong Sheth, MD Joey G. Philip Pediatrics John Brewer, MD Everett F. Porter Family Medicine Gretchen A. Schueckler Jane M. Parmington, MD Pediatrics Davindra Seelagan Thomas S. Scanlan, MD Internal Medicine Tracey C. Shanahan Fronk C. Mezzadri, MD Medicine/Pediatrics Neha N. Sheth Theodore Putnam, MD Pediatrics Kristen A. Smizzi Harry Metcalf, MD Family Medicine Britto M.Svoren John Fudyma, MD Internal Medicine Rommel M.Tolentino G. lawrence McNally, MD Pediatrics Judith A. Toski Herbert Joyce, MD Independent Health Admin. Rosolic Viterbo G. Jay Bishop, MD, FACP, & Anthony 0. Bartholomew, MD Internal Medicine Debra L. Wojtonik Russell Voughon, MD Pediatrics Nora L. Yip Geraldine Kelley, MD Internal Medicine Phys ician w I n t e r 1 9 9 9 �··· ·· · · ·········· · ············· · · · · · ··· ·· ········· ····· · · ·········· · ············· · ··· · · a THROUGH TH E Em oF A STU DE NT . . . "This past summer, as part of my Primary Care Externship, I spent six weeks at a practice, during which time I not only witnessed the bond between my preceptor and his patients, but also formed my own relationships with patients. I learned that sometimes when medicine can't cure things, an understanding and supportive ear can! This was the most exciting time in my medical school career. I experienced many things and was filled with many confusing emotions: happiness and sadness, insecurity and confidence, anger and serenity. This summer I learned what medicine is all about. " Class of 2000 - D oRoTHY A DLER , - P RECEPTOR , D AVID HOLMES , M D Bailey Family Health Center CO NTINU ED SUPPORT NEEDED The Primary Care Externship Program is currently supported by a number of sources, including the Culpeper Foundation, Independent Health Foundation, Lake Plains Community Care etwork, Buffalo General Foundation, and CGF Hospital in jamestown. In order for this unique program to continue, it needs the support of the Buffalo community. A special endowment fund has been established by Evan Calkins, MD , to develop a more consistent funding source for the program in an age of decreasing capital. An accomplished physician and leader in the medical community, with a lifelong commitment to primary-care medicine, Calkins began the fund to encourage young people to explore and pursue the generalist careers. For more information about the Primary Care Extemship Program or giving opportunities, call Susan Orrange at (716) 829-2802; or E-mail her at sorrange@buffalo.edu. B u f f a l a Rural Communities Gain Internet Access to Health Information he University at Buffalo Health Sciences Library has received a $50 ,000 information-access project grant from the ational Institutes of Health and other federal funding agencies. It will be used to help more than 700 publichealth professionals in rural upstate communities connect with the Internet and acquire access to a broad range of health information now available online through the National Library of Medicine ( LM) and its affiliated medical libraries. The UB project will serve the 17 counties of Western and Central New York, their county health departments and the regional office of the state Department of Health. The grant was awarded through a program called "Partners in Information Access" funded by the LM and its National Network of Libraries of Medicine, of which the UB Health Sciences Library is a member. Other funding agencies are the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Association of State and Territorial Health Officials. Sharon A. Gray , UB project director, senior assistant librarian and head of reference and education services for the UB Health Sciences Library, says the Physician W I n t e r 1 9 9 9 program is designed to increase awareness of the services offered by the agencies involved. "UB librarians," she says, "will use their expertise to organize Internet resources on public health and to teach health department staff to search these sources effectively. " Gray says the UB project has targeted more than 700 public-health professionals for training through workshops. Also, a Web site linking various information sites will be developed and county health department program managers , county health commissioners and the Western ewYork PubHealth Coalition will collaborate on the • project. L M z director • Donald ~ A. B. Lindberg says the projects funded will make it possible for publichealth agencies to address a variety of community health problems and special populations. They then will be able to respond more effectively to disease outbreaks and environmental health risks that affect the health and well-being of entire communities, he says. The UB project was designed by Gray; Maurizio Trevisan, MD , professor and chair of the UB Department of Social and Preventive Medicine; Robert O'Shea, PhD, emeritus professor of social and preventive medicine; and two of the department's adjunct professors, Erie County Health Commissioner Arnold Lubin and jacques Berlin of the state health department. - P ATRICIA DONOVAN ® �. . . . . . . . . . . .. . . .. . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . [1] ~ ~ I Honors Brunch Recognizes Firstand Second-Year Achievements h s B recognizing academic excellence among first- and second-year students was held at the University at Buffalo School of Medicine and Biomedical Sciences on October 11, 1998, in Harriman Hall. The following is a list of award recipients and a description of the awards received: received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to the student with the highest combined average in the two first-year physiology courses. JAY MORROW DEPARTMENTAL AWAR DS he departments of the School of Medicine and Biomedical Sciences have establish ed awards to recognize meritorious performance in their courses as well as outstanding achievement in other curriculum-related activities. BR'TTA M SVOREN received the Department ofPathology's Komel Terplan Award, presented to the student with the highest combined average in the twosecond-yearpathologycourses. Svorenalso received the Department of Pharmacology and Toxicology's Douglas S. Riggs Award, presented to the secondyear student with the highest average in the Fundamentals ofPharmacology course. received the Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the pathology laboratory. ALTER WALEK M HORB NSKI received the Department of Pharmacology and Toxicology's Edward A. Carr, Jr., Clinical Pharmacology Award, which is presented to the MD/PhD student who achieves the highest average in the Fundamentals of Pharmacology course. CRAG THOMAS M KEENAN received the Department of Anatomy and Cell Biology's James A. Gibson, Wayne ]. Atwell and Oliver P. Jones Award, which recognizes the student with the highest combined average in the anatomical sciences courses of gross anatomy, histology, neuroanatomy and embryology. CHRISTOPHER ADAMS received the Department of Biochemistry's Edward L. Curvish Award, which recognizes the student with the highest average in the two first -year biochemistry courses. ® HOPE E CAWDERY received the Department of Microbiology's Ernest Witebsky Award for Proficiency in Microbiology, which is presented to the second-year student with the highest grade in the Microbiology and Immunology course. LIN received first prize for the Department of Pharmacology and Toxicology's Astra-Merck Cardiovascular Drug Monograph Awards, which are presented to the second-year students based on the quality of a monograph written in the form of a package insert. Lin also won first prize in the department's 1998 USP Patient Information Competition. JENN FER MELISSA WOLF received the Department of Microbiology's Marek Zaleski Award, which is presented to the student who best combines high standards of academic achievement with outstanding service to the community.Each year's recipient is chosen by members of the second-year class. B u f f a l o Physician w I n t e r 1 9 9 9 �··············· · ··········· · ·················· · ······· · · · ········ · ········ · ········· · · · · E . ~~· e ' ' received second prize for the Astra-Merck Cardiovascular Drug Monograph Award competition. AARON THO J. S GUYER \11 '<EE and received the McGrawHill book awards, which are presented each year to the two highestranking students in the first-year curriculum . SC received the Evan Calkins Primary Care Achievement Award, presented to an outstanding student in the Primary Care Summer Externship Program. s N A PENA received the etter Award, which is presented to a student fellow for outstanding performance in the Primary Care Summer Externship Program. Pena also received third prize for the Astra-Merck Cardiovascular Drug j Monograph Award comj petition, described above. J 1 f r 2000 Jennifer Lin Steven Lo Todd Loftus Michael Logue Beth Lucas Dionysio Momois Andrew Moyer Everett Porter David Rice Christopher Santangelo Tracey Shanahan Andrew Stone Moriso Stumpf Britto Svoren Cheryl Tourossi Felicia Tenedios Rommel Tolentino Amy Vandewater Eric Woffner Wolter Woleck Nora Yip Dorothy Adler Mothijs Brentjens Anthony Caprio Thomas Caprio Daniel Carl Hope Cowdery Leslie Chamberlain Julie Cheng James Chevalier Frederic Chi Joimie DeRosa Christopher DiMaio Kimberly Dumoff Sumo Gono Rose Graham Modhuri Guntupolli Alissa Huston Adriano Koczaroj HeyJoo Kong Brion Klogges Marta Kalthoff Sharmeelo Kuperon Justin Kwon Charles Lou Jennifer Lee ) 1 Christopher Adams John Borgoy Thomas Botto Amy Broun Keith Chon Damian Compo Ryan Den Haese Michael Duff·Roffoele Sosho Gilmore Aaron Guyer Ann Marie Hedges Steven Kom Thomas Keenan Christopher Kling Somi Lewin Kevin Mallen Joy Morrow Barbaro Odell Songito Patel Elysso Peters David Piccioni Kilian Salerno Dovindro Seelogon Robert Setlik Mudit Sharma Koreno Steiding Robin Yates Daniel Yoon Morino Zoydmon Klagges Completes Alpha Omega Alpha Student Research Fellowship :l. rion Klogges, Closs of 2000, was the recipient of on Alpha Omega Alpha Student Research Fellowship, which provided him with $3,000 in support of a research project he completed during the summer of 1998 in the laboratory of laura E.Nikloson, MD, PhD, on instructor of anesthesia at the Massachusetts Gen· era! Hospital in Boston, Massachusetts. Under Nikloson's direction, Klogges used a \"Ideo Motion Analysis System to assist in quantitating the static and dynamic compliance of culture tissue· engineered arterial grafts in vitro. He I 8 R 1 A N K L A G G E 5 e s ,f n n e p n 9 L A (pictured on page 24) GRET DEAN'S lETTERS OF COMMEND ATION he Dean's Letters of Commendation are awarded to students who achieve 75 percent of available honors points each year. Two honors points are earned for each credit hour of honors performance; one point is earned per credit for high satisfactory. B u f f a l o Physician W I n also participated in a preliminary study examining the effects of several pharmaceutical compounds on the functional characteristics of these engi· neered vessels. Klogges graduated cum laude from Providence College in Providence, Rhode Island, where he double majored in biology and psychology. Alter graduation, he worked in the laboratory of William Abbott, MD, chief of vascular surgery at Massachusetts General Hospital. Alpha Omega Alpha is the only notionalhonor medical society inthe world. Its purpose is to recognize undergraduate medical school achievement andto perpetuate excellence in the medical profession. t e r 1 9 9 9 �• ······ · ····· · ························· i, • Multifaceted Approach to Treatment of Addiction D I RECTOR OF NAT IONAL INSTITUTE ON DRUG AB U SE HO L DS TOWN HALL MEET I NG AT UB he ultimate cure for drug addic- he said , while tion will probably involve a com- also emphasizbination of biological, behavioral ing the need to and social considerations, Alan I. make sure these Leshner, PhD , director of the a- findings are distional Institute on Drug Abuse seminated both IDA), announced during a recent visit to the practice to the University at Buffalo. community and Leshner's UB visit was one of several to the general IDA town meetings conducted nation- public. wide during Red Ribbon Week in Contrary to October 1998 to create awareness what most peoabout the realities of drug abuse and ple believe, sciaddiction. ence "says" that In a talk titled "Drug Abuse and drug addiction is a preventable problem Addictions: Myth versus Reality, " and a treatable disease, he maintained. Leshner clarified common misconcep- "The success rates for drug abuse treattions about the nature of drug abuse and ment are comparable to the success rates addiction, focused on scientific advances for any other chronic relapsing illness that have altered researchlike diabetes , hyperteners' fundamental views of sion and cardiovascular the problem and anabnormalities. But we can nounced immediate steps do better. " the NIDA is taking to imLeshner also emphaprove treatment. sized the importance of Citing drug abuse and addiction as distinguishing between two distinct subamong the most complex phenomena groups of people who abuse drugs: facing today's society, Leshner acknowl- One group is made up of those who take edged a tremendous stigma attached to drugs to "feel good, " known as sensadrug addicts and drug addiction. A tion seekers; a second group is made up further hindrance to the search for work- of those who take drugs to "feel better," able treatment approaches, he added, or as a form of self-medication. Essenis the fact that so many misconceptions tially, both groups "like what drugs do abound. to their brains. Although, in the past, a "We have ideologies galore that exist problem has been that we lumped evabout the phenomenon; luckily, how- eryone together both in prevention and ever, we now also have scientific data. " in treatment. " Advances in science over the past 20 Leshner showed slides of functional years have revolutionized fundamental MRI scans depicting increased activity views about drug abuse and addiction, in the brain's reward circuit after drug ® B u f f a l a P use , noting that this area of the brain has traditionally been the focus of studies. Recently , however, researchers have begun to look at how drugs and drugassociated stimuli relate to a wide spectrum of brain functions , such as emotional memory, he reported. Drug addiction is fundamentally a brain disease: Drug use alters the brain state and, over time , actually causes brain changes that result in the compulsion addicts experience, Leshner said. "Compulsion, which is the essence of addiction, occurs because drug use over time changes the brain in ways that persist long after the individual stops using drugs. Treatment needs to attend to those brain changes, both pharmacologically and behaviorally. "Drug addiction is not just about moral weakness and failure , as many people want to believe," he continued. "The final common path for addiction is the brain, but when and how one becomes addicted depends on an intersection of elements, including genetics. " hysician w I n t e r 1 9 9 9 �······ · ···················· · ············· · ····· · ······· · ······· · ··········• ·· ~ t t "COMPULSION, WHICH IS THE ESSENCE OF ADDICTION, OCCURS BECAUSE DRUG USE OVER TIME CHANGES THE BRAIN IN WAYS THAT PERSIST LONG AFTER THE INDIVIDUAL STOPS USING DRUGS. TREATMENT NEEDS TO ATTEND TO THOSE BRAIN CHANGES, BOTH PHARMACOLOGICALLY AND BEHAVIORALLY." Leshner noted that the complexity of addiction is compounded by a chronic relapse rate caused by stress and exposure to drug-associated stimuli. "In the past few years, we have discovered that when an individual is merely exposed to such stimuli, the brain reacts the same way it does when the individual has taken drugs, which shows that addiction is a brain disease that has social and behavioral aspects embedded into it. "Like it or not, we need to acknowledge that when we are dealing with Harold Strauss Named Chair of Physiology and Biophysics arold C. Strauss, MD, former Edward S. Orgain Professor of Cardiology at Duke University Medical Center and a specialist in ion-channel function, has been named chair of the Department of Physiology and Biophysics in the University at Buffalo School of Medicine and Biomedical Sciences. Strauss held appointments in medicine and pharmacology at Duke, and for the past13 years served as director of its multidisciplinary Specialized Center of Research in Ischemic Hearl Disease/Congestive Heart Failure. He brings to UBan extensive research background in the electrophysiology of cardiac cells B u f f a I o addicted individuals, we are dealing with individuals in another brain state. lt was very difficult for people to grasp this 10 years ago, but we have finally come to understand that people are compelled to use drugs because they are in a different brain state, and treatment needs to attend to those brain changes. "The reason we have to care about the nature of the illness, which in this case is biobehavioral, is that it tells us about the nature of the treatment we have to use," he continued. "Treatments need to attend to the biology, the behavior and the social context simultaneously or they will not work as well. " Leshner announced that the NIDA has declared its next major nationwide initiative to be improvement of treatment. Toward this goal, the institute is developing a new ational Drug Treatment Clinical Trial Network to facilitate and is principal investigator on three major federal grants studying the structure and function of potassiumchannels in order to develop safer and more effective antiarrhythmic drugs. Anative of Canada, Strauss earned his medical degree from McGill University in Montreal in 1964 and completed an internship and junior residency at Montreal's Jewish General Hospital. From 1966 to 196B,he was a postdoctoral fellow in pharmacology at Columbia University's College of Physicians and Surgeons. He then completed a one-year residency in medicine at Bronx Municipal Hospital Center, Albert Einstein College of Medicine, and a two-year cardiology residency at New York's Presbyterian Hospital. In recognition of two decades of involvement with the American Heart Association, Strauss Physician W I n t e r I 9 9 9 the dissemination of treatment information. "We are going to use science to improve the quality of existing treatments and look for new treatments." The project will involve a network of interconnected sites around the country, he explained. The hub of each site will be a coordinating center, such as a university or hospital, and each coordinating .. center will be attached to 10 or 15 local < community-based treatment programs "' that will become partners in the research u to be carried out. The research will involve testing scientifically developed " treatments in real-life settings rather than in the laboratory. "People want a simple solution to drug abuse and addiction , but we will never have a handle on the problem until the solutions are as complex as the truly multifaceted problem that we are trying to address," Leshner concluded. + received its Award for Meritorious Achievement in 1996. He has served on various committees and boards of the National Heart, lung and Blood Institute of the National Institutes of Health. He isassociate editor of Circulation Research and is on the editorial board of the Journal of Cardiovascular Electrophysiology. As a researcher, he has published more than 100 articles in peerreviewed journals and authored numerous review articles and book chapters. Amemberoft he New York Academy ofSciences and a diplomate of the American Board of Internal Medicine, he is affiliated with several additional professional organizations. + -LOIS B AKER �rm················································································ · ······· g Sexual Identity Issues in aClinical Office Setting to this is if your life or someone else's life is in danger. Do you have any attraction to members of one~ own gender and is part of the questions?" Right there an atmosphere continuum of sexual expression. Many gay and lesbian youths of trust has been created and the message sent that the adolescent's rights first become aware of and experience their sexuality during will be respected. A similar statement, emphasizing confidentiality, can be adolescence. Therefore, pediatricians who care for teen-agers need to made to adults. How we ask the sexual history is understand the unique medical and psychological issues facing homoimportant. Everyone develops his or sexually oriented youths. her own style with which they are comfortable. The HEADSS model of -from the American Academy of Pediatrics' Policy Statement on interviewing adolescents involves discussing Home, Education, Activities, Homosexuality and Adolescence Drugs, Sex and Suicide. What we don't Most primary care specialties have a hear. We can foster this feeling by want to do is assume heterosexuality similar policy statement concerning ho- having materials in the waiting room: by our questions. To a male, we don't mosexuality. However, few physicians posters depicting same-sex couples want to ask, "Do you have a girlfriend? " feel they have been adequately trained to alongside heterosexual couples; books In doing so, we implicitly communideal with issues of sexual identity. To and pamphlets that discuss issues of cate that it isn't possible he's gay and this end, I presented a Grand Rounds at sexual orientation; or a rainbow sticker it's bad if he is. Consider trying this phrase instead: Children's Hospital ofBuffalo onjuly 24, on a window or wall (the rainbow is the gay pride symbol). "Some of my male patients your age find 1998, titled "Caring for These simple actions themselves attracted to men, some to Your Gay/Lesbian/ BY are profound gestures women, and some to both. How is it for Bisexual Patients and FRANK P . of affirmation for youth you?" This question resonates with paFamilies." Colleagues CARNEVALE. MD starved for images of tients on several levels. It affirms and have since told me of themselves and for normalizes their experience by stating their success in using the places they can turn to they are not alone. It presents their emergapproach I outlined at ing sexual identity in nonthreatening that time. This approach entails three for help. That's what they see. What they hear are the statements true-to-life terms-that they "find themsteps: Safety, Support and "Referral"three simple, brief, inexpensive, yet we make and the questions we ask, selves attracted." (For most people, inteenormously powerful, interventions for both of which speak volumes. For grating their sexual identity into their dealing with sexual identity issues in a example, if it's the first time I've met lives involves first noticing their feelings; the teenager, I like to preface my en- it's a discovery process.) Finally, the quesclinical office setting. tire interview with a statement about tion accepts all points on the Kinsey Scale confidentiality: "Now that you're an by not assuming any identity from the STEP 0 E: SAFET This is the first step for an important adolescent, I will treat you differently outset. And with that we've taken Step reason. It's the basis for creating an than the younger kids. I'll be asking One. We've created an atmosphere oftrust, atmosphere that is conducive to open you questions about many aspects of which opens the door to communication. discussion. Without a sense of safety, your life and it's important for you to none of the remaining steps will take realize that what you tell me is confi- STEP Two: SuPPORT place. Safety is simple to achieve. People dential. I won't talk about it with your What if the patient responds that he perceive a sense of safety from their brothers, sisters or parents, unless or she has feelings of attraction tosenses-what they see and what they you want me to. The only exception ward the same sex? Q,\IOSEXUALI TY IS TP-,:; PERSISTENT SEXuAL and emotional B u f f a l o Physic ian w I n t e r 1 9 9 9 �. . . . •. . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'llt"!'' ll'!'ll"'i ii'P.II ~, ,.ft'J'I ~ I ll ill This leads us to Step Two of our three-step model: support. The elements of this step are listening, affirming, questioning further, correcting misinformation and assessing risk. In other words, all the normal things we would do with any other issue or concern. LI STEN ! G: This may be the first time they are talking about this. Let them tell you where they are. It's a significant moment in a person's life when he or she shares this with another. A FFI R M ! G: "Many people your age have this experience; it's okay." Q UESTION I NG FU RTHE R: "Tell me more about that." "What do you think?" "What types of sexual experiences have you had?" "Have you been with men, women or both?" C O RR ECTING MI SINFO R MATION: Patien t: "Well, I'm afraid this means I'm gay." Doctor: "What if you were?" Patien t: "No way, then I'd never have kids!" Doctor: "Some gay men and lesbians do have kids. Some choose not to." Patien t: "But if I'm gay I'll get AIDS." What a great chance to discuss STDs and pregnancy prevention. A SSESS ! G RI SK : We can address STD/HIV risk, substance abuse, suicide and physical abuse; B u f f a l o again, we can ask all the questions we would normally ask as part of the adolescent interview. STEP THREE: "REFERRAL" I put referral in quotes because by referral I mean connecting the patient to appropriate resources. Obviously, if appropriate, we can refer to a therapist, a psychiatrist or a substance abuse counselor. More commonly, "referral" involves providing pamphlets, booklets, books and phone numbers of supportive organizations. RESOURCES FOR PHYSICIANS' OFFICES A supportive group of volunteers from PFLAG (Parents Families and Friends of Lesbians and Gays) provided the Children's Hospital Grand Rounds audience with resource packets on this subject. The PFLAG team has sifted through the current literature and distilled, compiled and organized the information into a usable format. The packets can be provided to patients ancl!or their families if the family knows the person is homosexual. If you would be interested in receiving a copy of this packet for your office, simply mail a $3 check (to defray postage and handling costs) to PFLAG, Attention: Resource Folder, P.O. Box 861, Buffalo, Y 14225. + Physician w I n t e r I 9 9 9 f· · "!) Cu '' lc 'D '95 recently completed his pediatric residency at Children's Hospital of Buffalo and, in]anuary 1999, joined the University at Buffalo's Student Health Center. Dr. Carnevale wishes to thank the following individuals and organizations for their support and their roles in the Grand Rounds presentation: Elizabeth B. Conant, PhD, Camille Cox and Curt Gregg,from PFLAG; Mary Alice Boyd, MSW, from the Gay and Lesbian Youth Services (GLYS) of Buffalo; and the teens from GLYS who sat on a panel for the presentation. He would also like to thank Gerald Daigler, MD, from Children's Hospital of Buffalo; and Ross Hewitt, MD, who assisted in obtaining funds from Abbott Laboratories in support of producing the resource folder. 0 �The Evolving Ethics of Medicine JEROME KASSIRER , MD ' 57 , KEYNOTE SPEAKER FOR INSTITUTE OF HUMAN RELAT IONS AWARDS HE \1A. XFv1 "0. 'CE A BUFFALONIAJ'.., always a Buffalonian" was illustrated by the celebration surrounding the return of Buffalo native jerome P. Kassirer, MD, editor-in-chief of the New England]oumal of Medicine, who was in town October 26, 1998, to receive the Institute of Human Relations Award from the American jewish Committee of Western New York (AJC-WNY) . Kassirer, who earned his medical degree from the then- University ofBuffalo in 195 7, was honored for his promotion of medical professionalism, ethical scientific conduct, patient involvement in decision making and reliable approaches to assessment of quality health care. The AJC-WNY, in presenting Kassirer with the award, acknowledged his numerous editorials on these topics, as well as others on professionalism, appropriate use of firearms, the abuses of managed care, and political intrusions into medical decisions. In a keynote address, titled "The Evolving Ethics of Medicine," Kassirer lauded the AJC for battling intolerance for nearly a century and cited the murder of Dr. Barnett Slepian, Buffalo obstetrician/gynecologist and abortionist, as an example of how much farther the world has to go in order to truly be "united as one human race. " Aftpv ar11A Before an audience of more than 200, Kassirer then discussed a number of current controversies in the medical field and outlined their ethical implications. "This is the most tumultuous time in the history of medicine. Technology and scientific advances in providing medical care have overtaken society's willingness to pay for them. rr magna cum laude from the University of Buffalo School of Medicine in 1957, Jerome P. Kassirer trained in internal medicine at Buffalo General Hospital and in nephrology at the New England Medical Center in Boston. He joined the faculty of Tufts University School of Medicine in 1961 , was named professor of medicine in 197 4 and was the Sora Murray Jordon Professor of Medicine from 1987 to 1991 . From 1971 to 1991 he was associate physician-in-chief of the New England Medical Center and B u f f a l o Health-care reforms occur minute by minute. This is not the same field that I entered 40 years ago, but physicians can still influence the course of medicine and maintain quality," he stated. Kassirer is concerned with a marketdriven health-care system in which expansive health maintenance organizations (HMOs), powerful investorowned conglomerates and armies of health-care lawyers and consultants vie for available monetary resources. "We used to have a simpler one-patient and one-doctor system, but now the purchasing power of employers, and the HMO practice of treating populations rather than individuals, drives the industry. Physicians need to take control and get back to the practice of medicine," he emphasized. Currently, physicians are working longer hours and seeing more patients per hour to maintain their incomes, he contended. More and more time is spent processing paperwork, and stress is rampant. As HMOs become dominant in a community, physicians must join them in order to maintain their offices and keep seeing patients. "Capitated care has tempted some doctors to under-test and under-treat their patients and avoid the patients who are seriously ill. The industry today pits the ethical needs of patients against physician income and job security. Physicians can be torn between their patients and their families ," he said. vice choir of the Deportment of Medicine at Tufts.ln 1991 , he become the 38th editor-in-chief of the New England Journal of Medicine. Throughout his career, Kossirer has published numerous original research and clinical studies, textbook chapters and books on nephrology (acid-bose equilibrium, in particular), medical decision making and the diagnostic process. He was o founder and coeditor of Nephrology Forum in the journal Kidney International and of Clinical Problem Solving in Hospital Practice until1991 . Physician w i n t e r 1 9 9 9 �< Kassirer was elected to Alpha Omega Alpha (AOA) as astudent and was named the AOA Distinguished Clinical Teacher of the Year in 1989. He was named Distinguished Alumnus of 1991 by UB's School of Medicine and Biomedical Sciences and received the Distinguished Faculty Award from Tufts University School of Medicine. He has honorary degrees from the University of Massachusetts in Worcester, Thomas Jefferson University in Philadelphia, the SUNY Health Sciences Center in Syracuse, l'Universite Rene Descartes in Paris, Tufts University and the Medical College of Ohio. B u f f a I a Physician W I Kassirer served on the American College of Physicians' board of governors and board of regents and in 1997 received the college's John Phillips Award for his contributions to clinical medicine. He is past chair of the National library of Medicine's Board of Scientific Counselors and past chair of the American Board of Internal Medicine; he is also a member of the Association of American Physicians and the Institute of Medicine of the National Academy of Sciences. n t e r 1 9 9 9 �While admitting that his talk might be interpreted as painting a bleak future for the field, Kassirer counIn Kassirer's view, the greatest threat tered: "We should encourage our to the medical field is loss of integrity, children and our grandchildren to folwhich can be realized when physicians low in our footsteps and enter the under-treat their patients and decide medical field. After all, we are not that "it's for the best"; or, worse, use the selling fake jewelry, we are not makHMO to justify suboptimal care. ing weapons of mass "We have to rememdestruction. ber that the fee-for" THIS IS THE MOST TUMULTUOUS TIME IN THE HISTORY OF We are privileged service method was not MEDICINE . TECHNOLOGY AND SCIENTIFIC ADVANCES IN PROVIDto help people and perfect. The demands make a decent living of HMOs for prevenING MEDICAL CARE HAVE OVERTAKEN SOCIETY'S WILLINGNESS TO while we help them. " tive and cohesive care PAY FOR THEM . HEALTH-CARE REFORMS OCCUR MINUTE BY Crediting UB with have improved mediMINUTE. THIS IS NOT THE SAME FIELD THAT I ENTERED 40 YEARS giving him a superb cine. Managed care has medical education as AGO , BUT PHYSICIANS CAN STILL INFLUENCE THE COURSE OF also forced us to pay well as teaching him more attention to preMEDICINE AND MAINTAIN QUALITY ." how to write, Kassirer ventive medicine, to the closed by strongly enmanagement of chronic diseases, to the quality of care and the cost policies in their region and to deal with dorsing the concept of medical schools of care. I believe that we would not have ethical lapses when they arise. "We need teaching medical ethics as a means of made so much progress in these areas to maintain the public trust or we have helping future physicians learn how to without the prodding of managed care. " nothing. We must remain patient advo- better provide quality care in what is Kassirer outlined ways physicians can cates and fight for their rights and reject sure to be a challenging health-care preserve their integrity, suggesting that attempts to limit care," he emphasized. environment. + CONTINUED OTHER FROM 1998 PAGE RECIPIE 31 the first thing they should do is admit that money isn't everything. Also, they should remain true to themselves, and not bend to pressure from outside sources, including pharmaceutical companies and manufacturers of medical devices. Instead, local physicians should stand together to help create medical TS OF THE INSTITUTE OF HUMAN RELATIONS AWARD OF THE AMERICAN jEWISH Cow~11TTEE OF WESTERN NE\\ YoRK: I. PUTNAM , MD , EVAN CALKINS , MD , LINDA C. DUFFY , PHD , FREDERICK E . THEODORE professor emeritus of medicine and family medicine at the University at Buffalo School of Medicine and Biomedical Sciences; consultant in geriatrics programs, Health Care Plan; and partner, Promedicus Group, was honored for "his long and devoted leadership in medical education and outstanding contributions in the fields of geriatrics/gerontology, rheumatology and general medicine." associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences and executive director of the Women and Children's Health Research Foundation, was honored "for designing and developing the Doctor's Pediatric Immunization Program, and expandable Children's Hospital of Buffalo's Expert Software System that monitors and tracks childhood vaccinations." MUNSCHAUER Ill , MD , associate professor of clinical pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, director of Ambulatory Services and chief of the Division of General Pediatrics, Children's Hospital of Buffalo, was honored "for his tireless effort in the establishment of outreach pediatric centers that provide quality health care to needy children in their own communities." ® B u f f o l o associate professor of clinical neurology and internal medicine at the University at Buffalo School of Medicine and Biomedical Sciences, associate head of the Department of Neurology and head of the Vascular Disease Prevention Research Center, Buffalo General Health Systems, was honored "for his groundbreaking research in multiple sclerosis and the development of a simple selfexamination that can detect atrial fibrillation, a major risk factor for stroke." P hysician w I n t e r l 9 9 9 �BY J . LINDA CORDER . PHD , CFRE The Gift to Know Them Deeply bers, each of whom lighted a candle before I trouped over, with speaking. the Class of 2002 and a few assorted others, Some recited poetry-"Death be not proud ... " to Harriman Hall for a memorial service. I could not stop for death, Death kindly "Because That experience influenced me to change stopped for me ... "-old favorites that have focus, however briefly, from thoughts of helped many of us to accept the death of facilitating philanthropy to another type of someone close. Several gave examples of what gift, that of a person's body, given to facilitate the they learned-about cancer through a tumor education of future physicians. in a woman's lung; from finding an implanted I was struck, initially, with the diversity of pacemaker that had not been "enough" to our newest class-roughly half women and half keep the heart of a man, younger than his dad, men, a rainbow of skin tones , a rich texture of beating; viewing in awe the slack, translucent various ethnic backgrounds and, as I was to skin of a woman who reminded hear, a broad representation of one student of his granny. Anpersonal religious beliefs. Our The service was simple; those memorialized were known other student read a letter from a beautiful children of yesterday, person whose body became "a our healers and health-care givers not by name but by what they had taught. teacher" for a previous class. One of tomorrow ... entreated, "Don't think of this as The service was simple; those my deathbed; rather, think of it as a bed of life," followed by memorialized were known not by name but by what they what each organ might mean if donated, what nerves and other had taught. Though unknown while living, they were rectissues might teach to those with the patience to learn. Several ognized as true friends in their generosity of spirit and their talked about the relationship they experienced with their lasting impact on the lives of the students who had shared cadaver-what they learned always outweighing the frustra"the privilege to cut them and know them deeply .., of not knowing details that will forever remain hidden. tions One of the faculty members told about his mother's end, each speaker lit the candles of those seated nearby, At the decision to leave her body to the medical school where he had bathed in candlelight. Each of us left the until the room was received his education. This past Thanksgiving was his service with a single rose, symbol of memory and hope ... family's first without the smile of his mom across their table. So it was that on one of the year's dark, gloomy days, I He recalled an earlier Thanksgiving when she had first paused in my daily routines to light candles, to celebrate discussed her decision, and the experiences that had led to and remember generous folks I did not know. With those her choice. As an educator, this was one final way she could students, I was thankful for mute teachers who had made influence and teach another group of young people. such a contribution to the understanding of human strength We learned some facts from the chair of the Department and frailty, the diagnosis of disease, the alleviation of pain of Anatomy and Cell Biology. Our school is one of very few and suffering. Standing with those young, idealistic physiin the world with a gross anatomy lab populated entirely by cians of the future, I realized that it is for experiences like those who made a conscious choice of that place as their final these that I chose both my profession and UB's School of destination. We are extremely fortunate that over 7,000 Medicine and Biomedical Sciences. The focus of that memopeople now living in Western New York have made arrangerial service was, indeed, different from my daily routines. ments to join that distinguished company in the future. Our However, the purpose of "anatomical gift" donors is very students are privileged, knowing that those people from much the same-facilitating the education of future physiwhom they learn held medical education and research in the in the best way they know. cians highest esteem. Our school is fortunate to have students who show such reverence and respect for the human spirit and the Linda). Corder, PhD, CFRE, is an associate dean in the School of Medici ne and individual bodies that were animated by that spirit. Biomedical Sciences at the Uni versity at Buffalo. She can be contacted by phone As an onlooker, I gained a sense of their journey of at (71 6) 829-2773, toll free at J-877-826-3246; by fax at (716) 829-3395; or by E- mail al ljcorder@acsu.buffalo.edu. discovery through reflections from at least 15 class mem - B u f f a I o Physician w I n t e r 1 9 9 9 �1998 Distinguished Medical Alumnus Named JOSEPH BELL ANT I, MD '58 MD, director of Georgetown University's International Center for Interdisciplinary Studies oflmmunology, received the Distinguished Medical Alumnus Award from the University at Buffalo School of Medicine and Biomedical Sciences at a dinner held in his honor on September 12, 1998, at the Buffalo Club. Bellanti, an expert in developmental immunology, earned a bachelor's degree from UB in 1954 and a medical degree in 1958. Before beginning his career at Georgetown, he interned at Millard Fillmore Hospital, completed a pediatric residency at Children's Hospital of Buffalo , was a ationalinstitutes of Health trainee in immunology and spent two years as a research virologist at the Walter Reed Army Institute of Research in Washington, DC. Bellanti joined the Georgetown faculty in 1963 as an assistant professor of pediatrics and microbiology, and by 1970 had attained the rank of professor in both fields. He also is director of the Division of Immunology and Virology in the Department of Laboratory Medicine at Georgetown University Hospital. Adopting a multidisciplinary approach to medical research before it was fashionable, Bellanti spearheaded development in 1975 of the International Center for Interdisciplinary Studies of Immunology at Georgetown . The center brought together basic and clinical researchers, allied health professionals, statisticians and health educators. B U f f o l - L OlS B AKER Past presidents of UB's Medical Alumni Associationgather to honor Dr. Bellonti. John R.Wright, MD, dean, UB School of Medicine and Biomedical Sciences; Mrs. Jacqueline Bellonti; Joseph A. Bellanti, MD, Closs of 1958 and this year's recipient of the Distinguished Medical Alumnus Award; Elizabeth l. Maher, MD, president, Medical Alumni Association. ® He has been director of the center since its inception. Bellanti has held many leadership positions in professional societies, including director, and later cochair, of the American Board of Allergy and Immunology; president of the Society for Pediatric Research and of the American College of Allergy and Immunology; member of the board of directors of the National Coalition for Disease Prevention and Environmental Health; and member of the board of regents of the American College of Allergists. An author of more than 200 scientific articles and abstracts and editor of the textbook Immunology, Bellanti served for 10 years as editor-in-chief of Pediatric Research. He also is past editor of Annals of Allergy. + Franklin Zeplowitz, MD '58; Paul H. Wierzbieniec, MD '74; Robert E. Reisman, MD '56. o Physician w I n t e r 1 9 9 9 �Let the Adventure Begin! · - STUDENTS BID A HALE- AND- HARDY BON VOYAGE ON SEPTEMBER 12 , 1998 , AS THEY PREPARE TO EMBARK ON A WHIRLPOOL JET TOUR AT NIAGARA-ON -THE- LAKE , ONTARIO . THE OUTING TOOK THEM THROUGH THE WORLD· FAMOUS RAPIDS AND STONE-WALLED CANYONS AT NIAGARA w{e a mistake. But not from the inside . The roof look." funny, odd, strange, a\'\0 \\'hich means thev can look at more than the bael\ of the D 1e wav we see it, whv build a strai~ht roof when you front seat. ~ l uch more, in fact. can build a perfeetlv ~ood crooked one'' Because the Land Rover DiseO\·erv has more windows It's somethin~ up w se,·en passenl\ers in the Land than anv other -lx-1. Rover DisCO\'Crv will rrulv appreciate. \\'ith the ele,·ated roof and stadiumlil;e sea tin~. • • \\'hv nm take one out for a test drive·~ ~'!'!!!!""~ ,\nd instead of just looking into it , look out of it. passengers in the rear ha\'C ample headroom . DISCOVERY Land Rover Amherst A NOIUHTOWN AIJTOMOTM COMPANY 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com B a a p y a n w n e 9 9 �. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1] ~ . -MARK YOUR CALENDARS! t's not too early to plan for the 1999 Spring Saturday, May l. For more information, call the Clinical Day and Reunion Weekend. Medical Alumni Association at (716) 829-2778. A cocktail reception will be held on Friday, The reunion classes are of 1939, 1949, 1954, 1959, April 30, 1999. The 62nd Spring Clinical 1964,1969, 1974,1979,1984, 1989and 1994. Here's Day and Reunion Dinners will be on what your reunion chair has to say to you ... ELIZABETH OLMSTED CLASS O F 1 939 CLASS OF 1954 CLASS O F 1969 Elizabeth Olmsted Ross Mayday! Mayday! Mayday! Last chance to celebrate your 60th May Day '99. Nicholas C. Carosella, Edward A. Rayhill 45 Years! (an you believe it? Come join your friends and classmates in celebration. James White, Hanley M. Horwitz, Gerald D. Stinziano Don't miss our 30th! It should be fun to see how we, the school and Buffalo have changed in 30 years. Let's get reacquainted and renew old friendships. Ross CLASS OF 1949 Richard L Schwartz, Robert (. Harvey It has been 50 years since graduation. Don't miss this chance to get together and celebrate. CLASS OF 1959 William J. Mongan Please come to our 40th reunion. Roam L HARVEY CLAS S OF 1 974 CLASS O F 1 964 J. Frederick Painton Bruce F. Middendorf Looking forward to seeing all of you at our 25th class reunion. Our 35th reunion is imminent. Return to Buffalo to renew old friendships and pleasant memories. J. fREDEIIU PAINTON ® Buffalo BRUCE Phys i F. MIDDENDORF cian w 1 n t e r 1 9 9 9 �························ · ·································································· --··, ' 1 9 4 EDWARD M . TRACY '43 CLASS E. SHIELDS 1 5 0 s and his wife , Elaine, write: We OF 1984 March 1998 and bought our daughter's home. Life in Pensacola is much more laid back. The 1998 summer was unbearable, so we are planning to return to our chalet near Ellicottville, Y, next summer. Ed is involved with a barbershop chorus and quartet. We miss our friends. Our E-mail address is Eohohensee@aol.com. EDWARD CLASS 1 OF 1 989 Barbara J. Bambach, Denise M. Callari Ten years already! Come share memories, laughs and ac· complishments! 9 WILLIAM 6 E . 0 ABRAMSON s text on radiology for medical students. 1 9 7 0 s THOMAS A. LOMBARDO JR . '73 has been elected to the board of trustees at the ichols School of Buffalo for a three-year term. Lombardo, an orthopaedic surgeon and a ichols parent, is director of CGF Health System, secretary of the YS Society of Orthopaedic Surgeons, immediate past-president of the medical staff and current chair of the Department of Orthopaedic Surgery at Millard Fillmore Health System. Lombardo and his wife, Donna, reside in East Aurora, NY, and are the parents of four daughters. ' 60 writes: l have been elected a Life Fellow of the American Psychiatric Association. l'm working part time in a solo private practice of psychiatry and addiction medicine at Sheppard Pratt Hospital in Towson, MD. I'm working less, traveling more and BAMIACH recently had the second edition of his text Clinical Radiology: The Essentials published by Lippincott Williams and Wilkins. This is an introductory RICHARD H . DAFFNER '67 HOHENSEE ' 54 moved to Pensacola, FL , in David F. pfalzer Please come bock to reunite with Herb and the rest of the Class of '84. J. 9 Frank T. Schreck Sex, lies and videotape ... we'll capture it all. Show up! CLASS Bmm is prac- ticing internal medicine in Charleston , SC, and lives on Seabrook Island. He also teaches diabetic care in Beijing, the People's Republic of China. OF 1979 Peter E. Shields Come bock for our 20th reunion and reminisce with your old friends. PETER s 0 I RICHARD 5 . LEE '74 writes: have been appointed western regional medical director for the Sleep etwork, Inc., and Northern evada Sleep Disorders Cen- ter. In April 1998, I became a diplomate of the American Board of Sleep Medicine. enjoying both. HENRY M . BARTKOWSKI retired for the third time on October 14, 1998. He sold his practice of 30 years to Memorial Hospital of Salem County, FL. He travels to Fort Hood , TX , to see his grandkids, Garrett (6) and Skylar (4). He also sees all the Washington Redskin games because his daughter, Stephanie, JOHN J . LAMAR '63 CLASS OF 1 994 Donald M. Slate While following our dreams, we all have disbursed but there will be a party next year an May first! I cannot believe it's been five years, so come bock and we'll share stories, laughs and a couple of beers. B u f f a l o Phys ician is a Redskinette. w I n t e r 1 Q Q Q '76 , a pediatric neurosurgeon, was recently appointed chief of pediatric neurosurgery at Henry Ford Hospital in Detroit, MI, and William Beaumont Hospital in Royal Oak, MI. His special areas of interest are brainandspinalcord tumors,spine instrumentation, and brain and spinal cord injury. Bartkowski's research work involves cerebral ischemia in children. ® �l ll ························································································· HERBERT B. NEWTON '84 writes: My son, Alex (5), has started rics (Amherst, NY), effective but I love it. I came August 1998. I continue to work bus, OH, because of my hus- ogy, was made a fellow of the kindergarten. He is heavily into as a part-time pediatrician at band, Emeka. I have three ch il- American College of Radiology soccer and swim lessons. Ashley the Erie County Health Depart- dren: Chiedu ( 4), Chidi (2), at its annual meeting in Septem- (21J2) is enjoying preschool. ment. My husband , RICHARD E. and Chinenye (9 months). I ber 1998. Fellowships in the college are On the academic front, I have b e e n GERGELIS '84, is an assistant professor in the University at think I keep myself busy. I named Buffalo's Department of Psy- LIVERPOOL '90 . He is well and ANGELO M. DELBALSO '78, chair of UB's Department of Radiol- awarded to members for scientific or clinical re- search in the field of radiology or Classnotes can also be significant contributions to its literature. Criteria for selection also one s significant submitted via E-mail to: bpnotes@pub.buffalo.edu include performance of outstanding service as a teacher of radiology, service to organized medicine and outstanding reputation among colleagues and the local community as a result of long-term superior service. BENSON ZOGHLIN '84 writes: The whirlwind of activity grows ever stronger. In addition to a busy group practice in family medicine, lam president-elect of the Lakeside Hospital medical staff and chief of family medicine at Lakeside. Our group precepts third-year medical students from the University of Rochester and 1 precept at Highland Hospital's Family Medicine Residency Program. I am on the board of directors of the Lakeside Foundation. Mindy is busy with her law practice, and jacob (9) and Rachel (13) have their own hectic pace. has a daughter, Asha, who is my godchild. the top five neu- involved in fore nsic work. We rologists in Central have three children: Kristyn (11), Kimberly (8), and Ohio by an Scott(4). We have remained indepen- loyal to Western dent survey reside in Williamsville. We hope ew York and sponsored and pub- to see you all at our respective reunions, and can't believe it's lished by the Columbus been 15 years! JOEL K. SHUGAR '85: See letter in an exchange program as a member of the International Medical Relief organization of Western ew York. The pro- gram is designed to bring physicians from Third World countries to Buffalo for additional training and to send local physicians overseas to work in countries where sufficient dependent practice associations. molecular biology at the University of Texas at San Antonio. 1 9 9 s 0 Mindy and Icontinueourstudy in ciation with Sheridan Pediat- easy being on call all the time, o BURNETTE THOMAS '94 proudly announce the birth of their daughter, Kristen Killian Burnette. Kristen was born on July ll, 1998, and weighed 6 lbs., 9 1/ 2 oz. She was 19 3/ 4 inches in very well. MARC ROMANOWSKI '93 AND CINDY ROMANOWSKI '94 are proud to announce that they Isshin Ryu karate. l CAROL ANN KILLIAN AND cently took a position in went into solo practice in OBI Gyn one year ago. lt is not a I've gotten married. My wife's doing THOMAS BOYER '89, PHD, re- NGOZI OSUAGWU '90 writes: f cal Group. length . All are experience with managed-care organizations and physician in- tice of general and vascular surgery with the Buffalo Medi- pecting our first child in April. with officials in Tanzania. credentialing at Independent Health. She brings 12 years of first child. I continue my prac- RIYAZ HASSANALI '86 is involved has recently returned to her na- of physician management and the birth of Olivea Marie, our name is Sherry, and we are ex- on page 40. tive Buffalo, NY, with her appointment as assistant director MICHAELA . VASQUEZ '90 writes: Melissa and I have celebrated ATUL KUMAR GUPTA '91 writes: health-care options are not available. Currently, he is working ROCHELLEJ . PLESKOW '85, MS , f keep in touch with STEVEN chiatry, based at the Erie County Medical Center, and is actively Monthly magazine. I was also named to the Central ervous System Panel of the ational Comprehensive Cancer etwork. Also, recently I was informed that I will be listed in the 1998-99 issue of The Best Doctors in America. I remain associate professor of neurology and director of the Division of euro-Oncology at the Ohio State University Hospitals and james Cancer Hospital. B Colum- of ELAINE M. SCHAAF '85 writes: I'd like to announce my asso- ® to p y s c a n had a son, Marcus ] r., born on August 28, 1998. They reside inWilliamsville, Y, where Marc is an orthopedic surgeon and Cindy is practicing rehabilitation medicine. w e 9 9 9 �............... . ...................... . .................... . .............. ..............• ._-·._ • RESIDENTS R AYMOND 0 . S C H ULTZ '95 , a plastic surgeon who specializes in problems of the hand and wrist and in reconstructive surgery, has joined the Center for Plastic Surgery. His main office will beatthecenter's new Orchard Park, NY, facility at 3725 orth Buffalo Road. Schultz completed a general surgery residency at UB from 1991 to 1995. Currently, he is a clinical assistant professor at UB, where he is actively involved in research, having recently made presentations on facial nerve injuries and compression neuropathies. IN MEMORIAM an internationally known ophthalmologist and eye surgeon who ME Y E R H . R IW C H UN '27 , of surgery and chair of ophthalmology at the UB medical school , died at age 95 on October 25, ety, the Maimonides Medical Society and the former Buffalo Eye and Ear Hospital. Active in the 1998, in Buffalo. Riwchun, who maintained a private practice in Buffalo from 1929 to 1985 , Sight Conservation Society, he was a member of the advisory board of the Buffalo Eye Bank. In 1979, he and his wife , Ann , were headed the departments of ophthalmology at Buffalo General Hospital and Children's Hospital , respectively, in the 1960s. He was attending ophthalmologist at the former Deaconess Hospital and ophthalmologist-in-chief at the former Rosa Coplon Home. He was a lieutenant colonel in jointly named Outstanding Citizens of the Year by the Buffalo News for their work with the blind. D ONALD L. E HRENREICH ' 5 3, a clinical professor of neurology at UB School of Medicine and Biomedical Sciences and a neurologist with the Buffalo Medical Group , died ovember 18, 1998 , in Buffalo General the Army Medical Corps during World War ll, serving as chief of eye service at Walter Reed Hospital in Washington , DC. Highly regarded as a teacher in the UB medical school , Riwchun was a Hospital 's Hospice Unit. Ehrenreich , who was 70, suffered from cardiac and other medical problems. He earned a diplomate of the American Board of Ophthalmology and a fellow of the American College of Sur- bachelor's degree from UB in 1949 and a medical degree from the UB medical school in 1953. He became an instructor in the geons and the American Academy of Ophthalmology and Otolaryngology. He served as president of the Buffalo Ophthalmology Soci- Department of Neurology in the I medical school in 1961. Since 1983, he had served as a clinical professor in that department. He was acting head of the neurology department at Buffalo General Hospital for six years in the 1980s, served as president of the hospital's medical staff in 1986 and was a member of the board of trustees for six years. In 1978 he joined the Buffalo Medical Group and later served as chair of its board of directors. Survivors include his wife, Rivona H.; a son , Mark D. of Kenmore; a daughter, Beth E. Lichtenberg of Chicago; a brother, Arthur, of Phoenix; and a sister, Margery Rabow of Sarasota , FL. O SC AR R . OBE RKIRC H ER ' 62 died August 6, 1998. A classmate writes: Oscar, a pediatric nephrologist, retired from the Geisinger Medical Center at Penn State University two years ago. Friends, family and patients will miss this wonderful man. had served as a clinical professor Richard H. Webber, 74, Professor Emeritus of Anatomy, Dies Author of numerous scientific papers, Webber received grants from the National Institutes of Health while at U8to study involuntary nerve pathways to blood vessek in the leg. His major research interests involved the autonomic nervous system and, in later years, neuropeptide changes in gingiva. He retired from UB in 1990. Webber was a member of Phi Rho, a professional and neurological society; the American Association of Anatomists; the Cajal Club, an anatomy organization; Sigma Xi and the American Association of Dental Schools. He was a Fellow of the Human Biology Council. Survivors include his wife, Donna Marie; six daughters, Michaeline Reining and Donna Goss of Grand Island, Margaret Hooper of Ogdensburg, Patricia Majtyka of North Tonawanda, Anne Smith of Pullman, Washington, and Kimberly Marshall of Buffalo; a son, Thomas, of Rochester; and eight grandchildren. ichard H. Webber, professor emeritus of anatomy in the UB School of Medicine and Biomedical Sciences, died November 23, 1998, in Millard Fillmore Suburban Hospital in Amherst, New York. He was 74. Webber was attending Cornell University in 1943 when he joined the Navy. Following his discharge, he completed his bachelor's degree at St. Benedict's College in Atchison, Kansas, then earned his master'sin zoology at the University of Notre Dame in 1949 and a doctorate in anatomy from St. louis University in 1954. From 1954 to 19 59 he was an assistant professor of anatomy at the Creighton University Medical School, where he was principal investigator for several research grants from the U.S. Public Health Service. Prior to coming to UB in 1961 , he was an associate professor at Temple University. B u f f a l a Physician W I n t e r 1 9 9 9 ® �• .............. . ... .. ... . . . .. . .... . ....... . .. . ............ . .............. . . . ............... I 1 9 8 0 s writes: Well , I've been meaning to do this for years, so better late than never. joel K. Shugar '85, checking in for the first time since graduation. I've got a lot to report. After my internship in internal medicine at Millard Fillmore, of which I have especially fond memories, I completed my residency in ophthalmology in Gainesville, at the University of Florida. While in Gainesville, I met my soul mate, Michelle, whom I relentlessly pursued until she agreed to marry me. After seeing a lot of trauma during a rotation in jacksonville, as well as living through the Gainesville murders ordeal, we decided to settle in a rural location and set up practice in Perry, Florida, in 1991. In retrospect, it was the best financial decision we could have made, since rural areas are relatively sheltered from managed care and physician demand exceeds supply. We started as a small "Mom J O EL S HU GAR ' 85 , and Pop, " but the practice experienced growth beyond our wildest expectations. Because of the critical physician shortage in the area, we offered laboratory services and family care in addition to ophthalmology. Havingspent5 ,000 hours moonlighting as an ER physician to pay off my loans in addition to my internal medicine training, I was comfortable to offer those services to fulfill the community need. However the ophthalmology practice grew explosively, and it became obvious the days of the solo practitioner and "Mom and Pop" operations were numbered. What also became obvious is that physicians need to take back more control of health care and that I either needed to hire someone in a suit, or pretty soon I would be working for nonphysician-directed corporate medicine. So I recruited the chief operating and chief financial officer from a 500-bed hospitalnursing home facility to be the COO/CFO of our practice. Together we are evolving a physiciandirected healthcare system. The practice was folded into Nature Coast Health Care , a multi-specialty group practice that currently has 80 employees. We have a couple who are respectively boarded in internal medicine and pediatrics as well as a nurse practitioner specializing in women's health. We are recruiting a family practitioner to complete the primary care group in our Perry location. We are also in the process of establishing several satellite locations and would welcome applications from any colleagues from UB. In addition to the Family Care Center, we just completed construction of ature Coast Regional Surgery Center/Nature Coast Eye Care Institute, which won Medicare approval in October and will undergo JCAHO accreditation in January. We anticipate ENT, general surgery and gastroenterology joining us in the near future as well. In addition to being very busy surgically, our practice has produced significant research, including the first reported use ofTPA for central retinal artery occlusion.! have been fortunate enough to be selected as a peer reviewer for Archives of Ophthalmology and thejoumal of Cataract and Refractive Surgery, and have served as a faculty member of the American College of Eye Surgeons. Other than work, Michelle and I have taken the time to get and stay in very good shape. We lift weights and do yoga together; I run three miles a couple times a week as well. o children in the picture yet, but the negotiations are going on, so stay tuned! Well I promise it won't be another l3 years before you hear from me again! For colleagues who would like to reach me, my office phone number is ( 850) 584-2778 , and my E-mail address is eyeworks@perry.gulfnet.com. Louis Bakay, 81, Retired Professor, Chair of Neurosurgery OUIS BAKAY, a brain surgeon, professor emeritus of the University at Buffalo School of Medicine and Biomedical Sciences, and retired chair of neurosurgery, died on September 10, 199B, in his Buffalo home. Anative of Hungary, Bakay received his medical training at the University of Budapest. He came to the United States in 1948 as a Harvard Research Fellow at the Massachusetts General Hospital, where he remained until 1961 . He was appointed that year as professor and chair of neurosurgery at the UB medical school, where he served for 23 years. Bakay focused his research on the blood-brain barrier and aspects of cerebral edema. He was the author of several books on those topics, as well as chapters in 14 surgical handbooks and more than 100 scientific papers. Several of his books were translated and published in Spanish, Russian and Japanese. After his B u f f a l o retirement in 1984, he wrote amemoir, Gallery of Ghosts, followed by Gastronomic Exotica. Bakay received the Distinguished Alumni Award in 1989 from the Massachusetts General Hospital, an honor given to only five graduates of the hospital's neurosurgical program who had made significant contributions to neurosurgery. He was cited for his pioneering work on brain injuries. In 1997, the Louis Bakay Neuroscience Laboratory was dedicated at Buffalo General Hospital and a fellowship in neurosurgery was established in his name. He is survived by his wife, Nancy; daughter, Stephanie of Boston; son, Nicholas of Los Angeles; and sister, Margitt de Balas-Piry of Budapest. P hysician W I n t e r 1 9 9 9 �No one knows better than medical professionals the importance of teamwork to get things done. That is why most New York physicians and surgeons choose MLMIC as their professional liability insurer. MLMIC's responsive team of underwriters, claims personnel, policyholder services representatives, risk management consultants, medical experts, and defense attorneys provides our insureds with the best liability protection and the highest level of personalized service available. Owned and operated by its policyholders, MLMIC has successfully defended more New York physicians than all other insurers combined. With one of the country's largest and most experienced claims departments, MLMIC also offers the State's only true peer review of claims experience. These are just a few of the reasons why MLMIC is the only medical liability insurer endorsed by the Medical Society of the State of New York. Caii80Q-275-6564 (NY metropolitan area), MLM~C ~ledical ~ Liability :-tutuallnsurancr Company or 800-35~56 (Upstate) for more information and to find out about available premium discounts. 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The McGuire Team. ofExperts ·rr .. .. • ~ ~~·· .. ;. '" ~·~ The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. l. I .' h '·~, ···~·'' .~ ,__,.~ . • \y Cost Effective! ... •• • • ~ .. The McGuire Rehabilitation Centers' average charge per case is more than 35% LOWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. u T_,u I = Inpat ient Admissions I = Inpatient Discharge I = Outpatient Follow-Up Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age- 78; admission F1M score 72.5; discharge F1M score- 97.6; F1M change- 25.1 points; length of stay efficiency- 1.40; onset time- 17; discharge disposition- 8(1% to community. Based on 12 months ending March 31, 1998. The McGuire Rehabilitation Centers rely on the national The results are in_The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMsM rehabilitative outcomes. This tool is known as FIMsM<: improvement, discharge to home, and cost effectiveness. Our successful rehab program delivers results Instrument; Functional Independence Measure, developed ~HE by the UB School of Medicine along with the Center for .J j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. . It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMR5M) rehabilitation services. to establish rehab outcomes that ~pU Jl DTT ~JI'T"TfqJ\f Call 1-888-POSTACUTE. can be measured and calculated ..& ~.J.U.L .Jr1.l ~\7~ c:/'J.1CGULRE '-. rod~::::u::o.m ~-" .,_C!!!'!!~ '~"'"'"" '"'"'~ UB "'·" '<h" ~. Autwnn View • Garden Gate • Banis Hill • Northgate � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n03-1999-Winter Table Of Contents A list of subunits of the resource. Steady Leadership in Changing Times Managing Mental Health with Care Harold Varmus Delivers Cori Lecture Major Health-Care lntitiative Medical School Town Hall Meeting A Student's Perspective Alumni Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/7a6733e16c085ba43c1392384baa82b9.pdf 14e5f8eaaf0e8ab3c5a4ce10cc92c3ff PDF Text Text �BUFFALO PHYSICIAN Volume 34, Number 1 ASSOCIATE VICE PRES IDENT FOR UNIVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Dear Alumni and Friends, lr HAS BEET\1 "THAT TIME OF YEAR" -\GAIN - Spring Clinical Day and five-year reunions for alumni; orientation programs for incoming chief residents; achievement awards ceremonies; the pre-finals "follies" presentation by first- and second- Kathryn A. Sawner year students; graduation dinners and, of course, graduation itself. During it all, I ED ITOR endeavored to perfect the art of being in more than one place at one time-with less- Stephanie A. Unger ART DIRECTOR/DESIGNER Alan j. Kegler PRODUCTION than-complete success, but it was fun trying! The good news is that all events were highly successful. The 60th class reunion was organized by Dr. Elizabeth Olmsted Ross, who, with Cindy Todd the able assistance of Mary Glenn from our development office, com- STATE UNIVERSITY OF NEW Y ORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMED ICAL SCIENCES posed a "class book" complete with photographs and an update on Dr. john Wright, Dean virtually every member of the class of 1939. No doubt this will become a much imitated technique for celebrating future class reunions. Ap- ED ITORIAL BOARD Dr. Bertram Partin, Chair proximately, 20 members of the Class of 1939 were able to attend the Dr. Martin Brecher Dr. Harold Brody Dr. Linda j. Corder Dr. Alan j. Drinnan Dr. james Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Ms.jennifer Wiler Dr. Franklin Zeplowitz reunion events. The 50th reunion class won the prize for TEACHING HOSPITALS [rie County Med1cal Center Kaleida HealthThe Buffalo General Hospital The Children's Hospital ofBuffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System Catholic Health SystemMercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center ©The State University of ewYork at Buffalo Buffalo Physicia11 is published quarterly by the State University of ew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents, and friends. The staff reserves the right to edit all copy and submissions accepted for publication. the highest attendance rate, with 2l members of that class able to participate in reunion festivities. The Spring Clinical Day program focused on women's issues, specifically breast and ovarian cancer. Ms. Betty Friedan, a founder of the National Organization for Women and the author of the seminal 1963 book The Feminine Mystique, gave the Stockton Kimball lecture. She pointed out that the reasons women tend to live longer than men may not just be due to hormones and/or genetics, but may indeed reflect differences in life-style and, perhaps most importantly, differences in the way men and women handle stress. Graduation ceremonies featured Dr. D. Bruce Johnstone as keynote speaker. Dr. Johnstone, former chancellor of the SUNY system and currently a very active member of the University at Buffalo faculty, presented a powerful message to the students. Having overcome serious illness himself, he could speak with authority on the marvelous challenges and opportunities that await our graduates. The Dean's Advisory Council also met in conjunction with the Spring Clinical Day festivities and the annual] ames Platt White dinner to discuss the variety of issues with which the medical school is currently grappling. The advisory council provides invaluable advice and counsel to me as dean and represents a group of dedicated alumni not only from this geographic region but from other parts of the country, as well. We are all making an earnest attempt to keep in contact with alumni and, with the help of this group and others, we plan to organize more regional alumni events over the next year. Busy as this time of year always is, it marks the culmination of what we are all about-graduating physicians and scientists for the future and preparing for our next group of students, interspersed with occasional alu mni reunions and celebrations. All of these events represent an important cycle and one in which I hope each and every reader of Buffalo Physician will want to participate. I look forward to meeting with as many of you as possible during this next academic year. (--7 ~ ~" R. Wdgh<, MD Dean, Schoo l of Medicine and Biomedical Sciences �V 0 L U ME 3 4 , NUMBER 1 ["SuMMER 1999 L 3 0 1999 2 ASpecial Place loP Women NEWLY ESTABLISHED CENTER FOR WOMEN WITH DISABILITY by Jennifer Gold 8 14 Peak ExpePience HeaPing Loss ReseaPch BolstePed THOMAS CUMBO, U 8 CLASS OF 1 9 9 9 , YEAR, $ 5 . 7 MILLION RECOUNTS MEDICAL PROGRAM PROJECT EXCURSION TO NEPAL GRANT FROM THE RECEIVES FIVE- NATIONAL INSTITUTES photography by Rhea Anna OF HEALTH by Lois Baker Medical School • GRADUATION ARRIVES! • MATCH DAY Student Perspective 1 999 RESULTS TOMORROW'S • PHYSICIANS CONFRONT NEW MOUSE CALLS CHOICE COLUMN • STEP STUDENTS Mission Improbable by Stacey Blyth WIN FIRST PLACE IN SUZANNA GOODYEAR STATEWIDE POSTER ATTENDED MEDICAL Classnotes COMPETITION SCHOOL AT AGE 5 4- A AN UPDATE ON HER WHAT CAN YOU TELL CAREER US ABOUT YOURS? STORI ED PAST- by Betsy Sawyer photography by Gary T. Truman 1999-Maria loTempio and Patrick DiAbbrocci Celebrate Graduation Day, Saturday, May 8 THE (LASS OF Alumni • SPRING CLINICAL DAY; BETTY FRIEDAN DELIVERS STOCKTON KIMBALL Closs of 1990, Knows It's Never Too late to Follow a Dream SuzANNA GooDYEAR, LECTURE • REUNION WEEKEND FESTIVITIES & PHOTOS �: JENNIFER ��I 1997, in an effort to identify and address these barriers, researchers at the University at Buffalo completed one of the first assessments of the health status of women with disabilities. The results of the assessment were so compelling that they spurred formation ofa multidisciplinary Center for Women with Disability, which opened in September 1997 as part of the Western New York Neuroscience Center at Kaleida Health's Buffalo General Hospital (BGH). "The health concerns of many women with disabilities are not met through the traditional health-care delivery system. Often, these women are not treated in the context of wellness but only in terms of their disease," explains Carol Brownscheidle, PhD, UB clinical assistant professor in the Department of Neurology, and director of the new center. The health-needs assessment, which was designed by the Women's Health Collaborative Research Group (WHCRG) under the auspices of the Neuroscience Center, was completed by more than 300 women with multiple sclerosis (MS), stroke or other neurological disorders. The respondents' median age was 45, and half were moderately to severely disabled. More than 20 percent of the women reported a history of gynecological problems, such as uterine fibroids, endometriosis, ovarian cysts, irregular menstrual periods and deterioration of MS during menstruation; a similar percentage reported experiencing reproductive and postmenopausal health problems that were inadequately treated. Forty percent of the women said they were sexually inactive, while 70 percent of those who were postmenopausal indicated they weren't receiving hormone-replacement therapy. 0 MARCH B u f f a l o In sum, the women reported experiencing insensitivity to their special health-care needs; lack of accessible medical equipment, such as examination tables and mammography machines; and difficulty getting to the various facilities for treatment of specific problems, according to Brownscheidle, who chairs and directs the WHCRG and was instrumental in developing the survey. Galvanized by the survey results, Brownscheidle began work on the creation of the Center for Women with Disability. In talking about her involvement with the project, she is quick to acknowledge the ongoing assistance and support she has received from others, including Lawrence jacobs, MD, who is Irvin and Rosemary Smith professor of neurology at UB, head of the Department of Neurology at BGH, and project director for the ew York State Multiple Sclerosis Consortium (NYSMSC), and Dennis Weppner, MD, MBA, UB associate professor of clinical obstetrics and gynecology and clinical director of obstetrics and gynecology at Millard Fillmore Hospital Suburban, both of whom serve as co-medical directors for the center. Today, the Center for Women with Disability is a place where women with special health-care needs receive a variety of services, including social and supportive services that are intended to assuage feelings of isolation and loneliness. For many women with MS, post-stroke impairment, post-polio paralysis, cerebral palsy, spinal-cord injury, spina bifida or movement disorders, such as Parkinson's disease, the neurologist is the gatekeeper for health care, Brownscheidle notes. "We've built on that and formed a kind of one-stop health shopping center. When a woman comes in for stroke treatment Phys l clan Summer 1 9 9 9 �disability; they don't just deal with neurology, but OB-GYN issues, too," notes Elizabeth Roden, who has epilepsy and regularly attends the center. "I really wish something like this had been around when I was first diagnosed." Recently , the center expanded its services to include orne women have limited movement, and urology, with care provided by Philip Aliotta, MD. "Bladder dysfunction is lt can be quite common with this difficult for population and requires them to use the immediate medical attenstirrups on a tion if an infection develconventional pelvic-exam ops," explains Epstein, who table," explains Susan adds that Aliotta provides Epstein, MS, MEd, clinical services at the center twice coordinator for the center, a month and sees approxiwho, along with Weppner, mately 10 to l2 patients developed a pelvic-exam each clinic day. "Dr. Aliotta chair specially adapted for has conducted research on women with disabilities. bladder function in patients (See article below.) "Other with neurological disease, women may not be able to and we are fortunate to have stand upright for mammohim as part of our team," gram screenings or, if they says Brownscheidle. are spastic, may find it difWhile improving access ficult to perform a breast to health care remains the self-exam. In many cases, primary mission of the centhe women simply have a ter, it has begun addressing difficult time getting to the broader, quality-of-life different specialty offices," issues by offering programs she adds. on community-service Although the center has opportunities, networking, been open less than two social services and careers. years, the patients feel that The Outdoor Adventure the access it affords them to Susan Epstein MS MEd and Denms Weppner ~D MBA, developed a pelvicProgram offers wilderness one-stop health care is the exam cho1r specially adapted 1or women with ch~o~1c uisab1ing co•di ons. wheelchair hikes , and the key to its success. "I espeWomen Helping Women Program links women with cially like how the different types of care and services are disabilities to volunteer opportunities in assisted-living consolidated. These are professionals who address all settings and nursing homes. Monthly "focus luncheons" aspects of a woman's life and how it can be affected by or for follow-up visits for multiple sclerosis, she can go to other rooms in the center for a pelvic exam, a Pap test, an ultrasound or to have her blood pressure checked," she explains. ''s G.xnecologic For a woman who has multiple sclerosis (MS), it can be very difficult to transfer from a standard 22 -inch-high wheelchair to a conventional 30-inch-high examination table in a physician's office. For a woman with a neurological disorder that causes spasms, loss of control of lower limbs or pain, transferring to such a table can be impossible. Instead of being a neutral apparatus for the provision of health care-especially gynecological care-the exam table becomes still another barrier, both physically and emotionally. Recognizing that access to examination tables con be a major issue for women with disabilities in need of gynecologicol care, Susan Epstein, MS, MEd, clinical coordinator for the Center for Women with Disability, and Dennis Weppner, MD, MBA, UB associate professor of clinical obstetrics and gynecology, decided to solve the problem. From the start they realized that, to be successful, B u f f a t o Physician they would need to abandon the traditional model for a gynecological exam. The solution came one day while Epstein was at the dentist. lying in a comfortable chair during a long procedure, she thought, "This will work." And it did. Epstein and Weppner immediately contacted PoHerson Dental, which has been in the specialized business of making dental chairs for more than 100 years. They identified a choir that can be lowered to 22 inches to facilitate transfer from a wheelchair. It also had a knee break, which allows positioning for a pelvic exam. Allen stirrups, with a boot-like fit, were aHoched in order to increase comfort and decrease the effects of spasticity. "This sounds like a simple solution, and it is," admits Epstein. "But, until now, there has been nothing that would accommodate the needs of a woman with a chronic disabling condition." Summer 1 9 9 9 0 �feature specialists who come to the center and answer questions on health topics in an informal setting. Some women travel from as far away as Niagara Falls to attend these luncheons, with transportation provided gratis by john Arnet, president of We Care Transportation, a local specialty transportation company. Also, valet parking is available and can be accessed at BGH's main entrance. Other support for the luncheons comes from Biogen, a biotechnology firm that makes the drug Avonex TM, for treatment of MS. A no ther quality-of-life project under way is the development of a Career Center, scheduled to open in fall 1999, which will focus on re-employment of clients by instruction in such areas as resume composition, interview skills, managing home finances and self-esteem building. A fully accessible computer lab will introduce clients to basic PC and Internet skills. Provisions of the Americans with Disabilities Act, job Accommodation Network and opportunities available through vocational education will be presented to clients. Recent statistics show that lack of employment can lead to feelings of loneliness, pessimism, morbid or gloomy thoughts and self-pity in approximately 75 percent of unemployed disabled women, in comparison to 25 percent of employed disabled women, according to Brownscheidle. "Employment is viewed as a productive use of time that improves outlook on life and augments one's contribution to society, whether it involves full-time or part-time work. The Career Center will provide career counseling and aptitude testing, as well as individual and small group sessions to achieve these goals," she says. Carolyn Miller, who regularly visits the center since her diagnosis with MS, says living with a disability can be extremely isolating. "It's a lonely life," she relates, adding that she sometimes feels "vulnerable and depressed" about her inability to enjoy many of the activities she used to, such as volleyball and waterskiing. "It's nice to be involved with the other women," says a u f f a 1 Ilona Tylwalk, who has MS. "There's an interchange of ideas, and we can talk about our problems and different illnesses-because not everyone has MS. "The lunch lectures are great," she adds. "''ve never been disappointed by one." The center's educational goals extend beyond the patient population in an effort to reach health-care professionals, as well. "Women with disabilities are just as susceptible to the three leading causes of death in women in the United States-heart disease, cancer and stroke-and therefore should be screened and counseled accordingly," says Brownscheidle. Unfortunately, the diagnosis of a major disease, such as MS, often overshadows every other aspect of a woman's health, with the results being that broader health-care concerns, including access to primary care, are overlooked. "We listened to our patients and heard the same thing over and over again-that access issues were often ignored and gynecological examinations were demoralizing and impersonal. They just didn't feel comfortable," says Brownscheidle. "Some of the women have even been asked by their gynecologists why they wanted to know about sexually transmitted diseases or birth control. Did they actually have a sex life7" o Physician Summer 1 9 9 9 �Despite such concerns, Brownscheidle states that progress is being made toward better understanding and that "even within the past year in this country, the healthcare profession as a whole has started to focus more closely on specific health issues affecting women with a disabling condition." Weppner emphasizes that the center is not only taking a proactive role in treatment and education, but is also furthering research efforts by ensuring that the women who visit the center are enrolled in the NYSMS registrythe largest population-based cohort of MS patients reported to date. The research implications of this database are enormous, he explains, and the close association with UB's School of Medicine and Biomedical Sciences adds impetus to the center's ability to contribute to the treatment of neurological diseases in general, as well as to the comprehensive care of women, in particular. "By approaching our research from a multidisciplinary perspective, as well as looking at data from the perspective of gender differences for these diseases, we may discover information we might not have otherwise found ," Weppner says. Since its inception, the Center for Women with Disability has attracted the attention of national healthcare organizations, including the New York State Depart- B u f f a 1 o Physician ment of Health, Baylor University and the Mayo Clinic, which last spring sent representatives to Buffalo to visit the center. ln addition, Brownscheidle was invited to present information about the center and the health-care assessment survey at the American College of Obstetricians and Gynecologists 1998 annual meeting in New Orleans and at the Women's Health Issues in Multiple Sclerosis Roundtable in Houston. She also moderated a national conference on women with MS and their healthcare concerns in Amelia Island , Florida, in june 1998. Although the center has not been widely advertised , patients, too , are finding out about it, and their numbers are growing steadily. "Patients are hearing about us ," says Epstein. "Recently, a woman who is an amputee called us to say that she was so thankful for the center because she hadn't had a Pap smear in 10 years. " Exposure and recognition like this is likely to engender continued interest in the growth and development of this unique center for women with disabilities, leading to even more comprehensive services for its patients. However, for Leona lrsh , an Episcopal priest diagnosed with MS, the fact that the center even exists is like an answer to a prayer. "I cannot say enough about what they are trying to do for us. It means so much that they are looking at us as whole people. " + Summer 1 9 9 9 0 ��Class of 1999 B f f a 0 p h y s c a n 5 m m e 9 9 9 0 �started about one year before my actual departure, when I called Dr. Brendan Thomson, whom Dr. Copley had listed as a contact person at the close of his article. Dr. Thomson is a UB alumnus (Class of 1970) who resides in Phoenix and actively runs an ongoing Nepali-American exchange program. He had been the guiding inspiration behind Dr. Copley's decision to travel to Nepal and had accompanied him on his journey When Dr. Thomson returned my call the next day, we realized that we are both graduates of Canisius College and UB medical school and found that our shared jesuit heritage resonated well. He gave me names , numbers and the advice I needed to begin organizing the most daunting task I had ever attempted. Specifically, my goals were to coordinate a medical experience for myself in a location halfway around the world, to complete my residency applications prior to leaving, and to not get killed or lost once I arrived at my destination. The details involved in implementing these goals were tremendous and the obstacles and stresses, extraordinary, but my zeal for adventure and the critical support of my family, girlfriend and several local members of the medical community enabled me to accomplish what I had set out to do. The hardest part of this excursion, I have since realized , was not the trip to Nepal itself, but convincing myself early on that it was worth all the sacrifices and risks I was taking. Having gone and returned, I no longer have any doubt that it was the best thing I could have done , as the trip contributed to my medical education and personal growth in ways I am only now beginning to fully understand. I left for the Far East in September of 1998 not ® B u f f a I o knowing what to expect but strongly motivated by a lifelong interest in biology , travel , wilderness medicine and foreign cultures. My plans to "go it alone " changed for the better at the last minute, when DJ, a good friend of mine from California, decided to come along. Arriving in Bangkok, Thailand, we settled in for a 14-hour layover priorto leaving the next morning for Kathmandu. As the sun was rising, we boarded the plane, which was filled with a motley assortment of colorful passengers, including local Nepali people, trekkers and climbers, and even some celebrities coming from around the world. I met and talked with jon Krakauer, author of Into Thin Air, after which I realized this was going to be a unique experience. Once we took off, I soon received my first dose of the Himalayan mountains , watching as the peaks cut through a thermocline layer of clouds like islands. The jet stream over the Indian subcontinent skims over Mount Everest and a comet-like trail of ice is commonly seen trailing off the peak. We wound through these giants until we approached the emerald green valley of Kathmandu far below. When we finally landed, I was overwhelmed by sensations I had only previously read about in books. The air was muggy from the jungles that surround the city, the sun was extremely hot and masses of people were everywhere, Physician Summer I 9 9 9 �.' Tibetian monks in the village of Pokhara in western Nepal invite Tom, left, and DJ to join them in a pick-up game of hockey sack. Pictured below, a monkey looks on as bodies are cremated on a pyre at Pashupatinath Temple overlooking the Bagmati River. although few seemed to have any real place to go. A loneliness and desperate feeling of emptiness consumed me as I pondered the enormity of spending more than six weeks in such a place. E\\ Co:--;cEPTS ABOL T LIFE, DEATH A\D BAsiC ExiSTE ·cE Once we boarded a epali cab and were under way, I was able to appreciate for the first time both the poverty and the history ofthis ancient place. Looking out my window, I marveled at the small crowded houses, dirt roads, completely disorganized traffic and hordes of people-a mosaic of life that exists under the watchful eyes of the Buddha, which peer from the many temples and stu pas that dot the region. Religion in Nepal is a blend of Buddhism from the north and Hinduism from the south, both mixed with a touch of Animism and Christianity. This blending makes the country a true melting pot and a place where people are very accepting of diverse philosophies and practices. Little did I realize how my perceptions of death, life and basic existence would be challenged and modified during my stay. My mentor during my stay in epa! was Dr. Buddha Basnyat, a local physician who had befriended Dr. Thomson during his first visit to Nepal years before. At the time, Dr. Basnyat had been intent on completing an internal medicine residency in the United States, and Dr. Thomson had helped place him at a Phoenix hospital and had invited him to stay in his home during the three-year fellowship . B u t t a l a Physician When we arrived at Dr. Basnyat's home, I was relieved to finally meet him and his wife and their three children. We were immediately escorted to their family room, where we exchanged "namastes" (a epali greeting meaning "I salute God in you"), after which we were offered tea. DJ and I soon realized that we could not have been blessed with a nicer family to ease our transition. Through the Basnyats, we were introduced to the many facets of Nepali culture, including its festivals, traditions and arts. One such art was the practice of relaxation, which stems from the belief in Nepal that work and leisure time are of equal importance. As a result, hours each day are devoted to relaxation and cultivating a balance between rest and activity. DJ , the Californian, adapted immediately; this medical student, in contrast, had a much harder time with the practice! A MIXTURE OF PEOPLE -\\0 DISEASES FRO\! AROt.; D THE PL.-1.'\ET In arranging for my excursion to Nepal, the plan was that I would "shadow" Dr. Basnyat during his work day at a general medicine clinic, where he is in Summer 1 9 9 9 �private practice with several partners. I would also accompany him on general rounds at the local hospital , conduct research with the Himalayan Rescue Association (HRA) and have some free time to go trekking. I spent the first two weeks in Kathmandu adjusting to my new environment, finding decent $3-aday rooms and struggling daily to maintain perspective. Patients at the clinic were truly a mix from all over the planet, which is to be expected when working roughly 180 degrees oflongitude from Cleveland. A simple fever workup takes on new meaning when a patient has recently been in India, sporadically taken his Lariam (anti-malaria medicine), flown to Lhasa, Tibet (a gain of about 3,200 meters in altitude in one day), cannot remember which vaccines he received, and has come to Kathmandu where he has not been too conscientious of sanitary conditions and has "reveled in the local festivities. " I saw much gastrointestinal illness, ranging from amoebas to cyclospora; sexually transmitted diseases; tuberculosis of all manifestations; rabid dog bites; infected leech bites; a host of dermatology, from psoriasis to cutaneous tuberculosis; and malaria. We also had a good share of common internal medicine problems , but these were often quite advanced. At Patan Hospital I saw untreated malaria , typhus, japanese encephalitis, chronic obstructive pulmonary disorder, anemias, amoebic liver abscesses, rabies and several other exotic maladies. I experienced for the first time the frustration of limited resources, and I developed respect for the local physicians and those whose religious devotion calls them here. While I did have a difficult time adjusting to the poverty of these patients, especially the children, I was impressed by the family presence in the hospital and by how much responsibility the patients' relatives assume. B u f f a l o LHR. L G RESPEC r 1OR \\- JLD PLACES In addition to my experience at the clinic and hospital, I was also very fortunate to work with Dr. Basnyat at the HRA. This organization coordinates rescue missions in the mountains, staffs physicians at strategic trekking and climbing routes, educates trekkers and studies Himalayan climate and biology. Dr. Basnyat's interests lie in high-altitude medicine and extreme environmental physiology. If they live, individuals who are seriously ill at altitude are likely to become patients of Dr. Basnyat's back in Kathmandu. Especially poignant to me in my work with the HRA is a case of a European man who ascended too high, too fast, along the Everest route. He ended up with a horrible case of cerebral edema and was found unresponsive with a pulse-oxygen rate of 38 percent (a rough measure of oxygen saturation in the blood, with the normal rate being about 90 to 100 percent); he never recovered full brain function. More than anything, this furthered my respect for the power of these and other wild places for both the sudden climatic changes that can cause havoc and the subtle insults that can accumulate over time. This firsthand exposure to the field of geographic medicine-which offered me a chance to combine my love of biology with medical work-confirmed for me that this is a discipline I will certainly continue to explore in the years ahead. At the HRA, I had a blast learning the local geography, giving advice to climbers, lecturing about acute mountain sickness (AMS) , designing research projects and, most notably, helping Dr. Basnyat develop theories to explain data he collected from a recent study of his. A theory I developed to help explain one possible component of AMS pathogenesis is currently being tested in the vicinity of Mount Everest, and my frequent daydreams are a testament to how excited I am over the possibility of having conjured a novel idea. I am fascinated by exotic diseases and intrigued by the prevention of such problems, especially when the added complexities of political and cultural differences are factored in. A. U\GUDED TREK L THE WILDER. ESS Soon it was time for DJ and me to leave Kathmandu for a long-planned 10-day trek in the Himalayan wilderness. We went without guides , often resorting to a global positioning system for direction. I had more than my share of leeches, headaches, pain, loneliness, silence and time to think while trudging through the remote terrain. Physician Summer l 9 9 9 �While on o bockcountry trek to Annopurno Sonctuory,Tom Cumbo, leh, come to the oid of o porter who cut his foot with on ox. I learned that this discomfort is the price one pays for the spectacular views normally reserved for IMAX theaters and the wisdom that potentially unveils itself during times of quiet reflection. We were blessed with cloudless mornings, interaction with the natives and time to think about our priorities in life. Dr. Basnyat's father, a devout Hindu, had previously given us lessons on filtering sensations and becoming pleasantly detached from our environment, and the extremes of emotion and physical sensation that characterized our trek provided plentiful fodder for this practice. The Nepal wilderness is harsh, featuring constant avalanches, landfalls, extreme variations in altitude and temperature, wild animals, disease and, at times, mysterious inhabitants. Clouds seem alive as they stream over the high passes. Glaciers creak and moan before unleashing rolling splinters of ice. Sinkholes open in the glacial field, unexpectedly swallowing tons of debris. Small streams become roaring rapids farther down the slopes as they swell with runoff from the icy peaks above. Buddhist prayer flags break the characteristic silence of the open range with crisp flaps, sending constant meditative mantras into the open air. As a final destination, we climbed into Annapurna Sanctuary-a holy land at 5,000 meters that is surrounded by 8,000-meter peaks--where we sat for days, staring in profound awe at the vast panoram;;~ . I also had my share of patients on the trek, which was especially frightening because, for the first time in my medical career, I was working completely alone. I treated climbers who had clear signs of acute mountain sickness and impending complications, others who were maladjusting psychologically and a B u f f a l a Physician local who sliced his foot with an ax and was bleedingprofusely.Itiscomical now to picture myself three days from civilization, using a latex glove with a small hole cut in the finger to irrigate the wound while getting loose translations from the patient's family and shooing curious animals away. Improvisation is often necessary in these circumstances. THE \\ tSDO\t Gu ED FRO\t SLCH AVE. TLRE My time in Nepal was one of the most challenging experiences I have ever had. I spent the majority of the trip adjusting to one tough emotion after another, interspersed with the most tremendous highs. The wisdom gained from such a venture will sei¥e me well for the rest of my life. What did I learn? In essence, I learned about the value of moderation and balance and the importance of family and close friends. I also learned that very rarely does the worst-case scenario in a particular situation actually materialize; that one must practice what one is passionate about; and that life can be cruelly unfair. This year-long project, with all its stresses and rewards, has altered my life dramatically. There were several moments when I felt sensory overload was imminent from the intensity of my experiences. Things I thought were constants have vanished, often painfully. Insights and opportunities have helped fill the void and offer direction. Home again, I thank God for these challenges, the maturation they have spurred and the opportunities they have unleashed. + Summer 1 9 9 9 �Funding Bolsters Research on Hearing Loss UB RECE IVES $5 .7 MILLION PROGRAM PROJECT GRANT FROM NIH he University at Buffalo has received a five-year, $5.7 million program project grant from the National Institu tes of Health (NIH) to expand studies aimed at understanding and treating acquired hearing loss, a condition that affects approximately 28 million people in the United States alone. The grant funds four projects in which investigators are studying the function of the peripheral and central auditory system in an effort to determine how and why noise and certain therapeutic drugs cause loss of hearing. Principal investigator is Richard ]. Salvi, PhD, professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences, and codirector of UB's Center for Hearing and Deafness. In awarding the grant, the IH is supporting UB's efforts to build on significant contributions made over the past 12 years by an internationally recognized research group in the Center for Hearing and Deafness, a multidisciplinary effort involving 30 scientists from eight departments and three schools within UB. "This grant is wonderful news for the university," says UB President William R. Greiner. "It will enable Professor Salvi and his team to expand their pathbreaking research into the causes of acquired hearing loss. The outstanding work conducted by this group is a stellar example of the interdisciplinary research that we foster at UB. Their studies promise not only to advance scientific knowledge about acquired hearing loss, but to benefit millions of people who suffer from this affliction. We are proud that our center received this prestigious NIH grant and look forward to its continued success as a worldwide leader in its field ." UB Provost David]. Triggle notes that program project grants provide funding that makes it possible for scientists to research several related directions simultaneously. FOLR OvERLAPPI"<G RESEARCH THEMES The Center for Hearing and Deafness was established in 1987 by Donald Henderson, PhD, professor of communicative disorders and sciences and otolaryngology, and Salvi, both of whom came to UB that year from the University of Texas at Dallas. They were joined in the mid-1990s by researchers Robert F. Burkard, PhD, associate professor of communicative disorders and sciences and otolaryngology, and Sandra L. McFadden, PhD, research assistant professor of communicative disorders B u f f a l o P and sciences and psychology. Today the center is focusing its research on four overlapping themes that form the basis for the current program project grant. These projects target ( 1) molecular and cellular mechanisms of hearing loss; (2) effects of ototoxic agents and noise on cochlear function ; (3) functional alterations of the central auditory brain regions after partial or temporary hearing loss; and (4) the role of the ears' inner hair cells in the brain's processing of auditory stimuli. "To understand why a patient experiences difficulty in processing hysician Summer 1 9 9 9 �New W. M. Keck Foundation Center for Computational Biology BY complex sounds, we need first to understand how the auditory system processes acoustic information along the entire auditory pathway," explains Salvi. "Damage that originates at the periphery, or inner ear, can cascade through the system, disturbing activity throughout the entire auditory pathway, even spilling over to other sensory, motor, cognitive and emotion centers. This functional reorganization, or plasticity, is poorly understood because of a lack of an integrative research approach to acquired hearing loss. Our project provides such an approach, " he adds. + u f f a l o P hysici CHAMBERLAIN AND EL L E N G OLD BAU M ·D grant from the California-based W.M.Keck Foundation will move the University at Buffalo to the forefront in single-molecule research, an area of investigation so promising that the journal Science recently devoted an entire issue to it. The grant-funding the creation of a new W. M. Keck Foundation Center l for Computational Biology at the University at Buffalo-will allow a team of researchers in the School of Medicine and Biomedical Sciences to purchase high-speed computers that will greatly accelerate their study of the activity of ion channels. Ion channels are protein structures that regulate the flow of electrical currents in cells; when malfunctioning, they can lead to a wide spectrum of diseases. The UB researchers-Frederick Sachs, PhD, and Anthony l. Auerbach, PhD, professors of physiology and biophysics, and Feng Qin, PhD, research assistant professor of physiology and biophysics-have developed software programs that are revolutionizing the way scientists interpret ion-channel activity, which is so complex and timeconsuming that, until recently, many researchers simply gave up on it. With their "QUB" software, researchers around the world are able to discover in minutes how long it takes for an ion channel to change shape, which enables them to understand how it functions, or malfunctions. Previously, such calculations would have taken months. According to Sachs, it was Feng Qin-ot the time a graduate student and someone whom Sachs describes as "brilliant"-who developed the algorithms on which the software is based. "For 20 years, scientists have been collecting data on the random movements of molecules, but they didn't know how to interpret this information," says Auerbach. "Qin made several breakthroughs, and now the analysis is relatively easy." Scientists and software vendors have responded positively to the methods the UB team developed, and the instructional workshops that they hold are well attended. "Our programs are becoming the 'gold standard' for ion-channel research," says Auerbach. "The Keck grant is important to our future because it provides us with computing power that will allow us to push the limits of molecular dynamics," he adds. The Keck Foundation grant supports work that is part of an ongoing structuralbiology initiative at UB; it also builds on other recent corporate grants that are helping to make UB one of the top-1 0 supercomputing sites in the U.S. Founded in 1954 by the late W.M. Keck, founder of the Superior Oil Company, the W. M. Keck Foundation is one of the nation's largest philanthropic organizations. Its grants focus primarily on pioneering efforts in the areas of higher education, medical research, science and engineering. + PROGRAM PROJEa INVESTIGATORS, /eft to right, Sondra l. McFadden, PhD, Donald Henderson, PhD, Richard J. Salvi, PhD, ond Robert F. Burkard, PhD. B SUZANNE a n summer 1 9 9 9 ��···· · ··········· · ·· · ·· · ····· · ··· ·· · · · · ·· · ······· ············· · ···· · ····· · · · ········· · ··· · <· ~ ' ' ® Commencement for the School of Medicine and Biomedical Sciences at the State University of New York ot Buffalo wos held on Moy 8, 1999, ot the Center for the Arts on the North Campus. This year, the school conferred 144 MD degrees, 2 MD/PhD degrees, 35 PhD degrees and 52 master's degrees. Graduates induded students from the Graduate Division of Roswell Pork Cancer Institute. Pictured center, left to right: David Pawlowski, Daniel Perregoux, Stephen Przynosch ond Mary bsePuthiyomodom. Clockwise, from upper left: 1 faculty ond graduating PhOs Tiejon Wu, Or. Germaine Buck, Or. Arthur Michalek, Or. loon Dorn, Enrique Schistermon ond Jeanne Perla 2 Malcolm Heagle II 3 Honored Speaker Or. D. Bruce Johnstone 4 Or. Richard Sorkin, Brian Duffy and Or. Frank Schimpfhauser 5 Mary Rose Puthiyomodom ond family 6 Raquel Tonuzi. 6 u 111 m • r I 9 9 �Wiring Medicine for the Future LA S ARE uNDER VvAY at the University at Buffalo CONTINUING MEDICAL EDUCATION (CME) . CALENDARS OF LOCAL AND REGIONAL PROGRAMS AT UB AND THROUGHOUT WESTERN NEW YORK . CALENDARS OF NATIONAL AND INTERNATIONAL MEETINGS. CATALOGS OF PRODUCERS OF CME PROGRAMS. ONLINE INTERNET CME COURSES. to establish an online medical-information system to serve the educational, research, patient care and administrative needs of UB's dispersed multi-institutional health-care network. Funding in support of this futuristic planning has been provided to the university's Health Sciences Library through a two-year, $283,000 Integrated Advanced Information Management System (!AIMS) grant from the National Library of Medicine ( LM). Gary Byrd, director of the Health Sciences Library and the project's principal investigator, says the system will offer ready access to a virtual, knowledge-based library, as well as clinical-care, research and educational information resources. "The goal is to provide health-information resources that are organized and available across an electronic infrastructure that will enhance the processes by which health-care professionals teach and learn, conduct biomedical research, administer health organizations, provide patient care and offer consumer health information," he says. The Health Sciences Library will collaborate on the project with the Schools of Health Related Professions, ursing, Dental Medicine, Pharmacy, and Medicine and Biomedical Sciences, as well as with affiliated health-care organizations. For participating institutions and organizations, the project is expected to optimize and integrate information-technology goals and strategic priorities; help make effective use of shared expertise and technology; and offer an adaptable, sustainable, high-quality and cost-effective medical-information network with links to many sources of health-care data. The !AIMS grant will also provide programs and tools to help educate and train individuals to use easy-to-navigate, convenient and timely point-and-click workstations. Through these workstations, users will be able to access information independent of time constraints, physical location, organizational affiliation or workplace technology. The lAlMS program was initiated by the NLM, a division of the Nationallnstitutes of Health, in response to a report in the early 1980s by the Association of American Medical Colleges on the role oflibraries in information management. The report recommended that academic medical centers develop information networks to help integrated medical units communicate better. Co-principal investigators for the grant are Bruce Holm, PhD, associate dean for research and graduate studies in UB's School of Medicine and Biomedical Sciences, and Francis Meyer Jr., vice president for information systems and technology for Kaleida Health. + - 18 Buffalo P hysician P ATRICIA Summer D ONOVAN 1 9 9 9 �·········································· · ·········· ·· ···· · ······· · · · · · · · · · · · · · · · · · · ·· · ·. • g I Students Who Are aSTEP Ahead OUR BufFALO->\REA HIGH SCHOOL students participating in the Science and Technology Entry Program (STEP) at the University at Buffalo School of Medicine and Biomedical Sciences were awarded first place in the Natural Science Category I for a poster they presented at the STEP Statewide Student Conference held May 22-23, 1999, in Syracuse, New York. The poster, titled "Heart Health utrition: The Regulation of Homocysteine by Folic Acid, Vitamin B-6 and B-l2Intake," was prepared and presented by Latasha . Evans, a junior at Holy Angels Academy; Lynette A. Gholston, a sophomore at Villa Maria Academy; Nichole M. Gonzales, a sophomore at iagara Wheatfield Senior High School; and Aprile Hollinsworth, a sophomore at Buffalo Traditional School #192. The group received $250 for the first place finish and each member was presented a certificate. The purpose of the STEP Program is to assist underrepresented minority or economically disadvantaged secondary school students in acquiring the prerequisite skills necessary to pursue pre-professional or professional educational programs in scientific, technical or health-related fields, according to Carolyn Hamilton, EdD, assistant dean for Minority Affairs at UB. STEP is open to qualified students in grades 9 through 12. Those who earn entrance to the program complete a two-week orientation, after which they begin the Summer Component, which places them in a university-affiliated hospital where they gain exposure to science and health care through work experience. "This experience is enriched by field trips to the UB South Campus, where the students visit the Neuroanatomy Museum, learn how to conduct research on the Internet in the B u f f a l o I students to the statewide conference, says the four young women researched their winning poster presentation on the Internet and at the Health Sciences Library, as well as contacted a lentil producer in Idaho to obtain dietary information, food samples and recipes. In addition, Murray Ettinger, PhD, Distinguished Teaching Professor of Biochemistry, assisted the students in illustrating a molecular model of homocysteine; and Raymond Dannenhoffer, PhD, in the Department of Anatomy and Cell Biology, provided the students with two heart models. Dennis Nadler, MD, associate dean for Undergraduate Medical Education, andj ohn R. Wright, dean of UB's School of Medicine and Biomedical Sciences, also provided support for the students. "The judges reviewing the posters interviewed the students about their research and each was able to answer a number of questions in a very knowledgeable way," says Coplin. "They were Health Sciences Library, participate in sessions in the Gross Anatomy Laboratory and assist and observe medical students who are examining standardized patients," says Monyuette Y. Coplin, STEP program coordinator in the Office of Minority Affairs. "Many of the students also attend UB's Mini-Med School and Mini-Vet School," she adds. During the academic year, the students attend Saturday classes in biophysics, biochemistry, applied math and computer science that are taught by first- and second-year medical students. "The medical students are good role models and will often informally share information Left to right: Aprile Hollinsworth, lynette Gholston, Nichole Gonzales, latasha Evans with the STEP stu- and Mrs. Monyuette Y. Coplin, STEP's program coordinator at the University at Buffalo. dents about how best to prepare for careers in health care or poised throughout the competition science," says Hamilton. and we are all very proud of their In addition to the hospital experi- accomplishment." + ence, academic instruction and laboratory exercises, students can avail STEP and its activities are supported by a themselves of a Tutorial Program if they grant from the New York State Education are experiencing difficulty with school- Department. For more information on the prorelated subjects. Also, to ensure they gram at UB, contact Monyuette Y. Coplin in have the best possible chance of meeting the Medical STEP Office at (716) 829-2802; their career goals, the students receive or e-mail her at myc@acsu.buffalo.edu. vocational and career counseling. - 5. A. UNGER Coplin, who accompanied the Physician Summer �• ··· · ······· · ··· · ······ ···· · ······· ····· · ······ · ······ ·· · ·· ····· · · · ········· · ·· · ········· ~ I Renee Abderhalden· Friend Internal Medicine, SU Y/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, NY Match Day 1999 Bettina Ackermann Pediatrics, Eastern Virginia Stephanie Babcock Pediatrics, Cleveland Clinic CLEVELAto;D, 0 H Lisa Balduf Surgery, Universtty of New Mexico School of Medicine ALBUQUERQUE, M Medtcal School Fayyaz Barodawala Medicine (Prelim), SU Y/Buffalo ORFOLK, VA Daniel Alexander Orthopaedics, Henry Ford Health Science Center Detroit, Ml Graduate Medical-Dental Education Consortium, Buffalo, NY; Diagnostic Radiology, Dartmouth-Hitchcock LEBANON, N H Martha Aliwalas Family Practice, University of Pittsburgh Medical Center, St. Margaret Todd Battaglia Orthopaedics, University of Virginia PITTSBURGH, PA Michael Ament Medicine (Prelim), Renee Baughman Obstetrics/Gynecology, SUNY/Buffalo Graduate Medical-Dental Education Consortium Untversity of Colorado; BUFFALO, CHARLOTTESVILLE, vA Y Neurology, University of Colorado DENVER, CO Lynn-Marie Aronica Obstetrics/Gynecology, SU Y/Buffalo Graduate Medtcai-Dental Education Consortium BIJFFALO, NY Kurt Benham Ophthalmology, SUNY/Buffalo Graduate Medical-Dental EducatiOn Consortium BUFFALO, Y Florence Bero Family Practice, University of Vermont/Fletcher Allen BURLINGTON, VT jorge Arzola Marrero Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, Y Jason Borton Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Tahsina Atiquzzaman Family Practice, Stony Brook Teaching Hospital STONY BROOK, NY ® B u a Y �Amy Breden berg Family Practice, john Peter Smith Hospital FORT WORTH, TX Thomas Cimato Internal Medicine, Hospital of the University of Pennsylvania PHILADELPHIA, PA William Breen Ill Family Practice, Eastern Maine Med1cal Center BANGOR, ME Thomas Cumbo Internal Medicine, johns Hopkins University/Sinai Hospital of Baltimore BALTIMORE, MD Ann De Nardin Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Molly Susan Esposito take to the air waves with their news. Andrea deRosas Medicine (Primary), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Susan Esposito Emergency Medicine, johns Hopkins Hospital BALTIMORE, MD Deidre Brown Family Practice, SUNY/Buffalo Graduate, Medical-Dental Education Consortium BUFFALO, NY joyce Cummings Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y Andre Dick Surgery, Penn State Geisinger HERSHEY, PA Brian Cambi Internal Medicine, Yale-New Haven Hospital EW HAVEN, CT Patrick D' Abbracci Internal Medicine, University of Southern California Los ANGELES, CA Melissa Dilanni Internal Medicine, Brown University PROVIDENCE, Rl Christopher Carlson Internal Medicine, University of Michigan Hospitals ANN ARBOR, M! Chantell Dalpe Obstetrics/Gynecology, State University of ew York Health Center SYRACUSE, y Michael Docherty Internal Medicine, University of Cahforn1a, San Diego Medical Center SAN DIEGO, CA Andrew Fagelman Urology, Maimonides Med1cal Center BROOKLYN, Y John Carter Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y Patricia Danaher Family Practice, Washington Hospital WASHI"'GTON, PA Brian Duffy Surgery, Eastern Virginia Medical School ORFOLK, VA Tanya Falkowski Pediatrics, University Maryland Medical Center BALTIMORE, MD Christopher Deakin Psychwtry, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, y David Dugan Surgery (Prelim), SU Y/Buffalo Graduate Med1cai-Dental Education Consortium BUFFALO, Y Barbara Fare Medicine/Pediatrics, Orlando Reg10nal Med1cal Center ORLANDO, FL Barbara DeGuiseppe Psychiatry, SUNY/Buffalo Graduate Medical-Dental EducatiOn Consortium BUFFALO, NY Nadine Duhan Surgery, Rush-PresbyterianSt. Lukes CHICAGO, IL Albert Chu Pathology, Hospital of the University of Pennsylvania PHILADELPHIA, PA Lynn Dunham Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y jessica Edwards-Reich Obstetrics/Gynecology, Long Island jewish Hospital NEW HYDE PARK, NY Philip Ehrlich Medicine (Prelim), Alton Ochsner Medical Foundation, New Orleans, LA; Ophthalmology, Louisiana State University Eye Center EW ORLEANS, LA Douglas Evans Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Educauon Consortium, BUfFALO, Y; Orthopaedic Surgery, SUNY/ BuFFALO Graduate Medical-Dental Education Consortium BuFFALO, NY Craig Feinberg Internal Medicine, George Washington University wASHINGTON, DC Victor Fila dora II Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, NY; Anesthesiology, Brigham & Women's Hospital BOSTON, MA Oren Fix Internal Medicine, Boston University Medical Center BOSTON, MA James Flaherty Internal Medicine, McGaw Medical Center-NW C!liCAGO, !L John Fojtik Emergency Medicine, MCP Hahnemann University PHILADELPHIA, PA Corey Harrison, center, looks to the future. 9 9 �• ·········· · ········ · · · ···· ·· ·· · ······· ·· ~ I Karen Foti Pediatrics, Tulane University School of Medicine, ew Orleans, LA Timothy Fox Emergency Medicine, Maine Medical Center, PORTLAND, ME Medicine (Prelim), University of Utah Affiliated Hospitals SALT LAKE CITY, UT; Radiation Oncology, University of Utah Affiliated Hospitals SALT LAKE Cny, UT Malcolm Heagle II Pediatrics, University of South FLORIDA, TAMPA, FL Elizabeth Francis Medicine (Prelim), Mary Imogene Bassett Hospital, Cooperstown, Y; Dermatology, Penn State Geisinger DANVILLE, PA Brandy Helminiak Emergency Medicine, Ohio State Umverslty Medical Center COLUMBUS, OH Natasha Frangopoulos Surgery (Prelim), Mt. Sinai Hospital, New York, NY; Otolaryngology, Mt. Sinai Hospital EW YORK, NY John Henry Medicine (Prelim), University of Rochester/Strong Memorial Hospital ROCHESTER, NY; Neurology, University of Rochester/ Strong Memorial Hospital ROCHESTER, NY Eric Fung Surgery (Prelim), State Umverslty of ew York Health Center, SYRACUSE, Y; Otolaryngology, State Umversity of New York Health Center SYRACUSE, Y Renee Hernandez Internal Med1cine, Einstein!Montefiore BRONX, NY Karen Gerber·Vecsey Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BurrALO, NY jennifer Griffith Surgery, University of Rochester/ Strong Memonal Hospital ROCHESTER, NY Molly Harrington Pediatrics, Maine Med1cal Center PORTLAND, ME Corey Harrison Emergency Medicine, University of Massachusetts WORCESTER, MA Lisa Hazard Maria loTempio Otolaryngology, University of California Los Angeles Medical Center Los ANGELES, CA Stefan lucas Anesthesiology, University of Rochester/Strong Memonal Hospital ROCHESTER, Y Kristine Klein Obstetrics/Gynecology, Albany Medical Center Hospital ALBA~Y. Patricia Lugar Internal Medicine, McGaw Medical Center-Northwest CHICAGO, IL y Mitchell Kolker Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Otolaryngology, SU Y!Buffalo Graduate Medical-Dental Education Consortium, BUFFALO, Y Kelly Holes Family Practice, SUNY/Buffalo Graduate Medical- Dental Education Consortium BUFFALO, NY Brett Mascia Pathology, University of Virginia CHARLOTTESVILLE, v A lucy Mastrandrea Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Margaret lafferty Pediatrics, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, y Teague Horton Pediatrics, University of Virgima CHARLOTTESVILLE, VA Shannon Howe Pediatrics, SU Y!Buffalo Graduate Medical-Dental Education Consortium BuFFALO, NY Timothy McGrath Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Orthopaedic Surgery, SUNY/Buffalo Graduate Med1cal-Dental Education Consortium BUFFALO, NY Henry lee Medicine (Prelim), McGaw Medical Center-Northwest CHICAGO, IL; Ophthalmology, Wills Eye Hospital, Thomas jefferson University PHILADELPHIA, PA Wayne Hwang Medicine (Prelim), SU Y!Buffalo Graduate Medical-Dental Education Consortium, BUFFALO, N Y; Diagnostic Radiology, Allegheny General Hospital PITTSBURGH, PA Amy jones Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y a Michael Lipke Surgery (Prelim), New York University Medical Center NEW YORK, NY Won Hee Kim Medicine/Pediatrics, Stony Brook Teaching Hospital $TONY BROOK, NY Keith Herr Psychiatry, Emory University School of Medicine ATLANTA, GA B Ellyn Sellers share in the excitmenl. Edward Kim Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, Y Haruka ltakura Internal Medicme, Hospital of the University of Pennsylvania PHILADELPHIA, PA Group hug said it all this day for Keith Herr, lisa Thebner and lisa Balduf. Left to right: Sandra lee, Edward Kim and Sanjiv Kayastha Plastic Surgery, Spectrum HealthDowntown GRAND RAPIDS, Ml 0 Karen lee Pediatrics, University of Massachusetts WORCESTER, MA Carri·Ann Megargel Internal Medicine, SU Y!Buffalo Graduate Medical- Dental Educauon Consortium BUFFALO, NY Sandra lee Psychiatry, YP Hospital-Cornell NEw YoRK, NY Michael Melman Research Tingting Li Internal Medicine, Barnes-jeWISh Hospital ST LOUIS, MO Daniele Merlis Pediatrics, Albert Einstein College of Medicine, jacobi Medical Center BRONX, NY Michael Lioudis Graduate School MBA, Umversity of orth Carolina CHAPEL HILL, C Susan Miller Pediatrics, SU Y!Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY p y s a 5 m m e 9 9 �··· · ···· · ····· ·· · ·· ············· · ··················· · ············ • · ·. ~ I Charles Roche Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, NY; Diagnostic Radiology, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Charlie Pan Medicine (Prelim), St. joseph Mercy Hospital ANN ARBOR, Ml; Radiation Oncology, University of Michigan Hospitals ANN ARBOR, Ml Kathryn Montgomery Pediatrics, University of Connecticut FARMINGTON, CT Natesh Parashurama Surgery (Prelim), Boston Universtty BosTON, MA Amy Morrow Pediatrics, University of Michigan Hospitals ANN ARBOR, Ml Parag Parikh Surgery (Prelim), University of California, Irvine Medical Center, IRVINE, CA; Otolaryngology, University of California, Irvine Medical Center IRVI NE, CA Khader Muqtadir Medicine (Prelim), Evanston NW Health Care EVANSTON, IL; Diagnostic Radiology, Cleveland Clinic CLEVELA~D. OH Zulma Rosado Family Practice, Jamaica Hospital Medical Center jAMAI CA, NY Ari Rubenfeld Surgery (Preitm), Georgetown University, WASHINGTON, DC; Otolaryngology, Georgetown University WA SHI GTON, DC Rupal Patel Transitional, Crozer-Chester Medical, SPRINGFIELD, PA ; Ophthalmology, SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Elena Napolitano Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Physical Medicine and Rehabiiitation,UMDNJ EWARK, j Frank Salamone Otolaryngology, Umverstty of Cincinnati CINCINNATI, OH Ahlam Saleh Family Practice, University of Massachusetts Medical Center Health Alliance Hospital-Leominster FITCHBURG, MA David Pawlowski Family Practice, Duke University Medical Center DURHAM, NC Daniel Perregaux Emergency Medicine, Mancopa Medical Center PHOENIX, AZ Heidi Narins Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, Y Anthony Santilli Internal Medicine, Brown University PROVIDENCE, Rl Marsilia Seiwell Obstetrics/Gynecology, SUNY/Buffalo Graduate Medtcai-Dental Education Consortium BuFFALO, NY Stephen Przynosch Family Practice, Toledo Hospital TOLEDO, OH Jeffrey Nechleba Orthopaedics, Hamot Medical Center ERIE, PA Mary Rose Puthiyamadam Medicine/Pediatrics, Penn State Geisinger HERSHEY, PA Bretton Newman Family Practice, Columbta St. Marks SALT LAKE CnY, UT Ellyn Sellers Famtiy Practice, Catilion Health Systems ROANOKE, VA Crystal Nicholson -Springer Pediatrics, Nassau County Medical Center EAST MEADOW, NY Michael Rauh Surgery, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, Y Daniel Nosek Family Practice, Palmetto Richland Memorial Hospital CoLuMBIA, SC James Reuther Psychiatry, University of Texas Medical School HousToN, TX Joy Nwachukwu internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Kevin Robillard Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, Y Sonia Shah Internal Medicine, Medical College of Vtrgmia Richmond , VA Shams Sheikh Medicine (Prelim), University of Rochester/Strong Memorial Hospital, Roc HESTER, Y; Diagnostic Radiology, Yale-New Haven Hospttal NEW HAVEN, CT Gregory Shipkey Emergency Medicine, Darnal Army Community Hospital FoRT HooD, TX Michael O' Brien Internal Medicine, Brown University PROVIDENCE, Rl Natalie Sikka Pediatrics, Baylor College Medical HousTON, TX Thomas O'Donnell Otolaryngology, Penn State Geisinger DANVILLE, PA B a 0 p h y c a n 5 m m e 9 9 9 I Jenny Speranza Surgery, Stony Brook Teachers Hosptta! STONY BROOK, y Brian Stout Pediatrics, Umversity Hospttals CLEVELAND, OH Michael Stratemeier Emergency Medicine, orth Shore Umverstty MANHASSETT, NY Ivan larkin Surgery (Prelim), Monmouth Medical Center LONG BRA NCH, j lisa Thebner Pediatrics, Emstein!Montefiore BRONX, NY Eric Thierman Medicine/Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Katherine Timoszyk Medicine (Prelim), Georgetown University Hospital, WASH I GTON, DC; Neurology, Duke University DuRHAM , NC Racquet Tonuzi Medictne!Pediatrics, SUNY/Buffalo Graduate Medtcai-Dental Educauon Consortium BUFFALO, NY Sylvia Tufano Obstetrics/Gynecology, Untversity of Connecticut FARMINGTON, CT Jayadeep Varanasi Internal Medicine, University of orth Carohna Hospital CHAPEL Ht LL, NC Leonard Vaughan Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Amy Weinstein Internal Medicine, McGaw Medical Center-Northwest CHICAGO, IL Ryan White Urology, Albany Medical Center Hospttal ALBANY, NY Judi Wolf Pedtatncs, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY �Mission Improbable SUZANNA GOODYEAR , 'Z" \ '90, ENTERED US' S MEDICAL SCHOOL AT AGE 54 GooDYfi\R \V\S BOR"< atatimewhenprofessionalcareeroptionsforwomenwerefew and generally considered little more than stopgaps until marriage and children came along. Small wonder, then, that she nearly missed out on fulfilling her girlhood dream of becoming a physician and caring for the poor and needy "It's something that's been in my blood all my life," she says. "My uncle was the medical director of a Quaker mission in Kenya in the 1930s, and it was something I knew I wanted to do. But I didn't know how to get there and I didn't know who to ask." From the age of 14 through her teens, of a pharmaceutical company. A couple Goodyear held tightly to her goal. lt of years later, after taking a position in wasn't until her college years that her the Biochemistry Department at Albany dreambegantofade.Shehadstartedout Medical College in Albany, ew York, as a chemistry major and pre- r - - - - - - - - . she again thought briefly 8 v med student at Earlham about applying for medical 8 E T 5 v College in Richmond , school. But self-doubt won 5 A w v E R out, and she allowed her Indiana, but there were no dream to return to dormancy. strong female role models after whom she could pattern her As the years passed, she immersed career. It was the 1950s, and women herself in her chemistry pursuits. While physicians-especially women in on staff at the New York State Departprivate practice-were not common. ment of Health in Albany, she was honWhile at Earlham , she had an ored in the 1966 edition of Outstanding opportunity to work with a few women Young Women ofAmerica for her work in physicians in the wards of a psychiatric measuring radioactive fallout. Nine years hospital. However, instead of spurring later, she became one of the department's her on, the experience only served to senior radiologic chemists. discourage her. As rewarding as Goodyear's career 'These women were my mother's appeared, deep down she still wasn't generation, and I was not impressed. satisfied . Despite her success-and They were subordinate to the men . imperceptibly to everyone, including Where the men were surgeons, the herself-the seeds of her dream had women took care of coughs and colds. continued to send forth roots. Doubts As I look back today, I admire them, but about the career path she'd chosen l didn't then. l was 21 and l didn't see increased in the 1970s as she met and them as pioneers," she says. began socializing with several women "l think if l'd had a mentor , l might physicians. Unlike those she'd known have gone on. But there was no one to in college, these women were enjoying show me the way, sol gave up. " successful medical careers. After completing a master of science Around that time, circumstances at degree in biochemistry in 1957, she work began to shift, as well. There were went to work in the research laboratory cutbacks and frustrations at the lab, B u f f a l o Physic including increasing problems with the computers . Annoyed with the programmers' inability to correct the problems, Goodyear took a 10-week math application course and began to do some programming on her own. "I also took a course in statistics because the department was reducing staff and l realized these were good skills to have," she says. "But l didn't enjoy it that much , and l knew l didn't want to do it for the rest of my life. l'd work on the computers for an hour or so a day and then head back up to the lab to do something else. That's when l finally sat down and asked myself, 'What would l do ifl could do anything in the world?"' The answer hit her square in the heart: lt was 1983, Goodyear was 52, and she knew she still wanted to be a doctor. "l sat down and cried," she says. Then she set out to change her life. BAcK To ScHooL AT 54 t first, Goodyear was secretive about her decision to apply to medical school. "lt was very difficult to find anybody l felt l could confide in. l didn't need the entire health department lab putting me down. So l'd sneak into the library to get information on medical school and costs. " A i an Summer l 9 9 9 �Today Suzanna Goodyear, MD '90, works for Health Access, a free clinic in rural Clarksburg, West Virginia, where she serves indigent and low-income patients_ One of her surreptitious factgathering efforts netted the study guide for the Medical College Admission Test (MCAT). At the back ofthe booklet she found the information she needed on the application process. "I saw that I needed to do some review work to prepare," she says. "After all, I'd been out of school for more than 30 years. So I started taking courses at Russell Sage College in Troy, New York, and reading textbooks on my own during my lunch hour. " Continuing to work full-time in the B u f f a l a lab, Goodyear spent the next two years studying genetics, organic chemistry, biology and physics. To broaden her experience, she also worked as a volunteer with geriatric patients. She passed the Red Cross Water Safety course and taught swimming lessons. Next, she completed coursesinFirstAidandcardiopulmonary resuscitation and joined an emergency ambulance crew. After being on call every Friday and Saturday night for two years, she completed tests to become a licensed emergency medical technician. The preparation paid off and, at Physician Summer 1 9 9 9 age 54, she passed the MCAT. But scoring well on the test was just one hurdle on the way to gaining acceptance to medical school. She then had to convince an admissions commiHee that she was a good investment, despite being older than most other applicants. "Once I knew what I wanted, assuring other people that I could do it became my greatest barrier to medical school," she says. While interviewing at UB's School of Medicine and Biomedical Sciences, she readilyconcededthatshewasolderthan �the typical student and then pointed out the advantages. "I told them, 'Statistically I may have less time, but you don't really know that about anyone. The average age for a doctor to commit suicide is 45, and I'm past that. I have no children, and I'm past that. I have many years to devote to medicine."' Thomas Guttuso, MD, director of admissions at UB's School of Medicine and Biomedical Sciences, says that although the school does not have an official age policy, Goodyear's application "did raise eyebrows." "In the case of an older student, concerns arise about the appropriateness of spending the money it takes to educate a medical student versus what society will get back," he says. "However, we judged Goodyear's application like everyone else's, on the suitability of her qualifications. " Recalling his interview with her, Guttuso says, "She was very energetic and we felt she would give back to society what she gained from a medical education. And her career certainly bears this out." In April 1986, Goodyear received notice of her acceptance by UB. Her next step was to retire from her job, which, at the time, involved monitoring airborne radioactivity from the Chernobyl disaster. She was ready to become a full-time medical student. AGE G~P A ge has its advantages, Goodyear realized, as she discovered that she was better off financially than many of her fellow students. ''I'd had a good job with the State of New York, and I was eligible for early retirement at half my state salary. I didn't have to scrimp, like so many of my classmates did. Also , I had never married and had no children and my parents had died a few years earlier, so I didn't have family responsibilities. I was entirely free to go my own way." On the other hand, after 30 years in services. In her third year of residency at the professional world, Goodyear had the local hospital, she worked at the developed certain expectations of her clinic several evenings a week. peers. "It irked me when classes started "One night when I was finished with late because people couldn't get up in my shift, I was talking to one of the the morning and be there on time. I felt founding physicians. My excitement the same way as an intern and resident. about the program must have shown I expected things to start on time and for through, because they found the money people to pull their own load. I may to pay me as a full-time staff member. have been slower, but I worked hard so I started in August 1993, following people wouldn't have to do my work." graduation and completion of my Goodyear's social life was affected by family practice boards in july." Today, Goodyear continues at Health the age gap, as well. "My interests were different, and I didn't know how to Access, which is one of about a dozen socialize with my peers," she says. "I free clinics in the state. Supported by attended the Methodist church near cam- state and community funding, the clinic pus. It was an older congregation in what serves patients who meet federal stanhad been a working-class neighborhood. dards for poverty, have no insurance, are not eligible for Medicaid and have no That's where I got my best support." Another problem, Goodyear says, was other source of assistance. West Virginia her inability to stay awake between limits Medicaid to pregnant women, 1 and 3 p.m. "I could study all morning disabled persons and children under age and all evening, but not in the after- 18, leaving a large population of patients noon," she says. "When I went back to eligible for the clinic's assistance. "One of the reasons we use such school, I had no trouble with nightschool work. But afternoon lectures were strict guidelines is so we can access indigent patient programs," she says. dreadful. They still are!" "At this level, the hospital provides 100percent assistance to our patients, and MISSIO'\ TO THE NfED) uring her senior year in medical many major drug companies offer school, Goodyear had an opportu- special pharmacy assistance programs." Health Access provides primary care, nity to experience the mission field. She spent eight weeks at the Presby- as well as referrals to specialties, through terian Mission Hospital in Kikuyu, the volunteer service of medical staff in Kenya. It was rewarding, but enough of the community. All of Clarksburg's phya culture shock to prompt her to seek sicians are on the local hospital staff, charitable opportunities closer to home. and about 90 percent of them donate After her return to the States, she time to the clinic. Additionally, a pharfocused on serving impoverished maceutical company in the area donates many of the products the clinic needs. patients in rural America. For Goodyear, "working part-time "I was fascinated by an article written by a doctor who'd set up a clinic in for the pittance that a charitable healthAppalachia, and I wanted to do some- care organization can pay" represents thing similar. That's why I came to the apex of her career and fulfillment of Clarksburg, West Virginia, for my a lifelong dream. residency," she says. "Caring for people who really need it When a new community clinic for is the most rewarding thing I've ever indigent and low-income patients done," she says. "And to think I almost opened in Clarksburg in October 1992, missed it. Sometimes the highly Goodyear was quick to volunteer her improbable is possible, after all." + D B u f f a l o Physician Summer 1 9 9 9 �B y L 0 I S 8 A K E R Empowerment · and WomenS Health EQUAL OPPORTUNITY FOR A LONG, FULFILLING LIFE Betty Friedan, the first president of the National Organization for Women and the nation's best-known feminist, presented an informal talk on the impact of women's empowerment on their physical and mental health on May 1, 1999, during the 62nd Spring Clinical Day sponsored by the UB Medical Alumni Association, held in the Buffalo-Niagara Marriott in Amherst, New York. clearly brought about this Friedan was the first change, Friedan noted, woman to present the Stockpointing out that this ton Kimball lecture and to change has an important receive the association's impact on women's health, Stockton Kimball Award. as well as on their econoWomen's health was the mic status. theme of this year's Spring She referred to an early Clinical Day, which featured study that found that several presentations on women's mental health breast and ovarian cancer. peaked when they were in Accustomed to speaking their 20s and dropped before gatherings attended dramatically after age 40, almost exclusively by compared to men. "It was women, Friedan opened her thought normal for remarks by joking about the women to go into depresnumber of men in the audision in menopause," ence, a legacy of a profesFriedan said. sion that for many years was Author and feminist Betty Friedon. "It even had a classifialmost exclusively male. She cation: involutional melancholia." contrasted that historical state of affairs with When women were defined only by their the current situation, in which enrollments in feminine role, not as individuals in their own many medical schools are half women. In fact, right, life was over after 40, she noted. "The the class entering the UB School of Medicine love story was the only one that women could and Biomedical Sciences this fall will have a be a hero of. But now, women's mental health majority of women for the first time in the after menopause is better, maybe better even school's 153-year history. than it was in their 20s, 30s and 40s. " The empowerment of women through the women's movement of the 1960s and '70s Buffalo Phys CONT I NUED ON i cian Summer PAGE 1 9 28 9 9 �As women en tered the professions in large num bers, the con cept of the working woman took on a negative tone, Friedan observed. "The hype was 'Women have to have it all,"' she said. "But nobody ever says anything about men having it alL For 30 years people h ave been trying to prove that women's employment is bad for children and they couldn' t do it. Now the newest study sh ows that employment is good for children . .. . Big news! " "Of course women are happier when they aren't living exclusively through their children and they aren't seething with frustrated rage," Friedan said. "There is also less stress and pressure on the man when he isn't solely responsible for providing for the family. That has to be good for children." Friedan said that, while empowerment has had a positive effect on women, th ey historically have lived longer than men, and she suggested this discrepancy as a fertile area for study. "Something about the male role must be a killer. There should be research into the things about women's roles that are good for life," she said, going on to state what she thinks some of those might be. "We carry with us a biological grou nding in a sensitivity to life," Friedan said . "It is part of the socialization of women. We don' t have to suppress our tears and fears. " She offered three characteristics that women who are vital into their 90s have in common: the ability to deal with change, th e ability to deal with loss and the willingness to take risks. Medical Alumni Lifetime Achievement Awards his year's recipients of the School of Medicine and Biomedical Sciences' lifetime Medical Alumni Achievement Awards are as follow: • Elizabeth Olmsted Ross, MD '39, clinical assistant professor of ophthalmology at UBwho has been in private practice in Buffalo since 1944. (See profile on page 39.} then went on to complete fellowships in gastrointestinal physiology at the university's Cardiovascular Research Institute and at the Veterans Administration HospitaL Throughout his career, Way has been recognized for his excellence in teaching and has received numerous commendations and citations for his contributions in this area. From 1991-1992, he was president of the Son Francisco Surgical Society and from 1995-1997, served as chair of the board of trustees lor the Society lor Surgery of the Alimentary Tract. Currently, he is a consultant to the Gastroenterology and Urology Devices Advisory Panel for the FDA. • James E. Youker, MD '54, professor and chair of the Department • Stephen C. Scheiber, MD '64, of Radiology at the Medical College of is professor of psychiatry at NorthwestWisconsin. In recognition of the excelern University and executive vice presilence Youker has brought to his departdent lor the American Board of Psychiament-especially in the areas of patry and Neurology, a position he has tient care and research-he was given held lor 10 years. "However, to all of the Distinguished Service Award by the us-more than anyone else inthe United Medical College of Wisconsin in 1989.1n States-he is someone who is seen as 1997, he was a recipient of a Gold the standard bearer for American psyMedal of the Association of University chiatry and neurology," said Susan Radiologists. Youker has served as a Mcleer, chair of UB's Department of member of the Board of Chancellors Psychiatry, who introduced Scheiber. She and as vice president lor the American added that Scheiber has built a national College of Radiology. He has also served reputation as an educator and scholar STEPHEN c. SCHEIBER, MD on the board of trustees for the Radioconcerned with the health of physicians logical Society of North America. Currently, he is a and the educational process in psychiatry. "But, most member of the executive committee of the American importantly," she said, "Steve has worked tirelessly Board of Medical Specialties and is president-elect of to ensure that residents in psychiatry and neurology the ABMS. access quality training" and noted that his work with • Lawrence W. Way, MD '59, vice chair ofthe the American Boord helps to assure that patients have Department of Surgery at the University of California access to well-trained and skilled professionals." at San Francisco and director of UCSF's Videoscopic Scheiber has served on the editorial boards of numerCenter in the Department of Surgery. Anative of St. ous peer-reviewed journals, has been a reviewer lor Louis, Missouri, Way attended Cornell University be- NIMH grants and has been honored as a visiting guest lore earning his medical degree at UB. He completed professor at over 50 medical schools throughout the his internship and residency training at UCSF, where he nation. New Alumni Association Otficers Elected B u f JOHN f a l o P J . hys BODKIN, i cian II , MD , Summer 1 9 9 9 �Clinical] Madeline and Frederick Szymanski, Closs of 1939, enjoying 60-yeor reunion festivities. Elizabeth Olmsted Ross and John H. Remington, celebrating 60-yeor reunion. Elizabeth Moher, Closs of 1983, with Betty Friedon, this year's recipient of the Stockton Kimball Award. Robert Harvey, Closs of 1950, leh, accepting this year's attendance trophy, which was presented by Richard Collins, Closs of 1983, incoming president of the Medical Alumni Association. Cathy and John Montroy, Closs of 1938, relaxing at dinner. B u f f a l o Ph ysici an Summe r 1 9 9 9 �first row: Frederick]. Szymanski; second row, left to right: Anthony V. Postoloff, Frank T. Riforgiato, john F. Montroy, john). Squadrito, john H. Remington, Elizabeth Pierce Olmsted Ross, Roy E. Seibel, Sr. first row, left to right: jacqueline Paroski, judith Weinstein, julia Cullen; second row, left to right: john Egan, George Erickson, john Sharp, Robert Harvey, Frank Pfalzer, Bradley Aust, Robert Smith, Robert Sanford, Charles Bathrick, Lawrence Carden, Henry Thiede, Irving Lang, Philip Dennen, Richard Schwartz, Paul Buerger, Max Schneider, Pierce Weinstein. first row, left to right: John Kutrybala, Clay Burchell, Sylvia Griva Lizlovs, Allen Lesswing, Donald Wilson; second row, left to right: William Howard, james Youker, Robert Miller, john Conboy, Robert Pletman, Louis Cloutier, Donald Murray, Malcolm Leslie, Robert Oshrin, Edward Wenzlaff, Edward Rayhill, Edward Bockstahler, Richard Mayer, Nicholas Carosella, jack Lemann. ® B u f f a l a Physician Summer 1 9 9 9 �CLASS REUNIONS First row, left to right: Max Doubrava, john McMahon, Daniel Kozera, joseph Monte, David Denzel, Donn Yacht, Sandra Wiltse, William Mangan, George Baeumler, Constantine Cretekos, Charles Anderson, Eli Isaacs. First row, left to right: William Fleming, Frederick Painton, Leo Michalek, Walter Hoffman, Irving Sterman, Elizabeth Serrage, Stephen Scheiber, David Weinstein, james Tibbetts, David Ziegler. First row, left to right: Penny Gardner, Thomas Scanlon, Moira Burke, Mona Milstein, Evelyn Roisman, David Arkin, Hachiro Nakamura, Daniel Levin, Dorothea Downey, Madeline White; second row, left to right: Timothy Harrington, David Schreiber, Michael Pisick, Hanley Horwitz, William Major, Marion Wind, Robert Hartog, james White, james Cavalieri, Gerald Stinziano, David Sherer. B f f a l a p h y s c a 5 m m e 9 9 ® �• · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ··········································· first row, left to right: Anna G. Engel, Sandford Pleskow, Leslie Ford, Thomas Chmielewski, Gordon Avery, Daniel Morelli; second row, left to right: Louise Stomierowski, Bruce Thiers, Daniel Lasser, Hing-Har Lo, Diane Matuszak, Virginia Sybert, Thomas Varecka; third row, left to right: Bruce Middendorf, Richard Buckley, Alan Burstein, john Manzella, jocular Ford, Lawrence Oufiero, james Smith; fourth row, left to right: Paul Wierzbieniec, Roy Seibel, james Pietraszek, Richard Hershcopf, james Budny. First row, left to right: Bruce aughton, Robin Adair, Walter Balon; second row, left to right: Frederick Eames, Richard Irene, Arthur Rosiello, joseph Buran; third row, left to right: john Crofts, john Canty, Peter Shields, Frank Schreck, Charles Francemone; fourth row, left to right: Donald Armenia, Lawrence Sinatra. first row: Thomas Mahl, Karen KimbreliNauschuetz, Kevin Rosteing, Amy Rosteing, Laura Booth Chan, Raymond Chan; second row: Richard Gergelis, Mark Billinson, john Dyster, julie Dessloch, Andrew Knoll, Robert Rattner, Michael McMullen, Herbert Newton. ® B u f f a I o Physician Summer 1 9 9 9 �CLASS REUNIONS First row, left to right: Michael Rosenband, Barbara Bambach Skomra, jeanette Smith, joan MurrayIsaacson, Carol DeCosta, Richard Ruh; second row, left to right: Sharon Zeigler, Amy jeffery, Carolyn Dukarm, Christopher Hamill, Andrea Messina, Christopher Skomra, Lee Guterman, Pamela Reed, Mary Schamann, Paola Seidel, Richard Ferguson, jonathan Bean, David Blaustein, Dawn Gais; third row, left to right: Eric Southard, Paul Lecat, Mark Pundt, Christopher Bartolone, Geoffrey Seidel, Raul Vazquez. 300MHz Pentium II· Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Drive • Iomega Zip Drive atapi • 17" .27NI SVGA Digital Color Monitor • 8MB AGP Graphic Accelerator • 56K V.90 PCI Fax/Modem • 36x IDE CD-ROM B f a 0 p y • Sound Blaster 128 PCI Stereo Sound Card • Soundimage Subwoofer System • 3.5" High Density Floppy Drive • Microsoff Windows• 98 • Corel Wordperfect Suite 8 (includes; Wordperfect So, Quattro Pro 8•, Presentations 8·) • Zodiac 1000 CD Bundle Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! 1·716 ·743 ·0195 T ECHNOLOGY DISTRIBUTION NETWORK www.tdn.net 1000 Young Street . Suite 270. Tonawanda NY 14150 . Fax: (716) 743.0198 s c a n S u m m e 9 9 �r m · · · · · · · · · ·· · · ·· · ······ · · · ········· · ··· · ··· · · ~ Tomorrow's Physicians Confront Choice BY UL \1. rt:' STACEY r nuo r ~A BLYTH on the morning of October 24, 1998, I had no idea how that one call and the events precipitating it would change my experience as a second-year medical student. When I answered the phone, my classmate asked, "Have you heard?" "About what?" I responded. She proceeded to tell me about the murder of Dr. Barnett Slepian. As she spelled out the details , I went a little numb. Despite being safely at home with my husband and daughter, my sense of security was altered. A bullet shattered a window, a man's flesh, and his family's future. That same bullet instilled in me a sense of urgency and a need to evaluate my changing role in the abortion debate. Since that October day I have begun to read about the subject and discuss it with the people around me for the first time. What follows is just some of what I've learned and pondered during these past months. Abortion is a part of human history. Legal or illegal, it has always occurred; legality simply increases its safety and decreases the rates. Maternal mortality and loss of fertility increase exponentially when abortion is illegal, and abortion rates are highest in countries where the procedure is illegal (for instance, Peru's rate is 52 procedures per 1,000 women). That's not to say that our rate in the United States-23 procedures per 1,000-could not be significantly lower. ® Stacey Blyth, a third-year medical student at the University at Buffalo School of Medicine and Biomedical Sciences, is co-coordinator of the local chapter of Medical Students for Choice. MSFC National has over 4,000 student members and assists BO active chapters across the country. just compare that to a rate of 6 procedures per 1,000 women in the etherlands, which has a long history of safe, legal access in combination with reality-based sex education and widely available birth control. This information made me wonder why we are still having this discussion. Whether abortion is legal or illegal, abortion rates will never reach zero due to the imperfect nature of birth control, cases of medical necessity and, more importantly, the imperfection of humanity; however, we could significantly reduce the rates by providing our patients with better options. According to current statistics, 4 3 percent of the women in the U.S. will have an abortion by age 45. Most women who choose to terminate a pregnancy do so only once. Only one unmanageable pregnancy in a reproductive lifetime of roughly 30 years is really quite remarkable. These patients are typically young, and two-thirds plan to have children in the future . They come from every conceivable racial, ethnic, socioeconomic and religious background. During the first year of medical school, we talked a lot about our future role as physicians. We were helped to understand that to be good physicians, we B u f f a 1 a P would need to provide nonjudgmental care to many patients who made life choices with which we were not personally comfortable, such as smoking. Our job will not be to judge our patients' actions and then provide care if we deem them worthy. Yet nowhere in our discussions was any mention made of a woman's right to a safe, legal medical procedure (even if we might not make the same choices for ourselves). When physicians provide care, they are performing important services that save and improve lives; it has nothing to do with validating their patients' actions or lifestyles. To provide high-quality health care over a lifetime, I must forever search my soul for empathy, tolerance and a basic regard for humanity. The rhetoric surrounding abortion is being manipulated to increase intolerance in our culture and drive people to hate. A disturbing trend that is not well understood unless you really pursue it is the growing alliances between extremist hate groups of all sorts and some extremist groups in the anti-abortion movement that advocate violence. During the past 10 years these groups have participated in an hysician Summer 1 9 9 9 �............. . ........................... .. ............. . ............ . ............. . . increasingly violent campaign to shut remove the pro-choice bumper sticker been able to move beyond abortion to down abortion clinics and, as a result, from our truck because she was afraid talk about larger public-health and the number of providers has been the bad people would blow it up. The reproductive-health issues. We are strugsteadily decreasing. Currently, 84 per- idea that I have to choose between being gling to understand how our education cent of the counties in this country do a good doctor and protecting my child and future practice habits can positively not have a single abortion provider, and from the infectious hatred of these people (or negatively) influence our society's roughly 60 percent of the remaining is a constant source of conflict for me. collective well-being. As future physiThe American Medical Association's cians, we are challenging ourselves to providers are at or past retirement age. So what do we do when these brave official position is that the decision of confront intolerance. Given the priviolder physicians retire? These men and whether or not to terminate a pregnancy leged place we will assume in this women remember the carnage and abuse is a private matter between a woman society, it is my belief that we must hold that women suffered as a result of illegal and her physician. This position works ourselves to the highest of standards. abortion; however, the physicians who on paper, but if our current abortion We must find a way to embrace humanhave trained since 1973 do not have this providers are approaching retirement ity in all of its imperfections if we are to horrible experience to help them and we are not training our future establish the trust necessary to provide understand the massive public-health physicians in all aspects of reproductive quality care to our patients. As the anti-abortion movement has imperative of safe, legal access. How services, who will have the skills necesbecome more violent, it has also become can we ask young physicians, just sary to help women make difficult smaller and more out of school rna rgi na lized. and with otherwise I The fear its mempromising futures, TO PROVIDE HIGH-QUALITY HEALTH CARE OVER A LIFETIME, bers instill in us to take on this MUST FOREVER SEARCH MY SOUL FOR EMPATHY, TOLERANCE is real, but the work alone? AND A BASIC REGARD FOR HUMANITY . THE RHETORIC danger our mediJust when I begin cal ins ti tu tions to make my peace SURROUNDING ABORTION IS BEING MANIPULATED TO INCREASE and practitioners with my own loss INTOLERANCE IN OUR CULTURE AND DRIVE PEOPLE TO HATE . will face if they of personal safety, expand student Dr. Slepian's words education and come back to haunt me. He spoke with Medical Students for choices? More than 90 percent of abor- patient services is, in actuality, extremely Choice last year about his training in a tions are currently being performed limited. Terrorism should never be a less volatile time and of his desire to outside of hospitals, yet most medical factor in determining which medical decrease his workload. Unfortunately, students and residents still train in hospi- procedures are available to our patients. The precedent that will be set if the because younger students were not tals. This must be remedied if students anti-choice movement is successful being trained, he felt he could not aban- are to get real exposure to a vital medical don the disadvantaged population to procedure and gain appreciation for how should frighten all of us, regardless of whom he provided care. But what really essential abortion services are for many the choices we might make in our pergot to me was his description ofhow anti- women and families. Unless we find a sonal lives. I for one refuse to let my choice protesters would picket his home way to include abortion training in the morality and future practice habits be and stalk his children. They would standard medical education, it can be dictated to me by an angry minority with guns. I will continue to believe in a accost them at school and at the grocery marginalized and limited by terrorists. here's the surprise ending: So world where we can draw upon the store with violent, threatening rhetoric Despite the bleak tone of most of this diversity of the human community to about their father. My daughter, who will turn eight article, I remain stubbornly optimistic. gain strength, not create fear. + soon, has little more to worry about Faculty support and involvement in right now than what color butterfly clips student efforts to learn about this issue Sources for 111formalion,n tins article incluclr she should wear in her hair, but she have been encouraging. As we've The Alan Guumachcr lnstltuu· c~~ IHL notices things. Even though we have discussed abortion provision, we've agr-usa org) ,\tcdical Students for C.ho1ce tried to shelter her from this violence, come to a much better understanding of www.ms4c.ot g, and the SoutiH'tll Po' crt\ she recently asked my husband to the complexity of this issue. We've even Lcm Center (Win~ Sf1lccnter org). --- - S u f f a I o Physician Summer 1 9 9 9 �8 Y L I N D A J . C 0 R DE R , PH D, C F R E AWord from the Dtrector of Development " development program, over time, is the growth of its endowment. Yet, in the cycle of academic seasons, we have spent very little time discussing this aspect of support for the school. just what is so important about endowment? Endowment is an institution's land, buildings and invested capital resources. In the arena of public higher education, most of the former-land and buildings-are maintained by the state. The latter generates funds to be used, in perpetuity, to support designated programs. One ofUB's earliest endowed funds was a gift from Devillo W. Harrington, who was injured during the Civil War. He was brought to Buffalo, where interns from UB treated his wounds. He recovered, remained in Buffalo, and decided to go to medical school, graduating in 1871. In honor of his twenty-fifth anniversary of graduation, in 1896, he established an endowment. For over a century, the Harrington Lectureship has brought outstanding medical sci en tis ts to Buffalo. Since The endowment is, in a very real sense, the then, many school's security for its future. others have contributed to the school's overall endowment to provide permanent support for designated programs they believe are important to the quality of the academic experience. The endowment is, in a very real sense, the school's security for its future. The school has a variety of funding sources, of which the state's share is relatively small, approximately 12.7 percent. The school's clinical practice plan provides the largest single source of income, while research grants and contracts, annual gifts and endowment gifts comprise small- but significant and increasing-sources of income. Endowment income provides perpetual funding for either the general unrestricted use by the dean (extremely important) or for specified programs established in accordance with the terms of the endowment gift. Endowment income provides a hedge against downturns in the economy; fluctuations in the political climate; variations in the numbers ® Buffalo of alumni and friends supporting the school's annual appeal and other changes in our academic environment. Today's students and faculty benefit from past endowment gifts, while tomorrow's school is being created by today's gifts. I ( '> Additional endowment gifts are the surest way to grow the school's endowment and to protect its mission and vision. Endowment also grows through prudent investment of endowment resources for the long term. A balanced fund, consisting of high-quality, readily marketable stocks, bonds and other assets, is important to meet the goals of growth to outpace inflation and to provide a steady income stream that supports the programs designated by endowment agreements. Several investment advisors, overseen by UB Foundation's (UBF) Investment Committee, manage the school's endowment, and a similar committee oversees the school's state-held endowment. The investment objective is to maximize total return-dividends plus market value-within reasonable risk parameters. Each year the endowment disburses an income stream for current use in accordance with each fund's stated purpose. The percentage disbursed varies slightly between state-held and UBF-held endowments. Generally, between 4 percent and 6 percent of the total endowment's average market value, calculated over the previous three to five years, is made available for spending. The rest of the total return is retained with the endowment principal to secure and even increase its future buying power. The market value of the school'sendowmentassetswas$l32,l61,604,asof]une30, 1998. A year prior, this amount was $111,265,374. Five years ago, in 1993, the school's combined endowment stood at $69,398, 610. The 1998 total represents an increase of over 90 percent in value since 1993. Within the next five years, I trust the endowment will "beat its own record" and at least double in value. This will require many new, significant endowment gifts, in addition to the ongoing wise management of the funds already in the care of the State University and UBF. Watch for additional information about endowments in a future issue of Buffalo Physician. In the interim, if you would like information about initiating a named endowed fund, or have any questions, please contact me by phone, toll free, at 1 (877) 826-3246; or by e-mail at ljcorder@buffalo.edu. Physician Summer I 9 9 9 �Dear Fellow Alumni, As THE E'W PRESIDE T OF THE MEDICAL ALGM I AssociA TIO!\ , I plan to continue the good work started by our previous presidents. Thanks to the leadership and direction from our past president, Elizabeth Maher, and the hard work of Patricia Duffner, this year's Spring Clinical Day, titled "Women's Health," was a tremendous success. The lecture by this year's Stockton Kimball lecturer, Betty Friedan, was interesting, insightful and humorous. Already, plans are under way for next year's event. The Physician- Student Mentoring Program is one of the more tangible ways the Medical Alumni Association demonstrated its commitment to improving the experiences of the students this year. I would like to take this opportunity to salute my medical school mentor as someone who left a very positive mark on my medical career and to whom I am still grateful. Dr. Clayton Peimer and I were paired up in August of 1979. I remember asking Clay, "How in the world do you remember how to treat something like congestive heart failure?" Clay, a hand surgeon, replied, "After you treat something 500 times in medical school and residency, on the 501st time, it begins to sink in." Clay, I have never forgotten that quote and I appreciate all that you did for me and taught me during that period. I hope that I can leave as significant an imprint on the students with whom I come in contact. This is the beauty of the mentoring program. Please consider volunteering for the program by calling the Medical Alumni Office at (716) 829-2778. On August 9, 1999, the Medical Alumni Association will sponsor The White Coat Ceremony at the Center for the Arts on the North Campus. At this ceremony, the first-year students will be given their clinical white coats on the first day of their orientation for medical school. We are proud to take part in this and sponsor such a significant and meaningful event for the first-year students. I look forward to the upcoming year and continued success for the Medical Alumni Association. R ich ar d L. C o ll ins , MD President, Medical Alumni Association CLASS 1 9 3 s 0 writes: "I am a physician on the MediVan, a doctor's office on wheels that gives care to the elderly indigent. This is pro bono publico activity without remuneration. ANG E L O LAP I , MD '37 , 1 9 5 s 0 BERNARD H . SKLAR , MD '56 , writes: I retired November 1, l99l, andam loving it. I saw Dave Ben-Asher ['56] last winter in B u f f a l o P Tucson,AZ. He was looking good. My E-mail address for the computer literate is bsklar l@idt.net. Would love to hear from you. 1 9 6 0 s HARO L D BRODY, PHD , MD '61 , SUNY Distinguished Teaching Professor in the Department of Anatomy and Cell Biology at UB, and his wife, Anne, received the Lynn Millane Community Service Award from the Amherst Senior Citizens Foundation, hysician NOTES Inc., on April 23, 1999. The award is presented to individuals who, through volunteer or professional involvement, have helped maintain and support senior programs that provide socialization, educational and cultural activities, social support and wellness. Anne Brody has been especially dedicated to improving the quality of life for senior citizens and has devoted many years of work toward this goal, according to Dr. Brody. Summer I 9 9 9 R O NALD I. DOZO RETZ, MD '62, was honored April 30, 1999, at the UB Alumni Association's annual awards banquet, which recognizes individuals who have distinguished themselves in their career or in their service to the university. Dozoretz is founder, president, chief executive officer and chair of the board of FHC Health Systems, the largest privately held company providing behavioral health services in the U. S. and Canada, and second �• ·· · ·· · ··················· · · · ········ · ·· ·· · · ···· · ········ ·· ······························ I largest mental-health managedcare company in the nation. of Ophthalmology at Children's Hospital of Pittsburgh. He is the past president of the medical clinical medicine at UB and a frequent lecturer and consultant with the Crohn's and Colitis ROBERTA M . GILBERT , MD '62, staff of the hospital and is president-elect for the American Association for Pediatric Ophthalmology and Strabismus. He also serves as a reviewer for the jour- Foundation of America. writes: "I married joseph Douglass in August 1998, author of Red Cocaine and a new book on progress on the fate of the MIA-POWs. We live in Falls Church, VA. My new book, Connecting with our Children, will be out September 1999 (published by Wiley and Sons). My first book, Extraordinary Relationships, has been in print seven years and continues to do well." nal of Ophthalmology, American journal of Ophthalmology, journal of the American Association for Pediatric Ophthalmology and Strabismus and has served on the editorial board of Binocular Vision. 1 received the Pennsylvania Academy of Ophthalmology's Distinguished Service Award on March 19, 1999, in Pittsburgh. He was honored by Pennsylvania's eye physicians and surgeons for his extraordinary work and for contributions to the specialty of ophthalmology. Biglan is director 7 5 was honored at Springfest '99, the Co u nty Medical Center's (ECMC) annual black-tie dinner dance, which was held this year on April24, 1999, at the Hyatt Regency Buffalo. ovak has been director ofECMC's gastroenterology unit since l980.In addition, he attends in the Hepatology Clinic and recently developed an on-site GI consultative service at the Erie County Home. He is also a professor of B was named to New York Magazine's Uune 7, 1999) Best Doctor "Hall of Fame." For the last 20 years he has had a private practice of orthopaedic surgery in Manhattan, Y. f f a l o 1 9 8 0 5 MD '74, begins a four-year term as a member of the board of directors of the American Academy of Dermatology (AAD). Thiers is professor of dermatology at the Medical University of South Carolina. In addition, he holds clinical appointments as attending physician at Medical University Hospital, Charleston, SC, and chief of the Der- has been named to the board of directors of the American Acad- BRUCE H . THIERS , matology Service at Charleston Veterans Administra- emy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons. Toriello is chief of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, Y, and attending orthopaedic surgeon at St. John's Queens Hospital, Catholic Medical Center, Queens, NY. He also currently serves on the board of directors for the New York State tion Medical Center. Thiers has Orthopaedic Society and is a delegate of the House of Del- served the AAD in many leadership positions, in- egates for the Medical Society of the State of ew York. cludingassociateeditorofthejournal of the American Academy of Dermatology. He has also served Be sure to include your name and a phone number or address where you can be reached. Your fellow alum look forward to reading about your storied past! u Experimental Dermatology, journal of the European Academy of Dermatology and Venereology, Current Opinion in Dermatology and Clinical Dermatology. EDWARD A . TOR IELL O , MD '80, Here are some ways you can submit your story.... e·mail: bp-notes@buffalo.edu fax: 716-645-2313 mail: Editor, Buffalo Physician, 136 Crofts Hall, Buffalo, NY 14260 a favorite memory, anecdote or inspirational moment that you associate with your medical education? How about a favorite professor, mentor or classmate you'd like to tell about? Buffalo Physician is putting out a call for stories about your past, which we will publish in future issues of the magazine. ® 0 JAN M . NOVAK , MD '70, Erie ALBERT W . BIGL AN , MD '68, 9 JACOB D . ROZBRUCH , MD '73, as editor of the Year Book of Dermatology and Dermatologic Surgery, consulting editor of Dermatologic Clinics and as a member of the editorial boards of P hysician KENNETH J . ROT H , MD '83, writes: "Havingservedaschairman of the Department of Internal Medicine and vice chief of staff, I will assume the role of chief of staff at Sharp Memorial Hospital in San Diego, CA, on january l, 2000. Sharp Memorial Hospital is the flagship hospital for Sharp Healthcare, which is the largest provider of health care in San Diego County." H E RB N E WTON , MD '84, writes: "I just returned from participating in the 1999 Spring Clinical Day lectures and the 15th Summer 1 9 9 9 �.......... . ... . .. . ............. . ............. . . . .... . . . ..... .. . . . . . . . . ............ .... . ·· ~- -~. ' reunion celebration for our class. The lectures were excellent and focused mainly on breast and ovarian cancer. Although the number of returning classmates was modest, we had an excellent time at the class reunion reception Friday night. Many of us went out afterwards for chicken wings and beer. On Saturday night, the reception dinner was held at the Dakota Grill, which turned out to be an excellent venue. The dinner and service were outstanding. We all had a great time getting reacquainted and caught up on our careers and families. The dinner was organized by Dave and jill Pfalzer, both of whom should be congratulated for all the hard work they put into this great event! From all of us who participated in the dinner reception , l would like to offer a toast to Dave and jill. Thanks guys!! 1 9 9 CHRISTOPHER '91 , has 0 5 MARTIN , MD been appointed medical director of the inpatient child and adolescent psychiatric program at BryLin Hospitals. The 20-bed , short-term program treats children and adolescents with attention deficit!hyperacti vity disorder, dual diagnosis, conduct disorder, depression, suicidaVhomicidal behaviors and other emotional problems. Martin, who is a board certified child and ado lescent psychiatrist, is in private practice with Suburban Psychiatric Associates in Williamsville, NY, and has been on BryLin Hospitals' staff since May 1996. 8 u f f a 1 o P I Elizabeth Olmsted Ross, MD '39, Honored 1999 Recipient of Lifetime Medical Alumna Achievement Award Olmsted Ross has served in ovolunteer capacity with many community organizations, as well as in on official capacity with professional societies. From 1955to 1957, she was president of the Buffalo Ophthalmologic Society; from 1962to 1964, she served as president ofthe New York Stole Women's Medical Society; and from 1964to 1965, she was president of the Women Physician League of Buffalo. During World War II, Olmsted Ross served as a medical officer in the Civil Air Patrol of Buffalo, Tonawanda and Lockport. An avid pilot, she also instructed navigation in the Buffalo Patrol and was a charter member of the "99's", the Notional Women's Flying Organization. For many years, she and her husband Ira G. Ross enjoyed soiling their 38-foot Zeeland Yowl "Tonuki" some 35,000 nautical miles on the Great Lakes and the North Channel and chartering and scuba diving in the Caribbean. In 1991, after her husband's death, Olmsted Ross initiated on endowment for the Ira G. Ross choir in Medical Informatics at the University at Buffalo School of Medicine and Biomedical Sciences. This choir was recently funded and will be implemented during the upcoming academic year. Recently she was honored by the Buffalo Blind Society, which named their newly renovated area the Elizabeth Pierce Olmsted Educational Center and by the Western New York Blind Association, which changed its nome to the Elizabeth Pierce Olmsted, MD, Center for the Visually Impaired. Throughout her active career, Olmsted Ross has also published extensively in professional journals and mode numerous presentations regarding her research in ophthalmology. For these and other contributions to UB and her profession, it was with great pleasure that John R. Wright, dean of the School of Medicine and Biomedical Sciences, presented Dr. Olmsted Ross with the Lifetime Medical Alumna Achievement Award on May 1, 1999. iven that the theme for this year's Spring Clinical Day was "Women's Health," it was only fitting that Elizabeth Olmsted Ross, MD '39, was awarded o Lifetime Medical Alumna Achievement Award (see also page 28). Following graduation from UB, Olmsted Ross completed o rotating internship at the then-E. J. Meyer Memorial Hospital. In 1941, she obtained on externship in ophthalmology at Strong Memorial Hospital, followed by o residency at the University of Illinois Eye and Ear Infirmary. Three years later she become the youngest person on record to become odiplomate of the American Boord of Ophtholmology. ln 1947, she also become a diplomate of the American College of Surgery. Olmsted Ross has been in private practice in Buffalo since 1944 and, over the years has been affiliated with nine hospitals. She received ocommendation for 50 years of service at Millard Fillmore Hospital and o citation for service at Deaconess Hospital, where, in 1968, she was named chief of the Deportment of Ophthalmology and choir of the residency program. In addition to starting her practice in 1944, Olmsted Ross subcontracted with Curtiss Wright Corporation to establish their Safety Goggle Program and industrial lighting standards. Later, working with Cornell Aeronautical Laboratory, she initiated investigation of ocular hazards of high-energy radar on technicians. This led to participation in o research program for the Air Force Medical Center of Griffiths Air Force Bose and Cope Canaveral, research at Tufts University, and o contract with RCA to examine personnel on their radar ship operating at Cope Canaveral. In 1955, Olmsted Ross began teaching clinical ophthalmology at UB's school of medicine and in 1974 was named clinical assistant professor, oposition she still holds. Today, she is also o member of the UB's President's Associates, the James Plott White Society's executive committee and the editorial board of Buffalo Physician. hysician su m mer 1 9 9 9 �• ········· ·· ········ ·· ···································· · ······· · ············ ···· ······ . I GREGORY A. ANDREWS, MD JD , has published a book, titled The Complete Guide to Premedical Success (MedLaw Books Inc. ISBN 0966052501). A re- retired from private practice in 1969 and a year later moved view written about the book states that it is "an all-encompassing guide containing crucial information for premedical students" and concludes: "This 'nuts and to Tequesta, FL. In addition to teaching, Stoesser '93, bolts' guide to achieving the doctor dream covers many of the common issues and questions that arise from students considering medical school. Dr. Andrews, dedicated to the education of young people considering medicine, has created a book that will be an asset on any student's bookshelf. " to Cleveland to complete his surgical residency at St. Luke's Hospital. In 1950, he began his private practice as a surgeon and for 38 years was as- S practiced as a board certified surgeon from 1940-69 at E.). Meyer Memorial Hospital University starting July 1999, to care for the growing population of adults with complex congenital heart disease. IN MEMORIAM FREDERICK G. S TOESSER, MD '29, a longtime Buffalo-area surgeon, died March 8, 1999, in Waterford Health Care Center, Juno Beach, Fl. He was 95. Stoesser served as an associate clinical professor of surgery in UB's School of Medicine and Biomedical Sciences and taught at the university for 32 years. He ® during that time. A past president of the Buffalo Surgical Society, he also served as president of the UB Medical Alumni Association, the Buffalo Academy of Medicine and the Millard Fillmore Hospital staff. Stoesser's research included work on the use of hyperbaric oxygen to treat disease, and he was instrumental in bringing the first hyperbaric chamber to Buffalo. In 1956, he received a patent for a vein stripper, the proceeds from which he gave to the UB medical school for an endowment to support medical students in financial need. KENT L BROWN , MD '42, died April 30, 1999, in St. Vincent's Hospital, Erie, PA, after a brief illness. He was 83. Following graduation from UB, Brown, a native of Westfield, Y, served aboard the USS San Francisco during WWII. In 1946, after discharge from the service, he moved u Amherst after a long battle with cancer. He was 62. Schultz was a clinicial assistant professor in the Department ofMedicine and had Note: Our e-mail address has changed. and Millard Fillmore Hospital, where he was chief of surgery from 1961 - 1967. He also was a consulting surgeon at DeGraff Memorial Hospital B ROBERT SCHULTZ, MD '65,died March 27, 1999, in his home in sociated with and Lafayette General Hospital JOSEPH KAY, MD '94, writes: "I was married on ovember 2, 1996, to Kathryn Fox of Hamburg, NY. After finishing my Med/ Peds residency at the University of Michigan Hospitals, I served one year as pediatric chief resident at that institution. I will be persuing further training in a combined pediatric and adult cardiology fellowship at Duke Karen Brown Johnson of Schenectady, NY; three sons, KentJr. of Honesdale, PA, David of Sherman and Garry of Columbus, OH; a sister, Martha Brown Akin of Chautauqua, NY; and ll grandchildren. f f a l o served on UB's faculty since 1970. He was also a past president of the UB Medical Alumni Association. Schultz maintained a private practice in internal medicine, renal disease and St. Luke's, where he eventually became chief of staff. He also was affiliated with St. Vincent Charity Hospital and Health Center in Cleveland and was named chief hypertension. In addition, he served as chief of nephrology at of staff there in 1980. Following his retirement in 1983, Brown left Cleveland and returned to Millard Fillmore Hospital. He was instrumental in the development of Western New York's first outpatient dialysis center and founded the High Blood Pressure Control Program of Western New York. A past president and board member of the Western New York chapter of the American Heart Association (AHA) , he served on the board of Chautauqua County, where he served as a medical consultant and a member of the board of directors at Westfield Memorial Hospital. Brown was keenly interested in the history of medicine, in medical personalities, in forensic problems related to medicine and in innovations in surgical techniques. Many of his directors of the New York State affiliate of the AHA. In 1984, he was named Man of the Year for the AHA's Western New York observations and information he accumulated went into several books and numerous scientific papers he wrote. In 1946 Brown's chapter for his dedication and support in the fight against heart disease. Schultz was also a member of the National Kidney Foundation, serving on the Western New York board of directors and executive commitee. In 1975, he received the organization's Distinguished Service Award. Survivors include his wife, Sharon, three sons and two daughters. father-in-law and mother-in-law, Garry Cleveland Myers and Caroline Clark Myers, founded Highlights for Children magazine, still a leading periodical for children in America. Brown and his wife, Elizabeth Myers Brown, contributed greatly to the ultimate success of the magazine. Survivors include a daughter, p s I c I a s m m e 9 9 9 �Pubnona•y Rehabilitation Specialized care for: • COPD • Asthma • Emphysema • Pneumonia • Post-Ventilator Therapy • 'fracheostomy Care Garden Gate Health Care Facility is pleased to offer a rehabilitation program specializing in the care of individuals with pulmonary disorders. Patients admitted to the Pulmonary Program have an individual plan of treatment developed by the in-facility clinical team and medical staff in conjunction with the referring p hysician. Fwe Star Care For Your Loved One Rated outstanding in our community with five stars out of five, according to The Inside Guide to America's Nursing Homes. THE UWCGUIRE l{.EHABIL1Tlfl1(9~ CENTEI{ Located at Ganlen Gate Health Care Facility 2365 Union Road in Cheektowaga 1-888-POSil\.CUlE or 929-1715 All major insurances and Medicare payments accepted. �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT B UFFALO U.S. Postage PAID 3 4 35 MAIN ST. BLDG.22 Buffalo, NY BUFFALO NEW YORK 14214-3013 Permit No. 311 ADDRESS SERVICE R EQUESTED Your stock may pay more dividends than you thought possible You dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income for life, a charitable deduction and reduce or eliminate taxes. And for UB it can mean more scholarships, research funds or the realization of your own personal vision and goal for the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716l 645-3312. T ~ University at Buffalo ~ State University of New York University at Buffalo • Office of Gift Planning • 103 c enter for Tomorrow • Buffalo. New York 14260-7400 • 716-645-3312 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n01-1999-Summer Table Of Contents A list of subunits of the resource. A Special Place for Women Peak Experience Hearing Loss Research Bolstered Medical School Mission Improbable Alumni Student Perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/921ef24ffa18e8c64e5a98f93dc13604.pdf 3e2931c9565d3a095daa32c35adcbc26 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1999 �neaP Alumni and FPiends, On the first day of orientation week, incoming students, parents, spouses, family and friends participated in the second BUFFALO PHYSICIAN \10lumc 34 umber 2 annual White Coat Ceremony, held this year in the Center for the Arts. (See article on page l2 of this issue of Buffalo Physician.) This event-based on an idea generated and ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES brought to fruition by Assistant Dean Tom Flanagan-will no doubt represent one of ~mnh the more memorable experiences for our students and, quite frankly , for everyone Dr Ctrolc Petro DIRECTOR OF PUBLICATIONS Kathryn A Sawner EDITOR ~tephame A Unger ART DIRECTOR/DESIGNER \Lm J Kegler PRODUCTION C.mdy lodd STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john\\ nght Dean EDITORIAL BOARD Dr Benram P<>rtm. Charr Dr Martin Brecher Dr Hawld Brody Dr lmda J Corder Dr Alan J Dnnnan Dr James Kanskt Dr I Iizabeth Olmsted Dr Stephen Spauldmg Dr Bradley f Truax 'vis. Jenmfer \\tier Dr f rankhn Zeplu" nz TEACHING HOSPITALS f-ne County MediCal Center Kaleida Health-Ihc Buffalo General Hospttal fhe Chtldren's llospnalufBuffalo Mtllard ftllmore Gates Hospttal \1tllard hllmore ~uburhan llospnal Ros\\ell Park Cancer lnsUtute \eteransAffatrsWestern. ·e" )ork I kalthcarc S} stem Catholic Health S"tem\1ercy Health System SISters of Chanty Hospttal ·,agara I ails Memorial Medical Center ©The State universny of ew York at Buffalo Buffalo Ph1 sinan is published quarter!} hy the State UniverSI!) of :--:ew York at Buffalo School of \kdicme and Biomedtcal Sciences and the Oil ice of Publications. It ts sent, free of charge. to alumm, facultv students, reSidents. and friend~. rbe staff reserves the nght to edit all copy and submtssions accepted for publication. else involved. This being the second incoming class to have participated in the White Coat Ceremony, it dawned on some of our third-year students that they might have "missed something. " Therefore, at their request, a similar White Coat Ceremony was held a week later, on their first day of classes. Again, this event, like the first, was made possible by the generous support of the Medical Alumni Association, the Parents' Council, the james Platt White Society and our other generous student supporters. Incoming students were also treated to another form of welcome: a completely renovated Butler Auditorium and G26 classroom. During my student lunches last year, one of the most recurrent complaints about the medical student experience here was related to the "dismal" classrooms and the condition of the student lounge. Although Butler has been our best classroom, it lacked the most current educational technology suitable for computer presentations, and the carpet had seen better days. Those renovations, plus a new screen, are now in place. G26 was a slightly different story and over the summer was completely gutted and refurbished. Finally, with help from the Parents' Council and Polity, the student lounge has also been refurbished and now represents a more hospitable refuge for the students. Our plans for the coming year include completely refurbishing Farber 144 and establishing a new, more spacious and suitable student study-space and lockerroom facilities. Other projects are on the drawing board and will be implemented once the necessary planning and funding processes have been completed. It is our conviction that a good learning environment includes physical accouterments as well as all of the more intangible essentials. Our students also experienced another "first" this year as the United States Medical Licensing Examination (formerly the ational Boards) was offered via computer only. (See article on page 8 of this issue of Buffalo Physician .) Although one of the advantages appeared to be almost instantaneous feedback, the "spread out" nature of administration actually delayed the reporting of results. These standardized tests must be subjected to statistical analysis and therefore require completion by all candidates before validation is possible. So much for progress! A final note: Dr. Tom Flanagan really has retired, having completed the initial two years of his planned "retirement" as an assistant dean in the Office of Medical Education. We are all indebted to Tom for making this invaluable contribution to the school and look forward to his continuing participation in school events, even if on a less formal or frequent basis. In the meantime, we wish him and Grace all the best as they enjoy a well-deserved bona fide retirement. John R. Wright, MD Dean, School of Medicine and Biomedical Sciences �VOLUME 34 , NUMBER 2 .-----------------~ AUTUMN 8 On the Trail of Schistosomiasis Electronic Testing Makes Its Mark 2 14 1999 ARevolutionary Look at Medicine SCIENTISTS HUNT FOR MEDICAL LICENSING EXAM .JOSEPH GAGLIARD I GENES IMPLICATED IN NOW TAKEN BY COMPUTER, ASSUMES PERSONA OF THE DEADLY DISEASE REPLACING PAPER- AND- REVOLUTIONARY WAR by S. A. Unger PENCIL COUNTERPART Doc TO TEACH HISTORY photography by Frank Miller by Corrine Streich Hospital News and Philip LoVerde Photography by John Consoli CHANGES COME TO REGION'S VETERANS ADMINISTRATION SYSTEM Research • POTATOES DELIVER Medical School HEPATITIS 8 • • VACCINE Classnotes HARRY L . MOUSE CALLS METCALF , GALLSTONESMD ' 60, RECEIVES • LIFESTYLE LINK "THE SURFACTANT BERKSON AWARD STORY"- -AN UPDATE • GUM DISEASE AND • WHITE COAT CEREMONY STROKE RELATIONSHIP • FACULTY MEMBERS HONORED Alumni • THOMAS FLANAGAN , PHD ' 6 5 , RETIRES AFTER Student Perspective LONG AND DISTINGUISHED HEALTH - CARE POLICY: CAREER AT UNIVERSITY TO TREAT OR NOT TO TREAT-POLITICS Is AN ANSWER by Joseph S. Ross CC'VER ILL T RAT I Bv '> r HA E C~RTER THE (LASs oF 2003--White Coat Ceremony on September 9, 1999, Initiates First-Year Students �The FORGE S IMPLICATED in Schistosonriasis I T's OT DIFFICULT to understand why a sense of urgency underlies The S. monsoni efforts to find a cure for schistosomiasis. Victims of the disease are infected species of schistoso· miasis looms large in with parasitic flatworms that flourish in their blood vessels, discharging Dr. Philip LoVerde's eggs that cause debilitating, often deadly, damage to their tissue and vital life. As coordinator for the World Health organs. Currently, some 200 million people-the majority of whom are Organization's children-have schistosomiasis, making it the world's second most serious Schistosomiasis Genome Project, the University at Buffalo professor and parasitic infection, next to malaria. According to the World Health Organization (WHO), about 10 percent of these cases are severe, resulting in an associate chair of estimated one million deaths each year. Compounding the problem is the microbiology, fact that only one drug is effective in treating schistosomiasis, and the pidured right, is parasite is rapidly developing resistance to it (see article on page 4). determined to out smart the deadly flatworm. PHoros 0 Bl FR:\'\K MILLER Buffoto A . o PHILIP LoVERDE Physician Autumn 1 9 9 9 �GE ETIC EPIDE~liOLOG\ STL D\ T\KES l~B SCIE TISTS TO BY S. A. UNGER BH \ZIL �PHILIP LoVERDE, PHD, professor and associate chair of microbiology at University at Buffalo's School of Medicine and Biomedical Sciences, is a scientist who knows firsthand about the urgent concerns that drive the search to find a cure for schistosomiasis. Widely regarded as a leading international expert on the disease, LoVerde has spent the majority of his career attempting to gain a better understanding of schistosomiasis and ways to treat its victims. Currently, he is coordinator for WHO's Schistosomiasis Genome Project and is a member of the organization's Expert Panel on Parasitic Diseases. In 1998, he completed a term as chair of the ationalinstitutes of Health's Tropical Medicine and Parasitology Study Section and today is president-elect of the American Society of Parisitology. In an effort to move schistosomiasis research in a direction that utilizes the new tools and technologies growing out of the Human Genome Project and other related endeavors, LoVerde has embarked on an ambitious genetic epidemiology study aimed at identifying and localizing specific genes influencing schistosomiasis infection and its clinical course. "Our goal is to improve our understanding of the underlying genetic determinants of resistance to reinfection and disease progression," LoVerde explains. This understanding, in the long term, may contribute to the development of vaccines or other interventions, he adds. In order to complete the study, which is funded by a five-year, $1.25 million grant from the ational Institute for Allergy and Infectious Diseases, LoVerde and his collaborators have traveled to Minas Gerais, a state in Brazil where schistosomiasis is endemic. \11DI<I L \I r111 \lou:ctL\H LL\LL According to LoVerde, there are three components that play a role in the transmission of infectious disease: (l ) the environment where the agent is being transmitted, (2) the �c. c. Om goal is to improve our understanding of the nnderlying genetic detenninants of resista11ce to reinfection and disease progression.·") infectious agent's genes that control its virulence and how it infects an individual, and (3) the host and the host immune system and genes that regulate the immune response to the infectious agent. For years, scientists have studied the environment and the genes of infectious agents (in this case, parasites); however, until recently, they haven't had the sophisticated molecular and mathematical (epidemiological) tools necessary to study the contribution of host genetics to hostparasite interactions. LoVerde and his group are interested in exploring this latter component with the aid of these tools. Specifically, they are interested in what happens to an individual when exposed to the 5. mansoni species of schistosomiasis and , following that exposure, how the immune system responds in terms of eliminating the parasite, something scientists call protective immunity. By studying endemic populations, they are trying to identify phenotypes , combinations of genes in individuals that imbue them with a specific trait. In this case, the scientists are looking for immunologic phenotypes that confer on individuals the ability to: (1) become resistant to schistosomiasis , (2) prevent reinfection, and (3) avoid development of severe hepatosplenetic disease (enlargement of the liver and spleen, which can cause death). Once this phenotype is developed, the scientists will use genetic epidemiology tools (e.g., quantitative genetic analysis , including variance components methods) to discover and test the relative contributions of genes and environment to the variation of a given trait. After the role of host genetics is clarified, they will use a gene-hunting technique called linkage analysis to home in on where the genes implicated ducted. in the phenotype are located on a I B u f f a l o Physician Autumn 1 9 9 9 �c.c. We've been able to show for the first tin1e that inclivicluab \\'ithin the san1e fa1nil~ all respond in a sitnilar fashion to an antigen-they sho\\T the san1e pheno~1)es. in1n1unologically. to the infection. specific chromosome. If specific genes are identified, scientists can then study their complex interactions with the immune system and develop a much clearer understanding of how to devise interventions at the molecular level. completed, involves treating everyone in the village and taking blood samples in order to extract serum, which contains antibodies. (Antibodies are protein molecules produced by the immune system in response to substances called antigens. An antigen is any foreign FII Ll) lh . . , I \ H( II pH()\ II) I . . , K L' D \ 1'\ substance that, when introduced into the body, is recogTo accomplish this complex task, the UB scientists are nized by the immune system and targeted for destrucstudying the population of a village called tion.) The third procedure involves Melquiades, where they have conducted studying the response of antibodies to demographic and genealogic analyses to schistosomiasis antigens , which enables determine who lives there and who is scientists to begin piecing together the related to whom. With the assistance of exact way a person's immune system Brazilian physicians, they have also mounts an attack and then , from that, performed stool exams and completed construct a phenotype. ultrasounds to ascertain who is infected, The immunologic phenotype the UB the level of intensity for infection and the team is interested in identifying pertains clinical stage of disease. "We determine to how T cells respond to antigens by intensity of infection by counting the numreleasing molecules called cytokines. "In ber of worm eggs per gram of feces, " particular, we are interested in a sub-type explains LoVerde. "An infection of 100 ofT cells called Th 1 because they produce interferon gamma, a potent cytokine that eggs per gram and over is pretty severe, marking the point between clinical and promotes the response of macrophages, subclinical. " The results of these tests have which can kill schistosomiasis parasites," revealed that 68 percent of the says LoVerde. Other cytokines village population is infected they are interested in tracking and that the mean egg-perare T F alpha, the overgram feces ratio is over 200. expression of which correlates Once prevalence and with severe hepatosplenetic intensity were determined , the disease, and Th 2-type research team set out cytokines, which produce an to identify phenotypes , a antibody called IgE that has process that involves three been shown to be important procedures. First, they used in protective immunity against their genealogic data to build schistosomiasis. "So these rea family tree called a pedisponses are phenotypes, and gree. " The pedigree in we can measure them, " Melquiades is made up of over 2,000 explains LoVerde. "And if there is in fact a Schistosomiasis is people, of whom 800 are still alive. And it genetic basis for these immunologic phenoendemic in the turns out that the area we're studying is types, we would expect to find familial Brazilian state of one huge pedigree. ow, that's really aggregation of them. As it turns out, this is Minas Gerais. significant because we can perform matches the case. We've been able to show for the first statistically and can look for the identifitime that individuals within the same family cation of genes or associations of traits that result in all respond in a similar fashion to an antigen-they show certain phenotypes we're measuring," explains LoVerde. the same phenotypes, immunologically, to the infection. " The next procedure , which is currently being This is extremely important, LoVerde points out, 0 B u f f a l a Physic i an Autumn 1 9 9 9 �Parasitic flatworms of the Schistoso- person's skin, they can penetrate matidae family are responsible for unbroken tissue and eventually the three main species of schistoso- enter the bloodstream, where they miosis found worldwide (primarily in feed and grow. The worms then Asia, South America, Africa, the migrate to the circulation of the Middle East and the West Indies). intestine or bladder, where they de- Depending on the species of worm, posit eggs that are discharged in the the female flushes out 300 to 3,500 feces or urine. Thus, the cycle begins eggs daily. Eggs that come in contact anew-but often not before the with freshwater hatch, releasing ciliated larvae that go in search of a snail host to infect and grow within. Over time, microscopic worm larvae leave Pictured above is study collaborator Fred Lewis, PhD, of the Biomedical the snail and swim about in fresh-water. If they come in contact with a Research Institute in Rockville, Maryland. "because we know that in people with severe hepatosplenetic disease, the number of parasites is an important indicator of how well they do; yet we also know that in people with the same high number of parasites, some go on to develop severe disease, while others don't. So, it's something besides just the number of parasites, and we think it's host genes." for genes believed to be implicated in the immunologic phenotype. "In humans, there's a major locus on chromosome 5 called q3l-33 , which correlates with resistance to reinfection of schistosomiasis and, lo and behold, what we find is that there are genes that produce cytokines that behave a lot like lL-4, which controls lgE production. This means that the level of expression of lL-4 by T cells is determining in part whether or not somebody is going to be resistant or susceptible to reinfection, and so this major locus seems to be controlling the host-genetic response," explains LoVerde. "Once we identify the genes, this will give us insight, at the molecular level, into the immunological mechanisms that account for either disease resistance or disease progression. And then what we can do is intervene, because we will know what the target is and we will know what we have to focus our vaccines on, as well as ways to manipulate those vaccines." + TIIIIIL IIOHCI L'-, With an immunologic phenotype established, the researchers are using genetic epidemiologic methods described earlier to quantify the relative importance of genes , environment and gene-environment interaction for determining a given phenotype. According to LoVerde, current results point to genetics accounting for as much as 45 percent of the host's response . In the final stage of their study, they are using the powerful statistical technique of variance components analysis combined with linkage analysis to search B parasite has left a trail of devastation within its human host. u f f a l o Physician Autumn 1 9 9 9 0 �BY NICOLE PERADOTTO Medic Ilice • 1111 Cl hat's because last spring, the Class of 200 1-collectively they represent some 17,000 students nationwide-became the first to take the computerized version of the Step One exam. By this fall, all three steps will be offered only on computer, following the decision by the ational Board of Medical Examiners ( BME) to replace the USMLE paper test with its high-tech "e-test" counterpart. That's right: The sharpened No. 2 pencil has at last given way to the mouse. And such a change can trigger exam anxiety even among children of the computer age . "There was definitely a lot of concern about the test-more so than in years past, I'm surebecause the game was changing completely, and we were the first to play by the new rules ," Adams says. In fact, the NBME first began considering a change to computer-assisted testing 22 years ago, although they didn't start working toward that goal until 1996. The new format follows a national trend at century's end that has seen standardized test takers at various educational levels go from shading in ovals in neat rows to pointing and clicking their way 0 B u t t a l o through exams. In addition to the USMLE, such standardized tests as the Graduate Record Examination (taken annually by 400,000 people) and the Graduate Management Admission Test (taken annually by 200,000 people) are now computerized. In most countries, the Test of English as a Foreign Language is also offered electronically. "The biggest reason we went this way was security," explains BME president Tom Bowles, MD. "It's very hard to steal exams that have been administered electronically. " Another improvement over the conventional format is convenience, as the step exams can Physician Autumn • 1 9 9 9 �ILLUSTRATION BY now be taken throughout the year rather than just biannually on set dates. ' omputerizing the exam will allow much greater scheduling flexibility and convenience than in years past," says Frank Schimpfhauser, PhD, assistant dean for educational evaluation and research at UB's School of Medicine and Biomedical Sciences. "Students can arrange to take the test based on their own study needs and academic schedule. Also, those who have had to change their test date-either for illness or for another reason-are finding the new format much more accommodating to their needs." Since it emerged on the scene more than a . B u f f a l o Phys ici an STEPHANIE CARTER decade ago, computerized testing has not received universal passing marks however. One concern has been that with so many test dates available, opportunities for cheating will abound. Other critics worry that the tests are unfair to students who are not computer literate and question whether e-testing is worth the hike in exam fees that typically come as part of the new package. "The computer doesn't magically transform a test into a better test," notes Robert Schaeffer, director of the ational Center for Fair and Open Testing, in Cambridge, Massachusetts. "But it seems inevitable that once you have the technology, people want to use it. So you have these multiple-choice Autumn l 9 9 9 0 �(·Testing "There was definitely a lot of concern about the test-more so than in years past, I'm sure-because the game was changing completely, and we Were the first tO play by the neW rules." - Christopher Adams, Class of 2001 marathons whose existing flaws may only be reinforced on computer." Furthermore, he points out, computer tests end up costing students more on two fronts. First, the price tag for the test increases, which will be the case for medical students starting in 2000. Second, whenever the format of a test is altered, students tend to invest in updated preparatory classes, such as Princeton Review and Kaplan Preparatory Classes. nd then there's the dreaded "black screen of death," when computers craSh beroreor during an exam. That happened to a group of students taking Step One exams thispastsummer, acknowledges Bowles of the BME. However, he adds, the affected students in this case were accommodated with "fairly rapid re-testing. " "With the paper-and-pencil exam, we had disruptions caused by hurricanes, exploding boilers, bomb threats and so forth," he continues. "If you take the total number of examinees who experienced disruptions this time around, it's not a whole lot different from the previous era." 'Tm sure the students who are affected by the glitches think it's not good, but when you look at the total picture, it's been very smooth," says - Alice Wooden Kelly, director of administration at the BME. She feels students will appreciate the many benefits of e-testing, including receiving their results faster, more than they will mind some of the drawbacks to the new format, such as paying a little more for the test. ® B Beyond having been transferred to the computer, other aspects of the step exams have changed dramatically. The Step-One exam, for example, has been reduced from a 700-question, two-day test, to a 350-question, one-day test. The Step Three exam, which will be offered for the first time this fall, incorporates sophisticated case simulations into the 14-hour exam. Test takers will be presented with "virtual" patients, and will be expected to take a history, order lab tests and so forth. As the test progresses, the patient's condition will change based on the student's decisions. "The case ~.J<. simulation is virtually impossible on a paper, , and-pencilexam,"Bowles f• ·~ says. "We think it challenges the examinee to a higher level of clinical reasoning. " As he watched the Class of 2001 ready itself for e-testing, Schimpfhauser, too, noticed severe test dread hitting the student body. "Everyone was extremely nervous because it was a new situation," he says. "For many, the computer testing is perceived as an improvement in the examination procedure, but some students thought that it would compromise their ability to show what they know." Danielle LaPrairie counts herself in the latter group. She excels at standardized tests-the kind that involve filling in hundreds of digitype bubbles with a o. 2 pencil. She worried that staring at a computer screen for seven hours would strain her eyes. She wondered how she would adjust to taking notes with a marker on a dry-erase board rather than working through problems on scratch paper. In short, c u f f a l a she feared that any change in the formula she knew so well might adversely affect her score. Then she practiced for the exam on the CD-ROM she received with her registration materials. "After that, I felt much better about taking the test on the computer. It brought it back down to being worried about what type of questions would be asked," she says. And how did she like the exam? "I had never sat in front of a computer for that long. I was very nervous about that. It was forcing me to change the way I take tests. But looking back on it now, I don't think it had that much of an effect on how I did." Overall, UB students had few complaints about the new Step One exam and tended to prefer it to the paper-andpencil test. While some worried that an abridged exam would mean broader questions (which it didn't), their pretest anxiety was somewhat assuaged by the fact that the exam had been cut back to one day. While taking the USMLE at Sylvan Learning Centers, where the exam is administered locally, Michael Duff didn't miss his o. 2 pencil for a minute. "It was just so simple," he saysreferring to the format; that is, not the questions. And Duff doesn't consider himself among the most computer literate of his generation. He was a physics major as an undergraduate, so his calculator was his best friend. But as an instructor of an MCAT prep course, Duff recognizes that one of the biggest mistakes students make in a paper-and-pencil test is answering questions in the wrong order. "I liked this test because I didn't have to go back and forth between a test booklet and an answer sheet. The questions I Physician E · TESTING CONTINUED ON PAGE 29 Autumn l 9 9 9 �The Smfactant StoiY-An Update INFASURF G_OES TO MARKET WESTERN NEW YORK HEALTH RESOURCES WESTERN NEW YORK HEALTH DATABASE FULL TEXT REPORTS SECTION FACILITIES , ORGANIZATIONS , AND AGENCIES OTHER SOURCES OF INFORMATION HE SPRI G 1999 ISSGE of Buffalo Physician featured a Special Report titled "The Surfactant Story," which chronicled pioneering contributions made to the field of surfactant therapy by University at Buffalo scientists and physicians over the past four decades. Prominent among those profiled in the article was Edmund "Ted" Egan, MD , UB professor of pediatrics and physiology and president and chief operating officer of 0 Y, Inc. , a company he founded in 1985 to manufacture and distribute Infasurf, an exogenous surfactant product that he and his colleagues had developed for the treatment of neonates with respiratory distress syndrome (RDS) . At the time that issue of Buffalo Physician went to press in May, 0 Y, Inc., was unable to commercialize Infasurf due to a legal challenge from one of its competitors, Abbott Laboratories, which in 1994 claimed Infasurf infringed on the patents of its surfactant drug, Survanta. In September 1998, a jury in District Court in Buffalo ruled in favor of Abbott Laboratories, but a final judgment had not been entered. Onjune 23 , 1999,Judge Richard]. Arcara ruled that Abbott Laboratories failed to prove 0 Y, Inc. , had infringed on its paten I.. The judge also issued an "estoppel," which prevents Abbott Laboratories from claiming infringement based on a principle-of-fairness doctrine. "We're jubilant here, " says Egan . "This is the culmination of a 14-year odyssey. That's how long we've been working on this project." The decision will allow 0 Y, Inc., to proceed with manufacturing Infasurf at its facility in the Baird Research Park on Sweet Home Road in Amherst, New York. "We will also be able to hire more employees and to rehire employees who were laid off after the decision that came out last year,"says Egan. In addition to being used a:u~ treatment for neonates with RDS , Infasurf is also currently being studied in clinical trials involving pediatric patients who receive the drug for a wide spectrum of respiratory disorders. In a study published in january 1999 in Critical Care Medicine (Vol. 27, o. 1), it was shown that these patients experienced rapid improvement in oxygenation and , on average, were extubated 32 percent sooner and spent 30 percent less time in the pediatric intensive care unit than control patients. As a result, larger, blinded, controlled studies are planned. + �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Lifelong Cultivation of Character WHITE COAT CEREMONY I NITIATES C L ASS OF 2003 '\1 ALGl-ST 9, 1999, the Univer- sity at Buffalo's School of Medicine and Biomedical Sciences welcomed its Class of 2003 at the second annual White Coat Ceremony, held in the Center for the Arts on the orth Campus. The ceremony is now a rite of passage for first-year medical students , who are reminded of their responsibility to "care" as well as "cure" patients by endorsing a psychological contract of professionalism and empathy at the start of their medical careers. To formalize this commitment, they are officially "cloaked" with their first white coats; then, as a group, they recite the Physician's Oath, a modern Sean Garvin, left, and Micheline Lubin, above, proudly "cloaked" with their new white coots. version of the ancient Hippocratic Oath. Opening remarks were made by medical school deanjohn R. Wright, MD, who highlighted the fact that the Class of 2003 is the last class entering the school this millennium. The Physician's Oath, he added, was "specially designed for our school because the ethical basis of medicine is an evolutionary process" and one that requires updating to reflect current issues." Number of applicants: 2,200 (440 of whom were interviewed) The students were Class size: 13B (plus 4 MD/PhD students) then addressed by Where they call home: 69 of the students ore from Western New York, Wesley L Hicks, 21 from the "extended" Western New York region, 13 from upstate New DDS, MD '84, an asYork, 33 from downstate New York, and 2 from out-of-stole. sociate professor of Female-Male ratio: 76 women and 62 men otolaryngology at Undergraduate degree institutions: 2B of the students graduated UB, who implored from the University at Buffalo, 19 from Cornell University, 9 from Conisius them never to forCollege, and Bfrom the University of Rochester; other institutions get that "you are not represented include SUNY at Binghamton, Yale University, Johns Hopkins here only because of University and Rochester Institute of Technology your grade point Average science grade point average: 3.6 (overage overall GPA, 3.6) average and MCAT Average MCAT score: 9.B scores ... but you A"Class" Profile -2003 are here today because your letters of recommendation and your interviews revealed you as having character. "In my view, character is a sense of integrity, noble purpose, thoughtful determination, intellectual curiosity and generosity of spirit," he added. "As I think of my colleagues, teachers and mentors whom I admire and respect, I know this to be true." Hicks also reminded the students that "learning histology is a semester's challenge; it's finite. Integrating honesty, determination and wisdom into your practice of medicine is a lifetime's commitment. If you remember nothing else from our conversation today, remember this: What translates the mechanics of medicine into the art of healing is the character we bring and communicate at our patients' bedsides." In concluding Hicks noted, "But to live your lives and apply to your practice of medicine the highest standards of character requires individual effort, introspection and, at times, emotional angst. Above all, it requires your giving yourselves to something outside of self." + - 5 . A . UNGER ® B u f f a 1 a Physician A. u t u m n 1 9 9 9 �Two Faculty Members Honored MARK YOUR CALENDARS r \CGLT't \1[\,1BERS 1 THE SCHOOL OF MEDICI E and Biomedical Sciences were honored this summer at the school's annual faculty meeting. BRUCE A. HoLM, PHD, professor of pharmacology and toxicology and of gynecology-obstetrics, and associate dean for research and graduate studies, received the George Thorn "Young Investigator" Award. This award recognizes investigators under age 45 who have demonstrated outstanding scientific achievement and the potential for continued contributions to the academic programs and creative environment of the School of Medicine and Biomedical Sciences. Holm, whose work has attracted millions of dollars in grant awards to UB , won the award for his research on lung surfactant and oxygen toxicity affecting alveolar cells. He was also recognized for his exemplary commitment to UB students and academic programs. George Thorn, MD '29, is one ofUB's most distinguished alumni. In 1939, in recognition of his research on Addison's disease , he received the highest honor that can be bestowed upon a medical scientist in the United States-the Gold Medal , awarded by the Bruce A. Holm, PhD American Medical Association. In 194 2, he accepted the Hersey Professor of Theory and Practice of Physics at the Harvard Medical School, which began his long association with that institution. Later in his career, Thorn was named president of the Howard Hughes Medical Institute, and in 1984 he was appointed chair of its board of trustees. ·MAURIZIO TREVISAN, MD, professor and chair of the Department of Social and Preventive Medicine, received the 1999 Stockton Kimball Award, honoring a faculty member for academic accomplishment and worldwide recognition as an investigator and researcher. Trevisan is known internationally for his research into cardiovascular disease risk factors. He is primarily responsible for establishing the Women's Health Initiative at UB through a $10 million grant M . . T . MD aunz1o reviSan, from the ational Institutes of Health. Stockton Kimball, MD '29 , was dean of UB's School of Medicine from 1946 to 1958. Dr. Kimball's contributions to the training of physicians in Buffalo spanned more than a quarter of a century. Under his dedicated leadership as dean , the medical school attained new heights of recognition. + \\0 B u f f a l o Phys i c i an Autumn 1 9 9 Our Health Care Industry at the Crossroads, What Lies in the Future? Location: Date: Time: Keynote Speakers: Adams Mark Hotel Wednesday, November 17, 1999 8 a.m.-5 p.m. Nancy Snyderman, MD Medical Correspondent on ABC's Good Morning America George Will Columnist, Washington Post Present Michael Millenson Author of Demanding Medical Excellence Panel Discussi Physicia Panelists Community and business leaders Health-care provider, CEOs, Insurers l. N. "Nick" Hopkins, MD Irene S. Snow, MD Allyn Michael Norman, DO Registration Fee: $80 For more information, call Independent Health Foundation at 635-4959. @ Minority Alumni Reunion University at Buffalo School of Medicine and Biomedical Sciences "Coming Together in the New Millennium" Date: April 7-9, 2000 Place: University Inn, Buffalo, New York For more information, contact Dr Carolyn Hamilton, assistant dean for Mmonty Affairs. Phone: (716) 829-2802; fax: (716) 829-2798; or e-mail, cah7@acsu.buffalo.edu In the summer issue of Buffalo Physician a graduation picture of Maria LoTempio and John Carter was published in the table of contents. In the photograph, Carter was incorrect~ identified as Patrick D'Abbracci. Match Day /Northwestern University Under the Match Day listings in the same issue, McGaw Medical Center of Northwestern University was incorrectly listed as McGaw Medical Center Northwest or W under the names james Flaherty, Henry Lee and Amy Weinstein. Peak Experience The normal pulse oximetry rate is approximately 96-100 percent, depending on the altitude of the patient. It is not 90-100 percent as stated in the article "Peak Experience," published in the summer 1999 issue of Buffalo Physician. <D 9 �JOSEPH GAGLIARDI' MD '7 9' TEACHES KIDS WHAT PHYSICIANS USED TO DO FOR A LIVI~G SLOUCHED IN CLASSROOM SEATS, the seventh and eighth graders wear the guarded, "what's-this-guy-tryingto-pull?" expression of adolescents when their teacher introduces Dr. Alexander Dobbs. Authentically dressed as a regimental physician and surgeon in General George Washington's army, Dr. Dobbs (aka joseph Gagliardi, MD, Class of 1979, family physician and addictionologist in Columbia, Maryland) jumps directly into his monologue. "Despite the victories at Trenton, Princeton and Saratoga, the war for independence is floundering. The small, poorly fed and ill-equipped Continental Army suffers from many maladies," he says in the present tense, with just a shading of colonial syntax and mannerisms. ��When he [Dr. Dobbs} tells the students that he washes his instruments in plain water between operations, some are appalled and others refute it. Even junior high school students understand the necessity of sterilization, but they have little understanding that there was life before ER and Chicago Hope. welcome lecturer at local schools, historical societies and medical conferences, Gagliardi delights teachers with the unique learning experience he brings to their classrooms. However, media-sophisticated kids who have grown up with Mortal Kombat and MTV music videos are not an easy audience for a serious guy in a funny suit. So Dr. Dobbs starts slowly, commenting on the boys' strange attire , at the rips in their jeans. He asks the girls why they are there (girls often did not have an opportunity to go to school in colonial times). Then he gets all of the children out of their sedentary slouches, and teaches the girls to curtsy and the boys to bow. ow they are amused. He talks about himself. Like Benjamin Franklin , Dr. Dobbs is one of 17 children. He was told at the age of 10 that his father could no longer afford to keep him, and he was apprenticed to a physician. "Before I could begin my medical studies, I had to learn to read ," Dobbs says. ow the kids start asking questions , and he gives them an anecdotal but accurate overview of the rigors of daily life and the social mores of colonial times. After nine years of honing his presentation skills, Gagliardi knows just how gory to make the medical details of his lecture, and when to ask for volunteers. Using reproductions of colonial surgical instruments , he simulates a leg amputation in a military hospital during a Revolutionary War battle. By introducing them to medical practices of the past, Gagliardi hopes to broaden their understanding of modern medicine and to teach students that what happens in a doctor's office today isn't so bad. "Maybe they won ' t scream bloody murder if the doctor wants to take a P throat culture, now that they know that in Dr. Dobbs's day he'd have bled their necks to cure a sore throat. " Gagliardi started speaking publicly in 1990, when his son's social studies teacher asked if there were parents with special interests who would come to class to talk about them. An avid student of the history of medicine, Gagliardiplaying himself- gave an overview of practices from the American Revolution to the Civil War. The students were impressed. Some even told their parents that something of interest had actually happened at school that day and they related grisly details about how legs were once chopped off without anesthesia or the sterilization of instruments. After he had given several more lectures as himself, Gagliardi decided that a more dynamic approach would be to allow students to interact with a physician from the colonial period. The transition, he figured, would "give me a chance to get out of the 20th century completely and play around in the 18th." But he wasn't altogether confident. Lecturing came easily to him , but could he be convincing as Dr. Dobbs? To make his characterization as authentic as possible, Gagliardi read in depth about late-18th century American life, concentrating not only on general history but also on the subjects of dress, social customs, medicine and science. He also traveled repeatedly to colonial Williamsburg to observe the authentically dressed impersonators of aristocracy and tradesmen at work. Although he admired their skill and the physical beauty of the reconstruction , he thought that visitors should be given a truer picture of life in colonial times. hysician Autumn 1 9 9 9 �o emphasize the contrast between the life of a child today and that of one 250 years ago, Gagliardi decided to stress details of Dobbs's own childhood. For Dobbs, not having any schooling was not nearly as bad as having no time to play. To survive, average families worked together from dawn until dark every day except Sunday-which was spent praying in church and doing other "quiet" activities. One Sunday, the young Alexander Dobbs was seen running and playing, which led to Dobbs's father being fined by the church warden. Because the fine was much more than his father could afford, the boy was sent from home to work as a physician's apprentice. On the eve of every public appearance, Gagliardi goes to bed thinking B u f f a l o about these details, as well as other aspects of Dobbs's life. In the morning he puts on his long coat, one-size-fits-all breeches (with a knotted string as a belt), a three-cornered hat, and riding gloves. On the way to school he plays tapes of colonial music on the car stereo. "When I step out of my car, I go into the school office and introduce myself as Dr. Alexander Dobbs," explains Gagliardi. 'Tve never had any acting experience, so this helps keep me in character." The more convincing he is as Dr. Dobbs, the more curious the students become about women's roles, disease causation, and other issues they can learn about from their 18th-century visitor. The combination of medicine and social sciences in Gagliardi's outreach to students is a logical progression of his educational background and interests. Physician Autumn l 9 9 9 As an undergraduate at the University of otre Dame, he studied sociology and education, intending to become a social studies teacher. During his senior year, a course on the sociology of medicine sparked his interest in the science. He entered medical school at the State University of New York at Buffalo in 1975 and completed his family practice residency at the University of Maryland in 1982. While in medical school, Gagliardi started the Mad-Med newspaper and, in conjunction with classmate Peter Condra, MD '79, founded the Mad Med Choir. He also established the Mad-Med Talent Show, the forerunner of the school's current talent show. Today, he practices with Patuxent Medical Group in Columbia, Maryland, where he lives with his wife, Diane, who works in early childhood education, his 17-year-old son, ] oe, and 14-year-old �"May be they won't scream bloody murder if the doctor wants to take a throat culture, now that they know that in Dr. Dobbs's day he'd have bled their necks to cure a sore throat. " daughter, Christine. He also serves as an invited to the Universal Studios in Or- from Vermont to Alabama. associate professor of psychiatry at the lando, Florida, where he appeared on a Predictably, when he speaks before University of Maryland, training third- live show called "Ask the Family youngsters, there are always a few who year medical students in addiction Doctor," which airs on America's Health try to trick Gagliardi into admitting that issues; and as a clinical instructor, work- Network. In addition, he has lectured to he drives a car and gives his patients ing with students who rotate through his numerous medical organizations, aspirin. Once while demonstrating a leg practice in four-week intervals. amputation in a lOth-grade Since first donning the garb history class, he saw a boy slip and persona of Dr. Dobbs, out of his chair onto the floor. "I Gagliardi estimates that he has thought, 'There's a comedian reached more than 10,000 stuhere,' and waited a few seconds dents across Maryland. (All perfor him to get up. When he didn't, formances are done in his free I went over, saw he had fainted, time and without charge to and helped him come around." schools and historical organizaGagliardi later learned that the tions throughout the state.) In boy passes out whenever he hears recent years, he has also spoken discussions about blood and before the American Academy of gore. That was the only time Family Practitioners at its annual Dr. Gagliardi has had to stand in conference in Boston and was Mock amputation elicits strong reaction from a captured audience. for Dr. Dobbs. + ® B u f f a l a Phys i cian Autumn 1 9 9 9 \ I �HIS FALL, THOMAS D. fLA AGAN, PHD, announced his retirement from the University at Buffalo School of Medicine and Biomedical Sciences after a long and distinguished career. As Dean Wright explains in his message in this issue of Buffalo Physician (see inside front cover), Flanagan retired as professor emeritus of microbiology in August 1997, but agreed to remain at the university to serve for two years as assistant dean for student and curricular affairs in the Office of Medical Education (OME). Flanagan, who received the Dean's Award for Distinguished Service this year, came to UB in 1962 to begin work on his PhD. Following graduation, he completed a postdoctoral fellowship in what was then the Department of Bacteriology and Immunology, where he studied under Almen Barron and Ernest Witebsky. In 1966, he was named an instructor in the Department of Microbiology. In 1973-1974, Flanagan was a guest research worker in the Department of Tumor Biology at the Karolinska Institute in Stockholm, Sweden, and visiting professor of microbiology at the University of Linkoping, also in Sweden. Two years after returning to UB, he was named professor in the Department of Microbiology. In 1982, he again took a leave from UB to serve as a guest research worker at the ational Institutes of Health in Bethesda, Maryland. In 1986, Flanagan was appointed acting chair of the Department of Microbiology at UB, and in 1987 he was named chair, a position he held until1990. "Tom served as acting chair of the Department of Microbiology during a tumultuous period in the department's history and served as chair during an equally challenging time," says Wright. "For over two decades he directed the sophomore Medical Microbiology course and, for much of that period, I was his counterpart in Pathology. Through this long relationship , I developed enormous respect for Tom, particularly for his dedication to students." \ I B u f f a I o Phys i c i an According to Wright, Flanagan's major research interest was virology and for much of his career he headed the Virology Laboratory both at Erie County Medical Center and at UB. In addition to many other school-wide activities, he promoted student research and chaired the school's student research fellowship committee for almost 20 years. "When I was appointed Interim Dean and needed someone to help out in the Office of Medical Education-in particular, to address the needs of first- and second-year students-! looked to Tom Flanagan for help," says Wright. "Then·, in September 1997, we took advantage of the fact that he was willing to continue his part-time work in OME, even though he had just assumed emeritus status in the Department of Microbiology." Although the position was officially part-time, according to Wright, "Tom not only exceeded any mythical time commitment limitation previously established, but he brought his wisdom, years of experience with students and his enormous compassion to that office. We are greatly indebted to him, not only for his years of service as a faculty member and leader within the Department of Microbiology, but for the many important contributions he has made to OME over the past two years." In commenting on his years of service at UB, Flanagan says, "One of the things that's been very exciting about working here is that there's been a lot of change, ferment and energy towards growth and increase in stature for the university, and this is something I see continuing." Teaching, he adds, has been an especially rewarding endeavor: "It's been frosting on the cake to be able to teach-to interact everyday with young people who are well motivated in a balanced way, who retain their idealism and who know what they want to accomplish. It's very energizing for everybody involved." Retirement, says Flanagan, will involve "anything that can fit around playing golf. " He adds that he and his wife, Grace, plan to spend about five months each year at their home in South Carolina. + Autumn 1 9 9 9 �s ········· · ········ · ················· · ····· · ···························· · ················· · BY SCOTT THOMAS Change Comes to the Veterans Affairs Healthcare System WESTERN NEW YORK FACILITIES RETOOL AND RESTRUCTURE YO E CASTING A WARY EYE line would have to be pleased with what's been going on within Editor's note: he following the Department of Veterans Affairs (VA) Western New York ltuUt IStlltWS(InQ hrce-pmt senes Healthcare System. highlighting t han~cs 111 the A series of reorganizational moves and the establishment of ealth-t are deliver} ~} ster11.s in Western several community-based clinics are enabling the VA to deliver C\\ health services more conveniently, more effectively and less Yorll. Pre\ to us articles gtl\ C (Ill 0\ ei\IIC\\ on the federal government's bottom expensively than ever before. And because the system has been oj ( hanges that resulted m the retooled to emphasize primary and preventive care, the VA has onnatwn of the Kalc1da become a more well-rounded health-care delivery system, not just lealth S\ stem (Bufblo a place where veterans go for acute and emergency treatment. Ph\ siCian, Summer 1998) c nd in the reconj1guring of rhe Callwlu Health .'>}stem (Buffalo Physician, Spring 1999). 11 ® historic 11-story Buffalo facility on Bailey Avenue was integrated organizationally with the VA's Batavia facility, creating what is now a single management structure that allows more resources to be directed toward patient care. Goals of the integration have included the establishment of patient-privacy projects, purchase of high-tech equipment and upgrades in patient amenities. In addition to patient-care concerns, changes in the VA Western ew York Healthcare System have been spurred by the twin necessities of every healthcare delivery system today: competitive pressures and cost containment. In the 4 7-counties included in the VA Healthcare etwork of Upstate ewYork, the "Often, veterans were coming to us only when they needed emergency services," says Roger Maddigan, who, as manager of medical VA care, is responsible for overseeing the agency's community-based clinics and primarycare services. "Back in 1995-1996, we saw that we needed to change and to start providing general health services that emphasize preventive care and the treatmentofchronicdiseases-things that we see a lot of in our population," he explains. "Since then, there's been a shift to primary care. We've been telling people, 'Don't wait until you're so sick that you have to come to the emergency room."' It was also during this time-in March 1995-that administration of the Buffalo Phys i c i an Autumn 1 9 9 9 �············· · ········ · ·· · ···· · ········ · · ··· ·········· ·· ··· ···· ·········· · · ·· ····· · ······· [ i ] population of veterans is expected to shrink by 22 percent over the next 10 years, according to VA statistics, which means fewer potential patients making use of the system. Also, because many veterans obtain their care outside the VA system, the VA has recognized the need to emphasize patient services and quality of care in order to help it compete with other providers. Additionally, the system faces the challenge of a patient population sig- veterans than ever before. We find an increasing number of veterans who either opt to come here for their care, for which we receive reimbursement from their insurance company, or who come because they have no private health insurance. "We believe we provide superior health care because we concentrate on preventive health care. For example, we look very closely at smoking, hypertension and diabetes, and we have some very aggressive programs to treat these conditions." emphasized outpatient care, to the point where 75 percent of surgeries are done on an outpatient basis. During last year alone, 412,121 outpatient visits were made to VA facilities in the Western ew York system. This turn toward outpatient and clinical care is reflected in changes in the delivery ofservices at the agency's Batavia hospital, as well as in the establishment of community-based VA clinics in Jamestown, Dunkirk, iagara Falls and, most recently, Lockport. "We saw that there are veterans living in outlying areas, and it was very much a disadvantage for them to travel long distances for their primary health care," Maddigan says. "So we established clinics in outlying areas to serve these populations. We're also looking at establishing additional clinics within the City of Buffalo , particularly in South Buffalo and on the East Side. There's a population of veterans who find it difficult to travel to Bailey Avenue, even from a relatively short distance." Operation of the community-based clinics is contracted out through a bidding process. The Niagara Falls clinic, for example, is operated by Horizon Health Services, a private, not-for-profit company, which currently serves 600 to 700 veteran clients at the site, The Bailey Avenue facility is increasing outpatient services to the point where 75 percent of surgeries ore done onon outpatient basis. nificantly older than the general public. In 1998, 47 percent of all patients in the VA's upstate network were over age 65. "Some people feel that the VA is dying and going out of business. That is totally wrong," Maddigan says, adding that 18 percent of eligible veterans in the region currently seek care in VA facilities. "Last year we treated more individual B u f f a l o P hys i ~ ne notable outcome of these recent changes is that the number of beds at the VA's Bailey Avenue facility has been reduced to 167, down from approximately 500 beds a decade ago and a high of 900 when it opened in 1950. With two primary-care clinics located at the Bailey Avenue facility, however , the VA has increasingly cian A utumn 1 9 9 9 according to Jennifer Vogel, MS, Horizon's director of medical services. Before its association with the VA, she says the clinic was best-known for its mental health services, particularly for patients with substance abuse problems. With the addition of the VA contract, Horizon began providing primary care services, which now account for a significant portion of their business. �[1] . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . ... . . . :.: · · Laboratories and PFr Center Accessible to Non-Veteran Patients lung function in patients with such disorders as chronic obstructive lung disease, asthma and interstitial lung disease, as well as damage from asbestos and other irritants. t The Cardiopulmonary Exercise Laboratory, offering exercise studies that measure oxygen uptake, carbon dioxide output, heart rate and cardiac electrical activity during progressive exercise on a bicycle ergometer or treadmill, and measurements useful in a patient experiencing unexplained shortness of breath, for example, or as a training aid to serious athletes. Physicians interested in referring a patient to any of the three labs can call the VA at (716) 862-8635. Physicians may also refer patients, regardless of their veteran status, to the VA's Positron Emission Tomography (PET) Center, which is a joint venture between the Unversity at Buffalo and the VA. The center, which is directed by Alan H. Lockwood, MD, UB professor of neurology, nuclear medicine and communicative disorders and sciences, can be reached at (716) 862-8871. The Veterans AHairs Healthcare System is assigned by law to treat veterans of America's armed forces, but there are circumstances in which it accepts non-veterans as temporary patients. For example, it was recently announced that three specialized laboratories at the VA's Bailey Avenue facility will begin accepting non-veterans by referral, pending final approval. VA physician Brydon Grant, MD, a professor of medicine, physiology and biophysics at UB's School of Medicine and Biomedical Sciences, and head of the school's Division of Pulmonary and Critical Care Medicine, says the labs became accessible to the public because they're operating so efficiently that additional capacity has become available. THE LABORATORIES ARE : t The Sleep Laboratory, providing overnight polysomnography and sleep latency tests, mostly in the diagnosis of sleep apnea . t The' Pulmonary Function Testing Laboratory, using spirometry, oximetry and other measurements to gauge htPLICHIO . S FOR MEDIC \1 EDLCATIO The changes taking place in the VA system are also affecting clinical training programs at the University at Buffalo School of Medicine and Biomedical Sciences. "From the educational point of view, it's technically harder to set up teaching activities for outpatients because they come in, they're seen and they leave," says Gerald Logue, MD, vice chair for education in the school's Department of Medicine. "That's a challenge that the medical school is faced with-not just at the VA , but everywhere. Fewer and fewer numbers of patients are being admitted to the hospital these days. " Logue, who is head of the Division of Hematology in the Department of Medicine, served as chief of staff at the VA until a year ago, so has experienced many of the changes firsthand. Today, as director ofUB's residency program in internal medicine, he's finding it a challenge to give residents the kind of exposure to patients they need while in training. "Ward services have decreased and, formerly, the provision of these services was a very efficient means for teaching. You have captive patients and a team of students and interns taking care of them and making rounds to see them as many times a day as they care to. Because that has obviously changed, we're now having to find ways to get the students involved in specialty clinics and in freestanding or private offices and venues that aren't part of the hospital setting. Teaching that takes place in a clinic, however , is more labor intensive because you do a lot more one-on-one. In a hospital, one attending can work with a resident, a couple of interns and a couple of students. In a clinic you can just teach one person at a time. " D ue to logistics, such as long driving times, the teaching ofUB medical students at the VA currently takes place at the Bailey Avenue B u f f a l o location rather than at the community-based clinics, according to Logue. Many students are assigned to the facility's primary-care clinics, and "virtually all UB medical students will at one time or another have a rotation at the VA, " he says. "For example, in third-year medicine, about one-fourth of the class goes there for training. " With regard to resident training, Maddigan says , "We include the resident clinics in our primary-care services as much as we can. Our goal is to help the residents train in a way that best reflects what the real world is like, so we very strongly emphasize with them the management of chronic disease and preventive health care. "For the veteran , what they're seeing looks seamless because they have the same resident for three years," he adds. "In a way , our primary-care clinics can be thought of as group practices , with each having approxi- Physician Autumn l 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] mately 8, 000 enrolled veterans. " And as Logue notes, despite the logistical difficulties of matching physiciansin-training with clinic staff and patients, the medicine being practiced in the clinic settings is of the highest caliber. "Generally speaking, the outpatient experiences are evolving and, I think, getting better and better," he says. "When you bring a patient into the hospital, you tend to have data overload with test results and so on. In an outpatient setting, there's much less data. You learn to depend more on the basics, on taking the patient's history, doing a clinical exam. In that sense, it's almost back to basics-it's even better." Whether it be patient care, facilities management or medical education, the challenges faced by Western New York's VA Health care System are in many ways no different from those faced by the region's other health-care systems. While each is driven by its unique mission, history and vision, the end goal for all is to discover ways to maintain the integrity of patient care in as cost-effective a way as possible. For the VA system, this difficult end goal seems best grounded in the "back-to-basics" approach noted by Logue-no doubt, familiar territory for America's veterans. + Drug May Protect Against Hearing Loss esearchers in University at Buffalo's Center for Hearing and Deafness have shown for the first time that a compound called leupeptin may help protect against the noise-induced hearing loss caused by living in noisy industrialized societies. Using an animal model, the researchers found that treating the inner ear with leupeptin before exposure to high-level noise, comparable to a jet engine, reduced the loss of sensory hair cells by 60 percent. Hair cells convert sound waves into electrical impulses that are sent to the brain. Leupeptin, however, did not protect against the damaging effects of the anti-cancer drug carboplatin that can cause deafness in treated patients. "The results are very exciting for two reasons. First, they provide clues to the cellular events that lead to sensory-cell death in the inner ear. Second, they suggest a potential drug-therapy approach to protecting the ear against sound damage," says Richard J. Salvi, PhD, lead investigator, who is a professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences and co-director of the Center for Hearing and Deafness. Salvi and his colleagues at UB have been collaborating with Alfred Stracher and Abraham Shulman, both at the SUNY Health Sciences Center at Brooklyn, to investigate ways to protect the auditory system from damage via noise and ototoxic drugs, common causes of deafness in Western societies. Their current study-which was funded in part by a $14,000 grant from the Martha Entenm~nn Tinnitus B u f f a l o Physician Research Foundation-was based on the knowledge that, in many cases, degeneration of nerve function is caused by a cascade of events, beginning with a trauma that induces an increase of calcium in nerve cells. Excess calcium, in turn, increases the level of enzymes called calpains, which promote the breakdown of proteins and other factors critical to nerve functioning. "Drugs that inhibit the action of calpains, of which leupeptin is one, have been shown to decrease or prevent destruction of nerve functioning that results in neuromuscular atrophy in cases of trauma or genetic disorders," Stracher notes. Salvi and colleagues set out to determine if leupeptin also could protect the sensory hair cells in the ear from noise and ototoxic drugs such as carboplatin-knowing that such insults cause an increase in calpains--and thus prevent hearing loss. The researchers treated the right cochlea of chinchillas with leupeptin for 14 days. On the fifth day, some of the animals were exposed to noise, at 100 decibels or 105 decibels. The left ears of all animals served as controls. Results from the noise exposure study showed massive loss of hair cells in the ears not treated with leupeptin, while only a few hair cells were missing in the treated ear. A similar study, designed to determine if leupeptin would protect against hair-cell loss caused by carboplatin, showed leupeptin offered no protection, Salvi says. Other researchers on the study included Jain Wang and Dalian Ding, research scientists in the Center for Hearing and Deafness. For more information on this study, refer to their recent paper published in NeuroReport (Vol. 10, No. 4). Autumn l 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ----~- - - - --- - - - - -~-- -- - -- ' -" . Lifestyle Underpins Gallstones he Western lifestyle of little exercise, lots of saturated fat, lots of refined sugar and little fiber is a major risk factor for the deve lopment of yet another chronic disease- gallstones- a new University at Buffalo study shows. Published in the February 1999 issue of the American journal of Clinical Nutrition, the study is one of the few popu lation-based investigations of factors affecting the development of gallbladder disease over time. Results showed that body mass index and intake of refined sugar and saturated fat were directly associated with the formation of gallstones. The relationship between saturated fat and gallstones was stronger in men than in women . Conversely, physical activity and a diet high in monounsaturated fat, dietary cholesterol and insoluble dietary fiber were protective against gallstones, results showed. "This study confirms that gallbladder disease is one of the diseases of Western civilization ," says epidemiologist Maurizio Trevisan, MD, professor and chair of UB's Department of Social and Preventive Medicine and author of the study. "It's one more message that a diet high in fat and refined sugar and a pattern of low physical activity can get you into all kinds of trouble. " The results are interesting to epidemiologists, he says, because they support the hypothesis that common pathophysiological mechanisms may underlie the chronic diseases afflicting Western populations. Gallbladder disease is increasingly common with age and affects more women than men. Twenty percent of women are ® reported to have gallstones at autopsy. The study was conducted in the small farming community of Castellana in southern Italy. In 1985 and 1986, researchers administered ultrasound scans of the gallbladder and took blood samples from 1,429 men and 1,043 women selected randomly from the population. Persons free of gallstones at that time were reexamined by ultrasound between May 1992 and June 1993; they also completed questionnaires concerning sociodemographic PARTICULARLY INTERESTING WAS THE F I ND I NG THAT SATURATED FAT I NTAKE APPEARS TO HAVE A STRONGER RELATIONSHIP TO GALLSTONE FORMATION I N MEN THAN IN WOMEN , TREVISAN SAYS . status, medical history, dietary habits and physical activity. The 55 men and 49 women who had developed gallstones during the study period then were matched with controls from the study population. To give a B u f f a l a P more complete picture of dietary intake, these participants provided information on how often they ate certain foods. Analysis of the data from new cases and controls showed that age, body mass index (an indication of obesity) and prevalence of diabetes were higher in those who developed gallstones than in those who did not, while physical activity was lower. Dieting, caffeine and smoking appeared to have little effect. Dietary analysis showed that higher monounsaturated fats and calories expended lowered the risk of gallstones, while higher consumption of refined sugars and saturated fat were directly related to gallstone formation. Particularly in- ~ teresting was the finding that saturated fat intake appears to have a stronger relationship to gallstone formation in men than in women, Trevisan says. Women had higher rates of gallstones at the first three quartiles of saturated fat consumption, but theirrisk increased slowly as consumption increased. In men , however, the risk doubled at each quartile of consumption; at the highest quartile, men were at a higher risk of developing gallstones than women. "These findings seem to suggest that other factors , such as hormones or metabolism, may be more powerful risk factors for gallstone formation among women than saturated fat intake," Trevisan says. The research team was headed by Giovanni Misciagna, chief of the laboratory of epidemiology and biostatistics at the Institute S. De Bellis in Castellana. + ~ hysician -LOI S A utumn BA KE R l 9 9 9 0 ~ �·· ···· ······ ·· · · · · ······ · ······ ··· · ·· ····· ·· · · · · · · ···· · ·· · · ··· ·· · ···· · · ··· ···· · · · ··· · · · ··· • ' ' . 0 . Potatoes Deliver Hepatitis BVaccine an eating potatoes protect humans against hepatitis B? Roswell Park Cancer Institute (RPCI) and the Boyce Thompson Institute (BTl) at Cornell University began clinical trials in July I999 at RPCI to test the safety and immunogenicity of the world's first potential oral vaccine against the hepatitis B virus. Subjects will receive the vaccine by eating potatoes genetically engineered to contain it. More than 2 billion people worldwide are affected by the hepatitis B virus , a leading cause of liver cancer and the cause of more than I million deaths annually. Although an effective vaccine is available to prevent hepatitis B, it is too expensive for developing nations to afford . The vaccine must be imported and refrigerated- at a cost of$100 to $150 per personand three injections are required over a six-month period, which prohibits mass immunization in Third World countries. The trial that began in July is the culmination of several years of collaborative preclinical work by Yasmin Thanavala , PhD , UB research assistant professor of microbiology and professor and cancer research scientist in the Department of Immunology at RPCI; Charles Arntzen , PhD , president and CEO of BTl and adjunct professor of biological sciences at Cornell University ; and Hugh Mason , PhD, BTl assistant research scientist and assistant professor of plant biology at Cornell. The program is funded primarily by the ational Institutes of B u f f a l o P hys i Allergy and Infectious Diseases, part of the ationalinstitutes of Health (NIH). In previous pilot studies, researchers inserted DNA extracted from hepatitis B virus into tobacco leaves. An immunologically important protein antigen known as HBsAG was partially purified and injected into mice, where it elicited the same immune responses as those triggered by the commercial vaccine. More recently, the researchers produced this vital protein in potatoes that are edible, making them more suitable for testing oral vaccines. In the current placebo-controlled, double-blind Phase I study, health-care workers who previously responded to a licensed injectable vaccine receive an oral booster dose delivered by a sample of transgenic potato that expresses the hepatitis B surface antigen. BTl generated the potatoes for the clinical trial with financial support provided by Axis Genetics of Cambridge, UK. The clinical trial is coordinated jointly by Thanavala and Martin Mahoney, MD '95 , PhD '88, UB assistant professor of cian Autumn 1 9 9 9 . . family medicine and director of the RPCI Employee Health Clinic, who will be responsible for conducting laboratory testing and clinical assessment. "We are very pleased to be taking the next logical step with this research, " Thanavala says. "The continued support of my basic research by the IH and the World Health Organization, along with the recent collaboration with Axis Genetics , offers us a novel way to impact public health and control hepatitis B worldwide." "This project is a wonderful example of moving research ideas from the laboratory bench to the bedside," adds Mahoney. "We are pleased to participate in this trial to bring this vaccine into a clinical setting. " Research with genetically engineered foods opens up limitless possibilities for delivering vaccines, not only for hepatitis B but also for such diseases as malaria and leprosy. There also may be a market for these "garden variety" vaccines in industrial countries. + - D EBORAH P ETTIBONE AND C ATHERINE D ONNELLY Hodgkin'sSmvivors Face Second-Cancer Risk ersons treated for Hodgkin's disease in childhood are at high risk for developing a second malignancy and should be monitored closely by their physicians throughout their lifetimes , researchers at the University at Buffalo and Roswell Park Cancer Institute (RPCI) have shown in two recent studies. > 0 f- �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ' / ' Specifically, their findings showed that persons treated for Hodgkin's disease as children were at nine times the risk of developing a second cancer, with risks of developing certain types of cancer much higher than that, compared to patients without Hodgkin's disease. The risk of developing thyroid cancer in males was especially high164 times that of controls. In addition, the relative risk for breast cancer was found to be eight times greater for females; fornon-Hodgkin's lymphoma, 15 times greater for males and 23 times greater for females; and leukemia, 19 times greater for males and 25 times greater for female. "These are big relative risks," says Daniel M. Green, UB professor of pediatrics, a specialist in pediatric oncology at RPCI and senior researcher for the studies. "These findings should alert physicians to the need for careful and continuing screening at a much earlier age than the American Cancer Society recommends for the population at large," he adds. The studies involved 182 patients treated at RPCI for Hodgkin's disease between 1960 and 1989, all of whom were less than 20 years old when their disease was diagnosed. By the time they were 30 years from diagnosis of Hodgkin's disease, 2 7 percent of the patients had developed at least one second cancer, excluding skin cancer. The second of the two studies, which reported on the incidence of skin cancer only, found that the most important variable was combined treatment with radiation and chemotherapy. Of patients who received radiation therapy alone, 3 percent developed skin cancer 20 ® years after the diagnosis of Hodgkin's disease compared to 5 percent of the patients who received combined therapy. + - L OIS BA KE R Gum Disease-Stroke Relationship Found he first national populationbased cohort study of periodontal disease and cerebrovacular disease, conducted by UB researchers, has shown that people with severe gum disease are twice as likely to have the type of stroke caused by blocked arteries than those with good oral health. The relationship of gum disease and stroke was stronger even than the link between gum disease and heart disease, says lead author Tiejian Wu , MD, PhD, research assistant professor in the Department of Social and Preven tive Medicine in the School of Medicine and Biomedical Sciences. "This is the first major study to look at this question," says Wu. "There have been a few other very limited studies, but the number of subjects was small and was drawn from restricted populations. This study also looked at subgroups- men , women , blacks and non-blacks. Periodontal disease was associated with an increased risk for cerebrovascular disease in all groups." The study cohort comprised 9,962 adults between the ages of 25- 75 who took part in the first National Health and Nutrition Examination Survey ( HA ES I) conducted from 1972 to 1974anditsfollow-up, which was completed in 1992. Respondents' oral health THE RELATIONSHIP OF GUM D ISEASE AND STROKE WAS STRONGER EVEN THAN THE LI NK BETWEEN GUM DIS EASE AND HEART DISEASE, SAY S LEAD AUTHOR TIEJ IAN W U , MD , PHD . 0 Buffa l o P hys i cian Autumn 1 9 9 9 �·· ·· · ···· ···· ······ · · ·· ······ · ··· ·· · · ········ · ···· · ······ · ·· ··· ······ · · · ···· · ········· ···· • .. . . was categorized as no periodontal disease , gingivitis, periodontitis, or toothless , based on information collected during HANES I. Cerebrovascular-disease events were confirmed in the follow-up survey through hospital records and death certificates. Results showed that periodontitis was a significant and independent risk factor for developing cerebrovascular events and for non-hemorrhagic stroke- loss of blood flow to the brain due to a blockage rather than a burst vessel. Periodontitis was associated with a twofold increase in non-hemorrhagic stroke risk . The study found no association between periodontal disease and hemorrhagic stroke or TIA. According to Wu, periodontal disease is thought to increase the risk of stroke in much the same way it increases the risk of heart attack. "Bacteria, endotoxins and other bacterial products from gum pockets enter the circulation and may promote an inflammatory response , causing cells to proliferate in the blood vessels and causing the liver to increase production of clotting factors. Bacteria may also attack the vessel lining and damage endothelial cells ," he says. "Further, several periodontal pathogens can induce platelet aggregation and may promote plaque formation that can cause blockages and clotting. " Maurizio Trevisan, MD , professor and chair of the Department of Social and Preventive Medicine and the study's coauthor, says, "While more studies are needed for a conclusive statement about the cause-and-effect association, the consistency of the findings in different gender and racial groups , and the strength of the association between two chronic conditions prevalent in the adult population, may have important implications for individual and public health. " + - B u f f a I o L OI S BA K ER Physic i WOMEN .. w iTH CERTAIN PHYS ICAL CHARACTERISTICS LI NKED TO H IGH LEVELS OF TESTOSTERONE- THE MOST ACT IVE > 0 1- ANDROGEN-MAY HAVE A GREATER 1- R ISK OF DEVELOP I NG BREAST CANCER THAN WOMEN WITHOUT THESE CHARACTER IST ICS . Breast Cancer Risk and Insulin Levels aola Muti, MD , PhD, University at Buffalo epidemiologist and assistant professor of social and preventive medicine, has received a two-year $238,000 grant from the United States Army Medical Research and Materiels Command to conduct the first major study of the relationship between breast cancer risk and levels of insulin in the blood. She also will investigate breastcancer risk and its association with levels of male sexual hormones, or androgens; female sexual hormones; and insulin-like growth factor 1 (IGF-I) , a protein that promotes changes in breast cells. Muti, who has been researching the an A utumn 1 9 9 9 role of hormones in the development of cancer, has shown in an earlier study that women with certain physical characteristics linked to high levels of testosterone- the most active androgen- ma y have a greater risk of developing breast cancer than women without these characteristics. Her current study, which builds on her previous research , aims to show that the risk of developing breast cancer is associated with the hormonal conditions of increased insulin levels in the blood; increased bioavailability of IGF-1 ; increased levels of androgens-specifically, total and free testosterone; and increased levels of estrogens-specifically, total and free estradiol. Finally, Muti hopes to show that the increased bioavailability of IGF-1 and the higher concentrations of the sexual hormones are caused by the higher insulin levels. Teresa Quattrin, MD , UB associate professor of pediatrics and director of the Diabetes Center at Children's Hospital , and the Italian ational Cancer Institute in Milan are collaborating on the study. + -LOIS B AKER ® �~ - · ·· · · · ·········· · ······ · ·· · · · ····· · · ·· · · ··· · ····· · · · ·· · ·· ·· · · ··· · · ·· · · ·· ·· · · ····· · · · ·· · lfij expected as managed-care physicians to be knowledgeable and efficient providers of health care- supplying appropriate medical services, maximizing the utility of patient contact and maintaining quality patient care. And we are expected as physicians in the community POLITICS IS AN ANSWER to be sensible and judicious members of society- remaining nonjudgmental and understanding, being sensitive to every HREE YE-\RS AGO I BEGA to have a gnawing feeling in my person's predicament and valuing the health of the community above all else. stomach. The sensation was not a pain that might lead me to a These expectations are severe by any estimation, but they are reasonable. physician's office for a checkup or to my medical texts for causal "The glory days of American medicine" is a phrase that's come to represent insight. Instead, it was a feeling of disappointment. the era where a Marcus Welby- type At the time, I was living in Tucson , of 20 years ignorant of the status of physician could practice medicine Arizona , and working on an epidemio- health care as a privileged commodity. independently, concerned only with logical project seeking to discern the The son of a pharmacist, I was raised in a the patient's best interests . While relationship between physical activity reasonably wealthy home, where health society's expectations for a primaryand chronic disease in postmenopausal care and medical information were never care or specialty-care physician were Hispanic women. The disappointment wanting. Like everyone else, I had been similar then to what they are today, began one day while I was driving back inundated with statistics detailing the they were different with respect to the from Phoenix, where I had met with the fact that 42 million people in the United community physician. state's project coordinators for the study. States (or 25 percent of the population) Free care, or care at appropriated costs, I should have felt great. I was 22 years are uninsured. Yet what I began to was both a common and anticipated old and living in one of the most beau- realize, as I thought about the women practice many doctors used to ensure tiful regions of our country. I had been enrolled in the Arizona study, was that and improve the health of the commugood health is each person's nity. In addition, prestige was inherent in accepted to medical school at the University at Buffalo greatest need and that health the practice of medicine. Physicians were and would begin classes in professionals are just as respected members of the community. responsible for the health of They were asked to serve as public six months. And I was on vacation (being away from the community as they are officials and were role models for prosschool and working on public health for that of the individual. perity in the United States. projects is certainly a vacation for me) . As medical students, we are challenged Today, however, in the era of manBut all I could think about during to meet the needs of our future patients aged care, a physician's ability to fulfill that 110-mile drive through the desert in spite of the changing U.S. health-care the community's expectations seems were the women enrolled in our study. system. We are expected as primary-care compromised. Gone are the opportuniThey did not agree to participate physicians to be diagnostic and rational ties to provide independent free care, because they were interested in further- at the first moment of patient-physician replaced by utilization review and capiing research or because they had time contact-limiting preventable disease, tation. Gone are the prestige and proson their hands. o. The majority of the reducing unnecessary distress and im- perity of medicine, replaced instead by women participating in the study were proving patient health. We are expected the business and entertainment indusdoing so because it provided them with as specialty-care physicians to be profi- tries . Gone is the physician as a role health-care services for that short span cient and expedient when consulted on model for success, replaced instead by of time. Access to health care, I was cases of advanced disease-assessing the the independent consultant or computer beginning to realize, was a privilege best plan for treatment, working in technologist. But physicians should most of them did not have. cooperation with the primary physician not be discouraged: They are still of Until that time, I had spent upwards and improving patient health. We are considerable importance to the society. Health-Care Policy: To Treat or Not to Treat ® B u f f a l a P hysician Autumn 1 9 9 9 �Last April , I attended a three-day political leadership training workshop in Washington, DC, that prepared medical students to become successful advocates for the public's health. At the Political Leadership Institute, we were taught how to design a political strategy, research an issue, write a position paper or an editorial for submission to an advocacy group or newspaper , speak in public and lobby a public official. The weekend , which was sponsored by the American Medical Student Association , was so bus y that I didn't even have time to see the sights of our nation's capital! Instead, I learned how my actions as a medical student, and eventually as a physician , can affect the health of my community. It may seem insignificant, but the dues paid to a medical organization supplement its office of legislative affairs. That organization may one day be instrumental in convincing a senator Physicians must not diminish the political power that is inherent in their profession by being nonparticipants in, or even apathetic to , health-care policy making. Their patients cannot afford it. Despite the image doctors have of being detached from politics, in reality they have always played a significant role in the political process. Five doctors signed the Declaration of Independence. Before the Civil War , there were about 20 doctors in every Congress; after the war , individual political participation dropped , but physician power stayed strong through the formation of organizations like the American Medical Association , the American Medical Student Association and the Association of American Physicians and Surgeons, all of which represent physicians in the political arena . Why have physicians always continued to participate in politics? Political affairs affect the health of the community. I E-TESTING CONTINUED FROM PAGE 10 popped up right in front of me, I clicked a button and I was done. " When Duff had finished his exam, his study partner, Christopher Adams, still had four days before he sat down to his test. "We had really been pushing each other, and the camaraderie was great," Adams says. "You couldn't sleep in because that person was waiting for you. You couldn't leave the library early because that person was counting on you . After Mike [Duff] took his exam, I felt like I hit a wall. Your jokes just aren't as funny when you're telling them to yourself. " B u f f a l o Physic i an to introduce significant tobacco reform legislation. Participating in a voterregistration drive is time consuming; however , publicizing key political issues and convincing fringe voters to cast their ballots may elect a state representative who supports universal access to health care. Writing a thoughtful and informative editorial on breast cancer for the local paper may help the community better understand, prepare for , or prevent a disease that over 184,000 women are diagnosed with each year. Similarly, lobbying a city council for increased funding for community clinics may help limit the spread of infectious disease. Three years ago, I could see no reason why so many middle-aged women were participating in an epidemiological study except for the express purpose of obtaining health-care services. I can still see no other reason, but I hope that my actions eventually will provide those women with health-care privileges. As an advocate for the public's health , my participation-every physician's participation-in legislative affairs improves the health of the public. As health professionals, we must remember that we are just as responsible for the health of the community as we are for the individual. + josLpli S. Ross is c th . -d-) a su.c L • c:. ••.• L Unhcrsil) at Buffalo ~clwol of \lcdicinc and Bwmcdical SCiences . As e-testing makes its mark on a new generation of students one thing is certain: The new format has profoundly changed the experience of taking a standardized exam. With literally hundreds of exam dates available, gone is the shared misery of hundreds of students huddled over test booklets. Gone, too , is the room monitor telling students when to take a break. Now, the computer does that for them. For his part, Adams isn't the least bit nostalgic about the old days. He'll take the mouse over the pencil any day. But in this brave new world of test taking, he may do well to ensure that his next test date coincides with his study partner's, because there's still no replacement for camaraderie. + Autumn 1 9 9 9 ® �BY L I N D A J . ATrue Story ' "I don't go out much and really can't plan to have dinner with you .... Well I guess you can come see me, so long as you promise not to talk about money ... " I had been at the University at Buffalo for less than a year and was traveling to her city for a professional meeting. I decided to meet some of our past donors and thank them for what their gifts had made possible. In her case, she and her husband (deceased) had established a modest scholarship endowment several years earlier. There was no additional information on file so I checked the current value of the endowment (credible growth), the number of students who had received scholarships, and off I went. She, her cats and I had lemonade by her pool and talked. She told me about her family-"a single and two sets of twins"; her husband and his early practice; and the vacations with five kids and a tent. She also showed me pictureschildren, grandchildren and pets, trips they had taken, and friends. She told me she volunteered at a local senior citizens' center during tax season to help others with their taxes. In her eighties, she expressed amazement that so many of those "old people" didn't know how to fill out their tax forms. When dinnertime rolled around, she smiled and said she would join me after all, if the offer were still open. At a nearby restaurant, we continued the conversation. She talked about the heartbreak of watching her beloved husband lose track of who she was and, then, who he was. She talked about her dream of seeing a day when the mysteries of Alzheimer's Disease were understood and there were options to slow or halt its progress, and preventive measures to keep it at bay. A week or two later, I sent a brochure developed by the chair of nuclear medicine, for he, too, had a dream- using marked neurons to visualize the activity of the brain. A relatively new diagnostic tool at the time, Positron Emission Tomography (PET) was used at only a few centers in the state, to study the secrets of brain physiology and to diagnose various conditions that didn't show up with other types of technology. This crazy dreamer wanted UB to build one. That was nearly ten years ago. In the intervening time, she and I developed a long-distance friendship, a definite fondness and appreciation, each for the other. During one conversation she said, "My husband and I never complained about paying taxes. He earned a good living ® Buffalo C 0 R DE R , PH D, C F R E and that's our country's way of paving the roads and providing schools for children. It was fair and we didn't mind that much. But, I don't want to give away half of our hard-earned resources when I die. My children will share the amount that's excluded from taxes. Now, help me figure out how to arrange the rest so Uncle Sam won't get any." This woman knew she had the means to make an impact "somewhere." She wanted to make a difference in the understanding of Alzheimer's Disease. She believed that UB's proposed center was a way to "light one little candle against the dark." The department chair tirelessly made enthusiastic presentations to anyone who would listen, which painted a picture of what that type of research center could be. Using PET scanners, he explained, researchers might slowly uncover the secrets of how human brains process information and what happens when they lose that ability to function. She became captivated by the convergence of those dreams. Her creative planned gift, a charitable trust that would eventually fund an endowment for the PET Center, his negotiations involving the school's partnership with the Veterans Administration, a combination of other funding sources and additional private gifts made the building of the PET Center possible. The center was completed while she was still able to maneuver easily. She was present at its grand opening, along with her oldest daughter. She helped to unveil a modest plaque commemorating her husband's life and her commitment to this center. After the dedication, her daughter made a rubbing of the plaque. It was copied for all her children and then framed and hung in her living room. Her charitable trust reached maturity this past summer. ow, there is a major endowment bearing their names that will keep her dream alive and similar research moving forward, forever. My friend died peacefully, at age 93, with her oldest daughter again by her side. Her last act of generosity was to have a vital portion of her brain removed immediately following her death and conveyed to a group of Alzheimer's researchers at one ofHarvard's affiliated hospitals. She was then buried next to her husband back home in Buffalo. What is essential lives on, in those of us who knew her and cherish her memory-and in the future research that her endowment will make possible. CONTINUED ON PAGE 31 Physician Autumn 1 9 9 9 �Endowments of the School of Medicine . di al S. 1ome c c1ences HE SCHOOL'S E DO\\.-NlENT IS COMPRISED OF DOZE. S of separate funds, many named for the individual or couple who initiated them. Collectively, they provide valuable resources that enrich the lives and academic experiences of students, faculty and staff, and the wider community in our region. They provide scholarships, annual lectures, underwrite research and travel to present research results. Endowed chairs strengthen individual departments and the school as a whole. Visiting professorships bring the students into contact with nationally known professors who spend a day or several days on campus. We have a strong endowment. We need to expand it. The difference between a great institution and one that is merely adequate is often found in the size and strength of the endowment. Listed below are the school's endowments. Those listed in bold received additional gifts this past fiscal year. Those with an asterisk (*)were established between july 1, 1998, and] une 30, 1999. Those with both an asterisk and bold lettering were initiated and at least partially funded during that time period. Gifts to the school may be designated for any existing endowed fund. New endowments that meet funding guidelines established by the university may be established at any time. Please give me a call if you have questions, notice an inaccuracy or would like to make arrangements for a new endowment in your name or in ' Linda J. Corder (lyn) is the associate dean and director of honor of somedevelopment. She may be reached toll-free at 1 (877) one you admire 826-3246. Her e-mail address is ljcorder@buffalo.edu. or love. I H.W. Abrohmmer Memorial Scholarship Sidney Addleman Memoria l Dr. and Mrs. Joseph A. Chozon Medical Scholarship Dr. George J. Alker Fund for Neurodiology Clinical Preventative Medicine Fellowship Theodore & Bessie G. Alpert School of Medicine Scholarship Almon H. Cooke Scholarship Alpha Omega Alpha Library Fund Patrick Bryant Costello Memorial Alpha Omega Alpha Endowment CTG Oncology Fund American Academy of Family Physicians President's Award James H. Cummings Scholarship Deportment of Anatomical Sciences Library Fund Edward L. Curvish M .D. Award Anesthesiology Deportment Endowment The Elizabeth Medical Award Bocceelli Medical Club Award Dr. Robert M . Elliot Scholarship L.B. Badgero Medical School Fund Eleanor Fitzgerald Fairbairn Scholarship Wolter Barnes Memorial Scholarship Family Medicine Endowment •virginia Barnes Endowment Feyler Fund for Research in Hodgkins Disease Dr. Charles A. Baudo Award in Family Medicine Dr. Grant T. Fisher Fund Thomas R. Beam, Jr. Memorial L. Wolter Fix, M.D. '42/'43 Endowed Scholarship Dr. Robert Benninger Fund in Orthopaedics Edward Fagan Memorial Prize Robert Berkson Memorial Award in the Art of Medicine Ford Foundation for Medical Education Museum of Neuroanotomy Fund (Bernhoft-DeSontis Library Thomas Frawley, M .D. Residency Research Fellowship Fund Marcos Gallego, M.D. Clinical Excellence Fund Fund Anatomy, Cell Biology and Neurobiology) B u f f a Louis J. Beyer Scholarship James G ibson Anatomical Prize Paul K. Birtch M.D. Fund Wolter S. Goodale Scholarship Dr. Solomon G. Booke and Rose Yosgur Booke Fund •trene Pinney Goodwin Scholarship James H. Borrell Urology Fund A. Conger Goodyear Professorship of Pediatrics • Anne and Harold Brody Lecture Fund George Gorham Fund Clayton Milo Memorial Dr. Bernhardt S. and Dr. Sophie B. Gottlieb Award George N . Burwell Fund • carl Granger, M.D. Endowment Dr. Winfield L. Butsch Memorial Lecture in Clinical Surgery Dr. Pasquale A. Greco Loon Fund Vincent Capraro Lectureship Fund-class of 194S The Glen E. Gresham, M.D. V isiting Professorship Dr. Charles Cory Memorial Dr. Thomas J. and Barbaro L. Guttuso Scholarship & Award l a Physic i an A. u t u m n 1 9 9 9 �c ENDOWMENTS CONTINUED FROM PAGE Omega Upsilon Phi Chi Scholarship 31 Josephine Hoyer Orton Trust Fund Victor A. Panaro Medical School Fund F. Corter Ponnil, Jr. , M.D. Award Endowment Gynecology-Obstetrics Department Endowment Stephen J. Paolini, M .D. Memorial Jean Sarah Hohl Memorial •Parkinson Research Fund •Eugene J. Honovon Scholarship John Paroski Memorial Award Florence M. & Sherman R. Hanson Fund for Robert J. Patterson Resident Award Medical Education Dr. Mark Pettrino Memorial DeVille V. Harrington Lectureship Primary Care Achievement Fund The Hekimion Fund Progressive Medical Club of Buffalo Fund Hewlett Family Enrichment Fund for Psychiatry Psychiatry Department Endowment Charles Gordon Heyd Medical Resources Fund Dr. Hermon Rohn Memorial Lecture t Dr. Fronk Whitehall Hinkel Scholarship Albert and Elizabeth Rekote Choir in Cardiovascular Disease Rolph Hochstetler Medical Research Fund Albert C. Rekote Rehabilitation Medicine Library Fund Donald Rennie Prize in Physiology Abraham M. Horowitz Fund R.R. Humphrey & Stuart L. Vaughan Scholarship James N. Johnston Scholarship Douglas Riggs Award in Pharmacology and Therapeutics The Ring Memorial Fund C. Sumner Jones Library Fund Emile Rodenberg Memorial Award Harry E. and Loretto A. Jordon Fund Thomas A. Rodenberg and Emile Davis Rodenberg H. Colvin Kercheval Memorial Scholarship Elizabeth Rosner Fund Dean Stockton Kimball Scholarship Dean Stockton Kimball Memorial Ira G. Ross Chair of Medical Informatics Dr. James E. King Postgraduate Fund Dr. Sheldon Rothfleisch Memorial Fund Morris Lamer and Dr. Robert Bernat Scholarship Harold S. Sones and Thelma Sones Medical Scholarship Dr. Charles Alfred Lee Scholarship Philip P. Song Memorial Fund Dr. Garro K. Lester Student Loon Sorkorio Family Endowed Choir in Diagnostic Medicine Fund Schafer Fund in Cardiovascular Diseases Lloyd Leve Fund The Lieberman Award Hans Lowenstein Award Scholarship of the Progressive Medical Club of Buffalo School of Medicine and Biomedical Sciences Unrestricted Lupus Scholarship Fund Endowment William E. Mabie D.D.S. and Grace S. Mabie Fund Lillie S. Seel Scholarship Dr. William H. Monsperger Fund Irene Sheehan Fund Dewitt Holsey Sherman and Jessica Anthony Sherman Fund Claro March Medical Scholarship Medical Alumni Endowed Scholarship Dr. Lois A. and Ruth Siegel Teacher' s Award Annual Participating Fund for Medical Education Endowment S. Mouchly Small, M.D. Award in Psychiatry Medical School Lectureship •s. Medical School Closs of 1957 Scholarship Mouchly Small Education Center Fund •Irvine and Rosemary Smith Chair in Neurology Fund Medical School Class of 1958 Scholarship Dr. Irving M. Snow Fund Medical School Class of 1963 Scholarship •Mary Rosenblum Somit Scholarship Medical School Closs of 1973 Scholarship Marion Mellen Fund Morris and Sadie Stein Neuroanotomy Prize John H. Talbott Visiting Scholarship •Microbiology Memorial Fund Trevett Scholarship Dr. David Kimball Miller Award Richard E. Wahle Research Fund Eugene R. Mindell, M.D. Choir in Orthopeoedic Surgery G. Norris Miner, M.D. Memorial Award Mildred Slosberg Weinberg Endowment E.J. Weisenheimer Ophthalmology Award • philip D. Morey Scholarship Dr. Mark Welch and Beulah M . Welch Scholarship Richard Nagel, M .D. Anesthesiology Research • James Platt Wh ite Society Endowment Dr. Anges S. Naples Memorial Scholarship Williams /Bloom Medical Research Fund The Dr. S. Robert Narins Memorial Award Dr. Morvin N. Winer Fund for Dermatological Research Notional Medical Association (Buffalo Chapter) Scholarship Witebsky Fund for Immunology Naughton Endowment Dr. Ernest Witebsky Memorial •Nephrology Research Endowment Forney R. Wurlitzer Fund Dr. Erwin Neier Memorial Dr. Mark Zaleski Award Antoinette and Louis H. Neubeck Fund Hermon and Rose Zinke Scholarship Neurology Deportment Endowment Dr. Benjamin E. & Lila Obletz Prize Fund in Orthopaedic Surgery l·udou·mcfztS 1 udoumem, Dr. Elizabeth P. Olmsted Fund in Biochemistry B f f a l a p h 5 c * drc nody cstJblislzcd 111 bold hav< r<"I"CIV<"d a n ~1tis 111 t fis,al year 1998- 1999 u m 9 9 �Dear Fellow Alumni, l T \\AS ~1Y HO'\OR TO SPEAI\. AT THE \.1EDICAL SCHOOL\ ORIL 'T \-:-'0 for the first-year class on October 9, 1999, in Butler Auditorium. During that time, I introduced the class to the Physician-Student Mentoring Program, in which the Medical Alumni Association pairs up each medical student with a community physician in a nonacademic advisory role. We are optimistic about this program and are pleased to announce that we received a sufficient number of physician volunteers this year to match all students. Later that day, I was also pleased to take part in the White Coat Ceremony that was planned by Dr. Tom Flanagan and reported on in this issue of Buffalo Physician (see page 12). It was a wonderful program that will be expanded next year, and I urge anyone interested to feel free to attend. In mid-September the Past Presidents' Dinner of the Medical Alumni Association was given in honor of Robert E. Reisman, MD '56, recipient of the 1999 Distinguished Medical Alumnus Award. Bob's receipt of this award, which will be reported in the next issue of Buffalo Physician, was prompted by a wonderful nomination fromjerome Kassirer, MD '57, former editor-in-chief of the New England journal of Medicine. We on the Governing Board were so pleased to be able to give Bob this award. Spring Clinical Day is being organized by Colleen Mattimore , MD '_9 1, and our Stockton Kimball lecturer will be Maxine Hayes, MD '73. Dr. Hayes is the assistant secretary of community and family health for the Washington State Department of Health, where she oversees a staff of more that 200 and manages an annual budget of over 300 million dollars. Early in the Clinton Administration , Dr. Hayes was on a short list for the Surgeon General post There was an out-of-town reception in San Francisco on October 12, 1999, at the American College of Surgeons' 85th Annual Clinical Congress. The Medical Alumni Association co-sponsored a reception in conjunction with the Department of Surgery at this meeting. All alumni attending this meeting and alumni living in the area were invited to a reception at the Renaissance Park on October 12. The Community Physicians Speakers Program will be starting up this falL This is a very well received program in which the Medical Alumni Association arranges for physicians in the community to come and speak to the first- and second-year classes during lunch to discuss the lifestyles of the various subspecialties. The Medical Alumni Association provides pizza and soft drinks for the talks. The Medical Alumni Association partially sponsored a party held for the first-year class on August 12, 1999, on the USS Little Rock. This event provided a good opportunity for Dr. John Bodkin, Dr. Bertram Portin and me to meet and welcome members of the class. Finally, we are seeking nominations for next year's Distinguished Medical Alumnus Award. (See nomination card inserted in the inside back cover of each Buffalo Physician.) As a reminder, your nominations must be received by March 1, 2000. Richard L Collins, MD President, Medical Alumni Association l 0 Physician Autumn l 9 9 9 ® �• ··········· · · · ····· ·· ··· · ························· · ········· ·· ···························· - ' JOHN E . SH I E L DS JR ., MD '68 , Ham L. Metcalf, MD '60 writes: "Relocated to Hampton Bays, Y. Wife, Bernice, has pro- Receives Berkson Memorial Award gressive MS. Prime Care of Hamptons. FAA consultant. GD consultant. Addiction medicine consultant. " arry L. Metcalf, MD '60, clinical professor Department of Family Medicine, in presenting the of family medicine at the University at award to Metcalf, noted that he has acted as an Buffalo, is the recipient of this year's advocate for continuing and comprehensive patient RobertS. Berkson, MD, Memorial Award careboththroughhispracticeandinthemedicalsystem in the Art of Medicine. Dr. Berkson was that has evolved to serve patient needs. - - - - loved by his patients, respected by colA politically active physician, Metcalf has effecleagues and students, and his special --lively implemented programs and expertise in the "Art of Medicine" is enacted initiatives for the advancement meant to be perpetuated by this award. of medical education and patient care at state and federal decision-making levels. For over thirty years, Metcalf has been committed to educating graduate The award also recognizes that Metcalf "is well respected by his physician and postgraduate students in the art and science of medicine, a commitment that colleagues and medical students and, has been enhanced by his strong role most importantly, by his patients, whom modeling as a physician and the respect he has he continues to serve in a compassionate and caring garnered for his abilities in patient care. manner that indeed elevates his practice of medicine Dr. Thomas C. Rosenthal, professor and chair of the from a science to an art." [ n 1 9 3 0 s HUBBARD K . MEYERS , MD '36 : writes: "I participate in the retired physicians journal Club, which meets biweekly in Green Valley, AZ. The club has 30 members from various states and areas of specialities, including: dermatology, internal medicine, general practice, surgery , orthopedics, anesthesia, neurology and psychiatry. 1 9 5 0 s LEONARD R.SC HAE R , MD , '55 , writes, "Since retirement in 1991, I have been involved in mostly volunteer activities. (!even volunteered for a coronary bypass in 1996.) I have been a docent at science museums, lecture to high ® school senior boys regarding testicular cancer, serve on the advisory board of Emeritus College Division of Diablo Valley College. I have taken many adult education classes as well. Latest hobby: have had supporting roles in a couple of movies, including Bicentennial Man, starring Robin Williams, and SF0-2000, starring Timothy Hutton. Both will be released near the end of the year. Mostly I enjoy my two precious granddaughters, Danielle and Talia , who live 10 minutes away! Send e-mail! nanapop@ hotcoco.infi. net B u f f o I o 1 9 6 0 1 ER IC J . 7 s 0 MD '74 , R U SS ELL, writes: "Elected president of the American Society of Neuroradiology (ASNR) for 1999- 2000; program chair for the AS R annual meeting in San Diego in May 1999, with 3,000 attending; member of the editorial boards for the American Journal of Neuroradiology and Radiology; a member of the executive council for the Society for Cardiovascular and lnterventional Radiology. I also am a regional member of the UB Medical Alumni Association board. My wife , Sandra K. Fernbach, MD, and I have two daughters: Gabrielle Robin, 16, s J OH N . J . L A MAR JR . , MD '63 , and Meredith jean, 12. writes: "Retired as of October 1, 1998. Have 2 1/ 2 grandchildren. Must visit Ft. Hood to see our 1 9 8 s 0 K EVI N FEREN TZ, MD '83 , writes: "I have been awarded the Exemplary Teaching Award for full-time faculty from theAmericanAcademy of current grandchildren and their parents. Doing lots of fishing and gardening." B E RT W . RAPPOL E, MD '66, has been elected to a two-year term as president of the Eighth District Branch of the Medical Society of the State of ew York. Rappole, a surgeon in jamestown, NY, is past officer of the District Branch Family Physicians.! received the award in Orlando, FL, at the Congress of Delegates meeting in September 1999. I've been in Buffalo several times over the last year, giving lectures on smoking cessation to practicing physicians. It's always good to come back." and a past president of the Chautauqua County Medical Society. Physician 9 A. u t u m n 1 9 9 9 �······· · ····································· · ········· · ······ · ······· · · · ············ · · · · · · • • • MARC LEVINE , MD '83, writes: P HI LOMENA MUFALLI BEHAR, "My wife, DEBBIE FELDHEIM Johnson Foundation on a sur- MD '92, writes: ')erryandibought I early 1950s, serving at Thule Air Force Base in Greenland. From [MD '84] and I recently cele- veillancesystem a home in Memphis, TN, in May 1953--1973, he practiced medicine brated our fifteenth wedding for tracking to- 1999. I completed a two-year inl.ockportand was Niagara County anniversary. We live in the bacco control pediatric otolaryngology fellow- health commissioner from 1973 Maryland suburbs of Washing- activities in the ship in Atlanta in June 1999 and until his retirement in 1983. Clifford ton, DC, with our three chil- United States. dren: Sammy,Max and Jeremy, The goal of the initiative is to am currently in private practice. Jerry works for Thomas and Betts was a fellow of the Royal Society of HealthinEnglandandoftheAmeri- age 4, 6 and 8. We both gradu- identify policies that are effective as their director of transportation. can College of Surgeons. ated from the Washington in reducing adolescent tobacco Psychoanalytic Institute several use. Prior to coming to RPCI, years ago and have private Giovino was with the Centers for practices in psychiatry and Disease Control in Atlanta, GA, psychoanalysis. In addition to where he was Chief of the Epide- time spent raising our three busy miology Branch of the Office on boys , we are active in the Smoking and Health. psychoanalytic community and 1 teach in various settings. 9 9 s 0 GALE BURSTEIN AND P ETER ROBERT LASEK AND COLETTE BLOOM , MDs '90. Gale writes: PRUEFER LASEK, MDS '84, write: "Peter and I moved to Atlanta, "We are happy to announce the GA, in June. I am a medical epide- birth of Eric Colin Lasek on April miologist at the Division of Adolescent and School Health at the 7, 1999. We left our practices at Geisinger Medical Center for op- Centers for Disease Control. Peter portunities in Plano, TX, lastJuly. is an assistant professor in the GI Hello to all our friends. Sorry we Division at Emory Medical School. couldn't make the reunion." MICHAEL K. LANDI , MD '94, and his wife, Antonietta, announce Our son, Zachary,just turned one DEBBYAND WALLACE S ALTER, MDs '85, are living in Grand Junction, CO, with their three children, Jeremy, 12, Brittany, 10, and Garrell, 8. They practice family medicine together and have started the area's first multispecialty group with family medicine, internal medicine and OB-GY -Columbine Medical Associates. the birth of their daughter, Lily Marie, on july 21, 1999. She year old in August. WeseeLAURIE BURTO N, MD '90, very fre- weighed 5 pounds, 12 ounces. Mom and baby are doing great! quently. She is a pediatric/ER doc at Egleston Hospital and assistant professor of pediatrics at Emory University." E-mail: gibs@cdc.gov IN MEMORIAM FRANCIS J . CLIFFORD, MD '42, lLANA FEI NERMAN , MD '93, professor emeritus of anatomy at UB's School of Medicine and Bio- writes: "After completing my oto- medical Sciences and a former in iagara County commissioner of Boston, MA, inJune 1998, Cary, health, died May 17, 1999, in laryngology residency Lockport, NY, after a lengthy ill- GARY GIOVINO, PHD '87, has Jeremy and I tried relocating to ew Jersey. However, we soon joined the faculty at Roswell Park realized that Massachusetts was ationfrom UB, Clifford served twice Cancer Institute (RPCI) in the more our speed and are now set- as an Army physician. During Department of Cancer Prevention, tling down in Dartmouth, MA. World War II, he was stationed in Epidemiology and Biostatistics. He is responsible for leading a project Jeremy will be five years old this October and his brother/sister will orthem Europe with the 83rd Infantry Division and was ordered funded by the Robert Wood hopefully arrive in September. to active duty again during the s m B f f a l o p c a ll. u ness. He was 86. Following gradu- n 9 9 THOMAS J. MURPHY, MD '45, died June 1, 1999, in Syracuse, Y, at age 76. Murphy was born in Binghamton, NY, and attended otre Dame University prior to attending UB's medical school. He was an internist for 40 years and a clinical professor for medical students at St. Joseph's Hospital in Syracuse. He was a past physician for Le Moyne College and a consulting staff physician at the Syracuse Developmental Center, Plaza Nursing Home and St. Joseph's Hospital. Survivors include his �• ............................................................................. .. .. . .. . ... . . I his Snyder home after a lengthy illness. He was 85. In addition to conducting a private practice , Link was chief pediatrician at Sisters Hospital, where he also was wife, Theresa M. "Hunnie," six daughters and two sons. SAMUELP . AVERSANO , MD '49 , died on May 16, 1999, in Rochester, Y. Aversano was a native of Rochester, attended Madison High School and Syracuse University, where he graduated with a BS in chemistry. He was in the U.S. Army at Pearl Harbor when president of the staff in 1967-68. Until his retirement in 1987, Link worked extensively with disabled children. He was physician-incharge at the Erie County Health Facility for Children and School it was bombed at the beginning ofWWli and he received an honorable discharge in 1945. Fol- 84, and the new School 84 was dedicated in his honor. He was clinic medical director for the lowing graduation from medical school, he completed his postgraduate training at the then E.J. Meyer Memorial Hospital in Buffa lo. He spent his professional life in Rochester, where he was in solo general practice for 15 years before becoming associate medical director of St. Ann's Home for the Aged, a position from which he retired in 1987. He is survived by his wife, Mary Aversano, and by his son, Thomas, of Baltimore, MD. ROBERT T . DEAN , JR , MD ' 55 , d ied of lung cancer on May 24, 1999. Following graduation from medical school, Dean returned to his home in Phoenix, AZ, where he interned at Good Samaritan Hospital. He practiced general medicine for five years before taking a three-year residency in psychiatry at Colorado Psychopathic Hospital (19611964). He then went into the private practice of psychiatry in Phoenix , retiring in 1995 from active practice. He continued as a consultant until his death. He is survived by his wife, janet, and four children: Patricia Lewis, Robert T. Dean, Ill, j. Richard Class of 1994 during Spring Clinical Day and Reunion Weekend First row, left to right: Ted Szarzanowicz, Michelle Penque, Carol Killian, Patricia Geil, Maya Srivastava, Gloria Delvalle; second row, left to right: Thomas BurneHe, Wendy Snyder, Richard Kozak, Amy Ferry. Dean and Misty Ihrke; and five grandchildren: jesse Lewis, 15 , Carly Lewis, 12, Kelsey Ihrke, 8, and Lindsey and Taylor Ihrke, 2. His wife, janet, says, "He loved the practice of medicine and, especially, psychiatry. It never became routine or mundane for him. " IN MEMORIAM F A C U L T Y ELLIOTT MIDDLETON JR ., MD , a former professor of medicine and pediatrics in the School of Medicine and Biomedical Sciences , died on March 7, 1999, at Maine Medical Center, in Portland, ME, after a brief illness. He was 73.During his 19 years at UB , Middleton served as director of the Division of Allergy and Immunology in the Department of Internal Medicine and co nducted research on the biological effects of natural food substances on health. He was a diplomate of the American Board of Allergy and Im- s f f a l o munology , which Muscular Dystrophy Association of Western ew York at the former E. ] . Meyer Memorial Hospital and at WCA Hospital in jamestown. The Muscular Dystrophy Association presents an annual medical award in his he co- founded , and the American Board of Internal Medicine. name. Link conducted research on cerebral palsy and muscular dystrophy, including clinical tests on several drugs for treatment of the diseases. He was chair of the Middleton was also a past president of the American Academy of Allergy and Immunology, and from 1983 through 1988, he served as editor of the]oumal of Western ew York chapters of the Cerebral Palsy Association and the Muscular Dystrophy Association and for several years was chair of the New York State Cerebral Palsy Advisory Board. He was a member of the board of direc t ors of Special Help for Special Children and the medical advisory committee for the March Allergy and Clinical Immunology. In 1991, he received the Distinguished Service Award from the American Academy of Allergy and Immunology. JOSEPH s K . LINK , who served as a faculty member in the School of Medicine and Biomedical Sciences and as apediatric consultant for chronicdisease research at UB, died April 12, 1999, in MD , p h 5 + of Dimes. c a A u m n 9 9 9 �Your stock may pay more dividends than you thought possible vou dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income for life, a charitable deduction and reduce or eliminate taxes. And for UB it can mean more scholarships, research funds or the realization of your own personal vision and goal for the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716! 645-3312. T~ University at Buffalo ~ The State University ofNew York University at Buffalo • Office of Gift Planning • 103 Center for Tomorrow • Buffalo, New York 14260-7400 • 716-645-3312 �BUFFALO PHYSIC IAN Non- Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage 3 4 35 M AIN ST . PAID B LDG . 22 Buffalo, NY 4 53 BUFFALO NEW YORK 14214-3013 s~R ARY OEPT Permit No. 311 ADDRESS SERVICE R EQUESTE D We Get Rehab Results! Our Superior ~M hnprovement Vs. National and Northeastem Regional Subacute Facilities Five Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIMsM increase vs. the national average for all admissions. Stroke • Pain Management • Medically Complex • Orthopedic • Cardiac • Infections • Cancer • Joint Replacement • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. 0 ***** The McGuire 1eam. ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! I = Inpatient Admiss ions I = Inpat ient Discharge I = Out patient Follow-Up Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FlM score 72.5; discharge FIM score 97.6; FlM change - 25.1 points; length of stay efficiency - 1.40; onset time - 17; discharge disposition- 80% to community. Based on 12 months ending March 31, 1998. - The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMSM rehabilitative outcomes. This tool is known as FIMSM<-~ improvement, discharge to home, and cost effectiveness. Instrument; Functional Independence Measure, developed Our successful rehab program delivers results by the UB School of Medicine along with the Center for j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used ~CGUL~ and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRsw) rehabilitation services. to establish rehab outcomes that ~pU J1 Call 1-888-POSTACUTE. can be measured and calculated .& ~~ ~\7.J. ,.,...HE .l. DTT 'M"'JI'T""Tfq]\f .l.I'1I. '-.. IDd~=::::n.m-<~M-G!E!!!!!J§ueeoom.oo.--., '-·~''-""-'"' Autumn View • Gatden Gate • Banis ffill • Northgate � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n02-1999-Autumn Table Of Contents A list of subunits of the resource. On the Trail of Schistosomiasis Electronic Testing Makes Its Mark Medical School A Revolutionary Look at Medicine Alumni Hospital News Research Student Perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/cc869a60ddb94d9ea3a6c4035b92b899.pdf d5254410ff1823e31a6597ef6f13dfdf PDF Text Text �1111111 ••rsici•• ASSOCIATE VICE PRESIDE T FOR UNIVERSITY SERVICES Dr. Carole Smith Petro Dear Alumni and Friends, DIRECTOR OF PUBLICATIO Kathryn A. Sawner EDITOR As you can see, the magazine has a new look. With the beginning of the new millennium, its Editorial Board and staff decided now was a good time to update the publication's eight-year-old design and give it a Stephanie A. Unger ART D I RECTOR/DES 1 G N E R Alan]. Kegler "cleaner," more contemporary appearance. Most notable are the new cover masthead, designed to allow more room for the photo image, and the new typefaces inside, chosen ASSISTANT DESIGNER Lynda Harmel for easier readability. Also, the articles themselves are formatted in a more varied way in order to invigorate content and better convey the stories about our medical community. As always, your feedback is important and we hope you will e-mail, call, or write us with your comments. PRODUCTION CooRDINATOR Cindy Todd STATE UNIVERSITY OF One aspect of Buffalo Physician that hasn't changed is its goal of keeping its readers apprised of developments affecting our school. As we enter the new millennium, one topic that will be closely followed is the fact that EW YoRK AT BuFFALO ScHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john Wright, Dean stewardship of increasingly scarce resources continues to represent our most significant and pressing challenge, a situation that will no doubt extend well into the years ahead. Superimposed upon significantly reduced state financial support (related to negotiated, but as yet unfunded, state salary increases) and significant reductions in hospital support (GME and Part A funding), we are headed for some difficult times indeed. In addition to the effects of managed care and the reduced hospital funding related to the 1997 Balanced Budget Act, we have yet to feel the effects of the pending, much publicized, GME-funding "reform"- a particularly critical issue for New York State. Those of you associated with other academic medical centers around the country are no doubt experiencing similar challenges. Despite all the gloomy financial projections, however, life does go on. A number of positive accomplishments over the past year are beginning to have effects. While work on the new curriculum is still in progress, some physical improvements have already been accomplished. Refurbishing G26 and Butler, our two major lecture halls, has been extremely well received and by late spring we hope to have renovated more appropriate student study space and offices for key student organizations. In addition, planning has begun for the redesign of Farber 144, our most challenging lecture room rehabilitation project thus far. When completed, the physical facilities available for medical education on the South Campus will not only be attractive but more functional and up to date. Finally, through their own initiatives, our students continue to inspire and motivate EDITORIAL BOARD Dr. Bertram Portin, Chair Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder Dr. Alan]. Drinnan Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Ms.]ennifer Wiler Dr. Franklin Zeplowitz TEACHING HOSPITALS Erie County Medical Center KA.L£/OA HEALTH: Tire Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System CATI-IOLIC HEALTH S'iSTE.\1: Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center us all. Of particular note is their willingness (perhaps a more appropriate term would be "eagerness") to help one another. In addition to the Students Offering Support (S.O.S.) Program described in this issue of Buffalo Physician, student-run tutorials have cropped up at a variety of levels, in particular those involving sophomores helping freshmen. Although. faculty supervision is provided, it is really the students who drive these programs.! think you will agree that whatever this new millennium has in store for us, our graduates will continue to play a major role in shaping the future of medicine. 7 ~~ MD Dean, School of Medicine and Biomedical Sciences @TIE SUI£ IIIYIISITT IF 1£11 Tlllllllfflll Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It rs sent, free of rharge, to alumni, faculty, students, resitients, and friends. The staff reserves the right to edit all copy and submissions accepted for publicatio11. S �VOLUME 34, NUMBER 0 p H y s c A Features The 'Insider' Steps Out Jeffrey Wigand, PhD '73, takes on the tobacco industry BY NICOLE PERADOTTO Back into Shape Help for osteoporotic compression fractures of vertebrae BY S. A. UNGER The Edge of Possibility Russell Crowe portrays Jeffrey Wigand in a.scene from The Insider. The film dramatizes the UB graduate'slife-shattering ordeal with the tobacco industry. Irwin Ginsberg, MD '44, otologist and inventor BY S. A. UNGER COVER PHOTO 20 New Roles for Dr. Carlos Pato and Dr. Mary Anne Rokitka 21 Dr. Charles Severin and Debra Stamm join OME 22 Students form rock band 25 Melatonin linked to bone growth 26 Research Institute on Addictions joins UB 27 $4.2 million NIH grant to study bipolar disorder 28 Han a Choe, Class of 2002, describes how new S.O.S. peer-support group was formed in response to survey of firstand second-year students 17 Robert E. Alumnus 31 Mark your calendars for Spring Clinical Day and Reunion Weekend 2000! 3D Thomas Frawley, MD '44, recalls faculty support; establishes endowment for research BY WILSON BAKER 35 Saar A. Porrath, MD '61, remembered JAN2 8 LIUuatif N ���First Whiff of Smoke copy of the minutes-one that had been cut down, the scientist says, to "two and a half pages of vanilla." In 1989, Wigand-who earned his doctorate in biochemistry at the University at Buffalo School of Medicine and Biomedical Sciences in 1973-accepted the most lucrative job of his career: a $300,000a-year position as vice president for research and development at Brown & Williamson, a subsidiary of British-American Tobacco. Presiding over 243 employees and a $30 million budget, Wigand was the senior scientist at the world's second-largest tobacco company, manufacturer of Kool, Viceroy and Capri cigarettes. To his former colleagues, it must have seemed like Wigand was sleeping with the enemy. After all, he had spent more than two "Missing were concepts and discussions that were very controversial and contentious-concepts that could prove an embarrassment during litigation. And I had no choice in the matter. I had to [sign off]."(A Brown & Williamson attorney has denied that documents were improperly altered.) Wigand was stunned: A lawyer telling him how to think about science? "That bothered me immensely," he recalls. But things got stranger still. According to Wigand, after the Vancouver conference the company held a "Caution in Writing" seminar, offering decades in health care, working as a director of corporate development for Pfizer, director of WIGAND REFERS TO THIS TIME-CHRONICLED IN THE marketing for Ortho Diagnostics Systems (a division of}ohnson & Johnson) and senior vice MOVIE THE iNSIDER-AS fHE PERIOD WHEN "ALL HELL president of marketing for Technicon, a company that sells blood-analysis equipment. BROKE LOOSE."H IS MARRIAGE WAS FALLING APART, Tobacco? "!thought I was going to be using my skills HE FEARED FOR HIS LIFE, A• D CBS HAD HIRED FORMER to make a difference-to make an intrinsically SECRET SERVICE AGENTS TO ESCORT HIS DAUGHTERS unsafe product safer for those who had to smoke. I thought I could do something that would TO SCHOOL. make a difference socially," says Wigand, who also holds a bachelor's degree in chemistry and a master's degree in biochemistry from UB. Ten months into his tenure at Brown & Williamson, howparticipants advice on "how to write, what not to write, who gets ever, Wigand caught his first whiff of smoke. Attending a meetcopies of what, who communicates with whom. A system was ing in Vancouver, British Columbia, he and other scientists created by which information was controlled and edited and vetted from British-American Tobacco's subsidiaries discussed possiby lawyers," he contends. bilities for safer cigarettes. Following the five-day meeting, At company parties, Wigand began overhearing colleagues Wigand returned to Brown & Williamson's Louisville, Kenusing code words: "Zephyr," for example, meant "cancer"; "Ariel" tucky, headquarters and enthusiastically circulated a 22-page and "Project 16" referred to smoking research Brown & Williamson summary of the meeting's minutes to his colleagues. A few days conducted during the 1970s. "These were documents I couldn't read. later, a company lawyer asked Wigand to sign off on a revised I was the senior scientific officer for the second-largest tobacco !I I l uffal• Pb pici11 W1nter 2000 �company in the world, and I couldn't get access to research documents," he says. By this time, Wigand had grown increasingly unsettled about his company's practices. It wasn't only the fact that his daughters, who learned about the dangers of smoking in school, were asking him, "Why do you do what you do?" He was also starting to grapple with that question himself. And yet, Wigand stayed. He stayed, he says, even after he realized that the company was not committed to a safer cigarette. He stayed even after repeatedly dashing with the company's thenpresident, Thomas Sandefur. The more questions he asked, the more isolated he became. Wigand says he felt like everyone was watching him and describes how his office was moved from a remote section of the building to an area adjoining the offices of the senior executives. Then, in March 1993, Wigand was fired. "I was between a rock and a hard place," he says, explaining why he didn't leave until forced out. "I had relocated my family, and I guess I just didn'twant to create havoc for them. "Don't mistake me," he adds. "I was looking for a job. But leaving the health-care industry to work in the tobacco industry and then trying to get back into health care is not a simple task." Wigand says he was fired after he objected to the use of the additive coumarin in pipe tobacco. After reading a study showing that the vanilla-like flavoring causes tumors in mice, he urged Sandefur to remove it from Brown & Williamson's products. "I felt that was enough to warrant that we take it out immediately. But I was told to mind my own business and to keep searching for another replacement. I took a stand and was fired two months later." (Brown & Williamson spokesmen have said that the company used safe levels of coumarin and that it does not use the additive anymore.) ix months after Wigand was fired, Brown & Williamson sued him for reportedly violating his confidentiality agreement by discussing his salary and health-care benefits with a former colleague. The company interrupted his severance and health-care benefits, which he especially needed for his daughter Rachel, who had been diagnosed with spina bifida. In order to have the suit dropped, Wigand reluctantly agreed to an onerous confidentiality agreement-one he would ultimately break. Couldn't Keep Silent Any Longer Jeffrey Wigand might have gone down as just another former tobacco executive- one of hundreds who leave the industry quietlyand take company secrets to the grave. "All I wanted when I left was what I was entitled to-my severance pay and retirement benefits," Wigand says. But when company executives decided to sue him, "it came back to haunt them," he adds. Winter 2000 l 1flal• Hysicin 5 �In early 1994, Wigand agreed to help Lowell Bergman, a producer for 60 Minutes, analyze documents from Philip Morris about that company's research into fire-safe cigarettes. "They code-named it 'Project Hamlet: To Burn or otto Burn,"' Wigand remembers. As it turns out, Wigand wasn't the only one worried about lawsuits. CBS executives feared that Brown & Williamson would charge them with "tortious interference," claiming that they had induced Wigand to break his confidentiality pact. In an unprecedented and embarrassing move by the network, CBS shelved the interview in the fall of 1995. she poured through the documents, his anger mounted. "The industry has always said [a fire-safe cigarette] was a technical impossibility. And then I read in those papersproduced by Philip Morris in 1985 and 1986-that they had developed a fire-safe cigarette and had tested it against their leading product, Marlboro, and had found it equal to Marlboro. But they elected not to put it into the marketplace because there was no legislation that forced them to." (A Philip Morris spokesman has said in previous published reports that the company has been unsuccessful in creating a fire-safe cigarette, but that research on Wigand refers to this time-chronicled in the movie The Insider-as the period when "all hell broke loose." His marriage was falling apart, he feared for his life. CBS had hired former Secret Service agents to escort his daughters to school. He kept a gun in his house. When he traveled, he used assumed names and unmarked entrances. I it continues.) Bergman quickly came to realize that Wigand had more to offer than his work as a paid scientific consultant. He had a story to tell-one that no one had told before. Unaware that Wigand had signed a confidentiality agreement, Bergman began pushing him to go public. Meanwhile, Wigand's name began making the rounds within the antitobacco crowd. He became an advisor to the Food and Drug Administrationusing the code name "Research"-and served as a witness in several federal inquiries into the Out There. Naked. After the 60 Minutes debacle, Wigand's name was leaked to the press, along with lengthy excerpts from his interview with Mike Wallace. Four days after the story broke, Brown & Williamson sued Wigand, with the company's lawyers instructing him to appear in a Kentucky court for violating his confidentiality agreement. Defying the Kentucky order, Wigand traveled to Mississippi. Facing possible contempt proceedings, he went ahead and testified in that state's massive lawsuit against tobacco companies to recoup Medicaid money paid out for smoking-related illnesses. "I didn't go to jail," Wigand says. "But the threat was very real." «HAD IT NOT BEEN FOR JEFF WIGAND AND tobacco industry. INDIVIDUALS LIKE HIM COMING FORWARD A. D Then, on April 14, 1994, the CEOs of seven BASICALLY DRAWING ATTENTION TO THE TOBACCO tobacco companies sat before the House SubcomINDUSTRY, WE WOULDN ' T HAVE HAD THE TOBACCO mittee on Health and the Environment and testified under oath that they did not believe nicotine SETTLEMENT." -K. MICHAEL CUMMINGS, MD was addictive. As Wigand watched his ex-boss, Sandefur, raise his right hand, something in him snapped. "That's when I knew that if I kept silent any longer I would be just as culpable asanyofthe men on TV. !just After Wigand testified in Mississippi, a reporter with the Wall couldn't live with my conscience anymore. Somebody had to do Street journal obtained the sealed deposition and reproduced excerpts it," he says. from Wigand's allegations of company misdeeds. (It was Within weeks, a man called his house twice, warning Wigand to keep an eye on his daughters. Confidentiality Disagreement In August of 1995, Wigand agreed to a 60 Minutes interview. Yes, he would discuss what he knew of Brown & Williamson's use of coumarin. Yes, he would discuss how the documents about safer cigarettes had been cut. Yes, he would say that he believed Sandefur perjured himself when he said he believed nicotine wasn't addictive-but only if CBS promised to cover his legal costs in the likely event that Brown & Williamson sued him. 6 lulfalt Pbysiciu Winter 2000 only then that CBS aired the interview- a bowdlerized version on the network's evening news and the complete version on 60 Minutes.) Less than a week later, the Wall Street journal reported on another story related to Wigand-a 500-page dossier prepared by his former employer titled "The Misconduct of JeffreyS. Wigand Available in the Public Record." In an attempt to discredit him, investigators working for Brown & Williamson combed through Wigand's past. They read his PhD dissertation for possible plagiarism and searched his resume for misstatements. They even looked into his demands that an airline reimburse him for a cleaning bill after his luggage was returned wet. �is "an American hero." "There have been many people who got out of the industry and have insider information, but very few who have spoken out. He spoke out against the industry, causing great disruption in his life," says Cummings, adding that Wigand is today serving as a consultant on a Roswell Park project to determine a protocol for testing nicotine During production of The Insider, Jeffrey Wigand, left, meets his film counterpart Russell Crowe (second from the left) and lowell Bergman (rigbt) meets AI Pacino (second from the rigbt), who portrays him in the film. delivery devices. "Had it not been for Jeff Wigand and individuals like him coming forward and basically drawing attention to the tobacco industry, we wouldn't have had the tobacco settlement," Cummings points out. " ... .. .. . .• ® .. . . ... ....• In its article on the contents of the dossier, the Wall Street Journal concluded: "A close look at this file, and independent research by this paper into WIGAJ. D WAS STUNNED: A LAWYER TELLING HIM HOW key claims, indicate that many of the serious TO THINK ABOUT science? ((THAT BOTHERED ME allegations against Mr. Wigand are backed by scant or contradictory evidence .... Some of the IMMENSELY." BUT THINGS GOT STRA. •GER STILL. charges ... are demonstrably untrue." I had people inspecting every aspect of my life," Wigand recalls. "And they took it all out of "Jeff Wigand showed just what price you are going to pay if context. Because I went after somebody because my luggage was defect," adds Joe Cherner, president of Smoke-Free you ruined in transit doesn't mean I falsified a claim. In the end, I must Educational Services. say that it backfired on them. But that was a hard place to be. Out Wigand doesn't want to discuss the most severe price he paid by there. aked . speaking out-his marriage, which collapsed under the pressure "It was a terrifying time in my life. This wasn't for the faintof that period. And yet, if he had to do it over again, he says he hearted. Many people would not have given me good odds of wouldn't hesitate. surviving, much less succeeding." "I have no regrets about what I did. I would do it again ifl had to. Hopefully, history will reflect what I did as something that was No Regrets honorable-something others will take as a lesson. ' ' I n June of 1997 the proposed multibillion-dollar settlement "I take no small satisfaction in the role I played-no small of the Medicaid suit that originated in Mississippi was held satisfaction," he adds. "I continue to spread the word. And I will up by one sticking point: Brown & Williamson's lawsuit not stop spreading the word." 4D against Jeffrey Wigand. After a series of closed-door meetings, company executives finally agreed to drop the suit, allowing the settlement to proceed and Wigand to get on with his life . Today he's a high school teacher in Charleston, South Carolina, and the head of Smoke-Free Kids, an organization he founded that educates children about the perils of smoking. "I use actual industry documents and experiments and examples from the silver screen and advertising to help them make healthy and educated choices," he explains. To K. Michael Cummings, MD, director of cancer prevention at Roswell Park Cancer Institute, Wigand Winter 2000 I I If Ill n J SiC iII 7 ��I New treatment for osteoporotic compression fractures of the venebra BY PHOTO BY JosH LEVI S. A . u GER E Winter 2000 ltffal1 Pbrsicial 9 �lee Guterman, PhD, MD THE PAST, when an osteoporotic compression fracture occurred, there wasn't much physicians could do for their patients. More often than not, standard treatment included pain < T medication, bracing and bed rest. Today, however, the outlook for treatment of these fractures is considerably brighter due to the introduction of a new procedure called percutaneous vertebroplasty, the goal of which is to strengthen injured vertebral bodies by filling them with a type of bone cement traditionally used by orthopedic surgeons to affix prosthetic implants. Currently, this investigational procedure is being performed by only a small number of physicians in the United States, one of whom is Lee Guterman, PhD, MD '89, assistant professor of neurosurgery at the University at Buffalo's School of Medicine and Biomedical Sciences. According to Guterman, percutaneous vertebroplasty was developed by a group of physicians in France in the mid-1980s and popularized in the United States in the mid-1990s by colleagues of his at the University ofVirginia in Charlottesville-Jacques Dion, MD, and Mary Lee Jensen, MD-both of whom are radiologists. In the past year, Guterman, who practices at Kaleida Health's Millard Fillmore Gates Hospital, has completed more than 20 percutaneous vertebroplasties. Dedicated to teaching the procedure to other specialists around the country, in May 1999 he taught a course at the American Association of eurological Surgeons in New Orleans, and in October he traveled to Boston, where he taught a course at the Congress of Neurological Surgeons. Recently, he served as a member of a committee that developed standards of practice guidelines for percutaneous vertebroplasty. * Needle Placement with fluoroscopic Guidance Patients undergoing percutaneous vertebroplasty receive local sedation and are awake throughout the procedure. A needle similar to that used for bone marrow biopsies is used to penetrate the injured vertebra. Precise placement of the needle is accomplished using fluoroscopy, a form of real-time X-ray that enables the surgeon to visualize the needle tip and follow its progression in three dimensions. The cement-called methyl methacrylate-is injected via the syringe into the fractured vertebra and must be mixed with carefully timed precision because it begins to harden in minutes. Before the cement is prepared, however, surgeons first must perform vertebral venography, which accomplishes several things: It helps confirm needle placement within the bony trabeculae, 10 lu ff a le Plysici11 Winter 2000 clarifies definition of the fractures in the bony cortex and, most importantly, according to Guterman, outlines the venous drainage pattern. "The vertebral body is made up not only of bone, but it's also made up of veins that drain into the vena cava," he says. "So the first thing we do is inject a contrast medium to see what the venous drainage pattern is. If it is very fast-flowing, there's a chance the cement will enter the vena cava and be carried up to the heart and into the lungs." According to Guterman, if a fistula, or direct connection, is found between the vertebral body and vena cava, the surgeon has several options. "To shut off that connection," he says, "you can take cement that is at a stage where it is ready to solidify and inject it more slowly, which closes off the pathway. Then you can approach from the opposite side and fill up the vertebral body from there. I also sometimes use small sponges made of collagen foam to seal the passageway, then go ahead and insert the cement." Once the venograph has confirmed placement of the Left is an X-ray of a vertebra prior to percutaneous needle and a safe vertebroplasy, and right is an image of the same venous drainage pat- vertebra filled with the methyl methacrylate material. Once the procedure is completed. tern, the surgeons mix patients can ambulate after two hours bed rest. �Vertebral bodies are strengthened by filling them with a quick·setting bone cement. the ingredients of the cement until a "toothpaste" or "cake glaze" consistency is reached, at which time it's ready for insertion. Because the material is not sufficiently radiopaque, chemical compounds containing either barium or tungsten powder are added to it at this time. "By doing this, we opacify the cement, which means it will scatter X-rays, so when we inject the material we can view it much like you would view an angiogram," Guterman says. In general, complications for percutaneous vertebroplasty are rare. One important reason why surgeons need to view the cement as closely as they do, however, is to avoid the procedure's most serious potential complication-epidural overflow with spinal cord compression. ormally, the procedure takes approximately one hour, depending on how many vertebrae are treated. Guterman says he routinely treats two levels per session, and sometimes up to three. Once the vertebroplasty is completed, the patients rest in bed for a minimum of two hours in order to assure that the cement sets properly. After that, they are free to ambulate and resume normal activities. Vertebroplasty'sFuture: AWork in Progress uterman reports that 70-80 percent of the patients he has treated with vertebroplasty have experienced improvement in symptoms; he also notes that Drs. Jensen and Dion at the University of Virginia recently completed a study on 100 patients in which they demonstrated a decrease in pain, a decrease in patients' use of narcotics and improved ambulation. The procedure is currently not approved by the Food and Drug Administration; however, clinical trials are planned, and Guterman anticipates participating in a controlled study at UB in the near future. While percutaneous vertebroplasty has proven to be effective for a growing number of patients, Guterman emphasizes that the procedure is not for everyone and that proper screening of patients is essential to success. "People have back pain for a lot of reasons, and often they have multiple complaints, especially if they are older," he says. "They could have osteoporotic compression fractures, but they could also have degenerative disease or a herniated disc. However, if they can identify one spot in particular that is painful and you take an X-ray and find there's a fracture, then there's a reasonable certainty- maybe 80 percent- that vertebroplasty is going to work. It's not going to cure them of osteoporosis and it's probably not going to take away all their pain, but it will very likely take care of the pain that's due to that fracture. " In looking to the future, Guterman predicts a day when percutaneous vertebroplasty will be used preventively, with significant savings in health-care costs. "I can see the dayand this is conjecture on my part-where imaging technology will be used to identify high-risk patients who are then treated prophylactically with the type of bone cements we are using today or yetto-be developed materials that either regenerate bone or bolster it so fractures don't occur in the first place," he says. "The savings in the area of rehabilitation alone would be huge because patients with multiple osteoporotic compression fractures usually never recover full function. " In addition to osteoporotic compression fractures, percutaneous vertebroplasty is also being used for malignant tumors of the bony portion of the spine, according to Guterman. "This does not cure the tumor, of course, but if a patient is experiencing significant pain and can't ambulate because of structural problems, vertebroplasty is one method for dealing with this limitation." Guterman has already seen notable improvements made to the way vertebroplasty is performed and reports that "a company called Parallax Medical has devised a new method for delivering the cement, which is extremely helpful; it changes the whole procedure and, in my opinion, makes it much easier." Teaching other neurosurgeons about vertebroplasty is a priority for Guterman. " eurosurgeons are very well suited for vertebroplasty because they typically operate on the spine and are able to understand radiographic anatomy of the spine," he says. "Also, they have to use the same trajectory to put the needle in that they would use to introduce a pedicle screw for spine fusion, so it's just another step to instruct them in how to properly insert the cement." While few physicians in the United States are currently trained to perform percutaneous vertebroplasty, Guterman anticipates that this will change as ongoing studies confirm its benefit to patients suffering from osteoporotic compression fracture or malignant spinal tumors. "We're finding this to be a very effective procedure," he concludes. "It works." CD *The standards ofpractice guidelines were developed under the auspices of the American Society of Neuroradiology, the American Society of Interventional and Therapeutic Neuroradiology, and the American Society of Spine Radiology. The committee on which Dr. Guterman served was co-chaired by john D. Barr, MD, and fohn M. Mathis, MD. W i11 t e r 2000 1 111111 nysiciu 11 �p H B y F R A 0 T 0 S S T 0 ~ K R y By S. A. 12 L' �Working at the Despite the fact that his field has developed at such a brisk pace over the course ofhis career, Ginsberg was not a man to be left behind. By the time he retired from active practice in 1997, he was widely regarded as one of Buffalo's finest ear surgeons. A hugely extroverted man with a flair for energetic joke telling, Ginsberg is also known for his warm bedside manner, his generous mentoring of students, his quick mastery of basic science and his downright uncanny ability to understand and engineer biomedical devices and instruments. Given that he is now planning to bring to market a state-of-the-art device he invented for the removal ofear wax, the question perhaps is not whether Irwin Ginsberg has kept up with technology, but whether technology has kept up with Irwin. leci~ilf u lee••• a lutu It was through Ginsberg's love of the automobile that his talent for science and engineering first became evident. Some of his earliest memories are of refusing to go to sleep at night until Otologist Irwin Ginsberg, MD '44-surgeon, educator, researcher and inventor-reflects his mother let him play with a set of toy cars with which he was infatuated. As an adult, this interest translated into a fascination with owning and renovating vintage automobiles, and by mid-career he was full tilt into amassing what was to become one of the best classic-car collections in the world. But it wasn't Ginsberg's innate technical abilities that drew him to medicine and surgery; it was the near death of his mother when he was six years old. "She had a ruptured appendix, was riddled with peritonitis and was admitted to Buffalo General Hospital under the care of Dr. Marshall Clinton," the 78-year-old Ginsberg recalls. ''I'll never forget it. I can still see the room: It was on Michael Corridor on the third floor. Every time I walked down that corridor when I was an intern and a doctor, I remembered the time my mother was a patient in that room." Ginsberg especially remembers going to the hospital one day with his father and overhearing Dr. Clinton say, ''I've done all I can do. All I can tell you is to go home and pray. It doesn't look very good." "I heard that and if affected me deeply," Ginsberg says. "As it turned out, she was on death's door for three weeks and then suddenly went through some sort of crisis and recovered. I remember the day Dr. Clinton put his arm around my dad's shoulder and told him we could take her home in a few days. I knew right then and there that's what I wanted to be-a doctor. on fifty years of change. II r 11 t er 2 0 0 0 1111a11 nrsicin �I just figured you had to be something really great if you could do that for somebody; if you could help a boy get his mom back." T a·ning at Home and Abroad Upon graduation from Bennett High School in 1938, Ginsberg entered premedical studies at the then-University of Buffalo. By 1941 he had earned a degree in chemistry and was admitted to the university's School of Medicine. "We finished in three years at that time because doctors were wanted for the war, so they put us all through an accelerated program, which meant we went to school during the summer, too," Ginsberg says. "I was only 22 when I received my medical degree, and I had gotten married just a year earlier," he adds, explaining that this was a time of great change in his life. Following his graduation in 1944, Ginsberg completed his internship at Buffalo General Hospital, after which he served in the navy for several years. Upon discharge from the service, he moved to ew York City to pursue studies in surgical pathology and research at Columbia Presbyterian Medical Center. He completed his residency in surgery at Mount Sinai Hospital in 1948 and the following year returned to Columbia Presbyterian Medical Center to begin a residency in otolaryngology, training under Edmund Fowler, MD, whom he considers to be one of his foremost mentors. Asked why he chose to specialize in otolaryngology, Ginsberg explains, "When I was rotating through the head and neck department during my general surgery training, I fell in love with the ear, just pure and simple, because of the beauty of it. And I'm still in love with it; it's never tired me out because when you work with the ear, you're often working at the edge of possibility and so that has been a great challenge for me." Ginsberg's appreciation for "working at the edge of possibility" and his aptitude for engineering merged in a fortuitous way while he was completing his residency in otolaryngology and was strapped for funds. During this time, he became aware of a research project at the medical center in which investigators were l alfal1 Plysici11 Wi11ter 2000 measuring the electrical potentials for the stomach in an effort to develop a method for early detection of stomach cancer. In order to do this, they needed to place a silver-silver chloride electrode in one lumen of a Miller-Abbott tube, a task that was proving difficult because the electrode had to be housed in a tiny piece of Lucite machined out of a Lucite rod. "They couldn't get anybody to make those pieces because they were so small, and they drove people mad," Ginsberg recalls with a chuckle. "So I said I could make them. I went down to Canal Street and bought a wrecked jeweler's lathe for eight dollars, put new bearings in it, got a pair of Zeiss twopowered magnifying glasses and developed a technique for making the electrodes," he says. "They worked pretty well, and they helped me get through my residency and support my wife and two children." When Ginsberg completed his training in otolaryngology, his professors declared him "a good technician" and recommended that he go to Europe for further training. "In those days, they'd say they were sending you to Europe to 'get polished,"' Ginsberg recalls. He spent 18 months abroad and completed a fellowship at Guys Hospital in London, where he trained with Robert J. Cann and Sir Victor egus, as well as with other surgeons of repute in Switzerland, Sweden, Scotland and Denmark. The Golden Da so C OS ge Once his training was completed, Ginsberg decided to return to Buffalo, despite having offers to join practices in London and New York City. "I like Buffalo as a city, and my family was here, so I decided to return here to live," he says. "I opened up an office at 333 Linwood, a building that had many E T men in it at the time, and I did very well." So well, in fact, that in 1968 he built his own office building at 897 Delaware Avenue, which today remains one of four locations for the Buffalo Otolaryngology Group. It was during those first years when Ginsberg was in private practice-in the early 1950s-that stapedectomy came to be standard surgical procedure for the treatment of otosclerosis, a �IN ]UNE 198J, DAVID RADLIN, AGE 10, TOOK A RIDE WITH DR. lRWL GINSBERG IN HIS VI 'TAGE PACKARD. DAVID's FATHER, BARRY RADLI ',REMEMBERS THIS RIDE WITH FO 'D. ESS BECAUSE, WHILE E.' ROL'TE, DAVID HAD A TALK WITH DR. GI. 'SBERG A 'D DECIDED HE WOULD WEAR HIS HEARING AIDS AT SCHOOL, DFSPITE THE I-ACT THAT HE WAS BEl TG TEASED BY HIS CLASSMATES. I T 1996 DAVID GRADUATED FROM SYRACUSE UNIVI:.RSITY WITH A DEGREE L' RETAIL AND MANAGE 1E T AND HASSI. TCE EMBARKED ON A CAREFR IN VISUAL DISPLAY. hereditary ear disorder that causes deafness due to growth of excess bone in the middle ear. Ironically, stapedectomy was the first medical procedure in which microsurgery was utilized, and in mastering this technique, Ginsberg couldn't help but recall his early work making electrodes with the aid of Zeiss magnifying glasses. "The golden days for microsurgery were when stapedectomy was perfected," he recalls, "but the most dramatic thing for a surgeon was realizing you could help someone who was deafhear. The operation was done under sedation, so while the patients were still on the operating table, they'd say, 'Oh, it's wonderful, doctor. I can hear!' I tell you, that was a great feeling." ot so great, however, are his memories of the patients no surgical intervention could help. "When a mother would bring her new baby to me and say, 'I wonder if my child can hear or not,' and I knew very quickly he couldn't, sometimes I'd have to walk out of the office to compose myself before I could talk with the mother and tell her her baby was deaf, with all that such a diagnosis entails. It's an awful sentence to give someone." Ginsberg says that children who are deaf or hard of hearing are in special need of support and encouragement. He recalls fondly a case of a 10-year-old boy, David Radlin, who resolutely refused to wear his hearing aids because he was teased mercilessly at school. In desperation, his father, Barry, brought him to see Ginsberg. "I took him for a ride in my Packard with the top down, and afterward he decided he'd wear the hearing aids," Ginsberg remembers with a laugh, adding, "You have to support them all, support them like mad!" P onee ng Coc ea Imp an s In 1968 Ginsberg hired Thomas P. White, MA, MBA, as his audiologist, and the two have worked together ever since. White, who holds a joint appointment as an assistant professor in the Wir~ter 2000 l1ffale Hysiciu 15 �WORKING A T T H E E Department of Communicative Disorders and Sciences at the University at Buffalo, worked with Ginsberg in the early 1980s to develop the first comprehensive cochlear implant program in Buffalo. "Our group always prided itself on being up on state-ofthe-art developments, so we had kept our eye on the implants for a number of years as the procedure was going through its early stages of experimentation," he says. In 1984, Ginsberg decided it was time to move ahead with learning the procedure himself, so he took White to Europe, where they traveled to England, Germany, Switzerland and Austria to talk to and observe surgeons performing the implantations. In Vienna they met with electrical engineers Erwin and Ingeborg Hochmaier, who had designed a cochlear implant called the Vienna Device. "Dr. Ginsberg liked this device best because it had a special application in that the electrode that did the stimulation didn't enter the inner ear," White explains. "And he felt this was an important difference because the inner ear is a very delicate structure, very small, and he didn't want to ram a wire in there. Too, he didn't want to rule out the possibility of future developments." Upon returning to Buffalo, Ginsberg was anxious to begin performing cochlear implantations, but the Vienna Device, which was being manufactured in the U.S. by the 3M Corporation, was still in the process of being tested by the Food and Drug Administration (FDA) and was only available through 10 clinical trial sites, all of which had already been set up. Through persistent efforts and a little good luck, Ginsberg's practice was eventually named a test site when one of the original investigators dropped out of the trial. In 1985, therefore, he began performing the procedure according to the strict FDA guidelines. "We did about 10 patients at the start, and it was a very emotional experience for all of us," White says. "You wait about a month for healing to take place, and then you stimulate the device with the external equipment. When a person tells you that he's hearing something for the first time in his life, it evokes very strong feelings. And often the patients cry." g Researc ing n en g White says Ginsberg contributed greatly to the education of audiologists in Buffalo by teaching at UB and opening his practice to students. "When I was hired, Dr. Ginsberg agreed to make his office accessible to audiology students from the university. Anybody who wanted to could come down to his office and, under supervision, get experience testing in a real environment. And I 16 l1ffaf• Hysicin Wi11ter 2000 D G E 0 F POSSIBILITY think his professional commitment to the emerging field of audiology has been exceptional. It has really made a difference for the students." In addition, Ginsberg volunteered his time to teach a seminar at UB called Clinical Otology for the Audiologist. "Throughout his career, he always treated audiologists as colleagues," says White. "And he always supported our field because he felt audiologists helped him to find better ways to treat patients." In the late 1980s, Ginsberg founded an Ear Research Laboratory to study temporal bone anatomy. Although the laboratory is no longer in existence, scientists at UB today acknowledge that Ginsberg's laboratory was in many ways a precursor to presentday laboratories at the university that focus on basic science inquiries into hearing and deafness. One such scientist is Richard Salvi, PhD, professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences and co-director of UB's Center for Hearing and Deafness. "Dr. Ginsberg has been one of Buffalo's best ear surgeons for many years, and he's made significant contributions to the field of otology in this city. Recently I invited him to come and give a lecture to my students, and he brought along with him a device called the Earigator that he has invented to remove ear wax," says Salvi, who agreed to let Ginsberg demonstrate it on him before the class. "The device is incredibly well designed; he's worked all sorts of clever features into it that are really remarkable, and it works very well." Ginsberg is pleased with his new device, too, and says that it's in the process of being commercialized. But the Earigator is just one of many ongoing projects for this protean ear surgeon, who insists he's only "semi-retired." Recently, he passed an important personal milestone in his life when he auctioned off his beloved classic-car collection. "It was sort of a heartbreak to sell, but what do you do with things like that in my stage oflife?" he asks. "I drove in a Mille Miglia [a 1,000mile race along the coast of California] about six years ago, but that was stretching it. I was in my 70s, and I decided I didn't want to spin out anymore." Ginsberg may not be spinning out in auto races anymore, but he's also not sitting back in the slow lane, watching the world go by. As Salvi observes, "Dr. Ginsberg's at an age when most people would be lying on the beach, relaxing, but he's sharper than ever, and he's still contributing to his field." CD �MEDICAL S C H 0 0 L E W S 1999 Distinguished Medical Alumnus Named Nationally Recognized Allergist and Immunologist RoBERT E. REISMAN, MD '56 clinical pro- and aside from his exceptional professional fessor of medicine and pediatrics, received expertise-for which he is sought after by the Distinguished Medical Alumnus Award physicians and patients all over the Westfrom the University at Buffalo School of ern ewYork area-he is one of the genMedicine and Biomedical Sciences at a din- tlest, kindest and most thoughtful doctors ner held in his honor on September 23, I have ever encountered. He is one of a 1999, at the Buffalo Club. small cadre of physicians who always A 1956 graduate of the medical school, listens to his patients' Reisman is an attending physician and complaints." allergist at Kaleida Health's Buffalo Although Reisman General Hospital (BGH) and Children's has been a full-time Hospital. In addition, he served as co- practitioner throughdirector of the Allergy Research Labora- out his career, he has tory at BGH, in the Department of also managed to Medicine at UB from 1970 to 1990. conduct a superb Over the past four decades, Reisman research program in has integrated into his career the varied allergic diseases, pursuits of clinical medicine, research, according to Kasteaching and dedication to the allergy- sirer. "With Dr. Carl immunology discipline. He has authored Arbesman, he eluciover 200 articles, papers and book chap- dated many fundaters, many of which address clinically mental aspects of allergic diseases, relevant issues in anaphylaxis, asthma, especially the mechanisms of insect drug allergy and stinging insect allergy. He allergies," he explains. is co-editor of the allergy-immunology text Reisman's service to his field includes Expert Guide to Allergy and Immunology, the presidency of the American Academy which was published in 1999 by the of Allergy, Asthma and Immunology; American College of Physicians. In addi- chair of the American Board of Allergy tion, he has played a major role in the and Immunology; a member of the Ameritraining of allergy-immunology specialists, can Board oflnternal Medicine; and chair as well as students, residents and other of the Residency Review Committee of the practicing physicians. American Medical Association for Allergy Jerome P. Kassirer, MD '57, former and Immunology. In 1993, he received the editor-in-chiefofthe New England journal prestigious honor of being awarded the of Medicine, nominated Reisman for the Mastership in the American College of award. "Dr. Reisman was a year ahead of Physicians, one of only 15-20 such awards me in medical school in Buffalo and was bestowed by the college each year. CD my resident at Buffalo General Hospital _ s . A . u N 0 E R when I was an intern there nearly four decades ago," he says. "''ve followed his career closely since that time, and he is one of the most impressive physicians I have known. He has become one of the most highly respected practitioners in Buffalo, Wint e r 2 000 Lett to right: Jerome Kassirer, MD. Rena Reisman. and Hoben Hersman, MD l affale Hysiciu 17 �MEDICAL SCHOOL N E w s he Primary Care Summer bternship Program wishes to extend a heartfelt thank you to all the preceptors who continue to make this program a success. Many of these physicians volunteer their time year after year to ensure that students experience the true practice of medicine early in their careers. The program, which has just concluded its seventh year, offers first- and second-year medical students a paid six-week externship during the summer months. Students are placed in the offices of generalist physicians throughout Western New York, where they enjoy varying degrees of interaction with patients, incl uding taking histories and performing physicals, while participating in the daily operation of an office. Jennifer Paglino Adamson Richard Ruh. MD Mark Swetz, MD Steve Lana, MD Antoinette Alonzo Thomas R. Gerbasi, MD Victoria Amodeo Angela Ferguson, MD Amy Braun Chester Fox. MD Audrey Chan G. Jay lishop, MD Kristin Clark Andrea Manyon. MD Ellen Rich, MD Jennifer Clementi Anthony 0. Jesse Cone Bartholomew, MD Jeffrey Conklin Thomas S. Scanlon. MD John Brewer, MD Neu Daley J. Thomas Reagan, MD Cheri Dwyer Keely Dwyer Dawid Holmes, MD Kimberly Erway Colleen Mattimore. MD Mary Schamann. MD George Figueroa John Thompson. MD James Galas Gaurang Sheth, MD Anjeli Gupta Nicholas Aquino. MD Aaron Guyer Brad Truax. MD Mark Haggerty Ann Marie Hedges Gregory Jobes Michael Kader Steven Kam Brian Kenjarski 18 l l l l al• Hys iciu Family Medicine Pediatrics Pediatrics Family Medicine Internal Medicine Family Medicine Internal Medicine Internal Medicine Internal Medicine Family Medicine Family Medicine Family Medicine Pediatrics Family Medicine Pediatrics Medicine /Pediatrics Independent Health Administration Independent Health Brad Truax. MD Administration Jane M. Parmington. MD Pediatrics Internal Medicine Dnid Milling, MD Internal Medicine Jack P. Freer, MD Independent Health Brad Truax, MD Administration Independent Health lrad Truax. MD Administration Wi11t e r 2 000 The externship program is currently supported by anumber ofsources, including the Charles E. Culpeper Foundation, the Independent Health Foundation, the Lake Plains Community Care etwork, and the New York State Department of Health. There is also an opportunity for individuals to support the program; for example, a special endowment fund has been established by Evan Calkins, MD, to develop a more consistent funding source in this age of decreasing capital. For more information about the Primary Care Summer Externship Program or giving opportunities, please contact Susan Orrange at (716) 829-2917/2012 or e-mail her at sorrange@buffalo.edu. c:D Duid Kim Ellis Gomez. MD John Sauret, MD Danielle LaPrairie Ashok Naik, MD John Jaeger. MD Eileen Lau Chelikani Y.P. Varma, MD G. Lawrence McNally, MD Sabina Lim Frank C. Menadri, MD Leah Millstein Dwight Lewis. MD Morcos Morcos Howard Sperry, MD Dhruti Naik Michael Ndegwa Njuguna Richard Castaldo, MD lrenda Perez lrad Truax. MD Sara Ponkow Rebecca Puchalski Karena Steiding Andrew Swan Juliane Thurlow Steven Weitzman larbara Stouter, MD Catherine O'Neil, MD Janet Sundquist, MD Theodore Putnam. MD Peter Kowalski. MD Harry Metcalf, MD Donald Robinson. MD Charles Hershey, MD Frederick Downs. MD Ashok Naik, MD John Jaeger. MD Peter Winkelstein. MD Sanford Levy, MD Mark R. Klocke, MD Michael J. Aronica. MD Debra Wojtanik Robert Wong Adam Wychowski Dana Yip Jack F. Coyne, MD Raphael Wang, MD Gregory Snyder. MD John Fudyma. MD Robert Ramsdell Laura lendano Teresa Russell Dnindra Seelagan Robert Setlik Jonathan Siuta Kristen Smini Family Medicine 01/GYN Pediatrics Pediatrics Medicine/Pediatrics Family Medicine Internal Medicine Internal Medicine Independent Health Administration Pediatrics Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Internal Medicine Family Medicine 01/CYN Pediatrics Internal Medicine Pediatrics Medicine/ Pediatrics Pediatrics Pediatrics Family Medicine Internal Medicine �Through the (yes of aStudent I I I Neva Daley , Class of 2001 Preceptor: John Brewer, MD, Upper West Side Family Health Center Public Heahh \ externship at the Upper WestSide Family Health Center with much anticipation. I was unsure what to expect, but I knew I would enjoy the diversity that family medicine has to offer. As the externship progressed, I began to realize that the benefit of being an extern in this particular clinic went far beyond practicing clinical skills. Yes, I was receiving fine clinical teaching from the various physicians and nurse practitioners, and I was also getting an introduction to the complexities of practicing medicine in an underserved community. The patients were primarily African American and Hispanic of low socioeconomic status. I learned the importance of having just as much respect for patients in poor economic situations as I would for those from a suburban middle class environment. I observed how the physicians addressed the components of the lives of each of their patients with thoroughness and sensitivity. Issues prevalent in this underserved population included affordability of medication or physical therapy if not covered by insurance, transportation costs to a referred physician, lack of compliance for follow-up visits, abuse of (even the sale of) pain medications, poor family planning and contraceptive use, and domestic violence. A significant proportion of the patients also were refugees from Eastern Europe, the Middle East, Vietnam, and Africa. Due to the large number of refugees treated at the clinic, I had to use an AT&T Translator Service with several patients. During the course of the summer, I was able to help deliver care to three members of a family who were among the first wave of refugees from Kosovo. One had been severely beaten by Serbian soldiers before his arrival to the United States. I was humbled to be able to help those who had endured such hardships and brutality. Each of the refugees I saw this summer expressed so much gratitude for the care they were given, and I felt deep satisfaction. It amazed me that I had reached a stage in my medical education where I could help the poor in this manner and have a true impact on the lives of others. !twas as if my childhood dreams of maybe one day serving in an international capacity were slowly unfolding- right here in Buffalo. CD Winter 2000 lallale ••rsiclu 11 �M E D C A L SCHOOL E W S Mary Rosenblum Somit Scholar hip a he Assisting undergraduates in the School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO SENIOR Diana Pratt, who volunteered this summer to help deliver needed medical services to villagers in remote areas of the Himalayas, is the first recipient of a Mary Rosenblum Somit Scholarship. The award, made possible by an endowment established by former UB executive vice president Albert Somit, provides Pratt with a $1,800 scholarship for the 1999-2000 academic year. Somit, who served as the university's acting president in 1977, says he established the endowment "to honor my mother, who like so many others of her generation, left family, friends and all that was familiar in Russia to seek a better life for themselves and their children." Widowed when Somit was four, Mary Rosenblum Somit continued to work hard at several low-paying jobs to ensure that her son would be able to attend a good college. Somit initiated the scholarship fund through a $75,000 bequest commitment to benefit "hard-working and deserving undergraduate students" in the UB School of Medicine and Biomedical Science . Deciding he wanted to see immediate results, Somit has given additional gifts so he could activate the fund and meet the needs of students like Pratt, who he says is "precisely the sort of student I had in mind. " Pratt, whose goal is a career in medicine, was part of a group that recently returned from a 28-day trek to India led by UB professor of medicine Richard Lee, MD. Currently, she is pursuing a bachelor of science degree in medical anthropology and special studies and expects to graduate in May 2000. Pratt notes that although her journey to the Himalayas was exhausting and demanding due to precarious trails and high CARLOS P ATO, MD, associate professor of psychiatry and adjunct associate professor of pharmacology and toxicology, has been appointed associate dean for clinical affairs in the School of Medicine and Biomedical Sciences. Pato will work directly with John Wright, MD, dean of the School of Medicine and Biomedical Sciences, and Bruce Holm, PhD, senior associate dean, on matters relating to university faculty and programs within UB's affiliated clinical sites, including clinical research and space allocation issues within all ofUB's health-care affiliates. A UB faculty member since 1996, Pato also serves as codirector of the UB Laboratory of Psychiatric and Molecular Genetics. The lab's research program focuses on the genetics of psychiatric disorders and substance-use disorders. The program is funded by the ational Institute of Mental Health ( IMH ) to study the genetics of schizophrenia and bipolar disorder, and has pilot projects in obsessive compulsive disorder, alcoholism and substance-use disorder. In November 1999, it was announced that Pato and his wife, Michele T. Pato, MD, received a $4.2 million grant from the IMH to search for a gene(s) that may be linked to bipolar disorder (see page 27 for more information. ) Pato has received many awards, including a National Research Service Award and a Young Investigator Award from the ational Alliance for Research on Schizophrenia and Depression. He has also published numerous scholarly articles, conference proceedings and - LOIS BAKER Medical Alumni Association Scholarship altitudes, the knowledge she gained about the health-care challenges faced by the region's villagers gave her newfound "wisdom and on, a -ye· student at he University at Buffalo School of endowment fund. Recipients are selected by the admissions commiHee according to considerations of financial need and academic merit based on the incoming appreciation for both cultural and medical diversity." While at UB, Pratt has been a volunteer tutor with UB's Learning Medicine and Biomedical Sciences, Center and has worked for the past three years in the Office of CD Disability Services. is this year's recipient of the Originally from Lockport, New Medical Alumni Association Schol- York, Eaton is a graduate of Case ATTENTION STUDENTS Look for these upcoming events ... AMA/AMSA Physician-Medical Student Golf Tournament, Spring 2000 AMSllnnual Residency Fair.lpril2000 More information to come! 20 CD book chapters. 1 111111 nysiciu Wi11ter 2000 students' applications. arship. The scholarship is made Western Reserve University, where possible by the she earned a bachelor of science generosity of degree in chemistry. She says her alumni through their reunion long-termgoal is to return to Lockport CD :ticem .. gifts - S. A. desig- nated to the edical Alumni Association UNGER �Sever"n ,Jo"ns 0 E asAss"stant Dean CHARLES SEVERIN, MD '97, PHD, has been named assistant dean of student and curricular affairs for years one and two at the University at Buffalo School of Medicine and Biomedical Sciences. Severin, who is a clinical associate professor of anatomy, came to UB in 1981 to serve as assistant professor of anatomy. Since joining the faculty, he has been consistently recognized for his service to students and teaching excellence, having received the Seigel Award as Outstanding Teacher in Basic Sciences for five years (1982, 1991, 1993, 1994 and 1998). In 1999, he won the award for residency teaching. In 1993, at age 46, Severin decided to enter UB's medical school in addition to maintaining his teaching responsibilities in anatomy. "I went to medical school to improve my teaching. I felt if I had the clinical background I could insert this experience in my lectures," he says. "Also, I was serving on a number of committees in which student issues were being discussed in depth and I wanted to better understand what the students were experiencing-to be able to better relate to them," he adds. "Dr. Severin was chosen for this position because of his extraordinary record as a teacher and as a student advocate," says Dennis adler, MD, associate dean for academic and curricular affairs and head of the Office of Medical Education (OME). "He is enormously respected and loved by students, as evidenced by his having been named recipient of the Seigel Award as many years as he has." Originally from Youngstown, Ohio, Severin earned his AB degree in biology in 1970 from St. Louis University, where he also completed his MSCR degree in anatomy in 1972 and his PhD in 1975. Prior to coming to UB, he was assistant professor of anatomy at the University of Texas Medical Branch at Galveston. 4D Rokitka Named Assistant Dean MARY ANNE ROKITKA, PHD, clinical associate professor of physiology and biophysics, has been appointed assistant dean for biomedical undergraduate education in the School of Medicine and Biomedical Sci- ences. She will continue to have primary responsibility within the school for developing and overseeing education programs for undergraduate students potentially interested in careers in the biomedical sciences. A faculty member since 1975, her research involves comparative environmental, animal and hyperbaric physiology. New Director of Student Services dean for academic and curricular affairs and head of the Office of Medical Education. In particular, of student services in the Office of he adds, "we wanted to designate 'Jiedical Education lOME) in the somebody who is not directly in the School of Medicine and Biomedical promotion pathway to advocate for Sciences. She is the first to hold students and to provide them with his position, which was created to assistance and support." Stamm earned a bachelor of provide improved support and arts degree in psychology at the services to students. In her role, Stamm serves as a State University of New York at student advocate and acts as a Geneseo in 1992 and a master of "aison between the student body education degree in college coun- and administration. She also is avail- seling and student personnel ad- able as a resource person for stu- ministration at UB in 1995. Prior to lent clubs and organizations rec- joining the staff in OME, she was ognized by Polity.In addition, Stamm admissions ill be coordinating the Primary coordinator in Care Externship Program (see re- the Offices of ated article on page 181 and will be Admission orting to implement a new pro- and Financial gram called MedCAREERS, a four- Aid at Har- ear career planning program cre- vard Medical School ated by the Association of American Medical Colleges and the American in Boston, Massachusetts. Medical Association to assist medi- Stamm is available to students cal students in selecting a specialty. on a walk-in or appointment basis. "Our goal in establishing this She can be reached by phone at new position in OME was to upgrade (7161 829-2802; or by e-mail at theservicesweprovidetostudents," says Dennis Nadler, MD, associate In 1993, she received the Chancellor's Award for Excellence in Teaching and has been named an honorary member of the Mortar Board and Golden Key national honor societies. She also received the o.edu. Charles W. Shilling Award from the Undersea and Hyperbaric Medical Society in 1991 and the first annual Dr. Mary Anne Rokitka Award from the Great Lakes Chapter for the Undersea and Hyperbaric Medical Society in 1990. Rokitka, who has an impressive record of university and community service, holds two master's degrees and a doctoral degree from UB. - LO IS \V i 11t er 4D - S . A. U N a E R 2000 BAKER l1ffale Hysici11 21 �M E D C A L SCHOOL B v 5 C 0 T E W S 2002: Sta eOd sse T THOMAS Second·year students form rock band District, they rehearse in the basement of a rented house on Callodine Avenue. There, in a litter of pizza boxes, beer bottles and backpacks-with a wa her and dryer for ambience- the members of the rock band Super-RelateD work out the details of their highenergy contemporary sound. A Marshall amplifier the size of a filing cabinet blasts out the music as lead vocalist Andy Swan lets fly with an original song called "Original Song." You got to see there isn't a need to get excited I'm the least of burdens but I hold on, should move on, That's what I gotta do. This is medical school? Well, no. And for the four University at Buffalo medical school students who make up SuperRelateD, that's the whole point. "Most people in class are completely wrapped up in school," says Mike Campoli, the group's bass player. "I can't deal with that." "You can get involved in the clubs and stuff, but they're still attached to the school," says Rich Oh, the band's lead guitarist. "This is something that's totally unrelated." Which is why these four members of the Class of 2002- the fourth is drummer Dave Krakowski- are manhandling their schedules to make time every Friday afternoon to work on their music. They play cover versions of pop hits originally recorded by the likes of Mathew Sweet and eil Young, but they' re also developing a roster of original songs, actively seeking to play more nightclubs, hoping to release a CD by the end of the academic year- in short, putting a lot of nonmedical energy into the rock-star dream. Yet it was at school that the idea for SuperRelateD was conceived, almost by accident. The band members got together for the first time in January 1998 to perform at the student talent show, which promised to be 22 1 11fal1 Hysitill Wrnt er 2 0 00 a successful debut except for the fact that they didn't have a drummer. Krakowski, a bassist by training but quick to pick up other instruments, was nudged into the breach. "I was elected," he says. "Literally, on the day of the show, Mike and I went to the music store and bought a drum set, and I watched an instructional video that came with it." That night, SuperRelateD closed the show with a brief set of power rock tunes: cover versions of Radiohead's " Bends" and Guns' ' Roses' "Patience." Big dreams were born. Final exams and the summer break separated the band for a while, but this academic year they've taken up the cause with a vengeance. They've recorded a demo tape, shopped it around to various nightclubs, and played a live gig at a newly opened club in iagara Falls. (It wasn' t exactly Madison Square Garden, they discovered: The owners had put a new roof on the building and that evening were testing it by dumping water on it. The roofing job wasn' t great, apparently, as the ceiling sporadically leaked water over the band as they played, inches from megawatts of microphones, amps and speakers. They survived.) For each member of SuperRelateD, their dream requires an investment of scarce time, not to mention money. Besides the $600 drum set, they've spent more than $3,000 on amps and other equipment. "Every time you get something new, you discover something else you need," Swan says. But as an antidote to the rigors of anatomy class and hospital rounds, the band is something they're only too happy to pursue. One of their more pleasant challenges is accommodating each performer's tastes in music, and they're not all that similar. Among their influences, Campoli cites Captain Beefheart, Lynyrd Skynyrd and Led Zeppelin; Krakowski listens to AC/DC, Pearl Jam and modern electronica; Oh is into current British pop like Stone Roses and the Posies; and Swan loves Pink Floyd, Queen and the Black Crowes. SuperRelateD includes, left to right, Rich Oh. Mike Campoli. Andy Swan and Dave Krakowski. Opposite, Andy Swan. normally lead smger on guitar. takes a turn on drums. �The band members As befits a rock band, the musicians are a varied, eclectic bunch. Swan grew up in the Southern Tier of ew York, sang in a small a cappella group at Cornell University, and spent a year after college on the beaches ofVenezuela. Oh, from Buffalo, played in various bands in high school and at the University of Chicago. Krakowski, a ew York City native who'd never played in a band before, graduated from the State University of New York at Geneseo, after which he migrated to Antarctica, where he spent three months doing research. Campoli played in a band called French Toast at Rutgers University in his home state of ew Jersey. But fate brought them together in Buffalo, and only time will tell how far Super RelateD will go. Two people who are working to make as much happen as possible for the band are Charlton Byun, another second-year medical student, who helps out with sound and equipment; and Dan Yoon, a third-year student in UB's joint MD/ MBA program. Yoon, a versatile musician himself who has a studio set up in his Amherst home, is acting as the band's manager and giving advice on technical aspects of performing, as well as how to approach club owners and how to construct a crowd-pleasing set of songs. "They have a very high-energy stage show," Yoon says. "The songs they choose and the way they play them is really exciting. They know how to get people going." Yoon is studying marketing and other management topics this year, which has played right into his efforts to develop the band. "I would base a Jot of their marketability on the fact that they're just excellent musicians," he says, "which, by the way, is actually pretty common among medical professionals. "These guys all love it like I do," he adds, "to the point where we're all finding the time to approach medical school from the perspective that although medicine is going to be our profession, we still need to make time to do other things we love. And I really think they actually have a shot. In my opinion, they're as good as any band I've heard in Buffalo." Oh, yes, and the name? "The current name, SuperRelateD, was thought up by Rich during a class on immunology," Swan says. "And we all agreed it sounded cool. Originally, we were Val Salva, but we switched it because we didn't want it to be a medschool pun." And make no mistake, the band is no joke; its members are proud of what they're doing and are seriously devoted to developing their talent in this creative realm. Says Mike Campoli of their planned CD: "I want it to happen for us so that someday when I have kids and they ask, 'Who's this band?' I can tell them, 'We're the band!"' Winte r 2000 got together for the first time in January 1998 to perform at the student talent show, which promised to be a successful debut except they didn't haye adrummer. l• ff a l • n rsi c i u 23 �RESEARCH ms N E w s the liver than full-term infants. president and chief medical This deficiency could leave them officer of TRC. Robert A. Klocke, MD, susceptible to infection because of the immaturity of their professor and chair of the UB million grant from the Institute immune system." Vivien Carrion, MD, and Department of Medicine, says for Child Health and Human De- Linda Duffy, PhD, both of the the grant "provides a solid base for us to continue and even to UB expand our ongoing research in University at Buffalo pediatric researchers have received a $1.2 Work are collaborating with renal disease." Upstate New York Transplant Services, Inc., (U YTS) on a cal trial of vitamin A's potential to bolster the immune systems of Hospital, Brian M. Murray, MD, UB associate professor of medicine, develop ways to increase organ very premature babies, an action -LOIS BAKER Department of Pediatrics are co-principal investigators on the study. CD antibody response to the hepatitis B vaccine, adminis- who has received early funding donation in the African American community. studying the role of growth fac- The grant is part of a $13 million effort funded by the Rocco C. Venuto, MD, pro- tered to all infants at about three-year, $180,000 grant to through this grant is currently tors in the progression of kidney disease, differentiating between those that are beneficial and toxic. The researchers will use .. Related Professions and Social and Kaleida Health's Children's ational Institutes of that could help prevent poten- .JIIII.if!"!'l'!'!~"'"!'!f'l!'l~~!!!!ll~'--'!lr"!!lii tially deadly infections. 0 The UB Schools of Medicine and Biomedical Sciences, Health Health, to conduct the first clini- velopment, .." .. Organ Donation Among Minorities Studied organ donation across all one month of age, as an indi- fessor cator of vitamin A's immune- second UB researcher who has boosting potential. Mark received TRC grant money, tor of UNYTS, will be principal Ballow, MD, UB professor is conducting ongoing, collab- investigator on the grant. Judith of pediatrics and chief of orative research in the area of Tamburlin, PhD, UB assistant the Division of Allergy and blood-pressure control during research professor of clinical Immunology and Pediatric pregnancy, a topic he has been laboratory sciences and anatomy direct the study. Vitamin A's role as a modula- segments of the population. Mark Simon, executive direc- exploring for nearly 25 years. and cell biology, will be project Nephrology Rese rch Endowe "If we can understand the role of the kidney in controlling blood director and coinvestigator. The UNYTS-UB collabora- Rheumatology at Kaleida Health's Children'sHospital of Buffalo, will of medicine and a National Organ and Tissue Donation Initiative to increase Total Renal Care, Inc., (TRC) has pressure, then we can become tion in the first year of the grant tor of the immune function has donated $500,000 to the Univer- better at avoiding hypertension will be aimed specifically at the been studied in both animals and sity at Buffalo School ofMedicine and perhaps at saving the lives of humans, and results have shown and Biomedical Sciences to es- pregnant women and preventing that it is essential for supporting tablish the Nephrology Research premature births," he says. the immune system against infec- Endowment Fund to partner with Total Renal Care Holdings, Inc., headquartered in Torrance, tion, according to Ballow. UB in the battle against kidney "Despite many improvements in disease. "We are proud to sup- California, is a provider of inte- recent years in treating very-low- port the endeavors of our partner grated dialysis services for patients birthweight preterm infants, institutions like UB, which was suffering from chronic kidney infection remains a major problem," he says. "Preterm infants chosen because of the strength of its academic program and its failure, also known as end-stage CD renal disease. have lower levels of vitamin A in excellent research," says Stan M. - SUZANNE their blood and lower reserves in Lindenfeld , MD, senior vice "IF WF CAN UNDERSTAND THE ROLE OF THE KIDNEY L CHAMBERLAIN CONTROLLING BLOOD PRESSURE, THEN WF CAN BECOME BETTER AT AVOIDING HYPERTENSION AND PERHAPS AT SAVING THE LIVES OF PREGNA ••T WOMEN AND PREVE 'TING PREMATURE BIRTHS." l 1 1f al1 Hysicin Wi11ter 2000 �African American community. years of the grant, the emphasis biology in the UB School of Dental Medicine. By exposing mouse will be on increasing organ pre·osteoblasts and fully During the second and third donation in the Western ew York Hispanic and Native American communities, respectively. Statistics compiled by U YTS show that in Buffalo, 50 percent of patients needing organ transplants are African Americans, while the consent rate for donation from this ethnic group is only 14 percent. This low donation rate poses problems on two accounts: It limits the number of organs available in general to a population in which the need is great; and it decreases the possibility of obtaining a compatible match. Rejection rates for African Americans are higher when the organ is from a donor of another race. 4D -LOIS BAKER Melatonin Linked to Bone Crowth University at Buffalo researchers have shown for the first time that melatonin may play an important role in promoting bone growth. The study was conducted by Jerome A. Roth, PhD, professor of pharmacology and toxicology in the UB School of Medicine and Biomedical Sciences, and Moon·ll Cho, PhD, professor of oral differentiated rat osteoblasts to melatonin, the researchers were able to show that normal body levels of the hormone sped up the transformation of pre-osteoblasts to fully differentiated osteoblasts and induced both types of cells to produce increased amounts of several bone matrix proteins responsible for bone formation. "After binding to its receptor on the cell surface, melatonin signals the cell to produce and mineralize bone matrix proteins," Roth says. ''This has not been shown before, and we are now investigat· ing what cellular events are taking place to make this happen." "We know melatonin decreases with age and that bone loss, which can lead to osteoporosis, is an inevitable part of aging, especially among women," Cho says. "Can melatonin help prevent osteoporosis? Our research indicates it may have that potential." Under standard growth conditions in vitro, mouse pre· osteoblasts undergo cell differentiation to osteoblasts and mineralization in 21 days. Roth and Cho showed that in the presence of melatonin, cell differentiation was completed by day 12 and was Exercise a Cood Workout for ..Ju enile t ew research on the effects of exercise on juvenile arthritis indicates it is OK-advantageous, in fact-for these kids to be kids. Children with juvenile arthritis who took part in an eight-week individualized program of resistance exercise at the University at Buffalo significantly improved their ability to function, some by equivalent or greater at that point than cells grown for 21 days. Most significantly, says Roth further experiments showed that the mouse pre-osteoblasts responded to normal body levels o melatonin, but the cells needed to undergo five to seven days of differentiation before they were capable of responding to melatonin at that level. "These findings place melatonin with a select handful of other agents-includingglucocorticoids, bone morphogenic proteins and vitamin D-that are known to stimulate mineralization in osteoblasts," says Roth. "Because melatonin levels decrease during the aging process, the possibility must be considered that melatonin may have a significant influence on the rate of synthesis and maintenance of bone in the elde ly. -LOIS as much as 200 percent, as shown in preliminary results of the study. Equally important, their pain, disability and use of medications decreased significantly. The research was conducted by adine Fisher, EdD, assistant professor of occupational therapy and rehabilitation medicine, with support from the ational Institute on Disability and Rehabilitation Research. In ovember 1999, she presented results of eexpected to see achange in the disease with exercise, but we didn't expect to ee so much," says Fisher. Everybody showed tremendous hysiological ·mprovement.'' the study in Boston, MA, at a joint meeting of the American College of Rheumatology and the Association of Rheumatology Health Professionals. "We expected to see a change in the disease with exercise, but we didn't expect to see so much," BAKER says Fisher. "Everybody showed tremendous physiological improvement-better strength, endurance and even better aerobic capacity, although these exercises weren't designed for that. Everyone had less pain. ~NTINUED Winter 2000 ON PAGE 26 1111111 Hysicill 25 �N RESEARCH .... .. E w s Res arch Institute on Add"ctions "oins UB sion of hepatitis C. RIA scientist! The Research Institute on Addic- addictive gambling, one involvin tions (RIAl, formerly a component a nationwide survey of gamblin .. I~N TI N UEO behavior and alcohol use, and the Alcoholism and Substance Abuse second evaluating coping skills in Services (OASASI, became part of individuals who have partners who University at Buffalo on November are pathological gamblers. PA G E 25 at the institute at 1021 Main Street in Buffalo, New York. lished at UB in 1968 by the state Department of Mental Hygiene to ally for its research on the develop- conduct research into alcoholisn " Some kids showed 200percent improvement," she adds. "That's pretty exciting." Fisher designed the exercise ment of substance-abuse problems and potential treatments. Cedric and the prevention and treatment Smith, MD, UB professor of phar of substance abuse. The institute macology and toxicology (see be umps $8.1 million a year in exter- low), was RIA's first director, serv program and has shown its al research funding into the local ing unti11979. Through a series of conomy, in addition to expending changes in administration, both at benefits in previous studies of elderly patients with osteoarthritis. However, until now, an individualized resis - The sho examined t nature. prevalenc and consequence of complete memory lapsesso-cane tance exercise program had never been tried with children. a state budget of $3.1 million. other researchers around the country-have found to be a relatively common occurrence. Specifically, Smith was asked to describe the results of studies he has carried out in collaboration with Cynthia Pristach, MD, clinical associate professor in UB's Department of Psychiatry, in which they examined the effects of blackouts on subsequent drinking in both moderate drinkers and alcoholic patients. under the administrative jurisdiction of OASAS, although the two Characteristically, indjviduals ill retain its identity and remain institutions maintained close re- experiencing blackouts don't realize they have had memory loss until hours or days after n its present location. Gerard J. searc c ional ties. 4D - LOIS BAKER research professor of psychology, said of the transition: "We are delighted with our merger with the niversity and are excited about he new opportunities that will re- 20,20 Features Cedric Smith as Exp rt on Alcoholic ultfor both RIA and UB." Connors id the institute will continue to ocus its research on alcohol and other substance use and abuse and that it has expanded it emphasis to include compulsiv inflammatory compounds. infant development in alcoholi - families; ways of reducing DWI rc ambling. Current RIA researcl ·ncludes investigating alcohol us in early marriage; parenting an cidivism; skills training for parent of adolescent drug abusers; an heavydrinking,druguseand blood to-blood transmission betwee1 lllfall nysieiu least 10- 20 percent of the population. The interest in blackouts stems in part from apparent skepticism on the part of the public regarding what Smith and his colleagues-as well as RIA will function as a free-stand- controls at baseline and that the exercise program significantly decreased these cytokines and increased production of anti- LOIS BAKER UB and at the state level, RIA moved particularly interested in establishing that blackouts not only do occur, but are experienced by at ing research institute within UB and onnors, RIA director and UB An accompanying investigation conducted by )aya Venkatraman, PhD, associate profes~blackouts"­ sor of nutrition, found that can occ that children with with alcohol juvenile arthritis had higher concentrations of pro-inflammatory cytokines in their blood than normal 26 The merger brings RIA back to its roots. The institute was estab RIA is recognized intemation· FROM recently began two projects or of the New York State Office of 18, 1999, during ceremonies held • sexual partners in the transmis Wi11t e r 2 000 The October 18, 1999, edition of the ABC television news program 20/20featured Cedric Smith, MD, professor in the Department of Pharmacology and Toxicology, as an expert on memory disturbances produced by alcoholic beverages. The show examined the nature, prevalence and consequences of complete memory lapses- so-called "blackouts"that can occur with alcohol consumption. Smith was interviewed by Cynthia McFadden, who was recovery from the intoxication, according to Smith. Furthermore, although alcoholic patients (approximately 70 percent) often suffer repeatedly from blackouts, the episodes are not limited to alcoholic individuals. "The particularly puzzling and frightening �aspect of blackouts is the fact that a $2.6 million project also funded the individuals appear to have an intact memory and can act 'nor- by the IH, now entering its third year. "Although a genetic linkage has been presumed to underlie bipolar disease in many individu- mally' during the time period that they subsequently can't remember," says Smith. "Fortunately, some individuals appear less susceptible to blackouts than others." Currently, Smith and his colleagues are preparing to publish new data they have gathered from their studies on alcohol-induced blackouts. CD -S.A. UNGER $4.2 Million Crant to Study Cenetics of Bipolar Disorder Carlos . Pato, MD, and Michele T. Pato, MD, associate professors of psychiatry and co-directors of the Laboratory of Psychiatric and Molecular Genetics at the University at Buffalo School of Medicine and Biomedical Sciences, have received a $4.2 million grant from the ational Institutes ofHealth to search for a gene or genes that may be linked . .... .. to bipolar disorder. Identifying the molecular basis of such a linkage could lead to advances in diagnosis and treatmentofthe disorder, which affects millions of people worldwide . The husband-and-wife team are conducting their research with the relatively homogeneous population of the Azores, Portuguese islands located in the North Atlantic about 1,000 miles off the coast of the Iberian Peninsula. This same population forms the study base for their search forgenetic markers for schizophrenia, als, this research promises to reveal the molecular basis of that linkage, and may well lead to important diagnostic and therapeutic advances," says months. Persons in the manic Pato explains. "In addition, the Azores have a centralized health system, and alllO psychiatrists on phase of the disorder can be psy- the islands are collaborating on chotic, are easily distracted, experience exaggerated feelings of well being, exhibit inflated the project." The researchers will look for hereditary pathways of the disease using a variety ofapproaches. "We will select genetic markers be cyclic, with sufferers remaining manic or depressive for self-esteem and may indulge extravagantly in irrational activities. In the depressive phase, persons ex- and look at how the markers behave in well families, compared to a family where the illness shows up several times," Patosays. "We'll perience inertia, loss of self-esteem, withdrawal, also look to see if illness and Biomedical sadness and may even be we'll develop a description of each suspect gene and determine Sciences. Carlos suicidal. Present how often it occurs with illness." An important aspect of the study will be a haplotype relativerisk analysis. Using this approach, researchers John Wright, MD, dean of the School of Medicine and Pato, principal investigator on this research project and associate dean for clinical affairs in the medical school, says bipolar disordercommonly referred to as manic depression-affects about 0. 7 percent of the worldwide population, with a large percentage having a possible genetic component. "The most consistent and signifi- treatments for bipolar disorder focus on managing these symptoms. The Patos say they hope that uncovering the genetic etiology of these disorders will be an important step in developing improved treatments and, possibly, specific cures. Through a pilot study, the researchers already have identified 25 families with 84 affected mem- cant risk for developing bipolar disorder or schizophrenia is bers. That population will be expanded in the newly funded being related to a person suffering from the same illness," he says. "Though it is likely that five-year investigation to include 225 persons with bipolar disorder and their parents. A third study group will be composed of all other Azoreans with the disorder. "The Azores are ideal for a nongenetic factors play an important role in the expression of these illnesses, a significant portion or risk must be genetic." Bipolar disorder is characterized by dramatic mood swings between mania and depression. The mood swings develop and subside spontaneously and may genetic analysis because the islands are geographically isolated and the population has remained relatively homogeneous, with most inhabitants descended from a few families," Winter genetic markers co-exist and analyze genetic patterns from ill person to ill person. In addition, Mllthough a 11enetic linkage as been resumed to derlie bipolar sease in many ividuals, this will analyze the set of esearch promises genes from a patient's oreveal the parents that were not olecular basis of passed on to that that linkage, and patient, with the nonay well lead to inherited set then nponant acting as a control. iagnostic and Both researchers therapeutic hold adjunct appoint- advances." ments with the Center for euroscience at the UniversityofCoimbra in Portugal, which is collaborating on the project. The Whitehead/MIT Center for Genome Research will perform a genome-wide scan and collaboCD rate on all data analysis. -LOIS BAKER 2 000 laffale Hysicin 27 �S T U D E N T COLUMN Sendin Out an S.O.S. BY H A N A C H 0 E Students Offer i ng Support Peer Group Established yet I stared at the clock as if it were alien to me. I just wanted it to stop bothering me so I tried willing it to be silent. Finally, itsincessantnagging forced me to drag myself across the room to turn it off. I had classes. .... 28 l11falt Hysiciu Though the morning sun streamed through the window blinds heralding a new day, I convinced myself that it would probably be too cold, or classes would be boring, or that I could read and study on my own and, oh, that I wasn't feeling too well either. This day was just not a good day. I crawled back into bed, relieved that I had been able to rationalize my way out of going to school. Perhaps I was getting sick; it was winter in Buffalo, ew York, after all. Maybe I had hypothyroidism; hadn't we just learned about Hashimoto's thyroiditis and the concomitant lethargy? Surely, there was a physiological explanation. Yet, in the back of my mind, in my heart of hearts, I knew it was something else: I was depressed. But how could I be? I had always been a proactive, strong, independent soul with high ambitions and strict control over all aspects of my life. While at Columbia University as an undergraduate, I had been vice president of my senior class and felt I had a bright future. Following graduation, I took time off to Winter 2000 prepare for medical school, get some experience in the work force, and earn a master's degree in biology at ew York University, to boot. Accomplishment, scholarship and leadership had not been foreign to me. But now I felt trapped in a futile struggle against apathy towards school, career, life. And in the vicious cycle of life's quirks, the less I cared, the worse I performed in school and the worse the situation progressed. It was as if I had been performing all along and, now, I could not muster the energy or desire to go back on stage anymore. I needed help, but did not know where to turn. Approaching a dean seemed intimidating, and friends seemed to be having some of the same problems. We did not have advisors, and I wondered, "Did UB have counselors specifically for medical students?" Because several of my fellow students had similar questions and concerns, we began a quest to find answers and forge solutions. We decided to get a consensus ofhow many students were suffering doubts, fears and emotional stress. Therefore, in March 1999, we conducted a survey of the classes of 2002 and 2001. Some sobering facts were revealed: 62.1 percent of the 120 students of the class of 2002 and 69.7 percent of the 85 second year students in the class of 2001 who responded said they had experienced a period of significant psychological and emotional distress at least once since attending medical school. These statistics confirm the trend that during medical school training, while students are taught to empathize with, diagnose and treat patients, our own physical, mental and emotional health suffers. We further found that almost a third of the class of 2002 (43 students) and a quarter of the class of2001 (31 students) were distressed enough to need help or counseling. More disturbing is the fact that these medical students-typically characterized as bright and intelligent, motivated and achievement oriented-did not know where to turn for help. What will medicine be like in the next millennium if medical students today cannot obtain help to maintain their own health and happiness? The reality is that �A RECENT ARTICLE IN NEWSWEEK ... TITLED «THE SILENT A1 GUISH OF THE HEALERS" ADDRESSES THIS CYCLE THAT EVENTUALLY MANIFESTS ITSELF IN THI:. DETERIORATION OF THE PHYSICIAN-PATIENT RELATIONSHIP AND, INCREASINGLY, IN MALPRACTICE LITIGATION. the problem stems not from a lack of coping abilities, but because there is often a stigma attached to medical students and physicians who admit they need help; it's as if we were admitting a weakness. The awesome responsibility of caring for the people in our community and the fiduciary expectations placed on physicians can be not only intimidating but debilitating, especially when shouldered by clinically naive medical students. However, to concede that we cannot handle adversity not only forces us to relinquish control of a situation, but exposes a fallibility that is not allowed. Hence, it is safer to assume the pretense of unyielding strength and flawless competency. Moreover, the Marcus Welby phenomenon traps us and transforms us into demigods in the eyes of our families, friends and communities. How then can we possibly admit we need help? It is one thing to cope with the vicissitudes of life in our own personal lives; it is quite another to be defined by our career and to play a role that is immune to doubts, fears and tragedy. Physicians may become captives of the emotional and psychological duress associated with caring for the health of entire communities, which involves confronting pain and death at every step. Ironically, as administrators of health care, we are trained to recognize the signs that a patient's health is compromised, yet we ignore these same signs in ourselves. Would it make us too vulnerable if we remembered that we are in fact only human? If we do not tend to ourselves, we cannot fully and sincerely attend to our patients. A recent article in Newsweek (September 13, 1999) titled "The Silent Anguish of the Healers" addresses this cycle that eventually manifests itself in the deterioration of the physician-patient relationship and, increasingly, in malpractice litigation. My peers and I refuse to accept this state of affairs and are endeavoring to change it. As a result, in April 1999, we established a student-run peer support group called S.O.S., for Students Offering Support. Through sheer determination and dedication we have initiated a program-the first of its kind at UB-that will promote the health of the medical student body. Though our group is still in its infancy, its mission is centuries old and found throughout the animal kingdom: We must take care of our own if we expect to survive. If we medical students and future doctors are to work together on the wards, in teams and in group practices, we must work together to preserve the sanctity of our collective well being. Therefore, S.O.S. reaches out to students by offering education and peer support on four levels. The first level of support includes a resource center that provides information on service agencies in the community and a lecture series that addresses issues such as stress reduction, family planning and seasonal affective disorder. With prevention as the trend in health care for the millennium, our responsibility is to educate not only our patients, but ourselves and our peers. The second level of support is a pager service offered daily for direct and immediate peer support and referrals. As one S.O.S. member states, "I believe that an S.O.S. volunteer can demonstrate the same personal attention and compassion on the phone that a physician would show during a face-to-face visit." It's inspiring that students are concerned enough for fellow students that they will take time out of their busy schedules to be on call for others. The third level of support maximizes the benefits of group discussions to further examine issues like maintaining relationships and exploring spirituality throughout a medical career. Finally, the fourth level is the bridge to professional therapists and psychiatrists. By matching medical students with psychiatrists in the community, we are encouraging them to seek help when they have problems. And now, almost a year has passed since that morning I lay in bed, willing my alarm to cease its noise. I admit I am still anxious about the challenges ahead. However, I do know there is strength in numbers; I will support and be supported by my peers. I encourage 4D you to do the same by sending out an S.O.S. For more information on S.O.S., visit the group's website at http://www.smbs.buffalo.edu/polity/sos. What will medicine be like in the next millennium if medical students today cannot obtain help to maintain their own health an happiness? The reality is that the problem stems not from alack of coping abilities, but because there is often astigma attached to medical students and physicians who admit they need help: it's as if we were admitting aweakness. {ana Choe zs a second-year student at the Uni~erstty at Buffalo School of Medicme and Biomedical Sciences. Wi11ter 2000 1111111 Plysicill 29 �N E w s "Can You B • By Li nda J . Cor de r , PhD, CFRE on my birthday, about a decade ago. His eyes were intense but kind as he welcomed me to his kingdom, the Department of Medicine at St. Louis University's School of Medicine. Obviously a benign monarch, he offered me heartshaped cookies baked by one of the office staff for Valentine's Day. While he went to find coffee, I explored the landscape of his office, noting that the walls were covered with a lifetime of honors. These included a citation of appreciation for his term as president of the American College of Physicians, hung not far from his UB diploma. Tom was also in charge of graduate medical education. On a tour of St. John's Mercy Medical Center, everyone we met grinned in response to his quiet greeting. Along the way, he indulged my obviously nascent knowledge of the field of medicine by explaining the various stages of medical education and training. Tom also fervently extolled the virtues of music, literature, art and "living life." We ended our sojourn in the library, where a large oil painting of him was propped against a set of shelves. "When you next visit," he said shyly, "that will be hanging; the library was recently named for me." Over the intervening years, Tom shared more stories about his life. I learned that he is a spouse, a dad, and a man deeply involved in his community. He also plays the piano, reads widely and enjoys excelling at golf. Driving down Buffalo's "memory lanes" a few years ago, Tom described to me his UB days, which were spent mostly at the hospital because he lived in a house in Allentown where the heat seldom made it to his third-floor room. As a result, the residents dubbed him "that student who hangs around." One night, he recalls, a woman was brought into the ERin a coma and he was encouraged to observe as an "amber-colored fluid" was injected into a vein. The patient immediately awoke and asked where she was. "To a kid, this seemed like magic, or a true miracle," Tom remembers. Later, he learned that the woman had been in Addisonian crisis. 30 l 1 fla l1 H ysi c i11 Winter 2000 Tom was in the hospital that night because his room was freezing, a fortuitous circumstance that changed his life, as he made up his mind then and there to dedicate his energies to the study of Addison's disease. When he completed his residency, Tom's dream was to conduct research with George Thorn, a UB graduate known for his seminal work in endocrinology. After interviewing Tom in Boston, Dr. Thorn decided he would be a welcome addition to his lab; however, due to funding, he had to delay offering him a fellowship for a year. Fearful that a dream deferred would never come to pass, Tom returned to Buffalo broken-hearted. A group of faculty-Jed by Dr. John Talbott-told Tom, "We will finance your first year of research until Thorn can provide fellowship funds." Recalling this offer, Tom asked me with unmitigated awe, "Can you believe that?" The UB faculty encouraged Tom to "learn and return" but didn't hold him to an agreement when he was offered "a rank and salary UB simply couldn't match." His mentor said, "We want what is best for you, so take it." Again Tom said to me, "Can you believe that?" Recently, Dr. and Mrs. Frawley completed funding an endowment that will enable other young physicians interested in research to pursue their dream. This story is not just about the Thomas Frawley, M. D. Residency Research Fellowship Fund, although it will make a difference to the school forever. What strikes me as amazing is the aspect of Tom's story that pertains to his decision to embark upon a career in medical research and how dedicated professors and an outstanding UB alumnus worked together to effect a remarkable outcome. It also shows how "serendipitous" can become "likely" when people and resources are dedicated to students and to creating an academic environment that exceeds expectations. Lyn Corder is associate dean and director of development. She may be reached by phone, toll free, at 1-877-826-3246, or by e-mail at ljcorder@buffalo.edu. �Spring Clinical Day and e nion Weekend 2000 Mark your calendars I Cass of 1955 t's not too early to plan for the 2000 Spring Clinical Day and Reunion Weekend. John H. Peterson A cocktail reception will be held Friday, April28, 2000. The Ray Schiferle 63rd Spring Clinical Day and Reunion Dinners will be on Saturday, April 29. For more information, call the Medical Alumni Association at (7161 829-2778. John H. Peterson The reunion classes are 1945, 1950, 1955, 1960, 1965, 1970, 1975, 1980, 1985, 1990 and 1995. Here's what your reunion chairs have to say . . . Admit it, you've stayed away too long! Come enjoy Spring Clinical Day activities and our 45th reunion. The clock is ticking, so plan to attend. Details very soon. -Ray Class of 1945 Herbert Joyce Herbert Joyce Ray Schiferle We encourage all of those of the Class of' 45 who are still able to come to attend our 55th reunion. The festivities will be the grandest yet for the double nickel on 4/29/2000. Class of 1950 Class of 1960 James Kanski RogerDayer ]ames Kanski Sidney Anthone Save thedatesApri128 and 29,2000. It's our 50-year class reunion and great plans are being made to make it a monumental event. You will be hearing from us about further details. Call your closest classmates and start planning to share the event. Please let us know of any ideas you may have to make the occasion even more special. Plan now for our May 2000 reunion. It's time to renew old friendships, reminisce and share a few laughs. -James Hope everyone will join us for our Can-Am celebration of our 40th. -Roger Bob Patterson Sidney Anthone In '95 we had a great time with 20 classmates. Let's try and double that for our 45th. You wouldn't believe all the tales traded about. Please try and make it. -John Roger Dayer Bob Patterson Wi11ter 2000 1111111 Plysiciu 31 �S P R. I G C IC'AL Ll DAY AND REU 10 WEEKEND c sso 5 2000 985 Beth Maher Joe Cardamone Jack Coyne Joe Cardamone It really has been 35 years since graduation. Let's all get reacquainted. I look forward to seeing you at our reunion weekend April 28-30, 2000. Come and join us in the "City of Light" in the spring of the new millennium. Beth Maher 970 Don Copley Don Copley Be sure to reserve the dates for our 30th medical school reunion in April. Andrea and I look forward to seeing you. If you attended our last reunion, you'll recall the fun we had reminiscing, comparing career twists and reviewing life's little adventures. And don't forget to bring along some belly laughs! Jack Coyne s 990 Ray Paolini Ray Paolini John C. Stubenbord John C. Stubenbord On April 29, 2000, we will be celebrating our ten-year reunion. Please mark your new 2000 calendars now and share with your classmates some fond memories of good times. It's been 25 years since we were all together in Buffalo. Come on home to the place of our medical beginnings. Hope that you all can return for April 29, 2000. 95 Martin Mahoney Tara Sosa Paolini Margaret W. Paroski Martin Mahoney Let's begin the new millennium by renewing old friendships. Margaret W. Paroski Tara Sosa Paolil1i 3 2 l 1ffal1 Hysicin Wtnter 2000 Let's get together to catch up! Plan to join us for our five-year reunion .... Hope you can attend. �Dear Fellow Alumni, I have been privileged to participate in many interesting and exciting events over the past few months. In mid-September, Dr. john Bodkin, vice president of the Medical Alumni Association, chaired the reunion chairs' dinner, held at the Transit Valley Country Club. Dean Wright spoke, and we had a chance to meet with the chairs of the individual reunion classes that will be held in April 2000. It was a welcome opportunity for us to meet these volunteers and show our appreciation for their stepping forward to chair their respective reunion dinners. Later in September, the past presidents' dinner was held at the Buffalo Club in downtown Buffalo. At this event, we were pleased to present the Distinguished Medical Alumnus Award to Dr. Robert Reisman in honor of his many contributions to allergy and immunology and to our medical school. In accepting the award, Dr. Reisman gave a wonderful talk about his career and his thoughts on the past, present and future of medicine. On October 9, 1999, I was privileged to speak before the Parents' Guild during Parents' Week for the first-year medical students. The Parents' Guild is an impressive organization that has been established to try to improve aspects of the medical education experience. This was a well-organized day that gave the parents an opportunity to visit the classrooms, meet the professors and see where their children are learning the basic sciences. The Physician-Student Mentoring Program got off to a rousing start this year under the direction of Dr. Stephen Pollack, who was successful in matching 140 physicians one-on-one with medical students. The goal of this program is to provide students with a nonacademic advisor who can be available on an informal basis to answer any personal or professional questions they may have. Dr. Anthony Markello has volunteered to chair the Community Physicians Speakers Program. In this program, the Medical Alumni Association arranges for physicians in the community to come and speak to first- and second-year classes to help acquaint them with the hours and dedication needed for the various fields of medicine. We have begun to plan our fourth-year medical student reception, held each spring and sponsored by the Medical Alumni Association. The reception, which will be chaired this year by Dr. Bodkin, is a splendid annual event in which the fourth-year students and their significant others come and celebrate the close of their medical school experience. Finally, plans for Spring Clinical Day 2000 are beginning to take shape. The theme for the day will be "Children's Health," and our Stockton Kimball lecturer, as announced in the last issue of Buffalo Physician, will be Maxine Hayes, MD '73, assistant secretary of community and family health for the Washington State Department of Health. Dr. Bruce Rogers, head of the Division of Maternal-Fetal Medicine at Kaleida Health's Children's Hospital, has also accepted Dr. Colleen Mattimore's invitation to participate in the program. Other speakers have been invited, and we are awaiting their response. This is an exciting time to be on the Medical Alumni Association's board. If you are interested in joining our board, please drop me a line through the Medical Alumni Association office at 101 Cary Hall, or call the office at (716) 829-2778. RICHARD L. COLLINS , MD President, Medical Alumni Association Winter 2000 l11fale Hysicin 33 �CLASS 1940s Ralph T. Behling, MD '43, My wife, Rita Clancy Behling, died in July 1998. I remarried in August 1999 to California widow with five children. Jacqueline Paroski, MD '49, North Tonawanda, Y, Pediatrics. "Julie Cullen and I were the first women interns at the Millard Fillmore Hospital. We were also among the first women physicians in the U.S. Navy. I was the first woman president of the medical staff of the DeGraff Memorial Hospital and first woman to be head of pediatrics at DeGraff." John Sharp, MD '49, Holmes Beach, FL, Internal Medicine. "From 1959 to 1987 I was chief of cardiopulmonary medicine at Hines VA Hospital near Chicago, IL. I was also professor of medicine at the University of Illinois and Loyola University in Chicago. I did research in cardiorespiratory physiology and was associate editor of the fota- nal of Applied Physiology in the 1980s for five years." jacksue@gte.net 34 NOTES rics/gynecology at the University of Mississippi from 1967-1974; assistant/associate dean of Academic Affairs at the University of Mississippi from 1970-1974; and chair of obstetrics/ gynecology at the University of Rochester (NY) from 1974-1995. I am now retired." thiede@rochester.rr.com Irma Waldo, MD '49, Hillsdale, NY, Pediatrics/ Primary Care. "I have skied for 40 years and am serving on the ski patrol at the Catamount ski area in Hillsdale, NY. In addition to private solo practice, I have always done school health, and with the County Health Department held well-baby and immunization clinics. In semi-retirement. I was attending MD and medical director of our county nursing home and Twin County Alcohol and Substance Abuse Services of Columbia and Greene counties." 1950s Eugene Beltrami, MD '54, Williamsville, NY, Obstetrics/Gynecology. "I am director of Medical Legal Affairs for the Department ofVeteran's Affairs nationwide." Henry Thiede, MD '49, Jacob Lemann Jr., MD '54, Pittsford, Y, OB/GY "I was chair of obstet- ew Orleans, LA, Internal Medicine. "I was an l tffal• Hysici11 Winter 2000 instructor in medicine at Boston University School of Medicine from 1961-1963; assistant/ associate professor of medicine at Marquette University School of Medicine in Milwaukee, WI, from 1963-1968; associate professor and chief of Nephrology Division at Boston University School of Medicine from 19681970; professor of medicine and chief of nephrology at the Medical College of Wisconsin from 1970-1990; clinical professor of medicine (part-time), Tulane University School of Medicine in New Orleans, LA, from 1995-present." J]emannla@aol.com Ernest Meese, MD '54, Cincinnati, OH, Cardiothoracic Surgery. "My first wife, Marge, was killed in auto accident in 1984 (32 years of marriage). I remarried Rockell Dombar in 1985 and in 1992 had twins Matthew and Donyel, now seven years old. I am still actively practicing thoracic surgery in Cincinnati, where I have lived for 34 years. I am active in state and local American Cancer Society and am a lifetime board member." Thaddeus Reszel, MD '54, Robert Dshrin, MD '54, Buffalo, NY. "I am with Buffalo Amherst Allergy Associates, Department of Internal Medicine, Rheumatology and Hepatology and senior partner of a fivephysician allergy/ immunology practice. Also, president of the ew York State Society of Allergy and Immunology from (1997-1999). orth Tonawanda, NY. "I am in part-time office practice at Reszel Family Practice." John Kent, MD '55, Hackettstown, NJ, Obstetrics/Gynecology. "I have been golfing, traveling, reading, relaxing for the past 13 and a half years of retired life." Joshrin@worldnet.att.net Robert Pletman, MD '54, Schenectedy, NY, Urology. "I am president of Schenectady Urologic Associates. I served 18 years as chief of urology and five years as chief of staff at St. Clares Hospital. I am active as a hospital trustee." E-mail BernardS. Shapiro, MD '57, writes: "I was forced to retire from general surgery due to a knee injury, and moved to ashua, NH, to live closer to our four grandchildren and their parents. I've done some teaching of medical ethics to seniors at an institute of learning in retirement. I also work CONTlNUED ON PAGE 36 �In Memoriam Kenneth H. Eckhert, Sr. MD '35, a member of the School of Medicine and James E. Long, MD '31, a fonner faculty member in the School of Medi· cine and Biomedical Sciences, died November 10, 1999, one day before his 93rd birthday, in Buffalo General Hospi· tal after a brief illness. Long, who joined the UB faculty in 1946, received a bachelor's degree from UB in 1924 and gradu· ated from the UB medi· cal school in 1931. During his career, he established a private general-medicine prac· tice on Parkside Avenue in Buffalo and also was affiliated with Buffalo General Hospital as an associate physician. When he retired in 1977, he was awarded a Citation of Professional Medicine by the UB medical school. A vet· eran of World War II, Biomedical Sciences' clini· cal faculty for more than 40 years, died November 26, 1999, in his Buffalo was boarded in radiology, radiation therapy and can Cancer Society and berg earned bachelor's and nuclear medicine and was working to build a master's degrees from the quality assurance. His network of patient advo· University of Buffalo before passion was for making a cacy centers around the difference in the treat· country. He had been . entering the Anny in 1942. After the war, he briefly ment of breast disease honored by Los Angeles studied psychology at the and, to this end, he County and the cities of Los Angeles and Santa University of Chicago before helped introduce the use He was 88. A native of returning to UB to study of noninvasive needle Monica, among others, Buffalo, Eckhert graduated medicine. He graduated biopsies of the breast and for his contributions to home after a long illness. from the University of Buf· falo in 1931 and from the university's medical school in 1935. He served on the medical school faculty from 1940 to 1981, retiring as a clinical instructor emeritus. He received the Dean's Award from the medical school in 1968. During his long medical career, Eckhert was chief of sur· gery at Deaconess Hospital and senior cancer research surgeon at what is now Roswell Park Cancer lnsti· tute. Among his survivors is his son, Kenneth H. Eckhert, Jr., MD '68, clinical assistant professor of surgery in the UB medical school. Long joined the Anny in 1942 and served as a Committee of the Ameri· Williamsville home. He was 80. A Buffalo native, Stul· Gardner Cox II, MD '48, died major in the 20th Gen· in June 1999 at age 76 in eral Hospital, University Holyoke, MA. from the School of Medicine other organs in the Los health care. He was au· and Biomedical Sciences in Angeles area. In 1975, he thor of a book titled The 1952. After receiving train· opened one of the first Multimodality Approach centers exclusively dedi· to Breast Imaging and . Harvard University and Mas· cated to breast diagnos· consuHed and lectured sachuseHs General Hospital, tics. Called the Women's internationally on breast . ing in child psychiatry at Stulberg returned to disease, patient· Buffalo and entered centered disease private practice. He state management . served as director of and patient advo· · the Child and Adoles· cacy. In addition, he cent Clinic on three worked successfully · occasions and was with national, state : honored by the clinic andlocalheaHhcare policymakers on for 37 years of ser· · vice. He joined the of Pennsylvania, Unit. Breast Center, this facility women under age 50, and : also worked with the psy· became a medical blue· the allocation of tax . chology department, in· print and effective busi· revenues from the sale of cigarettes for use in structing clinical students in ness model for other such group therapy. Stulberg had centers that were estab· breast cancer research. been a life fellow of the lished across the nation Porrath is survived by his American Psychiatric Asso· in the following decades. wife, Toni Bernay, PhD, ciation since 1967. Porrath served as presi· and his three children: Bunna-lndia Theater clinical associate professor and, while stationed in emeritus of psychiatry, died India, was awarded a November 24, 1999, in commendation for Millard Fillmore Hospital research in malaria after becoming ill in his dent of The American So· Mitchell Bernay of Dallas, ciety of Breast Disease, TX, Ellen Lord of Buffalo, The National Consortium NY, Laura Chalfin of Los . at his home in Beverly Hills, of Breast Centers, and Angeles, CA; and his sis· · CA. A pioneer in medical vice president and trea· ter, Hedria Lunken, and . diagnosis and treatment of surer of the International mother, Tibey Porrath, · women's heaHh, Porrath Society of Senology. He both of Buffalo, NY. died September 12, 1999, Burton Stulberg, MD '52, to mammograms for : UB medical school · clinical faculty in 1989. He · Saar l. Porrath, MD '61, He served in the China· legislation pertaining Saar A. Porrath, MD '&1 was a Fellow of the Ameri· was a member of the can College of Radiology AHernative Medicine treatment. Winter 2000 l1ffall Hysitill 35 �CLASSNOTES parttime now at the VAMC in Manchester, NH, doing GI endoscopy and small surgeries two days a week. I would love to hear from my classmates. n bernshap@aol.com Constantine Cretekos, MD '59, Pi ttburgh, PA, Child and Adolescent Psychiatry. "I have worked at the same agency for 30 years and have loved it." James Doyle, MD '59, Dana Point, CA, General Practice-Anesthesiology. "I am now retired. Recently I was visited by Dr. Ron Hoyt and his wife, Susan. He's a retired Air Force colonel. I also had dinner recently with Jay Stevens and Dorothy Rasinski and talked to Bob Wilbee and Larry Way on the phone. All are in good health." Seymour Grauer, MD '59, Syosset, Y, General Surgery. "I am director of surgery at orth Shore University Hospital in Syosset. I am happily married, actively practicing surgery, doing some administrative work and studying for a master's in medical management at ew School University. I am also traveling. Regards to all!" tgrauer@liu.edu 36 1111111 Hpici11 Dorothy Rasinski Gregory, MD '59, Long Beach, CA, Internal Medicine. "I served with the President's Commission on Ethics in Medicine and Biomedical and Behavioral Research and currently am on the VA's National Bioethics Advisory Committee." Eli Isaacs, MD '59, West Bloomfield, MI, Obstetrics/Gynecology. "I am still working, but not out of necessity." Isaacs l23@aol.com 1950s 1960s Barry Weinstein, MD '69, (R-Amherst) Erie County Legislator, 15th District was re-elected in the ovember 1999 elections. He ran unopposed. 970s Allen L. Carl, MD '79, has been elected to the American Orthopaedic Association (AOA), an international organization with a mission to enhance the quality of musculoskeletal health. Membership in AOA is achieved by those who have made a significant contribution to education, research and the practice of orthopaedic surgery. Carl is professor Winter 2000 of surgery and pediatrics in the Division of Orthopaedic Surgery at Albany Medical College. He specializes in the treatment of spinal injuries and disorders in children and adults. 1980s Thomas Pullano, MD '8D, writes: "Since completing my fellowship in neonatal medicine at the University of Colorado, I have been working in Dallas. I am now medical director of the eo natal Intensive Care Unit at Presbyterian Hospital Dallas and a member of Magella Medical Associates. !ina]" article in the Greenville Magazine. Hollins is medical director/administrator for the Roger C. Peace Rehabilitation Hospital, which is part of the Greenville Hospital System. He is the first African American to ever hold such a post in the hospital system. Hollins began practicing in Greenville in 1991, following completion of his residency training in Buffalo in Physical Medicine and Rehabilitation. His wife, Suzette, earned an advanced graduate certificate in information and library sciences from UB in 1988. They are raising their three daughters in Greer, SC. 1990s Tina Marie Gardner, MD '87, Donato Borrillo, writes from Stamford, NY: "I am extremely busy in a hospital-owned outpatient practice. I also teach reading to atrisk kids, serve as a Cub Scout leader and am an attending at a nursing home. In my abundant free time, I camp with my husband, Joe, and our two sons, Jake (9), and Luke ( 4). MS, MD '90, JD, Dennis C. Hollins, MD '87, PhD, was recently selected for inclusion in the annual "Best Doctors in Greenville [South Caro- writes: "! married Christine Wells of Cleveland, OH, and have a ninemonth-old baby girl, Jessica. After graduating from UB medical school, I went on to obtain my law degree from Case Western Reserve University and am licensed to practice law in Ohio. In addition, I completed an aerospace medicine residency at Wright State University (board certified) and have a commercial multi-engine instrument-rated pilot's license. Currently, my family lives in England, where I practice as a flight surgeon for the 352nd Air Force Special Operations squadron at RAF Mildenhall. Cheers! William Palmer, MD '90, and his wife, Stephanie, announce the birth of Jayson William Palmer on September 6, 1999. He joins his sisters, Janee, 9, and Jilian, 7. Palmer is currently in an office-based physical medicine and rehabilitation group practice, Rehabilitation Associates of Indiana, in Indianapolis, I Krista M. ( Prigg) Kozacki, MD '91 , writes: "Life is wonderful in Florence, S.C. We had our third child, Emily Marie, on July 9. She weighed 7 pounds. Her twin brothers Stefan and Jacob (age 6) think she is their little princess. I more than ever advocate breast feeding to my patients now! I am loving my private practice more and more every day. It has been five years. I also get to interact residents. Call if anyone gets this way." EDITOR'S OTE: Due to space limitations, several Classnotes submissions were held for the following issue of Buffalo Physician. �Your stock may pay more dividends than you thought possible You dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income fOr life, a charitable deduction and reduce or eliminate taxes. And fOr UB it can mean more scholarships, research funds or the realization of your own personal vision and goal fOr the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716l 645-3312. T~ University at Buffalo ':t=:::l The State University ofNew York University at Buffalo • Office of Gift Planning • 103 Center for Tomorrow • Buffalo, New York 14260-7400 • 716-645-3312 �l•ffale Pllyslcla• State IIIYirslty If lew Yerk at l1ffal1 M35 •ail St. 1111c. zz l1ffale lew Yerk 1U1•·3113 Non Prof I Org U S Postage PAID Buffo o NY Per I No 311 We Get Rehab Results! Our Superior ~M Improvement Vs. National and Northeast-em Regional Subacute Facillties Hve Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIM5 M increase vs. the national average for all admissions. • Stroke • Pain Management • Medically Complex • Orthopedic • Infections • Cardiac • Cancer • Joint Replacement Eatll'lg • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. **** The McGuire Team ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! =Inpatient Admissions The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. I = Inpatient Discharge I = Outpatient Follow-Up Our case mix is consistent with the Northeas t and national subacute region. Our average s tatistics are: length of stay - 25 days; age - 78; admission FIM score 72.5; discharge F"JM score - 97.6 ; FIM change- 25 .1 points; length of stay efficiency 1.40; onset time - 17; discharge disposition - 80% to community. Based on 12 months ending March 31 , 1998. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on F!Ms"' rehabilitative outcomes. This tool is !mown as FIMSM< improvement, discharge to home, and cost effectiveness. lnstJument; Functional Independence Measure, developed Our successful rehab program delivers results by the UB School of Medicine along with the Center for j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRs"') rehabilitation services. to establish rehab outcomes that ~~"DU FJ"'JI'T"T~J\J Call 1-888-POSTACUTE. can be measured and calculated ~.L.U.J. ~\7~ "F"'H£ .1 c:/J'fCGULRE Jl DTT to document successful results. 1' .J.I1J CENTEP<B Copyright 1998 Uniform Data System for Medical Rehabilitation, a divisio: f ~ '-.. U8 Foundation Activities, lnc. All rights reserved. Autumn View • Garden Gate • Banis ffill • Northgate B P 0 003 00 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000 Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n03-2000-Winter Table Of Contents A list of subunits of the resource. The 'Insider' Steps Out Back into Shape The Edge of Possibility Medical School Research News Student Column Alumni Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/ccab49be147472dcc459717ee4d7dd5e.pdf a6913708f10bcf62f46ae02019168081 PDF Text Text �l1ffale P'ysiciaa ASS OC I ATE V IC E PRESID ENT F OR UNI V ERSITY SERV I C ES Dr. Carole Smith Petro Dear Alumni and Friends, DIRE C T O R OF P U BLI C AT I O N S Kathryn A. Sawner E DI TO R Stephanie A. Unger I l 5° I N 01 :51 - • f" 'Sl 1' At this writing, we have AR T DIRE C TOR/DESI GNE R just returned from our Dean's Advisory Committee meeting in Las Vegas, ably hosted by Alan]. Kegler joan and Max Doubrava (Class of '59). Max also arranged a mini-reunion of the Class of '59, and I am happy to report that class spirit is very much alive and well. Next month ASSISTA NT DESIGNER Lynda Donati we will be in La jolla to meet with another group of alumni. I have good news to report on the recruitment front: On May 1, 2000, Dr. john Yeh will be joining us as chair of the Department of Obstetrics and Gynecology. Also, on August 1, PROD UC TION COORDI N ATOR Cynthia Todd- Flick 2000, Dr. Kenneth Blumenthal will be joining us as chair of the Department ofBiochemistry STATE UN IVER S ITY O F (see pages 26-28 for details). Our next major challenge will be to shore up the Department YORK AT B U FFALO S C HOOL of Surgery, an essential medical school department that urgently needs some help. By now many of you have probably heard of the federal audit under EW OF MEDICINE AND BIOMEDI C A L SCIEN C ES Dr. fohn Wright, Dean way in Buffalo, involving the medical school and a number of its affiliated hospitals. This type of audit has been experienced by almost one-third of the medical schools in the country and has caused considerable concern at each location. In our very distributed system, it has been very difficult to monitor the practice plans as closely as would be ideal. But the bright side is that, once this is all over, we might achieve a more consolidated system. Similar audits are going on at Stony Brook and Downstate, but we don't have too many details yet as to where our own particular audit is headed. I just wanted to let you know firsthand in case you were to hear about it secondhand. Our medical students are putting the finishing touches on a "Professionalism Program," the centerpiece of which will be a student-generated code of conduct and student involvement in implementation. This has been a much hoped-for student-initiative for some time; thankfully-particularly in this increasingly difficult environment-our students have taken on the challenge. If you care to monitor progress, you can visit the students' website at http://www.smbs.buffalo.edu/CPCx.html. I am certain they would welcome your comments and input. We will be instituting several other facets of this important program at the resident and faculty levels, so stay tuned. We also plan to provide opportunities for input at Spring Clinical Day events. The Mini-Med School, directed by Harry Sultz and Alan Reynard, is a continuing success, and ours is the first in the nation to have a full-fledged "Mini-Med School Alumni Association." More than 2,000 participants have attended the program since its inception EDI TO RIAL BOARD Dr. Bertram Partin, Chair Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder Dr. Alan]. Drinnan Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T . Truax Ms.]ennifer Wiler Dr. Franklin Zeplowitz TEA C HIN G HOSPITALS Erie County Medical Center Roswell Park Cancer Institute Veterans Affa irs Western N ew York Healthcare System K ALEIDA H EAL TH: The Buffalo General Hospital Til e Children 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital C ATHOLIC H EALT H SYSTEM: Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial M edical Center in 1997, and Harry has received recognition for it from the community on a number of instances. just recently, he was recognized as a "Health Care Hero" by Business First, @TIE STITIINIYEISITJ I I lEI Ylll U lllllLD Western New York's business newspaper. In collaboration with the UB Law School, a program based upon a series of medical-legal vignettes and specifically targeted to the legal profession was launched on March 2, 2000. There is a lot going on here- some of it admittedly bordering on the unpleasant, but much more of it progressive and frankly uplifting. ~ ~C/~ ~ jn~:"N R. WRIGHT , Buffalo Physician is p ublished quarterly by the S tate University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alum ni, facu lty, students, residen ts, and frie nds. The staff reserves the right to edit all copy and submissions accepted for publica tion. MD Dean, School of Medicine and Biomedical Sciences T...=.:.. University at Buffalo -:a=:s The State University ofNt'w York �V 0 L U M E 34 , N U M B E R G) p s y H c A N HEALTH SCIENCES AUG 1 4 2000 Features 2 Rehabbing from Within A doctor's tale of trauma, and the long road back BY jONATHAN BEAN , 8 14 MD ' 89 Little Ears, Big Infections Vaccine developed for treating otitis media and COPD BY S. A. UNGER In 1989, soon after beginning his internship, Jonathan Bean, MD, was severely injured when hit by acar while crllSsing the street. Beginning on page 2, Bean, aphysiatrist, tells of his journey back to health. Brain Drain New clues to how alcohol affects the aging brain BY LOIS BAKER ABOUT THE COVER RODS A~D jONATHAN BEAN HOLDS THE SCREWS IMPLANTED IN HIS PELVIS AND LEG AFTER THE ACCIDENT. CovER 12 Michael White, Class of 2000, returns to his adopted homeland of Brazil to complete an infectious disease rotation 18 Program to help students gain entrance to medical school 20 New institute established 21 Grant supports development of two new centers 26 Kenneth Blumenthal named chair of Biochemistry 28 John Yeh, MD, named chair of Obstetrics and Gynecology 30 A salute to the Class of 1945 31James Platt White Society Annual Listing PHOTO 36 News from your classmates and other UB alumni 39 Stuart Collins and Peter julian remembered BY j o s H LEVINE 41 Deborah, Christopher and Adam White Memorial Fund established �Photos by Josh Levine • ................. W-IIIIIIIHI(ast- aftlrllllltllh.,lar ............. ,llhl. I 1111111 ••r•lcl•• ��IKETHEINCANDESCENTBARRELOF ASHOTGUN, the two headlights bore down. There was no turning back. I took two running steps and dove for the sidewalk. In that instant, I recalled afootball game from my youth. After intercepting apass, I was able to dive over the goal line before the tacklers stopped my momentum. I had the elated sense that I would triumph again. Apiercing crack and the sudden sensation of being forcefully twisted through the air jolted such thoughts away. As I carne to rest, 10 yards down the sidewalk, the smell of concrete dust permeated my nostrils. I instinctively attempted to stand, but it became evident I could not control my legs. Blood and torn flesh covered my right thigh. As I untwisted to lie back down, an exquisite raw pain enveloped my pelvis. I cried out for help. No one answered. I cried out again, but in response heard only the receding sound of screeching wheels in the distance. Eventually, assistance arrived. In the ambulance, with the siren blaring, I considered what would occur next. I could see the paramedic's watch on his wrist. Ironically, I would arrive at work on time. Survey of the Damage Twelve hours later, in a clouded state, I awoke in the surgical intensive care unit. There was a lattice of metal rods screwed into my pelvis and a full-length cast encasing my right leg. Surgery had been lengthy. My pelvis had been fractured in two places and my leg in three. More surgery was scheduled for the coming days. The nurse pointed to a button near my hand, explaining that I could control the morphine dose myself. She suggested that I get some rest. Pain ran up and down my body. I gave a press and fell to sleep. When I next awoke, I was in a private room. Dr. M., one of the • l 1 1f a l e Hysiei11 Spr in g 2 000 most respected members of the medical staff, smiled down at me. He explained that I was under his group's care, that my surgery had been 36 hours earlier and that my anesthesia was still wearing off. With some hesitation, he asked, "You're going into physical medicine and rehabilitation aren't you?" "Yeah," I said, "at Tufts." He shook his head in disbelief and said, "Well, I guess you're going to learn rehab from the inside." He pointed to the morphine pump. "These PCA pumps are new. I'm not so sure they' re a good thing." Turning to leave, he patted my cast and said, "Get some more rest. You'll need it." I looked around the room. A half-eaten sandwich and my sister's coat were lying on the chair at the foot of my bed. Still unable to stay awake, I closed my eyes. Occasionally, I awakened to see the faces of my concerned family or a nurse changing my IV, but each time I sank back into oblivion, my sleep deepening. Finally, I fell into a sleep that was profound; blissful, even. But in the distance I could hear someone calling my name. His voice became louder and increasingly urgent. I was being yanked from the comfort of my dreams. I felt him slapping my arm, and then a sharp stab at my wrist. Opening my eyes, I saw Rick, one of my fellow interns, drawing a blood gas. I had never seen him so frightened. He clamped an oxygen mask on my face and told me I was being transferred to the Intensive Care Unit. Later that day, with the overwhelming sensation that I was breathing through a straw, I underwent the obligatory workup. I had suffered a fat embolism. �Long Road Back Pain Mismanagement After an extensive debate, the physicians decided not to intubate me. Though the respiratory distress was a consequence of emboli released from the fractured bone marrow, they still felt that my use of the morphine pump was to blame. Today, I know better; nevertheless, for the rest of my hospitalization I was labeled as someone for whom narcotics should be minimized. Over the course of the next month, I learned firsthand many of the pain-management principles that would later be a part of my physiatry training. For example, I learned that pain medications with a half-life of four hours should not be prescribed every six, and that it takes 15 minutes for a nurse to deliver a prn medication and an additional half hour before it takes effect. I learned about the difference between bone pain and neuropathic pain, and that narcotics do little to quell the latter. Most notably, for the next nine weeks I came to know the unrelenting tedium, frustration and helplessness of pain mismanaged. An important topic in every physical medicine and rehabilitation text is the medical consequences of bed rest and immobility. Bed rest affects every organ system. As a consultant, I am familiar with the facts: Hemoglobin and blood volume decrease; muscle strength weakens l to 3 percent per day; and heart rate elevates one beat for every two days in bed. Conditions like constipation, postural hypotension and contracture often occur. I experienced these and other complications. Upon discharge from the acute-care hospital, my resting heart rate had elevated from 60 to 85, and my weight had fallen from 155 to lOS pounds. Once I was allowed to bear weight in my eighth week of hospitalization, the postural hypotension was so severe that it took 10 days of tilt-table training before I could stand without passing out. Coupled with the narcotics, the constipation became so bad that enemas and manual disimpaction were commonplace. B Devoted Friendship, the Best Medicine esides all of these issues, lying in bed for nine weeks was both boring and depressing. My concentration was clouded, so reading was very difficult. I became far too acquainted with the emptiness of daytime television. Evenings were the best times because my girlfriend, Melissa, would visit. She brought a VCR and we watched rented movies until visiting hours ended. Nights were very hard. Minus daytime distractions, my pain escalated, and the night nurses were always slower about delivering medications. Lying in the darkness, only partially able to turn side to side, I listened to the sounds of the hospital, wondering ifl would ever walk again. The worst times, however, were the mornings. In my dreams I was always healthy-swimming, climbing mountains or just running with reckless abandon. Waking to the cold truth of the hospital room and my broken body was like being hit by a car all over again. Importantly, for three straight weeks, I was distracted by the sound of snoring. Reclined in the chair at my bedside was Dave Blaustein, a fellow intern and one of my best friends from medical school. After completing his night-float shift, he visited me rather than going home to sleep. Unshaven, with his rumpled lab coat draped askew, he often had a fresh banana peel lying on his -Jonathan Bean today chest. (My family kept the bedside stocked with fresh fruit and juice.) with his wife, Melissa, and long· Upon waking, I'd nudge Dave with time friend and DB alumus my long-handled reacher, and for the next 20 minutes we'd talk like David Blaustein, MD '89, right. we always had, joking about the doctors who took themselves too seriously and cursing the nurses who had given us a hard time. We also talked about sports and politics and shared stories of past escapades. He always left time to hear how I was doing and to validate my frustrations. As much as anything else, he helped me to feel as if things were normal, even if circumstances were not. He taught me about healingthat there are times when devoted friendship is the strongest medicine of all. Spring 2000 l1ffala Pbysic i u 5 �A The Group of Four fter nine weeks of lying in bed fulfilling the typical passive role of a patient in an acute-care hospital, I was transferred to Magee Rehabilitation Hospital. Inpatient rehabilitation requires a patient to function as independently as possible. Patients often wear street clothes, signifying a sense of normal life. For most patients, however, it feels more like boot camp. Given my anxious and disoriented look, it was clear to all those around me that I was a new admission. After having gone through the multiple initial evaluations by nursing, physiatry and social work, I was told to make my way down to the cafeteria for dinner. Now that the external fixeter had been removed from my pelvis, I was able to sit upright and independently propel my loaner wheelchair. Staff helped me when asked, but otherwise tended to those with greater needs. The other patients observed me, though no one initiated conversation and most avoided eye contact. This was particularly true for a group of four youngadult paraplegics of diverse racial background who wore fingerless black leather gloves and were unified by their reliance on lightweight custom wheelchairs. They joked together, darting glances in my direction during pauses in their conversation. Over the next few days, this group of four seemed to follow me around. They often hovered closely, be it in the cafeteria or the therapy gyms. Despite this progress, it took Like a group of adolescent skateboarders, they practiced pulling four more surgeries and five more years wheelies and jumping curbs. of rehabilitation before I considered They observed with knowing curiosity as I strengthened my myself substantially recovered. atrophied arms and shoulders. Though nearby, they never approached or outwardly addressed the fear I felt inside. Then on the fourth day, my physical therapist announced that it was time for me to use the stationary bike. Despite the fractures and nerve injury, the healthcare team agreed that with the return of strength, I would walk again . Initially I was concerned about pain or falling, but I felt more confident with each minute of riding. As my legs became more comfortable, I increased the pace. Closing my eyes, I soaked in the long-missed exhilaration of exercise. Eventually, I became aware that the group of four was parked around me. They had mystified looks on their faces. One spoke, "So, you can use your legs." "Yes," I said with a selfish pride, ''I'll start walking with crutches tomorrow." "Wow, that will be great for you," he said, with a mixture of generosity and sadness. 6 l affal1 Hysicin Spring 2000 I sensed the awkwardness of the moment and struggled with a response. He spared me the discomfort by asking about my injuries. He shared that he had suffered a lower-cervical spinal cord injury as an interscholastic wrestler. The others had suffered injuries from a motor vehicle accident, a gunshot wound and a diving accident. They wished me the best and then slowly wheeled away in separate directions. Framed by wheelchairs, with their narrow legs folded neatly beneath the seats, they suddenly looked young and vulnerable. At that moment, I realized that I had been undergoing a rite of passage, an initiation into the world of spinal cord injury (SCI). Once it was clear that my spinal cord was spared, the process suddenly ended. I became a spectator, not an insider. As a physiatrist, my training has taught me that in SCI almost all body systems are altered. The adjustments to the many social and emotional changes are even more challenging. It can be a very difficult and lonely transition. Throughout the rest of my hospitalization, I rarely saw any of those four again, though they always greeted me with kindness when I did. I Imaginary Finish Line n late January 1990, after three months ofhospitalization, I was discharged to home. In March, I returned to work. Despite this progress, it took four more surgeries and five more years of rehabilitation before I considered myself substantially recovered. Exercise and patience were my daily medications. Most of the feeling has returned in my leg, and every once in a while I go for a long run. At last year's Spring Clinical Day and Reunion Weekend-which included a reunion for the Class of 1989-I returned to one of my favorite places in Buffalo, Delaware Park. Running around the familiar path, my thoughts sifted through the last 10 years. With my asymmetric gait, I sprinted the last half-mile as if it were the end of an important race. As I passed the imaginary finish line, no one cheered or celebrated. The victory was a private one. My experiences did not dramatically change my goals, nor did they lead to some sort of religious epiphany. They have been woven into the fabric of my life. Ultimately, illness is a solitary experience of adjustments that are only partially shared with others. In recognition, as a physiatrist, I lend a hand, assisting my patients to feel intact again. 4D �Spring 2000 luffal1 Hysiciaa 7 �BY s. A. UNGER PHOTO BY K.C. KRATT Little Ears, Big Iiifections vaccines to prevent ear and respiratory tract infections lF YOU WANT TO GET the attention of parents with young children, just tell them that scientists are making significant strides toward developing a vaccine to prevent recurrent ear infections. A leader in this endeavor is Timothy F. Murphy, MD, a University at Buffalo professor of medicine and microbiology whose research is currently funded by a five-year, $1 million grant from the National Institutes of Health (NIH). The vaccine Murphy is developing targets a bacterium called non typeable Haemophilus influenzae (NTHI), which not only is the second most common cause of ear infections (otitis media) in children, but also is a leading cause of recurrent infections in patients with chronic obstructive pulmonary disease, or CO PD. A vaccine against THI is especially promising because it would be effective in both populations of patients. 8 l•ffale Plysicial S p ri n g 2 000 ��I LITTLE EARS, BIG INFECTIONS EDIA and COPD are enormous national health problems in terms of human suffering and cost," rphy, whose work in this area has been continuously funded by the NIH since 1983. "About 80 of children have a least one episode of otitis media by age three, and it is the most common reason £ rvisi s to pediatricians. Recurrent otitis media is painful and because it impairs hearing, it is associated with d lays speech and language development, as well as with learning problems in children as they reach school PD, which includes chronic bronchitis and emphysema, is the fourth leading cause of death in the States, with infections being the most common singie identifiable cause of these deaths." der for a vaccine to be effective against recurrent ear .._........-~,ions, it must work within the first months of a child's life, according to Murphy. This is because if a child's throat becomes colonized with NTHI during his first year of life-even in the absence of an ear infection- he may then be prone to ear infections throughout childhood. "Some vaccines do not induce an immune response in children under age two. It will be critical to develop a vaccine for ear infections that is effective in infancy because it will be important to immunize early to prevent recurrent infections, which are the real problem," he explains. To that end, Murphy's work focuses on two proteins on the outer membrane surface ofNTHI-P2 and P6-each of which has the appealing feature of being able to generate antibodies in infants. "P2 makes up 50 percent of the protein content of the outer membrane and is an immunodominant protein, which means it induces the human host to make antibodies to it," says Murphy. "And what's interesting about it is that if we look at its amino acid sequence among strains, it's different, particularly the parts of it called 'loops' that stick out." It turns out that these heterogeneous loops of P2 were key to answering a crucial question driving vaccine research in this area: Why do children with normal immune systems get recurrent ear infections? Itwas Murphy, working in collaboration with Howard Fadden, MD, at Kaleida Health's Children's Hospital ofBuffalo, who played a leading role in answering this question. "We now have reason to believe that it's because these children with otherwise healthy immune systems are making strain-specific antibodies to these so-called antigenically heterogeneous loops on P2, which leaves them susceptible to reinfection with the heterologous strains," Murphy explains. The fact that the strains are varied "outlines the challenge we face in trying to make a vaccine to prevent these recurrent infec- .. .. .. 10 laffal1 Pbysiciae Sp rin g 2 00 0 tions," he says. "So, the approach we've taken is to try and identify the proteins on the surface of the organism that are the same from strain to strain, or what we call 'antigenically conserved."' In his current study, Murphy has fully explored this approach and he and his team have successfully identified conserved loops on the P2 molecule. "In fact, we can now generate antibodies to these loops, and they kill multiple strains of the organism," he reports. The other protein Murphy is focusing on in tandem with P2 is P6. Since discovering this protein 15 years ago, Murphy has learned much about it, including the fact that Astrategy to present the it is antigenically conserved; in other words, it is identical in amino acid P& molecule for destruction, sequence from strain to strain. In with the goal being to produce addition, he has made several other discoveries that suggest that P6 would a"lethal mutation" in the make a good vaccine antigen. First, he targeted bacterium. determined that the protein is on the surface of the organism, so antibodies can easily bind to it. Second, studies he conducted on human serum-and confirmed by animal studies in other labs-indicate that antibodies to P6 will protect the host by killing the organism. Finally, he has demonstrated that P6 is critical to the viability of the organism; it can't live without it. This latter feature is noteworthy, according to Murphy, because bacteria, like all microbes, can shut off production of surface antigens if they are targeted for destruction, a trick scientists term "phase variation." "P6 is critical to the organism, so it can't shut it off," he says. "In fact we've actually attempted to make a mutant of NTHI that lacks P6 and have been unable to. The organism won't survive without it; it's a lethal mutation." The downside ofP6, however, is that it makes up only 5 percent of the surface of the protein, so in effect it is "hidden" by the organism. "What remains to be determined, therefore, is whether there's enough of a target there for the vaccine to work," Murphy explains. An answer to this question will begin to unfold in the years ahead, as UB has signed a licensing agreement with a pharma- �MURPHY IS ACTIVELY EXPLORING ANOTHER INTRIGUING POSSIBILITY: DEVELOPING A VACCINE THAT CONTAINS MULTIPLE ANTIGENS HOMING IN ON MULTIPLE TARGETS. ceu tical company, Wyeth-Led erie, in Rochester, New York, which is currently testing in humans a P6 vaccine based on Murphy's research. "What my lab has done is identify and characterize vaccine antigens and perform initial studies supporting the potential viability of the vaccine; it's up to the pharmaceutical companies to produce large amounts of the vaccine antigen for testing, which is now happening," says Murphy, who holds multiple patents on the P6 molecule pertaining to its gene and protein sequences and purification and diagnostic methods. C urrently, Murphy is dedicating his research efforts to continuing to learn as much as possible about the P6 molecule and the human response to it. "In particular, I want to know what parts of the molecule they [vaccinated individuals] are making antibodies to. Recently, we've done a lot of work on the antigenic structure of the P6 molecule, looking at how this protein is arranged in the outer membrane. Now we want to identify the specific parts of the molecule that are protective." Murphy is also actively exploring another intriguing possibility: developing a vaccine that contains multiple antigens homing in on multiple targets. Given the fact that P2 is so antigenically appealing, he posits, "Why not splice out its immunodominant loop-loop five, which is very heterogeneous from strain to strain, and people love to make antibodies to it-and put in there an important part ofP6? In other words, why not make P2 a vaccine-delivery system?" By developing a P2-P6 hybrid molecule, he says, "We'd be taking advantage of the immunodominant observation-that humans love to make antibodies to P2. But then we'd manipulate the molecule by putting in the P6 we want the host to make antibodies to. In essence, we'd be using the 'juicy' part ofP2 to rev up the immune system to kill p 6, which SanjaySethi,MD, collaborates will have a bactericidal effect. So we wouldn't be focusing exclusively on either P2 or P6. We'd be taking both routes." CD S p ring 2000 with Murphy on clinical studies. l11fal• Hysiciu 11 �S B MI W C H T U D E N T COLUMN Brazil Redox v HAEL I T E Mi chael White , MD ' 00 , Returns to Hi s Adopted Homeland ERY QUICKLY l REALIZED that my infectious disease rotation in Brazil was going to be a novel experience when, on my very first day at the Hospital Ferreira Machada, our group of 20 medical students was led by our professor into a room where a fouryear-old girl lay suffering on a cot. I .. .. c 12 l•ffal• nysicia• She was feverish and very jaundiced, and her abdomen was distended. As the doctor approached the child to perform an exam, she cried out with anticipatory pain. Very calmly and gently, the physician examined the wary child. It was obvious that every nerve ending was hypersensitive and that each touch sent bolts of pain through her tiny body. To give us further insight, the parents recounted the story of their child's illness. Approximately 10 days earlier, she had complained of abdominal discomfort and fatigue, which had progressed to nausea and vomiting. She then refused to eat, began to look yellowish and developed a fever. The physician took her parents aside to describe the gravity of the situation to them, explaining that their child's liver was not working well, which was why her skin tone was yellow and her abdomen was Spring 2 0 00 enlarged. Of even greater concern, he explained, was the fact that the minerals in her blood were not being maintained at appropriate levels. The child, he added, was also at a high risk of bleeding because her platelets were low. Unfortunately, the parents refused to have her placed in the ICU because their visitation time would be markedly reduced. During this exchange, we also learned that the family was very poor and unable to pay to have a sample of the girl's blood sent to Rio de Janeiro for etiologic determination of hepatitis. As a result, the students decided to pay for the test themselves. The next morning, we learned that the child had died. A week later the lab report arrived, confirming the infectious agent as hepatitis A. This shocking initiation into the Brazilian healthcare system was distressing, yet educational and very beneficial. Compared to the health-care system in the United States, the Brazilian system appears to be much simpler and more direct. As I soon discovered, however, it has an acute yet broad pathology of its own: Despite the fact that many of the country's health-care facilities possess all the amenities of American facilities, the Brazilian public is far too poor to access them. I also learned that in Brazil treatment regimens are frequently engendered without a definitive, formal diagnosis; for example, the child with hepatitis was treated with corticosteroids based solely on history and prior to etiologic delineation of her illness. Furthermore, I was very surprised to discover that clinical impression and physical diagnosis play the primary role in diagnosis and treatment in Brazil, whereas in the United States, a physician's interpretation is used as a startingpointand is characteristically implemented only after diverse and diagnostic laboratory tests are performed. This approach to diagnosis and treatment, although discussed frequently during medical school, had previously struck me as fraught with error and unreliable for practical application. However, my Brazilian experience taught me the merit of a methodical approach to the ill patient that �ALTHOUGH MY FOREIGN LANGUAGE STUDIES CONSISTED ONLY OF A SEMESTER OF EIGHTH-GRADE LATIN, l WAS A BOLD 18-YEAR-OLD WHO JUMPED AT THE CHANCE FOR SUCH AN ADVENTURE. UNDEltSTANI)ABtY, MY PAREN'f-5 WERE ANXIOUS ABOUT THEIR SON MOVING MORE THAN 5,000 MILES AWAY, BUT THEY WERE VERY SUPPORTIVE. includes a thorough and well-planned history and physical examination, as well as a fundamental understanding of disease processes and a faith in one's own medical judgment. In contrast, when working in a health-care system where frequent laboratory studies are the exception, fundamental understanding and application of basic medicine is the rule. In the following years, I often dreamed of returning to Brazil, and once I entered medical school, the idea of setting up a rotation there intrigued me. Not only would such an experience allow me to revisit that beautiful country, it would give me an opportunity to practice the new love of my life, medicine. Just Another Brazilian Medical Student A Homecoming of Sorts 1 hese experiences and powerful impressions were a stimulating introduction to the month-long infectious disease rotation I undertook late in the summer of 1999 as part of my fourth year of medical school. While the rotation was the source of many new and exciting insights, my visit to Brazil itself was not a novel experience; in fact, it was a homecoming of sorts, a sequel to a year-long visit I made to the country in 1990 while a senior at Portville Central School near Olean, New York. While in high school I had met a Brazilian exchange student, and we quickly became friends. As his visit drew to a close, he invited me to return to Brazil with him and live with his family. Although my foreignlanguage studies consisted only of a semester of eighthgrade Latin, I was a bold 18-year-old who jumped at the chance for such an adventure. Understandably, my parents were anxious about their son moving more than 5,000 miles away, but they were very supportive. My first few months in Brazil were among the most challenging of my life. I battled through various illnesses, a completely new diet, an inability to speak the language, and initiation into a very different culture. I attended a local public school, met more Brazilians, joined a basketball league and found a teacher who was willing to tutor me in Portuguese. Slowly, I learned. Through charades and common sense, I began to acquire a vocabulary and an understanding of the culture. My peers taught me how to speak basic Portuguese, including the slang terms, and my teacher taught me formal Portuguese, as well as how to read and write the language. By the time I returned to the United States in 1991, I was very proud of the fact that I could be mistaken for a Brazilian teenager due to my fluency in Portuguese. I n the fall of 1998, I began to contact friends in Brazil.to he.lp me arrange a rotatiOn 1n Campos, a city of 500,000 people located three hours north of Rio de Janeiro. Its economy is dependent upon sugarcane plantations and the factories that produce sugar granules, drinking alcohol and alcohol for use as fuel in cars. As residents of a plantation town, many Campistas are poor and uneducated; few study beyond high school. With the help of my Brazilian friends, I obtained contacts at a private hospital (Hospital Geral Doctor Beda) and a large public hospital (Hospital Ferreira Machada). Through these contacts, arrangements were made for my rotation. Prior to my departure, I spoke with Dr. Nelia Artiles Freitas, head of infectious diseases at Hospital Ferreira Machada. We outlined my responsibilities, agreeing that, throughout my stay, I would be treated as one of the Brazilian students from the local medical school (faculdade de medicina de Campos) studying infectious diseases. As a result, immediately upon my arrival in early August, I assumed the same hospital schedule as the other students; I also researched diseases, attended classes and took exams. Over the course of my rotation, I saw numerous infectious disease cases at various stages, including but not limited to lepromatous leprosy, leptospirosis, herpes encephalitis, tetanus with sorriso sardonicus, pulmonary varicella, ascaris, gonorrheal meningitis, disseminated TB, various fungal infections, HIV and I CONT I NUED ON P AGE While in Brazil, White was hosted by the Fusco family. Pictured above, is 11·year·old Gregory Arenari Fusco Soares, learning how to use a stethoscope by listening to his ownhean. 4 0 S pri ng 2000 luffale Pbpician 13 �14 �BY LOIS BAKER Alcohol' effect on the aging brain PHOTO BY K. KR TT Does drinking really kill brain cells? If not, what oes happen, and h w? Is the damage permanent? oes chronic alcohol abuse in late adulthood increase the deficits caused by aging? For 16 years Roberta J. Pentney, PhD, U professor of anatomy and cell biology, has pondered these basic questions concerning chronic alcohol abuse and brain function. Spri11g 2000 Blff311 Pbysiciu 15 �C ELL MORPHOMETRY-the quantitative study of the form and structure of cells-is Pentney's field, and her painstaking work with neurons in the cerebellum, the control center for movement, coordination and equilibrium, has yielded striking and unexpected answers to difficult questions. For example: Q: Does alcohol kill brain cells in adults? Not in the cerebellum. Q: What does happen? Alcohol damages dendrites, reducing message traffic between neurons. Q: Is the damage permanent? No, it's mostly reversible; however, neuronal structure is changed in the process. Q: Does alcohol abuse make people age faster? No. Age and alcohol appear to act on neurons in different ways. Why is this information important? "It shows that we are moving toward finding out how alcoholism damages the brain , information that eventually could lead to treatments or prevention of the destructive effects of alcohol on brain function in humans," Pentney says. "For a long time, people were looking at cell loss as the real measure of alcohol's effects," she says. "What we've seen through this research is that you don't have to lose entire neurons to disrupt brain function. All you need is damage, and we have developed a model for that kind of change with alcohol. "Damage to the brain caused by alcohol, we now think, is probably similar to the way alcohol affects the liver: There is dam age and repair. Alcohol acts on a 16 1111111 Pbpiciu Sp r ing 2000 number of molecules that interact with each other. Just getting to the point where we can look at a specific part of a cell that is involved is a big step forward. " Identifying that particular part of the neuron affected by alcohol-a structure called the smooth endoplasmic reticulum, or SER-has been accomplished with the aid of $1.4 million in grants from the National Institute on Alcohol Abuse and Alcoholism , including a current grant for $645,000. Pentney's research and that of her coinvestigator, Cynthia A. Dlugos, PhD, UB research scientist in anatomy and cell biology, concentrates on a condition called lateonset alcoholism. "Everybody else has been interested in dealing with alcoholism in the early also bears a striking resemblance stages of life," PenThe Purkinje neuron with full to a tree, and in scientific partney says. ''I'm looklance its branches are called, acing at a span during dendritic arbor; a magnification cordingly, the dendritic arbor. maturity that applies of (A) terminal segments and Pentney and colleagues are to human alcoholism, and at the com(B) loss of a terminal segment. on intimate terms with these arbors . They have examined bined conditions of thousands of light-microscope images aging and alcoholism." The object of her attention is a specific and electron micrographs-photos type of brain cell in the cerebellum called a taken with an electron microscopePurkinje neuron. Pentney considers this looking for changes in shape and signs neuron one of the most spectacular in the of thinning, and counting dendritic brain. Under the microscope it resembles a branches and segments and measuring vast riverine system with branching den- their length s. They have al so determined drites forming the tributaries. The neuron the total number of synapses, the sites �on the ends of branches that receive nerve impulses. Conducting this kind of research with humans is clearly out of the question. Pentney has been working with Fisher 344 rats, whose 22- to 27-month life span has been fully studied and documented. To mimic the neuronal responses of a middleaged human, she begins her interventions with rats that are 11 to 12 months old. In all investigations, Pentney and colleagues used long-term study periods, usually 40 to 48 weeks, to mimic human chronic alcohol intake. One group of middle-aged rats received a liquid diet containing ethanol. A control group of the same age received the same liquid diet with the same number of calories but without the alcohol, and a second age-matched control group received a standard rat-chow-andwater diet. The researchers examined and compared the structure of Purkinje neuron dendritic arbors from aU groups. Over the years a picture emerged of the of synapses. "This was a hopeful note," Pentney says. "Every change we saw was a reversible phenomenon. The brain was repairing itself after alcohol damage." That was good news, but it came with a cautionary note: While the number of terminal segments and synapses had returned to normal, the researchers knew from experience that their placement on the dendritic arbor most likely would be different than before treatment. Pentney's results supported the hypothesis that Purkinje neurons were changed after recovery. "The implications here are clear," she says. "The branching pattern in Purkinje neurons after recovery is not identical to that before recovery; you don't end up with the same arrangement. There is a fair amount of recovery, but the neurons may not function in the same way. A different branching pattern would result in a change in message transmission, which would change the way that part of the brain works. channels, they discovered that the channels were dilated in alcohol-fed rats. This change in neurons, Pentney says, is usually associated with the entry of excess calcium into the cell. o dilation was found in the control animals. "Calcium turns things on in cells," Pentney says. "Too much calcium stimulates too much activity and can kill cells. The SER sequesters calcium within the cell until it is needed. We're thinking that in the case of the Purkinje neuron, localized dilation of the SER is causing the loss of dendritic terminal segments but is not killing the whole cell." Knowing that alcohol-fed rats recouped their synapses after recovery, the researchers expected to see the SER function return to normal also, but it did not. At some point during alcohol recovery, aging began to have its own effect, independently producing dilation of the SER membrane. Finding out when in the life cycle this phenomenon occurs is important, Pentney says, because "THE BRANCHING PATTERN IN PURKINJE NEURONS AFTER RECOVERY IS NOT IDE TICAL TO THAT BEFORE RECOVERY; YOU DON'T END UP WITH THE SAME ARRANGEMENT." effects of alcohol on these neurons. The researchers observed a significant thinning of arbors in alcohol-fed rats, compared to controls. Next, they showed that this thinning resulted from the loss of terminal segments-those at the periphery of the arbors- at the point where they branch from the parent shaft. Because synapses are located on terminal segments, losing some of these segments would result in fewer synapses and, therefore, a reduction in message traffic between neurons in this part of the brain. According to Pentney, these findings may relate to some of the abnormal movements often seen in alcoholics, such as unsteady gait, tremors and Jack of coordination. Turning to examining the damage to Purkinje neurons after recovery from alcohol treatment, the researchers were in for a surprise: Expecting to see thin arbors and a Joss of synapses, they found instead lush dendritic arbors and the normal number "We now had a model that might apply to what is happening in recovering alcoholics," she says. "Most of their motor functioning returns to normal, but some does not." Having determined that parts ofPurkinje neurons disappeared in alcohol-fed rats, the questions now to be answered were, Why and how are these segments being eliminated? Pentney and colleagues considered the possibility that the segments had atrophied from lack of stimulation from interconnecting nerve cells in the cerebellum, which may have been killed by alcohol. That turned out not to be the case. They found instead a completely different mechanism at work. They were able to show that the cellular structure responsible for regulating the flow of calcium within the neuron- the smooth endoplasmic reticulum- was being disrupted in the alcohol-fed rats. Measuring the diameter of these calcium it will help define how alcohol and aging impair brain function-information that is relevant to recovering human alcoholics. "This information tells us that alcohol and aging may act on the brain independently," she says. "It also indicates that these two conditions are disrupting control of calcium in different ways, only one of which leads to deletion of dendritic segments and, by extension, to impairments of normal brain function." Next, the researchers hope to determine exactly what part of the SER membrane is being disrupted. "We are moving toward a mechanism of alcohol's effect on the aging brain," Pentney says. "This research allows us to look at particular components of neurons and understand how their function is related to structure. Maybe if something is missing, we can supply it. Maybe all we need is a single change to prevent these alcohol-induced impairments." <D Spri n g 20 00 lu ffaf• Hysic i aa 17 �MEDICAL B B E SCHOOL N E w s y T s y SAWYER Support for economically and academically disadvantaged students HE AMS PosT-BACCALAUREATE P ROGRAM takes potential medical students who have been impeded by special circumstances in their application to medical school and helps them prepare to try again. Cosponsored by the Associated Medical Schools (AMS) of New York and the University at Buffalo, the program was started in 1991 to promote minority enrollment in the state's medical schools. Currently, it enrolls 14-20 economically disadvantaged or minority students each year. "The Post-Baccalaureate Program is a well-coordinated, structured program of courses, counseling, tutorials and support that provides students with the opportunity to gain requisite skills for entry into medical school," says Carolyn Hamilton, EdD, assistant dean for minority affairs at the University at Buffalo School of Medicine and Biomedical Sciences. "It was designed for applicants who have been denied admission to medical school, to assist them in improving their performance in academic areas where they have shown weakness." Qualities of Character Enrollment in the program is by invitation, with admissions directors at eight participating AMS institutions referring students based on their positive showing during preadmission interviews. Once students gain entrance into the program and successfully complete all of its requirements, they are guaranteed acceptance into the medical school that recommended them . "These applicants represent a diverse cross section of the state's minority population," Hamilton says. "The chief thing they have in common is that they're talented, but they may be lacking in one area or another. The admitting school refers them to the Post-Baccalaureate Program because they show great potential, and because the school recognizes that if they had had that certain 'missing piece,' they would have been accepted." The program allows students to demonstrate abilities that may not be highlighted during a typical medical school admissions interview, says Adrian Jones, PostBaccalaureate Program coordinator at UB. 18 1 1 11111 Pb ysicin Spring 2000 Jones believes that because there are so many highquality applicants vying for a limited number of medical school slots, the interview process is geared to exclude rather than recruit students. This approach, he says, tends to work against economically disadvantaged candidates, who may be highly competent but may not have had exposure to the types of experiences and opportunities available to more affluent applicants. "Every person in th is program has had to deal with difficult circumstances and challenges,'' Jones says. "The fact that they've been able to function and to perform so well academically demonstrates qualities of character that can't always be measured in a one-hour interview." c c .c " �AChance to Thrive ow in his second year at UB's medical school, George Figueroa typifies the sort of person for whom the PostBaccalaureate Program was designed. As the youngest member of a large, close-knit family, Figueroa has carried the primary responsibility of financing his own education. With the aid of vari ous grants and loans, and sometimes two jobs at a time, Figueroa man aged to put him self through school at Rochester Institute of Technology. As undergraduates, he and his wife, Carol, planned a future that would include a family medical practice for him and a network analyst's career for her. Figueroa concentrated on maintaining a record of solid academic achievement while keeping his family afloat financially. Every spare moment was consumed by school, work and the prerequisite hours of community service so necessary to distinguish applicants in the eyes of medical school admissions officials. For the Figueroas, the Second·year student George Figueroa dream was well worth the sacrifice. works with Carolyn Figueroa's first application to mediHamilton, EdD, to cal school was declined because his provide other Medical College Admission Test students with the (MCAT) scores were not competitive. support he knows will Determined to succeed, he enrolled in make adifference. an MCAT preparation course and repeated the test. Although he was able to improve his score, the application period had passed by the time he completed the course, forcing him to wait another year. Figueroa's second attempt was only slightly more successful, garnering interviews by interested admis- sions officials but still no acceptance letters. "They say that every time you apply to medical school and get turned down , your odds of acceptance diminish," he says. "At the time, I was doing customer support for a cellular company and I was miserable. When my second try didn 't pan out, l was very discouraged." Growing increasingly anxious, Figueroa began researching other options, including a year-long graduate program in medical science at Hahnemann University in Philadelphia. While enrollment in the program offered a chance at medical school admission, there were no guarantees. Moreover, financial constraints on the famil y meant that Figueroa would have to leave his wife and two young sons behind in Rochester while he moved to Philadelphia for the year. Despite the drawbacks, he decided to go for it. "Being away from the famil y was the most difficult part," Figueroa says. "Philadelphia was a 14-hour bus trip from Rochester, and I couldn 't go home very often-only about once every four to six weeks. Our youngest wasn't even a year old when I started the program, and every time I'd come home he'd be bigger, taller and heavier. " Though grueling, the experience deepened Figueroa's resolve to achieve his goal. After completing the program in Philadelphia, he was ready to try again. This time he was placed on several medical schools' waiting lists, and most important, although his application was declined by UB, the university invited him to enroll in the Post-Baccalaureate Program. " It was an opportunity I couldn't refuse," Figueroa says. Although the program would require him to spend another year in preparation, he was assured of admission to the UB School ofMedicine and Biomedical Sciences if he successfully completed all program requirements. "The [Post-Baccalaureate] Program helped me immensely," he says, in retrospect. "I can see that if I'd gotten into medical school without the coursework, I'd have been like a guppy in a sea of sharks. All the pre-work gave me a much stronger foundation and has made the current work much easier. For one thing, I don 't have to spend so much time focusing on the minutia, so I can concentrate on some of the more difficult concepts. " In addition to keeping up with his hefty class schedule, family life and part-time job, Figueroa is committed to helping others navigate the path to medical school. CONTINUED ON PAGE ...... ......... "EEIIJ..- --.......... 1'111 ....... .......... ...... mlrllniJ . -.......... ..... 22 Spring 2000 l 1f f al1 Pb ysici a 1 19 �M B E L L E D C A L SCHOOL E w s y E New Institute for lasers, Photonics and Biophotonics N GoLDBAUM he University at Buffalo has established a new multidisciplinary institute to conduct research designed to harness the power oflight in a broad spectrum of applications and potential products, ranging from cancer therapy to telecommunications. The idea behind the formation of the Institute for Lasers, Photonics and Biophotonics is to foster economic growth in Western New York by tapping into UB's strengths in lasers, biotechnology and photonics (the use of photons, instead of electrons, as a medium for processing information). "The medical school is very excited about the institute," says Bruce A. Holm, PhD, the school's senior associate dean, and professor of pharmacology and toxicology and gynecology-obstetrics. "Our interest is twofold, related to the development of new therapeutic modalities for the treatment of conditions ranging from cancer to skin disease, and to the opportunity to use the institute as a mechanism for establishing a true biomedical engineering program that will expand our current activities in other areas." "Nanoclinics" aBillionth of aMeter in Size The Institute for Lasers, Photonics and Biophotonics- which will be headed by Paras Prasad, PhD, SUNY Distinguished Professor in the departments of chemistry and physics and Samuel P. Capen Chair in the Department of Chemistry- has its roots in UB's Photonics Research Laboratory (PRL), established in 1990 and considered one of the most advanced and comprehensive facilities for photonics research in the United States. One of the most promising technologies 20 N l affall nysicial Sprin g 2 000 developed by institute researchers is the nanoclinic, described by Prasad as "the world's smallest clinic." This tiny nanobubble-about a billionth of a meter in size- is designed to perform any one of a number of varied diagnostic or therapeutic tasks by carrying a chemical treatment or diagnostic tool to a specific site in the body. In cell-culture experiments, the group has already developed one formulation of the nanoclinic that selectively destroys cancer cells without the use of chemotherapy. "The entire purpose of this is to take the therapy inside the cancer cell," says E. J. Bergey, PhD, research associate professor of chemistry at UB. "The advantage of the nanoclinic concept is that we can target specific cancers and effect the therapy from within the cancerous tissue or cell, minimizing collateral damage to the healthy cells. The size of the nanoclinic is critical to allowing for efficient distribution throughout the body." The nanoclinics have the potential to be remarkably versatile in carrying optical probes, drugs, genes, inorganic compounds, controlledrelease substances and other diagnostic and therapeutic agents. In addition, hormones, antibodies or other appropriate chemical agents can be attached to the surface to selectively target specific types of cells, according to Bergey. "The nanoclinics can be of SUNY Distinguished Professor Paras Prasad, PhD, heads new institute. 'I tremendous benefit in the noninvasive treatment of early-stage cancer and infectious disease, as well as in gene therapy and oxygenation of damaged tissues," he says. To date, the institute has developed a working prototype and samples of the nanobubble material, both of which are available for testing. The Big Picture In the years ahead, the Institute for Lasers, Photonics and Biophotonics will build on its existing network of partnerships with both industry and research. Within the university, it already has ongoing relationships with other photonics research programs in the School of Dental Medicine, the School of Engineering and Applied Sciences, and the Department of Physics. In addition to I~ NTINUEO ON PAGE 22 • .." < ... �Support for Two New Centers an~ \ $3 . 8 million gr ant from Howard Hughes Medical Institute f B v L o I S four-year, $3.8 million award Medicine and Biomedical from the Howard Hughes Sciences. "It reflects well B A K E R Medical Institute has been not only on the quality of granted to University at Buffalo ' s Bruce Holm's proposal, but also on School of Medicine and Biomedical the university and its reputation. Sciences to speed development of two "In making the award to VB, new research centers. the Howard Hughes Medical InstiThe award will fund research sup- tute reviewers cited a number of port for five new faculty members and strengths," Wright notes. capital equipment for a new Center for "In addition to the quality of the Single-Molecule Biophysics, as well as proposal itself, UB's commitment to facilities for that center and a new Center the two centers was specifically noted, as was the school's recent growth in for Genomics and Proteomics. extramural grant support. The institute In recent years, UB has invested nearly $9 million in building renovations and citing VB as 'an institution rapidly on the equipment purchases that are vital to the two new centers, in addition to providing more than $2 million annually in salary to faculty members associated with the programs. The review of UB's grant request to the institute noted that "the institution has undergone recent growth, and extramural (external ) grant support has increased significantly-evidence that this is an institution rapidly on the rise. " Forty-one medical schools were selected for funding through the institute's Biomedical Research Support Program for Medical Schools from 105 that submitted proposals. UB's award is the second largest in the program. Only UCLA School of Medicine, the University of Michigan Medical School and Yale University School of Medicine-which each received $4 million-were granted more funding. Bruce Holm, PhD, senior associate dean in the medical school and author of the grant proposal, will serve as the project director. "This is no ordinary grant award," says John Wright, MD, dean of the School of rise' are encouraging words, indeed. We congratulate Dr. Holm and the faculty for this outstanding achievement." The Center for Genomics and Proteomics will be a joint effort with senior investigators located at Roswell Park Cancer Institute and at the Hauptman-Woodward Medical Research Institute. This state-of-the-art center will enhance existing expertise in the areas of human , mouse and microbial genomics. Capabilities will include microarray and mass spectroscopic analyses of genes and proteins that will enhance understanding of cancer biology, microbial pathogenesis and human-disease genes. The Center for Single-Molecule Biophysics will emphasize work on computational chemistry, structural biology and molecular biology. Five new faculty members will be hired to further develop this area. The goal, Holm says, is to study proteins and other macromolecules in space and time. Results from such research will provide insights into protein structure-function relationships that can solve clinical problems. ... • L Bruce Holm PhD, senior associate dean in the School of Medicine and Biomedical Sciences, will serve as the project director. Current work in this area is being applied to cardiac function, synaptic transmission, electrolyte secretion and tumor suppression. Anthony Auerbach, PhD, and Frederick Sachs, PhD, both proTHE REVIEW OF UB's fessors of physiology and biophysics, will GRA T REQUEST TO THE codirect this center. INSTITUTE NOTED THAT The work will be "THE INSTITUTION HAS overseen by an adviUNDERGONE RECENT sory board composed GROWTH, AND EXTRAof Holm; Wright; MURAL (EXTERNAL) John Hay, PhD, associate provost for reGRANT SUPPORT HAS search and chair of INCREASED SIGNIFIthe Department of CANTLY-EVIDENCE Microbiology; Harold Strauss, MD , chair of THAT THIS IS AN the Department of INSTITUTION RAPIDLY Physiology and BioON THE RISE." physics; David Hohn, MD, director of the Roswell Park Cancer Institute; as well as the codirectors of the two centers. S prin g 20 0 0 lufl a l 1 H ysi c iu 21 �M E C D A ~uvenile L N SCHOOL Arthritis Study reported on a study being led by Nadine Fisher, EdD, which, to date, has shown that children with juvenile arthritis who take part in an individualized program of resistance exercise experience significant improvement in their ability to function. The article inadvertently omitted Fisher's coinvestigators: Kathleen M. O'Neil, MD, a University at Buffalo associate professor of clinical pediatrics affiliated with Kaleida Health System's Children's Hospital of Buffalo; and Vylma Velazquez, MD, pediatric fellow. Fisher, who designed the exercise program, is an assistant professor of occupational therapy and rehabilitation at UB. 4D OF SU CC E SS, CO NT INUED FROM w s students' previous training and prepare them for the rigors of medical school." Students begin the program with a six-week summer THE W I NTER 2000 ISSUE of Buffalo Physician DE C REE E PA C E 19 Somehow, he finds time to tutor anatomy students enrolled in the Post- Baccalaureate Program and to function as treasurer of the Student National Medical Association. With other members of the association, he is involved in an effort to introduce a peer-mentoring program into UB's medical school. This informal program would link local undergraduates with medical students, who would answer questions and offer insight into various aspects of medical school admission and campus life. enrichment program in math and science. Continuing through the academic year, each student is placed in a 14-credit course of study tailored to meet his or her specific needs. The curriculum also includes daily tutorial sessions and a summer program of prematriculation studies offered on the campuses of each referring school. Participating institutions include Albany Medical College, Albert Einstein College of Medicine, New York Medical College, SUNY at Buffalo School of Medicine and Biomedical Sciences, SUNY Health Science Center at Brooklyn, SUNY Health Science Center at Syracuse, SUNY Health Sciences Center at Stony Brook and the University of Rochester. In most cases, tuition and fees are waived for students accepted into the program. Additionally, students are provided with monthly stipends for room and board and books. "The Post-Baccalaureate Program is proving to be very effective in helping underrepresented students get into medical school," Hamilton says. "Of the 127 to participate during the first eight years of the program, 115 subsequently gained admission. "The program provides the mechanism, but it's really up to the students to benefit from this opportunity. To succeed, they have to be motivated and focused." 4D The AMS Post-Baccalaureate Program is supported by the Josiah Macy ]r. Foundation and the New York State DepartmentofHealth. For additional information, contact Carolyn Hamilton, EdD, director, or Adrian ]ones, coordinator, at (716) 829-2802. Filling in the Gaps The Post-Baccalaureate Program at UB offers a comprehensive curriculum ofbiology, physics, chemistry, mathematics and English, as well as a variety of electives and instruction in organizational and study skills. "Individual coursework varies, depending on the student," says Hamilton. "All of these students are highly qualified, but each needs strengthening in certain areas. One student may need extra attention in chemistry, while another may need to improve performance on the MCAT. Still another may sign up for an elective course on the Greek and Latin roots of scientific terminology. The goal is to fill in gaps in the 22 laffale Plysicin Spring 2000 NEw INSTITUTE , C ONTINUED FROM PACE 2 0 giving its partners access to a broad range of scientific instruments and technologies and world-class testing and research facilities, the institute will offer technical expertise, joint efforts to develop new products, short courses on innovative technologies, and training and recruitment opportunities. For the university, the institute will offer an interdisciplinary graduate program of study, postdoctoral training, visiting-faculty programs, summer programs, and international collaborations and exchange programs. 4J:) �1111111 nraJclu 11 �MEDI C AL S C HOOL N S. Mouchly Small Education Center AN EDUCATION CENTER in honor of S. Mouchly Small, MD, has been opened in the Department of Psychiatry at Erie County Medical Center. Small, who died in 1996, was an internationall y known ps ychiatrist and educator who chaired the Universityat Buffalo's Department of Psychiatry from 1951 to 1978. Under his leadership, the department grew from a handful of faculty members into a major national training and research center of more than 150 profes- sionals. In the early 1950s, Small founded the Muscular Dystrophy Association and served as its national president from 1980 to 1989 and as chair of its executive com mittee until hi s death. In the mid1950s, he wa s in strumental in organizing the Erie County Mental Health Board and was its first director. In this capacity, he helped obtain funding for Buffal o General Hospital's Community Mental Health Center and played an integral role in estab- Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. E w s lishing the State Alcoholism Research Center in Buffalo. Small published extensively and was author of A Handbook of Psychiatry, a 1943 book that was widely viewed as an authoritative guide to ps ychiatric theory and practice. In recognition of his outstanding contributions to his field , Small received the E. B. Bowis Gold Medal from the American College of Psychiatrists, the Distinguished Service Citation from the American Psychiatric Association and UB's Stockton Kimball Award. In May 1997, UB 's Medical Alumni Association posthumously presented Small with the Walter P. Cooke Award. The award, given to nonalumn i, recognizes notable and meritorious contributions to the university that influence its growth and improvement. The 3, 000- squa re-foot S. Mouchly Small Education Center includes a conference room and library, administrative offices for the residency-training program and teaching space for clinical services. Included in the center is an area for journals and textbooks, as well as online computer services. The center, which was established through benefactors and donors, was formall y dedicated on October 29, 1999. Speaking at th e ceremon y were Su san McLeer, chair of the Department of Psychiatry, and John Wright, dean of the School of Medicine and Biomedical Sciences. In attendance to cut the ribbon during the ceremony was Small's widow, Mrs. Sophie Small. <:t) Rosenfeld Receives Distinguished Service Award • State of the art visual and performing arts center George Rosenfeld, MD, clinical associate professor of pediatrics at the • Exceptional college placement record University at Buffalo School of Medicine and Biomedical Sciences, has • Challenging curriculum with 17 advanced placement courses at Kaleida Health System's • Comprehensive community ~~~~_.~"'· service program • More than 60 sports teams been presented with a Distinguished Service Award from the medical staff Children's Hospital of Buffalo. Rosenfeld, a member of the staff at Children's for 48 years, has been a stalwart in • Average class size of 15 the hospital's teaching pro- • Financial aid available gram and has served as chair Only one investment lasts a lifetime Coeducational grades 5-12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net of its Lab Committee for the past 25 years. In addition, he and his wife established the George and Harriet Rosenfeld ' leh to right: Theodore I. Putnam, MD, George Rosenfeld, MD, Mrs. Harriet Rosenfeld, and Bernard Eisenberg, MD. Award and Grant, which honors the outstanding laboratory accomplishments of an individual on staff at Children's and offers a grant on a competitive basis to physicians interested in research. "George is a fine example of what we would want our resident physi- Acceptance granted to qualified students without regard to race, color, religion or national origin. 24 l1ffal1 Hysicia1 Spring 2000 cians to emulate," says Theodore I. Putnam, MD, chief of the Division of General Pediatrics. "This award is presented to him for his long and faithful service to Children's Hospital." 4D �New Online Catalog for Libraries ONCILL provides integrated access to medical resources medical practitioners at the forefront ofthe digital revolution is the mission of the Library Consortium of Health Institutions in Buffalo (LCHIB). In 1993, electronic access to medical information in our community was forever redefined when the consortium unveiled HUBNET (Hospitals and University at Buffalo Network). Today, an expanded HUB ET delivers such resources as MEDLINE, QMR, selected full-text journals, reference texts, drug information and consumer resources directly to homes, offices and clinical and hospital sites. The newest component of HUBNET is a Today, anyone with a shared electronic online library catalog that web browser and replaces the outdated card catalogs. The sysconnection to the tem-named 0 CALL for the Online Catalog Internet can search of LCHIB Libraries-was first implemented at EEPING WESTERN NEW YORK the library catalogs of any of the LCHIB participating hospital libraries, 24 hours aday, by visiting the ONCILL web site. Kaleida Health System libraries with support provided by a $200,000 grant from the National Library of Medicine (NLM). In 1998, LCHIB received a second grant from the NLM for $298,000 to include the card catalogs of the libraries at Roswell Park Cancer Institute, Erie County Medical Center, Kaleida Health System's Children's Hospital of Buffalo and the Catholic Health System's Sisters of Charity Hospital, Mercy Hospital and Kenmore Mercy Hospital. Today, anyone with a web browser and connection to the Internet can search the library catalogs of any of the LCHIB participating hospital libraries, 24 hours a day, by visiting the ONCALL website at http://oncall.buffalo.edu. The Library Consortium of Health Institutions in Buffalo is comprised of most of the medical libraries in Buffalo, as well as the UB Health Sciences Library. To learn more about the consortium's HUB ET and ONCALL services, contact Martin E. Mutka, director of the LCHIB at (716) 829-3900, ext. 143, or e-mail him at mmutka@acsu.buffalo.edu. -PAT PRIOR �PATHWAYS EDITOR's NOTE: The following are brief introductions to faculty who have recently joined the University at Buffalo School of Medicine and Biomedical Sciences. Additional profiles will be published in future issues ofBuffalo Physician. Chair, Department of Biochemzstry Professor, Department of Social and Prn·entive Medicine .loseph De.lames, MD Donahue joined UB's faculty as a biochemistry in 1974. While Clinical Assistant Professor, Department of Family Medzmze Social and Preventive Medicine in in Florida, he was also on the Dejames joined the University at july 1997. He earned a bachelor of staff of the C.V. Whitney Marine Buffalo's Department of Family science degree in biology from as assistant professor of KennethM. Blumenthal, PhD Richard Donahue, PhD, MPH professor in the Department of Medicine in August 1999. In Providence College, Providence, professor of molecular genetics, Blumenthal became assistant addition to practicing at Niagara RI, in 1976 and a master's in public biochemistry and microbiology professor of biological chemistry Family Health Center, he is work- health from the University of at the University at Cincinnati, Michigan in Ann Arbor, MI, in Kenneth M. Blumenthal, PhD, Research laboratory. at the University of Cincinnati ing with UB's Family Medicine has been named chair College of Medicine in Residency Program, teaching 1981. In 1983, he completed a doc- of the UB Department 1976 and was promot- residents, conducting research torate in epidemiology at the Uni- of Biochemistry, effec- ed to full professor in and serving as associate coordina- versity of Pittsburgh, Pittsburgh, tive August 1, 2000. 1986. While there he tor for the Clinical Practice of PA. Prior to joining the faculty at A specialist in the was honored for out- Medicine course for first-year UB, Donahue was a professor of study of protein struc- standing teaching for medical students. De)ames triple epidemiology and public health tures, Blumenthal is three consecutive years. majored in biology, philosophy at the University of Miami School currently At the time of his de- and African-American Studies at of Medicine in Miami, FL. His parture, he was chair ofthe medical school's Boston College, where he gradu- research interests include the epi- ated in 1990. In 1992, he earned a demiology of insulin resistance, National Institutes of Health Committee on Basic Research and master of arts degree in American/ coronary heart disease and diabe- (NIH) grant to investigate the associate director of the Ohio Puerto Rican Studies at UB. He tes; primary prevention of diabetes interaction of peptide blockers Center for Computer-Aided completed his medical degree at in youth; and coronary heart dis- with gastric chloride channels. Molecular Design, which is UB in 1996 and in 1999 served his ease in people with Type 1 diabetes. Blumenthal earned a bach- housed at the university. He family medicine residency at the elor of science degree in chem- also served three terms on the university, where he was chief istry from the University of university-wide research council. resident in 1998-1999. His clin- Wisconsin in 1967 and a PhD Blumenthal is a member of ical/academic interests include in biochemistry from the Uni- NIH site-visit teams and a past underserved populations, the principal investigator on a K. four-year $596,000 BLUMENTHAL Sarah C. Finnegan, MD, PhD Assistant Researc/z Professor, Department of Neurology Department of Pharmacology and Toxicology versity of Chicago in 1971. He member of three NIH study sec- impact of lower socioeconomic completed a three-year NIH tions. He serves on the editorial status on health, and teaching postdoctoral fellowship in bio- board of the Journal of Biological clinical skills to medical students. logical chemistry at the Univer- Chemistry and has authored July 1999 as an assistant research professor and Buswell Fellowship Finnegan joined UB's faculty in sity of California at los Angles or coauthored 50 papers in School of Medicine before join- refereed journals and five recipient in the Department of ing the faculty of the University book chapters. CD Neurology. She also holds a sec- of Florida College of Medicine L o r s BA K E R ondary appointment in the Department of Pharmacology and JoHN YEH, MD, WILL JOIN UB AS CHAIR OF OBSTETRICS AND GYNECOLOGY oN MAY 1, AND KENNETH BLUMENTHAL, PHD, WILL BEGIN AS CHAIR OF BIOCHEMISTRY ON AUGUST 1. 2 .. 26 1111111 Hysiciu Spring 20 00 �Toxicology, where she works with Psychiatry, Faculty of Medicine Dennis Higgins, PhD . Finnegan since 1971 , joined the Department earned a bachelor of science de- of Family Medicine in Ma y 1999. gree in chemistry at His clinical affiliation is with Erie SU Y at Binghamton County Medical Center' s Divi- in 1984, after which sion of Chemical Dependency. she earned MD/PhD Giordano completed his under- (physiology) degrees graduate premed studies at UB in at UB in 1994. She 1954, after which he earned his Chair, Department of Radiatwn Medicine Roswell Park Cancer lnstit11te interned in internal medical degree from the Univer- Prior to joining the University at human cervical cells by ionizing medicin e at Millard sity of Padua, in Padova, Italy, in Buffalo and Roswell Park Cancer radiation; in vitro screening Fillmore Ho s pital 1960. He completed his residency Institute in August of potential chemo- from 1994-1995 and in psychiatry at Buffalo State Hos- 1999, Kuettel served as preventive completed residency training in pital in 1964. From 1976 to 1991 , associate professor of using human prostate neurology at UB, serving as chief he served as chief of psychiatry at radiation medicine and epithelial cells; and resident in 1998. She then com- Mercy Hospital in Buffalo, and anatomy and cell biol- investigations of a new pleted pediatric residency train- from 1993 until May 1999, as ogy in the Department tumor suppressor gene ing, also at UB, in 1999. Finnegan, medical director of Addiction of Radiation Oncology in prostate cancer. who practices at Kaleida Health 's Medicine at Sisters Hospital, also at Georgetown Univer- Children 's Hospital of Buffalo, is in Buffalo. S . FI NN EGAN Michael R. Kuettel, MD, MBA, PhD of the National Board of Medical Examiners and the Professor and Chair, Department of Radwtion Oncology University at Buffalo American Board of Radiology (radiation oncology). Kuettel's research interests include the molecular mechanisms of neoplastic transformation of human prostate and At Roswell Park Can- interested in caring for children sity in Washington, D.C. M . K u Kuettel received his with neurological disorders, in- medical degree from Northwest· cluding those with developmental disabilities related to perinatal brain injury. Her research inter- Kenneth Hoffman, PhD Associate Professor, Department of Neurosurgery Toshiba Stroke Research Center ests involve elucidation of factors promoting the survival and regeneration of adult human neurons that may hold implications for degenerative disease processes. Hoffman, who joined UB 's faculty in September 1999, earned his bachelor of arts degree in physics, summa cum agents ET T E L cer Institute, Kuettel heads the Department of Radiation Medicine, a referral ern University Medical School in and resource center to health· Chicago, ll, and completed his care facilities across the country residency training in radiation and Canada that offers cancer oncology at The Johns Hopkins patients comprehensive care and Hospital, Baltimore, MD. He then innovative treatments such as the earned a PhD in anatomy and cell gamma knife, photodynamic biology from the Medical College therapy and brachytherapy. <L;) of Wisconsin. He is a Diplomate DEBORAH PETTIBO~E laude, from St. Louis Univer- P•ul B. Qlord•no, MD sity, St. Louis, Assistant Professor, Clinical Family Medicwe Department of Family Medzc111e MO, in 1976, Waltham, MA, in 1984. Prior to tomographic images, or temporal and a PhD in coming to UB, he was an associate 3D data sets, with a focus on vascu - physics from professor in the Department of lar or luminal structures. Specifi- Giordano, a clinical assistant pro- Brandeis Radiology at the University of cally, he is interested in determina- fessor in UB ' s Depa rtment of University in K. H o FFMA N Chicago. Hi s research interests tion of 3D vascular structures include developing ways to ana- from two or more views, quanti - lyze and present radiographic im- tative analysis of these structures age data, either projection images, and alignment of them with their projections. He is al so interested in the segmentation and quantitation of bone, vascular structures and the colon from CT data sets. Currently, he is funded by Spring 2000 lu ffalo Pbysici11 21 �PATHWAY .JohnYeh,MD 1983. Following a residency at research and strategic planning. study the role of growth factors Chair, Department of Obstetrics and Gynecology Beth Israel Hospital in Boston, He also served as executive in human fetal ova development he completed a fellowship in director John Yeh, MD, professor and fertility and reproductive endo- Women's Health Pro- vice-chair of the Department of crinology at Boston's Brigham gram at Regions Hos- Yeh is coauthor of a Obstetrics and Gynecology at the and Women's Hospital. pital in Minneapolis 1991 book, Legal Aspects the and has grants pending for cervical cancer research. University of Minnesota, has In 1987, Yehjoinedthefaculty and was director of of lnferlility, and is writing been named chair of the UB of Harvard Medical School, where the residency pro- a book on growth factors in reproductive medicine. He Department of Gynecology and he spent years conducting re- gram in obstetrics Obstetrics, effective May 1, 2000. search in the field of reproductive and gynecology. Yeh earned an AB degree endocrinology, teaching and from Harvard University in 1979 treating patients. In 1997, he has been funded by and a medical degree from the took the position at the University the National Institutes of Health University of California at San of Minnesota, where he was since 1989. Currently, he is prin- Diego School of Medicine in responsible for the department's cipal investigator on a grant to also has published many Yeh's research J · Y research abstracts, book EH chapters and scientific studies in professional journals. Lo s BAKER ests include the regulation of neu- his PharmD Stanley H. Kim, MD to study methods to improve rotransmitter release and produc- degree at the radiologic colon polyp detection. tion in the nervous system; regula- University of Clinical Asszstant Professor, Department of Neurosurgery tion of cytokine production and Arizona Col- Kim, who practices at Kaleida the National Institutes of Health release from cells of the nervous lege of Phar- Health System's Millard Fil- Tracey Ignatowski, PhD and and macy in Tuc- lmore Gates Hospital, joined interactions among proinflam- son, AZ, in UB's faculty as an assistant Research Assistant Professor, Department of Pathology matory cytokines, adrenergic re- Ignatowski joined UB's Department of Pathology as a research assistant professor in May 1999 and has served in a similar capacity in the Department of Anesthe- immune systems; sponses and opioid responses earned a bachelor of T. I G NATOWSKI M. KALSMAN 1991 and his professor of neurosurgery in medical de- July 1999. A specialist in inter- gree from the ventional neuroradiology, Kim during antidepressant drug ad- University of Arizona College of earned his bachelor of science ministration, providing possible Medicine, also in Tucson, in 1995. degree at the University of mechanisms of action for antide- He completed his family practice Michigan in Ann Arbor, MI, in pressants in the treatment of de- residency in Salt Lake City, UT, at 1986 and his medi- the University of Utah, serving as cal chief resident in 1997-1998. He Wayne State Uni- then completed a rural medicine versity in Detroit in during persistent pain, as well as pression and chronic pain states. siology since 1997. She degree from fellowship in Tacoma, WA, in 1999. 1990. He served his science degree in bio- Michael Kalsman, MD, PharmD logical sciences at UB Clllltcal Associate Professor, Department of Family Medicine His primary interest is in rural residency training medicine with an emphasis on in neurosurgery at obstetrics. He is also interested in Wayne State Uni- researching the use of the Internet versity from 19911993 and at The in 1990 and a PhD in 28 of pathology at the university in Kalsman joined the University at 1995. From 1995-1997 she was a Buffalo's Department of Family postdoctoral fellow at the Univer- Medicine in September 1999. He Ohio sity of Rochester in the Depart- practices at the University Pri- Columbus, OH, from 1995-1999. ment of Pharmacology and Physi- mary Clinic and is affiliated with In addition to interventional ology. Ignatowski's research inter- Olean General Hospital. He earned neuroradiology, Kim's clinical luflale Pbysiciaa Spring 2000 as a medical resource. State STANLEY KIM University in �idency Pro- NewYork,NY. He received a medi- pita!. Her interests include patient complex spine surgery and mini- gram and as- cal degree from George Washing- education and training medical mally invasive spine surgery. sistant professor in the De- ton University School of Medicine students and residents. in Washington, D.C., and com- partment of pleted residency training in sur- Susan Y. Kim, MD Social and gery and plastic surgery at St. Daniel Rifkin, MD Asststant Professor, Departmerzt of Radtation Oncology University at Buffalo Preventive Luke's/Roosevelt Hospital Center. Assistant Professor, Department of Neurology and research interests include Department of Radtation Medicine Roswell Park Cancer Institute Kim rejoined Roswell Park Cancer Institute (RPCI)and UB as an assistant professor of radiation medicine LI He then served a fellowship in Medical Director, Sleep Disorder CerJter of Western New York head and neck oncology and sur- bachelor of science degree in bioi- gery at Memorial Sloan-Kettering ogy, magna cum laude, at the Uni- Cancer Center in New York, NY. versity of Southern California in Loree is board certified by the Los Angeles, CA, in 1979 and American Board of Plastic Surgery his medical degree at St. Louis and the American Board of Sur- University School of Medicine gery. His research interests include in St. Louis, MO, in 1984. He thyroid cancer, microsurgery and then completed a master of pub- in Rifkin joined the UB's faculty in August 1998 and serves as medical directorofthe Sleep Disorder Center of Western lard Fillmore Hospital. Rifkin earned a bachelor of arts degree, free-tissue transfer. cum laude, in religion from Ham- ilton College, Clinton, NY, in 1988, sity of Michigan in Ann Arbor, SUSAN KIM gist, she is a graduate of the University of MI, in 1989. Li's research interests Nilsa M. Martinez:, MD and a medical degree from are preventive medicine, public Clinical Assistant Professor, Department of Family Medictne Dartmouth Medical School, health and chronic disease. Vermont School of Medicine in Burlington, VT. She completed her residency at St. Luke's Medical Center in Chicago, IL, and is board certified by the American Board of Radiology. Most recently, she founded and headed the stereotac- Thom R. Loree, MD C!tief, Divtsion of Head and Neck Surgtcal Oncology/Plastic and Reconstructive Surgery Department of Surgery Roswell Park Cancer Jnstttute Israel Medical Center in New York Assistant Professor, Departmertt of Surgery University at Buffalo City. At RPCI, she is practicing tic radiosurgery program at Beth ew York, located at Kaleida Health System's Mil- lic health degree at the Univer- September 1999. A radiation oncoJo- Medicine. He earned his Hanover, NH, in 1992. He served Martinez joined the his residency in neurology University Buf- at Strong Memorial Hos- falo Family Medicine pital, Rochester, NY, where Faculty Associates in he was chief resident in at She 1996. In 1997, practices at the Univer- he completed a October 1999. sity Primary Clinic in postdoctoral Houghton, NY, and is clinical and re- affiliated with Olean Hospital. General . MARTINEZ search fellowship in sleep Loree was appointed chief of the Martinez earned her bachelor of medicine and clinical neuro-oncology, including gamma Division of Head and Neck Surgi- science degree in neurosciences at neurophysiology at the knife radiosurgery. cal Oncology/Plastic and Recon- the University of Rochester in University of Mich- Rochester, NY, in 1990 and her igan Medical Center Carl LI,MD structive Surgery at Roswell Park Cancer Institute (RPCI) in Janu- medical degree at Boston Univer- in Ann Arbor, MI. His ary 2000. Loree, sity School of Medicine in Bos- clinical research inter- who is also an ton, MA, in 1994. She completed ests include all aspects assistant pro- her family practice residency at of sleep disorders fessor of sur- St. Joseph's Hospital Health Cen- medicine, with a pri- gery Associate Director, General Preventtve Medicine Residency Program Assistant Professor, Department of Social and Preventive Medicine Li joined UB's faculty in March 1999 as associate director of the General Preventive Medicine Res- Rifkin is medical director of the Sleep Disorder Center of Western New York. His clinical research interests include all aspects of sleep disorders medicine, with a primary focus on the effects of hypoxia on the brain. UB, ter in Syracuse, NY, in 1997. Prior mary focus on the ef- came to RPCI to coming to UB, Martinez was fects of hypoxia (often associated from St. Luke's! affiliated with the Hospital Inter- Roosevelt Hos- nists Group at St. Joseph's Hos- with obstructive sleep apnea) on the brain. <!;) at pital Center in T. LoREE Spring 2000 I DIIII O Pbys i c i 10 29 �DEVELOPMENT N E w s Salute to the Class of 194~ By Li nda J . Cor de r , PhD. CFRE \S_ \'1 lN OF r 1, I Sin) \J.G~I 1 11· H 'l\\ \II. Shortly after arriving, I switched on the rental car's radio and heard a narrator describing the USS Arizona in its underwater tomb at Pearl Harbor, barely a mile from Honolulu's airport. Then I realized the date was December 7th. The broadcast, from Washington, D.C., was a retrospective on the 1941 surprise attack that catapulted our nation into the Second World War. For me, that war was just a chapter in my history book, as vague as Vietnam is to our current students. I decided to visit the memorial, to imagine what medical students of that era might have felt as they tried to come to terms with the brutality of war while dedicating themselves to becoming physicians. Members of the Class of 1945 were UB's first to enroll after the U.S. entered the war. Seven months to the day of that bombing-July 7, 1942-they began their medical education at 24 High Street. They were on a fast track-three short years. All their youthful energy was bent toward learning the skills of healing, knowing that their most crucial tests might come under battlefield conditions far from home. The class bonded in a way that, from this vantage point, appears unique in the annals of the school. It may have been due to the attitude prevalent in the nation, or perhaps it was something within the walls of the school. I can't explain it; I 1945 lHE VAST MAJORITY just know it's there. THE SC HOOL's STUDENTS A look through WERE IN UNI~ORM. their 1945 yearbook shows the majority of students in uniform. Most went directly into active duty following graduation and picked up formal residencies following stints in the service. Thus, their paths took a variety of war-influenced turns, both before and following their training. Some became career military doctors. Many returned to Buffalo or practiced in 30 l •ttal• nysiein Spring 2000 small towns fanning out from Western New York into America's heartland and westward. Collectively, they have done a tremendous amount for the school. Some served on the admissions committee, as voluntary faculty members, and as mentors for students and residents. Others are generous with their resources, establishing endowments, supporting scholarships and the school's general fund (many of their names are in this year's Honor Roll, which follows). As a tribute to them and to the interweaving of their lives with World War II, we are working with volunteers to compile a memory book, for them, for the school, for those of us enriched by their stories. Every five years, like clockwork, they reunite in Buffalo to exchange stories and catch up on each other's lives. With each passing cycle, the group gets a bit smaller. Since their 50th anniversary, a hearty core has met every fall "in case they didn't all make it to their 55th." I have a feeling they will extend these annual conclaves as long as there are volunteers to handle the details. In addition to my ruminations on the Class of 1945, what did I learn from my visit to the USS Arizona? That war really is hell. That understanding that particular war simply is not possible for those of us born in its wake. That most people seem to feel genuine sorrow for the inhumanity of it all, when seen from nearly 60 years' perspective. (Flowers sent to mark the anniversary were from groups like the Japanese-American Friendship Association, and most of the visitors on my early-morning sojourn spoke Japanese.) So, I come down on the side of Anne Frank, believing both that most people are good at heart, and also that we need to find better ways to resolve our differences. A war worse than "The Big One" is too awful to contemplate. Or, as our friends in the Class of 1945 would attest, it's better to bind up wounds than to inflict them. Lyn Corder is associate dean and director of develoment. If you would like a copy of the 1945 reunion booklet, call the Development Office toll free, at 1-877-826-3246, or E-mail Lyn at ljcorder@buffalo.edu. �the Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the James Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis of lifetime membership. Names of Founders-Lifetime Members-are repeated in an annual category in any year that they make a new gift to the school. ntal in founding UB's medical school in 1846. F nde s' c· le Dr. Joseph Chazan '60 and Mrs. Helene Chazan Dr. Kenneth M. AHord '37 and Mrs. Joan W. AHord Buffalo, NY Williamsville, NY primarily physicians and attorneys, envisioned a school to train students for service to the community. The society's Founders help to actualize that vision by providing a generous base of support for programs and activities that enrich the academic environment and enhance medical training. Dr. Williard Bernhoft '35 and Mrs. Clarice Bemhoft Snyder, NY Dr. Kenneth H. Eckhert '35* and Mrs. Majorie Eckhert Buffalo, NY Ms. Rose Ellerbrock Dr. Willard Boardman ' 44 and Mrs. Jean Boardman '48 Winter Park, FL Amherst, NY Dr. George M. Ellis '45 and Mrs. Kelly Ellis Connersville, IN Dr. William Chardack Gulfstream, FL Spring Mr. DuVal Cravens and Mrs. Annette Cravens Buffalo, NY Mrs. June M. Alker DB's Founders, Providence, RI Mrs. Grant Fisher Lakeview, NY 2000 1111a11 Pkysiciu 31 �DEVELOPMENT fOUNDERS CIRCLE CO!"T·o Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley '44 and Mrs. Marigrace Frawley Chesterfield, MO Mrs. Christian Gretschel Genner Potomac, MD Mr. John Goodwin Williamsville, NY Dr. Pasquale A. Greco '41 and Mrs. Joan Greco Buffalo, N Y Dr. Glen E. Gresham and Mrs. Phyllis K. Gresham Snyder, NY Dr. Thomas J. Guttuso '60 and Mrs. Barbara L. Guttuso East Amherst, NY Dr. Eugene J. Hanavan Jr. '41 Buffalo, NY Mrs. Morris Lamer New York, NY Dr. Eugene R. and Mrs. June A. Mindell Buffalo, NY Dr. Richard J. Nagel '53 and Mrs. Forence Nagel E W S Annual Memberships Chairs' Circle Dr. and Mrs. Paul H. Wierzbieniec '74 Scholars' Circle Annual memberships, in the appropriate circle, are granted for one year, beginning January 1, for gifts received during the prior calendar year. The roster of the James Platt White Society "Class of 1999" follows. Just as a department chair leads a program, donors of leadersh ip gifts in this range of $10,000 to $24,999 are given special recognition. Amherst, NY One strength of an outstanding institution is the caliber of students who study there. Scholars in the James Platt White Society h ave made gifts to the school totaling $1,000 to $2,499 during the past year. Those marked with (**) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. Dr. Hilliard Jason '61 Boulder, CO Mr. and Mrs. Wilson Greatbatch Dean'sCircle Akron, NY The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Orchard Park, NY Dr. Richard B. Narins '63 and Mrs. Ellen B. Narins Dr. Willard H. Boardman '44 East Aurora, NY Winter Park, FL Dr. Albert C. Rekate '40 and Mrs. Linda Rekate '71 Max Doubrava Jr., M.D. '59 Hilton H ead, N C Anonymous Las Vegas, NV Philip D. Morey M.D. '62 Williamsville, NY Dr. Syeda Fazila Zafar and Dr. lsmaial Zafar East Amherst, NY Fellows' Circle Fellows in the school are recognized for the added depth they bring to postgraduate study. Within the society, Fellows are honored for gifts that total $2,500 to $4,999. Dr. Maria Naples Sarno '34 Syracuse, NY Marie Rose Sarno Syracuse, NY Dr. Charles A. Baud a '42 Boynton Beach, FL Mr. Sheldon M. Berlow Buffalo, NY Buffalo, NY Professors' Circle Dr. and Mrs. Harold Brody '61 Getzville, NY Dr. Kenneth Z. AHshuler '52 and Mrs. Ruth AHshuler A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporte rs whose annual gifts ra nge from $5,000 to $9,999. Dr. Melvin M. Brothman '58 Dallas, TX Snyder, NY Darcy Steinhart Amiel and Jack J. Amiel Dr. Allen Barnett '65 Pine Brook, NJ Dr. Elizabeth P. Olmsted Ross'39 Dr. Janet Sung and Mr. John Sung Dr. Charles D. Bauer '46, and Mrs. Mary A. Bauer Buffalo, NY Clarence, NY Williamsville, NY Dr. and Mrs. Robert J. Gillespie Buffalo, NY Caledonia, NY Dr. Philip S. Anson '79 Mr. Arthur H. Judelsohn Scarborough, ME Buffalo, NY Dr. J. Bradley Aust Jr. '49 Dr. Hak J. Ko San Antonio, TX Buffalo, NY Dr. George R. Baeumler '59 Dr. Susan V. Mcleer Kenmore, NY Buffalo, NY Dr. George Bancroft '81 and Mrs. Susan Bancroft '79 Dr. Richard B. Narins '63 and Mrs. Ellen B. Narins East Aurora, NY Dr. Dan Miller '48 Scarsdale, NY Dr. Claudia D. Fosket '85 and Dr. Robert J. Smolinski '83 Dr. John C. Newman Lewiston, NY Dr. John Parker ' 57 and Mrs. Dorris Parker Orchard Park, NY Dr. Charles S. Tirone '63 and Mrs. Anne Tirone '94 Latrobe, PA Williamsville, NY Dr. Edward D. Simmons Jr. Dr. Salvador M. Udagawa Dr. Phillip B. Wels '41 and Mrs. Elayne Wels Lakeview, NY Buffalo, NY Dr. and Mrs. James J. White Jr. '69 *deceased Dr. Nancy H. Nielsen '76 Orchard Park, NY Buffalo, NY Dr. Robert G. Smith '49 32 l1ff al o Hys ici an Sp r i n g 20 00 Drs. Elizabeth and Kevin Barlog'82 Amherst, NY Dr. Jared C. Bartow Sr. '66 and Mrs. Barbara Bartow '64 Grand Island, NY Dr. Paul D. Barry '71 Bethesda, MD Dr. Ralph T. Behling '43 San Mateo, CA Dr. Irving Sterman '64 Dr. Richard A. Berkson '72 and Mrs. Andrea Berkson Boynton Beach, FL THE CALIBER OF STUDENTS WHO STUDY THERE. Hamburg, NY Savannah, GA and Mrs. Gail Sterman ONE STRENGTH OF AN OUTSTANDI, G INSTITUTION I S Dr. WilliamS. Andaloro '45 Bradford, PA Williamsville, NY Clarence, NY Encino, CA Dr. Anita J. Herbert '63 Miss Thelma Sanes Dr. Janet and Mr. John Sung Dr. Kenneth Alford '37 and Mrs. Joan Alford Rancho Palos Verdes, CA Mr. Haskell Stovroff Dr. and Mrs. Michael E. Bernardino Buffalo, NY Buffalo, NY Mr. James I. Stovroff Dr. Joel M. Bernstein '75 Buffalo, NY Williamsville, NY �EVERY LEADER DEPENDS ON A SMALL CIRCLE OF ASSOC I ATES WHO HELP BRI 'G THE ORGANIZATION'S VISION INTO REALITY. Dr. Kathleen O'leary '88 and Mr. Michael J. Collins '90 Dr. Susan Fischbeck '82 and Dr. Patrick Hurley '82 Buffalo, NY East Concord, NY Dr. Suzanne F. Bradley '81 Dr. Mark R. Comaratta '85 and Mrs. Kathleen Comaratta Whitmore Lake, MI East Amherst, NY Dr. Theodore S. Bistany '60 Buffalo, NY Dr. Dennis l. Bordan '70 Port Washington, NY Dr. Martin Brecher '72 and Mrs. Geri Brecher Dr. Bernice S. ComfortTyran '58 Amherst, NY Los Altos, CA Dr. James B. Bronk '81 and Mrs. Suzanne Bronk Napa, CA Dr. linda J. Corder Buffalo, NY Dr. August A. Bruno Sr. '51 Dr. James J. Creighton Jr. '79 Amherst, NY Indianapolis, IN Clarence, NY Dr. Edwin J. Manning '61 Dr. Jack C. Fisher '62 Dr. Herbert E. Joyce '45 and Mrs. Ruth Joyce La Jolla, CA Lockport, NY Dr. Thomas D. Aanagan '65 and Mrs. Grace Flanagan '60 Dr. Wendy Kaiser '85 and Dr. Roger E. Kaiser Jr. '79 Williamsville, NY Clarence, NY Dr. Claudia D. Fosket '85 and Dr. Robert J. Smolinski '83 Orchard Park, NY Dr. Kyoichi Kano Williamsville, NY Tokyo, Japan Dr. Merrilll. Miller '71 Dr. Genievieve Kanski '58 and Dr. James R. Kanski '60 Coram, NY Eggertsville, NY Dr. Reiji Kasukawa Ann Arbor, MI Williamsville, NY Fukushima, Japan Dr. Kenneth Kim '65 and Mrs. Susan Kim Dr. Eugene l. Gaier Buffalo, NY Dr. Daniel E. Curtin '47 and Mrs. Elaine Curtin Dr. Penny A. Gardner '69 Mr. Michael T. Bukowski Orchard Park, NY Los Altos, CA Dr. David R. Dantzker '67 and Sherrye Dantzker Dr. Ronald F. Garvey '53 Roslyn, NY Dr. lawrence Golden '46 and Mrs. Nancy Golden '48 Dr. William M. Burleigh '67 Rancho Mirage, CA Dr. Jennifer l. Cadiz '87 Mechanicsburg, PA Drs. Virginia and Evan Calkins Dr. Roberta Dayer '72 and Dr. RogerS. Dayer '60 Williamsville, NY Tyler, TX Eggertsville, NY Buffalo, NY Dr. Michael Goldhamer '64 Dr. Philip C. Dennen '49 San Diego, CA Southbury, CT Dr. and Mrs. Glen E. Gresham Dr. Gerard J. Diesfeld '60 Arcade, NY Williamsville, NY Hambu rg, NY Dr. Frederick R. Downs '70 Dr. Kim Griswold '94** Dr. David T. Carboy '63 and Mrs. Jacqueline Carboy Attica, NY Buffalo, NY Ronald I. Dozoretz, M.D. '62 Lincroft, NJ Washington, DC Dr. Robert T. Guelcher '60 and Mrs. Elizabeth Guelcher Dr. Joseph G. Cardamone '65 and Mrs. Susan Cardamone Mrs. Ruth H. Dugan '65 Eden, NY Dr. Melvin B. Oyster '52 Dr. Nicholas C. Carosella '54 and Mrs. Mary Carosella Appleton, NY Hamburg, NY Niagara Falls, NY Dr. Robert Einhorn '72 North Brunswick, NJ Erie, PA Mrs. Gilda l. Hansen '44 Williamsville, NY Dr. John H. Hedger '75 and Mrs. Sandra Hedger Salisbury, MD Dr. Yung C. Chan '73 Dr. George M. Erickson '49 Dr. and Mrs. Reid R. Heffner Jr. Draper, VA Deland, FL Buffalo, NY Dr. Norman Chassin '45 and Mrs. Charlotte Chassin Buffalo, NY Dr. Yong Baek Chi Lockport, NY Dr. Prem K. Chopra West Seneca, NY Dr. and Mrs. Charles KwokChi Chow Dr. Joseph M. Failla '82 Dr. William J. Hewett '61 Bloomfield Hills, MI West Hartford, CT Dr. Domonic F. Falsetti '58 Dr. Fredric M. Hirsh '73 and Mrs. Donna Hirsch '75 Lewiston, NY Dr. and Mrs. leon E. Farhi Williamsville, NY Dr. Maynard H. Mires Jr. '46 Georgetown, DE Dr. Joseph F. Monte '59 Clinton, NY Buffalo, NY Dr. Robert A. Klocke '62 and Mrs. Barbara Klocke Williamsville, NY Dr. John F. Montroy '39 and Mrs. Catherine Montroy Bella Vista, AR Dr. Richard Kozak '94** Eugene, OR Dr. Daniel C. Kozera '59 and Mrs. Delphine Kozera Lackawanna, NY Dr. Beth Moscato '96 and Dr. John A. Moscato '68 Orchard Park, NY Dr. John D. Mountain '33 Manhasset, NY Drs. Marie Kunz '58 and Joseph l. Kunz '56 Lockport, NY Dr. Arthur W. Mruczek Sr. '73 Medina, NY Dr. Weerachai ladakom '91 Bangkok, Thailand Dr. Richard l. Munk '71 Sylvania, OH Dr. Andre D. lascari '60 Poestenkill, NY Dr. Masao Nakandakari '55 Honolulu, HI Dr. Thomas J. lawley '72 Atlanta, GA Dr. Tomoe Nishimaki Fukushima, japan Dr. Jack lemann Jr. '54 and Mrs. Mary MacDonaldlemann Dr. Thomas P. O'Connor '67 East Amherst, NY New Orleans, LA Dr. James M. Orr '53 Dr. Eugene V. leslie '51 and Mrs. Faith leslie Dr. Marvin G. Osofsky '59 Gallipolis, OH Williamsville, NY Nanuet, NY Dr. laurence M. lesser '70 Dr. Margaret Paroski '80 Atlanta, GA Buffalo, NY Dr. Harold J. levy '46 and Mrs. Arlene levy Drs. Jacqueline Paroski '49 and Paul A. Paroski DDS '45 Amherst, NY North Tonawanda, NY Eggertsville, NY Dr. John M. Hodson '56 Mr. Kevin Feor '80 and Mrs. Elizabeth Feor '78 Williamsville, NY Alice Jo Lichtman '58 and Marshall A. Lichtman, M.D. '60 Mr. Harold Housler Rochester, NY Webster, NY Rochester, NY Dr. Hing-Har lo '74 Snyder, NY Hong Kong Dr. Amy Ferry '94** Robert M. Jaeger, M.D. '47 Blacksburg, VA Bethlehem, PA Allentown, PA Dr. and Mrs. Gerald l. Logue Dr. Carlos R. Jaen '89** Williamsville, NY Dr. Michael E. Cohen '61 and Mrs. Joan Cohen Dr. Helen Marie Findlay '77 and Dr. Albert Schlisserman '77 Buffalo, NY Williamsville, NY Eggertsville, NY Dr. Thomas A. Lombardo Jr. '73 and Mrs. Donna Lombardo Lexington, MA East Aurora, NY Spring Dr. Robert J. Patterson 'SO and Mrs. Patricia Patterson '48 Dr. Norman l. Paul '48 Dr. Eugene E. Cisek Buffalo, NY Hamilton, NY Dr. Neal W. Fuhr '52 Dr. Julia Cullen '49 Eggertsville, NY Buffalo, NY Dr. Kaaren Metcalf '78 and Dr. Harry l. MetcaH '60 Dr. and Mrs. David P. Mind ell Buffalo, NY Dr. Stanley l. Bukowski '81 and Mrs. Romana Bukowski Buffalo, NY Dr. John Marzo Dr. Andrew J. Francis '84 Mount Dora, FL Washington, DC Dr. Frank A. luzi '88 La Jolla, CA Dr. Paul T. Buerger '49 Ms. Mary J. Bukowski Schutz Irene and Frank Jellinek '40 2000 Dr. Clayton A. Peimer and Mrs. Susan Peimer Eggertsville, NY Mr. Edwin Polokoff Boca Raton, FL laffa l1 Physician 33 �D E V E ~--------- SCHOLARS' CIRCLE, CONT'D Dr. Charles W. Pruet Williamsville, NY L 0 P M E Dr. Hiroshi Yoshida Fukushima, japan Dr. Roy E. Seibel Sr. '39 and Mrs. Ruth Seibel Dr. Wayne C. Templer '45 Dr. Gregory E. Young '77 and Mrs. Diane Young Dr. Molly R. Seidenberg '53 Dr. Arthur M. Seigel '70 Guilford, CT Dr. Bert W. Rappole '66 and Mrs. Mary Helen Rappole '97 Dr. Elizabeth G. Serrage '64 jamestown, NY Mr. Eugene M. Setel Boca Raton, FL Buffalo, NY Dr. Richard R. Romanowski '58 Cape Elizabeth, ME Buffalo, NY Corning, NY Dr. Henry A. Thiede '49 Pittsford, NY Dr. James C. Tibbetts '64 Sturgeon Bay, WI Dr. George Toufexis '76 Williamsville, NY Dr. Bradley T. Truax '74 Lewiston, NY Dr. Edward Shanbrom '51 and Mrs. Helen Shanbrom Santa Ana, CA Dr. John T. Sharp '49 and Mrs. Susan Sharp Lancaster, NY Dr. Thomas F. Varecka '74 Minneapolis, MN Dr. Alvin Volkman '51 Holmes Beach, FL Greenville, NC Dr. John B. Sheffer '47 Dr. Richard D. Wasson '58 and Mrs. Janet Wasson Williamsville, NY Dr. Charles H. Rosenberg '44 Stamford, CT Dr. Peter E. Shields '79 Williamsville, NY Dr. Arnold Wax '76 Dr. Elizabeth P. Olmsted Ross'39 Dr. Timothy S. Sievenpiper '68 and Mrs. Karen Sievenpiper '66 Dr. Pierce Weinstein '49 Dr. Jeffrey S. Ross '70 Holland, NY Dr. Wende W. Young '61 Canandaigua, NY Dr. Franklin Zeplowitz '58 and Mrs. Piera Zeplowitz Buffalo, NY Dr. David Ziegler '64 and Mrs. Susan Ziegler '61 Walnut Creek, CA Mr. James J. Trzaska Buffalo, NY Buffalo, NY East Aurora, NY Holiday, FL Special Members A few individuals and coup les were gra n ted multiyear memberships based on generous gifts made between 1989-1993. Henderson, NV West Palm Beach, FL Drs. Charlotte Weiss '52 and Dr. Hyman Weiss '52 Lebanon Springs, NY Edward H. Simmons, M.D. Mr. James J. Rosso '76 and Mrs. Cheryl Rosso Williamsville, NY Highland Park, Nj Dr. James A. Smith '74 Dr. Gary J. Wilcox '73 Buffalo, NY Orchard Park, NY Carlsbad, CA Dr. Albert G. Rowe '46 Dr. Albert Somit Dr. Charles E. Wiles '45 Tonawanda, NY Aurora, Co Dr. David W. Butsch Montpelier, VT Dr. John l. Butsch Buffalo, NY Dr. Marvin Z. Kurian '64 and Mrs. Eleanor Kurian Carbondale, JL Orlando, FL Dr. John J. Squadrito '39 Dr. Richard G. Williams '80 New York, NY Sarasota, FL Clearfield, PA Buffalo, NY Dr. Pina Sanelli '94** Dr. David D. Stahl '79 Mr. Ralph C. Wilson Jr. M edina, NY Orchard Park, NY Mrs. Marvin (Helen) Winer Boston, MA Dr. William C. Sternfeld '71 Dr. Stuart Alan Wolman '74 Sylvania, OH Beverly Hills, CA Snyder, NY Dr. louise M. Stomierowski '74 Dr. and Mrs. John R. Wright Dr. Stephen C. Scheiber '64 and Ms. Mary Ann Scheiber Garrett Park, MD Glenview, IL Dr. James N. Schmitt '52 Kenmore, NY •• Clln lllrcll •• ..,.. . . . . . '%1 ..... ........... ........ ....... s. Williamsville, NY Dr. John Naughton Sarasota, FL We have made every effort to en ure accuracy tn these hsts If ou ha e questio or corrections, please call Mary Glenn, toll free at Williamsville, NY Dr. Michael A. Sullivan '53 Williamsville, NY Dr. lin-lan Tang '84 Warren, N] Dr. Max A. Schneider ' 49 U B's Orange, CA Robert N. Schnitzler, M.D. '65 f OUNDERS, PRIMARILY PHYSICIANS AND ATTORNEYS, ENVISIONED A SCHOOL TO TRAIN STUDENTS FOR SERVICE TO THE COMMU, 'ITY. San Antonio, TX Dr. Adolphe J. Schoepflin '45 Ada, OK Dr. David S. Schreiber '69 Westwood, MA Dr. Joseph I.SchuHz'57 San Pedro, CA l 1 1f a lo Hys ieia n The following indi viduals left gen erous bequests or made arrangements for the school to recetve gtfts from testamentary trusts Gtfts from those listed were received dunng 1999. . . . . . . . . '15 Ms. Janet Butsch Dr. Edwin A. Salsitz '72 Dr. Arthur J. Schaefer '47 and Mrs. Elizabeth Ann Schaefer 34 w s Columbus, OH Rochester, NY Dr. Frank T. Riforgiato '39 and Mrs. Mary Cecina Riforgiato '37 E Dr. Michael Taxier '75 Amherst, NY Dr. Frederic D. Regan '45 N Dr. Fred S. Schwarz '46 Eggertsville, NY Fairview Park, OH T Buffalo, NY Dr. Kenneth J. Raczka '72 and Mrs. Rita Raczka Dr. John Y. Ranchoff '52 N S prin g 2 000 �Dear Fellow Alumni, NOW! R SUCCESSFUL S PRING C LINICAL D AY has recently come and gone. For those of you who missed this event-organized by Colleen A. Matti more, MD '91, and featuring the theme of "Children's Health"-be sure to look for coverage of it in the summer issue of Buffalo Physician. Prior to Spring Clinical Day, the Medical Alumni Association Board met and chose the following four alumni from reunion classes to receive achievement awards at Spring Clinical Day: Richard H. Alder, MD '45; D. Jackson Coleman, MD '60; N. Lynn Eckhert, PhD, MD '70; and Ani! B. Mukherjee, PhD/MD '75. The board also met to discuss nominations for the Berkson Award, which is given to the outstanding teacher among our faculty, and approved nominations of Robert Kalb, MD, and Corstiaan Brass, MD, to receive this year's honor. In addition to Spring Clinical Day, I am pleased to report that this year's Medical Alumni Association programs have all been successful. The Physician-Student Mentoring Program-in which first-year students are paired up with attending physicians in the Buffalo area-has had enthusiatic reviews from both the students and the physician-mentors. I encourage any of you in the Western New York area who would like to become involved in the program to contact the Medical Alumni Association office at the number listed below so that a student can be paired with you in August. The Community Physicians Program for first- and second-year students continues to meet with success, as well. The Alumni Association, under the chairmanship of Anthony Markello, MD '62, organizes speakers for these noontime meetings, which also include lunch for attendees. On February 2, 2000, Jack Cudmore, MD '62, and Daniel Kozera, MD '59, talked about their careers in medicine. For more information about any of these events, or other matters, please feel free to call the Medical Alumni Association office at (716) 829-2778. RICHARD L. COLLINS , MD President, Medical A lumni Association Spring 2000 luffal e Pb ysici ao 35 �CLASSNOTES 1940s Samuel Cassara, MD '44, writes from Rochester, NY: "I retired in 1997. I am a board certified pediatrician and was in the navy twice. The rest of the time I spent in private practice. I have three children: my oldest, my daugher, works in public relations for a private company; my son is an oral surgeon and my youngest is a social worker. Arthur J. Schaefer, MD '47, attended the American Academy of Ophthalmology's annual meeting in Orlando, FL, where he gave a threehour course on the surgical correction of malpositions of the eyelids. The meeting was held in conjunction with the PanAmerican Society of Ophthalmology and was attended by over 25,000 ophthalmologists from the United States and around the world. 1950s Richard Lyons, MD '50, writes: "I retired july 1, 1999, after 36 years of practice in anesthesiology; assistant clinical professor of anesthesiology at the University of Illinois; director of anesthesiology at Ravenwood Hospital Medical Center in Chicago, IL. Also retired from sailing, skiing and SCUBA. Widowed 36 l 11fala H ysieian since September 1998. Maintain homes in Evanston, IL, and Holmes Beach, FL. Looking forward to our 50th reunion." Ernest H. Meese, MD '54, received the American Cancer Society's (ACS) prestigious National St. George Medal in November 1999 at the Ohio Division's annual state meeting in Columbus, OH. The St. George Medal is presented annually to an outstanding division volunteer. Meese, who practices cardiathoracic surgery in Cincinnati, has been a dedicated volunteer for the ACS for 36 years and has served as president of the board of trustees for both the local Hamilton County Unit and the Ohio Division. He has also given many lectures in support of antismoking ordinance efforts and has seen the positive results of the ACS's work in his region. Currently, Meese serves as a lifetime member of the Hamilton County Unit Board of Trustees and as chair of the Tobacco Committee. Philip Brunell, MD '57, writes: "I retired from NIH a few months ago S prin g 2 000 but I am off to England to Great Ormond Street Children's Hospital as a visiting professor for three months in the spring. I still go into work at the NIH occasionally, edit Infectious Diseases in Children and serve as secretary of the World Society for Pediatric Infectious Diseases. Most of all, I enjoy my four grandchildren." E-mail address is: pbrunell@niaid.nih.gov Jacob Krieger, MD '59, Daniel Kozera, MD '59, Sandra Leininger, MD '59, Lackawanna, NY, Obstetrics/Gynecology. "I have been on the Board of Health for Erie County for over 15 years and have served as president. Due to heart disease, I left private practice of ob-gyn in 1986. Since then, I have worked parttime at the Erie County Health Department as a consultant in ob- gyn. I also consulted for the NYS Health Department and I am past president of Buffalo Gyn-Ob Society and past chief of ob-gyn at Buffalo Mercy and OLV hospitals." Danville, CA, Pediatrics. ''I'm healthy and happy!" Rochester, NY, Anesthesiology. "I was chief of anesthesia at Genesee Hospital in Rochester, NY, from 1969-1977; chief of anesthesia at Rochester General Hospital, Rochester, NY, 1984-1989; clinical assistant professor of anesthesiology at the University of Rochester School of Medicine from 1969-present." E-mail is: j mdkrieger@aol.com Richard Musgnug, MD '59, Medford Lakes, NJ, Dermatology. "I have learned over the years, as I am sure you all have too, life is too short and unpredictable to waste on things that don't have any real meaning in your life. If you can contribute something to a meeting, a committee, a board, etc., do it; if not, move on." E-mail is: Rcmus@aol.com E-mai 1960s Roberta Gilbert, MD '62, writes: "Just published Connecting with Our Children, Guiding Principles for Parents in a Troubled World. Wiley, NY, publishers." Robert W. Hamilton, MD '63, writes, "I was promoted to Professor Emeritus of medicine at the Medical College of Ohio on January 1, 2000. I have retired from the practice of medicine, but still teach parttime. I remain active in my church and with the Ohio Chapter of the American College of Physicians as vice president of the chapter. I am also learning to play the Great Highland bagpipes. E- mail address is: rhamilton@core.com Walter Ceranski, MD '64, Phoenix, AZ, Family Practice. "I became a grandfather six months ago." E-mail address is: 72772.137@compuserve.com Joseph DiPoala Sr, MD '64, Rochester, NY, Internal Medicine. "I am medical director and owner of the Doctor's Wellness Weight Loss Center to assist patients in achieving better health, physical fitness and weight loss. Plus rehabilitation exercise for elderly and those with osteoarthritis." E- mail address is: )dipoalasr@pol.net �__, !"'}' development and Medi· caid managed care, he Thomas C. Rosenthal, practice in the rural MD '75, professor and Western New chair of the Department York community Area Health Educa· of Family Medicine in the of Perry. Over tion Center, which he directs. For his also led efforts to create the New York State thalmology. It's still new and exciting and one of the most fun things in my life, along with hiking and kayaking and learning other 'new' things." University at Buffalo the next eight School of Medicine and years, he re- ongoing efforts in Irving Sterman, MD '64, Biomedical Sciences, has cruited and built the field of rural been named editor of the practice into health services, he The Journal of Rural a stable group was presented with Health, the peer-reviewed model. Boynton Beach, FL. "I was widowed in 1993 and remarried in 1995 and moved to FL. I am now working parttime doing disability evaluations, mostly for worker compensation cases in Syracuse, Y. I am enjoying traveling." E-mail address is: Turkyii@aol.com publication of the Rosenthal returned to National Rural Health his alma mater in 1986, Association INRHAJ. establishing the Office of A longtime contributor to the journal, Rosenthal the NRHA's Distinguished Educator Award in 1992. Rosenthal plans to broaden the journal's Rural Health at UB and audience and impact by leading the New York expanding its traditional focus on health-services has served on the Rural Health Research publication's editorial Center. Committed to research to include more board since 1997. His improving health care in articles on clinical issues interest in rural health underserved rural areas and social issues of rural began in the late 1970s, through research into health. when he opened a solo such issues as health professional workforce Michael Feinstein, MD '64, Scottsdale, AZ. "I retired on July 31, 1998, from my hematology-oncology practice on Long Island after 26 years. I am working parttime in a consultation practice in hematology-oncology in Phoenix." E-mail is: linmic@msn.com John Hazeltine, MD '64, Brainerd, MN, Otolaryngology. "I retired in October 1998. We are planning to live in Jack- sonville, OR, and will move this summer, nearer to our children in San Francisco. Retirement is terrific; I should have done it sooner." Stephen C. Scheiber, MD '64, writes from Deerfield, IL: "I am beginning my 15th year as the executive vice president of the American Board of Psychiatry and Neurology and I am currently - MARY BETH SP I NA for the Advancement of Psychiatry and the treasurer for the American College of Psychiatrists. I continue to be active on a number of committees of the American Board of Medical Specialties and participate in national meetings of many of the psychiatry and neurology specialty and subspecialty organizations." Elizabeth Serrage, MD '64, Cape Elizabeth, ME, Ophthalmology. "I still love practicing medicine C1aS'SiiOteS SPRING 2000 J. Michael Taylor, MD '64, Portland, ME. "I have developed a four-person dermatology practice in Portland, ME. I encounter Liz (Goering) and John Serrage regularly, both professionally and socially." E-mail: m.and. w.taylor@worldnet.att.net James Tibbetts, MD "64, Neurological Surgery. "We retired December 31, 1997, and are enjoying it and each other." Shorepeace@dcwis.com David Ziegler, MD '64, Walnut Creek, CA, Neurology. ''I'm retired and spend March in Phoenix- spring training (baseball)." E-mail is: Davidz@pc-systems. net Stuart H. Shapiro, MD '68. After graduation and board certification in radiology, nuclear medi- Spring 2000 cine, and public health, Shapiro turned his attention to the interface of politics, business and medicine. After staffing the U.S. Senate Health Subcommittee Committee, he became Health Commissioner for the City of Philadelphia and joined the faculty at Wharton School of Business at the University of Pennsylvania. He then moved into the private health-care financing at a large bank, then became senior vice president of a multinational nutrition company. Later he was named CEO of a publicly traded company that provides health care to prisoners across America. In 1997 he was recruited to be CEO of the President's Summit for America's Future with Presidents Clinton and Bush as active honorary chair and General [Colin] Powell as the chair. Shapiro continues to work with General Powell and to do private investing and consulting for for-profit and not-for-profit businesses. He feels he certainly may have the youngest children of anyone in the class- a daughter four and a son 11 months. E-mail'- - - address is: shapirostu@aol.com lu lf1l1 Hysieiu 37 �CLASSNOTES James Cavalieri, MD '69, Williamsville, NY, Pediatrics. "I am past president of the Buffalo Pediatric Society; past member of the board of trustees for Children's Hospital; and past board member of Independent Practice Associates. I am a founding member of Community Pediatric Associates ofWNY LLC. 1994 Pediatrician of the Year." E-mail address is: Jimkatec@aol.com John Fisk, MD '69, Springfield, IL. "I am professor of surgery at Southern Illinois University School of Medicine." E-mail address is: Jfisk@siumed.edu William Major Jr, MD '69, Orchard Park, NY, Thoracic Surgery. "I am executive director, IPA/ WNY, January 1999current." E-mail is: Wmajor@buf.adelphia.net William E. Stempsey, MD '78, SJ, has recently published a book titled Disease and Diagnosis, Value-Dependent Realism. Stempsey, a member of the Jesuit Community, currently is an assistant professor in the Department of Philosophy at the FACP, FAC, writes: "I retired from active solo practice of medicineinternal medicine and cardiology- in March 1999, not by choice but due to health reasons. In College of Holy Cross in Worcester, MA. In 1988, ten years after earning his medical degree at UB, Stempsey completed a master of arts degree in philosophy at Loyola University Chicago, after which he earned a master of divinity degree from the Jesuit School of Theology at the Uni versity of California at Berkeley. In 1996, he completed his doctorate in philosophy at Georgetown University. The book's publishers, Kluwer Academic, state that Stempsey's book "will be of interest to 1111111 Hysici11 Sprin g 1970s Russell P. Massaro, MD '70, lives in Elmhurst, IL, and is currently executive vice president for accreditation operations at JCAHO. Ashesh K. Maulik, MD '72, 38 May 1998, I was discovered to have pituitary macroadenoma. I underwent a craniotomy, followed by radiation therapy. Due to weakness and failing vision, I could not practice. Moved to Las Vegas, NV, to be near family. I miss Western New York and all the CME courses in Buffalo." 2 000 philosophers of medicine, value theorists, bioethicists, and physicians" because it "situates the practice of diagnosis in a new vision of how values permeate the world of disease and medical practice." More information on Disease and Diagnosis can be obtained by calling Kluwer Academic Publishers at (781) 871-6600; E-mail: kluwer@wkap.com Avery It Ellis, MD '77. PhD '79 has been appointed physician executive at the Department of Veterans Affairs Western New York Healthcare System. As clinical head of the veterans' facility, Ellis supervises the operation of both the Buffalo and Batavia sites, as well as community based outpatient clinics in Jamestown, Dunkirk, Niagara Falls, Lockport and Warsaw. Ellis received his undergraduate degree from Cornell University and his medi cal degree from UB, where he also received his PhD in physiology. He completed a medical residency and cardiology fellowship at Stanford University Hospital. In October 1999, he received an MBA from Duke University. At UB, Ellis is an associate professor of medicine and physiology, as well as director of the Cardiology Fellowship Program. A Fellow in the American College of Cardiology, he also holds membership in the American Heart Association, the American Society of Echocardiography and the New York Sate Cardiologic Society. of Andover [Maryland] and is medical director of two nursing facilities in the area and a local college. He has also been a mentor to family practice students and residents. - Terence Chorba, MD '79, writes: "After working on infectious disease issues in Kazakstan and central Asia for the Centers for Disease Control for four years, I am now working in Cote d'Ivoire [Ivory Coast] as director of Project Retro-CI, a collaborative AIDS/TB/ STD research activity of the Ministry of Health and the CDC." 1980s David Bristol, PhD '82, lives in Ann Arbor, MI, and is currently director of biometrics at ParkeDavis Pharmaceutical Research, where he provides guidance for development of treatment for cardiovascular diseases. Wesley L. Hicks, Jr. DDS, MD '84, FACS, has been ap- pointed director of the Fellowship Program in the Division of Head and Neck Surgical Oncology/ Plastic and Reconstructive Surgery at Roswell Park Cancer Institute (RPCI). In this capacity, he is responsible for the national accreditation and development of education and research programs at RPCI through the American Head and Neck Society. He will also continue to serve as associate professor in UB's Department of Otolaryngology. Anthony E. Turiano, MD '83, has been listed in the Guide to Top Doctors, a state-by-state listing of 15,000 doctors in 30 specialties nationwide who are most highly recommended by their peers. Turiano is chief of family practice at Suburban Health Care Andrew M. Knoll, MD '84, FACP, and Maritza Alvarado, MD '85, write: "Andrew has received a chancellor's scholarship at Syracuse University College of Law and graduates in August 2000." �In Memoriam Stuan Y. Collins, MD' 40, died on April 16, 1999. After being discharged from the Army Medical Corp, in 1946, Collins practiced medicine in Elmira, NY. Following his retirement in 1975, he resided in Tequesta, FL, with his wife, Marian, who survives him and who currently resides at 113 Cool View Drive, Noma Roberson, PhD '86, of Amherst, NY, recently published a book, titled Year 2000 and Beyond, which offers information about the potential impact of the year 2000; a checklist for personal information, housing, money, supplies, communications, transportation and personal computers; and spiritual guidance and devotion. Roberson is president/ CEO of a newly formed consulting company, Roberson Consulting Internationa!, the mission of which is to provide consultation to universities, Seneca, SC, 29672-2302. nity Hospital in Julian, named Julian was well known as Collins is also survived by Jersey City, NJ, a diplomate of a chef and culinary advi· three children and four after which he the American sor who frequently grandchildren. returned to But- Board of Ob- cooked in his home for Peter J. Julian, MD '47, falo to complete stetrics and Dallas restaurant chefs. his residency Gynecology in Besides his wife, Ruth Gray Julian, he is a Dallas, TX, obstetrician! training at Dea- 1954, moved gynecologist who practiced coness Hospital to Dallas with survived by a son, in Buffalo from 1951- in 1951. He then his family in nationally-known 1960, died of a heart entered private 1960 to start neoexpressionist artist attack in June 1999 at his practice on his own prac- Peter Julian, of New Dallas home. He was 74. A Humboldt Parkway with tice. He served as a clinical York, NY; a daughter, native of Buffalo, Julian Dr. W. Herbert Burwig, who professor at the University Linda Julian Richie of also completed his under· had the largest obstetrical of Texas Southwestern Dallas; a sister, Mildred graduate studies at UB. practice in Buffalo and Medical Center at Dallas, Nicholas of PA; and Following graduation from developed the city's first from 1960 to his retirement a granddaugbter. medical school, he interned group practice in obstetrics. in 1998. In addition to his at Margaret Hague Mater- (Burwig died in 1992.) reputation as a physician, foundations and government agencies that conduct health research and services for public education. Peggy Stager, MD '88, Dlufowobi Gbadebo, MD '91, writes: "My husband, Dick, and I welcomed our second son, Benjamin, on Superbowl Sunday, January 31 , 2000. Dick is certain that Ben's birthday is a sure sign that he will be a professional football player!" writes: "Buffalo Physician is sure a good way to keep in touch with events and developments within the University at Buffalo and the affiliated hospitals. As an alumnus of the Medical Department, I look forward to each edition of the magazine. Although my practive here in central Wisconsin is busy and rewarding, reading about my colleagues in Buffalo makes me homesick." Anhur Weissman, MD '86, writes: "I am a general surgeon at Tri County Memorial Hospital, in Gowanda, NY, and have a busy solo rural practice. I'm fortunate to be surrounded by excellent nurses and support staff and grateful to be alive and well, working and enjoying operating and office practice. Watching my kids grow up (Katie is 13-going on 35-and Zack is almost 9). Pat and I are planning our 20th anniversary trip to Paris. My best to all." E-mail is: arthursurg@aol.com 1990s Sean Cao, MD '90, was recently appointed associate chief, Division of Transplantation, Department of Surgery, at the University of California at Irvine's Medical Center. His address is UCI Medical Center, Bldg 26, Room 1001, Route 81, Orange, CA 92868-3298; his telephone number is (714) 456-8441. David J. Rodman, MD '91 , writes: "I have received an appointment in SUNY at Buffalo's Department of Chemistry as a research assistant professor and have joined the Biophotonics Institute [see related S prin g 2000 CD article on page 20 ]. I will be working on joint collaborative projects, including solid-state lasers and new drugdelivery systems. " Rosalind Nolan Sulaiman, MD '91, writes: "Rosalind Nolan Sulaiman and Adel Sulaimen are pleased to announce the birth of their second son, Kyle, last spring. Big brother, Cass, is now four." Daniel Pitterman, MD '92, writes: "I am an assistant professor of anesthesiology at Loyola University Medical Center in Chicago. My wife, Corrine, and I are expecting our first child in March." I~NT I NUEO ON PAGE + 0 l affale Pbysician 39 �CLASS NOTES BRAZIL REDUX Do you have a favorite memory, anecdote or inspirational moment that you associate with your medical education? How about a favorite professor, mentor or classmate you'd like to tell about? Buffalo Physician is putting out a call for stories about your past, which we will publish in future issues of the magazine. Here are some ways you can submit your story• •. bp-notes@buffalo.edu 716-645-2313 Editor, Buffalo Physician, 330 Crofts Hall, Buffalo, NY 14260. Be sure to include your name and a phone number or address where you can be reached. Your fellow alumni look forward to reading about your storied past! CONTINUED FROM PA GE 13 toxoplasmosis. Again, most of the diagnoses were based on history and physical exam, and I did learn how to perform a thorough medical examination and how to more efficiently use the history and presentation of the patient. I feel that this experience raised my skills to a new level and certainly deepened my appreciation for medicine. l Day-and Month-To Remember Joseph M. Kowlaksi, MD '93, has been appointed to the medical staff at the Erie County Medical Center (ECMC) Healthcare etwork. An orthopaedic physician/ surgeon, he will join the current team of specialists at ECMC's Spine Center. Kowalski earned his medical degree summa cum laude from UB, where he also completed his residency. He then completed a fellowship in spine surgery at Emory University in Decatur, GA. Prior to medical school, he earned a doctor of chiropractic degree from the National College of Chiropractic in Chicago, IL. Kowalski is a diplomate of both the National Board of Medical Examiners and Chiropractic Examiners. He is a member of the Alpha Omega Alpha Honor Medical Society and the orth American Spine Society. l1flal• Hysiciu Mansour V. Shirbacheh, MD '93, PhD, writes: "After obtaining my MD, I started general surgery training in Long Island, NY. However, in 1996, I decided to leave clinical training and join plastic surgery research in Louisville, KY. My research and many others culminated in the first hand transplant in the U.S. I also applied my research to my PhD dissertation. I received my PhD in physiology last May. I am currently training in plastic and reconstructive surgery in Louisville and will graduate in June 2001." Carollnn Killian, MD '94, Thomas Burnette, MD '94, write: "We are pleased to announce the birth of our second daughter, Lauren Killian Burnette, on November 24, 1999 (7lbs., 11 oz.). Big sister, Kristen, is now 19 months old and is adjusting well! Tom continues to practice internal Spri n g 2000 medicine and Carol Ann, emergency medicine, in NY. Catherine (Costello) Skae, MD '97, writes: "My hus- band, John, and I proudly announce the birth of our daughter, Anya Bernadette, who was born on January 21, 2000-9 pounds, 7 ounces. I am a third-year pediatrics resident at the Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, where I will be the pediatrics chief resident starting in July 2000." Paul Guttuso, MD '97, writes: "I will be starting a fellowship in sports medicine in July 2000. My wife, Trinia, an occupational therapist, just passed licensure for certified hand therapy. We are so proud!" Paul Rosen, MD '97, writes: "I will graduate from Mt. Sinai's Department of Pediatrics and start a fellowship in pediatric rheumatology at Children's Hospital of Cincinnati in July 2000." M y last day at the hospital is one I will always remember, as that's when I completed my most difficult assignment. Weeks earlier, a professor had asked me if I would be interested in giving a talk on hepatitis A. He gave me articles to read, as well as suggestions on what I should cover. He also recommended that I generate a handout for the students. So, on that last day-in front of my classmates, professors, nurses and hospital administrators! gave a 20-minute presentation in Portuguese. Although I was anxious about having to present such technical information in a foreign language, it went very well. I did have difficulty pronouncing certain medical words without a strong accent; however, the audience was responsive and helpful. After I finished, I realized that I had learned a lot about myself, my work ethic and my presentation skills. Having overcome such a challenging situation, I now feel I would be comfortable speaking in front of any group. Looking back on my experience in Campos, I can see that every facet of my education was enhanced, as I learned a tremendous amount about medicine- and myself. In short, I feel that my month in Brazil was a high point in my medical education, to date, and one that further affirmed for me that medicine is my career of choice. CD Michael White is a fourth-year student at the University at Buffalo School of Medicine and Biomedical Sciences. This summer he begins residency training in emergency medicine at Eastern Virginia Medical School, Sentara General Hospital, in Norfolk, Virginia. �HEN DEBORAH A. WHITE, MD '87, her husband, Christopher, and their four-year-old son, Adam, were killed m an automobile accident in February 1999, a number of people at the University at Buffalo School of Medicine and Biomedical Sciences felt a desire to bring together alumni, faculty, staff and friends with the goal of memorializing the Whites. Instrumental in this effort has been Dr. Gail Willsky, associate professor of biochemistry, who knew Deborah as a student and friend and remains close to her family. As a result of the efforts of Dr. Willsky and others over the past year, the medical school's Office of Development has established the Deborah, Christopher and Adam White Memorial Fund. Proceeds from this fund will support a summer internship for a first- or second-year medical student at UB who is interested in pursuing rural medicine as a career. As many of you know, Deborah was a native of Western New York and grew up on a dairy farm in Eden. Three years after earning her medical degree at UB, she joined a busy internal medicine practice in Middleport, a town of approximately 2,000 people several miles west of Medina, where she was on staff at Medina Memorial Hospital. The same year Deborah began her practice in Middleport, Christopher-who earned bachelor's and master's degrees in biology from UB-chose to give up his position as a cellular and molecular biologist at Roswell Park Cancer Institute to become a stay-athome parent. Today, the White's surviving children, Andrew, 10, and Elizabeth, 7, live with Christopher's sister, Mrs. Sue White Chiddy, in Elba. Mrs. Chiddy says the children are doing well and both show an interest in science. (Andrew says he'd like to be a veterinarian.) Friends and colleagues who knew of Deborah's dedication to rural medicine felt that an endowment supporting education and training in this area of health care would be the best way to honor her life as a physician. In the future, a student whose training is supported through the memorial fund will be expected to complete a summer internship in a rural setting, preferably in the Deborah and Medina area. In addition to supporting a rural internship, it is hoped that the fund Christopher White, will provide two additional awards: one to a with Andrew, Adam student graduating in the biological sciand Elizabeth. ences, and another to a student graduating Today, Andrew and in biochemistry, thereby honoring both Elizabeth live with Deborah's and Christopher's accomplishChristopher's ments in these fields. sister, Mrs. Susan For more information about the Chiddy, in Elba, NY. Deborah, Christopher and Adam White Memorial Fund and its support of students interested in pursuing careers in rural medicine and biological sciences, please contact Mary Glenn in the medical school's development office by calling (toll free) 1-877-826-3246; e-mailing glenn@acsu.buffalo.edu; or writing to: Office of Development, School of Medicine and Biomedical Sciences, University at Buffalo, 102 Cary Hall, 3435 Main St., Bldg. 23, Buffalo, NY 14214-3005. �We Get Rehab Results! Our Superior~ Improvement Vs. National and Northeastetn Regional Subacute Facilities Hve Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIMsM increase vs. the national average for all admissions. • Pain Management Stroke • Medically Complex • Orthopedic • Infections Cardiac • Cancer • Joint Replacement • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. 0 ***** 0 The McGuire learn. ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! Transfer =Inpatient Admissions I The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. To1let Transfer =Inpatient Discharge I =Outpatient Follow-Up Our case mix is consistent with the Northeast and national su bacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FlM score 72.5; discharge FlM score- 97.6; FlM change- 25. 1 points; length of stay efficiency- 1.40; onset time- 17; discharge disposition- 80% to community. Based on 12 months ending March 3 1, 1998. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMsM rehabilitative outcomes. This tool is known as FIMsM© improvement, discharge to home, and cost effectiveness. Instrument; Functional Independence Measure, developed ,.,... Our successful rehab program delivers results by the UB School of Medicine along with the Center for ~ ~ because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRsM) rehabilitation services. to establish rehab outcomes that DTT ~JI'T""T""J\T Call l-888-POSTACUTE. can be measured and calculated .& ~~ ~\7~ c:MCGUL1?E ""J;'pU Jl W .J.L'1J '-.. -:::::U=Dom-i<MQ}!JJ:!!!j§UBF~--~ ~. Al rifFm =<d. Autumn View • Garden Gate • Harris Hill• Northgate BP 0004-00 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2000 Subject The topic of the resource State University of New York at Buffalo. 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Rehabbing from Within Little Ears, Big Infections Brain Drain Student Column Medical School Pathways Development Classnotes Memorial Fund Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n04 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/fb8a399d09f5525f5ef63efb48ff9171.pdf c8e4cd065beb7b044517e2ea752b6e79 PDF Text Text �l1ffale P~ysicial A SSOC IATE V I C E PRE S I DE T FO R U NIVERSI T Y SERVI C E S Dr. Ca role Smith Petro Dear Alumni and Friends, DIRE CTO R O F P U BLI C ATI ONS Kathryn A. Sawner EDI TO R Stephanie A. Unger ~\ RITI '(,, nn I·~D 01 Till \( ADF\11( n \R is upon us and both freshme n and sophomores are in the m idst of fina l examinations. Although the newly created study space ART DIRE cT 0 RIDE s I G N E R Alan]. Kegler is as yet un furnished (the furniture is on order), we have made some makeshift arrangements for students du ring their finals and for national board preparation. We hope to have this important student resource fully functional shortly. On another positive note, we hope to upgrade the computer lab during this next year, as the present computers are three years old and their warranties are about to expire. The newer machines (and redistribution of the o lder ones) will be helpful to the new curriculum A SS I STA N T DE S I GN ER Lynda Donati PR O D UCT I O N COO RDIN ATO R Cynthia Todd - Flick STATE UN I V ERSIT Y OF NE W as it begins to u nfold a year from now. Some of the o lder pentium computers will be YORK AT B u FFALO S c H oOL relocated to the Standardized Patient Project, which, as many of you know, is a project OF M E DI C I N E AND through which Buffalo has taken a leadership role in the development of BI O M E DI C A L S C IE NCES Dr. fohn Wright, Dean modules for the national board, as well as in the development of E DI TO RIAL B O ARD standardized testing. In collaboration with the national board, our own computer group, under the leadership of Dr. Ray Dannenhoffer, has devised a system to computerize studen t-"patient" interactions for reporting direct ly to the board. Using industry standard hardware and software wi th customized programming scripts, a pilot project was so successful that we have been asked to provide the computer support for each of the board's present test sites at the University of California at Irvine, Mercer University, Tulane University, the University of Massachusetts, East Carolina University, St. Lou is Un iversity and, of course, UB. We will configure the servers and workstations here and ship them to each of the participating schools. Our staff will then complete hardware and software installation on site and train loca l personnel on program operation. Since the standardized patient will soon be part of national board testing, our school's involvement in the process is something to brag about. Speaking of"bragging rights," our Mini Medical School has a few of its own. Through this innovative progra m , Harry Sultz and Alan Reynard have developed a remarkable community resource. The Mini Medica l School recently received a welcome "shot in the arm" through a generous gift from Esther and Don Davis. This support will provide muchneeded financial stability as the project branches out in both subject area and community coverage. We have already been alerted to a need in the Southtowns, and the facu lty are looking into telemedicine venues in order to reach an even broader community. This, of course, has implications for a range of programs at UB, includ ingCME and GM E possibilities. Finally, Dr. john Yeh, from the University of Minnesota, joined the Department of Dr. Bertram Portin, C hai r Dr. Martin Brecher Dr. Haro ld Brody Dr. Linda f. Corder Dr. Alan]. Drin nan Dr. fames Kanski Dr. Elizabeth O lmste d Dr. Steph e n Spau lding Dr. Bradley T. Tru ax Ms.fennifer Wiler Dr. Franklin Zeplowitz TEA C HIN G H O SPITALS Erie County M edica l Ceuter Roswell Park Cancer Institute Vet erans Affairs Western N ew York Healthcare System K A U :IDA Hf: A l_ J fl: Th e Buffalo General Hospital The Children 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillm ore Suburban Hospital C ATH OLIC H f. A l TH SY<Tf.\1: Mercy Health System Sisters of Charity Hospital Niagara Falls Mem orial Medical Center ® TIE STITI IIIYIISITY If lEI Till AT II HALO Ob-Gyn as chair on May I. He has recruited four new facu lty and is working on a fifth . And we look forward to the arrival of Dr. Kenneth Blumen thal, from the University of Cincinnati, who will begin leading the Department of Biochemistry around the first of August. Greetings to you all, and best wishes for a very pleasan t and relaxing summer. 7 ( / ~</~ R. WRIGHT, MD Dean, Sch oo l of Medicine and Bio m edica l Scien ces jOHN Buffalo Physician is published quarterly by the State University of N ew York at Buffalo School of M ediciue aud Biomedical Sciences aud the Office of Publications. It is seut, free of charge, to a/umui, faculty, students, restdents, aud frieuds . The staff reserves the rig/It to edit all copy and submissions accepted for publication. T...:l:... University at suffal;rk -:.=:s Tiu>State University ofNew �V 0 L U M E 35, NUMBER 0 H Special 2 group helps first-year students 14 Match Day 18 Graduation N Concussion in sports: new guidelines call for "time-out" BY S.A. UNGER MILLER Wake·up Call Difficult decisions for a gifted young athlete S. A. BY UNGER Carl Lindros, left, father of hockey stars Brett and Eric Lindros, has teamed up with University at Buffalo professor Barry Willer, PhD, right, to institute back·to·play guidelines following concussion in amateur sports. The story of their successful international effort begins on page 2. Baseline Scoring UB professor's neurocognitive test used by FL and NHL BY S. A . UNGER 21 Professor 13 New tutorial A Safe and Sound COVER prospective students an in-depth preview c s eport PHOTOGRAPHY BY FRANK 8 10 y Theodore Bronk remembered 22 New faculty 23 Nancy Druar wins Naughton Award ILLUSTRATION BY WHITNEY SHERMAN 25 Maxine Hayes returns to UB to deliver Stockton Kimball lecture 27 Medical Alum ni Lifetime Achievement Awards 29 Reunion classes traditions begin today your classmates and other UB alum ni 36 First Minority Alumn i Reunion held 40 Medical Alumn i Association officers elected reception October 29 in Chicago 41 Photographs from Spring Clinical Day and Reunion Weekend gatherings �or ort by S. I. Unger Photos by Frank Miller -Carl ,, lin~ros �Due to concussion. Brett Lindros, right, was forced to withdraw from the National Hockey League in 1996 at the age of 19. His injuries served as an impetus for his father, Carl other young athletes from experiencing what his son-former professional hockey player Brett Lindros-experienced that led Carl Lindros four years ago to seek out Barry Willer, PhD, an expert in traumatic brain injury and a professor of psychology at the University at Buffalo School of Medicine and Biomedical Sciences. Since that time- due in large part to Lindros's inspiration- Wilier has become a highly visible leader in international efforts to establish return-to-play guidelines following concussion in amateur sports. The pivotal event that allied Willer and Lindros in their efforts to prevent concussions in sports took place in Buffalo on ovember 24, 1995, during a ational Hockey League (NHL) game between the New York Islanders and the Buffalo Sabres. During that game, while his father watched from the stands, Brett, a second-year player with the Islanders, sustained a concussion that not only changed his life forever but, indirectly, impacted the world of amateur sports, as well. Lindros. to work with University at Buffalo professor Barry "While watching Willer to develop guidelines aimed at keeping young athletes the game, I rememout of sporting events for asafe period of time following a ber seeing Brett check an opposing player in concussion. Pictured with Brett is his older brother Eric. of open ice late in the the Philadelphia Flyers. who today is fighting his own first period," Lindros well·publicized battle with concussion. recalls. "He wasn't hit in the head, but the deceleration from the contact caused him to be concussed." When Brett didn't come back on the ice at the start of the second period, Lindros became concerned and went to the locker room to look for him. There he saw something he says he will never forget. " I found Brett sitting alone, trembling. And right away r could see he wasn't himself," explains Lindros. "He was very disoriented-one moment he was coherent and the next moment, incoherent; he was fading in and out. l could see that it was a serious issue." S 11mm er 2000 Bu ffalo Physician 3 �he next morning, having returned home to Toronto, Lindros went to the public library to discover what he could about concussions. It was through his research in the weeks that followed that he first learned about the Ontario Brain Injury Association (OBIA), an organization that Willer-a native of Canada-has been affiliated with as avolunteer for more than ten years. "In my search of the literature, I found a lot of current " He'd go 'in and out,' and there were noticeable changes in his behavior. He was anxious and jittery-like he had too much papers on severe traumatic brain injury, but hardly anything about repeated mild traumatic brain injury, and it's these caffeine-so he couldn ' t focus on anything for very long." Over several months, Brett's symptoms gradually abated; types of injuries-concussions-that are the most preventable," says Lindros. "What I did find about concussions tended however, in the interim he sought the opinion of three promito be published in the last 10 years, but the theories they nent neurologists, each of whom recommended that he not play discussed were often contradictory, and they confused me hockey again. As a result, on April 15, 1996, at age 19, Brett because I was looking for clear direction," he adds. formally announced his withdrawal from the sport. Despite the dearth of published research on concussions, Knowing what he now knows about concussions, Lindros is Lindros did discover startling statistics about the scope of the thankful that his son was not hurt worse than he was. "Brett's problem, including the fact that an estimated 30 percent of all concussion [in November 1995] was his second in an eight-day youth in the U.S. and Canada will experience a concussion period. What I realize now is that he was probably playing in a before they leave high school and that, of these cases, only concussed mode that night." about one-fourth will be seen by a physician. In hindsight, Lindros also realizes that Brett might have been As long as there is only one minor concussion, the symptoms playing in a concussed mode earlier in the session, as well. are, for the most part, reversible, and the brain recovers within "For example, l remember on one occasion Brett's coach about five days. However, when there are multiple minor conasked him what he was doing during a shift, and he couldn't cussions, particularly if these concussions occur tell him because he couldn't remember. close in time, the probability of irreversible brain damage "Clearly, Brett could have been seriously and permanently rises dramatically. injured in Buffalo. If he had had a significant direct blow to his More worrisome still is the fact that if a young athlete is head that night, there's no telling where he'd be today. There 's allowed to return to play too soon following a concussion and no doubt he was playing when he should not have been. " sustains a second, even minor, blow to the head, he or she can experience a rare, but lethal, condition called secondimpact syndrome. On March 12, 1997, the American AcademyofNeurology (AA The more Lindros learned about concusheld a news conference in New York City for the purpose of sions in the weeks following Brett's injury, announcing return-to-play guidelines it had established. In the more concerned response to an invitation from the AAN, Brett attended the news he became for his son, whose symptoms were debilitating. "He ut of this discussion evolved the guidelines that were adopted in 1998, which, couldn ' t dial a digital phone, he couldn't according to Willer. have been worded in such a way that they "not only make sense read, he couldn't drive, medically. but are presented in a format that enables mom·the·team·trainer to readily and what was really frustrating was that his understand them-mom, that is, whose occupation may be accounting, not medicine." symptoms weren't consistent," says Li ndros. 4 Butt a I o Physician S 11111111 er 20 0 0 �-~ - - - - -- ~~--~-------------------~------------- conference and participated in a panel discussion on the guidelines and their role in attempting to prevent concussion in sports. Soon after this event, the Lindroses were contacted by the OBIA and asked if they would lend their support to the organization's fund-raising efforts, which they agreed to do with the stipulation that a portion of the proceeds raised go to disseminating information about the AAN's guidelines. In response to this request, the president of the OBIA initiated preliminary discussions with the Canadian Hockey Association (CHA) in an attempt to get the association to agree to adapt the AA 's guidelines. It was when these discussions came to an impasse in the summer of 1997 that Lindros asked Wilier-whom he had met at an OBIA event-if he would help get the stalled negotiations with the CHA back on track. W iller agreed to collaborate with Lindros on the project, as well as on a myriad of other preventive strategies aimed at keeping young athletes out of sporting events for a safe period of time following a head injury. On January 1, 1998, their efforts came to fruition when the CHA formally adopted return-to-play guidelines that had been painstakingly crafted by Willer with the assistance of John Leddy, MD, a UB associate professor of clinical orthopaedics and associate director of the university's Sports Medicine Institute. Getting the return-to-play guidelines adopted by the CHA was a very significant step forward, according to Willer, because "the association governs all amateur hockey in Canada, which makes it the first bona fide sports organization to have adopted guidelines regarding concussion." Willer, who has been involved with hockey as a player and coach for most of his life, says he agreed to focus his efforts on hockey not only because he loves the sport, but because he felt it would be an effective conduit for introducing return-to-play guidelines in other amateur sports, which in fact it adopted them on an informal basis, with formal adoption expected to take place sometime this year. When this happens, the guidelines will apply to all international hockey events, including Olympic hockey. Furthermore, if other, alternative guidelines aren't adopted [by the Olympics], the return-to-play guidelines of the International Ice Hockey Federation will apply, by default, to all Olympic events." Willer reiterates that the initial impetus for establishing return-to-play guidelines came from the AA but emphasizes that these guidelines, while groundbreaking, do not translate well to the realities of amateur athletics. " Prior to the AA announcing their guidelines and publishing them in the journal ofNeurology, there were no really authoritative guidelines anywhere. The problem, however, was that the AAN guidelines were basically written for professional sports or other environments where a qualified trainer is on-site and the athletes' histories of concussion are available; in other words, they assume that there is someone on the bench-either a physician or a professional trainer-who can immediately appraise an athlete's condition and determine if he or she can return to play at that time or not." has been. "Hockey was born and bred in Canada, so the international sporting community still looks to Canada and the CHA for leadership," he notes. "Because the CHA adopted the guidelines, the International Ice Hockey Federation also recently S 11 111 111 e r 2 0 0 0 Bu II a I o Physician 5 �when you 'sprain your brain' it's a bigger deal than spraining your knee ing your knee or ankle. If you play on abum knee or live with abum knee, that's one or ankle. If you play on a bum knee or live with a thing. But if you don't come back fully from abrain injury, it's different. You may be bum knee, that's one left with asignificant decline in mental functioning." thing. But if you don't come back fully from a brain injury, it's different. You may be left with a When Lindros suggested to Willer that the UB professor apply functioning." significant decline in mental his expertise and influence toward helping establish guidelines of tell the players. when you 'sprain your brain' it's abigger deal than sprain· a similar nature in amateur sports, Willer and his collaborators began by going to the CHA to meet with the individuals within the association who develop educational programs for trainers. "What ensued was a debate that centered on the questions, 'What can we realistically expect from the volunteer trainer/ coach on the sideline who is just somebody's mom or dad and who has little or no medical background? What kinds of decisions can we expect him or her to make about a player's condition?"' explains Willer. Out of this discussion evolved the guidelines that were adopted in 1998, which, according to Willer, have been worded in such a way that they "not only make sense medically, but are presented in a format that enables mom-the-team-trainer to readily understand them-mom, that is, whose occupation may be accounting, not medicine. " (See guidelines on page 7.) Essentially, the guidelines adopted by the CHA involve three basic modifications to the AAN guidelines. In addition to providing wording that better helps inexperienced trainers identify a concussion when it occurs, they recommend that all concussed athletes be asked to see their physician before they return to play. "Also, given the substantial increase in risk for irreversible damage due to repeated concussions, if an athlete has three concussions in the same year, it is recommended that he or she rest away from the sport for the remainder of the playing season," explains Willer. "These guidelines help make sure nobody goes back to playing sports until they've fully recovered from symptoms of a head injury," emphasizes Leddy, who, as a team physician for intercollegiate athletics at UB, knows firsthand about the dangers of concussive injuries in amateur competition. "I tell the players, 6 8 u f fa I o Physician S llllllll cr 2 000 Despite the apparent simplicity of the modifications made to the AAN guidelines, they required a long series of discussions with the CHA, with final wording changes taking place as late as December of 1999. Lindros feels Willer's role was crucial to making the project a success. "Due to his scientific expertise and credibility, he [Willer] was able to facilitate the whole process and gain the complete support of Canadian amateur hockey through the CHA. He brought order and cohesion to the effort." Physicians' Role aKey to Success Because the guidelines recommend that players see their physician before returning to play, Willer and Leddy have also been working to provide physicians with educational material about concussion in an effort to help them better assess when it's �safe to allow a child to return to playing sports. "Most family doctors, internists and pediatricians probably don 't see enough of these head injuries to really be very comfortable with treating them, and it's not something they' re taught about in medical school," notes Leddy. " 1 think most physicians need more education about how to identify when a concussion has occurred, as well as how to identify and treat symptoms of postconcussive syndrome." F urthermore, he cautions, "These injuries can be difficult to diagnose, at best. There are a lot of symptoms that mimic other things; also, athletes are prone to minimizing symptoms or downright denying them to the doctor. " Toward the goal of educating physicians, Willer is developing an educational package that includes the return-to-play guidelines, information on symptoms of concussion, and assessment procedures for concussed athletes. Through his affiliation with the OBIA, he is also working to organize a medical advisory committee on concussions that, in addition Management e .o eyes; or if eyes open, cannot s Guidelines Following Concussion 1. Remove from the contest. 2. Monitor symptoms (con- Developed by the Ontario Brain Injury Association and approved by the Canadian Hockey Association. fusion, headache, etc.). If they persist longer than 15 minutes from the time of injury, the athlete should be referred to a physician immediately. The injury should then be treated as a Second-Degree/ Complex Concussion. 3. Always check for a possible neck injury. 4. Notify parent or guardian and do not administer any medication. 5. Cannot return to play without approval of a physician and at least 24 hours of symptom-free rest. First-Degree/Simple 1. Confusion, also defined as an altered state of consciousness, that lasts for less than 15 minutes (e.g., asks the same question repeatedly, such as "What happened?" or does not know simple facts, like who the opponent is or what the score is). 2. No loss of consciousness. 3. Dizziness, headaches, nausea, lethargy; may have some memory loss. to establishing a consensus on post-concussive symptoms, will sponsor educational conferences for health-care professionals. " In the long run," he says, " the goal is to help physicians be a little more astute at picking up symptoms and a little more aware of the long-term consequences of concussions themselves." Lindros commends this comprehensive approach to education because he fe els it can lead to protection for all children, not just those involved in sports. "These guidelines, and the awareness they help create, apply to everyone, including parents who see their child fall off the swing set and hit their head. They aren ' t just for sports, but for life in general. What they remind all of us is that the clock doesn't start ticking-a child or an athlete doesn ' t go back to play-until he or she is symptom-free at rest and with exertion for an appropriate period of time. " Essentially what we' re saying is, 'Let's have greater respect for the body and things we do to the head. ' When the body isn ' t treated with respect, a minor concussion can lead to significant, long-lasting problems. " CD Second-Degree/Complex seem to focus, does not answer to name, may be limp). 2. Loss of consciousness may only last seconds but is still serious and must result in removal of the player from the contest. Management ec m aos 1. Always check for injury to the neck. 2. Remove from contest and disallow return that day. 3. If unconscious, or condition deteriorates, stabilize the head and neck and activate the Emergency Action Plan, including transfer by ambulance. 4.Cannot return to play without approval of a physician and at least one week of symptom-free rest. after any concussion requires a physician 's approval. In order to make the most informed decision, the physician must be made aware of the history of concussions and symptoms experienced by the athlete. Another important aspect of these guidelines is that the only known cure for concussion is rest. It takes time for brain cells to recover. When there is more than one concussion in the same season, a physician may recommend a much longer period of rest from sports. If an athlete has three concussions in the same year, the physician may recommend rest away from the sport for the remainder of the playing season. For more information, call 1. Confusion that lasts longer than 15 minutes, or a loss of consciousness (does not open More than One Concussion S· S o An essential aspect of these guidelines is that return to play S 11 mmer the Ontario Brain Injury Association pt 1-800-2635404, or visit their website at www.obia.on.ca. 2000 B u II a I o P h y s i c i a n 7 �by S. I. Unger Wake· Difficult decisions for agifted young athlete ) C) was quite sure hockey would be a big part of his life for as long as he wanted it to be. Today, however, the 17-year-old from Kenmore, New York, isn't quite so certain. That's because Dan recently suffered two debilitating concussions that have left him with a decidedly new appreciation for what it means to have a healthy brain. "Hockey has pretty much been my life. I started playing when I was four, and since the seventh grade I've played on teams yearround," he explains. And Dan hasn't been the only one enjoying the sport. "Hockey is a bonding experience for our family," says his father, Tom. His mother, Bonnie, says, "If you ever get to watch Dan play, the joy is in seeing him skate; he's just such a beautiful skater." john Mickler, Dan's coach at St. joseph's Collegiate Institute, also gives Dan high marks for his prowess on the ice. "Dan has been on the varsity since he was a sophomore. He's a very good player. He's fast and aggressive and plays with great enthusiasm, with a love of life." Dan experienced his first concussion in September 1998, while playing with an independent travel team, the Buffalo Saints, at a tournament in Toronto, Ontario. "I was skating up the middle of the ice and was hit behind with a cross-check," he recalls. "He didn't know where he was. He was disoriented, his eyes were dilated, and we knew he had to come off the ice," explains Tom, who was in the stands when the injury occurred and felt confused himself. "I know what needs to happen when a player breaks his arm, but I didn't have any idea what to do when Dan had his concussion," he says. Despite his initial uncertainty, Tom had the paramedics at the rink look at Dan. "They told us he had a head trauma, and that we needed to watch him pretty carefully," he remembers. The next day, the tournament was in full swing and Dan's team was scheduled to play again. When Dan got up in the morning, his father asked him how he felt, and he said he felt pretty good, that he didn't have a headache and wasn't disoriented anymore. ''I'm not proud of this, but when he asked me if he could play in the game that day, I said yes," explains Tom. In looking back on that decision, Tom now knows how 8 Buffalo Physician S11mmer 2000 fortunate he and his family were that day. "It was a very rough tournament. And while Dan didn't get hurt in the game, his closest friend experienced a concussion in it." The week following the tournament was the first week of school for Dan. "I didn't know why I was there or what I was supposed to be doing," he says. "I figure I'd had concussions before-maybe from playing football in the neighborhoodbut nothing ever stopped me before like this. I was startled." Over the following weeks, Dan's symptoms cleared up and he was again able to immerse himself in the sport he loved. A year went by, and Dan's concussion seemed a thing of the past. Then, on October 24, 1999, at the close of his season with the Buffalo Saints, he suffered a second, even more serious, concussion. The incident occurred at a tournament in Cleveland, Ohio, where Dan had traveled with the parents of a friend on the team. Despite the severity of his injury, no one seems certain about what actually happened. "It was the third game of the tournament, and I remember playing really hard and scoring a goal. After the game, we had free time on the ice, but I remember going over to the bench and just sitting down," says Dan. "I thought maybe I was super tired." Later, in the locker room, Dan's coach came in to talk to the team, but Dan couldn't understand him."[ didn't know what he was saying. I was lightheaded and dizzy, and I began to wonder what I was doing there and where my parents were. I almost got kind of panicky. I didn't even know what day it was." Although scared, Dan didn't tell his coach what he was feeling. ''I'm not a big guy," he explains. 'Tm only about 5' 8", and I didn't want to complain, but I was so tired I couldn't stand up." When his teammates dressed and left the locker room, Dan stayed behind. "The parents of Dan's friend waited in the lobby and became alarmed when he didn't come out," recalls Tom. "When the father finally went to look for him, he found Dan in the locker room alone, sitting on the bench. He didn't know what was going on or what had happened." All Dan remembers about the remainder of that road trip is that he slept in the car during the entire drive back to Buffalo. Bonnie Sanderson called Dan's pediatrician, who told her Dan had to stay off the ice for two weeks. Tryouts for the school �because l wasn't in shape, that maybe I had heat exhaustion," he says. Dan didn't try to skate again until the week ofThanksgiving, at which time he traveled with the team to Detroit and played in a game, the first since his concussion. Again, he felt as though he were suffering from heat exhaustion. "After that, I knew l needed to go to the doctor again; I just wasn't getting better," he says. The following Monday, Bonnie called a friend of theirs who is a neurologist, and he told her to bring her son in immediately. "He gave Dan an MRI and a complete examination and told us he couldn't be on the ice for another two or three weeks, or until his symptoms went away," says Bonnie. On December 15, 1999, Dan returned to play and has not reinjured himself since. "This last concussion was our wake-up call," says Tom, who accepts that Dan's playing days may be numbered. Dan, too, knows there may be difficult decisions to make in the future, but says he no longer looks at hockey in the same way. "Alii have to do is remember those couple of months when I couldn't think in math class and had to ask everyone to repeat things they Normally,l'm agood student, but I couldn't sit still in class for five minutes. I wanted to said to me four times. What's happened to me has brought me down to thinking about what get up and walk out. I just had no ambition to be there," says Dan. "I slept a lot, had a I really want to do. I'm starting to think about headache all the time, was dizzy, and my head felt foggy.l didn't want to do anything." the pros and cons of continuing to play." As he helps his son grapple with the potential long-term implications of his injuries, Tom also ponders whether better Bonnie Sanderson also decisions about Dan's health could have noticed big changes in her been made from the outset. "As parents, I son. "Dan is usually on top think we needed a little more training and of things, both at school guidance. We need more information so we and at home. But many can all be on the same page when a player times when I would talk to gets a concussion. It would have been helpful him, I'd literally have to if we had had more explicit instructions say, 'Dan, are you with me?' about what to look for, what to do." He wasn't himself. He was Bonnie sees the problem in an even larger acting very goofy; that's the "I feel it's really a disservice when you context. best way I can describe it." read in the paper that a pro player has had a While Dan didn' t play concussion on Sunday and then is back at prachockey, he did go to his tice on Thursday and back playing in a game team's practice sessions, that next week. The media treats concussions where he'd watch from the like a broken leg. They make it out to be nobench. "I wanted to stand thing, so it's been hard to know what to think." on the bench to watch, but Like Tom, Bonnie feels different decimy balance wasn't good sions would have been made had she known enough to do that, so I rein September 1998 what she knows today. "I member I had to stand on would never have a child of mine go back out the floor instead." on the ice if I knew it would endanger his On November 17, Dan health," she says. "Yes, hockey is important to played in a scrimmage, but us as a family, but, as I tell Dan, 'I like you didn't feel well afterwards, just the way you are."' 4D he says. "I thought it was team were coming up, but since Dan had made the team the year before, Coach Mickler suggested he take some extra time off in addition to the two weeks. Unlike what happened after his first concussion, however, Dan's symptoms didn't go away, so Bonnie took him to see their pediatrician, who told her Dan couldn't return to play until his headaches subsided. "Normally, I'm a good student, but I couldn't sit still in class for five minutes.! wanted to get up and walkout. I just had no ambition to be there," says Dan. "I slept a lot, had a headache all the time, was dizzy, and my head felt foggy. I didn't want to do anything. "I really began to wonder what was wrong with me, what was happening to me," he adds. "It would have been easier if there had been a clear-cut blow to my head that caused my concussion, but we watched film from the game later, and even though I could see I was hit in the head a few times, nothing stood out as the hit that caused my concussion." 5 " 111 111 er 200 0 Buffalo Physician 9 �I I by S . A. Unger ne of the reasons why many experts feel concussion is such an overlooked problem-even a "hidden epidemic"-is because the affected organ is itself hidden from view. "Yet, when a brain is concussed, if you look at it on a microscopic or cellular level, there's a whole cascade of events taking place, including changes in blood flow and glucose and electrolyte metabolism," explains John Leddy, MD, UB associate professor of clinical orthopaedics and associate director of the university's Sports Medicine Institute. While physicians still don't understand all the physiological changes a brain undergoes when con cussed, what they do know is that concussions cause deficits in neurocognitive abilities, especially when more than one concussion is suffered within a short period of time. Due to recent advances in neuropsychology, neurocognitive tests are now available that measure these deficits more precisely than ever before. When used in conjunction with a standard neurological examination, they become powerful tools for assessing whether an individual has recovered from a concussion. Neurocognitive tests and the data they provide are of particular interest to professional sports organizations, which today are experiencing increased pressure from players' unions and insurance companies to adopt return-to-play guidelines that better protect athletes from preventable, career-ending head injuries. (See article on return-to-play guidelines established in 1997 by the American Academy of Neurology, page 2.) Several years ago, in response to these pressures, both the National Hockey League (NHL) and the National Football League ( FL) began participating in the HL!NFL Players' Association Concussion Testing Project, developed by Mark Lovell, PhD, a neuropsychologist at Henry Ford Hospital, in Detroit, Michigan. (Participation in the project is mandatory for NHL teams and voluntary for NFL teams. Currently, about 85 percent of the FL teams participate, not including the Buffalo Bills.) As part of the project, no athlete can practice or play with a team until he undergoes a baseline neuropsychological examination. In the event of a head injury, he is reexamined and the data are then compared to the "healthy" baseline as a means to measure the severity of his injury and his progress toward recovery. In 1997, Lovell contacted Ralph Benedict, PhD, a neu ropsychologist at the University at Buffalo School of Medicine and Biomedical Sciences, and asked if he could incorporate in the Concussion Testing Project a neurocognitive test Benedict had developed called the BriefVisuospatial Memory Test. As a result, Benedict's test is now a key component in the professional sporting world's attempt to keep players from returning to play too soon following a concussion. Also used in the project is a test called the Hopkins Verbal Learning Test. While completing his postdoctoral training and residency at the Johns Hopkins University, Benedict took a lead role in revising this test, which was originally developed by Dr. Jason Brandt. In addition to providing the Concussion Testing Project with the tools it needs to test the players, Benedict is also serving as a consultant with the project. In this capacity, he is available on an on-call basis should an NHL or NFL player be concussed while playing in Buffalo and require neurocognitive evaluation. Benedict's Brief Visuospatial Memory Test is also widely used outside of professional sports to evaluate cognitive function in individuals affected by brain injuries or disease. 4D �------------------------------------------------------------ ------- UB Selected as Site for High School Pilot Program n a related development, the University at Buffalo was informed in May 2000 that it has been selected as one of three national test sites for a new computer-based neurocognitive assessment program for high school athletes. (The other two sites are the Mayo Clinic and Henry Ford Hospital.) Developed by the same researchers at Henry Ford Hospital who developed the NHL/NFL Players' Association Concussion Testing Project, the new program involves giving high school students an abbreviated version of the professional-level test that can be administered by computer in 15 to 20 minutes. The UB effort--led by Barry Willer, PhD, UB professor of psychology, in collaboration with the Ontario Brain Injury Association and Brock University-will involve high school students in Buffalo, New York, and Niagara, Ontario. Significance of Cong·term ncuss·suotie)effects: "At minimum, parttopating schools are expected to assess every student involved in sports. What would be ideal, however, would be for all students to be assessed, since organized sports-while they do constitute high-risk activities-account for only about 15 percent of all concussions in this population," explains Willer. "Participation in this project to assess the feasibility and validity of the brief assessment procedure could be a major factor in the prevention of cognitive disabilities in young people," he adds. For more information on the HLINFL Players' Association Concussion Testing Project, e-mail Dr. Benedict at benedict@acsu.buffalo.edu. For more information on the new high school testing project, e-mail Dr. Willer at bswiller@ acsu.buffalo.edu. The Impact of Concussions on Youth •:• One-third of youth experience a concussion before the end of high school. •:• One-half of all concussions are accompanied by loss of consciousness. •:• Average age of concussion is age 10. •:• For children who experience more than one concussion, there is an increased likelihood that the problems described above will remain long term. •:• Children with protracted problems stemming from concussion are less likely to attend college. •:• Children who return to play too soon after concussion may experience very serious consequences, including secondimpact syndrome, which can result in death. CD •:• Ringing in the ears •:• Change in appetite •:• Loss of taste/smell Behavioral •:• Irritable/ Agitated •:• Quick temper •:• Can ' t sit still/ ervous •:• Moody/ Depressed/ Tearful •:• Sleep problems Cognitive •:• Mentally "foggy" •:• Memory difficulties •:• Poor concentration/ attention •:• Poor judgment •:• Fatigue •:• Difficulty finding words Physical •:• Headache •:• Dizziness •:• Fatigue/ Drowsiness •:• Blurry/ Double vision •:• Light/Noise sensitivity S 11 m 111 e r 2 0 0 0 Buff a I o Physician . . ~ .. 11 �M B M E D C A L ScHOOL N E w s y Second·look Day D KINNAMON ln · depth preview for prospective students \ 40 ~ D the first spective students could talk to first-year students. One University at Buffalo School of Medicine and popular session was the student question-and-answer l Biomedical Sciences "Second-Look Day" on panel, which included six students in different phases of April 29, 2000. The event was planned to give their medical education at UB. Topics ranged from the accepted students more interaction with cur- MD/MBA dual-degree program to long-distance rela- rent medical students and another chance to tionships, what day-to-day life is like, and opportunities see where they might be spending the next available during the clinical years. For julie Baker, a UB four years. undergraduate, the day was invaluable. "It helped me feel The idea came to first-year students Laura Cinski, )ill Albrecht and Steve more comfortable about my decision to continue at UB." Turkovich as they discussed their Inter- First·year student Lisa Reaves talking with Jim Krygowski, a biology major from Grove City College in Pennsylvannia. view Day experiences. The students felt continued to get acquainted at dinner so focused on interviewing that they and then enjoyed a night on the town weren ' t able to properly evaluate what with their new friends. "I was a bit UB had to offer them. They also thought nervous to meet my future class- Interview Day didn't offer enough mates," says Joe Kita, a St. student contact. Bonaventure student, "but I found Albrecht had attended a similar type that we have the same career goals of event at another school last spring and dreams. l felt like I could connect and felt it would be an ideal model for UB. "Second- to so many people and became excited Look Day lets the school sell itself," she says. "We want about the next four years." people to make an informed decision and to be happy here. The best way to ensure this is to give them lots of information about what UB's medical school is like from a student's perspective." The inaugural SecondLook Day at UB included mini-lectures in anatomy and L physiology presented by . Charles Severin, MD, PhD, z and Perry Hogan, PhD; smallgroup problem-based learning sessions with Murray Ettinger, PhD; student-led tours of facilities; and breakfast and lunch meetings where pro- 12 I u f fa I o Physician Afterwards, a group of the prospective students who had been corresponding by e-mail S 11mm e r 2 000 CD First·year student Joanna Shaw, below left, talks with prospective students. left to right. Joyce Yan Li of Yale University, Julie Baker of the University at Buffalo, and Penny Lawson of the University of Rochester. �The An of New tutor i al group helps first·year students lutorin Science Hi· "l;J , >O " experience gained by some second-year students in the University at Buffalo refer them to a better information source," says Mato. School of Medicine and Biomedical Sciences is now In addition to giving tutors the helping first-year students master their medical school opportunity to serve the school, coursework. The Buffalo Medical Tutorial Group, the tutorial program gives them launched in january 2000, consists of second-year the chance to review for board ex- students who volunteer to share not only their prior ams and to learn how to effectively knowledge of physiology, anatomy, biochemistry and communicate scientific ideas. It's the other first-year subjects, but also their insights on how best to learn them and have a successful first year. and foster camaraderie among The tutorial group is the brainchild of second-year student Anthony Mato, who, while an undergraduate at Cornell University, tutored biochemistry and organic and general chemistry in its Learning Skills Center. Inspired by that program, Mato approached former UB assistant dean Thomas D. Flanagan in October 1999 with the idea of starting a tutorial program at UB. "Our goal is to offer students help during evening hours when professors aren't around," says Mato. "We wanted to create a resource for students studying at night who otherwise couldn't get questions answered until their professor is available." While the group en- ~I K I courages students to consult their professors first, sometimes students are more comfortable talking to their peers, Mato says. "Some first-year students are intimidated by the faculty, and the idea ofcallinga professor at home is a big deal to them. That's why we're here." Four nights a week students can go to Sherman Hall also an excellent way to introduce first- and second-year students. The group, which attracted 22 student volunteers its first year, First·year student Lily Belli, /efr. being tutored by Anthony Mato. enjoys strong faculty support. Mato met with each of the first -yea r professors individually to discuss how the program would work with their courses, and the group communicates regularly with professors about any changes in course material. Each department provided a complete set of their courses' required textbooks, and B y faculty members donated meeting space, a D computer and a teaching microscope. A \I 0 'I Physiology professor james T. Goldinger, PhD, is their faculty advisor. "This [first] year's class is quite successful," says Perry Hogan, PhD, professor of physiology. "They're calmer about their involvement and their progress. The tutorial group could reasonably take credit for their students' imln•eltaH tlllir pncress. De tltlriallfll. CIIN I'IISIII~Iy talll cre~it fer tlllir strints's...tller smoother progress through the medical curriculum." and drop in on a number of sessions that take place in the But the tutorial group's biggest fans are students. "I physiology department conference rooms. These infor- perform better on exams," says Amy Puzio. "Rather than mal get-togethers can take the form of one-on-one meetings, Q -and-A sessions, roundtable discussions or test staring at a textbook, talking about the material solidifies the information for me." Mato's efforts were recently reviews. "Our time is owned by whoever walks in the honored with the school's student-nominated Louis A. room. We' re there to discuss whatever the students want," and Ruth Siegel Award. He is the first student to receive says Mato. Each tutor commits to a minimum of two this award, which is traditionally presented to faculty. hours a week and teaches a subject they did well in and are "A lot of people say they go to medical school because excited about. "We might not know the answer to every they want to help people," says Mato. "This program is a question, but we answer to the best of our knowledge or true test of that." 4D Summer 2000 I u ff a I o Pb y sic ian 13 �MEDICAL ScHOOL N E w s Dorothy Adler Thomas Jefferson University Paul Bogner Pathology, University of Michigan Hospitals PHILADELPHIA, PA ANN ARBOR, Ml Tamara Alberti Anthony Bottiggi Pediatrics, Medical College of Virginia General SLirgery, University of Kentucky Medical Center RICHMOND. VA LEXINGTON, KY Benjamin Alderfer Psychiatry, University of Colorado School of Medicine George Boucher DENVER, CO Graduate Medical-Dental Education Consortium Family Practice, his year's National Residency Matching Program (NRMP) results were announced on March 16 by Dennis Nadler, MD, associate dean in University at Buffalo's School of Medicine and Biomedical Sciences. Of UB's graduating medical students, 58 percent were placed in primary care residencies. Eighty·one percent of the students received their first, second or BUFFALO, Y BUFFALO, Y Mathijs Brentjens Internal Medicine, Emory University School of Medicine ATLANTA, CA third choice of placements. Twenty· nine AkkiiAii Internal Medici11e, Suzanne Burke percent will stay in Buffalo to train in University of Florida Health Science Center Emergency Medicine, SUNY/ the Graduate Medical Dental Education jACKSONVILLE, FL Consortium, while 52 percent will go Steven Ambrusko Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium out of state. In the primary care specialties, 34 BUFFALO, NY students were placed in internal medicine, 15 in pediatrics, 12 in family medicine, 9in medicine/ pediatrics and 5in obstetrics/gynecology. "Our students do consistently well in the NRMP with placements in some of the top programs in the country," says Nadler. "Our record in 'early' subspecialty match is equally impressive. We are extraordinarily proud of our students' achievements." Nationwide, 51 percent-or 6,931 graduating U.S. medical Jeffrey Amodeo General SLirgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Anthony Caprio Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, NY Thomas Caprio Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, NY BUFFALO, NY Daniel Carl Lisa Apfel Intemal Medicine, General SLirgery, SUNY/Buffalo Medical College of Virginia Graduate Medical-Dental Education Consortium RICHMOND, VA BUFFALO. NY Hope Cawdery Internal Medicine, Duke University Michael Banas Medical Center school seniors-matched to afirst·year residency position in Internal Medicine, SUNY/Buffalo DURHAM, NC one of the generalist disciplines. This is the lowest generalist Graduate Medical-Dental Education Consortium Leslie Chamberlain specialty match rate since 1995, when seniors also matched at BUFFALO, Y AmyBeuler 51 percent. According to the NRMP, 25,056 individuals participated in Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium Medicine/Pediatrics, Ohio State University Medical Center COLUMBUS, OH Julie Cheng Pediatrics, the match this year, aslight decrease from the 26,462 who BUFFALO, NY participated in 1999. Of the total active applicants, 73.4 percent Howard Blumstein Loma Linda University were matched, a4percent increase over last year. Internal Medicine, UMDNJNew Jersey Medical School CA -S.A . UNGER 14 Ramune Alexander Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Medicine/Physical Medicine and Rehabilitation, SU Y/B uffalo Buffal o Ph ysici an Summer 2000 PISCATAWAY, Nj �James Chevalier Internal Medicine, ew York Presbyterian Hospital-Cornell Christopher Di Maio Internal Medici11e, Thomas jefferson University Michelle Ehrlich Dermatology, Cleveland Clinic Foundation NEw YORK, NY PHILADELPHIA, PA CLEVELAND, OH Frederic Chi Orthopedic Surgery, University of Rochester/ Strong Memorial Hospital Louis Domenico Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Catherine Falkner Obstetrics/Gynecology, SU Y Upstate Medical Center ROCHESTER. Y Michael D'Angelo Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y: Diagnostic nadiology, Penn State Geisinger HERSHEY, PA James Doran Undecided Jaimie De Rosa Surgery (Prelim), Boston Medical Center Holly Drexler Family Practice, Williamsport Hospital BOSTON, MA; WILLIAMSPORT, PA BOSTON, MA Todd Duggan Internal Medicine, Medical College of Virginia James De Santis Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Kimberly Dumoff Pathology, University of Pennsylvania BUFFALO, NY PHILADELPHIA, PA Sorabh Dhar Medicine/Pediatrics, SU Y/ Buffalo Graduate MedicalDental Education Consortium Zeynep Ebcioglu lntemal Medicine, Thomas Jefferson University BUFFALO, Margaret Eberl Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium Y Kenneth Harris Pathology, Massachusetts General Hospital SYRACUSE, NY Ani Fleisig Gweral Surgery, Georgetown University Hospital BOSTON, MA Nishi Harvey Medicine (Prelim), St. joseph's Hospital WASHINGTON, DC BUFFALO, NY Otolaryngology, Boston Medical Center Steven Lo. 26. and his fiancee and classmate Reshma Katira, 25. were pleased-and relieved -to discover they will both be going to Chicago. RICHMOND, VA PHILADELPHIA, PA BUFFALO. NY Scott Frank Surgery (Prelim), Mercy Hospital of Pittsburgh ANN ARBOR, Ml PITTSBURGH, PA Bret Gelder Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY SumanGona Transitional, St Vincent's Hospital NEW YORK, Y: Ophthalmology, Mt . Sinai School of Medicine Aram Hezel Intemal Medicine, Beth Israel Deaconess Medical Center BOSTON, MA Michael Hochberg Surgery (Prelim), Mt. Sinai School of Medicine NEW YORK, Charles Howarth Medici11e, Columbia Bassett COOPERSTOWN, Y AllysonHowe Family Practice, Travis Air Force Base Fairfield, CA NEW YORK. NY Niels G•thgen General Surgery, Hospital of St. Raphael EW HAVEN, CT Shirley Huang Pediatrics, University of orth Caro lina Hospital Rose Graham Pediatrics, Children's Hospital of Philadelphia c CHAPEL HILL, PHILADELPHIA, PA Madhuri Guntupalli Surgery (Prelim), RushPresbyterian-St. Luke's Hospita l CHICAGO. IL; Ophthalmology, RushPresbyterian-51 Luke's Hospital CHICAGO, IL Alissa Huston lntemal Medicine, University of Rochester/Strong Memo rial Hospital ROCHESTER, NY Adriana Kaczaraj Internal Medicine, Mt. Sinai Hospital NEW YORK, John Hannibal Law School Y Y Kevin Stanley, 25. of Oswego. NY, vociferously shares his results. On his right is Madhuri Guntupalli and to his left. Andrew Stone. . .• L ... z . .c L S 11 111 111 er 2 00 0 Buffalo Ph ysician 15 �M E D C A L N ScHOOL E Second·year student Sandy Singh and his sister. Abhilasha (Abby) Singh, 25. below. await news about her match results. w Jennifer Kam Brian Klagges William Lighthart Medicine (Prelim), SUNY/Buffalo General Surgery, Surgery (Prelim), Graduate Medical-Dental Education Consortium BUFFALO, NY: Diagnostic Radiology, Rochester General Hospital ROCHESTER, NY HeyJooKang Obstetrics/Gynecology, New York Presbyterian Hospital-Cornell NEW YORK, Y Reshma Katira Surgery (Prelim), RushPresbyterian-St. Luke's Hospital CHICAGO, IL: Ophthalmology, RushPresbyterian-St. Luke's Hospital CHICAGO, IL Mark Kenyon Pediatrics, Children's Memorial Hospital CHICAGO, IL ew England Medical Center BALTIMORE, MD Marta Kolthoff Jennifer Lin Obstetrics/Gynecology, University Health Center General Surgery, University of North Carolina Hospital PITTSBURGH, PA CHAPEL HILL, Matthew Krauza Steven Lo Internal Medicine, SU Y/Buffalo Medicine (Prelim), University Graduate Medical-Dental Education Consortium of Illinois College of Medicine BUFFALO, Neurology, University of Chicago CHICAGO, Y CHICAGO, Sharmeela Kuperan Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY HasitMehta Diagnostic Radiology, University of Texas Southwestern Medical School DALLAS, TX IL; IL Melinda Mesmer Medicine, Yale-New Haven Hospital NEW HAVEN, CT Alka Patel Todd Loftus Psychiatry, New York Presbyterian Hospital-Cornell Medicine/Pediatrics, University Hospital of Cincinnati CINCINNATI, OH Darshan Patel Justin Kwan Michael Logue Family Practice, Pinnacle Health- Medicine (Prelim), Intemal Medicine, New York Harrisburg Hospital Long Island jewish Hospital Presbyterian Hospital-Cornell HARRISBURG, PA NEW HYDE PARK, NY; NEW YORK, Neurology, Baylor College of Medicine General Surgery, SU Y/Buffalo Graduate Medical-Dental Education Consortium HOUSTON, TX Y c EW YORK, NY Eric Kirker BUFFALO, Union Memorial Hospital BOSTON, MA Y Penn State Geisinger DANVILLE, PA BUFFALO, NY Dionysia Mamais Jesenia Peiia Medicine/Pediatrics, Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Emergency Medicine, Jason Lake Internal Medicine, Walter Reed Army Medical Center WASHINGTON, DC St. Vincent's Hospital Charles Lau NEW YORK, Medicine (Prelim), Brigham & Women's Hospital BOSTON, MA; Diagnostic Radiology, Hospital Y Rosemarie Mannino Everett Porter Medical College of Virginia Internal Medicine, University of Rochester/Strong Memorial Hospital of the University of Pennsylvania Andrew Mayer PHILADELPHIA, PA Internal Medicine, BUFFALO, Y Medicine/ Pedia tries, Mt Sinai Hospital EW YORK, Cedars-Sinai Medical Center Los ANGELES, CA Donald McDonald Y Graduate Medical-Dental Education Consortium y Daniel McKenna Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium Robert Lewis BUFFALO, Internal Medicine, Talia McNamara Psychiatry, University of California at Los AngelesSan Fernando Valley Lenox Hill Hospital NEw YORK, NY ROCHESTER, Y Erin Reardon Emergency Medicine, Morristown Memorial Hospital MORRISTOWN, NJ Internal Medicine, SUNY/Buffalo BUFFALO, Jennifer Lee BUFFALO, NY Intemal Medicine, RICHMOND, VA Lynn Lawrence Pediatrics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium Donna Peace Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Jason Lorenc Y SEPULVEDA, CA Tara Reimer Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Gretchen Schueckler. 32, from Buffalo. NY. on the phone to spread the news while receiving ahug from Catherine (Kate) Falkner, 25. �-------------- - - - - - - - - - - - - - - - - - - - -- -- ---------- ----- NehaSheth Richard Telesco Pediatrics, Pediatrics, Priya Wagner Pediatrics, University of Connecticut FARMINGTON, CT University Hospitals of Cleveland Medical College of Virginia CLEVELAND, OH RICHMOND. VA Phaelon Silva Felicia Tenedios Melissa Reyes Obstetrics/Gy!Iecology, lntemal Medicine, New York Hospitals of C leveland Family Leave Madigan Army Medical Center Presbyterian Hospital-Cornell CLEVELAND, OH TACOMA, WA NEW YORK, NY Abhilasha Singh Michael Tinnesz Emergency Medicine, McGaw Medical Center-Northwestern University Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium David Rice lntemal Medicine, Wright Patterson Air Force Base DAYTON. OH CHICAGO, IL Walter Walek Surgery (Prelim), University BUFFALO, NY CamiRiley Intemal Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium Graduate Medical-Dental Education Consortium Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Medical Center Hospital St. joseph's Hospital Medicine/Pediatrics, Albany ALBANY, NY CHICAGO, IL Y, NY Lirim Tonuzi Graduate Medical-Dental Educatio n Consortium Medicine (Prelim), SU Y/Buffalo BUFFALO, Y Matthew Smith iiiternal Medici11e, SUNY/Buffa lo Graduate Medical-Dental Education Consortium Graduate Medical-Dental Education Consortium BUFFALO, NY; Neurology, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, BUFFALO, NY Graduate Medical-Dental Education Consortium BUFFALO. NY MEMPHIS, T Christopher Santangelo Andrew Stone Psychiatry, Internal Medicine, ew England Medical Center WASHINGTON. DC BOSTON, MA Gretchen Schueckler Internal Medicine, Brown University Jason Stopyra Emergency Medicine, Wake Forest University Baptist Medical Center Michelle Watson Surgery (Prelim), SU Y/Buffalo Psychiatry, SU Y/Buffalo Kevin Stanley Orthopedic Surgery, Un iversity of Tennessee College of Medicine Georgetown University Hospital Medical Center Hospital ALBA BUFFALO, NY; Diagnostic Radiology, SUNY/Buffalo Robert Wang Rommel Tolentino BUFFALO, NY Samuel S'doia ANN ARBOR, Ml Transitional, Catholic Health- Beth Smith Family Practice, SUNY/Buffalo Stephen Wampler Family Practice, University of Michigan Hospitals Medici11e/Pediatrics, Albany Igor Sirotkin BUFFALO, NY Lynne Ross y Graduate Medical-Dental Education Consortium BUFFALO, NY Theresa Wendel General Surgery, RushPresbyterian-St. Luke's Hospital CHICAGO, IL Michael White Judith Toski Emerge11cy Medicine, Eastern Virginia Medical School Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium Melissa Wolf BUFFALO, NY Family Practice, University ORFOLK, VA Hospitals of Cleve land Amy Van de Water Medicine/Pediatrics, University of CLEVELAND, OH Minnesota Medical School Emily Wong MINNEAPOLIS, M lntemal Medici11e, University of Michigan Hospitals Rosalia Viterbo General Surgery, SUNY/Buffalo ANN ARBOR, Ml WINSTON-SALEM, NC Graduate Medical-Dental Education Consortium Nora Yip Transitional, Mercy Hospital Marisa Stumpf BUFFALO. NY Un iversity of Connecticut PITTSBURGH, PA Obstetrics/Gy!Iecology, PROVIDENCE. Rl Bryan Scott ew England Medical Center Tracey Shanahan Pediatrics, Ohio State University/Chi ldren 's Hospital COLUMBUS, OH Kathryn Shanks Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, y -- BOSTON, MA Britta Svoren Pediatrics, Boston Combined Pediatric Residency BOSTON. MA FARMINGTON, CT Roy Vongtama Medici11e (Prelim), Vladimir Zelenko Graduate Hospital Rabbinic Educatio11 PHILADELPHIA, PA; Radiation Oncology, University of California at Los Angeles JamaiZohur LOS ANGELES, CA Buffalo Graduate MedicalDental Education Co nsortium Cheryl Taurassi Eric Waffner Pediatrics, l11temal Medicine, SUNY/Buffa lo Long Island jewish Hospital Graduate Medical-Dental Education Consortium EW HYDE PARK, NY Ge11eral Surgery, BUFFALO, Medicine/Pediatrics, SU Y/ BUFFALO, Y Y S11mmer 2000 luflalo Physician 17 �M E D C A L SCHOOL E W . . ... c L �S ummer 20 00 luffalo Physician 19 �M E C D A L E SCHOOL W S Songs Give S1 Million to School p and his wife, Janet H. Sung, MD, \1 founder and president of four radiological practices in Western New York, including Windsong Radiology, P.C., are giving a $1 million cash scholarship gift to the University at Buffalo's School of Medicine and Biomedical Sciences. "What better way to show our gratitude and appreciad tion," says John Sung, "than to provide scholarships for UB CFO ) \\ Children's Health for Kids medical school students who have good grades, need the money and demonstrate soundness of character, including a genuine, caring attitude, generosity of spirit and leadership potential?" Janet Sung concurs that the gift to the university "has made us very happy because my husband is finally realizing a dream that began when he was a college student in Korea, working his way through "What better way to show our gratitude and appreciation." -John Sung school and depending also on scholarships." The Sungs' story began in Korea, where both were born and attended college. They moved to the United States as a newly married couple in 1972, arriving in New Jersey with only $200. While Janet Sung completed her residency, John Sung earned his MBA from Seton Hall University and completed his CPA training. In 1977, they moved to Buffalo, where janet Sung held positions in radiology with area hospitals. John Sung worked first for the accounting firm Peat Marwick Mitchell, then taught at Daemen College before working full time with his wife. In 1987, the Sungs opened Harlem Radiology, P.C., in a converted Pizza Hut. Today they operate Windsong Radiology, which employs over 120 people and is the only free-standing clinic in Western New York with full diagnostic accreditation from the American College ofRadiology. -SUZANNE CHAMBERLAIN Frawley Establishes Fellowship Award , .\ LJ 1 made the first presentation of the "Frawley Fellowship Award" to V. Uma Valeti, MD, who is currently completing his residency training in internal medicine at the University at Buffalo School of Medicine and Biomedical Sciences. Frawley established the fund this year to support "worthy medical/surgical residents for whom medical research represents a primary personal interest and passion." Valeti, whose goal is to pursue an academic career in cardiology, has completed cardiovascular research in the laboratory of Dr. John Canty. Receipt of the Frawley Fellowship will make it possible for him to continue his research on ischemic cardiomyopathy and hibernating myocardium. Frawley began his own research career with the study of adrenal physiology at UB and then at Harvard University. He continued research on the adrenal cortex and also in carbohydrate metabolism at the National Institute of Arthritis and Metabolic Diseases in Washington, D.C. From there he went on to become professor and chair of I .. internal medicine and director of the first Division of Endocrinology < and Metabolism at St. Louis University School of Medicine. ... 20 -S. luffalo Hysician A. CD UN G ER S umm e r 2 000 Compiled by Pamela M. Rose, MLS, Health Scie11ces Library, U11i1•ersity at Buffalo, 3435 ,\1aill St., Buffalo, .''JY 14214-3002; (716) 829-3900, ext. 129; pmrose@acsu.buffalo.edu. �PATHWAYS Click Appointed to Ped"a r·c Surgery Po t Following a national search, Philip L. Glick, MD, has been In Memoriam appointed surgeon-in-chief at Kaleida Health's Children 's Hospital of Buffalo, clinical director of the Department of Pediatric Surgical Services at Kaleida and division head of pediatric surgery in the Department of General Surgery at the University at Buffalo's School of Medicine and Biomedical Sciences. Glick, a staff member at Children's Hospital since 1988, is a professor of surgery, pediatrics and obstetrics/gynecology at UB, where he also serves as vice chair of surgery for research, and training director for the Pediatric Surgery Residency Program. A Los Angeles native, Glick completed his undergraduate T. BRONK education at the University of California at Berkeley. He graduated from medical school at the University of California at San Francisco, where he also completed residencies in general surgery and fetal surgery and served as chief resident in general surgery. He was a senior resident and chief resident in pediatric surgery at the University of Washington and at the Children 's Hospital and Regional Medical Center in Seattle. - S. A. UNGER Summer 2000 Buffalo Ph ysi ci an 21 �PATHWAYS EDITOR's NOTE: 1 tH;. JVUVH'J.If.g are brief introductions to faculty Scott Coffey, PhD Marc S. Fineberg, MD 1ssi<tatlt Pr.Jte<sc r Amsta•Jt ( timcal Professor Depart•nent of Orthopaedic Surgery c·r.iver<ity at Buffalo Sports \1edi:i JC Institute who have recently joined the Universztv at Buffalo School of Coffey joined UB's faculty in November 1999 as an assistant professor in the Department of Psychiatry and is affiliated with the Community Mental Health Center at Kaleida Health's Buffalo General Hospital. He earned his bachelor of science degree in psychology at Medicine and Arizona State University in 1988, Biomedical his master's degree from the Uni- SCiences. his PhD from the University of versity of North Texas in 1992 and Mississippi in 1996. Coffey completed his training at the National Crime Victims Research and Treatment Center and was a National Institute on Drug Abuse research fellow at the Medical University of South Carolina. Prior to coming to UB, he was a research associate in the Department of Rehabilitation Sciences in the College of Health Professions at the Medical UniversityofSouth Carolina. His research interests include drug craving and impulsivity in substance-dependent individuals and the treatment of trauma victims with a comorbid substance use diagnosis. Fineberg joined UB's faculty as an Fineberg's current research thopaedic surgery in August 1999. interests include procedural He is affiliated with the UB Sports advancements in anterior cruci- Medicine Institute, with active ate ligament reconstruction surgical time spent at Kaleida through the Cadaveric Arthro- Health's Buffalo General Hospi- scopy Teaching Lab; and mag- tal and Millard Ambulatory Sur- netic resonance arthrogram gery Center, and at Erie County active (MRAA), a new test de- Medical Center. Fineberg earned signed to increase diagnostic a bachelor of science degree in sensitivity for occult soft-tissue biology, cum laude, from Syra- injuries of the shoulder. cuse University in 1989, and a medical degree from Northwest- Paola Muti, MD ern University Medica l School in 4ssocia te Professor VepartmetJt of Son a/ and Preventive .\ledicJtJe Senior Associate Research Snentist Research ltJstJtutc 011 4ddJctions 1993. He completed a general surgery internship at New York University/Bellevue Hospital Center in 1994, and a residency in In july 1999, Muti was appointed pediatric orthopaedic surgery at as an associate professor in UB's Shriner's Hospital for Crippled Department of Social and Preven- Children in Tampa, Florida, from tive Medicine, where from 1995 to March to April1995 and january 1999 she had served as a research to February 1997. He was execu- assistant professor. Currently, she tive chief resident in orthopaedic also serves as a senior associate surgery at New York University/ research scientist in UB's Research Hospital for joint Diseases from Institute on Addictions, a position july 1997 to june 1998, and a clini- she has held since 1995. Muti earned a medical degree from Mun wAs APPOL 1TED AS A • A~sociATE PROFESSOR IN 22 l 1 1fa l o Ph ysici an Summer ment of Orthopaedic Surgery from August 1998 to july 1999. assistant clinical professor of or- cal fellow in sports medicine at TIVE MFDICI E, WHFRF FROM Massachusetts General Hospital! Harvard Medical School's Depart- UB's DEPARTMENT oF SociAL AND PREVEN- 1995 TO 1999 SHE HAD SERVED AS A RESEARCH ASS ISTANT PROFESSOR. 2000 �University of Pisa in 1984 and a master of science in epidemiology Druar Named Recipient of Naughton Award Christopher T. Sempos,PhD ship in UB 's Department of Social \ssocrate Professor Director ot Graduate Stud. Department of Sacral and Pn" P>Jt'"p \1 .,, · and Preventive Medicine. Her Sempos joined UB's faculty in No- from UB in 1993. From 1996 to 1999, she served a Buswell Fellow- 5 named the first recipient of the Naughton research interests are in cancer vember 1999 as an associate profes- epidemiology, specifically hor- sor and director of graduate studies monally related cancers, such as in the Department of Social and breast and prostate; and in research Preventive Medicine. He earned a methodology and biomarkers. bachelor of arts degree in anthropology from the University of M. Matthew Phillips, MD Wisconsin, Milwaukee, in 1973, and Cllllrcal Assistant Professor Department of Ortlropocd•cs master of science degrees in nutritional services and preventive med- Phillips joined UB 's facu lty as a icine/epidemiology at the Univer- clinical assistant professor of or- sityofWisconsin, Madison, in 1979 thopaedics in july 1997 and is and 1982, respectively. He completed affiliated with Erie a doctorate in nutrition sciences at County Medical Center and Kaleida Wisconsin in 1982. For more than Health ' s Buffalo Federal Civil Service as a health stat- General Hospital istician, during which time he was (BGH ). He earned project officer for the Framingham his bachelor of sci- and jackson heart studies at the PHILLIPS 15 years, Sempos worked in the ence degree, cum National Heart, Lung and Blood laude, in chemistry Institute. He also served as chief of from St. Lawrence retary for the Medical Alumni Association Nancy Druar, the longitudinal studies branch for University, in Canton, New York, the National Health and in 1987 and his medical degree Examination Surveys, and assistant utrition Award, as announced by dean John R. Wright, MD, on April29, 2000, at this year's Spring Clinical Day and Reunion Week· end. The new award, established by John Naughton, MD, dean of the University at Buffalo School of Medicine and Biomedical Sci· ences from 1976 to 1996, recognizes a nonfaculty individual who has made signifi· cant contribu· tions to the school. Such an individual, the award acknowl· edges, is one who "day in and day out, in his or her NA NC Y DRUAR own quiet way, makes our school, with its affiliated teaching hospitals, a stronger, healthier and happier place for the rest of us to learn, work, conduct research, provide patient care and teach." Druar, who has served in her current role since 1980, is responsible for I . from UB in 1991. He completed to the head for the World Health coordinating the day-to-day operations of the Medical Alumni an internship in general surgery Organization Collaborating Centre Association office, including communications, dues manage- at UB in 1992 and residency for Health and Nutrition Examina- training in orthopaedic surgery tion Surveys. His current research ment, financial reporting and budget preparation. In addi· tion, for the past 19 years she has taken a lead role in planning at the university in 1996. He focuses on the relationship of then served a fellowship in joint body iron stores to risk of cardio- replacement and lower-extrem- vascular disease. "ambassador for the school" and an individual who through Krackow, MD, at BGH from 1996 Barbara Stefanick, MD "kept the vital machinery of the alumni office moving, to 1997. His clinical interests in- \ssistant Professor of Clilllcal Pc,thologr Dcpartmmt of Patholo " advancing the school's mission in ways immeasurable." clude hip and knee replacements, ity reconstruction under Kenneth failed or revised hip and knee Nomination letters on Druar's behalf referred to her as an her "intelligence, pleasantness and diligence to her task" has replacements, lower-extremity deformity and knee orthoscopy. the school's annual Spring Clinical Day and Reunion Weekend. Stefanick, who joined UB 's faculty Druar received the award at the Annual Faculty Meeting on May 26, 2000. Other awards presented at the me be reported on in the fall issue of Buffalo Physiciat CD in july 1999, is an attending pathologist at Kaleida Health 's S umm e r 2 000 Buffalo Pbys i c i an 23 �PATHWAY Buffalo General Hospital. She earned her bachelor of science Bianca WeinstockCuttman,MD degree, magna cum laude, in biology from UB in 1990 and her medical degree, cum laude, from the university in 1994. She then completed her residency training in anatomic and clinical pathology at UB, where she served as cochief resident from 1998 to 1999. Stefanick is board certified in anatomic and clinical pathology, and her clinical interests focus on renal pathology. Weinstock-Guttman joined UB's faculty in November 1998 as an assistant professor of neurology. Her clinical affiliations are with Kaleida Health 's Buffalo General Hospital and Baird Multiple Sclerosis Center at Millard Fillmore Gates Hospital. WeinstockGuttman earned her medical degree at the University of Foundation, where he then served Bucharest in Romania in 1983. She an EEG/epilepsy fellowship from completed a rotating internship at 1996 to 1997. In june I998, he Carmel Hospital in Haifa, Israel, completed a pediatric residency in 1986 and a neurology residency at Rainbow Babies and Children at Sapir Medical Center, Hospital in Cleveland . Wein- Meir General Hospital, stock's primary research interest Kfar-Saba, Tel Aviv Uni- is in epilepsy, EEG and neuro- versity, in Israel, in 1992. physiology. At the Mildred In 1996, she completed a )assoy Long-Term Monitoring three-year Neuroimmun- Unit, he and his colleagues are ology Fellowship at the assessing whether patients could Mellen Center for Mul- benefit from epilepsy surgery. tiple Sclerosis Treatment and Research at the Cleveland Clinic Foundation. At UB, her research and clinical focus continues to be MS. Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record Prot s >r p a d '\/ ,r 'PI ~' '-'' I a t n Wilkinson, who joined UB's Department of Social and Preventive Medicine in May 1998, also serves as a professor in UB's Department of Oral Diagnostic Sciences, Weinstock joined UB's faculty in in the School of Dental Medicine. August 1998 as an assistant pro- Prior to coming to UB, he was an fessor in neurology and director adjunct professor in the Depart- of pediatric epilepsy and neuro- ment ofEpidem iology at the School physiology. He is affiliated with of Kaleida Health's Children's Hos- at Albany. Wilkinson earned his • Comprehensive community service program pital of Buffalo, where he is bachelor's degree in 1969, his director of the Mildred jassoy master's degree in 1971 and his • More than 60 sports teams Long-Term Monitoring Unit. PhD in 1973, all from UB. He com- • Average class size of 15 Weinstock completed a rotating pleted a postdoctoral research • Financial aid available internship at Carmel Hospital in training fellowship at Duke Uni - Haifa, Israel, in 1986, and a pedi - versity Medical Center in Durham, atric residency at Hasharon North Carolina. At UB, his research Coeducational grades 5·12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net Acceptance granted to qualified students without regard to race, color, religion or national origin. laffalo Pbysician \/(flit I r ct r Jfl'ctlu, r1c tp1 rotcs<" JCpartmcllt • Challenging curriculum with 17 advanced placement courses Only one inveslrnenl lasrs a lifetime 24 Arie L. Weinstock, MD Cregg S. Wilkinson, PhD 5 u 111 m e r 2 0 0 0 Public Health, SUNY Hospital and Tel-Aviv interests include the ef- University, from 1987 to fects of low-dose radia- 1992. From 1993 to 1996, tion, and cancer induc- he served a pediatric tion related to environ - neurology fellowship at mental and occupational the Cleveland Clinic exposures. CD �- - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - --~ -- ~- -- the 63rd April29 2000 ACall to Physicians to Lend Their Voices Children's health in the new millennium BY jENNIFER LEWANDOWSKI AND s. A. UNGER Opportunities and Challenges," at the University at Buffalo's 63rd annual Spring Clinical Day held April 29, 2000, at the Buffalo-Niagara Marriott in Amherst, New York. The weekend event, which explored the theme "Children's Health Issues," was sponsored by the UB Medical Alumni Association. Hayes, the assistant secretary of Community and Family Health for the Washington State Department of Health, urged physicians to view the advent of a new decade and new millennium as an auspicious time to more proactively advocate for an improvement in children's health in our country. " It begins with a fresh commitment from each Pictured, letr. Maxine Hayes. MD '73. delivered Stockton Kimball Lecture. of us as individuals, wherever we are stationed, to be willing to move out of our comfort zone and get involved as advocates for children and their families," Hayes implored. "It might start with a small gesture: a telephone call to a powerful political figure, a letter to the editor of a newspaper, a talk at a PTA group, a testimony before a health committee ..• . I MAGINE A NATION in which the child poverty rate is the highest in the industrialized world . Imagine a nation in which social conditions are bringing about a rapid increase in youth depression, a nation in which children as young as preschool-age are being of a state legislature, a contribution to a child advocacy group, or through mentorship of a medical student. "We can all find ways to use the clout we have as physicians and stand up for children," she added, stressing that now is the time to reflect and focus on children, as "they do beautifully symbolize the promise of the 21st century." prescribed such antidepressants as Prozacand such stimulants as Ritalin. Imagine a nation in which youth in the fastest growing segments of the population are at the greatest risk for Hayes began her overview of the status of children's poor health status and care. The nation is the United States, and the challenges are health by presenting a historical survey of the development of medicine over the past millennium, highlight- growing exponentially, according to Maxine Hayes, ing the many strides made in health care, especially in the MD '73, who delivered the keynote lecture titled "The area of public health. From there, she turned her atten- Future of Children's Health in the New Millennium: tion to issues prevalent in the 21st century that threaten S 11mm e r 2 000 I u f fa I o Physician 25 �A L U M N our children, and ways in which physicians can take a leadership role function of America's families are also directly impacting children's in confronting these issues. Because chronic disease has supplanted acute illness as the pri- substantially more likely to have a family income below poverty than health. "Children who live in a household with one parent are mary threat to children's health, physicians who treat children today children with two parents," she reported. "In 1998, nearly 25 percent are faced with different challenges than were their counterparts in of children lived only with their mother and, today, more children the recent past, Hayes explained. Referencing data from the National live in step, blended, sequential or foster families, and many more Health Interview Survey on Disability, she reported that 15 to 18 are homeless." In all, "child poverty in the United States has nearly doubled since the 1960s," she stated. percent of all children today have "ongoing developmental, physical or mental problems that affect their functioning or that require compensatory services for maintenance of a functional level." These To this mix of social changes affecting our children must be added the fact that racial and ethnic diversity has grown dramatically in the conditions, she explained, range from such common diagnoses as United States over the past 30 years, noted Hayes, who predicted that, attention deficit hyperactivity disorder to severe psychiatric disor- after the 2000 census, "we will see a continuation of this trend." ders. "Assuring children's mental health and emotional well-being According to the Children's Defense Fund, Hayes said, minority children now make up 30 percent o f t h e populatiOn . under age 19, will challenge us in the new millennium," she said. Of special concern, she noted, is a rise in the reported incidence and by the year 2020, racial and ethnic minority children will make of depression in children, an increase she attributed to up 40 percent of the population under age 19. "Because minority "fHF BO.rOM the many "rapidly changing social conditions" encoun- chtldren are more likely to be poor than their non-Hispanic, white L,'<E IS "!HAT tered by today's youth. Hayes described a recent study of8,000 Americans 15 counterparts, they are often at risk of poor health status" she said. "And these children ca 11 no t b e ·tgnore d , as t h ey are fast becommg ' . the . PHYSIC lA "''>DO to 54 years of age in which only 2 percent of those age 45 HAVF ( lOl T. to 54 reported symptoms of clinical depression by their emergmg maJ·ority upon wh'IC h th.ts natiOns · , contmumg . . prospenty . and future will rest." late teens, while among 15- to 24-year-olds, 23 percent THE PROBLE~I reported serious depression before age 20. Furthermore, roo she said, teachers and pediatricians are documenting I<; fHAT more depressed youngsters than in the past. MANY 0~ U 1-AI ... lO l <;tIT." Among the "rapidly changing social conditions" that contribute to depression, Hayes said, are alterations in family structure, increased mobility of families and un- stinting exposure to global violence and unrest through television and the Internet. "With the click of a mouse, children can view graphic worldwide calamity and suffering," which causes increased levels of anxiety and Physicians today , Hayes sat·d , can h e1p counter these dtsturbmg . . trends in children's he a lth b Yb ecommg · .mvolved tn . one or more of the following four are nas.. po 1·tcy, practice, . research, and educatton . and training . . · With regard to po 1·tcy, s h e sat'd" strong mvestments 111 . preventton are key to assuring child health," emphasizing that "these mvestments are no 1anger a 1uxury or even a chotce." . . An example of such an mvestment 1·11 preventiOn, · . ts . the Chtldren's . s h e satd, Health Insurance Progran1 , w h.IC h sh e encouraged phystctans .. to become Compounding the problem of overexposure to calamitous news aware of and supp or t tn · t h etr · respecttve . states. In terms of practice and education, Hayes candidly told her audtence that "changt'ngde mograp h.tcs means we must d'tverst·ry our is the fact that many children today aren't provided with "the provider work force. We need practicing providers who are not only depression, she said. "As citizens of a global village, they are far less protected from worrying than children were in years past." anchors, the emotional support, they used to have growing up," tram~d 111 technical skills but culturally competent, as well." ow is divorce currently affects more than 1 million children in the U.S., the time, she said, for us to address the "- isms" in medicine-the "racism and se xtsm · th at create barners . to mutual respect and understand'mg. "Reterencmg c · the February 25 New England Journal and, at any one time in our country, some 500,000 children are in of Medicine editorial that addressed this problem in medicine as it foster homes, circumstances that further erode their emotional relates to gross inequities in the distribution of care, she added, "As support base and contribute significantly to depression. physicians, we need to acknowledge the role we ourselves play in closmg the gap in health disparities." Hayes explained. This is because children aren't spending nearly as much time with their parents as they did three decades ago. Also, Children are less "anchored" not only in a figurative sense, but in a literal sense, as well, because their families are relocating more fre- ln concluding, Hayes reiterated that, "As physicians, we have a quently, according to Hayes. Thirty years ago, children lived in one place umque opportunity today to make a difference for our children and for future gener a t"tons. sorne o f you may say ' I don ' t take care o f for an average of 21 years, a number that today has shrunk to seven. Hayes further explained that rapid changes in the structure and 26 The Badly Needed Clout of Physicians B u If a I o Physician S 11 111 m e r 2 0 0 0 CONTINUED ON PACE 28 �Medical Alumni lifetime Achievement Awards Honoring alumni for their outstand i ng contributions ach year at Spring Clinical Day and Reunion Weekend, medical alumni achievement awards are presented to graduates of the University at Buffalo's School of Med1cme and Biomedical Sciences who have made significant contributions to their fields. Recipients are nominated by their fellow alumni, with final selections made by the governing board of the Medical Alumni Association. This year's recipients are as follow: Richard H. Adler, MD '45 D . ..Jackson Coleman, MD 'GO ISO .. J.:c.ltl~wana ac<"CP _d 1 / Dr GcoriC Ellis For Dr. Richard H. Adler, former director of the Cardiothoracic Surgery Residency Program at UB's School of Medicine and Biomedical Sciences, receiving the Medical Alumni Lifetime Achievement Award represented "a valued gift from this fine medical institution" that launched and helped foster Adler's medical career, said Dr. George Ellis, who spoke of his friend's achievements and character. It was through his education at UB that Adler was given the opportunity to build on his medical knowledge at various institutions throughout the country and world, experience that prepared him for his return in 1949 to UB, where he served on the faculty until 1986, Ellis said. Perhaps the most notable experience for Adler, who also served as head of the Division of Thoracic Surgery at Buffalo General Hospital until 1986, was working in conjunction with his students and house physicians, who continuously stimulated his growth in medicine, Ellis said, adding that it was through his tenure at UB that Adler has been able to influence the next generation of UB students. In 1982-83, this service was recognized at UB, when Adler received the Louis and Ruth A. Siegel Distinguished Teaching Award with Honors. In all his work, he has been a staunch advocate of the clinician fulfilling the role of a caring provider, something he encourages his " Calling Dr. D. jackson Coleman a pioneer in ultrasonography and " ophthalmology, Dr. Thomas). Guttuso credited Coleman with discoveries that have increased the ability of ophthalmologists to ana- • lyze previously undiscovered diseases. "He is now a professor and chairman of ophthalmology at Cornell Medical College," Guttuso said. "He has won nine national awards and fellowships and he is credited with six inventions," he added, including an ultrasonically vibrated surgical knife, an apparatus for medicinally spraying an eyeball and a method for enhancing ultrasonic image data. In addition, Coleman has written some 56 book chapters, as well as a book titled Ultrasonography of the Eye and Orbit. He has also authored 120 publications, in 70 of which he is the first author, Guttuso said. As a visiting professor, Coleman has presented 16lectures throughout the United States and Canada, largely on the subject of ocular trauma. Coleman serves on the editorial boards oftheA11nals ofOphthal- mology and RETINA. In addition to being a diplomate of the American Board of Ophthalmology, he is a fellow of the American College of Surgeons and of the American Academy of Ophthalmol- younger colleagues to emulate, Ellis said. Adler believes wholeheartedly that "being a caring clinician and earning the trust and respect of a patient, is a cherished gift," Ellis concluded. CoNTINUED ON PAGE 2s S u 111 111 er 2 00 0 Buff a I o Physician 21 �A L U M N ogy. He also has served as president of the ew York Hospital Medical Board and on the Executive Faculty Committee at Cornell University Medical College. "He has contributed significantly, not only to his field, but to the knowledge of medicine everywhere," Guttuso said. "He is certainly the star of our class." Anil B. Mukherjee, MD '75 [.... vducec. Wl<. l.Ccep.cJ !J/ Dr. /urw s,ztbenlwrd A friend of Dr. A nil B. Mukherjee's since their early days of medical school in 1972, Dr. john Stubenbord explained that, after graduation from the UniversityofCalcutta in 1962, Mukherjee came to the United States, where he completed master's and doctoral degrees at the University of Utah. He then earned his medical degree from the N . Lynn Eckhert, MD '70 University at Buffalo 1975. After medical school, Mukherjee completed his residency training Jmnd ta t b; her broclnr, Dr. Kenneth H. Eckhert in internal medicine at Georgetown University, and in neonatal and "It's a privilege and honor to present this award to my sister," said Dr. a Kenneth H. Eckhert, who chronicled Dr. N. Lynn • pediatric medicine at the National Institute of Child Health and Human Development and at the ational Insti- Eckhert's achievements as a medical practitioner. After finishing medical school, Dr. Lynn Eckhert tutes of Health's Clinical Center in Bethesda, MD. Serving first as the senior investigator of the In all his work, pregnancy research branch of the NICHD and completed an internship at the Cleveland Clinic, said has been astaunch the NIH, then as chief of the section on molecu- advocate of the clinician lar and developmental genetics in the pregnancy her brother, himself a 1968 fulfilling the role of acaring branch, Mukherjee is currently chief of the sec- provider, something he tion on developmental genetics in the human graduate of UB. Shortly thereafter, she was married "to a wonderful physician encourages his younger genetics branch of the TCHD. Mukherjee, who served a brief stint as an who was studying at colleagues to emulate, Ellis assistant professor of pediatrics and human ge- Children's Hospital of said. Alder believes whole· netics at UB in the late 1960s and early 1970s, has Buffalo" and whose work heartedly that "being a also written hundreds of papers on genetics, with the Peace Corps took them to Oklahoma. "Lynn then took a residency in pediatrics at the University of Oklahoma, and from there she went "most of which I couldn't possibly understand," caring clinician and earning joked Stubenbord. the trust and respect of a Concluding, Stubenbord said he was hon- patient is acherished gift." ored to speak on behalf ofM ukherjee. "Ani! is a on to johns Hopkins University, where she became good friend, and I feel privileged to accept the I a Robert Wood johnson Clinical Scholar and re- award for him," he said. ceived her second master's degree-a master's in public health-in 1973," he said. Seven years later, she completed a doctoral degree in public health from johns Hopkins University. "A CALL TO PHYSICIANS" FROM PAGE 26 In 1984, she was named chair of the Department of Family and children,' or 'I am retired,' or ' I take care of children, but my practice Community Medicine at the University of Massachusetts Medical doesn 't involve children who are disadvantaged.' Others might say, 'I Center and, in 1991, codirector of the MPH Program at the am empathetic ... but I don't think I can do anythingaboutanyofthis.' university's Amherst School of Public Health. In the early 1990s, she served for one year as a visiting professor that too many of us fail to use it. It is true that most children in our "The bottom line is that physicians do have clout. The problem is in the Department of Community Medicine at the University of nation are in good health and have loving parents who tend diligently Zimbabwe and another year as visiting professor in the Department to their physical, intellectual and spiritual needs. But we live in an of Pediatrics at the University of Capetown. In 1994, she was named interdependent world and our destiny ... depends as much on Project HOPE's first William Walsh International Health chair. youngsters who are unhealthy, poor and alienated as on those who are cellor and dean of the International and Public Health Programs at more advantaged. "We can all find ways to use the clout we have and to stand up for the University of Massachusetts Medical Center. children," Hayes concluded. "They are depending on our voices. In 1997, she was appointed to her current position of vice chan- They are depending on us." 28 CONTINUED I u If a I o Ph ysici an Summer 2000 4D �I ----- ~~-- ~ ------------+~~---- FIRST ROW: ROBERT j. PATTERSON. V\ILLIAM S. WEBSTER, LEO ~~~NNING, ADELMO 0UNGHE, HELEN f. SIKORSKI: SECOND ROW: GEORGE TAYLOR, ROY '\<\'.ROBINSON, CARLA. CECILIA, RICHARD.). LEBERER, HY\IA:-1 TETEWSKY. ROBERT BERG.'ER, KARL MANDERS, WILLIA\1 STEIN. YALE SOLO\!ON, ROLAND ANTHONE: THIRD ROW: HENRY L. PECH, SIDNEY ANTHON E. ROBERT,'. Ku.·G. RICHARD LYONS ROBERT BENNINGER, GUYS. ALFANO, EuGENE.). LEFT TO RIGHT: ALBERT C. REKATE lYGAJ. jAMES Du.·N. Do:-~ALD THO\I~S. WARREN R. \!0:-<TGOMERY, jOHN G. 7.0LL, WILLIA\1 HILDEBRAND, j HIES P. SCHAUS. FIRST ROW: WINIFRED MERXA:-1, CLEORA K. KEELEY, jOHN H. PETERSON, C. DANIEL FAGERSTROM: SECOND ROW: S. JOSEPH LA\1ANCUSA, LAWRENCE f. BEAHAN . .)OHX H. KENT, fRANK.). GAZZO, ALBERT A. FRANCO. RAY G. SCHIFERLE, jOHN B. BAKER. FIRST ROW: HERBERT E. JOYCE, A. ARTHUR GRABAU, GE:O.:EVIEVE G. HOWEN. EARL K. CANTWELL ROBINSON, CHARLES E. JOHN G. WILES; SECOND ROW: "lORMAN GHASSIN, JOHN f. HARTMAN. WILLIA'.I S. ANDALORO, WAYNE G. Tn!PLER, IvAN W. KuHL, WILLIAM'\. MciNTOSH: THIRD ROW: K. jOSEPH SHEEDY. GEORGE M. ELLIS. jACOB S1 EINHART: FOURTH ROW: ROBERT l.AGLIA. GEORGE THORNGATE. IV. C. .\1. SCHOPP, \'ITO P. Summer 2000 laffala Physician 29 �SuMMER 2000 FIRST ROW : IRWIN STEINBERG, WILLIAM E. ABRAMSON; SECOND ROW : jOSEPH A. CHAZAN, EDWARDj. GRABER, fRANKLIN GLOCKNER. jAMES R. KANSKI, ROGERS. DAYER, SYLVIA SussMAN, HARRIS C. fAIGEL: THIRD ROW : jOSEPH C. >\NTKOWIAK, DANIEL A. GOLDBERG, H ARR I S ~.KENNER, L. LEITER, MARSHALL A. LICHT\IAN. ANDRE D. LASCAR!, NAOMI ALGIRDAS CAMZIUKAS, DONALDj. DONIUS. WILLIAMj. STEIN, DO!'iALD A. HA\O.IEL, D. jACKSON COLEMAN' GERALD DIESFIELD, EDWIN R. LAMM, EUGENE T. PARTRIDGE; FOURTH ROW : fRANCISj. KLOCKE. HARRY L. METCALF. DANIEL T. GIA!'o<TURCO. THO\I ASj. GUTTUSO, THEODORE S. BISTANY, ROBERT T. GUELCHER. ROBERT L. ~ALATESTA, DAV I D'\. FIRST ROW : SULAH MEGAHED, ALAN M. PODOSEK, STEVEN V. GRAB I EC, ALANj. f i NK, N. LYNN ECKHERT, LAURENCE :-...1. LESSER, WILLIAM f. BALISTRER I , D.H'IDj. ROSSMAN, AGNES \ I ESCHES. V. SZEKERES, DONALD SECOND ROW: HENRY L. P. COPLEY, jOHN D. fOLEY; WHITED, ARTHUR R. GOSHIN. THOMAS A. O'CONNOR, SHAFIC Y . TWAL, WILLIAM j. fiDEN, \ I ICHAEL FIRST ROW : ARTHUR M. L. LIPPMAN!'i, jA:-i ~-NOVAK. MORRIS, LANCE fOGAN, IRA HINDEN, SECOND ROW : jOSEPH G. CARDA~IONE, GEORGE B. ~OORE, GARY H. JEFFERY, GEORGES. STRAUSS, H. ELLIOTT LARSON, BENJAMIN j. WHERLEY. !1-frCHAEL S. FEINBERG. AUGUST J. D'ALESSANDRO. FIRST ROW: DAVID KLUG, LEO R. ~UIDO, \1ARY ELIZABETH ROEHMHOLDT, ~ ARGUERITE DYNSKI, LYKNE HOCHBERG PACE, BRENDAN C. BRADY; SECOND ROW: PAUL D. TRAUTMAN, HENRY P. TOMIAK, DENNIS C. WHITEHEAD, LAWRESCE C. MILLHOFER, WILLIAM I. COHEN, LUDWIG LICCIARDI, jACK CUKIERMAN, ~ARC 30 lullalt Hysician SummL'r 2000 F. P. fREER, jACK COLMA!>, jOHN H. HEDGER, jOHN C. STUBENBORD, jOHN LOVECCHIO. �----- ----- ----~~~~~------------ ---~ - - - - - ~-- FIRST ROW : MATTHEW G . SALTARELLI. MARC K. KLEME~TOWSKI. GALE BURSTEIN BL00\1, ~1ICHAEL B. MARINO, !\'IZA:\1 RAZACK, ANN RIZZO; SECOND ROW : PETER BLOOM. LIDIA V. WENZ, NGOZI 0SUAGWU, EILEEN M. SALTARELLI, VALERIE VULLO SAENGER, MICHAEL LICATA, RAYMOND V. PAOLINI. LAURA PANEBIANCO, jOYCE jANICE E. N. J. NICHOLSON. STEPHEN M. PATERSON, ALICE PIEN MILGROM. ERRICK, SHOBHINA G. CHHEDA. SuzzETTE N. ROBINSO'I, STEVEN j. HOWARD. DENISE ALOISIO, VIRGINIA FIRST ROW : BARRY A. CLARK, ROBERT SHALWITZ. PETER H. GREENMAN. MARK S. BORER, EvA KLO~OWSKI, LYNN \1. E. ROBERTSON; TH IRD ROW : PETER WINKELSTEIN. EDWARD F. KOWALSKI, ROBERT j. LEON. SEAN CAO, RAGHU RAM, l. STEINBRENNER, fRANK W. SANCHEZ, THOMAS DOUGHERTY; HOWARD SECOND ROW: ~! ARGARET W. PAROSK I , CONSTANCE B. LIVERPOOL. GREGORY D. SA:>.!BUCHI . RA:-.:JAN BHAYAI'<A. STOLL, MICHAEL HAYMAN, STEVEN F. LE:-.:Tz, THERESA STEPHAN HAil'S, EDWARDj. ROCKWOOD. LEFT T O RIGH T: KAREN E. DULL, TRACIE DIMARCO, MARTIN C. :v!AHONEY. TARA SOSA PAOLINI. PATRICIA A. KREBS. STEVEN M. FINKELSTEIN, GARY j. 'l!ELAN, DANIELLE NOTEBAERT FEELEY, ARAVIND HERLE, KATE GUERNSEY ACKERMAN. MIROSLAV P. BOBEK. GREGORY A. MCDANIEL. F I RST ROW : ELIZABETH l. MAHER. C. ADRIANA ALVAREZ, LUCIE A. DIMAGG I O, ELIZABETH SPATOLA; SECOND ROW : LOU ANI\ GART:-;ER,jOSEPH A. ZIZZI, RAYMONDj. MEEKS, CAROL HAMMER FORSTER, MARGARET E. REIDY, SHIRLEY V. GALUCKI, BARBARA P. UPPAL. ELAI:o.;E SCHAAF, LAUREL A. \1. STIDHAM; THIRD ROW : THOMAS B. ~1ICHAEL P. NANCOLLAS. CARLj. TURTSS I !\1. PFEIL. LY:\DA COWAN, IRA S. HANDLER, jACK F. COYNE, DAVIDj. FoRSTER. DoNALD TINGLEY. jOHN LEDDY, jAMES M. ESSER. jOHN R. FUDYMAN, M I CHAEL LAHOOD, DALE W. SPONAUGLE. Spri11g 2000 lufl al 1 Physicia n 31 �0 E V E L 0 P M E N T N E s w Tomorrow's Traditions Be ·nToda By Li nda J . Cor de r , Ph0, CFRE of memory and hope. region, joined with the medical school as official spon- extends back through the generations to a small group of sors of the Mini-Medical School for the next ten years. Buffalo citizens, primarily physicians and attorneys, who This is the third year that UB has participated in the founded the University in 1846. Their dreams included White Coat Ceremony. One ofouralumni, Don Pachuta, awarding degrees in all fields, being nonsectarian in governance, and training professionals to serve their region. History of Medicine at the University of Maryland, real- Ourcommunitynowextends to all states and throughout the world, where physicians, surgeons and scientists minds and hearts of future doctors, so initiated an en- institutions-labor in hope, providing tools for lifelong learning, nurturing curiosity and humanity. inaugural lecture himself. Both events reinforce that medicine is an art and that healing often has more to do The mission of the development staff is to serve as a with authentic communication between human beings catalyst to deepen and expand this noble endeavor. Our work complements that of faculty and administrators and than with the latest technology or complex equipment. In the fall, the Pathology Department will initiate a lecture in memory of Dr. Kornel Terplan, who earned an international reputation for his research in the areas professors and to express their appreciation for the educa- of tuberculosis and neonatal neuropathology. •.. \I E ll I C I -.; I much as possible about the dreams and priorities for the sons initiated the endowment, with the reminder that \1 0 R E T 0 ~ T IC B E T \\" E E :\ \\"\T\1 32 0 F T I \: \) 0 school's future. "although educational content and educational tools We listen to will change from century to century, the need to the stories of develop healthy minds, healthy bodies and a healthy alumni and environment will not change. We will always require friends, seeking disciplined scholarship, hard work, honesty, humility, C 0 .\1 \I L '.; I C. AT I 0 I A"\ EST C 0 \t P L E X I u I I a I o Phys ician ~ T II ·\ :"' TEl 11:-:01E Q L I P \I 1- ;-,: T . S11mmer humor and skepticism of the unproven . .. " On a final note, the first annual aughton Award to help the school realize was presented at the annual faculty meeting on its vision. Then, we en- May 24, 2000. This endowed award-established by Dr. john aughton for the "unsung heroes" of our This spring, Dr. Harry RT II A S \1 I T H H U :\t A ;\ B F I ' (, S TilE 0 R ~ I S A :-; H \· A I I :-; <; Dr. Terplan served our school and that department as chair for over three decades, and even those of us who never met him feel his presence in our community. His able them to "just do it." 0 GY Physician." This August, Dr. Pachuta will deliver the and friends an opportunity to "give back," to honor former finding those who want L T H I dowment to ensure that the tradition will be ongoing. He enhances the students' experiences. It also provides alumni common threads, ~ ized the personal importance of this ceremony in the also made provision for a special lecture for returning second-year students, with the theme "Dear and Glorious Development officers are matchmakers. We learn as :-; ll who served for many years as professor of Ethics and the use skills and knowledge they learned in Buffalo. Our immediate community, those who study, conduct research, guide grand rounds, and otherwise work within the school's walls-and in its network of affiliated tion and opportunities they received from the school. .~ known for their support of activities that enrich our Our community transcends both time and distance. It school-is described in detail on page 23. Sultz, founder of our Thus do the values in the school's collective memory Mini-Medical School, become the foundation of its future hope. Together, mem- was honored in a special bers of our unique community facilitate that process. 4D "Health Care Heroes" issue of Business First. At about the same time, Don and Esther Davis, Lyn Corder is associate dean and director of development. Slzemaybereachedbyplwne, tollfree,at l-877-826-3246,or by e-mail at ljcorder@buffalo.edu. 2000 �Dear Fellow Alumni, F\\t>lhiiJT T!H ~ A ""r)r I\ rrn \Jfri)(Af A11 I would first like to thank our outgoing president, Dr. Richard L. Collins, for the outstanding job he has done in leading our organization. Dr. Collins was successful in solidifying two wonderful programs during his tenure: The first was the Physician-Student Mento ring Program, which has become a huge success. The second was the White Coat Ceremony, in which first-year students are given their clinical white coats on the first day of their orientation to medical school; this is done in the presence of their families and many of the faculty members. On April 29, 2000, we held our annual Spring Clinical Day at the BuffaloNiagara Marriott. The program was titled "Children 's Health Issues," and our keynote lecture, delivered by Maxine Hayes, MD '73, addressed the future of children's health in the new millennium. For a report on this insightful and informative lecture, l refer you to page 25 of this issue of Buffalo Physician. This year, we plan on continuing all of the programs that have been offered to both the alumni and the medical students in the past. I would, however, like to focus on membership in the Medical Alumni Association. I know how valuable a physician's time is. Nevertheless, l do feel that as our university continues to make great strides in the medical community, our alumni association should be matching those strides step for step. We need to have a strong base of alumni-not only our older graduates, but also our recent graduates-to support the school in every way possible. We offer a lifetime membership that is very economical, especially for younger doctors who plan on being in the alumni association for the next two to 30 years. Our lifetime membership is also a way for older physicians who are in a more stable situation to support the alumni association and its programs. You 'll be hearing more from me in the fall about increasing our membership and the percentage of alumni who become lifetime members. If any alumni have ideas they wish to share or would like to volunteer their time to help with the association, please contact me at (716) 829-2778. !look forward to this upcoming year as one in which our association will grow and prosper. President, Medical Alumni Association 5 11 111 111 er 2 00 0 Bu If a I o Physician 33 �CLASS 1940s Edward Tracy, MD '43, writes: "I enjoy Buffalo Physician. It's good to hear about classmates, etc. I have been married 57 years to the same "Chick" (that's her nickname!) and we have seven children, all of whom are married. Two graduated from West Point Military Academy and two from The Citadel. Three of my daughters were educated in France. We have 15 grandchildren and one great-grandchild. I am still very active in private practice-internal medicine-and teach, pro bono, at the Medical University of South Carolina. The best to all of you, especially my classmates." 1960s Joseph A.Chazan, MD '&D. received Univer- sity at Buffalo's Distinguished Alumni Award at the Alumni Association's annual awards dinner on April 7, 2000. Chazen is founder of the Rhode Island Di- NOTES active in many civic, religious and arts organizations. He has served for nearly a decade on the UB School of Medicine and Biomedical Sciences alumni board and is a former chairman of UB's general alumni fund drive. Michael E. Cohen, MD '61, received the Samuel Capan Award at UB's annual Alumni Association's awards dinner on April 7, 2000. Cohen is professor of pediatrics and neurology and former chair of the UB's Department of eurology, received the Samuel P. Capen Award-the alumni association's most prestigious prizeon April 7, 2000. The award is presented for notable and meritorious contributions to the university and its family. Director of pediatric neurology at Kaleida Health System's Children's Hospital of Buffalo since 1978, Cohen and his UB colleague, Patricia Duffner, MD, coauthored the alysis Program and medical director of the Rhode Island Artificial Kidney Centers. He has made significant contributions to his community and is 34 lu ffalo Pbysician Wels Receives Chancellor Charles Norton Medal Philip B. Wels, MD '41, visionary and dedicated Biomedical Sciences, received the Chancellor benefactors of time, the Medical Alumni Charles P. Norton energy, ideas and Association's Medal-University at key funding. A uni- Achievement Buffalo's highest versity Founder and Award and the honor-on May 14, trustee of the UB Chancellor Capen Award. In 1997, 2000, during UB's 154th Foundation, Inc., general commencement. Wels has been the he was awarded Wels, who is Professor recipient of many the President's Emeritus of Surgery and awards from UB, Chair Emeritus of the including the Distin- than 60 years of ongo- Medal for more University at Buffalo guished Alumni Award, ing service to the UB Council, has long served the Dean's Award in the community. UB as one of its most School of Medicine and highly regarded textbook Brain Tumors in ties, including chair of the Tissue Committee and Representative of Private Practice to the Executive Committee. He is also a clinical associate professor of surgery at UB's School of Medicine and Western ew York for 25 years and is currently a member of Advanced Cardiac Surgical Associates, PLLC, a Buffalo-based practice group. Biomedical Sciences. 1970s Children: Principles of Diagnosis and Treatment, now in its second edition. A member of the medical-school faculty since I 968, Cohen also serves on the Dean's Advisory Council. Joseph R. Gerbasi, MD '62, was honored by the Erie County Medical Center's (ECMC) Lifeline Foundation at its Springfest 2000 annual black-tie dinner on April 15. Gerbasi has been the surgical director of transplantation at ECMC since 1969 and has served the medical center in many capaci- BP Areta Kowai·Yern, MD '72, Ross L. Guarino, MD '66, was installed as the new president of the Medical Society of the County of Erie on May 9, 2000. Guarino, who succeeds Datta G. Wagle, MD, has practiced cardiovascular and thoracic surgery in writes:"[ have taken a position as burn research director and tissue bank director at Cook County Hospital, Department of Trauma, Burn Center, Chicago, IL." Gordon Avery. MD '74. McLean, VA, Orthopedic Surgery. "I have been an FL team physician for the past five years with the Washington assnotes S " '" m e r 2 0 0 0 �Redskins. I am past president of the County Medical Society." the Community Workshop. Please say 'hi' to everyone for us." John and Kathleen Braico, MD '74, Queensbury, NY, Richard J. Goldberg, MD '74, writes: "I'm cur- Pediatrics. "We have been happily married for nearly 28 years and have built a successful group practice (five pediatricians and two nurse practitioners). John does general pediatrics as well as neurodevelopmental evaluations for kids with learning disabilities and has greatly helped their educational success. We are raising two healthy boys. Besides our prac- rently professor of psychiatry and medicine at Brown University, and psychiatrist-in-chief at Rhode Island Hospital and The Miriam Hospital. Recent new events include starting as editor of the Brown Geriatric Psychopharmacology Update. Also, I'm halfway through a two year master's degree program in medical management at Harvard University." rjgoldberg@lifespan.org E-mai nity Health of the University of Massachusetts Medical School, Worcester, MA. l have a clinical practice at a community health center in Worcester." E-mail address is Lasserd@ummhc.org Eric Russell, MD '74, Chi- cago, !L, Neuroradiology. "I was elected president of the American Society of Neuroradiology, 19992000. I am professor of radiology at orthwestern University Medical School and director of neuroradiology at Northwestern Memorial Hospital. l have published over 100 scientific publications/ book chapters." erussell@nwu.edu ~NTIN U ED ON PAGE 37 J. Manzella, MD '74, York, PA, Internal Medicine. "We take care of approximately 250 HIV patients." lf-jmanzella@ AGenerous Gift of Suppon yorkhospital.edu Diane Matuszak. MD '74, Columbia, MD, Preventive Medicine. "!have served as a local health officer ( 1982-1984) and as a state public health official for the past 14 years in the Maryland Department of Health and Mental Hygiene." Summerr@compuserve.com will provide a renewable tuition scholarship for at least one student in each Sanford Pleskow, MD '74, tice, we are both instructors for neonatal resuscitation. Kathy is a pediatric advanced life support instructor, and for six years she has been medical director of the Hole in the Woods Ranch camp for children with serious and chronic illnesses. She participates in an annual medical mission to Gua temala. John has been on the board of Head Start for 20 years, and Kathy is on the board of Howard Goldstein. MD '74. Cherry Hill, NJ, Adult and Pediatric Urology. "Children: Lee is a junior at Yale Medical School; Lauren is a sophomore at Columbia University; and Daniel is a junior at Cherry Hill High School." Daniel Lasser, MD '74, eedham, MA, Family Practice. "My current position is chair of Department of Family Medicine and Commu- Williamsville, NY, Internal Medicine."! have been happily married for 29 years (same person). Hobbies are travel, hiking, tennis and exercise. I have a daughter who is applying to medical school." says she worked hard to earn John Rowlingson, MD '74, he~ education during a period when state schools awarded scholarships Earlysville, VA, Anesthesiology. "My years of practice have taught me the importance of making pain management a priority. When the case is beyond your skillsget help. Remember, we can't help patients who won't help themselves." Jcr3t@virginia.edu While in medical school, she earned scholarships and summer jobs covering the costs of books and room and board. After completing training, GoHschalk practiced general surgery witli S limm er 200 0 B u If a I o Physician 35 �C L A N 0 T E he first Minority Alumni Reunion of the University at Buffalo School of Medicine and Biomedical Sciences was held April 7-9, 2000, at the University Inn and Conference Center in Amherst, NY. "Coming Together for the New Millennium" was the theme for the event, which included social gatherings and an educational program that focused on advances in the prevention and treatment of common health problems encountered in minority communities. The keynote address for the reunion was delivered by Kevin Greenidge, MD '77, who spoke on "Health Care Access without Health Care: A Minority Dilemma." Greenidge is professor and chair of the Department of Ophthalmology at the SUNY Health Science Center at Brooklyn. The following Classnotes were submit· ted by several attendees of the reunion: JOSEPH OE.JAMES, 36 8 u I I a I o Physician S11mmer 2000 \10 '96 KEV IN GREEN IDGE , \10 '77 �William Sperling, MD '66, Honored William Sperling, MD '66, has been named that meet monthly, bringing together pulmo- the "Dale Daniel, MD, Memorial Partner of nary physicians and thoracic surgeons from the Year" by the Southern California Kaiser Permanente, Balboa Naval Hospital Permanente Medical Group (SCPMG), a and UCSD to learn from one another and to partnership of SOO physicians who care for improve the care of patients. County Pulmonary Society and has worked health maintenance organization. Sperling joined SCPMG in 1974, when Kaiser with the San Diego County Lung Association Permanente was only seven years old in to help establish a Better Breathing Club for San Diego. He is credited with establishing William Sperling, MD '66 an ongoing relationship between SCPMG's chronic pulmonary disease patients. He has also chaired the Tobacco Free 2000 Commit- Internal Medicine Department and the tee for the San Diego County Medical Society and helped to residency program at the University of California at eliminate smoking in the local sports stadium and airport San Diego (UCSD). before state law required it. Sperling is a clinical professor of medicine at UCSD patients, understand their fears, reassure them and give addition to teaching at the university, he has actively them the best care possible," says Maurice Alfaro, a promoted pulmonary medicine educational programs colleague of Sperling's at SCPMG. Wynnewood, PA, Neurology. "I am very involved in a professional organization in the area of headache, and I Inc. I am spending my summers in Zimbabwe, Africa. BonniDutcher, PhD'7B. Amherst, NY, Orthope- Hoffman Estates, IL. "I am working as a medical science liaison for Genentech in Chicago. I set up the clinical trials with antibodies for cancer dies. "I am current chair of Credentials for Kaleida treatment. l would love to hear from old friends. " Health, president of orthtown Orthopedics, Bonnllll@yahoo.com and medical director of the Millard Fillmore Ambulatory Surgery Center. " Bennett Yogelman. MD '78. lecture extensively." Eschul6641 @home.com Paul Wierzbieniec, MD '74, Center for Women's Health and Women's Health Research, as well as the named recipient of the jean Manchester Biddick Professor of Women's Health Research. Their son, Paul, will start as a freshman at the University of Wisconsin this fall, and their daughter, Lindsey, will begin high school. Molly and Bennett have fond memories of medical 4:D trator of Brandeis University's business/ management graduate program from which I graduated in 1995." Magjersam@aol.com Philip Anson, MD '79, Scarborough, ME, Orthopedic Surgery. "After 14 years in a large subspecialty orthopedic practice, I took a twomonth summer sabbatical (as a Teaching Fellow ottingham, England) 111 and Molly Carnes, MD '78. school, where they met and are very grateful to continue to thrive in Leonard Katz, who Madison, WI. Both steered them to UW for are professors in the Department of Medicine their residencies. Phoenix, AZ. "I am retired from medicine and am now a rancher in Arizona, working for at the University of Wisconsin. Bennett is the associate chair for Robin Adair. MD '79, the Bitter Creek Land and Cattle Company, education and Molly is practice for the time (referee) for both men's director of the UW being to be an adminis- and women's lacrosse. Richard Zeschke, MD '76. eedham, MA, Pediatrics. "I've left clinical hotmail.com Snyder, NY, Internal Medicine. "I am currently professor of medicine and associate chief of the Division of Cardiology at UB." Canty@buffalo.edu Allen Carl, MD '79, "Lastly, he's never been too busy to listen to his and has been active in the pulmonary service there. In Elliott Schulman, MD '74, and spine) through AO-ASIF." Psalax@ John Canty Jr., MD '79, Sperling is past president of the San Diego patients in Kaiser Health Plan, a nonprofit I am also an oral examiner for the American Board of Orthopedic Surgery and a lecturer/ instructor (in trauma in I996 and opened a solo private practice on my return. I am team Slingerlands, Y. "I am professor of orthopedic surgery at Albany Medical College. My research involves spinal cord injury and scoliosis. In 1997 I had a traveling fellowship with the Scoliosis Research Society." Alscar@nyca p. rr .com Terence Chorba. MD '79, Atlanta, GA, Internal Medicine. "Buffalo is a great place to go to medical school and you were great classmates to be with." Tlc2@cdc.gov Peter Condro, MD '79, Richmond, VA, Nephrology. "Since 1985 I have lived in Richmond, Virginia, practicing with Richmond Nephrology." E-mail address is: physician for the U.S. Soccer Federation, on the los4441154@::ompuserv.com board of directors of the Margaret Garrisi, MD '79, Maine Lacrosse Foun- Scarsdale, dation and an official ductive Endocrinology S 11 m 111 e r 2 0 0 0 Y, Repro- CONTINUED ON PACE 38 Bu ffa l o Ph ysi c ian 37 �CLASS I CONTINUED FROM PAGE 37 and Infertility. Mjgraf@ mail.med.cornell.edu 98 Subhabrata Chakraborti, PhD '84, Tuscaloosa, AL, "!am working at the University of Alabama in the Department of NOTES Management Science and Statististics and am a professor of statistics. Published over 30 research articles and am associate editor of two statistics journals." Michael Mercado, MD '84, Windermere, FL, Family Medicine. "I've com- pleted 18 marathons since I graduated in 1984. I'm medical director at West Orange Family Medical Care (group practice) and Health Central Park (nursing home); and in-structor in Tang Soo Do Karate at the Traditional Martial Arts Center." A reception for alumni of the University at Buffalo School of Medicine and Biomedical Sciences will be held in conjunction with the Association of American Medical College's annual -.tlng October 27-November 2, 2000, in Chlcaco. Chlcaco MarrioH Kimberly Norris. MD '84, Middleville, Ml, Ophthalmology, and husband, Mike Nosanov, MD '84, Otolaryngology/ Head and Neck Surgery. "We practice together in our own practice, eye and E. .T. specialists, in Hastings, Michigan. l [Kimberly] am actively involved in childhood vision screening research and program development." Mnosanov@voyager.net William Reichman, MD '84, Princeton, N), Psychiatry. "I am director of the Division of Geriatric Psychiatry at the Robert Wood Johnson Medical School and vice chair of the Deptartment of Psychiatry. I am also COO of our university's Behavioral Health System." Reich man@u md nj.ed u Kevin Rosteing, MD '84, Green Bay, WI, Internal Medicine. "We live in Green Bay, a 'cool' beautiful place on the Great Lakes. We own a boat and spend some wonderful time on the water with our children." Kevinr@gbonline.com 38 Buffalo P bysician S 11111111 C r 2 000 Look for more information at the conference, or contact Mary Glenn at I 877) 826-3246; e-mail glenn@acsu.buffalo.cdu. Randall Solomon, MD '84, and Susan Abbott, MD '84, Setauket, NY, Psychiatry. Randall writes, "My wife, Susan, and I are both in private practice of psychiatry. Susan is medical director of]. T Mathe Hospital's adolescent inpatient psychiatric unit." Rsdomon3@bigfoot.com Michelle Stram, MD '84, Chalfont, PA, Internal Medicine. "I've been in a very successful, busy cardiology group practice. I am the managing partner of our office that employs a staff of 25. Michael Kaplan (internal medicine and endocrinology resident and fellow at UB) and I have two wonderful children David, 6, and Sara, 4. Mstram@worldnet.att.net John Oyster, MD '84, Lewiston, NY, Family Medicine. "I am assistant director of Niagara Falls Memorial Medical Center Family Practice Residency and a member of the medical school's Admissions Committee." David Crandell, MD '89, Needham, MA, Physical Medicine and Rehabilitation. " I am team physician for the Ballet Theatre of Boston. Team physician, U.S. Disabled Sports Team, Athletics World Championships, 1994, 1998." Carol DeCosta, MD '89, Brooklyn, NY, Physical Medicine and Rehabili tation. "I worked as a physician for the 1996 Olympic Games in Atlanta. Recently I started a private practice in rehabilitation and sports medicine in Brooklyn Heights, New York. Cdale2810@aol.com �Anna Hart, MD '89, Ports- mouth, VA, Otolaryngology/Head and Neck Surgery. "I was a U.S. aval Flight Surgeon for more than five years, stationed in Florida, then Washington State. I resumed my residency in otolaryngology/head and neck surgery in 1995 and will start as chief this summer. I have presented papers at several meetings, including the Academy of Otolaryngology/Head and eck Surgery and have also wife, Stacey, and l have an 18-month-old son, Ian, and are living in Westchester County, New York. Silberj@ rockvax. rockefeller.ed u Stuart Varon, MD '89, Baltimore, MD, Child Psychiatry. "I am medical director of child psychiatry at Sinai Hospital of Baltimore and an instructor at johns Hopkins University School of Medicine." Svaron@sinai-balt.com In Memoriam Thomas A. March, MD psychology at the VA Cen- South Buffalo for about '31. tral Office in Washington, 50 years and was on the age 96. March D. C., and as the director staff of Mercy Hospital was born in New Castle, of the VA Hospital at for 42 years. From 1957 PA. In 1946, after earn- American Lake, WA, to 1997, he served as ing his medical degree where he retired in 1973. associate medical direc- from UB, he completed In May of that year, in tor and later medical postgraduate training honor of his contributions director fo the Buffalo neurology and psychiatry to psychiatry, March was Chapter of the Blood at Columbia Unaversity. elected a Ufe Fellow by Collection Program of He entered the U.S. Army the American Psychiatric the American Red Cross. Air Force Medical Corps Association. He is sur- He was also a clinical in 1942 and became a vived by his wife, Rorie; instructor at UB for more flight and group surgeon daughter, Peggy Ander· than 40 years. In addition for the 8th Air Force son; son Thomas D. to his wife, Eleanor, he is published three papers. I am on the editorial 1990s Squadron based in En- March; and stepsons survived by five daugh- review panel for our academy's (Oto/H S) journal, which keeps me busy as well." Email is: Toddandkristina@msn.com Lyn M. Oyster, PhD '90, gland. He achieved the Richard and Greg Nace. ters and three sons. received University at Buffalo's Distinguished Alumni Award at the Alumni Association's rank of Lt. Colonel and Elton Rock, MD '59, 1947, March joined the Edward L. Valentine, MD '45, ent died Febru- Veterans Administration ary 25, 2000, at age 80. Alzheimer's Disease. Department of Medicme A World War II veteran, Rock started the Depart- in Pittsburgh, PA. During Valentine served in ment of Gastroenterology his VA career, he served Batavia, New Orleans and at Sisters Hospital in as the director of the VA Asheville/Black Mountain, 1970 and headed It until Hospital at Bedford, MA, NC, as a Navy medical illness forced h Oyster is a founder and as the deputy director of officer. He had private retire in 199 president of GenCyte, LLC, a microbiology company that patents genetic markers for breast cancer. The company will leverage its skill base in molecular biology, microbiology and cell culture to perform biologic laboratory services. It also plans to develop cellculture products for sale psychiatry, neurology and practices in Elma and Andrea Messina, MD '89, Wayzata, M , Obstetrics/Gynecology. "Hugh eeson and I work in the same large multispecialty group with over 350 physicians in Minneapolis. I never thought a neuroradiologist and OB/ Gyn would work for the same group; it's supposedly the shape of things to come." Jeffrey Silberzweig, MD '89, Elmsford, NY, Internal Medicine. "I am currently the medical director of the Rogosin Institute's Queens Dialysis Center annual awards dinner on April?, 2000. Cornell University Medical College. My American Academy of Orthopaedic Surgeons during ceremonies at the academy's 67th annual meeting in Orlando, FL, on March 15, 2000. after a long battle with CD Maxillofacial radiology child. We are moving at Virginia Commonwealth University School into our first home, in Rockville, Maryland. I of Dentistry, MCV campus, effective am presently an assistant clinical professor at George Washington August l, 2000. Elissa (Jaffe) Bookner, MD '91, see Scott Bookner, Richard Safeer, MD '93, writes: "After finishing University and the associate program director of the Family Practice MD '89. my residency in Ba ltimore, I married a won- Residency Program there. I am really enjoying teaching and, in to niche markets. Laurie Carter, DDS '83, PhD Glen M. Ginsburg, MD '90, derful woman. A year '93, has been appointed of Omaha, NE, was in- and a half later, we are associate professor and ducted as a fellow of the pregnant with our first director of oral and and an assistant professor of medicine at served in the Air Force Reserves untii19S3. In 5 11 111 111 e r 2 0 00 I CONTINUED ON PAGE 40 Bullalo Phys i c i an 39 �CLASSNOTES particular, I have had a chance to do some writing and lecturing on the topic of cholesterol management." New Alumni Association Sarah Finnegan, MD/PhD '94, has received a Electe Alumni Association. Duffner is a UB professor of neurology and pediatrics and a physician in the Depart=- John J. Bodkin, II, MD, was elected presi- ment of Neurology at Children's dent of the Medical Alumni Association on Hospital of Buffalo. April 29, 2000, at Spring Clinical Day. $10,300 grant from Fight for Sight, the research division of Prevent Blindness America, to conduct a study titled "Human Photoreceptors in Culture: Growth Factor Requirements and Potential Gene Therapies." <I;) Bodkin, a 1976 graduate of UB, is Colleen Mattimore, MD, class of 1991, is a clinical associate professor of the new treasurer for the association. family medicine and president Mattimore, a UB clinical instructor of of the Highgate Medical Group in pediatrics, is on staff at Williamsville, NY. Kaleida Health's Children's Hospital and Mercy Hospital Patricia K. Duffner, MD, class of 1972, of Buffalo. becomes vice president of the Medical A plan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anythjng you need to keep enjoying life. Ca/1686-8077. TilE CE:-..:TER FOR H"')SPICE& PALLIATIVE CARE www. hospiceb1!{folo. com 40 luffalo Physician S11mmer 2000 ��- Based on FIMsM Data t t They were drJl sergeants- and cheerleaders~' - Frank Stelarski, stroke rehab patient, Harris Hill H.C.F Why do our patients have better rehab resuh:s compared to the national average? Maybe rt's our staff. ''They knew exactly how far to push me,' ' says Frank Stelarski.''But they also encouraged me every little step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire Rehabilrt:ation THE UJ1CGUIRE ~HABILITATll91'{ CENTE~ Centers, call 1-888-POSTACUTE or visrt: www.mcguire-group.com. 1\ccognizcd ror excellence in guality care. AUTUMN BP 000 1 0 1 VIEW • GARDEN GATE • HARRIS "*****" HILL • NORTH GATE � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n01-2000-Summer Table Of Contents A list of subunits of the resource. Safe and Sound Wake·up Call Baseline Scoring Medical School Pathways Spring Clinical Day Development Classnotes Alumni Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/bcfff00ba3583dc294146c7b6185cfe0.pdf 52d832f26d014dd5c84fc1dd31f911f0 PDF Text Text �l1ffale P~ysicial ASSOCIATE VICE PRESIDENT FOR UN I \ ERSITY SERVICES Dr. C a role S mi t h Petro Dear Alumni and Friends, DIRECTOR OF PERIODICALS Sue Wue t cher EDITOR S t eplwnie A. Unger )I (, ! , the fi rst of the new millennium (depending, of course, o n how o ne defines the start date of a new millennium). We have just completed another highly successful orientatio n week for inco ming freshmen, which concluded wi th the now-traditio nal White Coat Ceremo ny. Dr. Robert A. Milch, MD '68, ART DIRECTOR/DESIGNER A lan ]. Kegler AssiSTANT DESIGNER Lynda Dona t i directo r of the Center fo r Hospice and Palliati ve Ca re in Buffalo, delivered an inspiring message to the first-year class and their parents, spo uses and friends. Dr. Do n Pachuta, MD '66, addressed the second -yea r students, focusing his comments on the humanistic philosophy that sho uld- must-underpin the physician's approach to learning and to practicing medicine. Do n is in the process of creating an endowmen t that will suppo rt an a nnual lectureship on the "humanism" underpinnings of medici ne. Students also received a copy of the new Code of Professional Conduct, published in an elegant booklet. Printing expenses for the booklets were underwritten by a generous unrestricted gift from Dr. and Mrs. Edward Shanbrom (Ed is an MD '51 alumnus who now resides in California). A special article on the code and how it was developed by our students last year will be presented in the winter issue of Buffalo Physician, which will also feature the complete text of Dr. Milch's talk. All in all, it has been an excellent start to the new academic year. This is the time of year fo r new arrivals to the uni versity. Dr. John Yeh joined us ea rlier in the spring as chair of Gynecology-Obstetrics. Even during this short period of time, the departm ent has undergone remarkable rejuvenatio n. In addition to four new faculty PRODUCTIO!'i COORDINATOR Cynthia Todd-Flick STATE l.JNI\ ERSITY OF NEW YORK AT BuFFALO ScHOOL OF MEDIC INE ~ND BIOMEDICAL SCIENCES Dr. / o lm Wrigh t , Dean EDITORIAL BOARD D r. B e rt ra m Portin, Chair Dr. Martin Brech e r Dr. H a ro ld Brod y Dr. Linda f . Co rde r D r. A lan f . D ri nnan D r. fam es Ka n ski Dr. Eliz abeth Olms t ed D r. S t eph e n Spa ulding Dr. Bradley T . T ru ax M s./ en n ife r Wiler Dr. Franklin Zeplowitz (besides Dr. Yeh}, the teaching programs at both the resident and medical student levels TEACHING HOSPITALS have received new life and there is an air of optimism and enthusiasm in the department. Erie Co unty .\fedica/ Ce nter Roswell Park Cancer In stitute Vetera ns Affairs Western New York Hea lthcare System Dr. Ken Blumenthal arrived in early August to assume the chair of Biochemistry. We are confident that he will grea tly strengthen this department, in terms of bo th its program and its wo rking relationships, and we all look fo rward to wo rking with him as he remolds this esse ntial basic-science department. In ea rly July, Dr. Elizabeth Capaldi joined the university as o ur new provost. For us, in the medical school, this is an extremely impo rtant positio n beca use it represents not o nly overall academic program leadershi p fo r the university, but also for the School of Medicine and Bio medical Sciences. This is a particularly critical period for the medical school as we attempt to remain current in teaching and resea rch yet accomm odate the buffeting fo rces that are all aro und us in the clinical enviro nment. One of the majo r tasks of the fall semester will be to fashion a durable affiliatio n KHHDA HI:A.IIII: T he Buffalo General Hospital Th e Ch ildren's Hospital of Buffalo Millard Fillmore Gates Hospi tal Milla rd Fillmore S ubu rban Hospi tal CATHOliC H fAITif Sr.\TF.\1: Mercy Hea lth System S ist ers of Charity Hospi tal N iagara Fa lls Me m orial M edical Cen ter ® THE STATE INIYUSIIY Of NEW YllliJIUIFlll agreement with Kaleida Health System (the merged Buffa lo General, Child ren's, Millard Fillmo re and DeG raff hospitals) . Central SUNY administratio n and community leadership will be very much involved in the process, which will likely chart the future directio n of o ur school and its clinical programs. No doubt it will be a fea tu red article in an upcoming Buffa lo Physician. We will certainly keep you posted. j OHN R. WRI GHT. MD D ean, Schoo l of M edicin e and Biom edical Scie n ces Buffalo Physician is published quarterly by the State Uni1·ersity of New York at Bujjalo School of Afedicit~e and Biomedical Scieuces and the Office of Pu/JiicatioiiS. It is sent, free of charge, to alumtll, facultj·, students, resiLICtJts, and friends. The staff rcscn'es the right to etfit all ropy aud submissions arrcpted for publiwtwn. T~ at Buffalo -:.:=:s University Tire State University ofNew York �VO L UME 35, p H y c s A Features 2 Internal Medicine's Man James P. alan's extraordinary contributions to his field and UB's Department of Medicine BY S .A . UNGER PHOTOGRAPHY 12 BY FRANK MILLER Eschewing Viewing Obese children learn to replace television with other activities BY S. A. UNGER PHOTOGRAPHY BY MARK DELLAS UB professor of pediatrics and psychology Leonard H. Epstein, PhD, has conducted pioneering research on childhood obesity for the past two decades. On page 12 begins astory about his current work aimed at teaching obese children to choose active behaviors over sedentary ones. COVER 16 Annual Faculty Awards 17 McAloon receives 2000 Humanism Award 18 Nielsen elected AMA's vice speaker 26 "Lonely for a 20 Auerbach wins jacob )avits Award 21 Hypertension redefined 23 Colon polyps unaffected by healthy diet Sciences Career Day a success White Coat Ceremony 25 Professors Albini and Gabrieli remembered Calling of My Own"-Umut Sarpel, class of2001, finds clinical rotations include an exercise in introspection PHOTO 29 Endowments crucial to chool's future 30 Listing of current endowments BY FRANK MILLER your UB classmates and other alumni N ��alkins certainly had this far-reaching goal in mind when he called • ' olan, but what he couldn't haw known at the time was that he was setting in motion a successful recruitment effort that would bring to the L'niversity at Buffalo a future chair of its Department of ~1edicine, and a man, who along with himself, would lead the department for a combined total of 3-l years. :\ot only would :\olan go on to work with Calkins to oYersee the growth of UB's Department of ~lediLine from approximateh- 50 faculty to more than 150, but he would also pia~· a leading role nationalh· in academic medicine, eventually serYing as president of the Association of Professors of ~1edicine and chair of the Board of Regents for the American College of Physicians. \\'ith his "official'' retirement from the State of, ' ew York in July 1999, • 'ohm brought to a dose a career in medicine that would have to be considered exemplary by any standard. Contributing to his stature is the fact that man\' of his colleagues and former students feel strongly that he will be remembered not so much for his long list of accomplishments as for his distinctly artful style of leadership-a stYle that could perhaps serYe as a model for any physician-leader today whose goal is to bring out the best in others under the most difficult of cirwmstanct>s. �The Early Years hen Calkins first approached Nolan about returning to UB, the university was still in the throes of adjusting to the enormous change it had undergone in 1962, when the University of Buffalo-a medium·sized private college founded as a medical school in 1846-was incorporated into the State University of New York (SUNY) system to form SUNY at Buffalo or, more simply, the University at Buffalo. Once the realities of this transition began to take shape, it soon became evident to everyone involved that the state was not just absorbing the buildings, faculty and staff of the University of Buffalo; it was also absorbing its remarkable history and ethos dating back 116 years to when the school was founded by such men as Millard Fillmore, James Platt White, Austin Flint and Frank Hastings Hamilton, all of whom went on to make their mark in the annals of American medicine. Added to this stir of proud history and state incorporation were the sweeping changes taking place in academic medicine at the national level. In large part, these changes were fueled by an unprecedented influx of dollars from the National Institutes of Health into the nation's medical schools, with the goal of promoting the growth and development of academic departments capable of fostering excellence in research. If a medical school were to compete nationally with the lulfalo Hpicin Autum11 2000 rush to develop sound academic departments that boasted the best and brightest in clinical and research faculty, then the best and the brightest it must recruit. At the time Calkins first contacted him, Nolan had just completed a clinical fellowship in medicine in the Liver Study Unit at Yale University's School of Medicine and was finishing up as chief resident in medicine, all the while contemplating the likelihood that he would set up practice in ew Haven, Connecticut. During his internship a few years earlier, he had met Christa, a student from Sweden who was studying microbiology at the university, and the two had married and begun a family. Returning to Buffalo was not in the picture. Calkins himself had come to Buffalo from Harvard University in 1960, when he was chosen to succeed the eminent internist John Talbott, MD, who had left UB to accept the editorship of the journal of the American Medical Association. While at Harvard, Calkins had become acquainted with Dr. Paul Beeson, professor and chair of medicine at Yale, whom he had talked with on several occasions about career opportunities. When Calkins was first offered the job as head of medicine at Buffalo General Hospital, he turned to Beeson for advice about whether or not he should accept the position. "Dr. Beeson had some connection with Buffalo," Calkins recalls. "I think his wife was from here. When I asked him what he thought about my coming here he said, 'Absolutely! It's going to be a great �The establishment of the division of endocrinology marked the stan of abuilding program that would continue for the next 17 years as 13 major divisions were gradually formed within the Oepanment of Medicine. opportunity and challenge. You get up there and get things going and then we'll exchange residents. ' "Well, what more terrific confidence could you give any young man coming into a program by saying on behalf of one of the major departments in the country that the chair would exchange residents?" asks Calkins. CE I B UFFALO, Calkins set to work identifying potential areas of growth and concomitant recruitment needs. At the time, the Department of Medicine for the university was cochaired by the heads of medicine at Buffalo General Hospital and Edward ]. Meyer Memorial Hospital (now the Erie County Medical Center). Calkins's counterpart at E. ]. Meyer Hospital was the legendary clinician David K. Miller, MD, the first full-time faculty member in medicine at UB, who had been head of medicine at the hospital since 1940. For many years, the two hospital-based departments operated largely independently; however, with the arrival of Calkins and the incorporation of UB into the SUNY system, the two heads of medicine began to acknowledge the necessity of working more closely to develop a university-wide department. In 1968, Miller volunteered to step down as cochair of the department. Following a national search, Calkins was chosen to lead the department, with the aim of developing it as a unified entity. From the time of his arrival at UB eight years earlier, Calkins had aggressively taken the lead in recruiting new faculty for his group at Buffalo General Hospital, which had a good base of clinically oriented faculty but a very limited number of research-oriented faculty, as was also the case at the E. ]. Meyer Hospital. "We were in a new era of medicine, where the emphasis was on integrating clinical and basic-science approaches," recalls Calkins. "We identified several areas where we thought if we put all our strength and energy into building in-depth, we would be able to develop programs that could be nationally competitive and attract major funding from the NIH, as well as set the standard for quality of care and for the teaching of students and house staff. " At the time, Calkins estimates that there were only about three or four facult y members in the Department of Medicine who were involved in focused research efforts. The first area that was identified as having a strong basic-science foundation upon which to build was endocrinology. Because the researchers in this group-most notably Dr. John Plager-were located at Roswell Park Cancer Institute, Calkins led an effort to bring them into the Department of Medicine at UB and give them faculty titles. He then recruited Dr. Keith Vance to head the new division. The establishment ofthe division of endocrinology marked the start of a building Alltllmn 2000 luffal1 Physician 5 �- -- - --------------------------------------------~~=---~~- program that would continue for the next 17 years as 13 major divisions were gradually formed within the Department of Medicine. medical school's teaching programs and faculty are disbursed among Buffalo's major community hospitals. For the Department of Medicine, this meant faculty would continue to be located in three hospitals: Buffalo General Hospital, Erie County Medical Center and the Department of Veteran's Affairs Medical Center. "On balance, I think that a university hospital is a tremendous advantage," says Nolan. "And I have always pushed for one, as did Evan Calkins before me. I never made it a secret that I thought that was the way we ought to go. But, early on--in the early 1970s--it was clear it wasn't going to occur, so then one had to accept it and make the best of it, and I think we did." Time to Bring the Talent Home EVERAL YEARS INTO THIS EFFORT, Calkins says he and Vance "got pretty lonely in coordinating the broad teaching responsibilities designed to integrate the basic sciences with clinical medicine." Thinking it time to bring someone on board who could help them with this work, Calkins again turned for advice to Yale's Paul Beeson, who recommended olan, his former chief resident. In the years ahead, olan and Calkins would fondlyand humorously--remember the recruitment effort that ensued. "We didn 't have much money back then and nobody would give us departmental funds for this type of thing, so when Jim came to Buffalo, we took him to a restaurant in the Southtowns where, for something like $3. 75, you stood in line and got your own food. Years later, when Jim and I were actively recruiting somebody and were trying to pull out all the stops, we took the person out for a nice dinner. Later, in an attempt to describe the dinner to someone, Jim joked, 'You know, it was the kind where you get waited on,"' Calkins recalls with a laugh. Smorgasbord dinner aside, Nolan found himself swayed by Calkins and soon he and his family were on their way to Buffalo, where he had accepted a dual position as associate professor of medicine at UB and clinical associate in medicine at Buffalo General Hospital. "Evan Calkins is a very dynamic recruiter," says Nolan, adding that the early 1960s were "very heady times for the university. SUNY at Buffalo was to be the flagship campus--the 'Berkeley of ew York State'--and it was a timeoftremendous growth." olan further explains that one of the great attractions that drew him back to Buffalo was the plan to build a new university/county hospital on the South Campus, at Bailey and Winspear, but recounts how, over the years, that idea--as well as a whole series of plans to relocate the medical school--was scuttled. It wasn't until the early 1970s that administrators finally made the decision not to build a university hospital and instead put into place the still extant affiliated-hospital model whereby the 6 lulfala Physician A 11t11 11111 2000 A Cool Head on the Hot Seat " AKI G TH E BEST OF IT," according to Calkins, involved putting Nolan to work using a special talent he was discovered to have soon after his arrival at UB. "We didn't have the power structure to work with that's in place today; we had to be on the various hospital committees and win by persuasion, by political savvy, in a sense," Calkins explains. And, as luck would have it, he and others soon recognized that olan had a remarkable talent for sitting on these committees and effectively lobbying for the needs of the Department of Medicine. "Jim is easily the best committee man that I have ever, ever seen," Calkins says. "We knew that if we put him on a committee, we could be certain that it would come out exactly the way the Department of Medicine wanted. Jim would sit down with all these senior people and he would represent our position by using his personal interdynamics, by taking a modest, friendly approach, never overemphasizing anything, not getting purple in the face and not pounding the table. This is just who he is and everybody liked and respected him very much and would, in large part, agree with the steps he proposed." As time went on, according to Calkins, olan grew increasingly practiced with committee work, and his skills became invaluable to the department and to the school of medicine. "He of course got better at it because we were always giving him the hot seat," Calkins recalls with a chuckle. "We didn' t waste him on the obvious [committees]. We put him on the ones where the whole future of the department would hinge. He was always much better at this work than I was because I would come in and be much more confrontational, more demanding, more un yielding. "This talent of Jim 's was a lead feature for him throughout his career," he adds, "and I know the dean on several occasions appointed him to chair very tricky committees involving subtle areas of great importance �" Making the best of it," according to Calkins, involved putting Nolan to work using aspecial talent he was discovered to have soon after his arrival at UB. to the school. Also, when he became involved with the American College of Physicians and the Association of Professors of Medicine he was able to do the same kind of work wonderfully well." Building on Buswell Fellowships Y THE LATE 1960s, the Department of Medicine faculty at Buffalo General Hospital had grown out of proportion to the needs or scope of care at the facility. "We were really bulging at the seams. We must have had at least 25 well-established young scientific doctors who had achieved national recognition and were getting major grants," recalls Calkins. At the same time, the county hospital was struggling financially and its faculty in medicine remained primarily clinically focused. Given this situation and the resignation of D. K. Miller as cochair of the department, the time was right, according to Calkins, to begin to bring the county's faculty into the new model for the department. To accomplish this complex transition, Calkins decided it was necessary to move a third of the department's fulltime faculty over to the county hospital. Also at this time, the decision was made to move the department's administrative offices to the hospital, where they remain today. A key factor that made it possible for the Department of Medicine to continue to grow over the next decade was the availability of Buswell Fellowships through the school of medicine. "One of the main reasons why the timing was right for what we were trying to do is that we had about 15 of these faculty fellowships at the assistant professor level, which were given on the condition that the faculty coming in spend 90 percent of their time on research during their first two years," explains Calkins. "So we figured that, in time, the financial support would begin to grow as these scientists became more clinically oriented, got more Autumn 2000 11 flail n y sic i a1 1 �patients coming in, developed as teachers and won recognition for their research activities." The plan, therefore, was to make full use of the Buswell Fellowships to recruit future division heads who would "get their feet on the ground while Jim and I were carrying out the core work of the department," Calkins recalls. In addition to olan, Calkins was working closely with Dr. Thomas Tomasi, who had joined the department in the early 1960s as head of immunology and was instrumental in recruiting key faculty to the department. "Tom Tomasi was a major colleague of ours for eight years. He played a very, very important role in the department during those early years because he helped us identify the key frontiers of scientific medicine and the people we should try to bring into the department," says Calkins. In all, the effort of these and other leaders in the department met with extraordinary success, and today both Calkins and olan proudly point out that of the core group of faculty brought into the department during their combined tenure, some 25 have gone on to chair departments or hold similar appointments elsewhere around the world (see list on page 10). Another area in which great strides were made involved the recruitment of talented residents, according to Calkins. "Dr. olan and Vance and I made a tremendous effort to recruit top-notch house staff in these early years because we recognized that some of the most effective teaching of medical students is carried out by these individuals, who also serve as role models for the students," he explains "So at a time when internal medicine occupied a particularly strong place in the eyes of medical students and house staff, we succeeded in attracting an exceptionally strong group of graduates from UB, as well as from such schools as Harvard, New York University, Temple, johns Hopkins and the University of orth Carolina," he adds. The Heart and Science of Medicine 1969, OLA WAS appointed professor of medicine in the department, and in addition to his growing administrative and teaching duties, he also continued to lead an active research program in liver disease and the effects of endotoxins. In the 1970s, he and his group made key discoveries that led to a better understanding of the role these toxins play in liver disease when the liver is affected by alcoholism and hepatitis. They also determined that antibiotics can worsen some liver diseases by increasing endotoxins. olan had also by this time established a stellar reputation as a teacher and clinician. "Jim is one of the most informed internists I know," say Robert Internal Medicine House Staff, 1976. A complete listing of those pictured here is not available; Klocke, MD '62, current chair of the Department however, the following individuals have been identified: Susan Arbuck, Thomas Avery, Raymond W. Bergenstock Jr., James Cirbus, Richard Curran, Richard Dolinar, Helen Findlay, Geraldine Kelley, of Medicine, who came to UB in 1970 when the Steve Lanse, Alan Leibowitz, Trudy Masters, Nancy Nielsen, James P. Nolan, MaHhew J. O'Brien Jr., department was just beginning to be more inRichard Rosenfield, Marilyn Telon, Henri T. Woodman, AntoineHe Wozniak. volved with the county hospital and who, in 19 78, was named head of the Pulmonary Division there. "He knows a lot about everything, not just his specialty of liver disease, and he is an excellent teacher. "I think the students who really appreciated him the most over the years were the residents, who benefited from his impromptu teaching at the bedside," Klocke adds. "He has such vast knowledge and yet organizes material very well when teaching. Also, because he doesn 't just focus on one thing and then another, he is able to see the big picture." "What's been important to me about teaching, in addition to the content itself," says olan, "is that, hopefully, you can mold individuals into compassionate physicians. And I have always tried to stress this when dealing with patients and with students-the idea of professionalism, of compassion and empathy." olan's gift for teaching both the "heart and science" of medicine resulted in his being twice chosen by residents to receive UB's coveted White Coat Award, which honors "excellence in teaching 8 Buffalo Hpician A utum tz 2 0 00 �and outstanding contributions to the education of house staff." Today, olan says he considers these awards to be among his most prized honors at UB. Creative Funding and Support for Faculty KEEP! G WITH HIS GROW! G stature as a teacher, researcher and administrator, Nolan was named vice chair of the Department of Medicine in 1973 and acting chair in 1978, when Calkins retired from that role. A year later, he was appointed chair of the department, a position he held until1995. "The first few years as chair of a big department like that are tough because you have to prove yourself, but then, over time, you gain confidence," says olan. "But the major thing I had going for me from the start was that I had good division heads and clinical directors, so after a while I was in a position to delegate and to do other things as well. Really, I was blessed with very, very good associates who took on major roles in both the educational and the research aspects of the department." While the department's faculty were exceptional, olan admits that their being housed in three hospitals did pose an ever-present challenge for him. "With the resources of a full-time faculty spread throughout three community hospitals, it's difficult to achieve a critical mass in any one location," he says. "This is especially true for the smaller divisions. It was also difficult to obtain the laboratory space that was needed for the department." An even larger dilemma for Nolan throughout his tenure as chair, however, was the chronic shortage of funds brought about by severe cutbacks from the state and Medicare, in combination with new fiscal austerities imposed by managed care. "Throughout the 1980s and '90s, the hospitals in Buffalo were very badly squeezed-as were hospitals everywhere," explains Nolan, and this directly impacted the medical school and Buffalo's entire health-care community in ways that hadn't been felt before, he contends. "There were times in the '60s and '70s and even into the early '80s, when the hospitals would get into some financial trouble and the university would just pick up their lines, and there were times when the university would get into trouble and the hospitals would step in. Nobody's helping out now; everybody's having to look out for themselves, and over the past 10 years it's become a tremendously competitive environment. "Even though we are a state school, the percentage of our budget that comes from the state for salary purposes is only about 15 percent; that's not a lot," he continues." owadays, over 50 percent of the compensation for the full-time faculty, even in a big department like medicine, comes from practice dollars, and those dollars are increasingly hard to come by." olan explains that these and other funding pressures have in turn "greatly impeded our ability to teach medical students in an ambulatory setting because the practicing physicians, who have always been supportive of teaching students in their offices, are having increasing difficulty doing this because they are under such tremendous pressure to process patients at a rapid rate." Given the pervasive funding shortages olan had to confront as chair, Klocke says it's a tribute to him that the department continued to grow-albeit not at the earlier pace-and that the faculty, for the most part, functioned as a cooperative and cohesive group. "Jim was very creative when it came to finding funding," he says with a smile. "He would go around and sell people on an idea, and then get a piece of funding from here and a piece from there and put together all the little pieces. I was able to recruit an excellent person from Yale-Jamson Lwebuga-Mukasa, who's at Buffalo General now-because Jim helped convince the hospital and the dean to make an investment. He was always very supportive in this way. "Too, Jim has a knack for making people feel wanted, and he is very good at acknowledging people's contributions in a quiet way," Klocke explains. "Actually, everything he does is done in such a low-key, gentlemanly way," he adds. "I have heard people who did not agree with him, but I've never heard anybody say he wasn't a nice person. Even when he had to make tough decisions that somebody didn't like, you knew it was never personal. "So even though there were huge cutbacks from the state and lots of financial and administrative problems when he was chair, he kept everybody going, and our department actually continued to Aut um 11 2000 II f f If I H JS i C iII 9 �grow. And thereally nice thing for me is that I inherited from him a happy and extremely cooperative department." When asked what he consider to be highlights of his tenure as chair, olan says he is in many ways most proud of the research efforts of the department. "At one time, we had more IH dollars than any other department in the four [SUNY] schools," he says, "and that was a source of great pride for our department-that we were able to attract people of that stature. And I think, as such, we developed a very good national reputation for the department as a place for young faculty to work. And during my time, as well as Evan's, we exported some very good people to other very good schools." In addition to this, olan says that he is also proud of the work he did in support of affirmative action during the 17 years he was Former Faculty Members chair. "We were all involved in affirmative action at that time in the sense that we made a real effort to attract medical students from the minority population who were superb," he explains. "Buffalo did extremely well in terms of percentages in this --area~he add,-'' and I'm proud of that." A Mentor and a Model N THE EARLY 1990s NOLA became an increasingly visible leader in academic medicine in his role as president of the Association of Professors of Medicine, a group comprising chairs of medicine across the nation, and as chair of the Board of Regents for the American College of Physicians. Both organizations provided a forum for him to address a central concern he had at that time: the trend toward specialization in internal medicine; in particular, the fact that 70 percent of all medical-school graduates were going into the specialties and only 30 percent into primary care areas. Many people feel that the energy and attention Nolan dedicated to this problem while a leader with both these organizations contributed significantly to the reversal of this trend by the close of the decade. "If you look at his writings from the '90s, you'll see he was writing very frequently in the Annals of Internal Medicine and other journals, talking about the value of the internist," says Klocke. "And as president of the Association of Professors of director, Fogarty Robert A. Murgita, chair and pro· International Center and associate fessor, Department of Microbioi· Gerald Keusch, T HE FOLLOW! G IS A LIST of former fac u lty members in Un iversity at Buffalo's Department of Medicine who hold or have held positions of chair (o r comparable positions). James C. Allen, chair, Department David R. Dantzker, president, Long of Medicine, University of South Island Jewish Medical Center, New Carolina; subsequently, vice presi· Hyde Park, New York director, International Research, ogy and Immunology, McGill Uni· National Institutes of Health, versity, Montreal, Quebec Bethesda, Maryland James P. Nolan, chair, Department Frances J. Klocke, director, of Medicine, State University of New Feinberg Cardiovascular Research York at Buffalo, Buffalo, New York Institute, Northwestern University Medical School, Chicago, Illinois dentfor medical affairs, Roper Hos· Medicine, Albany Medical College, Michael A. Apicella, chair, Depart· Albany, New York ment of Microbiology, University of Iowa College of Medicine, Iowa Robin DeAndrade, ment of Physical Medicine and Re· of Medicine, Atlanta, Georgia president, McMaster University 10 professor of medicine, Tufts-New ment of Medicine, State University England Medical Center, Boston, of New York at Buffalo, Buffalo, Massachusetts Thomas Provost, ment of Medicine, University of HamiHon, Ontario Illinois, Chicago, Illinois A!II!IIIITI 2000 chair, Depart· Albert F. LoBuglio, medical direc· ment of Dermatology, Johns Hopkins tor and professor, Comprehensive University, BaHimore, Maryland Cancer Unit, University of Alabama, Birmingham, Alabama Lawrence Frohman, chair, Depart· fessor, McMaster University, luffllo Hysicin chair, Depart· chair, Depart· habilitation, Emory University School Medical Center; currently, pro· Robert A. Klocke, New York City, Iowa John Bienenstock, dean and vice director, Digestive Disease Research Center and Paul J. Davis, chair, Department of pital, Charleston, South Carolina Andrew Plaut, �Medicine, which is a small but very influential group, he certainly played a major role in shaping the approach that chairs of medicine in this country took in terms of teaching primary care and what roles the departments of medicine were to play in this." Through the American College of Physicians, olan also participated in the national debate taking place in the early 1990s over President Clinton's proposed health-care plan. "This was a very exciting time on several points," he says. "One was the issue of needing to train more general internists, and the other was the whole question of universal health care. And this [latter] issue is one the college has always been in favor of; we believe everyone should be insured, so while I was chair of the Board [of Regents] we had meetings at the White House. I think many of us, myself included, were very disappointed that we didn't get something out of that," he says. Klocke feels that Nolan's national visibility as a leader in academic medicine has been invaluable to UB faculty, not only because it has "opened a lot of doors," but because it has provided a model of public service for others to emulate. "When I was offered the position of editor of the American journal of Respiratory and Critical Care Medicine in 1989, Jim was entirely supportive of my taking on this responsibility, even though it took up an enormous amount of my time for five years," says Klocke. "He felt it was important for my career, as well as for the university, and he was happy for my success, just as he always was for others." Since his retirement from the state in July 1999, Nolan has continued to write and see patients on a consulting basis. At Klocke's request, he is also helping with recruitment for the department and has agreed to continue serving as acting head of the Division of General Medicine until that position-which was vacated two years ago-is filled. Klocke says Nolan has been extremely supportive of him since he became chair of the department but, at the same time, has been careful not to exert his influence on the day-to-day operations of the department. "Jim has been very helpful to me since I became chair, yet he purposely moved his office to another floor so he wouldn't be around, wouldn't be in a position to second-guess me," says Klocke. "However, when I need advice, he's there for me. And on a couple of occasions, he's just stopped by and said to me, 'I know people don't come in to tell you that you're doing a good job, but I just wanted to let you know that things have gone well.' "That's been very heart Special thanks to University warming," says Klocke. Archives, Dr. Evan Calkins But coming from the "best and Dr. \Villiam A. Fleming committee man ever"-and for their assistance in locating a gentleman-certainly not photographs for this article. very surprising. 4D chair, David Schmidt, chair, Department Roswell Park Cancer Institute, This list was compiled by Department of Medicine, of Family Medicine, University of Buffalo, New York, and chair, De· drawi11g on the collective University of California, Connecticut partment of Molecular Medicine, mem ories of current and San Diego. (Dr. Ranney was Farmington, Connecticut State University of New York at former members of UB's Buffalo, Buffalo, New York. Department of Medici11e, mzd Helen M. Ranney, Health Center, the first woman to chair a department of medicine in the John B. Stobo, chair, country.! of Medicine, Johns Hopkins Uni· Philip H. N. Wood, chair, Depart- to ensure its accuracy and versity. Currently, president of Uni· ment of Epidemiology, University completerzess. Corrections or Morris Reichlin, vice president for versity of Texas Medical Branch, of Manchester, England commerzts are welcome and research at Oklahoma Research Galveston, Texas. every attempt has bee11 made Department can be sent John R. Wright, chair, Department Foundation, and George via e-mail to bp-notes@buffalo.edu; or by Lynn Cross Distinguish· Thomas Tomasi, chair, Department of Pathology, State University of writing to editor, Buffa lo ed Professor, University of Immunology, Mayo Clinic/Medi· New York at Buffalo. Currently, Phys icia n, 330 Crofts Hall, of Oklahoma, Norman, cal School, Rochester, Minnesota dean of SUNY at Buffalo's School U11 iversity at Buffalo, Buffalo, Oklahoma (the first department of immunol· of Medicine and Biomedical Sci- NY 14260. ogy in the country I. Subsequently, ences. (Dr. Wright was a Buswell David Sackett, chair, Department director, Cancer Center, University Fellow, working on amyloidosis of Epidemiology, McMaster Univer· of New Mexico; chair, Department with Dr. Evan Calkins from 1965-1967.1 sity, Hamilton, Ontario. Currently, of Cell Biology, University of New chair of the Department of Epide- Mexico, Albuquerque, New Mexico; miology, Oxford University, England. president/chief executive officer, Alllllmll 2000 4D l t ffa le Hys i c i u 11 �ST 0 R Y By S. A . UNGER • Obese children learn to turn off television is helping obese children learn to choose healthy behaviors. �high-calorie foods are red and should be eaten rarely; moderatecalorie foods are yellow and can be eaten in moderation; and low-calorie foods are green and can be eaten freely. According to Epstein, obesity carries the same risks for children as it does for adults: an increase in health problems that include diabetes mellitus, hypertension and high cholesterol. In addition, obese children are at higher risk of remaining so as adults. "Obese children who become obese adults have a very difficult time losing weight and maintaining a normal weight; only a very small percentage are successful over the long run," he says. "So most researchers feel the best hope is to catch kids early and try to prevent them from becoming overweight adults." As part of their ongoing effort to devise ways to "catch kids early," Epstein and his group are currently conducting a study aimed at better understanding how sedentary behaviors can be modified to treat and prevent obesity in children. In work funded by a 1,050,688 grant from the ational Institute of Child Health and Human Development ( ICHHD) of the IH, the researchers are specifically interested in discovering ways to modify a constellation of sedentary behaviors that are especially popular among today's children: watching television, playing video games and surfing the Internet. Sedentary Behaviors Move to the Foreground I n describing the stair-step approach he and his group have taken over the past 20 years to arrive at their current focus on sedentary behaviors, Epstein explains that their first studies- begun in the early 1980s at the University of Pittsburgh-demonstrated the efficacy of treating a child and his or her family together, versus just treating the child separately. From there, Epstein's group focused their attention on trying to understand the role of physical activity in treating obesity. "We started off with a review of the literature on activity, and it suggested that lots of people who begin exercise programs do not maintain them," he says. As a result, his group developed the idea of "lifestyle exercise." Instead of trying to get people to adhere to a very high-intensity exercise program, lifestyle exercise encourages changes in everyday behaviors; for example, parking farther from a store entrance and walking. In the early 1980s, Epstein's group completed the first randomized study done on a lifestyle exercise program and demonstrated that this approach toweightlossworks better than a traditional exercise program. Bythemid-1980s, therefore, Epstein's research had resulted in the establishment of innovative exercise and diet models specifically geared to treating obesity in the pediatric population. "About that time, however, we started to recognize that even though lifestyle exercise and diet were very useful, lots of kids still preferred being sedentary, so then we started to look at the competition-and the competition, of course, was television," recounts Epstein. THE RESEARCHERS ARE SPECIFICALLY INTERESTED IN DISCOVER! TO MODIFY A CONSTELLATIO POPULAR AMO OF SEDE G TODAY'S CHILDRE GAMES A TARY BEHAVIORS THAT ARE ESPECIALLY :WATCH! D SURF! G WAYS G TELEVISION, PLAY! G VIDEO G THE INTERNET. A utum" 2 000 l 1ffal1 Pbysician 13 �This realization was based on pioneering work being conducted at that time by two Harvard researchers, William H. Dietz Jr., MD, PhD, and Steven L. Gortmaker, PhD, who "were the first to effectively argue that sedentary behaviors-television viewing, in particular-were a risk factor in the development of obesity," according to Epstein. They did this, he says, by conducting studies that showed that sedentary behaviors replace high-energy activities while at the same time promoting increased caloric intake in response to commercials for food. B Behavior of Choice ased on Dietz and Gortmaker's studies, Epstein became interested in the idea ofbehavior-choice theory, and in the early 1990s he and his group began a series of studies aimed at better understanding how sedentary behaviors can be modified within the context of this theory to treat and prevent childhood obesity. Again, the sedentary behavior they were particularly interested in studying was television viewing because "it is estimated that by the time children today graduate from high school, they will have spent more time watching television than they spent in class," says Epstein. "Behavioral-choice theory recognizes that kids have a choice between two incompatible behaviors-they can either be active, or they can be sedentary," explains Epstein. "Therefore, we started to look at understanding how people allocate choicehow they decide to do things-and in working with behavioralchoice theory, one of the obvious things suggested by it is that if two things are incompatible, you can either reinforce the one you want, or you can reduce access to it." Subsequently, Epstein set up a study comparing weight loss between three groups: one reinforced for an increase in exercise; 1 .. Buffa a Pbysicia1 A ut11m11 2 000 a second, for a decrease in sedentary activity; and a third, for a combined approach. To reinforce behavior, contracts were set up between the children and their parents that enabled the children to earn points toward rewards that were activity based, as opposed to money or food; for example, going to the zoo with their parents. The results of the study, published in Health Psychology in 1995, showed that the children who were reinforced for being less sedentary- e.g., less television and fewer computer games- had a bigger weight loss than the children who were reinforced for increasing their physical activity. They also had equal fitness changes and a better adherence to the diet prescribed to all study participants. This study, which was the first to manipulate access to television, suggested "that at least this was an alternative approach to trying to work on getting kids to be more active," says Epstein. In an effort to replicate these findings and better understand how the children made their choices, Epstein and his UB group recently completed a study titled "Exercise in the Long-Term Control of Childhood Obesity," which was funded by a $1,073,213 grant from the NICHHD. Participants in this study were randomized to either increase physical activity or reduce sedentary behavior and, in addition to keeping a log on their exercise and food intake, they wore a beeper-size device called an accelerometer that provided the researchers with data about caloric expenditure. "Again, we found that the group that reduced sedentary behavior had substantial decreases in weight loss and improvements in fitness that were maintained over the two years we followed them," reports Epstein. "We also found that in the kids who reduced their sedentary behavior, about one-third of the time they substituted the behavior with physical activity, which �is exactly what we wanted. The other two-thirds of the time, they substituted it with other sedentary behaviors." Epstein emphasizes that the children were not being told what they had to do; instead, they were being rewarded for choices that freed up time for them to fill any way they chose. "Everybody likes to choose what they're going to do, and they are much more likely to change a behavior if they think it's their choice," he says. In 1997, Epstein and his group conducted a laboratory study that confirmed this supposition: "We got much better results for reinforcing children's behavior than restricting it," he says. Two years ago, with these preliminary results in hand, they began their current study, the goal of which is to look at different ways to reduce television that translates into different kinds of outcomes. "We know that reducing a broad constellation of sedentary behaviors-especially TV-is useful in treating obesity," says Epstein. "The study we're currently conducting is designed to identify specific techniques we might use to do that." 4D Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record • Challenging curriculum with 17 advanced placement courses • Comprehensive community service program • More than 60 sports teams • Average class size of 15 • Financial aid available Only one investment last; a liferirne Coeducational grades 5-12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net NICHOLS SCHOOL Acceptance granted to qualified students without regard to race, color, religion or national origin. �PATHWAYS THE Louis A. and Ruth Siegel Teaching Awards FOLLOWING The Louis A. and Ruth Siegel Awards are presented annually in order to AWARDS recognize the importance of superior teaching in the clinical and preclinical were presented years, as well as to encourage or1going teaching excellence. Recipients of the at the Univer- awards are chosen by students through a nomination process, with final input from a committee comprising representatives from each of the sity at Buffalo school's four classes. Louis A. Siegel, MD '23, served as an assistant School of professor in obstetrics and gynecology at the University at Buffalo School of Medicine and Biomedical Sciences for 21 years. In 1977, he and his wife, Medicine and Ruth, erJdowed the Siegel Excellence in Teaching A wards. Biomedical Sciences' Annual Faculty Meeting, held onMay 24, 2000, in Butler oversees and manages the school's House Staff and Special Awards entire research operation and Marsilia Seiwell, MD, GY lOB graduate training program," said Francis Whalen, MD, medicine Dean Wright. "In addition to his Pierre Giglio, MD, neurology many other activities, Bruce is our Gul Dadlani, MD, pediatrics essential liaison with the provost's Dilip Dan, MD, surgery office, as well as with government Dinesh Arab, MD, medicine and industry." Auditorium, Anthony Mato, Class of 2002 Farber Hall. Timothy Pardee, Class of2001 Stockton Kimball Award Dean's Award ors a faculty member for academic The Stockton Kimball Award honThe Dean's Award is given zn accomplishment and worldwide special recognition of extraordinary recop1ition as an investigator and service to the School researcher. Stockton Kimball, MD '29, was dean of the University at MD, professor of medicine and medical Sciences. Buffalo School of Medicine from chief of the Infectious Diseases Wright presented the award to Bruce Holm , PhD, senior associate dean, in recognition l uffall Hysician 1946 to 1958, and his Division at Buffalo Veter- contributions to the ans Affairs Medical Cen- training ofphysicians at ter. Murphy was honored UB spanned more than for being an outstanding a quarter of a cent!lry. scientific investigator in of his many contributions to the The recipient of school. " ot only does Bruce this year's Stockton maintain an extremely well-funded Kimball research program, but he also 16 Autumn 2000 Preclinical Award, Peter T. Ostrow, MD. associate professor of pathology and neurology (left); Volunteer Award, Howard E. Sperry, MD, clinical assistant professor of medicine (right); and Clinical Award, RichardT. Sarkin, MD, associate professor of clinical pediatrics (seated). of Medicine and Bio- This year, Dean H s Timothy Award IS Murphy, the field of microbial pathogenesis who hy has received notable recognition �for his development of vaccine he has developed protocols for antigens for ear and respiratory antibiotic usage and has emerged tract infections. In addition to asaleadingadvocateinNewYork his work at UB, Murphy has for the appropriate management served on numerous national of infections. study sections, review panels and international committees. In recent years, Brass has developed a strong interest in the use of computers in support of Berkson Memorial Award evidence-based medicine and has generously given of his time to The Robert S. Berkson, MD, Memorial Award is presented nn111Wily to honor the values nnd ideals epitomized by Dr. Berkson, who wns nn esteemed family physician in Buffalo. Patient wre wns his forte; competence, compassion, patience nnd dediwtion to teaching were his virwes. His expertise in the "nrtofmedicine" is teach residents how to research information online. For the past 10 years, Dr. in this nwnrd. Margaret McAloon, MD, associate professor of clinical medicine and pediatrics, was presented the University at Buffalo School of Medicine and Biomedical Sciences' Humanism Award at this year's White Coat Ceremony (see also page 24). Nominations for the award are made by directors of the thirdand fourth-year clerkships. McAloon's nominator stated: Robert Kalb has served as a "I cannot think member of the school's volunteer of another faculty faculty, integrating an active member I have private practice with an intensive teaching schedule. Throughout his career, Kalb has demonstrated a remarkable knowledge meant to be perpetuated 2000 Humanism Award worked with who has so gracefully exhibited all the of clinical and investiga- characteristics tive dermatology, which typically demon- The 2000 Berkson he has used to provide strated by the Memorial Award was exceptional patient care. recipients of this presented this year to During the year, he award Corstiaan Brass, MD, generously shares [Dr. McAloon is] lb clinical associate professor of medicine, and this knowledge by conducting week- Robert E. Kalb, MD, clinical asso- ly dermatology conferences, ciate professor of dermatology. supervising residents and students • able to treat people with sincere com- MARGARET MCALOON. MD passion, determine their physical, emotional and social needs, all while Brass has been a model physi- in dermatology clinics and giving cian who willingly volunteers his fourth-year students exposure to teaching a large team of health-care professionals. Her style time to teach at all levels of medi- the practice of dermatology seems effortless and is completely inspiring. She is also a cine, a dedication that has won through his office setting. <Ii) fantastic clinician because she has retained treatment modali- him the respect of students and -NANCY DRUAR ties that may have been forgotten by most, but which consis- colleagues alike. Over the years, tently work for her patients. At the same time, she is completely up to date on the newest proven treatment options. She is one BRASS HAS BEE A ~10DEL PHYSICIAN WHO WILL- INGLY VOLUNTEERS HIS TIME TO TEACH AT ALL LEVELS OF MEDIC INE , A DEDICATION THAT HAS of those special people I hope to emulate as a physician, teacher and mentor." Support for the Humanism Award is provided by the Healthcare Foundation of New Jersey. <Ii) WON HIM THE RESPECT OF STUDENTS AND COLLEAGUES ALIKE . A ll t II Ill tl 2 0 00 luf f al • Phy si c i an 11 �PATHWAY of the board of the ew York State sionary work in Botswana and - LOIS BAKER South Africa. Children's Names CoChiefs for Pediatric Gastroenterology Robert D. Baker, MD, and Susan S. Baker, MD, from Medical University of South Carolina, have been appointed co-chiefs of the Division of Pediatric Gastroenterology, Hepatology and u- trition at the Children's Hospital Chelikani V. P. Varma, MD {leh), has received the 2000 Pediatric Teaching Award from the Pediatric Residents Association of Kaleida Health's Children'sHospital of Buffalo. Varma, aclinical associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, maintains aprivate practiceD.L.C. Pediatrics-in Depew, New York. Pictured with Varma is Dawn M. Simon, MD '98, president of the Pediatric Residents Association at Children'sHospital. of Buffalo and professors of atric gastroenterology and have served as instructors in pediatrics at Harvard Medical School. Among their responsibilities at Children's are the administration and developm of the hospital's Gastroenterol- Buffalo School of Medicine and ogy Laboratory, as well as Biomedical Sciences. The husband-and-wife team earned their medical degrees from Medicine and doctorate degrees elected to the AMA's Council on from Massachusetts Institute of Scientific Affairs and sits on its ex- Technology. They completed in- research on cell gastrointestinal tract in pediatric patients. Their clinical interests include nutrition, dysmotil- ielsen, MD '76, PhD, ecutive committee and Strategic ternships in pediatrics at the assistant dean for student affairs Planning Task Force. She also cur- Children's Hospital of Buffalo in medicine and infec- at the University at Buffalo School rently serves the AMA on the la- 1973, after which they spent three tious disease. of Medicine and Biomedical tional Patient Safety Foundation Sciences and a clinical associate Board of Directors and the Com- professor of medicine, has been mission for the Prevention of elected vice speaker of the Amer- Youth Violence. In the past, she ker has served on the AMA 's Medical Imaging Team Wins Top Pri:ze tion's policy-making Ad Hoc Committee on A University at Buffalo team who received a doctorate in ra- House of Delegates. Structure, Governance won the prestigious Blue diation physics from UB this ican Medical Associa- If tradition holds, the election places and Operations. iel- Currently, ielsen Ribbon Award at the SPIE year. Other members of the International Symposium on team were Stephen Rudin , MD, sen in line for the presi - serves as the speaker of Medical Imaging held in june co-director of the Toshiba dency of the AMA, the House of Delegates 2000. The group received the Stroke Research Center and according to an of the Medical Society of award for a research presenta- director of the Division of AMA spokesper- the State of ew York. tion describing a new medical- Radiation Physics, and Daniel son who explained She has served as a trustee of the imaging technique developed R. Bednarek, PhD, associate that, in the past, State University of ew York at UB that could lead to im- professor of radiology and the vice speaker has assumed and chief medical officer for the proved diagnostic imaging us- research associate professor of ew York State Department of ing lower doses of radiation. neurosurgery and physiology Health's Western Region, and is a Primaryauthorofthestudywas and biophysics. Nielsen, an internist in private fellow of the American College of Parinaz Massoumzadeh, PhD, practice in Buffalo, has twice been Physicians and a former member the speaker's role, and the speaker has been elected president. l•lfal• Hysiciu Alltlllllll 2 000 ker function within the ity, complementary Nancy II. t 8 Both are board certified in pediatrics and pedi- pediatrics at the University at Temple University School of Nielsen Elected Vice Speaker of AMA years performing hospital mis- Society of Internal Medicine. fD j �McKinley Assassination [xamine~ By J a c k C. Fi sher , MD '6 2 VERY PRESIDENTIAL ASSASSINATIO ~ .; = ~ ~ = ~ % .. u r .. ~ - -; . . = ~ ! u c :: m United ballistic advisory, I have relied primarily on my uncle, Jack States history has prompted its own conspiracy theory and led Anthony, a retired engineer with a lifelong interest in historic to public rebuke of the physicians who tried to save their firearms. His theory was a "short load," which means that the patient. Indeed, following President McKinley's murder in 1901 cartridge was deficient of gunpowder and never reached its full the public was skeptical that any individual could act alone to speed or force. His suggestion was to weigh the residual ammuundertake such an anarchical deed, and the late president's nition retrieved from Czolgosz's weapon. Other cartridges might also be short of their gunpowder load . surgeons were eventually censured by CzoLGosz ONLY GOT Two With the cooperation of William Seiner laymen and professionals alike. SHOTS OFF BEFORE HE WAS and William Mayer at the Buffalo and Erie o evidence of a conspiracy was ever SUBDUED. HIS WEAPON County Historical Society, the unexpended found; like so many assassins, Leon Czolgosz WAS DOUBLE ACTION, AND cartridges from the assassin's revolver, acted as a solitary influence on history. HE SHOULD HAVE BEEN together with the two fired cartridge cases Whether or not the surgeons deserved the ABLE TO EMPTY HIS GU:--: IN and the deflected bullet, pictured below, were criticism they received is the principal issue THREE TO FIVE SECONDS. taken to the laboratory of Bruce that I will deal with in a forthcoming book Actual gun used in \NHY DIDN'T HE? Holm, PhD, senior associate dean about the McKinley assassination (Stolen the assassination in the School of Medicine and Glory, due out in the spring of 2001 ). of President Other questions have arisen during my research. Czolgosz Biomedical Sciences. Weights were recorded on a gram McKinley; held in patterned his attack on the 1900 assassination of Italy's King scale accurate to four decimal points. the collection of the The results clearly showed that one of the unused Humbert. He purchased at a Buffalo hardware store a weapon Buffalo and Erie identical to the one used against Humbert, a 5-shot .32-caliber cartridges was short of its full load of gunpowder, lending County Historical Iver-Johnson revolver. Whereas King Humbert's assailant was support to the theory that one of the two spent cartridges Society. able to fire four times, - r I .. Czolgosz got only two shots off before he was subdued. His weapon was double action, and he should have been able to empty his gun in three to five seconds. Why didn 't he? Furthermore, only one of the two bullets penetrated the body; the other bounced off the breastbone, resulting only in a superficial contusion of the skin. A .32-caliber revolver in 1901 could develop a bullet velocity of 700 feet per second and a muzzle force of 100 foot-pounds, more than enough to pierce the sternum and inflict serious damage to the chest cavity. Why didn't that happen? Shortly after the attack, a Buffalo police officer suggested to a reporter that one bullet likely failed because it was defective. For was also defective. Presumably, Czolgosz had purchased ammunition with significant manufacturing variations. One can speculate that if the assassin had emptied his revolver into McKinley's body, only three of five bullets would have penetrated. Why weren't all five shots fired? The best guess of experts I have polled is that the revolver's external hammer became entangled in the handkerchief that Czolgosz used to conceal his weapon. As the assassin went down, his right hand still held the revolver aimed at McKinley, but no more shots were heard. 4D Jack Fisher, MD '62-who will write a more extensive article on this subject for an upcoming issue of Buffalo Physician-is an emeritus professor of surgery at the University of Califomia at San Diego, where he is wrrently a master's candidate in U.S. history. Readers with questions or comments can e-maillzim at jfishermd@aol.com. �R 20 IUffliD E Pbp i c i ln E A R C H Autumr~ N 2000 E w �Hypertension Redefined hypertension is the most prevalent risk factor in heart failure, inversely related to cardiovascular risk." mutations due to exposure to X-ray or to anything potentially joseph Izzo, MD, University at stroke and kidney failure," he Additional authors on the Buffalo professor of medicine and pharmacology and vice chair of explains. "It is clear that lowering systolic pressure is associated with better outcomes in cardiovascu- study were Daniel Levy, director of the Framingham Heart Study carcinogenic that mimics X-ray damage, such as many chemicals research for the Department of Medicine, was lead author of a National Institutes of Healthsponsored clinical advisory statement released in May stating .. that systolic blood pressure is the important factor in lar and renal disease. "Systolic hypertension interacts with other major risk factors, such as high cholesterol and diabetes, which also increase with age, to amplify the age-re- of the National Heart, Lung and Blood Institute, and Henry R. Black, Roberts Professor and chair of the Department of Preventive Medicine, and associate vice president for research at RushPresbyterian-St. Luke's Medical Center in Chicago. 4D -LOIS BAKER BloodTest Measures Radiation Damage determining whether a person has hypertension-not diastolic blood pres- lated risk of cardiovascular events," he adds. Isola ted systolic hyperten- Scientists from the University at Buffalo have developed and patented a simple blood test that can measure accumulated cell sure, as traditionally thought. Making systolic blood pres- sion-defined as systolic pressure damage from ionizing radiation at or above 140 mm/Hg and dias- long before any physical signs sure the major criterion for diag- tolic under 90 mm/Hg-is the are evident. nosis, staging and therapeutic most common form of hypertension and is present in about management of hypertension, particularly in middle-aged and older Americans, represents "a major paradigm shift," the advisory states. It also calls for more vigorous control efforts and for abolishing the use of ageadjusted blood-pressure targets. "This shift affects 25 million people in the United States whose lives can be improved by the change," says Izzo, who adds that much evidence points to systolic pressure as the critical factor in determining the risk of heart disease. "For example, systolic two-thirds of people over the age of 60 with diagnosed high blood pressure, according to Izzo. Using diastolic blood pressure to define hypertension in persons middle-aged and older actually misrepresents the risk of potential heart problems, he notes. "Systolic blood pressure increases steadily with age in industrialized Western societies, whereas diastolic blood pressure increases until about age 55 and then declines. So in older persons, diastolic blood pressure is The testcalled the Transferrin Receptor Red Cell Assay, or "E-Trassay" -was developed by used in the microchip industry. "This test provides a way to measure damage before the first sign of cancer appears," Gong explains. "It also can determine if cell mutations from ionizing radiation are increasing over time. If so, an indi- The test-which vidual can take steps to requires adrop of stop the increase, per- blood and about two hours for analysis-can be taken as often as desired, SO subsequent blood tests can monitor any increase or patients who have redecrease in cell ceived radiation treatdamage. haps through a change in job, diet or environment. It gives people more control over their health." Potentially, the test could also allow cancer ment to reconstruct their past radiation doses, as well as project the amount of residual injury that will exist in the future, Gong adds. It could also be useful for determining exposure to ionizing radia- Joseph K. Gong, PhD, as- tion emitted by cellular phones, sociate professor emeritus of oral diagnostic sciences and chair of UB's Radioisotope Safety Committee. Using a specific biomarker, it reveals the extent of stem cell microwave ovens and computer screens. CONTINUED ON PAGE 22 SCIENTISTS FROM THE UNIVERSITY AT BUFFALO HAVE DEVELOPED AND PATENTED A SIMPLE BLOOD TEST THAT CAN MEASURE ACCUMULATED CELL DAMAGE FROM IONIZING RADIATION LONG BEFORE A Y PHYSICAL SIGNS ARE EVIDENT. Autumn 2000 I u f f al o Physic i a a 21 �RESEAR ~NTIN U ED FR O M PA G E 2 1 Gong and his co-investigator, Chester A. Glomski, MD, PhD, professor of anatomy and cell biology, were able to show that radiation exposure causes stem cells to express an excess of erythrocytes that bear receptors for the protein transferrin on their surface membrane. Knowing this cause and effect, it then became possible to use the number of red blood cells with transferrin receptors as a biomarker for radiation exposure. The test0 .." .. which requ ires a drop of blood and about two hours for analysis-can be taken as often as des ired, so subsequent blood tests can monitor any increase or decrease in cell damage. Also par t icipating in the research was Yuqing Guo, biophysicist and research scientist at Biomira USA, Inc., in Cranbury, ew Jersey. 4D -LOIS BAKER Another Piece to Insulin Pu:z::z:le In addition to enabling cells to absorb sugars, insulin is also known to dilate blood vessels, an action that is a boon to the heart because it allows blood to flow more easily and under less pressure. Precisely how this vasodilation occurs is a puule. But researchers have shown that when insulin comes into con- C N H E w s tact with cells in the blood-vessel lining, it induces the release of rise above baseline in the amount of enzyme. nitric oxide, a known blood- In addition to providing new wider application than previously thought, new research by University at Buffalo faculty has shown. information on the mechanism un- Thomas S. Mang, PhD, UB Endocrinologists from UB have derlying insulin's vasodilatory ef- clinical associate professor of oral vessel dilator. now supplied a new piece to this fect, these findings give insight and maxillofacial surgery, has puule by showing for the first time into the relationship between hard· found that by manipulating the that insulin causes cells in the ening of the arteries and insulin amount of a light-sensitive drug blood-vessel lining to increase se- resistance/diabetes, conditions and the intensity of the laser beam cretion of nitric oxide synthase, that often exist in tandem. "The that activates it, he can successfully the enzyme responsible for nitric oxide produc- lack of insulin or resistance to the action of insu- treat cancer cells deeply embedded lin will cause ing surrounding normal tissue. In tion. "This in the chest wall without damag- the vessel a study recently completed by new ob- constriction Mang and Ronald R. Allison, MD, servation and increase UB associate professor of clinical is impor- aggregation radiation oncology, this low-dose tant be- cause of it platelets PDT approach resulted in com- known to occur plete healing in nearly 90 percent provides in diabetes mel· of 102 recurrent breast-cancer the molecu- litus," Dandona lesions found in nine women who lar basis for the known vasodilatory explains. "Fur- had undergone surgery, fulldose radiation and chemotherapy. effects of insulin," says Paresh thermore, the fact that nitric oxide also may reduce the Dandona, MD, UB professor of expression of adhesion molecules proof of the ability to lower drug concentrat ions and raise light "These results offer further medicine, who conducted the re- on the surface of cells lining blood search in collaboration with gradu- vessels may prevent cells from intensity to successfully treat ate student Ahmad Alijada. adhering to the vessel lining. This certain difficult tumors, " says By introducing insulin into aor- adhesion is one of the initial Man g. " It allows broader applica- tic cell cultures in increasing con- events in arterial hardening tion of this therapy in patients centrations from 25 to 1,000 and blockage." who can truly benefit from it. " microunits per milliliter for a total -LOIS BAKER of six days-amounts similar to what would occur normally and in patients with obesity and type 2 diabetes-the researchers showed that nitric oxide synthase increased as the amount of insulin increased, with the highest concentration of PDT, which was developed at Roswell Park Cancer Institute, the site of UB 's basic cancer research New Light on Cancer Therapy Pho todynamic therapy, or PDT, one of the most promising new cancer treatments, may have much insulin resulting in a 250 percent programs, exploits the propensity of cancer cells to absorb higher than normal concentrations of photosensitive drugs. When exposed to light via lasers, these drugs become toxic and destroy the malignant tissue. Since normal tissue searc 22 luflalo Phys i c i u Autumn 2 000 surrounding tumors also absorbs a certain amount of the drug, the goal of researchers and clinicians is to find a drug-to-light ratio for each tumor type that will kill the �most tumor cells while sparing the Medi- Cancer Center; veys, restaurant-employment most normal tissue. cine ..-:::::::;;;;;;;;ii~~[FI!iljl=::;:;;;;'==-':::~:§::; University of statistics and complaint reports . In the current study involving t h a t Pittsburgh; A review of taxable sales breast-cancer lesions that had there University of showed no effect on sales from "'0 formed on the chest wall, Mang was no dif- Utah; Wake smoking restrictions in restau- ,. lowered the standard 2.0 mglkg ference in there- Forest rants in dozens of communities dose of the photosensitive drug to currence of pol- School in New York, California, Colo- of 0.8 mglkg. "If we used the standard yps between the Medicine; Walter rado, Massachusetts, Arizona, drug dose, we never would have diet intervention group and a con- Reed Army Medical Center; Veterans and Texas, he found. In addition, been able to use a light dose that trol group that didn't change diets. Administration Medical Center (Hines, bar revenues in California in- would reach deep enough to kill Peter Lance, MD, associate Ill; and Kaiser Foundation Research creased 6 percent 12 months the tumor cells without destroying professor of medicine and physiol- Institute (Oakland, CA). normal tissue," he explains. ogy, and principal investigator on -LOIS BAKER "By lowering the drug dose, <D was disappointed but not alto- normal tissue bleaches out before it does any damage, and by gether surprised by the negative results. "The study is consistent after smoking was restricted . Consumer surveys conducted in New York City at five months UB's portion of the trial, says he the small amount of the drug in and 18 months after passage of the Smoke-free Restaurants, Healthy Restaurants delivering more light, we can with the findings of previous reach deeper into tumors where smaller trials and of another large Restricting smoking in restaurants the drug concentration is still trial-the Wheat Bran Fiber has not been a recipe for econo- high enough to kill cancer cells. Study-published in the same mic disaster for the restaurant "These results offer a glimpse of issue. Clearly, dietary change does business, despite predictions to the parameters one might be able not make you less likely to develop the contrary, a University at Buf- to use for treating whole fields of new polyps after you've had all falo epidemiologist has found disease with little normal tissue existing polyps removed. following review of existing data. ew York City Clean Air Act indicated that "Studies showing adverse conse· the vast majority of quences typically consumers dined out are flawed, relying as often after the law on survey data or as before. "Analyses of anecdotal repons. restaurant-employment Our analysis shows statistics indicated that that the restaurant more restaurant jobs business remains were added in New healthy after smoke· York City two years free dining policies after the law went into are implemented." damage," Mang says. "It gives us "What the study does not ad- "Virtually all" published stud- good local control of disease." <D dress-and was not designed to ies on the issue show no adverse address-is what the environment effect in restaurants, hotels and of the colon should be to reduce bars, regardless of the study effect than the rest of ew York State where smoking the likelihood that small, innocent method used, says Andrew was still permitted," Hyland polyps will grow to become can- Hyland, PhD, research assistant reports. In Erie County, cers," he notes. professor of social and preventive per-capita restaurant employ- -LOIS BAKER Polyps Unaffected by Healthy Diet Y, Adopting a diet low in fat and high The researchers also noted medicine, who recently presented ment increased faster than in six in fruits and vegetables may have thatdespitetheirfindings, the idea his findings at the International of seven surrounding counties many health benefits, but lowering that a healthy diet may lower the Society for Environmental Epi- where smoking was permitted, 12 the risk of developing recurrent risk of colon cancer should not be demiology meeting. "Studies months after a county law went colon polyps-precursors of colon entirely discarded. Several fac- showing adverse consequences into effect. "Also, few people are cancer--does not appear to be tors, including study length and one of them. potential reporting errors, could typically are flawed, relying on survey data or anecdotal reports. Our analysis shows that the res- complaining about the law," Hyland notes. taurant business remains healthy after smoke-free dining policies are implemented." public health issue," says Hyland. Investigators from the Univer- have influenced this study's re- sity at Buffalo's School of Medicine sults, Lance says. In addition, such and Biomedical Sciences and the a diet is known to have a favor- seven other centers involved in the able impact on cardiovascular dis- : "Secondhand smoke is a serious "Policymakers need to understand that adverse economic claims five-year national Polyp Prevention ease and other chronic conditions. Hyland examined published Trial reported in the April20, 2000, Other sites involved in the study studies examining taxable sales, tion are unsubstantiated." issue of The New England Journal of were Memorial Sloan-Kettering consumer and restaurateur sur- -LOIS BAKER A11t11mn resulting from smoke-free legisla- 2000 <D l 1ffaf1 Hysiciu 23 �M E D C A L ScHOOL E W S First Biomedical Sciences Career Day G R ADUATE STUDENTS FROM and faculty, as well as from rep- Health, Schering Plough, Ros- the University at Buffalo School resentatives from the law firm well Park Cancer Institute. of Medicine and Biomedical of Hodgson, Ross, Andrews, Sciences, the Departments of The program included a key- an opportunity for one-on-one interactions. Roundtable discussions on specific career paths Woods and Goodyear, the note address by Claire Lathers, were also held with panelists Oral Biology and Pharmaceutics, and Centers for Disease PhD '74, FCP, director of the Ranjana Kadle, PhD, JD; Gary Control, DuPont Office of New Animal Drug Giovino, PhD; Sarita Chauhan, Roswell Park Cancer Central Research Evaluation, Center for Veteri- PhD; John Simich, PhD; Lyn Institute attended and Development, nary Medicine, U.S. Food and Oyster, PhD; Wilson Great- the First Biomedical Erie County Central Drug Administration. Her lec- Sciences Career Day Police Services For- ture was followed by a series of batch; Mark Connors, MA; jacques Berlin, PhD; Michael on May 31, 2000, at ensics Laboratory, the Food and Drug Administration, Gen short talks by Robert Genco, DDS, PhD; Allen Barnett, PhD; Vladutiu, PhD; and james David McCann, PhD; and Hernandez, PhD. The day end- learned about successful strate- Cyte, LLC, the National lnsti- Wade Sigurdson, PhD. During ed with a reception that includ- gies for career development and tute on Drug Abuse, the ew lunch, students were seated ed more networking with the management from UB alumni York State Department of with the invited guests to foster invited presenters. the Buffalo/ iagara Marriott. Students CLAIRE LATHERS Morales, PhD; Georgirene 4D Wh"te Coat Ceremony MEGAN MOORE OF P ITTSFORD, Y, being "cloaked" at this year's White Coat Ceremony by Daniel C. Kozera , MD '59, a board member of the Medical Alumni Association . The annual ceremony-a symbolic rite of passage for beginning medical students to help them establish a ps ychological contract for professionalism and empath y in the pra ctice of . ... . medicine-is sponsored by the Medical Alumni Association a nd The Medical L School Parents' Council. 0 The keynote speaker at the August 11 event was Robert Milch, MD, director for z the Center for Hospice and Palliative Care in Buffalo, whose talk will be featured In the winter issue of Buffalo Physicia11. Following Dr. Milch 's lecture, Margaret McAloon , MD , class is 23 . Their average science grade point average is 3.53 and was presented the " Humanism in Medicine Award " (see page mean MCAT, 9.60. Fifty-seven of the students are male and 79, 17 ) by Charles Severin, MD, PhD, assistant dean for students. female. Ten hold master's degrees and 113 were science majors. Seventy-five are from Western New York. -S. A. Ur-;cE R Thomas Guttuso, MD, assistant dean of admissions, then introduced each of the students while they were being cloaked. 24 For the Class of 2004, there were 1,987 applicants; of those, 463 were interviewed and 136 accepted. The average age of the l a lfa le Ph ysi c i aa Alltllmll 2000 �I AUTUMN 2000 llorls Albini, profe-r of microbiology Elmer ......._11, medical computlntfpl.....r A1<tumn 2000 1111111 ,.pic l u Z5 �S B U S T U y M U T AR P E L D E N C T 0 L U M lonely for aCalling of My Own Clinical r otations i nc l ude an exercise i n int r ospect i on OR MOST MEDICAL stu- dents, the clinical experience of the third year is like a carrot held out to entice them through the heavily didactic first two years. their conviction, I also realized I was lonely for a calling of my own. Gradually, my fear of third year began to mingle with a sense of anticipation for the opportunity I would have to experience each medical field. I decided that the best way to make peace with what lay ahead was to view it as a sort of exercise in introspection. I would fully immerse myself in each of the six rotations: internal medicine, psychiatry, pediatrics, surgery, family medicine, and obstetrics/ gynecology. I would try on every hat and see which one fit. Surely only one would flatter me, and the rest would look obviously ridiculous. But I quietly dreaded the A Possible Cure , but No Patient transition. After all, with almost 20 years of experience sitting behind a de k, I was good at being a student. I had become quite comfortable in Butler Auditorium, twothirds of the way back, slightly left of middle. I loved all the zebra diagnoses and esoteric nuggets of information and could not imagine what lured people from the top of this ivory tower to the bottom of the hospital totem pole. Furthermore, I still wasn't sure which specialty I wanted to pursue, and this ambiguity added to my sense of unease. I envied (and frankly distrusted) those characters who knew they were fated to be urologists or neurosurgeons. As much as I doubted 26 luffall Pbysicill A utumn 2 000 I showed up for the first day of internal medicine dressed sharply, not yet realizing the perils of uncomfortable shoes. My short white coat was brilliantly clean. To give the illusion of experience, I had forced in a few wrinkles and had stuffed the pockets with trusty reference books. My memory of the first week of internal medicine is a disconnected series of flashbacks. There was a lot of wading through lab results- random numbers that I knew were supposed to mean something to me. I couldn't have told you the cause of my patient's microcytic anemia, but I at least made sure that I knew his TIBC by heart. Did medicine really consist of merely juggling consults and labs? This was not the glorious career I had had in mind when I wrote my application essay for medical school. One of my new patients had a concerning set of symptoms: night sweats, weight loss, documented daily fever spikes and anemia. The team was "working him up"-a phrase that, at the time, seemed so aggressive to me. He had already had a history and physical, and although it seemed pointless, I knew I would have to repeat them. I dutifully palpated the thyroid, assessed the trachea for mobility and checked for tactile fremitusjust as I had learned in Butler Auditorium. On and on �fURTHERMORE, I STILL WASN'T SURE WHICH SPECIALTY AMBIGUITY ADDED TO MY SENSE OF UNEASE. I I WANTED TO PURSUE, AND THIS ENVIED (AND FRANKLY DISTRUSTED) THOSE CHARACTERS WHO KNEW THEY WERE FATED TO BE UROLOGISTS OR NEUROSURGEONS. AS I DOUBTED THEIR CONVICTION, I ALSO REALIZED I went with the esoteric details of the physical exam, feeling for epitrochlear lymph nodes and frustrated by the amount of time I was wasting. Then, much to my surprise, I felt something in my patient's axilla. Yikes, a 4 x 5 em axillary lymph node. (At least I thought it was a lymph node, since I had never actually felt one before.) "Sir, you seem to have a lump here. Have you noticed it before?" I proudly reported back to the team that I had found the lymph node-not the attending, not my resident, not my intern, but me, the lowly third-year. So this was medicine! As I arranged for the needle aspiration, I thought about how we were going to get to the bottom of his symptoms, discover his diagnosis and cure him. When we told the patient that we wanted to stick a needle into him, he promptly left the hospital against medical advice. I couldn't believe the team would let a seriously ill person just walk away. "He'll be back," they said. Medicine was not all brilliant diagnosis and glorious cure after all. The Missing Glasses P sychiatry was quite a change. Every day I faithfully rounded up the latest Jab values, but my reports on anemia were always met with statements like, "Yes, yes, but how has he been sleeping?" I was surprised by how much effort it took to detach myself from the numbers and actually pay attention to the patient. When had I gotten so comfortable with labs? What struck me about my psych rotation was the malleability of the human mind. Until I had spent seven weeks in a locked psychiatry wing, I had always assumed that one's personality was a fixed thing. I had friends who were moody, others who were cheery, and that was just how they were. But I was amazed by the phenomenon of the "titrateable" personality and marveled at watching rational minds emerge from once fully psychotic people. I WAS LONELY FOR A CALLING OF I especially remember one of my patients, who arrived in a comatose state. I thought he must have been suffering from a hopeless neurological disability, but we kept on with the medications. One morning I walked in and saw him eating breakfast, and the nurse told me he had been asking for his glasses. For the first time, I saw that some diagnoses take time to emerge and cannot be elicited by strictly objective measurements. As MUCH MY OWN. I would fully immerse myself in each of the six rotations: internal medicine, psychiatry, pediatrics. surgery. An "Old Hand" Draws Blood N ext on the Jist was my pediatrics rotation, where I met a five-year-old boy named Alex (not his real name) who was already in the hospital when I arrived and remained there throughout my inpatient rotation. After a while it seemed totally normal to see Alex playing in the conference area during afternoon rounds, and we all took turns wheeling him around the floor in his wagon. Somehow, the oddity of his continuous presence wore off, and I grew to think he was a normal boy who just happened to live at Children's Hospital. One day, Alex wanted to play a new game. Someone had given him a needleless syringe, and he said, "Let's pretend I'm gonna draw your blood!" A little macabre, I thought, but why not? Alex tied a tourniquet around my arm, and I winced at the squeeze. "It's gotta be tight!" he said in a mock adult voice. Next, uncoached, he expertly wiped down my forearm with an alcohol pad, then began slapping my arm to bring out a vein. "There's a good one!" he said in his doctorvoice, while pressing the syringe up against my arm and directing, "Hold still, I don't have enough yet." I couldn't help but laugh at this parody, but underneath I was horrified by his impression of the medical field. We were trying to heal Alex, but all he knew was that he had been kept away from his family for months, and every day he had blood drawn. It was disillusioning to realize that your most idealistic intentions are not always perceived as such. The last I heard, Alex was still in the hospital. Autum11 2000 family medicine. and obstetrics/gynecology. I would try on every hat and see which one fit. Surely only one would flatter me, and the rest would look obviously ridiculous. l off a le Pb ysician 27 �S l T U D E N T COLUMN WAS IN AWE AS MY ATTENDING SPOKE WITH HER. HIS COMPASSIONATE QUESTIONS ABOUT THE DEATH OF HER HUSBAND AND HER CURRENT FI ANCIAL SITUATIO WERE A TREATME T AS VALID AS ANY PILL OR SCALPEL. History in the Making H y the time I began my surgery rotation, I felt like I had figured out the routine. I had given up carrying references in my pockets, I spent all my time in comfortable scrubs and clogs, and the wrinkles in my white coat were legitimate. I also knew I could take the sleepless nights, the lack of food, and the scut work. Even though I had been duly warned by my classmates about this rotation, I was looking forward to it: Surgery was going to be great. My first days in the OR were indeed thrilling. I loved scrubbing in, and I loved pulling off the mask after we had closed up. This was Your Turn? better than watching ER! If you are a student After a while, however, the physical and emotional demands set in. One case was paror resident interested ticularly arduous: a deep abdominal procedure in contributing to this on an obese patient. I had a large Deaver retraccolumn in future tor in each hand, and my chief still couldn't get issues of Buffalo a clear look at the field. He told the circulating Physician, e·mail nurse to find a St. Mark's retractor. Why did that sound so much like a torture device from the bp·notes@buffalo.edu French Reign of Terror? The nurse handed me to suggest a topic. the oddly shaped tool and warned me that it was notoriously difficult to hold. The operation lasted six hours. As I stood holding the retractors, I tried meditating on whether it was possible to experience a higher level of pain in my arms. It was not. Mostly, I was terrified that I would contaminate the field with the proverbial bead of sweat that was working its way down my brow. At the end of the case, my chief turned to me and said, "That may be the second time in history that a medical student has held a St. Mark's retractor for so long without complaining. The first time was when I did it." Better Than a Pill or a Scalpel M oving on to family medicine after surgery was quite a shock. At first, I admit, I fought the gentle nature of the family practice appointment. It's just not humane to expect medical students to change pace so drastically. One day after I had begun to settle into my new 28 l alfale Hpiciu Autumn 2 000 routine, I went to the door of my next patient and picked up a thick chart, labeled "Volume II." After introducing myself to the patient, I tried to do a review of systems and to assess the state of each one of her many ailments, but I kept meeting with resistance. From my perspective, it seemed like she really didn't want to talk about her physical health at all. When I tried to present this patient to my attending, he smiled and said, "Let's go in and see her together." I had been told about therapeutic touch and the "art" of medicine, but nevertheless I was in awe as my attending spoke with her. His compassionate questions about the death of her husband and her current financial situation were a treatment as valid as any pill or scalpel. After we closed the door behind us, he said, "Sometimes you just have to know your patients." The Totem Pole and the Hat Rack s I write this article, I am completing my final rotation, obstetrics and gynecology. The other day, one of my classmates was talking enthusiastically about his experience in the rotation. "So, have you delivered any babies yet?" I asked. "Oh no," he replied, "but yesterday they let me deliver a placenta!" It's funny how you learn to be content with your place on the totem pole. Much to my surprise, this year that I dreaded is coming to an end. Despite what I've learned, I still don't know which field to pick. All the hats have fit, more or less. o one ever told me the choice would not be obvious, that fate would not present me with the answer as I had expected. There is an active decision-making process, and I can see now that whichever field I choose, it will involve sacrificing what I value in other fields. Lately, I've narrowed down my wardrobe to two hats. Every day I look in the mirror and try to figure out which one looks better on me. 4D A Umut Sarpel is currently a fourth-year student at the Unil'ersity at Buffalo School of Medicine and Biomedical Sciences. �DEVELOPMENT N E w s (ndowments Crucial to School's future By Li nda J . Cor de r • PhD. CFRE -- ( - - c s for the current "Campaign fo r UB: Generation to Generation" is to increase its endowment significantly. Establishing new endowed funds, adding to existing endowments and growing the principal through prudent investing-coupled with a sound spending policy-are all ways to increase the value of the overall endowment and to ensure the future of our school's mission and vision. Some of the School of Medicine and Biomedical Sciences' most cherished traditions germinated from dreams of our forebea rs whose gifts formed the core of its present endowment. With both private and public roots, our school benefits from a combined endowment that generates funds to support, in perpetuity, designated programs of the institution. One of the school's earliest endowments was a gift from Devillo W. Harrington. He was wounded during the Civil War ONE OF THE and brought to Buffalo General SC HOOL 'S EARLl Hospital, where interns from UB ES T E •oQ \VM EN TS treated his wounds. He recovered, WA S A GI FT FROM remained in Buffalo and went to D EV ILL O \V. medical school, graduating in H AR RI:-< GTO !<. H E 1871. In honor of the 25th anniWAS WOU :-<DED versary of his graduation in 1896, DURING THE CIVIL he established an endowment. For \\fAR AND more than a century, the HarringBRO UG HT TO ton Lectureship has brought outBuFF ALo G E =< ERA L standing medical scientists to H o s P 1 T AL, w H E R E Buffalo. Many others added gifts 1 NT ERN s FRoM U B to the school 's endowment, of TR EATED H 1 s which the most significant to date wo uNDs . is the Hochstetter Fund for Medical Research . Mr. Ralph Hochstetter, president of Cliff Petroleum, died in 1955, leaving UB a multimilliondollar bequest for scientific research. This endowment provides annual support for the Bertha H. and Henry Buswell Postdoctoral Fellowships, a program that underwrites up to three years of support for each of several young researchers in the biomedical sciences. Today, that endowment provides over $20 million a year-more than the original bequest. Endowment is crucial to the school's future. Thus, the development team spends a great deal of time facilitating new endowment gifts and providing information to donors of endowed funds about the programs they support and the financial status of the funds. Looking at the school's overall budget, annual gifts and endowment gifts are small, but significant- and increasingsources of income. Endowment income provides perpetual funding for either general unrestricted use by the dean (extremely important) or for specified programs established in accordance with the terms of an endowment gift. It also provides a hedge against downturns in the economy; fluctuations in the political climate in our community, region, state, nation and world; variations in the number of alumni and friends supporting the school's annual appeal; and other changes in the academic environment. Today's students and faculty benefit from the endowment gifts of previous generations. Tomorrow's school is being created by today's endowment gifts. The market value of the school's combined endowment assets was right at $145 million as of June 30, 2000. This represents an increase of nearly 10 percent since 1998, when the school's endowment was $132,161,604. During the "Campaign fo r UB: Generation to Generation," I trust the endowment will continue to show such significant increases. This will require many new endowment gifts designated for the school, in addition to the ongoing wise management of the funds already in the care of the State University of ew York and the UB Foundation. " D EVELOP M EsT" Co s T I ~UEo o s Autumn PAGE 30 2000 l alflll H y sici11 29 �-------- D - E - V E "T'Y J ~ L 0 P M E N T E W CLIN ICAL PREVENTAT I VE MEDICI NE FELLOWSHIp D flit " 'G PAGE, we list the School of Medicine and Biomedical Sciences' endowments held by both the UB Foundation and the state. Those in bold print received one or more gifts during the past fiscal year ( through 6/ 30/00 ) ; an asterisk* indicates a new endowment, established during the same time frame. Those of us who learn , teach a nd conduct research in this unique institution extend our thanks to all alumni and friends who made endowment gifts or finalized endowment agreements in the past year. If you would like information about 1n1t1ating a named endowed fund, or if you have any questions regarding the school's combin ed endowment, please Linda ( Lyn) ]. Corder, associate dean and contact me. director of development, can be reached, toll-free, at 1-877-826-3246, or via e-mail at Ijcorder@buffalo.edu. ALMON H. COOKE CHOLARSHIP PATRICK BRYANT COSTELLO MEMOR I AL CTG ONCOLOGY FUND ) AMES H. EDWARD CUMM I NGS SCHOLARSH I P L. CuRV ISH M.D . AwARD " MA X D OU BRAVA }R. S C HOLARSHIP FUND THE ELIZABETH MED ICAL AWARD DR. RoBERT M. ELLIOT ScHOLARSHIP ELEANOR FITZGERALD FAIRBA I RN ScHOLARSHIP FAMILY MED ICINE ENDOWMENT FEYLER FUND FOR R ESEARCH IN HoDGK I N's D i sEASE DR. GRANT L. T. FISHER FUND WALTER Fix M.D . '42, '43 E DOWED SCHOLARSHIP EDwARD FoGAN MEMOR I AL PRIZE FORD FOUNDAT ION FOR MEDICAL EDUCAT ION THOMAS FRAWLEY M.D . RESIDENCY RESEARCH H.W. ABRAHMMER MEMOR IAL SCHOLARSHIP THOMAS R. BEAM, ) R. MEMORIAL S I DNEY ADDLEMAN MEMORIAL DR. RoBERT BENNINGER FuND I N ORTHOPOED ICs " F uN D FOR CE LEBRATI NG PHI LANTHROPY DR. GEORGE) . ALKER FUND FOR RoBERT BERKSON MEMORIAL AwARD IN THE MARCOS GALLEGO M.D. CLINICAL NEURORADIOLOGY ART OF MEDIC I NE THEODORE & BESSIE G. ALPERT SCHOOL OF MED IC I NE SCHOLARS HI P MusEuM oF NEUROANATOMY FuND LOU IS). BEYER SCHOLARSH I P ExcELLENCE FuND RONALD GARVEY M.D. STUDENT L IFE ENRICHMENT FUND ALPHA OMEGA ALPHA ENDOWMENT PAULK. B I RTCH M.D. FUND )AMES GIBSON ANATOMICAL PR IZE ALP H A OMEGA ALPHA L I BRARY FUND " DR. W I LLARD AN D } EAN BOA RDMA N WALTERS. GOODALE AMER ICAN ACADEMY OF FAMILY PHYS IC I ANS PRESIDENT's AwARD EN DOWM ENT BOOKE FUND ANATOMICAL SCIENCES OF PEDIATR ICS GEORGE GORHAM FUND DR. BERNHARDT ANESTHES IOLOGY DEPARTMENT ENDOWMENT ANNE AND H AROLD BRODY LECTURE FUND CLAYTON MILO BROWN MEMOR IAL L. GEORGE B . BADGERO MEDICAL SCHOOL FUND VIRGIN I A BARNES ENDOWMENT . BuRWELL FuND DR. WINFIELD L. VINCENT CAPRARO LECTURESHIP FUND PH A RM ACOLOG Y - DR. CHARLES A. BAUDA AWARD IN CLAS OF I945 DR. CHARLES CARY MEMOR IAL FAM I LY MED ICINE DR. AND MRS. jOSEPH A. CHAZAN MEDICAL ScHOLARSHIP l uff lll n y sicill BUTSCH MEMORIAL LECTURE IN CLIN ICAL SURGERY * DR. ALL EN BARNET T F ELLO W S H I P I N Autumn 2000 A . CoNGER GooDYEAR PRoFESSORSHIP )AMES H. BORRELL UROLOGY FUND BACCELLI MEDICAL CLUB AWARD WALTER BARNES MEMOR IAL SCHOLARSHIP CHOLARSHIP I RENE P I NNEY GooDWIN ScHOLARSH I P DR. SoLOMON G. BooKE AND RosE YASGUR BERNHOFT- DESANTIS LIBRARY FUND FOR 30 FELLOWSHIP FUND . AND DR. SoPHIE B. GoTTLIEB AWARD * AD E LE M. G o TTSC HALK S c H O LARS HIP F uND CARL GRA GER M.D. ENDOWMENT DR. PASQUALE A. GRECO LOAN FUND THE GLEN E. GRE HAM M.D. VISITING PROFESSORSHIP DR. THOMAS). AND BARBARA ScHOLARSHIP & AwARD L. GuTTuso �GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT )EAN SARAH HAHL MEMORIAL EuGENE). HANAVAN ScHOLARSHIP FLORENCE M. & SHERMAN R . HANSON FUND FOR MEDICAL EDUCATION DEVJLLO V . HARRINGTON LECTURESHIP THE HEKIMIAN FUND MICROBIOLOGY MEMORIAL FUND ELIZABETH ROSNER FUND DR . DAVID KIMBALL MILLER AWARD IRA G. Ross CHAIR oF MEDICAL INFORMATics EuGENE R. MINDELL M.D. CHAIR IN DR . SHELDON ROTH FLEISCH MEMORIAL FUND HAROLD ORTHOPAEDIC SURGERY G. NORRIS MINER M.D . MEMORIAL AWARD PHILIP D. MoREY ScHOLARSHIP PHILIPP . SANG MEMORIAL FUND RICHARD SARKARIA FAMILY ENDOWED CHAIR IN AGEL M.D . ANESTHESIOLOGY RESEARCH HEWLETT FAMILY ENRICHMENT FUND FOR PSYCHIATRY DR. ANGES RESOURCES FUND DIAGNOSTIC MEDICINE FUND s. NAPLES MEMORIAL SCHOLARSHIP THE DR. S. ROBERT CHARLES GORDON HEYD MEDICAL ARINS MEMORIAL AWARD ATIO ' AL MEDICAL AssociATION, SCHOLARSHIP FUND NAUGHTON AWARD ENDOWMENT DR. ERWIN NETER MEMORIAL * DR. S u K K1 HoN G MEMO RI AL FuN D ANTOINETTE AND LOUIS H. ABRAHAM M. HoROWITZ FuND NEUROLOGY DEPARTMENT ENDOWMENT LUCIEN HowE PRIZE FUND DR . BENJAMIN E. & LILA 0BLETZ PR IZE FUND R. R. HUMPHREY & STUART Nu SIGMA C. L. VAUGHAN u ALUMNI ScHOLARSHIP . )OHNSTON SCHOLARSHIP SUMNER )ONES LIBRARY FUND EUBECK FUND IN ORTHOPAEDIC SuRGERY DR. ELIZABETH P. OLMSTED FUND I SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB oF BuFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES HARRY E. AND LORETTA A . )ORDON FUND VICTOR A . PANARO MEDICAL SCHOOL FUND H. CALVIN KERCHEVAL MEMORIAL FuND F. CARTER PANNIL )R., M . D. AWARD DEAN STOCKTON KIMBALL MEMORIAL ScHOLARSHIP UNRESTRICTED ENDOWMENT FUND LILLIE S. SEEL ScHOLARSHIP IRENE SHEEHAN FuND DEWITT HALSEY SHERMAN AND )ESSICA ANTHONY SHERMAN FuND DR . L01sA . AND RUTH SIEGEL TEACHER's AWARD S . MoucHLY SMALL M.D. AwARD IN BIOCHEMISTRY josEPHINE HoYER ORTON TRUST FuND PSYCHIATRY S. MOUCHLY SMALL M.D. EDUCATION CENTER FUND IRVINE AND ROSEMARY SMITH CHAIR IN ENDOWMENT STEPHEN). PAOLINI M . D. MEMORIAL FUND APLES SARNO SC H OLA RSHIP F UND ScHAFER FuND IN CARDIOVASCULAR DISEASES EPHROLOGY RESEARCH ENDOWMENT RALPH HocHSTETTER MEDICAL RESEARCH FuND )AMES * D R. MA RI A BuFFALo CHAPTER ScHOLARSHIP FuND DR. FRANK WHITEHALL HINKEL s. SANES AND THELMA SANES MEDICAL SCHOLARSHIP NEUROLOGY FUND DR. IRVING M. SNOW FUND DEAN STOCKTON KIMBALL MEMORIAL AWARD PARKINSON RESEARCH FuND MARY RosENBLUM SoMIT ScHOLARSHIP FuND DR. )AMES E. KING POSTGRADUATE FUND )OHN PAROSKI MEMORIAL FUND MORRIS AND SADIE STEIN NEUROANATOMY PRIZE MoRRIS LAMER AND DR. ROBERT BERNOT SCHOLARSHIP DR. CHARLES ALFRED LEE ScHOLARSHIP DR. GARRA K. LESTER STUDENT LOAN RoBERT]. PATTERSON RESIDENT AwARD * j o H N AN D ) ANET SuNG Sc H OLA RSHIP FuND DR. MARK PETTRINO MEMORIAL FUND ]oH PHI CHI MEDICAL FRATERNITY TREVETT SCHOLARSHIP SCHOLARSHIP FUND H. TALBOTT VISITING ScHOLARSHIP FuND * K o R NELL L. TE RPLAN M .D . L ECTURE FuND PRIMARY CARE ACHIEVEMENT FUND RICHARD E. \VAHLE RESEARCH FUND THE LIEBERMAN AWARD PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND MILDRED SLOSBERG WEINBERG ENDOWMENT HA PsYCHIATRY DEPARTMENT ENDOWMENT FuND E.). WEISENHEIMER OPHTHALMOLOGY AWARD LUPUS SCHOLARSHIP FUND DR. HERMAN RAHN MEMORIAL LECTURE DR. MARK WELCH AND BEULAH M . WELCH WILLIAM E. MABIE D . D .S. AND ALBERT AND ELIZABETH REKATE CHAIR IN LLOYD LEVE FUND s LOWENSTEIN AWARD GRACES. MABIE Fu D DR. WILLIAM H. MANSPERGER FuND CLARA MARCH MEDICAL ScHOLARSHIP CARDIOVASCULAR DISEASE ALBERT C. REKATE REHABILITATION MEDICINE LIBRARY FUND MEDICAL ALUMNI ENDOWED ScHOLARSHIP DONALD RENNIE PRIZE IN PHYSIOLOGY ANNUAL PARTICIPATING FUND FOR MEDICAL DouGLAS RIGGs AwARD IN PHARMACOLOGY AND EDUCATION ENDOWMENT THERAPEUTICS ScHOLARSHIP )AMES PLATT WHITE SOCIETY ENDOWME T WILLIAMS/BLOOM MEDICAL RESEARCH FUND DR . MARVIN N . WINER FUND FOR DERMATOLOGICAL RESEARCH WITEBSKY FUND FOR IMMUNOLOGY DR. ERNEST WITEBSKY MEMORIAL FUND MEDICAL SCHOOL LECTURESHIP FUND THE RING MEMORIAL FUND FARNEY R. WuRLJTZER FuND MEDICAL ScHOOL CLASS oF 1957 ScHOLARSHIP MEYER H. RIWCHUN PROFESSORSHIP IN DR . MARK ZALESKI AWARD MEDICAL SCHOOL CLASS OF 1958 SCHOLARSHIP OPHTHALMOLOGY FUND MEDICAL SCHOOL CLASS OF 1963 SCHOLARSHIP EMILE RODENBERG MEMORIAL AWARD MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP THOMAS A. RODENBERG AND EMILE DAVIS MARIAN MELLEN FuND HERMAN AND RosE ZINKE MEMORIAL SCHOLARSHIP RODENBERG SCHOLARSHIP FUND Autumn 2000 luffal1 Hysici11 31 �Dear Fellow Alumni, 'GI"\ :-.IY YEAR AS PRESIDE:-\T OF THE MEDICAL ALU\1 ' I AssOCIA'I'lO, ' , I am looking at a well-run, hard-working volunteer organization. Our organization has two major objectives. The first one is to promote and encourage alumni interest and activity in the School ofMedicine and Biomedical Sciences. This is done through our Spring Clinical Day and Reunion Weekend, countrywide meetings, awards dinners, luncheons and various other activities. The second objective is to help the medical students-from orientation through graduation-to assimilate into our profession, to grow as doctors and as human beings and to have some fun in the process. The Medical Alumni Association sponsors events at orientation. Along with the White Coat Ceremony for the incoming students, we have a Physician-Student Mentoring Program, which has received excellent feedback. Our Community Physician Program allows first- and second-year students to meet area doctors and talk about their specialties. We also organize a senior reception and a Match Day luncheon, and entertain requests from the student government. So, what's wrong with the picture? Here's where I start to sound like a guy on public television. Our organization, like most volunteer groups, relies on support from its constituents. Our school has about 6,000 living graduates, but we only average about 1,500 dues-paying members each year. We need your help! I would like to issue a challenge (again, just like public television). A lifetime membership in the Medical Alumni Association costs $750. This is a bargain for younger doctors and a great way for the "mature" doctors to support our school. In order to continue to increase all the association's activities each year for our school, its students and alumni, we need 200 new lifetime members by May 200 I. Anyone who joins the Medical Alumni Association as a new lifetime member between September 2000 and May 2001 will receive a free copy of our new University at Buffalo School ofMedicineand Biomedical Scie11ces Alumni Directory, which will be published in May 2001. As our pulmonary colleagues would say, "Come on, cough it up!" Please help your school-join the Medical Alumni Association now! jOHN I .... j. BODKIN II, MD President, Medical Alumni Association Pbysici11 A11t1111111 2 000 �CLASSNOTES 1940s 1950s Eugene J. Hanavan, MD '41 , Roland Anthone, MD '50, an associate clinical professor of orthopaedic surgery at VB, retired from practice February 29, 2000 and resides in Buffalo, Y. Buffalo, NY, "Did surgery and renal transplantation surgery for 50 years and am now enjoying retirement, although still doing some parttime work with BGH. Spend time with my wife playing tennis and golf." William E. Maloney, MD '41 , writes, "I retired to York Harbor, ME, after years of anesthesia practice in New York. I am married with three children and three grandchildren. My health is not too good. Broken hip, etc. Age 82. Anyone still alive of 194!s? Edward M. Tracy, MD '43, writes: ''I'll be 82 soon, but still practice internal medicine six days a week with a group of physicians I formed last year. I continue to be involved with students at the Medical University here [in South Carolina] and do the same in China. Chick (most of you know her) and I have been married 57 years and have 7 children, 17 grandchildren and 2 great grandchildren. I am in excellent health and enjoy my dog and horse." John G. Allen, MD '46, writes: "I am looking forward to my 55th reunion in spring 2001." E-mail is jallenl391 @aol. Sidney Anthone, MD '50, Buffalo, NY, surgery, "Am currently director ofU YTS." Robert E. Bergner, MD '50, Colden, Y, internal medicine: "Married 50 years and still happy. We have five children and eight grandchildren. I retired after 43 years in private practice. Still playing cello in the Orchard Park Symphony Orchestra and am singing in the church choir." Adelmo P. Dunghe, MD '50, Highland Beach, FL, family medicine: "! recently retired from the U.S. Army; happily retired since 1989; happily married since 1948." James C. Dunn, MD '50, Tucson, AZ, general surgery: "! have been on the faculty at the University of Arizona's College of Representatives of Bernard C. Harris Publishing Company, Inc., will start phoning alumni for the verification phase of our Unirerslty ilf Buffalo School at MedH:ine and BiomedH:al Sciences Alumni Direcfoty project. Much of the information to be verified on each individual's listing will be going into the directory; in particular, this includes current name, academic data, residence address and II"- number (if applicable!. The scope of this information is an indication of the comprehensive quality of the entire volume. The dlrec· tory will sort this data by name In the Medicine since 1978 in the Department of Anatomy. I was on the faculty at SU Y at Buffalo from 1957-1978, in the Department of Anatomy," E-mail is azcacti@acol.com. Yale Solomon, MD '50, Brightwaters, , ophthalmology, recently authored a book for laymen, titled Overcoming Macular Degeneration: A Guide to Seeing Beyond the Clouds, Avon Books. E-mail address is ysolomon@earthlink.net. James Youker, MD '54, was elected president of the alphabetical division, and by class year, and geographical location in separate sections of the book. There will also be a special message from the Alumni Office as well as photos and information about the school. Soon, locating fellow alumni will be as easy as turning a page in the Univer· sity ilf Buffalo School at MedH:ine and BiomedH:al Sciences Alumni Directory. You may resene your personal copy when your Harris representative phones, but don't delay because only pre-publication orders received at that tiRM will be guaranteed. American Board of Medical Specialties (ABMS) in March 2000. In this capacity, he will work closely with Steve Scheiber, MD '64, executive vice president of the American Board of Psychiatry and eurology, who is active on a number of committees of the ABMS. E-mail address is jyouker@mcw.edu Laurence J. Beahan, MD '55, Snyder, NY, psychia- try. "!am chair of the Sierra Club iagara Group 2000 and am publishing a book titled My Grampa's Woods: The Adirondacks. Am on the Public Health Committee Medical Society County of Erie." E-mail address is larry_beahan@adelphia.net. Leonard R. Schaer, MD '55, Alamo, CA. "I am retired." E-mail address is nanapop@hotcoco.infi.net. William J. Sullivan, MD ' 55. writes: "I am practicing half time at the present as the medical director of a group doing forensic psychiatry. I have stopped my psychoanalysis and psychotherapy. I hope and expect to continue to practice for a number of years more." I CONTINUED ON PAGE 34 assnotes Autumn 2000 l uff al1 Physician 33 �~ --- --- - - - -- - - CLASSNOTES CO NTI NU ED FR O M P AC E 33 the hospital will be named in their honor. Barbara YonSchmidt, MD '55, Oakland, CA, pa- thology. "I retired December 31, 1991, after working 35 years at Children 's Hospital of Oakland. " Jacques Lipson, MD '58, and his wife, Dawn, received the john Whitbeck, MD, Medal of Philanthropy for the Year 2000. This was awarded by the Rochester General Hospital Foundation. The newly constructed cancer and blood disorder center at 1960s William E. Abramson, MD '60, writes: "I enjoyed reading the Buffalo Physician summer 2000 issue. Also enjoyed seeing 30 of my classmatesstill vertical-at our reunion dinner on April 29, 2000. How come the Class of 1950 got the attendance trophy with 24 attendees, when we had 31 ?" {Editor's note: In re- sponse to Dr. Abramson's question, the Medical Alumni Association Office '11 who is chai~ explains that the attendallce trophy is determined by proportional represe11tatio11; i.e., the percentage of surviving members who attended. ] of the Department of Oral Diagnostic Sciences in the School of Dental Naomi leiter, MD '60, New York, Y, adult and child psychiatry. " I live near Lincoln Center and would love if my classmates visited with me. My eldest son is a "professor" at the ew School. My youngest son is starting his own theater company called Imbalance as director and artistic director. " E-mail is nl7012 @aol.com. Paullessler, MD '63, has been named director of Pain Management at University of Southern California's orris Comprehensive Cancer Institute in Los Angeles, CA. J. Richard Gunderman, MD '65, writes: " In 1999, I published a book, Raisi11g Your ChildA Love Story, on how to raise children. " E-mail address is: dickgund @aol.com. louis Trachtman, MD '65, writes: "Buffalo Physician is always enjoyable, but I was especially moved by Dr. Bean's article in the spring issue. It reminded me of the teaching methods of our professor of pathology at UB, Dr. Samuel Sanes, who taught the natural course 34 IU II I II rh JS I CI ID A11111mll 2 000 of diseases from the patient's perspective. P. S., I recently .....:t.:....,.L.:...;;;;....J had two articles published in our state medical society's journal, highlighting public health." E-mail: trachman@dhh.sta te.la. us. Andre D. lascari, MD '60, Poestemkill, NY, pediatric hematology/oncology. "I retired in April 1999. William G. Wolff, MD '69, is president of the New York State Radiological Society; councilor of the American College of Radiology; Advisory Committee on Radiological Health to New York State Department of Health. He is chair of the Department of Radiology at The ew York Hospital Medical Center of Queens, Flushing Hospital Medical Center, Coler-Goldwater Memorial Hospital; clinical associate professor of the Weill Medical College of Cornell University; and senior member of the American Institute of Ultrasound in Medicine and member of the Executive Committee of ew York Medical Imaging. 1970s John E. Knipp, MD '72, has been elected chief of medi- cine at St. Luke's Hospital m ewburgh, NY. Eric J. Russell, MD '74, Dr. Russell 's corrected E-mail address is e-russell@nwu.edu. Nancy A. Cunningham, PhD '78 and '80, has been a p- pointed medical library administrator in the Department of Educational Affairs at Roswell Park Cancer Center (RPCI ). In this role, she will supervise and direct personnel, fiscal and budgetary planning and operations of the Dr. Edwin A. Mirand Library and implement and coordinate library marketing and outreach activities. Peter Condro Jr. MD '79. Dr. Condro's corrected E-mail address is crrtfo ra rf@cs. com. 1980s Edward J. Rockwood, MD '80, writes: "My wife, joann Agnello Rockwood, died of breast cancer on july 29, 2000. She worked in the Medical Education Office at Millard Fillmore Hospital from 1977 to 1983, first with Dr. Harry Alvis and then with Dr. Luther Musselman. We have four daughters: Tiffany, 13, Delena, 12, Ashley, �In Memoriam school, Ihrig, who retired attended SUNY at Buffalo, editors of national and professor at Hershey in 1991, was on the staffs where he earned his un- local news media. He is Medical Center from 36 years at 71 North of Buffalo General, dergraduate and medical survived by his wife of 1972-1995. Yahn was Street in Buffalo, NY, died Children's and the former degrees. Klein co-founded over 30 years, the former a native of Olean, NY July 7, 2000, at age 71. A Lafayette General hospi- Williamsville Obstetrics Lois ("Cookie") Joseph and a graduate of St. native of Chicago, Ihrig tals for many years, as and Gynecology, where he Cominsky, three stepchil· Bonaventure University. graduated from the then- well as the Erie County practiced for over 30 dren and three children He was a Navy veteran, University of Buffalo in Medical Center. Survivors years. In addition, he was from his previous mar- a fellow of the Ameri· 1953, with honors. Follow- include his wife, the a clinical assistant pro- riage to Shirley Gerring. ing medical school, he former Jeanette S. Latona; fessor of OB/GYN at UB completed his internship two sons, four daughters, and an active member of Arthur E. Yahn Ill, MD at Bexar County Hospital and a brother. the American Medical As- '65, died at his orne n of Anesthesiology and sociation and the Ameri· Har• sburg, PA, on May the National Board of John J. Ihrig, MD '57, ho practiced dermatology for in San Antonio, TX, and can College of Anesthesiologists, a Diplomate of the American Board served three years in the Morton Paul Klein, MD can College of Obstetrics 15,2000,afteralong Medical Examiners. Air Force, where he rose to '62, died April 5. 2000 and Gynecology. An avid battle with spindle cell Surviving are his wife, the rank of captain. He in Delray Beach, FL, of recreational bicyclist, fibro sarcoma. He was Mary Ann Krastell then returned to Buffalo complications following a world and RV traveler and 60. Yahn had been on Yahn; three daughters, and began his practice in bicycle accident. He was gourmand, Klein was also staff at Harrisburg three sons, his mother, 1965 after completing his 68. A native of Union City, an active supporter of Jew- Hospital since 1971 and two sisters, and a brother. residency in dermatology NY, Klein served in the ish community activities in director of anesthesiology at UB. In addition to serv- U. S. Navy as a medical Western New York and a services there from ing as a volunteer faculty corpsman during the frequently published con- 1975-1977. He was also member at UB's medical Korean War. He then tributor of letters to the an assistant clinical 10, and Amanda, 5. I am a staff ophthalmologist at the Cleveland Clinic Foundation, subspecializing in glaucoma. » E-mail address is: edwardrockwood@aolcom. Steven R. Goodman, MD '84, practices physical and rehabilitation medicine in Federal Way, WA. He is a clinical associate professor at the University of Washington's Multidisciplinary Pain Center, where he teaches intramuscular stimulation for the treatment of neuropathic-myofascial pain syndromes. E-mail address is srgood@home.com. Francis Whalen, MD 'B7, writes: "I have just completed an internal medicine residency and will start a pulmonary critical care fellowship in July at Pittsburgh." E-mail address is fwhalen@adelphia .net. Thomas E. Kowalski. MD 'BB, has been named medical director of gastrointestinal endoscopy in the Division of Gastroenterology and Hepatology, Department of Medicine, at Thomas Jefferson University Hospital in Philadelphia. He is also associate professor of medicine at Jefferson Medical College of Thomas Jefferson University. 1990s Rohit Bakshi, MD '91, has been awarded a threeyear, $300,000 grant from the JH-Nl DS to study MRI findings in multiple sclerosis. The work will be carried out in the Department of eurology at Kaleida Health System's Buffalo General Hospital, where Dr. Bakshi is a neuroimager and MS specialist. E-mail address is rbakshi@buffalo.edu. Mary (Cappuccino) Bonafede and Joseph P. Bonafede, MDs '91. write: "We are happy to announce the arrival of our third child, Andrew Joseph, on February 1, 2000. Andrew joins his big brother, Sam, age 4, and his sister, Ella, age 3. Joe and 1 are both enjoy- A u t u mn 20 00 CD ing private practice (otolaryngology and pedia tries) on the eastern shores of Long Island. E-mail address is Mbon.465050@aol.com." Philomena Mufalli Behar, MD '92, writes: "My hus- band, Jerry, and I would like to announce the birth of our daughter, Julia Fay, on June 25, 2000. She weighed five pounds, 12 ounces, and was 18 inches long." E-mail address is: pmbehar@aol.com. C ON T IN U E D ON P AG E 36 1 1 If al• n ysic ian 35 �CLASS I CON TIN UED FR O \~ ~ 35 Warren Scherer, MD/PhD '92, writes: " I served as the ophthalmic surgeon for a medical mission to El Salvador in August 2000. I am currently in private practice in ew Port Richey, FL." E- mail address is warren scherer@hotmail.com. E-mai NOTES Michael Aronica MD '93, writes: "I am proud to announce the birth of our third child, Marykate. Meghan and Madeline just love their little sister. Mary and I are doing well in Buffalo, NY. I am enjoying my job with the Division of Internal Medicine and Pediatrics at the U Buffalo School of Medicine. My clini- cal duties are based at the Elmwood Health Center and Children's Hospital of Buffalo." Alissa Shulman, MD '93, writes: "I am pleased to announce I have recently joined a wonderful and busy plastic surgery practice- Plastic urgery, P. C.- in South Bend, IN. An additional note: I have continued with my artistic endeavors, both personally and professionally. Life is good!" E-mail address is: doctoral issa@aol.com. Donna (Sinensky) Ferrero, MD '94, writes: "I recently joined a large multispecialty private practice in orth Andover, MA- ew England eurological Associates, P. C. I am practicing physiatry. I am also happy to announce that my husband and I are expecting our first child in March 2001." Babak Parwar, MD '96, and Bobbie Parwar, MD '97. Babak writes: "I am in my fourth year of head and neck surgery at UCLA Medical Center. My wife, Bobbie, is in her second year of ophthalmology at the Jules Stein Eye Institute in Los Angeles." Kristin Larsen, PhD '97, writes: "It's been a good year for me. I got married in September 1999 and was recently promoted to junior faculty in the Department of eurology at Columbia University. My research angle is alternative therapies and preventions for Parkinson's disease." E-mail address is kell4@columbia.edu. A plan for livllg. Hospice really is a plan for living ... one that we can make together. With treatment options from you, plus emotional support, symptom I plan to keep going. management and in-home care from Hospice, we can help your patients make the most of their time with family and friends. Call 686-8077. T H E C E;>.;TER F O R H1)SPICE& PALLIATIVE CARE www.lzospicebtiffo lo. com 36 l•flale Pbysiciaa A utu m" 2000 �- Based on F/Mst-1 Data dnJl ffTheywere sergeantsand cheerleaders:' - Fronk Stelarski, stroke rehab patient Harris Hill H.C.F. Why do our patients have better rehab resuh:s compared to the national average? Maybe ~·s our staff ''They knew exactly how far to push me,'' says Frank Stelarski. ''But they also encouraged me every lfttle step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire THE Rehabil~tion ~~ry}Jfl.I(9!{ Centers, call 1-888-POSTACUTE or vis~ www.mcguire-group.com. Recognized for excellence in quality· care. CEN1E~ tf*****" AUTUMN VIEW • GARDEN GATE • HARRIS HILL • NORTH GATE �p H A R M A c 0 p 0 E I A GB's HISTORY OF MED!Clr-iE COLLECTIO:-i PRF.SE . . TS PHARMACOPOEIA Digitally reproduced prints from a pharma copoeia by Otto Karl Berg (1815-1866) are on display this fall in University at Buffalo's Health Sciences Library (HSL), South Campus. The botanical show was developed by the HSL and the university's iMedia staff and is the first in a series of "Art in the Library" exhibits intended to promote the History of Medicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume , published in Leipzig in 1863. Pictu red is Iris Florentina. RP 00 02 01 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n02-2000-Autumn Table Of Contents A list of subunits of the resource. Internal Medicine's Man Eschewing Viewing Pathways Research Medical School Student column Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0631d26b67e7c195cbebbec314b80cce.pdf a30bb80e02027354cbc75ce5d2d3abd1 PDF Text Text s I c I A N �lullala P~ysicial ASSOC IA TE V I CE P RES I DENT FO R lJ ' I \ ERSITY SER\ I CES Dr. Carole Smith Petro Dear Alumni and Friends, D I R E CTOR Of PERIODICALS Su e Wu etcl1er EDITOR S t ephanie A. Unge r B we will no doubt be in the grips of wi nter, which is supposed to be a bit more bracing here in Buffalo than in recent years. ,\RT DIRECTORIDESIG,;ER A lan]. Kegler evertheless, we do look forward to our predictable changes of seasons and hope CONTR I BUTING \\ RITFR that all of you have had a pleasant holiday break from the routine. The capital campaign "Generation to Generation" kickoff occurred on October 20, Lois Baker COORD I ~ATOR 2000, an event coinciding with UB Homecoming Weekend and the convening of our PRODUCT I ON Dean's Advisory Council. Our own medical school "Family Weekend" took place over the Cy nthia T odd - Fli ck two days that followed. The campaign kickoff was capped by a reception in the Center for the Arts and a marvelous presentation by the American Ballet Theater Company, 111 residence at UB during October. Based on progress to date (during the "quiet phase" of the campaign), ST~TE lJ'dVERSITY OF;\£" 'I ORK AT BurrALO ScHooL 0 F ~~ E D I C I N E A N D BIOMED I C·\L SC I ENCES Dr. j ohn W rig ht , Dean the School of Medicine and Biomedical Sciences' campaign goal has been adjusted upward to $50 million dollars. With Skip Garvey, MD '53, as our campaign committee leader, we not only expect to achieve that goal over the next three years but indeed to surpass it. Endowment means so much to a school such as ours, a fact to which I can personally attest as we manage our way through what have become very challenging times. A healthy endowment will enable many good things for the school, not the least of which will be the ability to attract the very finest student applicants and to provide them with the very best medical education experience. All this would benefit from a significant E.DITOR I AL BOARD Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. D r. Dr. Bertram Portin , Chair Mart in Brech er Har old Brody Linda]. C orde r Alan]. Drinnan ]am es Kan ski Eli za beth Olm sted S teph en Sp a ulding Bradley T. T rua x Franklin Ze plowitz increment in student scholarship availability, which has become so important in the recruitment of excellent students and, through endowed professorships, enabling us to recruit the very best faculty with whom our students can interact, learn and become inspired. As we head into completion of the fall semester, significant progress has been made on developing the new curriculum that we intend to implement in the fall of 2001. Dr. Reid Heffner (assistant dean for curriculum and chair of pathology) is coordinating this effort with the help of a team of dedicated, experienced teaching faculty. The intent is to better integrate course material into a more clinically focused formal in which repetition is intentional rather than accidental, and relevance to basic overarching biologic concepts and clinical application becomes more transparent. The curriculum will also provide more lecture-free time so students can consolidate information on their own and access modern instructional technology; for example, through the use of the computer lab. Since there will be more small-group teaching in the new formal, we arc already planning significant ex- TEACHING HOSPITALS Er ie Co un ty Med ica l Ce nt er Roswell Pa rk Ca n ca l11 stit11 t<' \'e te ra 11 s Affai rs W es te ru New Yo rk H ealt h ca re Syste m K-\11/1)-\ H fo\1 Ill : T h e B uffa lo Ge 11 era l H osp ital T h e Child re 11 's H osp ita l of Buffalo .\ I ill ard Fi llm o re Ga tes H ospilll l . I .\ I ill ard Fillm ore S ubu rba u Hosp tttl H I-\1111 Snrt.u: Me rcy H ea/t/1 Sys t em Sisters of C h ari ty H ospiw l N tagara Fa lls M e m oria l Me d ica l Ce ut er C-\riiOIH ® THE STATE UNIYEISITT Of NEW Ylll IT lUFf ILl pansion of that type of learning space to be ready in time for the implementation date. Although curriculum change is in fact a constant for most schools, this project promises to be more dramatic than any change effected in recent memory. It is unlikely to be perfect at implementation, but we think it will be a significant improvement for our students, nonetheless. Further improvements will be accomplished as experience with the new curriculum evolves. Our goal is to maintain the UB tradition of graduating physicians capable of meeting the challenges of the continually evolving world of medicine. .JOliN R. WRIGHT. MD Dean, School of Medici11e and Biomedical Sciences Letters to the Editor liu(falo l'hp1wm " pubh,hed qu.trterh h' the C nivcr>it\ at Bufl;11o School of ,\kdicinc .md BiomcdiLal Science!-. .111d the Offkc of <:ommunic.ltions. 1 etters to the h.litor arc wckomc and can be sent CIO Buflalo Phplcimz. 330 t rofh II all, L'ni,~;,i1y al Buff;,lo, Buffalo,!'\\ 14260; or ,·ia c·maillo hp-notcs •' butf.tlo.cdu. The 'laff re,crvc' the righl to edil ,,II ... ubmlssiom, for length and daritr . �VOLUME 35, Features 2 Warsaw after the War Morris Unher, MD '43, looks back on his year as a medical officer in post-war Poland PHOTOGRAPHY BY DR. MORRIS UNHER 8 Writing Code Medical students draft first -ever code of conduct for school BY DAVID FLINT. CLASS OF 2003 PHOTOGRAPHY BY FRANK MILLER Emergency medicine resident Ann Marsh competed on the U.S. Fencing Team in the 2000 Summer Olympic Games inSydney. The story of this remarkable physician·athlete begins on page 26. COVER PHOTO BY DR. MORRIS UNHER Medical School 34 Mark your 14 UB medical st udents named HHM I- IH research scholars 16 Frederick Sachs to lead international research project 20 Honors Brunch Awardees named 2000 Distinguished Medical Alumnus 26 Philip Wels selected for 1936 u.s. Olympic fencing team campaign, "Generation to Generation" 31 Lung function associated with longevity 33 Blood vessels reflect future health calendars for April 27-29, 2000, for Spring Clinical Day and Reunion Weekend Messages from Reunion Chairs 39 your UB classmates and other alumni In Memoriam Drs. Henry Morelewicz, Eugene Farber, Arthur Schaefer AP9 2 7 .- J . .J ���ter the nexpectedly, however, the dull routine came to an end when I received orders to report to the Surgeon General's Office in Washington,DC, followed by assignment as medical officer at the U.S. Embassy in Warsaw. Avivid memory 1have of my brief stay in Washington involves avisit from my parents, both native·born Russian, and asomewhat embarrassing moment when my mother asked my superior officer why it had to be hers on who was selected for this assignment. From Washington, I traveled to Camp Kilmer, ew Jersey, then on to the port of embarkation, where I boarded the USS Claymont, a "victory class" transport ship. During the boarding, I learned that I was to serve as transport surgeon for the 900 troops already on board. Fortunately, our voyage was uneventful. Our ship arrived at LeHavre, France, and from there I traveled to Paris where I spent a sleepless 36 hours enjoying the sights and sounds of that beautiful city, which was spared the destruction I was soon to encounter farther east. When it was time to leave Paris I boarded a troop train that carried me to Berlin. Along the way, I began to catch glimpses of burned-out villages. The Berlin I arrived in was a city divided between U.S., French and Russian sectors, all of which were in the throes of reconstruction following nearly complete demolition. From Berlin, I made the 400-mile flight to Warsaw on board a C-47 U.S. army transport plane that departed from Templehof Airport, a busy place with military planes taking off and arriving from many destinations. On our approach to the Warsaw Airport, I saw Russian planes sitting on the field amidst bombed-out buildings and potholed runways. When we landed we were met by a U.S. military attache's car and taken directly to the Hotel Polonia-war scarred, but still standing-and home to the U.S. Embassy while the destroyed embassy building was being reconstructed. The hotel was situated on Aleya )erozolimskie (the "Times Square" of Warsaw), across from tl1e railway station, which had been reduced to a pile of rubble. Arthur Bliss Lane was the U.S. ambassador at the time, and he and his wife and many of the embassy staff lived in the Polonia. Upon my arrival I received a very warm and friendly greeting. Soon I settled into my routine, providing medical care for employees of our embassy-American and Poles-as well as for employees of the British and Italian embassies. Rapid Immersion in "The Polish Problem" Medical facilities at my disposal were primitive. In the hotel, a oneroom dispensary had been established and stocked with medical supplies and equipment from the army medical depot in Berlin and luffale Physician Wint e r ZOO/ with occasional acquisitions from relief agencies in Warsaw. Dr. Fraczek Litwin, the Minister of Health, graciously placed the facilities of the Lecznica Ministertwo Zdrowia at our disposal and, in my year's tour of duty, scarcely a day passed without at least one staff member occupying a hospital bed there. Throughout my stay, I had neither a clerical nor medical assistant and, consequently, it was difficult to maintain adequate records. In all, it would be fair to state that my services as medical officer were utilized to capacity. In the course of performing my duties, I had the privilege of traveling extensively in Warsaw and throughout Poland, visiting many health installations, meeting members of the medical profession and observing the patterns of medical education and practice. Friendships with medical students, practicing physicians and health officials offered me much insight into the "Polish problem" as it was I will never referred to then. By the time I arrived in Warsaw, more than 500,000 Poles had drifted back to the city's ruins to live in what was left of cellars and crumbling attics. I remember observing how, in a burst of ambitious activity, the provisional government had posted one gutted building as the Ministry of Agriculture and another, as the Ministry of Health, and so on. Everywhere the individual and collective will to live and rebuild was strong, but the tasks seemed hopelessly overwhelming in scale. Despite the inevitable manpower shortage incidental to the war and enslavement, Poland was consigning an inordinately large proportion of her remaining men to serve in the armed forces that were being rapidly rebuilt. So, while platoons of singing troops marched through the streets and armed militia patrolled the ruins, old women and young students picked at the rubble. forget a young medical student telling me the harrowing tale of how, during the war, he took his third-year medical examinations by candlelight in an abandoned farmhouse while his fellow students guarded the doors and lonely road. �Warsaw'sdecimated railroad station, situated in the city's"Times Square," as seen from the rooftop of the Hotel Polonia. Physician Population and Hospitals Decimated Among the 10 million people who perished during the German occupation of Poland, 7,000 were doctors, or one-half ofPoland's physician population at the time. In addition, the country lost its most able administrators, educators and public health authorities. As a result of this grievous situation, it was a heroic, but unqualified group that assembled in the Ministry of Health's headquarters in 1945 to begin the Herculean task of rebuilding the country's health-care system. Although he held the position of minister of health, Dr. Litwin, an internist by training, had little formal public health experience. However, he possessed inexhaustible energy and a humanitarian political philosophy. In less than a year, this remarkable man reorganized the public health program in his country, efficiently integrated United Nations Relief Administration (U RA) and Red Cross aid and gave the harassed Polish people respite from the fear of epidemic diseases. In Warsaw, his ministry began the great task of rebuilding the Polish Medical Library; his laboratories began producing vaccines and serums; and his tuberculosis sanitarium began receiving patients. At the same time, Polish peasants once again began benefiting from care provided by their local public health officers. Years later, I learned that Dr. Litwin was purged in the "communist victory" of January 1947. Fearing the rise of epidemics-which fortunately never came-authorities hastily restored water purification and sewage disposal plants. Concurrently, immunization against typhoid fever was made compulsory as a prerequisite to obtaining food ration cards. Without dispute, Poland's worst enemies had by then become tuberculosis, venereal disease, malnutrition and infant mortality, which were overwhelming the resources and ingenuity of the country's health authorities. By the time my tour of duty ended, 1,000 new cases of pulmonary tuberculosis were being reported each week. Compounding the despair was the fact that Polish hospital staffs had been disintegrated, medical equipment looted and buildings destroyed. Fortunately, although there was a shortage of hospital beds immediately after the war, by the time I arrived, the recovery of hospital facilities was well under way and continued at a steady pace while I was working in the country. \V i nt e r 200 1 lulflll Physiciu 5 �--~ --- - - -- - Polish Medical Education, aSurvival Story I . . c The buildings that housed the University of Warsaw's undergraduate and medical schools were not spared in the destruction ofWarsaw. A far more irreparable loss, however, was the teaching staff, which was annihilated by German violence. In effect, the war brought to an end the education of doctors of medicine by official decree; however, I learned that surreptitious education continued in the guise of "schools of sanitation." I will never forget a young medical student telling me the harrowing tale of how, during the war, he took his third-year medical examinations by candlelight in an abandoned farmhouse while his fellow students guarded the doors and lonely road. After the war, despite the fact there were no books and instruments, classes continued to be held. In 1946, large classesthe majority of which were made up of women-were meeting in scattered clinics throughout the city. Strenuous efforts were being made to reorient the Polish clinical methods away from the German model and toward the AngloAmerican model, and the new Ministry of Health Library, which was being generously supported with U. S. contributions, was beginning to be a potent served as an associate clinical professor of force in Poland's medical education. To this day, I feel the survival of Polish medical education must be regarded as a minor miracle. View of Hotel Polonia, home to the U.S. Embassy staff and Dr. Unher while in Warsaw. Professional Integrity amid Crime and Politics In looking back on my experiences in Warsaw, I cannot conceal my unbounded admiration for the Polish physicians among whom I lived and with whom I worked. The caliber of the medical practitioners I met was extremely high and their efforts to bridge the gap of seven terrible years were commendable. Those few who were left to serve the country's 22 million people pooled their meager equipment and books and instinctively sought the urban centers. In the face of the nationalization program that had been instituted, they turned to group practice, and collective clinics comprised of 10 to 20 doctors were becoming common in Warsaw. All the physicians rallied to the task of rebuilding and restaffing hospitals. Eighteen- to 20-hour days were normal for the Polish practitioners, who often were required to walk many miles each day in shell-pocked streets, attending to this task and the many people in dire need of their services. Not surprisingly, counterinfluences sprung up that exploited the chaos surrounding efforts to rebuild the health-care system. For example, drugs were scarce and inequitably distributed; therefore, drug bootleggers who charged exorbitant prices prospered. Also during this time, the terribly reprehensible practice of replenishing the contents of discarded penicillin bottles with burnt sugar and offering them for resale was discovered. In all, I would say that the busy Polish physicians had many distractions during this troubled period. Not the least of which was the fact that the communist-dominated government was making vigorous efforts to recruit medical professionals to its ranks with offers of food and housing privileges. The vast majority resisted all attempts at conversion and so the government had no choice but to tolerate and refrain from molesting these valuable, virtually irreplaceable, members of the Polish population. �I:Jreerpta tre• • Letter He•e Days Gone by, but Never Lost During my tour of duty I traveled widely, both in Warsaw and other areas in Poland. The embassy provided me a car and I spent many hours visiting the square mile that once had been the 'Warsaw Ghetto.' I remember climbing several tall mounds of debris there to gaze in utter disbelief at the charred brick and twisted steel around me. Four hundred thousand people saw life for the last time in that ghetto, and the hot summer sun reminded those of us still alive that all the dead had not yet been buried. I also visited Krakow, Lodz, Zakopane and other places of interest and notoriety, including Auschwitz (or "Oswencin" in Polish). This terrible camp is a place I will never forget. While I was learning firsthand about these atrocities, I also became aware that a new version of the centuries' old tradition of "Jew baiting" was being practiced less than 200 miles from Warsaw, in the ravaged city of Kielce. While this deeply saddened me, it did not surprise me, as throughout my tour of duty I witnessed hundreds of miniature conflicts involving countless bitter, disillusioned and tragic people. Once I had been in Poland long enough to begin to see "the broad picture," it became clear to me that it was a country that had barely begun the long process of healing. In addition to my travels, I also had the privilege of playing host to and providing medical care for visitors to the embassy, some of whom were very memorable individuals. One such person was Dr. Fronczak, health commissioner of Erie County; Harold Stassen, a U.S. senator and then-candidate for president of the United States; Fiorella LaGuardia, former mayor of ew York City; and Franco Autori, conductor of the Buffalo Philharmonic Orchestra. Because of all these remarkable experiences-many of which still profoundly affect me today-it was with mixed feelings that I learned my odyssey in Poland was to come to an end in July 1947, at which time I boarded the Polish luxury liner the MS Batory and set sail for ew York City via Stockholm. While these are memories of a time far in the past, I was reminded just the other day that they are still close to my heart when I recalled an old tune, "Warszawa, Kochana Warszawa.'' "Warsaw, Beloved Warsaw.'' Morris \Vinter 2001 l11fal• Physiciu 1 �~ ------ On the following pages, you will read second-year student David Flint's description of how a Medical Student Code of Professional Conduct was recently developed at the University at Buffalo School of Medicine and Biomedical Sciences. The formulation of the code was largely a student-driven process, and the student participants and document architects are to be congratulated for a job well done. The creation of such a code has been periodically suggested over the years but rejected as "something better left to administration." The classes of 2000-2003 were up to the challenge, however, and the product of their collective labors has won wide, and well-deserved, acclaim. As an elegant finishing touch to this product, the code has been published as a very attractive booklet that will be distributed to each incoming class. This publication was underwritten as part of a generous unrestricted gift to the school from Dr. and Mrs. Edward Shanbrom (Class of'S!). We are indebted to the Shanbroms for this help. One might ask why such a code should be developed by students-or perhaps even developed at all. The first question can be answered in a single word: empowerment. What good is such a code if those who are obliged to follow it are not engaged in its creation? The second question might be paraphrased as "Isn't the Hippocratic Oath good enough?" As venerable as the Hippocratic Oath is, and even though we have modernized it to make it more contemporary, it still falls considerably short both for the present-day medical student and for the practitioner. When UB's medical school was founded in 1846, the states of medical knowledge and technology were such that a physician could probably get by with simply being a good and moral person endowed with a generous amount of common sense. One could occasionally do good, but the What better introduction to the rigors ofbeing a modern physician than a code ofprofessional conduct, created by students for students, which places significant responsi- ability to do harm was quite limited. Mother ature was bility on the students themselves? the great healer. In today's world, the ability to do considerable good is more than balanced by the ability to do considerable harm, with potentially devastating consequences. Decisions about when to intervene, or "merely" support, are critical and often difficult decisions for society, as well as for physicians. Ethical issues that our forefathers (and foremothers) could not have imagined now confront the practicing physician on an almost daily basis. The ability to prolong life is counterbalanced by both the finite nature of resources and the concept of quality of life. Finally, the notion of physicians being responsible for one another's behavior and mode of practice has now become a matter of law; and in jeopardy in most-if not all-states is the physician's right (license) to practice. What better introduction to the rigors ofbeing a modern physician than a code of professional conduct, created by students for students, which places significant responsibility on the students themselves? Our students have taken the challenge seriously, and although the actual code will undergo modification as a function of time and the experience of implementation, it is an excellent starting place. Again, thank you, students, for this extraordinary piece of work. John R. Wright, MD Dean, School of Medicine and Biomedical Sciences �A student's perspective on the year-long process �- - I CoDE - - - OF - -- -- - - - CoNDUCT By Dav d Fl nt, Class of 2003 , the University at Buffalo School of Medicine and Biomedical Sciences-despite its 155-year history-did not have a code of conduct While the university at large does have academic policies, our school did not have a code to address the special social and professional responsibilities of medical students. In an attempt to remedy this, Dr. john R. Wright, dean of the school, organized a committee of second -year students in the spring of 1999 and charged us with the task of drafting such a code. (In the fall , Dr. Charles Severin, assistant dean for students in the Office of Medical Education , expanded the committee by adding members of the class of2003. ) This was the start of a year-long process, the final outcome of which was the development of the first Medical Student Code of Professional Conduct for UB's School of Medicine and Biomedical Sciences. We started at the begin· ning, by asking ourselves, Why do we even need a code? On the first day of orientation to medical school and again at gradua· tion, we take an oath to our patients, peers and medicine. But what does that oath mean? Open Process Key to Consensus We started atthe beginning, by askingourselves, Why do we even need a code? On the first day of orientation to medical school and again at graduation, we take an oath to our patients, peers and medicine. But what does that oath mean? After discussing these and other questions, we decided that our goal in creating a code of professional conduct was to establish a set of common expectations for professional, social and academic behavior, and to provide a framework for discussion about our roles and responsibilities as physicians. To prepare ourselves to accomplish this goal, the committee reviewed journal articles highlighting moral and ethical dilemmas faced by students and physicians. We also reviewed do zens of honor codes from medical schools around the country, which ranged from militaristic to anarchistic, and everywhere in between. From this starting point, we then attempted to create a document that was general enough to have longevity, but specific enough to have practical application . The drafting process itself was eye-opening, as each committee member brought unique skills and perspectives to the ensuing debate about substance and form . Some of the issues raised in our discussion seemed uncontroversial; for example, there was limited disagreement over issues of academic integrity. Other areas resulted in more vigorous debate, such as, When and how is it appropriate to address issues of substance abuse among peers? Where is the line drawn between personal and professional life? In order for a document like this to be supported, there of course needs to be input from more than just eight students and a dean meeting in a conference room. Past attempts at creating a code of conduct at our school had failed , which is understandable because it is a substantial task to reach consensus between students, basic scientists, clinical faculty and administrators. To make the creation of the code an open process, therefore, we did a number of things: We held two 10 lulfalo Physiciaa 11'1 11 1er 2001 �CoDE "town meetings," which were audiotaped for those unable to attend, and we created a webpage that allowed for critiquing of the code, section-by-section. We also made a suggestion box available for anonymous comments and set up an e-mail address to receive input about the code. In addition to distributing hardcopy drafts of the code, we made copies of codes from other medical schools available for comparison. Furthermore, Dean Wright requested comments from the public, as well as from readers of Buffalo Physician. Of all these efforts, the web page was by far the most popular medium through which we received comments on drafts of the code. The page provided an easy way for students, staff and faculty to comment, and also made consolidating and reviewing comments much easier for members of the committee. (The design and maintenance of the webpage was greatly aided by staff in the Office of Medical Computing.) The debate that was made possible through open discussion encompassed a wide spectrum of issues. For example, Is it appropriate to include a portion of the Hippocratic Oath in the preamble? Should the code address the use and care of laboratory animals? Does it adequately address sexual harassment? oF CoNDUCT conflict of interest arise. ) The committee will also consist of two faculty members and one ad hoc administrative member, as chosen by Dean Wright. The dean's faculty representatives will vote, but the administrative member will not. Currently, members of the committee are working to develop a lunchtime speaker series centered around what we hope will be provocative vignettes that will serve as catalysts for debate about ethical issues. Efforts Win National Recognition In the intervening time since the code was finalized and disseminated, our efforts have been recognized by the Association of American Medical Colleges, the Medical Society of the State of ew York, and the assistant dean of Mount Sinai Medical Center, all of whom have expressed an interest in learning how we managed this process. Anyone who has ever served on a committee, whether in academia or in business, understands the hurdles that must be surmounted in order to prevent drifting deadlines and missed opportunities. The Medical Student Code of Professional Conduct for UB's School of Medicine and Biomedical Sciences could It is because the students, faculty and staff dedicated such a significant amount of time to thoughtful discussion of such issues as honor, integrity and professionalism that today we have a Medical Student Code of Professional Conduct that is a very powerful document. In April2000, after more than 1,200 hours of committee time, the student body voted to support the new code by a threefourths majority. Later that same month, the school's Faculty Council unanimously endorsed the student-approved code. It is because the students, faculty and staff dedicated such a significant amount of time to thoughtful discussion of such issues as honor, integrity and professionalism that today we have a Medical Student Code of Professional Conduct that is a very powerful document. Continuing Education and Adjudication In addition to the creation of the code itself, a legacy of this year-long process is the establishment of an institutional body that will have an unprecedented opportunity to take a leadership role in acting not only as an adjudicator, but also as a continuing educator in this area. The Committee of Professional Conduct will consist of two members from each of the four classes, who will be elected early each fall by their peers. First-year students will serve a one-year term, while second-year students will serve for the duration of their medical school careers. (One alternate will also be elected from the first-year class should a not have been created without commitment from the school's administration, most notably Dean Wright. As a committee, we received exceptional support from the Office of Medical Education, especially Dr. Severin. In addition, Dr. Dennis adler, associate dean for academic and curricular affairs, and Dr. Nancy ielsen, assistant dean for student affairs, provided amazing insight into the special issues arising in the clinical years. Finally, credit goes to Junda Woo '02, whose editing expertise helped make the code a much more readable document. D AVID FU I\T IS CURRENTLY A SECOND- YEAR STUDENT AT THE UNIVERSITY AT B UFFALO SCHOOL OF M EDICINE AND BIOMEDICAL SCIE CES. Editor'sNote: The full text of the M edical Student Code of Professional Conduct can be found at http://www. smbs. buffalo. edu/ fianlCPC. htm. Readers who do not have!nternetaccess may request a copy by calling Dr. Charles Severin at (716) 829-2802, or by writing him at the Office ofM edical Education, 40 CPS, 3435 Main St., Buffalo, NY 14214-3013. Beginning September 2000, each firstyear student entering UB's School of M edicine and Biomedical Sciences will be given a copy of the code during orientation. IV i n t e r 2 0 0 1 lulfalu Hysicin 11 �- · - -- - - ~ - ~-~ - -- Thoughts on professionalism and empathy Ro!IERT \1 LCH \ \!D Editor's Note: 011 68 \ugust 1/,2000. Robm \.,\filch,.\/[) '68, rlclnwcd the kcmott 'n rtrt at the lliPl!lal 1\ lute Coat Cercmon~ hdd for the mcolmllg class at the UmiWSlt~ at Buffalo School of ,\fcdtcmc and Biomcdiw/ ~ci<·nns. In the weeks followlllg the ceremony, Buftalo PlwsiLian recei1·ed lllllltewus calls frotll indil'iduals rcqucstmg a copy of .\Ttlch's speech and recommcruli>tg that 11 he reprinted in tht• magaztnt' (or the benefit of readers interested PI furthering dzscusston of profemonalism ilt medrwtc. \s a rc,rdt, his <pccclr i:published her<!, 111 zts e11tircty As medical dirctfor jiJr Hospice Buffalo and the Center for Hospnc a111i Palliatn·e (an in Bul)alo, ,\ttlch Ira; garnered worldwtdc recogm ticm for accomplishments 111 /m fteld. In I 989 he n:n ivd th· British Fmbassv \mhassador's Award for Contnbuttcms to the Intematzonal Hosptce ,\Towmt'ltt, and in }'}'}:; he rtCCli'Cli Cluldrcn'.; Hosptn fllltmational s I tfctllltt \chtn•emt'llt A ward. In a brief illfroductory talk at thc I l'hllt Coat Ceremony, Dean john R. II nght.•\1]), explai11ed that \filch practiced as " general surgeo11for 1;"years prior to dcudmg to pursue-full tune "a passi011 for e11d o(ltft care." He also described how \!ilch went on "to build pwgmms of national and tnterrwtWII<li rellOl\'11." /11 addillon, 1\'nght COIItmended \filch fin Ius e!jorts to l.e/p the medical school integrate the hosptcc program tnto its wmwlum "Bob zs a11 iltcreclthle tndt\'l(lua/ alllla co1•tpassi01wte pln.·sicia•t," he concluded, "and I thmk ;n 'rc l't'ry pril·t!eged to hal'c /u11r as our speahr at tl11s \\'hilt Coat Ccremo 11 - S.A.U. IT IS A PRIVILEGE TO BE PART OF THIS CEREMO Y TODAY, to witness the inception of your professional journey. The moment and the event are rife with symbolism, the temptations of metaphor and allegory irresistible. But I would like to think that we can do better than hackneyed allusions to virginity and ship launchings, and in my attempt to do so I hope that you will forgive me the politically incorrect use of the pronoun "he" in reference to all the sexes. As you know, the White Coat Ceremony is intended to emphasize the importance of both scientific excellence and compassionate care, to help "forge the contract for professionalism and empathy" between the one who wears it and those for whom he cares. In this, it is emblematic of the many dualities that henceforth will be at the center of your lives, like the caduceus with its twin serpents of knowledge and wisdom, the one useless without the other. In your first years, of course, your coats may be little more than functional accoutrements, pale tokens of the ultimate prize, a though "MD" tood for Medical Decolletage. They will become repositories for papers and pens, handbooks and broken slides, redolent of formaldehyde and the splattering of many labs. And they will continue to serve these utilitarian purposes. �These coats are like the doctor's frock coat of old, worn from morning to night in the performance of duty-a coat where he carried his instruments and upon which he wiped his hands and his chin; a coat that spoke to the distances he had traveled and the wounds he had dressed-an ensign of position long before it became a symbol of cleanliness and sterility. But the coat also carries greater symbolism, not the least of which may be that it is shorter than the professor's. Its stains are the medals of struggles against ignorance and illness and suffering. It sets you apart from the bewildering cast that populates hospitals and clinics, from other "health-care professionals" (and, I assume, health-care unprofessionals) . It draws attention to your duty, even in the face of your station. Its color speaks to the purity of your purpose and pursuit. To wear it without a sense of awe is to be a dandy-all style and no substance. It is the badge of entry into the arenas in which you have chosen to labor and to serve. It legitimizes your presence even as the least of learners. It grants you privileged access to the bedside and to the patient, and from this Delphic place the chance to glean things previously unknown. If in your first years you learned about disease, now you can learn about illness. The former occurs in organs; the latter, in people. The oracle is the patient, in all his frailty and unsightliness, whose diagnosis may be common but whose suffering is unique. If you would meet his needs, you must go beyond the mere proficiencies of your training. Listen to what you are hearing, remembering that sometimes the best way to auscultate a heart is to remove the stethoscope from your ears. Feel what you are palpating, see the world with his vision and understand his fears, for his fears are the manifestations of his needs. You must understand his values and goals and make them your own, knowing that cure is not the only legitimate outcome; if it becomes your sole focus, you are destined to be heartbroken. And you must be willing to share the power that is implicitly granted the physician, whose relationship with the patient is inherently one of inequality. Patients come to us because there is something "wrong" with them, and we have the knowledge and the skill they lack to make them whole once again. The coat, which signifies the repository of that knowledge and skill, must never become a barrier to their sharing, nor a cloak that hides beneath it an adroit but tyrannical practitioner. The struggle, then-and from your vantage point today you must accept this on faith-is to stay humane, to continue to fan the embers of compassion and empathy that lie at the heart of the instincts that brought you here. These are fires easily damped by the impetus to acquire knowledge and master skills. But while the aim may be to acquire, the goal should be to dispense, and the demonstration of those qualities of our shared humanity is every bit as valuable, if not more so, than the ability to draw blood or tie a square knot. It is reinforced by the recognition that what happens at the patient's bedside is not just a function of what you know, but of what you are. Still, you will find that the system and the Its color speaks to the process often conspire against this, and, if alpurity of your purpose lowed to, make it difficult to care. You must be and pursuit. To wear it vigilant to this and find ways to renew yourwithout asense of awe is to be adandy-all style selves by nurturing your own body, mind and and no substance. spirit as you would those whom you serve. There is a world ofbeauty outside medicine, and we do neither ourselves nor our patients justice by slighting our involvement with it. Music resonates with our inner harmonies; art gives us fresh views of life. Read uland and Selzer and Schweitzer, as well as the New England Journal ofMedicine. Their science may not be as exact, but their lessons are longer lasting and their contributions probably greater. The physicians truly worth emulating did not have a monochromatic vision of life, and their wisdom was enriched by the arts and their avocations as they gained insight into themselves, as well as into their patients. Let your coats remind you of this, especially when you take them off. Thoughtful men have written that the physician must also be a priest. This is not to confuse him with the gods at whose altars he works, or with the rituals he observes. Rather, it speaks to the summons to heal the soul as he would the body, and, in so doing, find the full richness of his calling. It is fitting, then, that today you don the first metaphorical raiment of priesthood. Today they are those of an acolyte, but other robes await. 4D �- - M B S v A E D C A ------ L E SCHOOL W S Cloister Program Opens New Vistas Three UB medical students selected as Research Scholars t{~ ) BLII \ 0 \ s( 0 () \1 Dll and Biomedical Sciences' students Margo McKenna and janice Sung, Class of 2003, and Charmaine Gregory, Class of 2002, are among 40 medical students selected nationwide for entrance into the prestigious Howard Hughes Medical Institute-National Institutes of Health (HHMI- !H) Research Scholars Program for the 2000-2001 academic year. the direct mentorship of a preceptor whom they select from over 1,100 tenured or tenure-track intramural scientists working on more than 2,600 research projects. In addition to working one-on-one with scientists, the students have an opportunity to meet and talk with accomplished investigators at weekly lectures and can attend national scientific meetings, NIH conferences and workshops. The HHMI-NIH Research Scholars Program, also known as the Cloister Program, was established in 1985 to give outstanding students at U.S. medical schools the Salaries and benefits for the research scholars, as well as administrative costs for the program, are provided opportunity to receive research training at the ational Institutes of Health in Bethesda, Maryland. Those cho- mentors, laboratory space and equipment and supplies for laboratory work. sen to participate in the program spend nine months to a year on the l H campus conducting basic research under by the HHM!. The IH, in turn, provides advisors, The UB medical school students have settled into their year of study and report that their experience in the Cloister Program, to date, is everything .. they had expected it to be. Margo McKenna has selected Leslie Ungerleider, PhD, as her preceptor and is ._,• working on a project titled "Emotion and Attention in the Human Brain: a Functional MRI Study," which is being - conducted in the Laboratory of Brain 30 and Cognition, a division of the National Institute of Mental Health. Specifically, she and her fellow researchers are looking at the amygdala, a region of the brain thought to be involved in the regulation of emotion and social behavior. The lab specializes in using functional magnetic resonance imaging (fMRI) to ask basic questions about how the brain works. "In the study, subjects are asked to perform a task while in the scanner, and the images that we collect can show which areas of the brain are most active and important for doing the task," McKenna explains. Research Scholars,leh to rigbt: Janice Sung, Charmaine Gregory and Margo McKenna. With regard to the Cloister Program, itself, McKenna says "it's an amazing 14 lalfalo Pbysiciu IVtttter 200/ �LIKE McKE. '!\'A A:--JD SU.i\G, GREGORY FEFLS 1HE CLOISTER PROGRA~I GIVES STUDL 'TS A.' EXCELLE!\'T OPPORTGNITI TO GAI:--J EXPOSURE TO BE:--JCH RESI:.ARCH I,' A U0.'IQUE E. 'VIRO. '~IE. '1. " P RES£. I"LY, l A~l • 'OT SURE IF :>!Y CAREER WILL L 'CLUDE BASIC SCIE, 'CE SOLELY OR IF IT \\'ILL SO:>lEHO\\' BE I 'TEGRAfED. H O\\EVER, THERE IS i':"O DOUBT L' :\lY :\II, 'D THAT THIS IS A 0. 'CE- I, ' - A-LifETl:\lE EXPERIL 'CE A, 'D 0. 'E THAT WILL !:>!PACT 0.' :>IY FL., TURE DECIS!O, 'S." opportunity for medical students who are thinking about incorporating research into their careers and an ideal setting for independent thought and creativity in the field of medicine." Janice Sung, who is working with Bar"In the study, subjects bara Bierer, MD, in the National Heart are asked to perform a Lung and Blood Institute on a project task while in the scanner, and the images that we collect can show which areas of the brain are most active and important titled "Effect of Gelsolin on Actin Dynamics in T Cell Signaling," concurs with McKenna. "I think the program is a wonderful opportunity to further our interests and understanding of the basic sciences that we were introduced to during the first two years of medical school," she says. "Also, living with 40 students with remarkably diverse backgrounds provides for doing the task." exposure to bench research in a unique environment. "Presently, I am not sure if my career will include basic science solely or if it will somehow be integrated. However, there is no doubt in my mind that this is a once-in-a-lifetime experience and one that will impact on my future decisions." White Family Memorial Fund Recipient B rian Bennett, Class of 2003, participated in the University at Buffalo School of Medicine and Biomedical Sciences' Primary Care Summer Externship (see article on page 22) as the first a unique environment that is fulfilling both intellectually and emotionally." Charmaine Gregory is working with preceptor Marc Reitman MD, PhD, Molecular Biology and Gene Regulation section chief in the Diabetes Branch of the ational Institute of Diabetes and Digestive and Kidney Diseases. The project they are working on, titled "The Role of PPAR alpha in the Hepatic Steatosis and Insulin Resistance of AZIP/FI Mice," utilizes transgenic mice (AZIP/Fl ), engineered in Reitman's lab, which have recipient of the White Family Memorial Fund. The fund-which memorializes Deborah A. White, MD '87, and her husband, Christopher, and son, Adam, who died in a car accident in 1999supports a summer internship for a firstor second-year student who is interested in pursuing a career in rural medicine. Bennett, who is from Bath, ew York, graduated from SU Y at Binghamton in 1998 with a bachelor a paucity of white adipose tissue and develop an insulinresistant diabetes mellitus. The lack offat cells, according of science degree in biology. "I was very pleased to have had to Gregory, leads to a sequestering of lipids in the liver and muscle. "A remarkable steatosis develops and an impressive diabetic state evolves," she explains. "One of my main goals throughout this past summer was to find out if my image of a small-town physician's life was "Peroxisome proliferator-activated receptor (PPAR) al- day-to-day basis. I am pleased to say that my experience reinforced not only how much I want to be a doctor, but also my selection of a small-town setting for practice. "I can't think of a greater distinction to begin my pha is a transcription factor that stimulates fatty acid oxidation and peroxisome proliferation in mice. I am investigating the effect PPAR alpha has on the steatosis, as well as the insulin resistant diabetes in AZIP/Fl mice." To accomplish this goal, metabolic, physiologic, and molecular studies are being conducted. Like McKenna and Sung, Gregory feels the Cloister my externship placed in Medina with Dr. Madejski," he says. representative of what a real doctor actually experiences on a professional career," he adds, "than to receive a scholarship in memory of the White family and connected with small4D town medicine." -S.A. U!-iGER Program gives students an excellent opportunity to gain IViHt e r 2001 l1ffal• Hysicin 15 �- - M - E - - D C - A . L -- -~ -·. --- - SCHOOL Kornel Terplan Memorial Lecture E W S The inaugural Kornel L. Terplan Memorial lecture was held October Sachs Leads Collaborative Project on Mechanical Sensitivity of Cells 5, 2000, in the lippshutz Room at the University at Buffalo School of !:>clcc t.il·, /ape '>u< IH< a '' I ec 1 ' o~, \fl .s Medicine and Biomedical Sciences. The lecturer was Donald L. Price, MD, professor of pathology, neurology and neurosciences at the Johns Hopkins University and president-elect of the Society of Neuroscience. Price, an internationally renowned scientist who has made major discoveries in the field of neurodegenerative disease, delivered a talk titled "Alzheimer's Disease, lessons from a has established an endowment to fund $500,000 ove r fi ve years, University at Buffa lo and th e Massachu - an annual lecture. Terplan's son, Martin setts Institute of Techn ology are th e only U.S, un ive rsities selected by the japanese Ministry for ongoi ng collabora tive projects, Terplan, MD '55, assumed a major role in falo to aHend the lecture, according to The researchers will stud y the physiological p rocess by which th e mechanical defo rmation of a cell is transfo rm ed in to elect ri cal Reid R. Heffner Jr., MD, professor and and chemi cal respo nses, For exam ple, mechani cal transductio n, chair of UB's Department of Pathology. mo re se nsitive than visio n, occurs when the movement of cells in creating the endowment and was in Buf- TERPLAN japa n Science and Tec hn ology M inistry to collabora te on a $10 m illio n resea rch p roject aimed at understanding th e m ec h- generosity of the Terplan family, which The event was made possible by the L. iop hysics researchers at Uni versity at Buffa lo's School o f Medicine and Bio m edical Sciences have been selected by th e ani ca l sensiti vity of cells, Fred eri ck Sac hs, Ph D, p rofesso r of ph ys iology a nd bi oph ysics, wi ll lead th e UB project, esti mated to in volve abo ut Genetic Approach." KoRNEL B Kornel Terplan, MD, was professor the inner ea r ge nera te nerve im pulses that res ult in th e sense of and chair of UB's Department of Pathol- hea rin g, Sachs and his collabo rato rs at UB discovered the firs t ogy from 1933-1960 and served for mechanical transducers in 1983 and, since th en, their labo ratory many years as a pathologist at Child- has bee n a wo rld ce nter for work o n biological mec han ica l ren's Hospital of Buffalo and Buffalo se nsiti vity. "In add iti o n to providin g the se nse of hearing, me- General Hospital. A 1919 medical cha nica l transdu ctio n also is in vo lved in to uch, th e measurem ent graduate of German University in of jo in t positio n, muscle tensio n, bo ne growth, blood -p ress ure Prague, Terplan was internationally regul atio n, fi lling of th e bladd er and intestines, and the regul atio n recognized for his work in childhood of cell , ti ss ue and orga nism volume an d size," Sachs explai ns. tuberculosis and brain pathology associated with chromosome anomalies of children. Through his work on the pathogenesis of "Altho ugh it is an esse nti al se nso ry process, mec hani cal transdu ctio n also ca n produ ce pa th ology. Ca rd iac fib rill atio n- was a frequent occurrence. In 1936, Terplan recruited Ernest th e un coo rdin ated co ntractio n of th e hea rt- ca n be initiated by m echani cal stress, Witebsky, MD, to the Department of Pathology. In the early 1940s and fai lure of th e Witebsky and Niels Klendshoj isolated the B-antigen found in hea rt is th e most human blood, a discovery that made blood transfusions safer. co mmo n ca use of TB, he proved that a reactivation of past cases of the disease "Dr. Terplan guided the Department of Pathology through d eat h wor ld wide. difficult times prior to and during World War II," says Heffner, U nd erstandin g th e "but his leadership was even more important during the 1950s, m ec h a ni s m s when there was considerable change and unprecedented growth mec hanical trans- in medical schools throughout the country. du cti o n w ill e n - "Not only was Dr. Terplan an eminent scholar and one of the lead- of ab le scie nt ists to rat io nal ing figures at the medical school, he was also a man with great energy deve lo p and enthusiasm who was known for his personal wannth," he adds. th erapies fo r di s- Following his retirement as chair of the Department of Pathology ease." (See related in 1960, Terplan continued a productive career for another 25 articl e o n page 3 1.) years, pursuing his lifelong interest in neuropathology. ., A. i. T he wo rk will be ca r ried o ut in collabora ti o n with 16 laflal1 Pbysiciaa IV1111er 200/ I �Kavinoky & Cook, said "Dr. Riwchun felt it was very important to give back to his alma mater and to provide training to young physicians. This desire to atUB. CD repay culminated years later in -LO IS BAKER his decision to donate part of his estate to the university, a Riwchun Endows desire that was ultimately carProfessorship of ried out by his wife's bequest." Ophthalmology Ann Riwchun was equally he University at Buffalo School of committed to the community Medicine and Biomedical Sciences has and Wisbaum praised her as received a $1 million gift to endow a pro- "a strong woman, a dedicated Masahiro Sokabe, chair of the Department of Physiology at agoya Medical School, who is heading the project and who spent a sabbatical year in Sachs' laboratory l fessorship in memory of internationally known ophthalmologist, eye surgeon and UB alumnus Meyer H. Riwchun, MD '27. mother and wife, and active civic leader." She was the first woman to Hospital and at Children's Hospital of Buf- serve as president of the Buffalo Association falo during the 1960s. Riwchun was attend- for the Blind, and was honored by many ing ophthalmologist at the then-Deaconess organizations for her civic leadership. In B 1979, the Riwchuns were Hospital and attending ophthalmologistin-chief at the former Rosa Coplon Home. The gift-a bequest from Riwchun's wife, Ann S. Riwchun, who died in 1999will fund the Meyer H. Riwchun Professorship of Ophthalmology in the " jointly named Buffalo During World War II, he was a lieutenant News Outstanding Citi- colonel assigned as chief of eye services at zens for their work with the blind. John R. Wright, MD, dean of the School of Medicine and Biomedical Sciences, hailed Riwchun as "a leader in the field of eye Walter Reed Hospital in Washington, DC. l C•~MBE Department of Ophthalmology. Ann Riwchun made the bequest to recognize and continue the work that her husband had pursued as a professor in the medical school, in his private practice and as head of eye services for the U.S. Armed Forces during World War II. "Dr. Riwchun was a highly regarded ophthalmologist and UB graduate who enjoyed a long and distinguished career in medicine, while his wife was equally dedicated to civic activities," President William R. Greiner said at the time the bequest was announced. " During their lives, they made a real difference in the quality of life for Western ew York residents and con- R I A I His patients ranged from enlisted men to such high-ranking officers as General of the Army George C. Marshall, as well as Ameri- care, whether he was using innovative surgical can and foreign diplomats, including Soviet techniques or educating medical students and Foreign Minister Andrei Gromyko. Along with maintaining a private practhe public about the issues of good eye care. tice, Riwchun taught at UB as a clinical proThis gift will allow UB to carry on that legacy fessor in surgery and ophthalmology, was ofleading-edge education in ophthalmology." chair of the Department of Ophthalmology Wright also said he expects the Riwchun and wrote numerous scientific papers on Professor to be named by September 2001. Riwchun, who died in 1998 at the age of eye disorders and eye surgery. The Riwchuns' leadership gift goes to95, earned his medical degree from UB in cialists in Austria before returning to Western ew York for a long career in medicine. wards meeting the School of Medicine and Biomedical Sciences' goal in the campaign for UB: Generation to Generation, a $250 million tinue to do so through this generous gift." The Riwchuns' long-time friend and at- He maintained a private practice from 1929- university campaign. Funds raised will be 1985, also serving as head of the departments torney Wayne Wisbaum, a senior partner at of ophthalmology at The Buffalo General used to enrich academic programs, support students and enhance university life. CD 1927, and then trained under European spe- Wint e r 2 001 l alfalt Hysiciu 17 �- - M E - D C A --- - ---- ---- -. ------- E SCHOOL L Distinguished Medical Alumnus Named Do.wld Ptt .L., ,\[/) .~ •• pct.l£... 1( vllCo!ogts. W S UB Hosts International Epidemiology Conference tures can work to improve the effectiveness of ISEE chapters in latin America , the Caribbean, Central America, Africa, and Univer- The 12th annual meeting of the Central and Eastern Europe," sity Medical School and a renowned specialist in pediatric oncology, \II) International Society for Envi- explains Vena. received the University at Buffalo's Distinguished Medical Alumnus ronmental Epidemiology (ISEE), Conference cochairs, in addi· Award from the Medical Alumni Association at a dinner September hosted by D. John Vena, PhD, of tion to Vena, were John Weiner, 28, 2000, in the Buffalo Club. the Department of Social and DrPH, and Germaine Buck, PhD. I' PROHSSOR OF Pill I ITRICS at Texas A&M A Buffalo native, Pinkel received a bachelor's degree from Preventive Medicine, was held For the full program and ab- Canisius College in 1947 and a medical degree from UB in 195 L He August 18-22, 2000, at the stracts, visit the conference web- served his residency at Children's Hospital of Buffalo, and was a Adams Mark Hotel in Buffalo, site at: http://www.phoenixwork research fellow at the Children's Cancer Research Foundation in New York. group.comlisee2000. Boston, now Dana-Farber Cancer Institute. Pinkel returned to Buffalo in 1956 to start the pediatric department at Roswell Park Cancer Institute. In 1961, he was appointed and 92 students from 45 countries attended the meeting, where the founding director of St. jude Children's Research Hospital in some 350 papers and three poster Memphis, the first institution devoted solely to basic and clinical sessions were presented on the pediatric research. theme of "Environmental Epide- ing members of the Class of miology in Pan America and the 200 I, who were recently in- Since leaving St. jude in 1973, he has accomplished a va- Left to right: Dean John R. Wright, Dr. Donald Pinkel and Dr. John Bodkin World: Building Connections." riety of tasks, including rejuve- "The purpose of the meeting scientists and students from CHRI'> TOP H E R ADA\1'. Midwest Children's Cancer around the world to exchange TH O \IA S BLA C K Center in the city; developing ideas for cutting-edge research in )OHS B O RGO \ pediatric leukemia research the field of environmental health," TH O \IA'o B OTT A programs at City of Hope says Vena, who adds that the event MARIS A BRA \ "IS Medical Center in California and was tremendously successful. The primary goals of the con- in Houston; and, as medical director, taking a key role in ference were to showcase ongoing BARB A RA GR EE SB E R(, interdisciplinary, international AAR O S GL YE R rebuilding St. Christopher's epidemiologic research and to KEI IS M O LLE:\ ELYSSA PE T ER'. facilitate more collaboration in KILl-IS S .H E RS O research and training worldwide. Award for Medical Research, the Kettering Prize for Cancer opportunity for the scientists to Research from the General Motors Cancer Research Foundation, highlight emerging global envi· the Zimmerman Prize for Cancer Research, the Biennial Winder- ronmental health issues, ex- mere Lectureship of the British Pediatric Association and the change the latest scientific Return of the Child Award from the Leukemia Society of America. findings and methodological An upcoming issue of Buffalo Physician will feature an in-depth approaches for a wide spectrum of article on Dr. Pinkel's career, including many fond memories he has environmental exposures and re- of his days in medical school at UB, as well as in training at lated health outcomes, and to talk CD Children 's Hospital of Buffalo. about ways in which organizational and administrative struc· - L O I S BAKER t c r 2 0 0 I SA SHA GIL\I ORE provide a forum to discuss how to "The meeting also provided an \\' 1 11 RYAS DFSHAE SE M.D. Anderson Cancer Center Pinkel has received many honors, including the Albert Lasker y sic i a a Alpha Omega was to bring together distinguished sor of pediatrics at the University of Texas Medical School in Houston. n ducted into Alpha this past fall. nating Milwaukee Children 's In addition to his post at Texas A&M, he currently serves as profes- I a If ale Congratulations to the follow- Hospital and establishing the Hospital for Children in its North Philadelphia neighborhood. 18 CD Approximately 400 scientists Alpha Omega Alpha is the only national medical honor society in the world. Its purpose is to recog11ize wtdergraduate medical school achievement and to perpetuate excellence in the medical profession. �A:z:odo Completes Alpha Omega Alpha Fellowship L \ C 2< 2, is the recipient of an Alpha Omega Alpha Student Research Fellowship, which provided him with $3,000 in support of a research project he completed during the fall of 2000 in the laboratory of Wesley Hicks Jr., MD '84, DDS, at Roswell Park In his research project, Azodo focused on understanding why granulomas form in the airway of cancer patients who undergo radiation therapy or have tumors surgically resected. Specifically, he worked to characterize the role of IL-l, an endogenous cytokine, in the response of tracheal respiratory epithelial cells (RECs) to injury. c I "We were trying to see how blocking IL-l or changing its concentrations affects the growth of porcine tracheal RECs, used as a model for human cells," explains Azodo. "IL-l is known to be an endogenous " result of signal transduction from membrane receptors. It also modi- .... fies the activity of several known mitogens and chemokines. In .. First-year student Diana Pratt is this year's recipient of the Univer- Cancer Institute. .. Medical Alumni Association Scholarship pyrogen and has many effects, both directly on the nucleus and as a particular, it plays a major role in the early attraction of neutrophils to the site of inflammation, which accounts for some of its destructive involvement. This investigation is complicated by the presence of two distinct sub-populations-IL-l alpha, and IL-2 beta-each with different proportions, sites of action and mechanisms of regulations." Originally from igeria, Azodo lived in Rochester, New York, for seven years prior to coming to the University at Buffalo in the fall of 1994 to begin work on a bachelor of arts degree in biology, which he completed in the spring of 1998. Currently, he has a strong interest in pursuing a career in radiology and says he would like to complete a residency somewhere in the southeast or mid-Atlantic, if he does not remain in Buffalo. "As an undergraduate, I had several opportunities to engage my talents and interests outside of the classroom, and I worried that my involvement in these activities would end when I began medical school, but I was wrong," says Azodo. "In my second year, I began a Radiology Interest Group (RIG) that has been recognized by the Polity [the medical student governing body]. The group now serves to introduce medical students in the preclinical years to this innovative and integral part of medicine as it is practiced today." In his second year, Azodo also had an opportunity to serve as vice president of the Student ational Medical Association (S MA). As the junior branch of better-known National sity at Buffalo's Medical Alumni Association Scholarship. The scholarship is made possible by the generosity of alumni through their reunion gifts designated to the Medical Alumni Association endowment fund. Recipients are selected by the admissions committee according to considerations of financial need and academic merit based on the in· coming student's applications. Pratt, a native of Buffalo, New York, graduated from UB in 1999 with a bachelor of science degree in biomedical anthropology. At this point in her education, she is .. interested in pursuing a career in c < family medicine, but plans to remain open to other possibilities, including international medicine. I -5. A. U:-.:GER Medical Association, the S MA provides an avenue for minority medical students to explore the unique contributions they can make to medicine, according to Azodo. "Through collaborative efforts with other groups during the 1999- 2000 school year, we introduced several non - .... minority students to the S MA," he says. "We also provided insight into what minorities could offer the medical community at all levels. In part, we accomplished this by discussing the prevalence of major diseases such as lupus and diabetes in the minority community and by sponsoring lectures, including one by Dr. Paresh Dandona that was well attended. "My work with the RIG and the S MA are just two examples of the kind of overall growth I have experienced and come to value during my time in Buffalo," Azodo continues. "On the whole, UB has been a wonderful place for part of my transition into adulthood." -5. A. 4D U~GER IVi11ter 2001 l 11fale Pbysiciu 19 �- - - M -- E D - C - A ----- ----- ------ SCHOOL L ------ E W S Honors Brunch Recognizes first· and Second·Year Achievements !I F A U-\I HO'\ORS BRc ( H recognizingacademicexcellenceamong Kathleen O'Donnell, '02, first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held October 22, 2000. The following is a list of award recipients and a description of the awards received. .. c c I ... .. 0 s: The Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the KATHLEEN o ·oo"<ELL Departmental Awards Kelly Gordon, '02, received The departments of the School of Medicine and Biomedical Sciences have established awards, described below, to recognize merito- the Department of Microbiology's Ernest Witebsky Award for Proficiency in rious performance in courses and outstanding achievement in wrriculum-related activities. Microbiology, which is Pharmacology and Toxicology's Edward A. given to the second-year Carr, Jr. Clinical Pharmacology pathology laboratory. Brian Maim, '02, received the Department of student achieving the Award and the DouglasS. Riggs Award. The former award is of Anatomy and Cell Biology's Gibson- highest grade in the microbiology and immu- Atwell-)ones Award, which recognizes the nology course. Dr. Witebsky was the found - achieving the highest average in student with the highest com- ing chair of the Department of Microbiology. Richard Newell, 'OJ, received the Department L received KELLY GORDO N bined average in the anatomical given to the MD/PhD student the Fundamentals of Pharmacology course, while the latter is sciences courses of gross ana - Christine Kerr, '02, received tomy, histology, neuroanatomy the Department ofMicro- and embryology. The award is presented to the second-year student with the highest average BRIAN MALM biology's Marek Zaleski in the course. Drs. Carr and Riggs were named in honor of past chairs of Award, which is presented chairs of the Department of Pharmacology the department: james A. Gibson, to the student who best Wayne ). Atwell and Oliver P. combines high standards and Toxicology. Maim also received the Department of )ones. ewell also received a McGraw-Hill Book Award, which is given of academic achievement with outstanding service to the two highest-ranking students in the to the community. The second-year class chooses the recipient. RI C HARD NEWELL first-year curriculum. Pathology's john B. Sheffer Award, which is C HRI STil\ E KERR given to the second-year student who has performed at the highest level in the laboratory portion of the courses in general and systemic pathology. Dr. john Sheffer prac- Sara Kaprove, 'OJ, received the Department of Christopher Mutty, '02, ticed pathology in Buffalo for over 35 years Biochemistry's Edward L. Curvish Award, which recognizes the student with received the Department of Pathology's Kornel and was acting chair of the Department of the highest average in the two Terplan Award, presented first-year biochemistry courses. to the student with the Kaprove also McGraw-Hill received a Book Award, in the two second-year pathology courses. Dr. Terplan was a past chair of the department. first -year curriculum. S AR A K A J>ROVE 20 II If Ill H J SiC iII \Vint er 2 001 l highest combined average which is given to the two highest-ranking students in the Pathology from 1972 to 1974. 1 C HRISTOP HER Mt:TTY �the student with the highest combined average in the two physiology courses in the first year. Dr. Rennie was a former vice president for research at UB and chair of the Department of Physiology and Biophysics. Discipline Honorary Societies A:-.; JEll GL:PT A The Association of Pathology Chairs Honor Society awardees were Christopher Mutty, Brian JI LL ALB R EC H T L AL R A C u..:S KJ Anne Wolpiuk , '02, Robyn Filipink, '02, and Maim, Kathleen O'Donnell, Jennifer Defazio, Diane Jill Albrecht '03, and Laura Cinski, '03, received Anjeli Gupta, '02, received the AstraZeneka Den Haese and Linda Cuomo, all the Class of 2002. the Evan Calkins Primary Care Achievement Cardiovascular Drug Monograph Award Award, which is given to one or two given to second-year students by the Depart- outstanding students in the Primary ment of Pharmacology and Toxicology. The Care Summer Externship Program. award is based on the quality of a mono- Calkins is a former chair of the graph written in the form of a package insert. Department of Medicine. 4:D Carlos Cedeno, '03, received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to J•""" •• DEFAzio Dean'sLetters of Commendation, 1999-2000 M ELII'DA K NOX Class of 2003 T ODD ) AN I C KI The Dean 's Letters of Commendation are awarded to students who D A\'ID K RAKOWSKI ) or'EL B ALLARD SARA K APRO\'E achieve 75 percent of available honors points in each year. Two honors points are earned for each credit hour ofhonors performance C H RI STOPHER A DA~IS M ARll'>A B RA\'1:-1 B ARBRA G REE:-.'BERG Class of 2002 VI CTOR A MODEO G ARRICK A PPLEBEE S L'Z IE A RIY ARATANA E LIZABETH B OLRKE ) E,.N I FER K ORZEN B RI Al'> M AL~! ) AMES B onE ) A~IES LI N ATAS H A M A"ES A "THO" Y M ATO CARLOS CEDEl->0 C H RISTOPHER M LTT\' KI T C HENG RI CH ARD K AT H LEEN O ' D oNNELL C H RI ST INA CLAR K ) EFFREY ) El->NIFER D EF AZ I O CARYN O RR D AN IELLE D oRsA:-.Eo T IMOTHY P ARDEE D IANE D E. · H AESE P HILLIP S EEREI TER L ISA E sLER E LIZABETH P ENDER M ELISSA D ESANTI S S ANDES H S ING H E sME F INLAY E RIC SCHAEFER K EELY D WYER- M ATZ KY ) ON \THAN S IUTA D A\'ID F l"TAK D A\ ID S CHLESINGER M ELANIE FI ORELLA ) ULI E V OGEL while one point is earned per credit for high satisfactory. Class of 2001 CHRI STOPHER L OGUE EWELL ORTH K ARA G ROSS M ARC. A UERBACH R OBYN F IUPI:-.' K AIM EE STA" I SLAWSK I A ARON G uYER SHALEE~ B ELA'! CHRISTOPHER F ORESTO A NDREI\' SWAN D A\'ID F LINT B oBBI W Ax K E\'1' M oLLEt< LI LY B ELFI A LICIA G ITTLEMAN A NDREW Sn1oNs A LFRED F RONTERA L YNDSAY WIL LMOTT- E LYSSA P ETERS S\'ETLAl'>A B LITSHTEY~ K ELLY G oRDON E ~11 LY T ENNEY ) ULIE G A\' I N LI SA G ELMAN KI LIAN SALERNO VI TO B RL'NETTI G REGO RY ) ANIS M ATTHEW T RAUGOTT ) ERR\' CHANG K YLE K ATO~A ) ULIANE T HuRLOW D A\'ID G RAY L INDA CuoMo D A\' I D K IM K ARES W EISS H OWARD H AO B ARTOS R oss Y APLE STEVEN W E I TZ~IA:-.' l l Honors Brune 1V i11 t er 200/ l 1 flal• Hp i c i ll 21 �---- M E D C A L --- SCHOOL -·-- -- E W --~- S The Primary Care Summer [xternship Program " Truly taught me what it takes to be a fine physician " 0 s p I \Is, ( Summer Externship Program has offered first- and second-year students a paid six-week experience during the summer months. Through the program, medical Through the Eyes of Students ... The following comments were made by students who participated in the 2000 Primary Care Summer Externship Program. students are placed in the offices of generalist physicians across Western ew York, where they enjoy varying degrees of interaction with patients, including taking histories and performing physicals. The externship experience clearly has a positive im- .lennifer K. Kor:z:en, Class of 2003 P Rl c F PTO RS: pact on student participants. In reviewing results of the program over the last three years, we found that 96 percent of externs "agreed" or "strongly agreed" that their clinical teachers improved their understanding of clinical "I am now only beginning to grasp all that I really learned practice (such as physical exams, medical decision making, treatment options, etc.). We were also pleased with this summer. Whether it was on the pathophysiology of the results of comparing pre- and post-externship surveys. how limiting HMO drug formularies can be, or how Twenty-seven percent of students felt that prior to the externship they had a broad or very broad much some patients really need reassurance from their doctors, I know my time at Geneva B. Scruggs Health exposure to career opportunities in primary care Care Center has been one of the best learning experiences We found that 96 percent of externs "agreed" or "strongly agreed" that their clinical teachers improved their type II diabetes, how to comfort a patient who has HlV, compared to 64 percent, post-externship. Since of my medical school career thus far. I do not think I will the program's inception in I 993, 67 percent of ever really be able to thank Dr. Gbadamosi, Dr. Lewis, or primary-care externs have entered generalist Susan [Ba ran ] enough for being able to watch them and residency programs, compared to 48 percent of the entire University at Buffalo graduating class work alongside them this past summer, for they have truly taught me what it takes to be a fine physician." during those years. We are grateful for the support of the various understanding of program sponsors, including the clinical practice. tion (whose significant three-year grant ended this past summer) and the Robert Wood Johnson Foun- ulpeper Founda- dation (whose Generalist Physician Initiative grant also ment of Health, the Western .leffrey Conklin, Class of 2002 PRECIPT OR: Fra11k C. Mezzadri, MD "One of the nice things about working for a large group ew York State Depart- practice like Quaker Medical Associates (QMA) was the ew York Rural Area Health chance to see different styles of dealing with patients and ended). Other sponsors include the Education Center and the White Family Memorial Fund. In addition to foundation and institutional support, hearing various perspectives on medical topics ranging from the diagnosis and treatment of patients to managed care. I the Primary Care Summer Externship Program welcomes left each day with at least one new insight that will help me a support from individuals; for example, Evan Calkins, MD, great deal once I get into practice. has established a special endowment fund to develop a confirmed my desire to work in the primary care setting and Externing at QMA more consistent funding source for the program. For more to treat both adults and children, and it also gave me a sense information about the program or giving opportunities, that I would really enjoy working in a group practice, assum- contact the Office of Medical Education at (7 16) 829-2802. ing I have the opportunity to choose my career path." -DFBRA STA~tM, 22 Fatai Gbadamosi, MD, Dwight Lewis, MD, a11d Susn11 Barnn, PA, Geneva B. Scruggs Health Care Center laflal1 Hysiciaa \\'t11tcr 200/ DirectorofStudelll Services �Student Preceptor Speciality MAL'REES GROSSI Drs. Colleen Mattimore & Mary Schamann Pediatrics MARK HAG(,ERTY Dr. Edward). Graber Internal Medicine KESSETH HALLI\\"ELL Dr. Sanford Levy lttternal Medicine CHRIS "CARL" RE\SOLDS Dr. Richard Castaldo Internal Medicine Scon HoRs Dr. Richard Castaldo Internal Medicine STE\"ES KA\1 Dr. Donald Robinson Family Medicine pediatrics and my desire to pursue this field, but also taught me a ILSTIS KA:<ALEY Dr. Raphael Wang Pediatrics wealth of information about how to be a good clinician and communicator with both children and their parents." )EsstFER KoRZE:-< Drs. Dwight Lewis Family Medicine .Justin Kanaley, Class of 2003 PRECEPTOR: Raphael Wang, MD, Williamsville Pediatrics "Beyond the one-on-one teaching that I received from Dr. Wang, I was able to become part of a team of health-care providers who made the office run very smoothly. Every nurse, nurse practitioner, secretary and doctor at Williamsville Pediatrics went out of his or her way to make me feel comfortable in the office. When my sixweek externship was finished, I didn't want to leave, for I truly felt that I had become a part of their team. The experience that I gained from this summer program not only emphasized my love of & Fatai Gbadamosi ROSA'" LASA Dr. Theresita Dolojan OB/GYN ALEXASDER LERSER Dr. john Fudyma Internal Medicine he Primary Care Summer Externship Program wishes to MARA Ltsscon Dr.) . Thomas Reagan Family Medicitte extend a sincere thank you to all the preceptors, listed CrsTHIA MARTISEZ -CAPOLI:-<0 Dr. Ellis Gomez Family Medicitte MATTHE\\ McKES. 'A Dr. Gregory Snyder Family Medicine MORCOS MORCOS Dr. Khalid 1ahran lttternal Medicitte/ Nepltrology HEATHER MoRGASTI Dr. Lawrence Me ally Pediatrics MICHELE 0DROBISA Drs. john Brewer, Roberta Gebhard & Kim Griswold Family Medicine THANK You, PRECEPTORS . . . . T below, who continue to make this program a success. Many of these physicians volunteer their time year after yea r to ensure that students experience the true practice of medicine early in their careers. Student Preceptor )ILL ALBRECHT Dr. M. jane Parmington Pediatrics DA:-<IELLE A:-<<.,LI\1 Drs. Russell Vaughan & Lorie Leonard Pediatrics SL SIL BAS SAL Dr. john Thompson Family Medicine LL'CIA PHROSE-Gtuo Dr. Mark Swetz Family Medicine Dr. Thomas) . Madejski Internal Medicine/ Geriatric Medicine )ES'\IFER PAYSE Dr. Arnold A. Abramo Pediatrics Drs. Thomas R. Gerbasi Pediatrics MICHAEL CHILLSGL' Dr. jack P. Freer Internal Medicine L•LRA Ct:-<SKI Dr. Sharon L. Ziegler Family Medicine )EFFREY CosKus Dr. Frank C. Mezzadri Medicine/Pediatrics LtsDA CL'0\10 Dr. Thomas S. Scanlon Internal Medicine Dr. Howard Sperry Internal Medicine AIRANI SATHASATHA'\ Drs. Catherine O'Neilt & Janet Sundquist Intemal Medicine )E:-<SIFER DEFAZIO BETH DmiARACKI Dr. David james Family Medicilte RACHEL SCH\IITT Dr. William Kuehnling Family Medicine DASIELLE DoRSASEO Dr. Peter Kowalski Family Medicine )OS ATHAN Stl'TA Dr. Peter Winkelstein Pediatrics MOLLY E.nos Dr. Rodney Logan Family Medicine STEPHES TL'RKO\KH Dr. Mark R. Klocke Pediatrics GEOR<,E FtuL"EROA Dr. Anthony C. Sorge Internal Medicine/ Pediatrics SHA\\S VAISIO Dr. Frederick Downs Family Medicine MtCH"\EL WHITESIDE Dr. David Milling Intemal Medicine Dwm Ft:-<TAK Dr. Medicine/Pediatrics Intemal Medicitte Dr. G. jay Bishop l111emal Medicitte LYSDSAY \\'tLL\tOTT -BARTOS Dr. Charles Hershey SEAS GARY!. CHRISTISA GRACZYK Dr. Michael) . Aronica Medicine/Pediatrics Tt:<A WL' Dr. Lorne Campbell Family Medicine Speciality A\tY PLZIO icholas Aquino & Shawn Ferguson )A\IISOS RIDGELEY Dr. Anthony 0. Bartholomew Itttemal Medicine ELENA SALKO\"SKY Dr. Ashok OB!GYN ll'i11ter aik 2001 1 1 11 111 Hysic i aa 23 �- - - --- - - - - M E D C A L -- - -- SCHOOL Mini-Medical School Thrives Gift from Davises supports school and new office . -- - E -- - - W S free to high school students enrolled in the Buffalo, Lockport, West Seneca and Williamsville school districts. Students are presented a curriculum focusing on the real-life applications of the sciences, which they in turn share with lOth graders at their school after completing the semester-long program. Retired business executive and community leader In addition, the Mini-Medical School hosts a Donald L. Davis and his wife, Esther, have made a Mini-Veterinary School, now in its third year, which $600,000 gift to the University at Buffalo's MiniMedical School, a highly popular, public-service medicine and pet health care. Also, in the spring of program presented by B , f D offers a five-week slate of courses in veterinary l \\ the School of Medicine R 5 2000, in collaboration with the UB Law School, a K program based upon a series of medical-legal and Biomedical Sciences. vignettes and specifically targeted to the legal profes- Long-time benefactors of sion was launched. Graduates of both the medical and veterinary the university, the Davises have reached the $1 million mark in their support of UB with their most recent gift. "The Mini-Medical School fits our guidelines for Esther and Donald L. Dnis benefiting the community and the university," says Esther Davis. "It has a very good format, builds on the strengths of the university and extends that knowledge to the community." "The university is the greatest thing that has happened to our area," Don Davis adds. "We wanted to do something that would benefit the entire community." In addition to guaranteeing support for the Mini-Medical School for the next I 0 years, the Davises' donation has also helped fund a new public-access office for the Mini-Medical School at 101 Farber Hall, directly across from Butler Auditorium where the school's programs are conducted. During a ribbon-cutting ceremony held on September 26, 2000, for the new office, Harry Sultz, DDS, MPH, director of the Mini-Medical School, welcomed and thanked the Davises, whom he referred to as "among the most generous, public-spirited citizens we have in Western ew York." The Mini-Medical School- which was started by Sultz and his associate Alan Reynard, PhD, in I997 as "a shoestring operation"- programs are eligible for membership in the MiniMedical School Alumni Association-the first of its kind in the nation-which provides additional science-related programs, clinics and tours, as well as discount enrollment for future programs with the school. Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record • Challenging curriculum with 17 advanced placement courses has been a highly successful endeavor by all measures. To date, • Comprehensive community service program over 2,000 participants have attended its programs, making it one • More than 60 sports teams of the most popular and far-reaching community services at the • Average class size of 15 • Financial aid available university. In March 2000, the success of the school was formally recognized by Business First, Western ew York's business journal, when it named Sultz a "Health-Care Hero." On!v one invesrment lase; a liferime In its core program, the Mini-Medical School provides a series of lectures dealing with subjects traditionally covered in medical Coeducational grades 5·12 875-8212 school, but geared to helping the public understand the science 1250 Amherst Street Buffalo. NY 14216 www.nicholsnet.net behind the medicine, according to Sultz, who is also dean emeritus of UB's School of Health Related Professions and professor emeritus in the Department of Social and Preventive Medicine. Building on the success of this format, the Mini-Medical School has expanded its offerings to include the High School Science Enrichment Program, which was begun in the fall of 1999 and is 24 c::J:) II f f If I Pb J SiC iII \Vi11t er 2 001 NICHOLS SCHOOL Acceptance granted to qualified students Without regard to race, color, religion or national origm. �D E V E L 0 P M E N T N E w s Gifts for Generations to Come By Li nda J . Cor de r , Ph0, CFRE 0? 1\l l \L 'Cl ) Campaign for DB-Generation to Generation was exciting. The Dean's Advisory Council and Campaign Steering Committee were on hand for special meetings with Dean Wright, a luncheon hosted by President Greiner and a universitywide reception. Our school is poised to top its original goal ($40 million ) shortly, due in part to grants its outstanding faculty receive from nonprofit organizations and private foundations. Thus, the committee agreed to raise the goal to $50 million. Gifts from individuals are increasing as more people realize the small percentage of the budget that comes from state appropriations (about 12 percent). What a tremendous difference philanthropy m akes to an institution like UB! Best of all, there are ways to give that benefit donors as much as their contributions enrich the school. After the kickoff, I was asked several questions regarding charitable trusts. While continuing to respond personally to requests, this column also provides a way to share some quotations about unitrusts that one of our alumni wrote to some of his friends. He warned me that including it here might signal the end of the long-running bull market. However, with the market's constant ups and downs in recent months, neither of us could be blamed for a change in its direction. He begins: "Eat your cake, have more of it and benefit UB Med," and continues: If you are a UB graduate in your fifties or older, there's an excellent chance that your kids are educated to the hilt, off on their own and doing well. There 's also a possibility that you may have bought stock that has gone up tenfold or more. If this applies, read on ... The Charitable Remainder Unitrust is a nifty invention. You not only get out of the tax you would owe if you sold it in value of the original stock purchase. The older y ou are, the larger the deduction , because you have less time left, less time to do something nice. Here's another feature: The winner that you select probably pays a skimpy dividend-or none. The charitable unitrust will pay you five percent [possibly more]. This may come at a time when you GI FTS FROM I:<DIVIDUALS ARE would like to have more money INCREASING AS MORE PEOPLE because of cutting back on your REALIZE TH E S~I ALL PERCENT income-or the inroads of AGE OF THE BUDGET THAT managed care. COMES FRO~t STATE Is a charitable remainder APPROPRIATIONS (ABOUT 12 trust complicated to set up? Will PERCENT) . WH AT A you have to go to a lawyer (which you hate to do )? Heck no. It's DIFF ERENCE PH ILA NTH ROPY pretty much an off-the-shelf, fillMAKES TO A:< INSTITUTI ON in-the-blanks product. UB will LIK E UB! help. So will I, a retired simple B EST O F ALL , TH ERE ARE WAYS country doctor who started on TO GIVE THAT BENEF IT DONORS the path at the noble building AS M uC H AS T HEIR CONTRI BU on High Street . . . TI ONS ENR IC H He ends with: Tell me about T HE SC H OO L. your big winner, brag about your class and I'll brag about mine . .. " I agreed to pass along letters if anyone wants to write to our "Dr. Feelgood. " This campaign provides opportunities for making gifts that will enhance the academic environment for this generation of students and those in the future. If you would like to find out more about the school's dreams or perhaps see an example of how a unitrust, or other charitable trusts, might benefit you and those you love, give me a call. The cam- [the appreciated stock], but you 'll be rewarded with a de- paign will continue through 2003 . Your benefits could last a lifetime; your legacy to the school would last forever. duction for your upcoming income tax return (s). The Linda]. Corder, associate dean, can be reached toll free at amount of the write-off is a generous portion of the increase 1-877-826-3246, or e-mail her at ljcorder@buffalo.edu. W i nt e r 2 00 1 la fl a l1 Hysiciu 25 �OLYMPIC FENCING COMPETITION ~-ent B v S C 0 T T THOMAS UB intern competes on Olympic fencing team NN MARSH WENT TO THE OLYMPICS last September and almost brought back the most rare of souvenirs. An emergency medicine intern in University at Buffalo's Residency Consortium, Marsh was one of three members of the U.S. fencing team that placed fourth in the 2000 Summer Games' team competition in Sydney, Australia. After their comefrom-behind win over fourth-seeded Hungary in the quarterfinals, the Americans lost an oh-so-close bronze-medal match to Germany, 45-42. It was the U.S. team's first-ever medal-round appearance in Olympic competition. "We would really have liked to have won a medal," says Marsh, who was participating in her third Olympic competition. "But we had a very good result. It was a big step for us to beat Hungary-the biggest win we've fitting exit from a sport she has pursued with a passion since the eighth grade in her native Michigan. Fencing's ever had." For the U.S., this win also represented a giant step toward legitimacy in the sport of fencing, which has long been dominated by Europeans. In fact, Marsh and with muscles," though Marsh dismisses that with a laugh-"more like high-speed checkers," she quips. "You're really trying to fake out your opponent," she says of the sport's mental aspects. "Are they really her teammates-sisters Iris and Felicia Zimmerman of Rochester, New York-left Sydney knowing that their going to be smart enough to try that move, or are they just trying to make you think they'll try it?" performance had won the sport new respect in the Fencers wear wire-mesh protective gear and scoring is kept by electronically registering "touches" that are made with the point of the foil. In individual competition, bouts are to I 5 points. United States. Marsh also placed I 6th in the individual foil competition. (The foil, a light, flexible weapon with a rectangular blade, is one of three weapons used in the sport.) If these Olympic games were Marsh's last-as she says they probably were-then she certainly made a 26 laffalo Pbysiciu Wi11t e r 2001 demands are many: quickness, agility, strength, balance and mental dexterity. The sport has been called "chess Team contests, in turn, are relay affairs in which each of the opposing teams' three fencers goes against one another. It can be grueling both physically and �emotionally, and Marsh says she gets sore during competitions from the tension. A competitor who is known for her always-attacking style, Marsh admits to having no patience with the careful parrying of some fencers. ''I'm pretty aggressive," she states. "I kind of overpower people. But I've been working on my defense a lot more, too." The showing in Sydney was even more impressive because Marsh, who had been rather busy adapting to her new life as an intern, didn't do a great deal of train- I .. • .. ing. She lifted weights, did some running and watched videotapes of potential opponents, but there just wasn't time to do the intensive training she's done in past years. "Maybe my attack isn't quite as strong anymore because I haven't had time to train as I once did, due to medical school and residency," she notes, "but I have more strategies and more of a well-rounded game." Once the competition was finally under way in Sydney, however, Marsh's veteran savvy kicked in, making the quarterfinal match against Hungary a drama worthy of its Olympic billing. "We were ahead throughout the beginning of the match," Marsh explains. "But in the middle they had a couple of good bouts, and they started catching up. I was feeling like the tide was turning and they were gaining on us. But our comeback was really dramatic, too. Iris won to get us back ahead, and I was last, against Hungary's top fencer. She's really strongone of the top 10 women in the world- and Acompetitor who is known for her always·attacking style, Marsh admits to having no patience with the careful parrying of some fencers. "I'm pretty aggressive," she states. "I kind of overpower people. But I've been working on my defense alot more, too." I always have trouble with her. But I just tried to focus and not get too nervous. "I felt a lot of pressure initially. She has some moves that always catch me off guard, so I tried to really keep that in mind when I was starting, and it worked for me. I beat her S-2." Match to the Americans. Adding to the piquancy of the victory was the fact that members of the Chinese and Cuban fencing teams watched from the stands, as did Chelsea Clinton, a friend of the Zimmerman sisters at Stanford University. After the foil was put away, the Olympics held other pleasures for Marsh. H er parents redeemed a slew of frequent-flier miles to be there, and the three of them toured the Great Barrier Reef. Also, the fencing team CONTINUED ON P AGE 29 Winter 200 / lulfal1 Hysiciaa 27 �OLYMPI C F E N C ING COMPETITION E PERSO FOLLOW ING Ann Marsh's Olympic efforts with a keen interest was Philip B. Wels, MD '41, professor emeritus in surgery at University at Buffalo School of Medicine and Biomedical Sciences and chair emeritus of the University at Buffalo Council. He had good reason: An outstanding fencer in his youth, Wels was himself once named to the U.S. Olympic team. But fate intervened. The year was 1936, and the Olympics were to be held in Berlin under the oppressive sway of Adolf Hitler. The United States boycotted the games, and Wels' Olympic team never competed. B 5 C then go to tournaments on Saturday and Sunday," he recalls. "I was pretty serious Y 0 T T THOMAS "I was a very, very unorthodox fencer. I didn ' t stick to the positions they taught me. My style was aggressive. 1 tried to use a more decep- Wels says that the missed opportunity was of course disappointing, but adds that the Olympic experience in the 1930s wasn ' t like it is now, with athletes devoting tive type of attack than forceful. J was a bouncing type of guy, all over the place." years entirely to training for the Games. The main focus then was intercollegiate competition, years and even for a time in medical school. After Philip I . Wels. MD '41. professor emeritus in surrery at the University at luflalo was inducted in the Ul Athletic Hall of Fame in 1965 for his fencin£ prowess. Wels pursued the sport through his undergraduate and Wels says he has plenty of great medical school, he served in the Army in the Pacific memories in that arena. In college at UB, he fenced with all three weap- during World War ll and when he returned to UB to complete his residency, he coached the UB team for a ons- a rarity- and placed fourth in couple of years, but "then just kind of faded out of it," the United States in foil. Wels also notes with pride that the he says. "It's a strenuous sport. 1n intercollegiate competitions, r fought both team and individual bouts, and UB fencing team he founded was more I would lose 10 pounds in two day of fencing." successful than most of the school's Wei 's remarkable accomplishments in this rigorous discipline were not forgotten, however, as in I 965 athletic teams, explaining that one year the wrestlers were 0- 6 and the basketball team was 0- 13, while the fencers went 6- 2. "I used to practice five days a week, he became an original inductee into the UB Athletic Hall of Fame. Former fencer Philip Wels, 'MD 41, a knowing observer 28 about it, and it kept me in great shape. l•flalo Hysician Wi11t e r 2 001 �METTLE, CONTINUED FROM PAGE 27 shared a house in Olympic Village with the U.S. women's judo team, giving the athletes a chance to compare notes on their sports. "That was a good opportunity for us; we really enjoyed talking to them and learning about their sport," Marsh says. "Fencing and judo are both martial arts, so there are some interesting similarities." Back in Buffalo after a nine-week leave of absence, Marsh quickly settled into her medical training, refocusing her energy and talents on emergency medicine. She recalls with enthusiasm an opportunity she had to help treat a 19-year-old man with four bullet wounds. "You definitely see people at their worst in the emergency room," she says. "But you have the ability to have a big impact." Since her return, Marsh has also been sharing the story of her Olympic experience with others. Her fellow residents had followed the competition closely and there's little doubt this group of doctors-in-training knows more about fencing than most. (Earlier in the year, in response to numerous requests, Marsh demonstrated the sport in a lecture hall at Buffalo General Hospital, fencing with a friend from Rochester. "People are always so impressed when they see it," she says.) But there's no fencing club in Buffalo and little free time in the life of a medical resident. So lately, for fun, Marsh has been playing tennis and learning the guitar. She says she'd like to eventually get married and have children. And she's realistic about competing against younger, bettertrained fencers. "What I don't want to be is the older woman who's still trying to compete at this level," she says. While her career as an Olympic athlete may be behind her, Marsh can certainly look forward to taking her gifts of agility, strength, balance and mental dexterity into the arena of emergency medicine, where no doubt they will serve her- and her patients- well. 4D Wint e r 20 01 luff1l1 Pbysiciu 29 �R E E A R C E H W Drug Delays Symptoms of Multiple Sclerosis LAURENCEjACOBS, 30 1111111 Physic i 11 Wi11ter 2001 MD �Medicinal Properties of Venom Examined the scientists found that the 20 Biophysicists at the University gan were more than twice as likely at Buffa lo h ave identified a component of venom from a to have died during follow-up C hilean tarantula that blocks tion. Women in the lowest group .... the action of ion channels re- were more than one and a half 0 percent of men with the poorest lung function when the study be· than men with the best lung func- sponsible for cellul ar mechani- times more likely to have died. th e . .. "This observation suggests cal responses-specificall y, the cell 's ability to feel. that those with lower lung- These channels or pores in the cell 0 function levels may need to pay membran e-called mechanics , sa ys Frederick acti vated ch annels also pl ay a causes them to open and close- Sach s, PhD, UB professor of role in th e successful tran sition have been implicated in func- ph ysiology and biophysics, and of newborns from th e placental tions as diverse as the se nses of senior researcher on the project. oxygen suppl y to using their touch and hearing, muscle con- " For example , cells swell traction and coordination, and during congestive heart failure, blood pressure regulation. This is the first report o f a and this peptide interferes with own lungs." The next re sea rch phase , Sachs says, will in vo lve identi - th at process," Sachs explain s. fying other biological actions of substance (in this case, a small " We al so know from earlier protein ) that specificall y blocks work that stretching the heart can initiate fibrillation. If we stretch -activated chann els. Until now, it has been difficult to associate these channels with can block the stretch-activated channels, we ma y be able to particular function s beca use block fibrillation , a cause of there were no chemical com- death following heart attacks." pound s known specificall y to Addressi ng another area , Sachs notes that tumor inva- the peptide and findin g a drug compan y to turn th e peptide into clinically useful drugs. 4D - L O I S BAKER on their lungs, " says Holger Schiinemann, MD, research assistant professor in the Department of Social and Preventive Medicine, who led the investigation. Schiinemann and colleagues analyzed data from the Buffalo Blood Pressure/Erie "It is important to note that the risk of death was increased for participants with moderately impaired lung function, not just those in the lower quintile." County Air PollutionPulmonary Function Study collected during 1960 and 1961. Lung Function Associated with Longevity The original study enrolled 2,273 women and men between the ages of 15 and 96 from whom How well your lungs function may information on lifestyle factors predict how long you live. This and health status , including pul- finding is the result of a nearly monary function , was collected. 30-year follow-up study conducted In 1990, a follow-up study deter- by University at Buffalo research- mined which participants had ers on the association between died and their cause of death. from the Universit y of Vir- sion of brain tissue produces a deformation of the surrounding norm al cells, causing them ginia, Michigan State University to release growth fa ctors that and NPS Ph a rma ce uticalsappears in the May 2000 issue of may fac ilitate or accelerate tumor growth . Stretch-activated th e ]oumal ofG eneraLPhysiology. channels may be the signal for impaired pulmonary function The newl y identified peptide no rm al cells to release growth and all causes of mortality. collaboration with· scientists ative effects, such as smoking, says. "Stretch - cause stretching the membrane block them . Re sults of the research-a particular attention to avoid neg- tumor s," h e stretch- activated channels be- toxin could have several clinical facto rs. "Th is peptide blocks In the study, published in the applic a tions re late d to ce ll those channels and may aid in September 2000 issue of Chest, The purpose of the current study was to investigate the I C O NT IN U ED ON PA G E 3 2 "foR EXAMPLE . CELLS SWELL DURIKG CO:SGESTIVE HEART FAILURE, A:\'D THIS PEPTIDE INTERFERES WITH THAT PROCESS." SACHS EXPLAL'S. F BR d C ~SE \T 0 . IF \1' "V\'E \LSO K 0\1 F~0\1 EARl ER \\ORK C \.BLOCK fHE STRE.Ct:-\Cfi\ATED C lA. H\f STREfU l G fHE HEARI (A l 'lTl-\TE ElS, \IE \1\1 BE \BLE TO BlOCK FIBRIL:..Ar"O A \1 ]OR OF DE \iH FOl:..0\1" (, Ht-\Rf ATTACKS. \Vint e r 2001 l1flal1 Hysician 31 �assistant professor, and between iron levels and risk of Maurizio Trevisan, MD, death from an y cause. professor and chair, De- .... .. public-health recommendations Preventive Medicine; must be based on reasonabl y solid Brydon Grant, MD, pro- evidence that what is being rec- fessor of medicine and ommended is both safe and effec- physiology, and War- tive," says Christopher Sempos, ren Winkelstein, MD, PhD, associate professor of social formerly of UB, now professor emeritus of and preventive medicine and lead author o n the stud y. the School of Public "Currently available data do Health, University of CONT I NUED FROM PAGE 31 Schiinemann says, noting that "Sound clinical guidance and partment of Social and California-Berkeley. not support radical changes in dietary recommendations for increased risk is found in per- The National Heart, lung and iron intake or screening b y association between pulmonary sons who never smoked, as well Blood Institute and the German ph ysician s to detect hi gh- function as among smokers. "The lung is Research Foundation (DFGJ sup- and mortality for periods that extended past 25 a primary defense organism ported the study. years, the limit of previous against environmental toxins. It - LO IS BAKER studies. Schiinemann could be that impaired pulmo- It is surprising and colleagues also nary function could lead to that this simple wanted to determine decreased tolerance against measurement for how long pulmo- these toxins. Researchers also has not nary function is a sig- gained more nificant predictor of mortality. derlie an increase in oxidative importance as a normal levels o f serum ferritin, " states Sempos . " Nor do th ey support the need for large-scale, randomized trials of dietar y Iron, Heart Disease Link Debunked restriction or phlebotom y as a means of lowering iron stores. " There have been more than have speculated that decreased The que stion of wh ether too two dozen studies conducted in pulmonary function could un- much iron increases the risk of dying from heart di sease has received another " no" an - recent years on the association general health- Results showed that stress from free radicals, and we assessment lung function was in know that oxidative stress plays tool. fact a significant pre- a role in the development of dictor of mortality in many diseases." swer via a populationbased, long-term , fol low-up study con - the whole group for the full 29 Schiinemann says the fact that ducted b y Uni- years of follow-up. "It is impor- a relationship does exist between versity at Buffalo tant to note that the risk of death lung function and risk of death researchers. was increased for participants should motivate physicians to The stud y, ap- with moderately impaired lung screen patients for pulmonary pearing in the function, not just those in the function, even if more research is October 2000 issue needed to determine why. "It is of A nnals of Epi- lowest quintile," Schiinemann CD says. "This suggests that increas- surprising that this simple mea- demiology, found no ed risk isn't confined to a small surement has not gained more a ss ociation fraction of the population with importance as a general health- " high-norm al" iron stores severely impaired lung function." assessment tool," he notes. and risk of death due to car- The reasons lung function may Also participating in the re- predict mortality are not clear, search were Joan Dorn, PhD, between diovascular disease, coronary heart disease or heart attack, or "RESULTS FRO\! THIS STUDY ARE CO "SISTE "T WITH OTHERS I:--; SHOWI;-.;G THAT IRO;:o.; DOES. "OT APPEAR TO PLAY A DIRECT ROLE I;:o.; fHE DEVELOP\!E. T OF CORO. ARY HEART DISEASE . ..\10RE RESEARCH STUDY THIS ISSUE I.' V.O\IF..· A."D \11:--;0RITIFS." 32 l1ffale Physicin \Vi11ter 2001 "EEDS TO BE DO;:o.;E TO �Blood Vessels Reflect Future Health Trevisan notes. "These were non- history of myocardial infarction, invasive, direct measurements of was conducted by Trevisan and vessel structure and function. colleagues in Italy. Forty healthy which showed positive findings, Researchers can see the future Our findings showed thickening subjects between ages six and 30 Sempos notes. Still, the subject years with a parental history of between diseases of the heart and circulatory system, and measures of body iron stores, only a few of in the blood vessels of children in the interior layers of the remains controversial. The current study was based with a parent who has had a pre- carotid artery and a malfunction premature heart attack were mature heart attack, and the of the endothelium, the lining of compared with 40 persons with on data collected from partici- picture is not pretty. the vessel. Both these abnor· no family history of heart disease, malities are indicators of 'pre- matched for age and gender. pants in the second National Health and ' utrition Examina- A study published in the New Trevisan says few stud- England Journal of Medicine tion Survey (NHANES II) between 1976 and 1980, and an (Vol. 343, No. 121 ies have looked at by University at the association analysis of death records through Buffalo research- between family December 31 , 1992. The study ers reports that ul- history of heart sample consisted of 1,604 per- trasound images disease and sons-128 men and 100 black showed structural both and functional ab· vessel struc- women; 658 white men and 718 white women- between the ages of45 and 74. "Results from this study are consistent with others in showing that iron does not appear to play a direct role in the development of to lead to atherosclerosis in children as young as was already reflected in Other researchers on the study included Anne C. Looker, .. results could • have important '" be further explored so we can better under- Trevisan, MD, senior author on clinical disease,' disease that the study and professor and chair doesn't yet have symptoms." in the Department of Social and Preventive Medicine. It has been known for some time that persons with a parental stand the causes and disease path of coronary-heart disease and plan early-intervention strategies," he adds. history of premature coronary A team of physicians from pants with a parent who had a disease are themselves at high the A. Cardarelli Hospital, heart attack before the age of 60 risk. This research set out to Federico II University and S. had vessel layers that were 11 determine if it was possible to Maria di Loreto Hospital in Disease Control and Preven - percent thicker and vessels that see structural and functional Naples, Italy; and M. Gene Bond, tion, and Daniel L. McGee of were 55 percent less reactive changes in the arteries of these director of the Division of Vascu- Loyola University Stritch School than blood vessels in children persons at an early age. lar Ultrasound Research at Wake of Medicine. with no parental history of heart The study, which involved re- Forest University Baptist Medi- attack. "This was not a measure- cruitment of children and young cal Center, were major contribu- ment of clinical disease," adults with and without parental tors to this study. Richard F. Gillum, Cuong V. Vuong and Clifford L. johnson, all of the ational Center for Health Statistics, Centers for -LOIS BAKER Results showed that partici· .. tions and need to "The parent's Ml their kids," says Maurizio ; clinical implica- six years. coronary heart disease," Sempos needs to be done to study this issue in women and minorities." ture and tunction. "These normalities known says, adding that " more research blood- CD LOI'i BAK~R searc 1Vi11ter 2001 laflale Hysiciaa 33 �-- ---- - --- --- --- -Mark vour calendars " Edmond J. Gicewicz In nineteen hundred and fifty-six we tried to learn to heal the sick. In the year of two thousand one let's get together and have some fun. Howard C. Wilinsky Here's what your reunion chairs have to sa The 40th reunion approaches. So much to do. So little time. Join the celebration! Louis J. Antonucci let's toast the new millennium together. After Jared C. Barlow all, it's over one·haH a century since we gradu· Thirty-five years-boy, have there been changes ated. See you in Buffalo. in all our lives. Come share and reminisce with your old classmates. Transit Valley Country Club, April 28, 2001. Allen L. Goldfarb Joel H. Paull Thirty years is a long time. let's definitely make sure we get together this year. We'll be in touch Robert E. Ploss let us all get together for our 50th and remi· with the details. nisce about our good years in medicine. looking forward to renewing old friendships and "re-living" some of our most fonnative years. See you there!-R. Ploss Linda Wild Don't put off-now is the time to decide to aHend our 25th reunion. Come back, renew old friendships and catch up on everything new in Buffalo and at the medical school. II f fIll PI J I i C iII i~ 1 n I cr 2 0 f) 1 �Sta•I•J L. l•llewslll £11011111-' ........,. c- ..... ...... _....a ............... ,.. .......... ....... ,.. ...... 15111 ....... ......,, . ., .... ..t I • rs Cell••• I. attl ere .l•••lfer H••lll•ll Ferrare , .............. . _ _ . . . . . . . . . .1... I •• I ...., Ul'. 1............ . . to a...r'IL- ,_.lllllllll,. lta""\1_....._.,..... 11,..._ S.•ferll H. LeYJ , ••• c......... ' -'-.;..);...._j , . . . , . . . . . . . . . . , . . ............. . . . . , . . ... ... ...., .. ......., c- ............... cllldl ., ................. s.e,.. ..... .... ........ - lrla .1. ll•t•l ...... ,....c..,_ ..... ., ...... .......... A plan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anything you need to keep enjoying life. Call 686-8077. T H E CEKTE R FOR H1SPICE& PAlLIATIVE CARE www.hospicebuffulo.com ltffah Urslclu II �- - -- --- - - - ~-- - --- --- . - -- Dear Fellow Alumni, Fl' \ l \K.S AGO, I \PI'ROACHI D DR. JAc K RICHFk (then- associate dean for alumni affairs ) and asked him about my doing some work in the medical school. Jack and I had been friends for a number of years, but even he was curious as to why I needed "another job. " He knew I was very busy with my practice and my wife and four sons at home. I told jack that after years of being on hospital committees and attending insurance company meetings and other medically related events, I needed a change. By joining the Medical Alumni Association, I felt I could learn a little about what was going on in the school and see if I wanted to do more. Indeed, my tenure with the Medical Alumni Association has been a very fulfilling experience. In today's world, especially in New York, most of the medical establishments are in turmoil. It seems almost everyone is loosing money, suing someone or is being bought and sold. There are constantly new rules, new players and outrageous situations with which to deal. The one constant for all UB graduates is the medical school. The Medical Alumni Association is our fraternity; the school, our house; and all the alumni , our "brothers and sisters." Sure, the school has its problems, but it will always be here and it is one place we are alwa ys welcome. With various opportunities in every department, there are many avenues to develop an ongoing relationship with our school, something we all need to do. Anyone wishing for more information, please call the Medical Alumni Association Office at (716) 829-2778. So, remember to support your school. join the Medical Alumni Association; become a lifetime member. Be healthy and happy. jOHN 31 p~ JS i Ci I I 1\!irrter 2 0 0 0 j . BODKIN II . MD President, Medical Alumni Association �C L A S S 0 T E S 1950s 1960s Robert A. Benninger, MD Franklin Glockner, MD '60, '50. Cape Coral, FL, orthopaedic surgery, "I am acting my age; no more flying or sailing. Assistant Pastor at Calvary Wesleyan Church." Truno, MA, orthopaedic surgery. "I retired as chief of orthopaedics, Albany, VA, 1998." E-mail is: glockner @medicine. net. Alfred E. Falcone, MD '50. Francis J. Klocke, MD '60, Jamesville, NY, plastic surgery, "Love you all! Retired!" E-mail is aefalcone@aol.com. Chicago, IL, internal medicine and cardiology, writes: "I work for Northwestern University Medical School, where I am a professor of medicine and director of the Feinberg Cardiov cular Institute. My wife and I have five children ranging from 30 to 39 years of age." E-mail is: fklocke@northwestern.edu. Eugene J. Zygaj, MD '50, Lancaster, Y, OB/GY "I play softball four mornings a week. Our group consists of90-!00 men over 60. Great exercise and fun." Irving Joffe, MD '55, Boynton Beach, FL, radiology. "I am partially retired, working part time for the Palm Beach Health Department, State of Florida. Also doing volunteer work in several clinics." John H. Paterson, MD '55, East Aurora, NY, OBI GYN. "I retired in 1998, and am working part time for a rural hospital in Bath, NY-lowpressure position. I have a cottage on Keuka Lake." Leonard R. Schaer, MD '55, Alamo, CA. "I am retired." E-mail address is nanapop@hotcoco.infi.net. Pathologist Fierro, an Author's Inspiration experiences as the chief of a Statewide Medical Examiner System, the State factual errors. She is also the inspiration behind the fictional medic Kay Scarpetta, characterized in many of Cromwell's books. Andre D. Lascari, MD '60, Poestemkill, NY, pediatric hematology/ oncology. "I retired in Aprill999." Lance Fogan, MD '65, Edwin R. Lamm, MD '60, Lakeland, FL, general surgery, general practice, nursing home care. "I am vice president for Medical Affairs for Genesis Eldercare; my wife, Rosemary, obtained a PhD and teaches nursing. I have certification as a medical director from the American Medical Directors Association and am a member of the board of directors for the Florida Medical Directors Association; president, Central Florida Physicians Alliance," E-mail is: rslamm 1@aol.com Valenc ia, CA, neurology, writes: "I retired in 1997. I'm teaching UCLA neurology residents two months a year. I fill in occasionally when needed at my former med group offices, take classes, travel. I haven't been bored yet!" E-mail is: lfogan@aol.com. Dean Orman, MD '65, Clarence, NY, internal medicine/ gastroen tero 1ogy, writes: "My wife, Donna, graduated from UB medical school in 1984 and practiced with an HMO for II years. Both daughters graduated from UB medical school and are practicing pediatrics. Whitney married a classmate, Andrew Feinberg, whose father and I were also classmates (Mike Feinberg)!" 1970s James M. Baker, MD '70, Poulsbo, WA, family practice, writes: "I worked in small towns all these years but have been forced financially to join a large group where I work less and make more. My youngest is graduating from college this year. My wife and I are active in church and enjoy the childless phase of life." E-mail is: baker poulsbo@pol.net Carl Ellison, MD '70, Tulsa, OK, Pediatrics, writes: "I retired from the U.S. Public Health Service in 1998 after 21 years. I am working for the Cherokee Nation as a primary care pediatrician." Email is: carlellison @gateway.net. Alan J. Fink, MD '70, Wilmington, DE, neurology, writes: "I am still married to Phyllis after 31 years. Our oldest son, Greg, is in his second year of dental school at the University of Pennsylvania, and our younger son is attending I CoNTINUED or.; PAGE 38 assnotes \\'i11ter 2001 I a fla il H J Si c i I I 37 �~-- -- CLASS COr-.iT I~ UED F RO M P AC E 37 Washington and Lee University. " E-mail is drafink@aol.com. John D. Foley. MD ' 70, El Paso, TX, pediatrics, adolescent medicine, writes: " I retired from the U.S. Army with 22 years of active duty in I 995. I am currently on the fu ll -time faculty at Texas Tech University H ealth Science Center, as an asssociate professor of pediatrics and the director of adolescent medicine." E-mail address is john52l6 @aol.com. - -- ----- - --- -------- I NOTES Jan M. Novak. MD '70. Williamsville, Y, gastroenterology, writes: "My son David is a graduate ofUB Medical School ( 1997 ) and son joshua is a UB Medical Student (2003 }. Our daughter judith is a graduate of UB 's English department and is now a graduate student in Health Care Policy at American University in Washington, DC. " Hug11 A. Sampson. MD ' 75. Larchmont, Y, pediatric allergy and Immunology, writes: " My wife, Anne, and I have three children, ranging Terence Chorba, MD '79 from 13 to I 8 years of age. I am currently a professor of pediatrics and biomedical sciences, the chief of ICEP Leaders~ip Award pediatric allergy and immunology, the Kurt Hirshhorn Chair in pediatrics and the director of General Clin ical Research Center at Mount Sinai School of Medicine." E-mail is: hasampson @aol.com. 1980s Christopher S. Walsh. MD '85. medical director of the Cancer Center of Virginia, in Fredericksburg, VA, has developed studying the association between HIV and other opportunistic illnesses. Terence Chorba, MD national Center for HIV, The Project is based in ' 79, writes: "Over the STD, and TB Prevention. the Infectious Diseases years, I have had an Project Retro-CI is an Ward of the Centre enjoyable career in the epidemiologic, labora· Hospitalier Universitaire U.S. Public Health Ser· tory and clinical de Treichville, the larg- vice with several unique research collaboration est public hospital in assignments. We used between the Ministry of Abidjan, and currently to live in Kazakhstan, Health (MOH) of Cote has a full-time staff of where I started an office d' lvoire, the Institute of 140 persons. My wife, for the U.S. Centers for Tropical Medicine in Lindy, is a nurse practi· Disease Control and Pre- Antwerp, and CDC . It tioner working at the vention (CDC) to address serves as CDC's primary U.S. Embassy. Our three infectious disease issues research center for the children are busy learn- in all five Central Asian study of HIV infection in ing French and are pa- Republics of the former Africa. The work is fo· tient with our efforts to Soviet Union. Currently, cused on preventing HIV keep up their Russian. If we live in Abidjan, Cote in uninfected persons; any classmates come to d' lvoire, where I direct preventing HIV disease in West Africa, I would be Project Retro-CI on persons already infected glad to meet them and assignment from the with HIV; assisting the reminisce about old International Activities MOH in monitoring the times." E-mail address is Branch of CDC's HIV/AIDS epidemic; and chorba457@hotmail.com. the VEEBAAT TM System, which debuted at the American Society for Therapeutic Radiology and Oncology 2000 exposition (ASTRO 2000 } in Boston , MA, on October 22-25, 2000 . VEEBAAT-which is an acronym for Verify Event Entries Before and After Task-is a new electronic decision support system designed to he lp reduce the risk of error in the radiation oncology treatment process. Walsh developed the system because he found that the new sophisticated digital technologies susbstantial ly improved automation, but none maintained the human cross-check process in a manner �that enabled efficient manual recovery to safe mode of operation, or what he calls "Symmetric Recovery TM." For more information on the new system, go to www.veebaat.com, or call VEEBAA T Medical Technologies, Inc., at (540) 785-4488. Michael Rokaw, MD '88, writes: "I'm in private practice nephrology in Shreveport, LA. I' m enjoying the change from academic medicine. While at the University of Pittsburgh, I received a National Kidney Foundation Young Investigator grant, a Paul Teschan DC! research grant and a National Institutes of Health First Award for sodium channel regulation. I authored seven papers and over 20 abstracts. My daughter, Sarah, is four years old (in K4) and enjoys swim class, dance class and gymnastics. My wife, Amy (we celebrated our ninth anniversary in April 2000) and I are loving southern living. Miss my classmates, and think of them often." E-mai 1990s Joseph Accurso, MD '92, writes: "! completed a five-year radiology/ nuclear medicine residency at UB after my three years in the U.S. avy. I spent one year in Antarctica, providing medical care to the U.S. researchers. I have been married for almost five years (no children yet) and am now with the Mayo Health System at the Austin Medical Center in Austin, M . E-mail address is: accurso. joseph@mayo.edu. Cynthia L. Jenson, MD '92, writes from Bangor, ME: ''I'm in my second year of private practice in anesthesiology. We are finally settled after a long first year. Alexandra is five and a half and is in kindergarten, and Erica is two and a half. Mark is staying home and loving it." E-mail address is: cjenson@prodigy.net Henry V. Morelewlcz, MD '38 champion of children with dl-bUity \V in t er 200 1 1 111111 Pbpiciaa �Eugene M. Farber, MD '43, Internationally known dermatologist Arthur .,J. Schaefer, MD '47, pioneer In oculoplastlc surgery 1111111 npiciu \\ ' ~J te r 2 00 I �- Based on FIM " Data drill ttTheywere sergeantsand cheerleaders.'' -Frank Stelarski, stroke rehab patient, Harris Hill H.C.F Why do our patients have better rehab resutts compared to the national average? Maybe it's our staff ''They knew exactly how far to push me.'' says Frank Stelarski. ''But they also encouraged me every little step of the way. When you've been through what I have, that really means a THE lot." To leam more about the nationally recognized McGuire Rehabilitation ~cJNn~l(91'{_ CENTE~ Centers, call 1-888-POSTACUTE or visit www.mcguire-group.com. * *" AUTUMN VIEW • GARDEN GATE • HARRIS HILL \\ ' 1 11 1 c • r 200 I NORTH GATE I I I I I I I Pb J s i c i 1 n 4 ~ �p H A R M A c 0 p 0 E I A UB s !IJSfORY 0~ \IEDIC.INE COILECTIO"< PRF~L·rs I'I!ARMACOPOEI \ Digitally reproduced prints from a pharmacopoeia by Otto Karl Bei·g (I8IS· 1866) were on display last fall in University at Buffalo's Health SCiences Librai)' (HSL), South Campus. The botamcal show "as developed by the HSL and the umversity's i \1edia staff and is the fir;t in a senes of "Art in the Libi·ary" exhibits intended to promote the History of \1edicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Tramoi· of i\1edia prepared the prints from the original art in the Berg volume. pub lished 1n Leipzig 111 1863. Pictured is Picea excel sa. H P OliO\ 0 I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001- Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n03-2001-Winter Table Of Contents A list of subunits of the resource. Warsaw after the War Writing Code Medical School Alumni Development Research Reunion Weekend Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n03 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/7bcd5093b224d6f9bc61a1aa833431f8.pdf 2289a7794b92d4331b9935dddf071114 PDF Text Text �l1ffale ••ysicial ASSOCIATE VICE PRESIDENT FOR UNIVERSITY COMMUNICATIONS D r. Ca ro le Sm ith Petro DIRECTOR OF PERIODICALS S ue Wuetcher Dear Alumni and Friends, EDITOR S tephanie A. Unger ART D I RECTOR/DESIGNER we anxiously await word from Punxatawney Phil and Dunkirk Dave, those furry little rodents who allegedly predict the end of wintry weather. eedless to say, they had differing messages this year (Phil saw his shadow, Dave did not), Alan f. Kegler CONTRIBUTING WRITER Lois Baker so apparently we now have a choice as to whom we believe. Fortunately, for those on the Campaign Committee, the Dean's Advisory Committee and/or the National Advisory PRODUCTION COORDINATOR Cyn thia Todd-Flick Group, it really didn't matter, as an early February "taste of spring" was experienced in Hilton Head, NC, where we held the annual "winter outing" for these dedicated volunteer groups. The meeting was hosted by Linda and AI Rekate, MD '40, and by Roger Farber UN I VERSITY AT BuFFALO. THE STATE UNIVERSITY OF NEW YORK. SCHOOL OF MEDICINE who, although not a UB alum, has strong family ties to this medical school. Twenty-one of AND BIOMEDICAL SCIENCES these committee/group members attended and a good deal of work was accomplished. Dr. j ohn W right, Dean After much discussion and reflection, the Buffalo Medical-Dental EDITORIAL B OARD Consortium voted to discontinue participation in the "Demonstration Project," a six-year resident-reduction program that was beginning to adversely affect the region's postgraduate educational experience. This action averted the need to reduce the resident quota to final-year levels and provided some needed flexibility to expand the pool, just a bit. The physician work force dynamics have changed dramatically since the Demonstration Project began in 1996, at which time a significant excess of specialists (by the end of the century) had been predicted. The Western ew York region Dr. Bertram Partin, Chair Dr. john Bodkin Dr. Martin Brech e r Dr. Haro ld Brody Dr. Linda f. Corder Dr. Alan f. D rinnan Dr. j a m es Ka nski Dr. Eliz abeth Olmsted Dr. Step /1 e11 Spaulding Dr. Bradley T. Trua x Dr. Franklin Zeplowitz (indeed, the entire country) is now experiencing significant shortages of anesthesiologists, radiologists, and medical oncologists, to name just a few of the specialty areas in short supply. We will continue our commitment to train physicians in the primary care disciplines but this action will allow us to more accurately respond to the real world's needs. A major financial benefit to our ailing hospital systems was yet another reason for with drawing from the project. On February 14, the Hauptman Woodward Institute (HW!) and the university announced an agreement to create a new Structural Biology Department within the School of Medicine and Biomedical Sciences, to be housed within HWI on High Street (see article on page 10). This formalizes the extensive collaboration that has evolved with HWI and Roswell Park (RPC!), and will facilitate even greater collaboration in the future. Indeed, our closer relationships with HWI and RPCI have enabled us to apply for significant new grant funding that would have been well beyond our reach had these collaborative interactions not been in place. This development also marks an important TEACHING HOSP ITALS Erie Co unty Medical Cen ter Roswell Park Cancer Institu te Ve terans Affairs W estern New Yo rk H ealth care System KALEIDA H EALTH: The Buffalo General H osp ita l The Cl1ildren 's Hospital of Buffa lo Millard Fillmore Gates Hosp ital Millard Fillm ore Suburban H ospital CATHOLIC H EALT H SYSTEM: M ercy H ealt /1 System Sisters of Charity Hospital N iagara Falls M em orial Med ical Ce nter @ UNIYEISITY IT 18fllll. THE SUTE UNIVEISIJT IF NEW YOlK step to developing the Buffalo-Niagara-High Street Medical campus, an idea that holds great promise for this community. The return of at least a portion of the medical school to High Street should engender a bit of nostalgia for some of our more "chronologicallyadvantaged" alumni. Although the planning process has generated predictable pockets of opposition and controversy, strong community support and visions of opportunity abound-not an unfamiliar path to progress here on the Niagara Frontier. ---7 ~MD Dean, Schoo l of Medicine and Biomedical Sciences Letters to the Editor Buffalo Physicim1 is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.edu. The staff reserves the right to edit all submissions for length and clarity. % University at auffalo k The State Ut~iversity ofNew Yor �VOLUME 35, NUMBER @ Features 4 Medicine Goes Molecular New fields of proteomics and bioinformatics are spurring multidisciplinary research collaborations in Buffalo BY S . A. UNGER, ELLEN GOLDBAUM AND LOIS BAKER PHOTOGRAPHY BY FRANK MILLER 12 McKinley's Assassination Surgeon and historian Jack Fisher, MD '62, revisits the the medical controversy one hundred years later The Temple of Musicat the 1901 Pan-American Exposition. here pictured at night. was the site of the assassination of President William McKinley inBuffalo, New York. DEPICTS A THREE-DIMENSIONAL STRUCTURE OF MEMBERS OF THE SHORT-CHAIN OEHYDROCENASEIREDUCTASE FAMILY, DETERMINED AT THE HAUPTMAN-WOODWARD MEDICAL RESEARCH INSTITUTE. WORK ON THE STRUCTURE RELATES TO BREAST CANCER AND THE SEARCH FOR MORE EFFECTIVE DRUGS TO TREAT THE DISEASE. 18 John Naughton, honored by AMS of ew York for distinguished service 22 jacobs study named Top 10 for 2000 by Harvard Health Letter 18 Paola Muti Emeritus Faculty Group formed 27 Robert Blake Reeves and james E. Allen remembered named first chair in family medicine at Tuft's University 23 jerome Kassirer honored by American jewish Congress studies breast cancer and the role of hormones and insulin 32 Cocaine use and heart attacks 33 Marjuana use and male infertility 34 Message from the director"Every Gift Vital to School's Future" 35 james Platt White Society 37 Edmund Hayes Society 40 ews from your UB classmates and other alumni 44 Eugene Morhous and George Alex Poda remembered �- Internal Medicine's Man T hank you for the wonderful article on James Nolan, MD, in the autumn 2000 issue of Buffalo Physician. He was an outstanding role model in internal medicine, and I am one of the legions of medical students who followed his lead into academic medicine. It has been a source of pride to watch his leadership of the American College of Physicians and his support of training of more generalists. Finally, during the time I was a minority student in Buffalo in the early 1980s, Dr. Nolan helped to shape a demanding yet inclusive and supportive environment m which excellence was expected. To me, this will be his greatest legacy. 0 - W hile scanning through the newly arrived autumn 2000 issue of Buffalo Physician, I discovered a wonderful group photo on page seven. In it are pictured the Internal Medicine House Staff, 1967, of the Buffalo General Hospital. I think the photo is wonderful because it shows Helmut G. Schrott, MD '66, my husband, in the first row, far right. However, he is identified as "Harold Schrott," an understandable mistake because everyone called him "Hal," but incorrect nevertheless. If you look in your database, I think you will find that he has long been a professor of internal medicine at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Sincerely, DavidS. Kountz, MD '85, FACP .+-J Mara J. Schrott Associate Dean for Postgraduate Education Associate Professor of Medicine Chief, Division of Primary Care UMDN]-Robert Wood Johnson Medical School I just wanted to let you know how wonderful your article on Dr. Nolan was. It was quite a tribute to a man who had an exemplary career. I remember Dr. olan as being an exceptional teacher and legendary clinician. Your superb article certainly brought that out. Congratulations on writing a real "gem." Stephen Lazoritz, MD '76 Vice President, Medical Affairs, Children's Hospital of Omaha I always enjoy reading Buffalo Physician and thought your article about Jim Nolan was very good, but I think you could have done better at identifying the people in the '67 photograph [of the internal medicine house staff]. The two women in the picture are myself-Carol Segal (not Siegel), the third from the left, front rowand Marie (Tony) Verso; I do not see Daphne [Hare] at all. Behind Tony on the end of the second row is Ron Rohe, who became chief resident after Bill [Fleming]. Kenneth Newmark is third from the left in that row. Bob Moskowitz is third &om the right, front row. Joel Schnure is the correct spelling for the resident between Dr. Calkins and Bob. Lou Wertalik is in the back row. Sincerely, Carol Segal, MD 2 luffalo Physician Spring 2001 ~--- �tion (successfully) at the Buffalo General Hospital. As far as I know, the mentoring program was accepted and carried on then for some time in the '50s. From the Buffalo Physician article, I gather that it fell on hard times and then was renewed and now apparently funding is being withdrawn from some other sources. I n regard to the unknown individuals in the photograph [of the internal medicine house staff] on page 7 in the autumn 2000 issue of Buffalo Physician, I believe I can identify the following: 1. SAMUEL ARMSTRONG 2. ORMA BERKOWITZ 3. ARTHUR COHEN 4. DAVID DANTZKER 5. DouGLAS GERSTEIN 6. LIBERATO !ANNO E 7. Ro ALD JosEPHSON 8. JOHN MENCH! I 9. DONALD MILLER 10. DouGLAS RosiNG 11. BRIA 12. JAMES STROSBERG 13. CALVIN TREGER 14. LOUIS W ERTALIK SHEEDY Sincerely yours, Douglas Gerstein, MD San Rafael, CA Primary Care Summer Externship Program I read with interest the article by Debra Stamm in the winter 2001 issue concerning the Primary Care Summer Externship Program ... and I thought you might be interested in the following story of my involvement in primary care training for Buffalo physicians. In the spring of 1950, I approached Dean Stockton Kimball to request that I be allowed to spend time in my junior/ Internal Medicine House Staff, 1967 senior year with a general practitioner, literally living with him or her and observing the practice of medicine and patient care at the level of a capable general practitioner. If I could spend my summer this way, I promised to report to Dean Kimball on my experiences and then, if approved by the faculty, the program could be offered to subsequent classes as an elective. Dean Kimball agreed and with the help of other faculty found a doctor in East Aurora, Dr. Donald E. Donovan, who was willing to be my summer mentor. I spent a fascinating month with Dr. Donovan, living at his home and answering all calls, seeing patients in his office and studying up on the subjects his patients called to my attention. During that time, I helped diagnose a coarctation of the aorta of one patient and helped to arrange for Dr. John Payne to correct that congenital condi- It is interesting how the direct care of patients has suffered in these modern times. The economics of medical care have been the most important factor, as well as the variable "prestige" of specialties. I guess "follow the money" is the American way of life, but there will always be a few romantic and selfless people who want to deal directly with patients' problems and ills. Thanks be for this. Sincerely, Robert E. Ploss, MD '51 Letters to the Editor are welcome and can be sent via e-mail to bp-notes@buffalo.edu; or by post to Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY, 14260. Letters may be edited for length and clarity. Spring 200/ lu flllo Physicin 3 �A<; r YtAR ABOl T Tills TI~ the biomedical community was abuzz with news that the much-vaunted Human Genome By S.A. Unger nd Ellen Goldbaum Project was coming to a climax as rival international groups, both private and government-sponsored, raced toward the finish line in what is arguably one of the most important accomplishments of the 20th century. But what does it mean now that we have sequenced the full complement of DNA in the human genome, and how can these data help scientists develop advanced medical treatments? Much like when a sculptor unveils his prize work of art only to be met with a quizzical, "What is it?" scientists today are now busy explaining to a highly expectant public why the Human Genome Project is indeed a masterpiece. In essence, what they are telling us is that although the Human Genome Project was a Photos By Frank Miller .t luffalo Phys ici aa "race," it was more specifically, a relay race-and only the first leg of it has been run. Spring 2001 �PROTEOMICS A N D The baton-the decoded human genome-is today being . • D .c " handed off to a new set of sprinters who will take it a second lap, bringing scientists just one step closer to what most nonscientists consider the "real" finish line: the translation of basic science into clinical science, where it has practical applications for patients. This second lap in the relay race is today being referred to as the "post-genomic era" because scientists running it are no longer focused on mapping and sequencing genes; instead they have turned their attention to the substances genes produce: proteins. E . . ..• xperts now estimate that we humans have some 30,000 genes that are responsible for churning out thousands of different proteins. The challenge is that, in most cases, the functiOn of these genes and their proteins is a mystery. Toward the goal of unlocking the secrets of proteins, a new scientific field called proteomics has sprung into being, the aim of which is to discover the structure and interactions of all proteins in a given cell. By studying the proteomic landscape of healthy and diseased cells, researchers may better understand the complex ways in which cells communicate at a molecular level, which in turn can lead to a better understanding of our body's metabolic pathways. Once these mysteries are deduced, pharmaceutical companies can collaborate with basic scientists to develop more sophisticated diagnostic devices, as well as new drug targets. In this new world of pharmacogenetics and pharmacodynamics, scientists will attempt to identify which misguided protein needs targeting and design BIOINFORMATICS drugs that bind to it in order to turn it on or off-a form of treatment that, because of its specificity, is predicted to produce few, if any, side effects. Although scientists do not know the details surrounding how proteins function, what they do understand is that a protein's function is often tied to a protein's shape; in other words, the way in which a protein interacts with other molecules is in many cases determined by its three-dimensional architecture. In this post-genomic era, therefore, much attention and tremendous resources are being marshaled toward the goal of modeling the three-dimensional structure of as many proteins as possible. More specifically, scientists who have expertise in structural biology are seeking to devise ways to better understand, and even predict, how a gene's D A directs amino acids to fold in order to create a protein's three-dimensional shape. (Based on current knowledge, scientists estimate that there are several thousand different classes of protein folds.) The quest to sequence proteins and model their shape promises to be as thrilling a race as was the one run to decode the human genome. Over the past few decades, scientists have devised a number of laboriously painstaking techniques to determine the shape of a protein. One of these techniques is crystallography, which involves bombarding single crystals of protein molecules with X-ray beams. The beams are diffracted by the atoms of the protein molecule thereby generating the diffraction pattern. This pattern is then analyzed by computer to define the protein's molecular Spring 2001 lulfale Physician 5 �-~ PROTEOMICS AND structure. A second technique involves nuclear magnetic resonance (NMR) spectroscopy, which uses powerful magnets to determine the chemical shifts of nearly all atoms of the protein. Knowledge of these shifts enables scientists to measure distances between protons, from which protein structure can be calculated. ·ke the Human Genome Project, the success of proteomics ill depend heavily on the ability of scientists to automate [ nd greatly accelerate these and other protein-modeling techniques-as well as protein-sequencing techniquesin order to process phenomenal amounts of information embedded within all the proteins in a given species, or its proteome. Integral to this automation effort will be the tandem development of new generations of supercomputers and robotics systems. Underpinning this entire post-genomic quest is the burgeoning new field of bioinformatics, where computer scientists and biologists work side by side toward the goal of harvesting information produced by the genome and proteome projects in order to provide medical researchers with the knowledge they will need to move forward with discoveries. Center of Excellence in Bioinformatics It was with an understandable sense of pride and accomplishment, therefore, that the University at Buffalo learned in January 200 l that New York State Governor George Pataki, in his "State of the State" address, proposed that Buffalo be designated as the site for a worldclass Center of Excellence in Bioinformatics. 6 lu llale Ph ysician S pring 2 00/ -- - - - - - - -- BIOINFORMATICS In what Bruce Holm, PhD, senior associate dean in UB's School of Medicine and Biomedical Sciences, describes as "one of the biggest announcements made at this university in at least a decade," the governor detailed plans for the center, which he said would be one of three established across the state as part of an ambitious $1 billion high-technology and biotechnology plan aimed at positioning ew York State as a worldwide leader in university-based research, job creation and job development. The other two centers- one of which would be located in Albany for nanoelec- I ... Scientists who HAVE EXPERTISE I • STRUCTURAL BIOLOGY ARE SEEKI:-;'G tronics, and the other TO DEVISE WAYS TO BETTER U . DERSTAND, in Rochester for photonics and optoelec- AND EVE •• PREDICT, HOW A GENE's tronics-would, along DNA DIRECTS AMINO ACIDS TO FOLD IN with the Center of Bioinformatics, serve ORDER TO CREATE A PROTEIN's THREEto link university reDIMENSIONAL SHAPE. searchers directly with private industry as part of what Pataki referred to as "the largest high-tech economic development initiative in our state's history." Making Buffalo a dedicated research site for bioinformatics is a natural progression of the pioneering work that the proposed center's three partner institutions-University at Buffalo, Roswell Park Cancer Institute (RPCI) and Hauptman-Woodward Medical Research Institute (HWI)-have been doing for years. Holm, �PROTEOMICS . . c AND who points out that the majority of the DNA used in the Human Genome Project came from volunteers in Western ew York, courtesy of Roswell Park Cancer Institute's proficiency in creating D A libraries, says Buffalo is uniquely positioned to make a Center of Excellence in Bioinformatics possible because the scientific areas in which it excels will be critical ingredients in the bioinformatics revolution. These ingredients, as outlined by Holm and others who will be involved in the center, include the following: ·Supercomputing. UB's Center for Computational Research (CCR), which is one of the world's leading academic high-performance computing sites, has the large-scale computing and visualization capabilities and the staff expertise necessary for tackling the massive computational problems presented by the data in the human genome. CCR already serves as the computational backbone for research under a $25 million National Institutes of Health (NIH) grant in structural genomics awarded to a consortium of nine institutions, including UB and HWJ (see article on page 9). "CCR provides the computing power that is essential for any successful bioinformatics initiative," says Holm. "Without it, we wouldn't even be in the game." "Proteomics and structural biology require massive supercomputing capabilities," says Jaylan Turkkan, PhD, UB vice president for research. "There are tens of thousands of different ways that proteins can fold, so only with high-end computing are scientists going to be able to model and predict what those folds are going to look like." 8IOINFORMATICS ·Structural Biology, Genomics and Proteomics. Over the past five years, more than $17 million in key scientific awards has been received by UB's School of Medicine and Biomedical Sciences, RPCJ and HWJ to study genomics, proteomics, structural biology and neuroimaging as they pertain to disease modeling and drug discovery. ·Generation of DNA Microarrays. The DNA microarray facility, jointly operated by UB and RPCI, allows scientists to detect thousands of genes simultaneously and analyze their expression. By creating custom gene "chips," each of which can contain thousands of genes, the facility is a boon to researchers investigating which of the 30,000 human genes are active in a given cell or tissue. ·Pharmaceutical Science. Pioneering work in UB's School of Pharmacy and Pharmaceutical Sciences led to the development of the field of pharmacodynamics, and continued work by the same researchers has resulted in new techniques to find markers of pharmacological effect that can be used to optimize new drugs and therapies. A t the same time, HWI and UB are home to the developers of SnB, the molecular structure-determination software based on the algorithm developed by Nobel laureate Herbert Hauptman, PhD, UB Distinguished Professor and president ofHWI, and the Shake-and-Bake algorithm developed by George DeTitta, PhD, professor and chair of the Department of Structural Biology in UB's School of Medicine and Biomedical Sciences and HWI executive director; Charles Weeks, PhD, senior research scientist at HWI; and Russ Spring 200/ l a lla l o Ph ysici an 7 �~--- ~---- PROTEOMICS I . . AND Miller, PhD, director of CCR and professor of computer science and engineering. SnB is the structure-determination software of choice in more than 500 laboratories across the United States. s za on Also at UB is the New York State Center for Engineering Design and Industrial Innovation ( YSCEDII), which has the virtual-reality capabilities to allow scientists to visualize and interact with three-dimensional molecular structures in large, immersive environments. The current arrangement at YSCEDII allows scientists to interact with biological data through visual data-mining techniques. Planned expansion to a fully developed, six-wall (walls, floor and ceiling) "cave"-a capability now available at only one other institution in the nation-will amplify the amount of information that can be displayed by a factor of six at the very least. This new environment will make it possible to 'walk through' a compound, evaluate the fit of a series of drug leads to a particular target protein and suggest changes to drug candidates to maximize their potential efficacy. eR Co ec on We have the right collection of institutions, individuals and facilities to make this [center] happen," says CCR's Miller. "In fact, many of us have been working collaboratively for years." And while it is very early, the business community is already starting to respond. A major firm with strong ties to the area and an interest in bioinformatics has stated that it is considering an additional significant investment in resources in Buffalo, now that a Center of Excellence in Bioinformatics has been proposed. 8 luffa le Physici11 Spring 2001 ·· - - - BIOINFORMATICS olm adds that because Buffalo is a very low-overhead place to locate a business, he expects to see more firms become interested in the area as the center gets going . "Heads are turned by this kind of investment," he says. That's also likely to be the response from federal funding agencies, according to Turkkan. "The federal government wants to see that a state supports a university's activities," she says. "When we can show them that we already have a coherent plan for this center, that we have space identified and major support from Albany, all of these things will make us that much more competitive, especially because they demonstrate to the IH that recruitment of top faculty will be much easier," she adds. In addition, Turkkan notes, the participating institutions have long histories of collaboration that include formal memoranda and faculty with joint appointments, and she emphasizes that it is the nature of those institutions themselves and the capabilities they posses that also make it possible to exploit bioinformatics in its broadest sense. All over the university, and in labs throughout the world, therefore, bioinformatics is driving such collaborations. Buffalo already is making and exploiting those connections, but it is Pataki's announcement that will put the area on the map. "It's time to recognize that Buffalo has some unique strengths," says Holm. "The money for the new Center of Excellence in Bioinformatics will allow us to take those strengths and turn them into an economic engine for this area." - -- �P ROTE OMI CS A N D BI O I NFO RMATI CS ctures -Woodward resonance ( MR) spectros- Medical Research Institute copy to determine protein (HWI) and University at structures.Knowingthemo- Buffalo have received grants lecular structure of proteins totaling $3.13 million to develop new, highB speed methods to determine is essential for designing new drugs to treat, prevent L o the molecular structure of proteins. The funding is part of a y B A $25 million center grant awarded to the Northeast Structural Genomics ( ESG) I K z: 0 .... . and cure diseases. George DeTitta, S E .... .. .... R ~ professor and chair of the Department of Structural Biology in UB's School Consortium composed of researchers of Medicine and Biomedical from UB, HWI, Cornell University, Sciences and HWI executive . ...• • ...•.. Columbia University, Yale University, director and CEO, and Jo- University of Toronto, Ontario Cancer seph Luft, HWI senior re- Institute, Pacific Northwest National Laboratories and Rutgers University, search scientist, will receive $1.75 million over the next home to the principal investigator on five years for their work in crystal- will receive $1.38 million for research the project, Gaetano T. Montelione. growth methods and techniques. The institute will use a newly developed, using NMR spectroscopy to establish The consortium was established in E protein structures. Approximately $1 response to the National Institutes of high-throughput robotics laboratory million was awarded through the Health's (NIH) Protein Structure Ini- center grant for the UB work, with the ational that will allow researchers to obtain crystals for X-ray structural analysis for additional $385,000 contributed by Institute of General Medical Sciences a large number of different proteins in a the National Science Foundation. (NIGMS). The initiative aims to capital- short time. The new laboratory was es- "The center grant supports the pur- tiative, funded through the IH ize on discoveries generated by the tablished with funds from the John R. chase of a cryogenic NMR probe, which Human Genome Project. Oishei Foundation, making Hauptman- The ESG Consortium is one of seven pilot research centers in structural Woodward scientists among the first to use this method of crystal production. will increase the sensitivity of our spectrometer by a factor of three or more, thus reducing measurement time of molecular genomics, a new field dedicated to "It is projects like these that exem- determining gene function by defining plify how critical initial support can be," the protein structure encoded in a gene's DNA sequence. The goal of the NIH initiative is to target proteins from various model organisms, including the fruit fly, yeast, roundworm and certain human proteins. The consortium will use both X-ray crystallography and nuclear magnetic DeTitta says. "The funding from the Oishei Foundation provided the infrastructure for the lab and also gave us another great opportunity to work with talented colleagues, including Tom Szyperski at the University at Buffalo." Thomas Szyperski, PhD, UB associate professor of chemistry, and his team structures about tenfold," Szyperski says. "This will enable us to solve protein structures by MR in an unprecedented rapid fashion. Such investments ensure that our research group, and thus UB's highfield NMR center, will successfully participate in the leading-edge endeavor of structural genomics, which will contribute to lay the foundations of this century's biomedical research," he says. Spri11g 200 1 4D Buffalo Physician 9 �PROTEOMI C S AND 8IOINFORMATICS New Structural Biolo Department Crea ed Univers i ty at Buffalo and Hauptman-Woodward Institute to Collaborate University at Buffalo and HauptmanWoodward Medical Research Institute (HWI) have agreed to establish a UB De- tutions for groundB breaking research in I. 0 structural biology and enables UB's students to have a unique educational opportunity to study both at the research institute and university," said Greiner when the agreement was signed. "It's a win-win situation, not only for UB and HauptmanWoodward, but also for Western New York because the region is now positioned to become a leader in this exciting field," he added. "We're looking forward to a long and fruitful collaboration partment of Structural Biology at HWI, initiating a 10-year collaboration that positions Buffalo to play a lead role in this critical field. Under the agreement, which was formally signed by Christopher T. Greene, chair of the HWI board of directors, and William R. Greiner, president of UB, on February 14, 2001, HWI will remain an independent entity and will continue to conduct with the Hauptmanits own research outside of Woodward Medical projects undertaken by UB de- Research Institute." "It is extremely repartmental faculty members. The new department will be a warding to have been a unit of the UB School of Medi- part of this developing cine and Biomedical Sciences, collaboration," said and Herbert A. Hauptman, PhD, Greene. "This new HWI president and 1985 Nobel department will not laureate in chemistry, joins the only allow Hauptmandepartment as a distinguished Woodward to conprofessor. George T. DeTitta, tinue its rapid growth, PhD, HWI executive director but also adds a new and chief operating officer, is teaching element to the department chair and professor. Main and High Street In addition, 15 other HWI re- medical corridor. It's searchers assume faculty posi- positive for us, the university, the medical tions in the department. " This agreement brings corridor and all of together two outstanding insti- Western ew York." 10 l aff a lo Ph ysician S prin g 2001 In his comments, Hauptman noted that "with l ~ Hauptman- Woodward involved with some of the world's leading scientists in crystallography and structural biology, this new department will provide a unique opportunity for students to learn and train in two different research environments-both an independent research institute and a university setting. "It will allow our scientists to mentor graduate students and v teach them our methods, spurring a greater interest in our work and facilitating the development of new relationships. "It also will encourage the breaking down of walls, which all too often isolate individuals and groups from one another, thus making the diffusion of ideas more difficult. These ideas are needed to stimulate creativity in the individual scientist. Without the combined strengths of the university and Hauptman- Woodward, this Left to right: Christopher Greene, chair of the board at Hauptman· Woodward Medical Research Institute (HWI), George T. DeTitta, professor and chair of the Department of Structural Biology at the University at Buffalo and executive director and chief operating officer of HWI, and Herbert Hauptman, PhD, UB Distinguished Professor and president of HWI. �PROTEOMICS AND 8IOINFORMATICS experience would not be pos- expertise in its midst. "This ini- capabilities, as well as its exper- South Campus to complement sible," Hauptman added. John R. Wright, MD, dean of tiative is also a key element of the larger bioinformatics initia- tise in biology, biochemistry and biophysics. HWJ's facilities. The agreement calls for UB to the School of Medicine and Bio- tive that will help to drive the UB and HWI are already staff the new department imme- medical Sciences, said the new future of the Western New York working closely as members of diately with a minimum of four Department of Structural Biol- economy," he stressed. the recently formed ortheast full-time-equivalent faculty ogy "will strengthen professional interactions that already exist The field of structural biology dates to the 1930s, when scien- Structural Genomics (NESG) Consortium, a collaboration positions. Two of those positions will be filled by six current and greatly expand the opportu- tists discovered it was possible to that has resulted in a total of HWI research scientists and by nities for future collaboration. crystallize proteins and view $3.1 million in grants to scien- them in three dimensions. tists at the two institutions for hired to work exclusively in the obel genomics research. With fund- department. UB and HWI cur- prize for an innovative mathe- ing from the John R. Oishei rently are recruiting those faculty members. The faculty members "In many respects, the science at Hauptman-Woodward Hauptman received a and at the medical school is complementary and this two new faculty members to be is therefore a parti- The department wiLL BE cENTERED AT HAuPTMAN- cularly fortunate align- compensated by HWI, ment for the Western New York community," in addition to DeTitta WooDWARD INSTITuTE [HWI], WITH UB OUTFITTING he further commented. DeTitta noted that are Robert H. Blessing, ADDITIONAL LABORATORY SPACE IN ITS BIOMEDICAL "this is an exciting time for biomedical research in Western and Hauptman, PhD, professor; Vivian Cody, PhD, professor; RESEARCH BurLDING o"N" THE SouTH CAMPus TO ew York. William L. Duax, PhD, professor; and Walter COMPLEMENT HWJ's FACILITIES . Biological scientists at A. Pangborn, PhD, associate professor. UB, Roswell, Kaleida, D'Y ouville and Canisius have Eleven additional HWI sci- matical technique called "direct methods," which has enabled Foundation, HWI recently established a new robotics labora- work-with structural scientists at HWI. Today, we cement a scientists around the world to tory that will allow researchers uncompensated faculty posi- determine the three-dimensional to grow a large number of pro- tions in the department. Hold- relationship that has been 40 structure of molecules rapidly and automatically, using com- tein crystals for X-ray structural ing the rank of professor are analysis in record time. UB has Jeremy A. Bruenn, PhD, D.Y. received $1.38 million through Guo, PhD, and Charles M . worked-and will continue to years in the making. "Out of this relationship, will puter programs. come medically relevant re- The aim of structural biolo- search of importance for its im- ESG for research using Weeks, PhD. Associate profes- gists in the 21st century is to nuclear magnetic resonance sors are Jane F. Griffin, PhD, pact on our health and on our understand the operation of (NMR) spectroscopy to deter- Debashis Ghosh, PhD, David A. local economy," he predicted. biological systems at the subcellular, molecular and atomic mine the structure of proteins, adding to the department 's Langs, PhD, and G. David Smith, PhD. Assistant pro - levels by studying the threedimensional structures of D A, R A and proteins. Knowing the armamentarium. fessors are Chang I. Ban, PhD, Faculty in the new department will perform advanced L. Wayne Schultz, PhD, Yang- structure of specific proteins will research and train scientists in liang Xu, PhD. enable scientists to target new drugs to treat chronic diseases. the methods of modern structural biology. The department will be centered at HWI, with In addition, a number of fac ulty members from UB's graduate school division at Roswell UB outfitting additional labo- Park Cancer Institute and other ruce Holm, PhD, senior associate dean in the School of Medicine and Biomedical Sciences, explained that "structural biology is a scientific cornerstone in the entists are being appointed to zhou Wang, PhD, and Hong- the future of pharmaceutical The collaboration combines HWI's internationally known development, and Buffalo is for- expertise in X- ray crystallography ratory space in its Biomedical UB departments will be affiliated tunate to have such world-class with Research Building on the with the new department. ( D UB's supercomputing Spri11g 2001 Buffalo Physician 11 ��Assassination in Buffalo Time to put the medical controversy to rest? < • • . . -• . •< . .. I ~ B y J A c K F I s H E R , M D '6 2 can still remember an afternoon stroll up High Street from the Buffalo General Hospital, where I was • .•. .. z .• . • assigned as afourth·year clinical clerk in 1962. My destination was asmall bookstore at the corner of Main (I can't recall its name, but someone will likely remind me). What I do remember, however, are the nice people who worked there and my first purchase: awell· preserved copy of Selected Papers, ~ .... . -. < :> Surgical and Scientific, by Roswell Park, MD, an esteemed professor of surgery at the University of Buffalo and one of Western New York's most influential medical professionals at the close of the 19th century. As I sat down to read Park's book, which was published shortly after his death in 1914, my interest was immediately drawn to the chapter titled "Reminiscences of McKinley Week." Spring 2001 I HI IIID PbysitiiD 13 �~ - - ~- ears later, I visited the Buffalo and Erie County Historical Society and took note of a display case featuring artifacts from the events surrounding President William McKinley's assassination in Buffalo at the 1901 Pan-American Exposition. Standing before the display, I viewed the assassin's nickel-plated revolver, the unspent ammunition and a faded typescript. As I leaned closer, I saw that the document was the original draft ofPark's "Reminiscences," made available to the historical society in 1945 by his son, historian Julian Park. Several lines and paragraphs had been penciled out, leading me to wonder what Park had written that he later decided his readers must not read. As I progressed through my surgical training, I never forgot the Pan-American Exposition's Temple of Music, where President ing abdominal trauma, I came to understand what had likely McKinley stood greeting well-wishers. The assassin, 28-year-old happened to our 25th President, and why-after being shot twice Leon Czolgosz (shole-gawz), was an angry, unemployed dissident in the abdomen-his condition deteriorated so rapidly despite the very best efforts of his surgeons. Eventually, I also became aware from Cleveland, Ohio. Although Buffalo police detectives and the of the fallen image of Buffalo and its surgical community due to dent-as were several "special agents," forerunners to the Secret the perception, by laymen and professionals alike, that the Service-no one even managed to spot Czolgosz before he stepped medical treatment the President received was substandard. From a copy of Park's typescript, I learned of his concerns 73rd Coastal Artillery brigade had been assigned to guard the Presi- up, thrust a recently purchased revolver at McKinley's breast and fired twice. ever intending to escape, and fully prepared to con- about the operation that had been hastily performed on President front the inevitable consequences of his act, Czolgosz calmly sub- McKinley by a gynecologist, Matthew Mann, and about his convic- mitted to the violent blows directed at him by a furious mob. tion that abdominal drains would have made a difference in the The President barely wavered and seemed to not know if he had outcome of the case. Implicit in the remarks Park had crossed out was the belief that the President's life could have been saved-and been injured until he saw fresh blood on his shirt. Within moments, the subsequent rebuke of Buffalo's med ical community avoided- where a hastily assembled surgical team decided to operate rather he was transferred to the exposition's modest emergency hospital, if those who were making decisions about his care had waited for than await the arrival of Buffalo's acknowledged expert, Roswell Park to arrive instead of allowing the surgery by Mann to proceed. Park, who at the time was operating in Niagara Falls. Over the years, while researching my book Stolen Glory: The Examination of McKinley's wound revealed that one bullet McKinley Assassination, I have come to recognize that the prevailing had bounced off his sternum, while the other penetrated the left historical opinion of most 20th-century writers is that the surgery was upper quadrant of his abdomen. Laparotomy was performed under considerably disadvantageous conditions in that the patient botched, an opinion that can still be elicited in Buffalo from many who are aware of some of the details of the case. I believe, however, that this is a conviction that is distorted by a century-old conception 14 the sudden, sharp report of gunshots pierced the grand hall of the McKinley assassination story. With accumulated experience treat- was significantly overweight, and lighting and instrumentation were inadequate. of McKinley's injury, as well as by comparisons to modern standards evertheless, two gastric perforations were found and repaired. of how his surgery and aftercare should have been conducted. In Since no other injury was perceived (and the bullet remained undis- contrast, I contend in my book that the available evidence, when covered), the decision was made to conclude the surgery. While the carefully considered in a historical context, supports a different incision was being closed, Roswell Park appeared at the operating conclusion; namely, that members of the surgical team available to room door. He conferred briefly with Mann and then lent his hand serve McKinley's needs acquitted themselves as well as anyone in the to making arrangements for McKinley to recover in the Delaware city or in the nation could have at that time, and that McKinley's Avenue home of exposition President John G. Milburn. wound in 1901 represented a mortal injury from the outset. Stolen Glory begins with the anarchist movement and the climate Meanwhile, the assassin had been transferred to Buffalo's downtown police headquarters before a lynch-minded crowd could assert of terror that led to the assassination of six heads of state worldwide its most fervent wish. Interrogation began at once and lasted between 1894 and 1912; however, for the purpose of brevity, the story can also begin on the afternoon of September 6, 1901, when Czolgosz denied complicity with anyone, he cited as his inspiration luf f a le Ph ys i till Spri11g 2001 through the night, resulting in a signed confession. Although --~ �America's notorious anarchist orator, Emma Goldman, who was then hunted down across the nation and eventually arrested in Chicago. President McKinley awoke the morning after his surgery and asked to see the newspapers. He was not the least bit curious about his assassin; instead, he wanted to know how the world had reacted to the speech he delivered in the exposition's esplanade shortly after arriving in Buffalo. Everyone assured him that his eloquent advocacy of reduced trade barriers in the Western Hemisphere had been greeted with considerable enthusiasm. Each of his surgeons, along with Park, expressed their delight with his quick mental and physical rebound and through periodic bulletins kept reporters informed that the President was destined for a prompt recovery. Wall Street reacted enthusiastically to the news. However, any physician today presented with all the evidence available that morning would have recognized sure signs of trouble: The President's pulse remained high-in the range at 120-and his urinary output following surgery had only been 270 cc. Measurement of the blood pressure and red blood cell concentration were not available in 190 l. Had they been, progressive hypotension and a rising hematocrit would have been observed as the week passed. Instead, all trained eyes were focused on bowel activity, the prevalent fear in that day being " intestinal toxemia." Accordingly, enemas of every known variety were given incessantly. On Thursday morning, the sixth postoperative day, Mr. Charles McBurney of New York City, who had been summoned as a consultant earlier in the week, visited the President again just prior to leaving Buffalo. Meeting reporters afterward, his optimism was apparent to all. When asked about the retained bullet, he jokingly replied that it lay where it couldn't even shorten Methuselah's life .c 0 c . 0 , • by a single day. o sooner had McBurney departed Buffalo's Terrace Street Terminal than the President's condition began to deteriorate. His pulse, then 130, was becoming weaker, his oliguria had persisted, and efforts to administer saline by subcutaneous clysis had been initiated too late. Most physicians today will recognize that McKinley was in shock, not because of hemorrhage, but because of the development of a pathologic third space with several liters of fluid having Spring 2001 Bu ff al o Ph ysician 15 �accumulated deeply within an inflamed retroperitoneum. What While Emma Goldman was still being hunted down as Czolgosz's accomplice, the assassin himself was quietly arraigned in a courtroom while reporters were diverted by the President's funeral service in Buffalo, held a few hundred yards away. In a pace McKinley had needed desperately, and did not receive, was intravenous fluid in significant quantity. Unfortunately, this was a physiologic requirement that would not be defined for many more years. On Friday, a week after McKinley had been shot, the signs of progressive heart failure were apparent to all of his physicians. Every known heart stimulant was used: strychnine, digitalis of justice unimaginable today, a swift trial was followed by electrocution of Czolgosz, all within six weeks of the shooting. ""· During this same period of time, McKinley's surgeons became the targets of stinging criticism from the press as well as from their medical colleagues, whose denunciations were paraphrased by journalists. In response, the sur- and adrenal gland extract. Even brandy was '"'~. '"~~,.~~'{·~~~\\ injected subcutaneously. "''' •''"'~"tS ~ ""1.· ····~~ l\ ~~...;:•:. . More consultants hurried to Buffalo from v~\'5 .... ..: ... r--~·~: turt:,lo ([outicr. -:::_ cities as far away as Philadelphia, Washington, -:".-C\T~A! D.C., and New York. Among them was Charles ~~: .'1lKI.\'LEY IS C\T~AI McBurney, who, upon arriving home had been x:-~.. p ......,.,, -~~~" •r DEAD! ~.::-:::;~ ~Lb. """ " ' IUit ~IS TiltS It~\1\'Q ~ ........... f.'l)r ) ,,,,,,,., ,.,:•;.::;,"llv, dumbfounded to learn of the President's condition and promptly boarded another train bound for Buffalo. Their efforts were all to no avail. William McKinley, "1\11 r h /II k'k)~~;" '"' lttn,vllll. -- lli'~ 25th President of the United States, died at 2:15A.M. on Saturday, September 14, 1901. The American public was stunned, for they had been led to believe that their enormously popular President would recover completely, an outcome many associated with continued economic expansion and prosperity. Instead, Americans were faced with a different kind of leader, Theodore Roosevelt, the unlikely running mate in the 1900 election whom McKinley advisors had called "a damned cowboy!" geons sought counsel from an attorney, and a statement was later issued assuring the public that they had been of one mind throughout the time they cared for the President, a distinct stretch of the truth. Congress meanwhile debated whether or not the surgeons should be paid for their services from the McKinley estate. Eventually they did allow funds to be appropriated from the national treasury because Mann and his chosen assistants had been serving McKinley in his capacity as President. Soon after McKinley died, Roswell Park dictated his recollection of the events surrounding the President's medical care. Once he completed this exercise, he placed the transcription in a desk drawer, where it remained for several years. Shortly before he died in 1914, he edited his comments, and the revised narrative was published true to his wishes. Not until 1945 Advanced Trauma Life Support (ATLSJ protocol. One of the technicians What 11 · McKinley Were Shot Today Secret Service personnel, while another would establish whether the n this, the lOOth anniversary of President William McKinley's other would be in charge of cardiovascular resuscitation of the patient, or nurses would take a history from paramedics or, in this case, from the President's airway and breathing are intact. At the same time still an- death, I have been asked by Buffalo Physician to comment on starting large-bore catheters in each of his anns and initially running how the injured President would be treated today and how approximately two liters of fluid if he showed signs of tachycardia or surgical care has changed since 1901. I have consulted with shock. At this time, we would also perfonn a thorough physical exam- Dr. Fisher on this and am eagerly awaiting his new book. ination, from head to toe, front to back. It should be first emphasized that the care rendered to the President would be no different than that given to any other X-rays to detennine the location of the bullet and its possible course. In patient in the Trauma Center of the Erie County Medical Center; that is, the case of President McKinley-or in the case of this hypothetical the same care is rendered to all patients without regard to their status. An patient-the entrance wound in the abdomen was anterior, and the in-house trauma-call team is present in the hospital 24 hours a day to bullet lodged posteriorly. Approximately 20 to 30 minutes after arrival respond to emergencies, and all trauma team members carry special in the Emergency Room, the patient would be taken to the operating trauma pagers. If we have advance notice, a room for exploration of his abdomen. (Specialized tests such as CT scan team of surgical residents, technicians and ER and MRis are not utilized in penetrating trauma.) The surgeon would personnel is available-gowned, gloved, and make a generous midline incision and perform a thorough and complete ready to go-in the Emergency Department. When treating the patient, we use an approach that follows 16 After we ascertained that the patient was stable, we would take l1ffalo Physiciaa S prin g 20 01 exploration of the abdomen. The incision might also be extended into the chest through the sternum to gain access to the heart and lungs as �was the original draft made available for historical interpretation . A comparison of the two documents reveals an edited version that is soft in tone and reflective of the determined effort made by everyone involved in the tragedy to bring order to the chaotic events that initially surrounded it. Perhaps it also shows a mellowing of Park's estimation of events after the passing of a dozen years. The unedited draft, however, clearly displays considerable angst on the part of Park and perhaps a degree of resentment as well. In it, he raises four issues: First, the haste in which the operation was performed despite the fact that there were no signs of hemorrhage and the President appea red stable; second, the inexperience of the principal surgeon , Matthew Mann, who, although a skilled gynecologist, had no prior experience with gunshot wounds to the abdomen; third, the inadequacy of the facilities used for the surgery (Park recorded that, in h is estimation, the President should have been transferred to the newly c . " , • needed. In an exploration for trauma, the surgeon would follow resect the pancreas using a stapler. Ligation of the splenic artery and vein these priorities: would be done and the whole specimen removed in one piece. The surgeon 1. Control of hemorrhage; would place suction drains, and the abdomen would be closed quickly. 2. Control of contamination; Once the operation was completed-which a senior surgeon would 3. Identify and evaluate all of the injuries; probably do in about two hours-the patient would be taken to the 4. Debride all devitalized tissue and remove all contamination and repair ICU, where a trained team of critical care specialists would monitor his and treat all of the injuries with appropriate surgery; 5. Close the patient. care. This would include urine output, NG output, and other parameters to optimize blood pressure, pulse and fluids. The team would also support the cardiopulmonary and metabolic needs of the patient as needed. In this case, we would debride and close the wounds of the anterior In all likelihood, the President's hospital stay would be approximately and posterior portion of the stomach. If bleeding was encountered, we 7 to 10 days without complications such as pneumonia or a pancreatic would give the patient blood. leak. In all, a total of 100 to 200 physicians, nurses and technicians During surgery, the President would be monitored as if he were in an would have been either directly or indirectly involved in his hospital intensive care unit IICUJ. Using clamps, the surgeon would take down the care. Clearly, the intensity ofthis care and the resources necessary to suc- gastrocolic ligament and omentum between the stomach and colon and cessfully manage such a patient justify the need for a trauma center. explore the underside of the stomach and pancreas. (The bullet that penetrated President McKinley traversed his pancreas to the left of the Dr. Seibel is a clinical professor of surgery at the University at Buffalo School superior mesenteric artery and vein, probably damaging the pancreatic of Medicine and Biomedical Sciences and director of Surgery and Trauma duct.) After the stomach and pancreas were explored, the surgeon would Services at Erie County Medical Center in Buffalo, New York. He wishes to mobilize the spleen and tail of the pancreas towards the midline and thank Dr. john LaDuca for his assistance in editing this article. S p ri n g 2 001 IDIII I O Physiciu 17 �expanded Buffalo General Hospital); and fourth, the omission of inserting abdominal drains. The autopsy revealed that both gastric suture lines were intact and that there was no peritonitis nor any collection of pus, although cultures taken at the postmortem examination grew a mixture of organisms. A large gangrenous cavity behind the stomach was consistent with significant inflammatory damage to the pancreas and adjacent organs. Also, the heart showed severe fatty changes consistent with failure. Unfortunately, McKinley's case preceded by several decades experiments performed by Alfred Blalock and Owen Wangensteen in which they showed that surgically induced ischemia followed by inflammation could result in clinical shock in the absence of hemorrhage. Specifically, they determined that blood volume contracted as fluid was drawn from the plasma and interstitial spaces in order to support a zone of severe inflammation. Without intravenous replacement of that fluid loss, they concluded, death would likely result from a failing heart. By addressing Park's four issues from the perspective of surgery as it was practiced in 1901-together with the hindsight inevitably gained by a century-long interlude-! have drawn the following conclusions about his concerns: In 1901, McKinley appeared clinically stable to his physicians. The standard response to any penetrating injury to the abdomen What attend the event has already been asked by the Secret Service to sub- c . 0 , mit their social security numbers to permit security checks. The ad- McKinley Needed Protection Today vance team inquires about potential public demonstrations involving local or national controversies. If required, a site for these protests will be designated within sight of the President's motorcade. The Secret n 1901, the Secret Service had not been charged with the responsi- Service cannot abridge constitutional rights of assembly or protest. bility of protecting the nation's President. After the McKinley When the President arrives in Buffalo, usually by air, he is driven by assassination, Congress corrected that omission. Today, the the Secret Service to the event. His route is never revealed in advance to Secret Service's capacity and impact far the media as McKinley's itinerary was in 1901. At the Historical Society, exceeds its modest presence a century no person unknown to the Secret Service comes within range of the ago. The following excerpt from Stolen President, with one exception. A space for bystanders has been desig- Glory: The McKinley Assassination, by Jack Fisher, MD '62, (see article on page 121 considers how the Secret Service would prepare today for a presidential visit to Buffalo, New York, and how it would nated and cordoned off behind the television cameras approximately 75 feet to the side of the front entrance. After the President has fulfilled his obligations and bidden farewell to local political leaders attending the event, he departs through the respond if a similar attack were to occur. The President will be attending a series of events in Buffalo that in- Historical Society's front entrance. Surrounded by his protective de- clude an award ceremony at the Historical Society, the former New tail, he stops, turns toward the television cameras, and waves. At that York State Building for the 1901 Pan-American Exposition. The Secret moment, the unthinkable occurs! A young man standing among the Service was informed two weeks in advance of the planned visit. Special bystanders draws a revolver from his pocket, aims, and fires twice at agents in Washington coordinate with their counterparts in Buffalo, the President before he is brought down. The Secret Service agents where one of 116 field offices is located. The Protective Intelligence close in around the President, prepared to take additional bullets if they Section begins its database search of individuals in Western New York come. They quickly pile into the car and depart. who made prior threats to a President or other government official. Police had already halted traffic on Elmwood Avenue, facilitating their Meanwhile, an advance team visits Buffalo and determines the entry onto the Scajaqueda Expressway, a planned emergency departure President's actual motorcade route. The team contacts the Erie route. Inside the vehicle, a still alert President identifies fresh blood on County Highway Department to determine where construction projects his shirt. Seeing this, a special agent alerts the driver to proceed im- might impede movement. Dr. Roger Seibel, or his designate, at Erie mediately to ECMC. Their limousine enters the passing lane and acceler- County Medical Center (ECMCJ will be notified of the visit. [See "What ates. On a closed-communication system, the Trauma Center is notified If McKinley Were Shot Today," on page 16.] of their approach. They exit at Grider Street and arrive at the trauma Planning is coordinated with the Buffalo Police Department; its responsibilities will include traffic and crowd control. At the Historical receiving ramp six minutes after departing the scene of the attack. At that point, Dr. Seibel's team takes over. Society building, all doorways and spaces are checked, with the aid of 18 explosives-sniffing dogs. This will be repeated on the morning of the visit The author is grateful to the Secret Service for their assistance providing and at that time, the building will be secured. Everyone designated to archive documentation from 1901, and for reviewing this descriptio11. laffalo Phys i c i an Spring 2001 • �then-as it is today-was prompt surgical exploration. Waiting would not have helped the President. of. In 1901, gynecologists performed many more laparotomies than did general surgeons, albeit not for gunshot wounds. However, Mann had selected two surgeons to assist him who were experienced with injuries of the kind that McKinley had experienced. + In 1901, elective surgery was often performed in private homes because infection was prevalent in hospitals. + In 1901, the placement of a drain meant use of long rolls of stiffened gauze. Plastic tubes attached to wall suction were not yet imagined. Thus, I conclude that it is extremely unlikely that significant changes in the course of treatment provided to McKinley by his surgeons would have made any difference in the outcome of his case. either is it likely that Roswell Park could have saved President McKinley, as the fate he suffered resulted from errors of omission, not errors of commission. Those errors were unwitting on the part of Mann, Park and their associates, none of whom understood surgical physiology as we know it today. or did they benefit from the capability we have today of monitoring our patients' myriad life functions or from having at our disposal the intravenous fluids and pharmaceutical cornucopia for critical life support. Given a careful and thorough review of historical facts surrounding the medical treatment provided to President McKinley by Matthew Mann, Roswell Park, and their medical colleagues, I believe that events surrounding his care should no longer represent a disparaging chapter in Buffalo's history. Any reconsideration of the McKinley tragedy should be nothing less than a celebration of one hundred years of medical and surgical progress culminating in a century of achievements that Buffalo's surgical community has contributed to significantly. jack Fisher, MD '62, is an emeritus professor of surgery at the University of California at San Diego, where he is currently a master's candidate in United States history. His book, Stolen Glory, The McKinley Assassination, will be available in july 2001 by subscription. For further information, contact Alamar Books at P.O. Box 2876 La jolla, CA, 92037, or by e-mail, at Alamarbooks@aol.com. Dr. Fisher can also be contacted by e-mail at jfishermd@aol.com. �' . - -- --- - PATHWAYS N EWS ABOUT ALUMNI, FACULTY AND STAFF AT THE UNIVERSITY AT UB's School of Medicine and Bio- BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES medical Sciences, in the September 2000 issue of the New Craig Smith, Distinguished Alumnus Visitor Craig Smith, MD '72, chief executive officer of Guilford Pharmaceuticals, recently visited University at Buffalo's School of Medicine and Biomedical Sciences as a Distinguished Alumnus Visitor. During his stay, Smith met with students, members of the Dean's contains ner held on April 26, 2001, at the BCNU, or carmustine, a cancer University Club in New York City. England Journal of Medicine, has been selected by Harvard Health Letter as chemotherapy drug used in the In announcing the award, Gregory one of the top 10 health advances treatment of glioblastoma multi- L. Eastwood, MD, president of of2000. forme, a particularly virulent AMS, told that agency in over 20 years. This cal Schools (AMS) of New York at wafer, which is made of a biode- its annual Deans and Trustees din- gradable polymer, search and graduate deCRAIG SMITH partments to discuss work under way at form of brain cancer. Currently, Deans wish to recognize your long winter 2001 issue of Buffalo Physi- service to the organization, in- trials for a diagnostic test it has cluding your tenure as President, outstanding leadership you have cian, showed that early treatment with one of the drugs used to control multiple sclerosis (MS)interferon beta-1a-reduced the rate of development of clinically definite MS for these high-risk individuals by 44 percent versus provided to the treatment with placebo. developed for Parkinson's disease. during which [time) you spear- -S .A. headed a restructuring of AMS to UNGER strengthen its statewide scope. We also wish to call attention to the Naughton Receives AMS Distinguished Service Award john Naughton, MD, dean of Guilford Pharmaceuticals, which UB's School of Medicine and he helped establish in 1993 to dis- Biomedical cover and develop drugs to diag- Sciences from ew York State Consortium on Graduate Medical jacobs was the first American Education and the many other researcher, beginning in the 1970s, ways in which you have served to test a form of beta interferon, a academic medicine in New York." -S.A. UNGER the body, in the treatment of MS. naturally occurring substance in nose, treat and prevent brain can- 1975 to 1996, cer and other neurological dis- was present- eases. Guilford's leading product, ed a Distin- the GLIADEL wafer, gained Food guished Ser- .Jacob's Study Touted by Harvard Health Letter and Drug Administration approval vice Award A study published by Lawrence of beta interferon. His prior re- in 1996, becoming the first brain by the Associated Medi- jacobs, MD, Irvin and Rosemary search has shown that the drug, Smith Professor of Neurology in approved by the Federal Drug cancer treatment to be cleared by GREC.ORY L. EAsrwo<..m, MD, PREsiDENT 10 (, -,~!{VIC f ro Since that time, he has lead several joHN NAUGHTON m AMS, .ow NALGHTO MS studies using interferon beta1a, a genetically engineered form rHAT "n!E DEA. 'SWISH ro RECOG IZF YOt:R lHE ORC,A I?ATIO , INCLL DING YOCR Tf.Nl RE AS PRESIDE 'T, DURL 'G WHICH [TIME] YOU SPEAR- HEADED A RES.RLC TURI c, Or AMS ro STRENG!HEN ITS STAlFWIDE SCOPE." 20 The study, also reported in the the company is involved in clinical Advisory Council, and faculty in several re- aughton that "the LAWRENCE jAcoss l u fla la Pb ysicin Spring 200/ �Administration in 1996, slows the accumulation of physical disability and decreases the frequency of clinical flare-ups in patients with .Jehle Honored by ACEP for Teach ng Dietrich Jehle, MD, FACEP, clinical director of Emergency Services at the Erie County relapsing forms of MS. - Lots BAKER Medical Center, has received the ational Emergency Medicine Faculty Teaching Award 2000 Holm Named a Top SUNY Researcher Bruce A. Holm, PhD, professor of pediatrics, pharmacology and toxicology, and gynecology/ obstetrics at UB's School of Medicine and Biomedical Sciences, was honored as one of the SU Y system's top research scientists at a dinner held in Albany, New York, on January 22, 2001. Holm, who is also senior associate dean at the School of Medicine and Biomedical Sciences, has conducted internationally recognized research on lung surfactant and oxygen toxicity affecting alveolar cells. In his address to the evening's 21 BR UC E A. HOLM honorees, SU Y Chancellor Robert L. King said, "Each of you has distinguished yourself and our university by the body of your work. Learning of the specifics of [this] work has validated all of my from the American College of Emergency Physicians (ACEP ). Jehle, who is associate professor and vice chair of the Emergency Medicine Program at UB 's School and BiomediDtETRt C H J E HL E plays host to tremendous research initiatives and has, and will, continue to make great contributions to our state, our economy and our society." -Lots BAKER tional Institute of Allergy and ant at RPCI Infectious Diseases, National stnce Institutes of Health. - S.A. U N GER 1999, has also been appointed to BRAHM H. SE GA L the faculty position of assistant sions of Infectious Diseases and Sethi and Berenson Funded to Study Emphysema Allergy, Immunology, and Rheu- Sanjay Sethi, MD, and Charles S. professor of medicine in the Divi- matology at UB's School of Med- Berenson, MD, in the Department icine and Biomedical Sciences. of Medicine at the University at Segal earned his medical de- Buffalo, have been awarded a gree from Albert Einstein College four-year, $750,000 grant from ew York. the National Heart, Lung and He completed residency training Blood Institute of the National ew England Medical Center, Boston, CON TI NU ED ON P ACE 22 cipient of numerous awards, including the Outstanding Mentor/Teaching STUDENTS' ANNOUNCEMENT Award and the Chairman's Teaching Award from UB's Department of Emergency Medicine. Jehle is recognized for devel- tudents for Health and Human Rights (SHHR), a local offshoot of Physicians for Social Responsibility (PSR), has oping the first study of bedside several members who are interested in recycling surplus ultrasonography in abdominal and unused medical supplies from hospitals for use in trauma by emergency physicians developing countries. This type of program was first orth America. He is also co- developed at the Yale-New Haven Hospital several years ago editor of a trauma ultrasound text and has been successfully implemented in hospitals across the that will be used as an instruc- United States. in tional guide for future ACEP The program works as follows: Supplies for patients are often Trauma Ultrasound courses fol- unused, but according to law cannot be reallocated for use with lowing its publication in 200 l. - S.A. UNGER other patients in the United States. Our organization is interested in systematically recycling these supplies and sending them abroad in keeping with the Yale-New Haven Hospital model, and we are we, as a great research institution, proven that the State University in Infectious Diseases at the Na- eases consult- in internal medicine at the cal Sciences, beliefs and my vision for where can go. Your achievements have infectious dis- of Medicine, Bronx, of Medicine is the past re- Massachusetts, and a fellowship has been an interested in finding a local hospital that is willing to participate Segal Named Assistant Professor of ed"c ne in this program. We have several potential recipients in Haiti and other countries in desperate need of supplies. Brahm H. Segal, MD, has been ap- If you know of a hospital or administrator who would be willing pointed director of the Division of to assist us in this endeavor, please e-mail Christina Chang at Infectious Diseases, Department cmcll@buffalo.edu; Betsy Schneider at eas26@buffalo.edu; of Medicine, at Roswell Park or Sarah Gaughan at sgaughan@buffalo.edu. Cancer Institute (RPCI ). Segal, who S prin g 200/ Buffa l o Pb ysi c i an 21 �PATHWAYS Tm A, Iv ~ OF COST EFFECriv~, PREY~ CO I BL HAlo, , F\\ YoRK, cALLS HIMSELF A. " 1A AG£D CARF IDEOLOGuE" \\ HO sEEs "HIGH-QC'ALITY, T fiH-ORIFNTt:D M~DIUNE .•. PRACTICED BY A GROUP Of PROVIDERS \\HOARE WILLI, "G TO ,I LOl SL'I AS~FSS A D IMPROVE THEIR l.)L \lLY OF CARE" AS THE BFSr \\AY ro DELIVER HEALTH CARE . however, the CONTINUED FROM PAGE 21 Institutes of Health to study the precise role that respiratory bacteria (Haemophilus injluenzae) play in regulating immunologic mechanisms of inflammation that lead to chronic obstructive pulmonary disease or emphysema. It has long been known that inflammation is present in the air- critical care medicine-and effective therapies in the future. role that bac- Berenson-an associate professor Both Sethi and Berenson are teria play in of medicine who is board certified affiliated with Veteran Affairs decreasing in infectious diseases-will com- Western New York Health- function has bine care System's Bailey Avenue their clinical and not been ex- research interests in an effort to facility, where the research will plored. In this provide a better understanding be conducted. -S.A. UNGER study, Sethian assistant of the basic causes of emphySANJAY SETHI sema. Such an understanding professor of medicine who is may in turn provide a basis for board certified in pulmonary and designing ways of people with emphysema; novel and more Robert Dickman, MD '68, Named Chair at Tuhs University n April 5, 2001, Robert L. Dickman, MD '68, was installed as the That philosophy was the foundation of his work as director of inaugural holder of the Jaharis Family Chair in Family Medicine ambulatory services at the Buffalo General Hospital, beginning in atTufts University School of Medicine in Boston, Massachusetts. 1972, and as a faculty member at University at Buffalo's School of This is the first endowed chair of Family Medicine in Medicine and Biomedical Sciences, where he earned his New England, and one of approximately 14 others medical degree in 1968. It guided him later him as a faculty member of the in the country. Dickman formerly served as chief of Tufts' Division Family Medicine Center at Case Western University; of Family Medicine, which he came to the university helped his creation, in 1982, of a new Department of to create in 1998. This effort involved strengthening Family Medicine at Cleveland's Mt. Sinai Medical existing family medicine programs and developing Center; and informed his work as a consultant for new ones, including a required third-year clinical Meridia Health Care Systems, as well as in his estab· clerkship. Experienced in shaping new organizations, ROBERT DICKMAN Dickman in 1971 was a founding physician of the Matthew Thornton Health Plan, one of the Northeast's first health maintenance organizations. Throughout his career, Dickman has integrated the principles In 1995, Dickman took the same philosophy to Israel, where he directed managed care programs at Maccabi Health Services, Israel's second largest health fund. of family medicine and managed care in academics, practice and In addition to his interest in managed care, Dickman has pursued management. The native of Buffalo, New York, calls himself a clinical and publishing interests in geriatrics, most recently con- "managed care ideologue" who sees "high-quality, cost-effective, tributing to a major family medicine text; and medical ethics, preventive-oriented medicine ••• practiced by a group of providers especially end-of-life care issues. who are willing to continuously assess and improve their quality of care" as the best way to deliver health care. 22 lishment of a family medicine group practice in Cleveland. laffalo Phys ic ian Spring 2001 Dickman will continue to administer the Tufts' medical school family medicine programs. �Jerome Kassirer Honored by American Jewish Congress Distinguished Community Leadership Award erome Kassirer, MD '57, received the Distinguished referred to as the 'conscience of American medicine.' Kassirer's Community Leadership Award from the American reputation as the 'conscience of American medicine' was furthered Jewish Congress on February 7, 2001, at a ceremony in July 2000, when he stepped down aseditorofthe N£/Minthewake held at the Westin Copley Place Hotel in Boston, of a decision made by the journal's publisher, the Massachusetts Massachusetts. The American Jewish Congress, which Medical Society, to begin adding the tagline "publishers of the New in its own literature refers to itself as the "Attorney England Journal of Medicine" to its other publications. General for the Jewish People," is an 80-year-old After graduating magna cum organization that works around the world to pro· laude from UB's School of Medicine mote religious freedom and diversity, defend the in 1957, Kassirer trained in internal civil rights of minorities, and guarantee the consti· medicine at Buffalo General Hos· tutional rights of all Americans. pital and in nephrology at the New In presenting Kassirer with the award, the Con· England Medical Center in Boston. gress notes that "as editor-in-chief emeritus of the He joined the faculty at Tufts Uni· New England Journal of Medicine {N£/MJ [he] has versity School of Medicine in 1961, made outstanding contributions in the areas of was named professor of medicine in medical care, education, research and health policy. 1974 and was the Sara Murray He has had a distinguished career as a caring physi· Jordan Professor of Medicine from cian, outstanding educator, researcher, innovator in 1987 to 1991. From 1971 to 1991 he was associate physician-in-chief clinical reasoning, and leader in promoting profes· jEROME KAS S JRER sional values. In numerous editorial op-ed pieces and of the New England Medical Center commentaries over the past two decades, he has and vice chair of the Depart- criticized our inadequate medical care delivery system, govern· ment of Medicine at Tufts. In 1991, he became the 38th editor-in· mental interference in medical decision making and the resis· chief of the New England Journal of Medicine. tance of the gun lobby to support reasonable safety measures. Also in 1991, Kassirer was named Distinguished Alumnus of He has tirelessly promoted integrity in patient care and re· University at Buffalo's School of Medicine and Biomedical Sciences search, endorsed a stronger role for patients in medical deci· and received the Distinguished Faculty Award from Tufts University sions and been a careful observer of the role business interests School of Medicine. He now teaches at Tufts, as well as at Yale have played in our American health-care system. During his University School of Medicine. tenure at the New England Journal of Medicine, he was often - S . A. U N c E R Spring 200 1 l uffafo Physician 23 �M B v S U N A G E R E D C A L S C H 0 0 L E W S AWealth of Knowled eand (xperience N e w M e d i c a I E m e r i t u s Fa c u I t y G r o u p Fo r m e d has found its counterpart in lifelong teaching and mentoring through a new group formed at University at Buffalo's School of Medicine and Biomedical Sciences. The group-called the Medical Emeritus Faculty Group (MEFG)-was begun last year in an effort to provide retired faculty with an opportunity to continue viable, interactive relationships with the medical school once their formal academic careers have come to a close. The MEFG got its start in January 2000, when Glen Gresham, MD, emeritus professor and chair of the Department of Rehabilitation Medicine at UB, met with Dean John R. Wright, MD, to discuss the idea of creating a more uniform way in which retired faculty could continue to stay connected with the school should they choose to do so. "In the past, when medical faculty members retired but wanted to stay involved with the school, they worked out informal arrangements with their former departments, but there wasn't a uniform approach to this transition," Gresham explains. "Also, there was no place for us to get together and to feel a part of a peer group. Many of us are in Buffalo for at least part of the year, but our interactions with the school were random-anything from being on the mailing list for Buffalo Physician to being invited to a lecture or some other event. It was kind of'luck of the draw."' ln talking with Dean Wright, Gresham explained that he and a core group of his colleagues felt they were not alone in perceiving that an attempt to establish an emeritus faculty group would be well received by a significant number of their peers. "Dean Wright was very supportive of this idea and suggested that we go ahead and pursue it," says Gresham. "He gave me the names of some people he thought would be interested and to this list we added other names to form an ad hoc steering committee, which began meeting monthly in the summer of 2000." The steering committee has been meeting on an ongoing basis since then and its members have embarked on an outreach effort aimed at inviting as many of their peers as they can locate to join the MEFG. With the assistance of Mary Glenn, from the offices of Alumni and Development, whom the Dean assigned to serve as a liaison with the group, committee members have contacted retired faculty by phone and letters, as well as by word of mouth. Currently, they are preparing to send out a questionnaire to all medical emeritus faculty in the school's database, which has approximately 200 names in it. ..".. ,.. • 0: 24 lulfale Physiciaa Spring 2001 �((Many of the current emeritus faculty have been leaders within the school and have a rich sense of history due to their long tenure here. They will be respected and effective ambassadors for the school." -Dean Gresham says he was pleasantly surprised when he reviewed the database, name by name, and identified 193 emeritus faculty who still list a principal address in Western ew York. "I had no idea there were so many; I thought maybe there would be 50, " he says. "But what I found is that there are a In the long run, lot of us. " Gresham foresees a The response to invitations to join the number of other group has been extraordinary, according to Gresham, who explains that memberinterest groups ship is open to anyone who meets the forming to establish a criterion of being an emeritus professor or faculty member from UB's School of "bank of expertise" Medicine and Biomedical Sciences. that's available to "This is a first-class group, and we'd be anyone who wishes to delighted to have anyone join who ' s interested," he says. draw upon it. Since its formation, the MEFG has accomplished its initial objective, which, according to Gresham, "was to bring us together and see how well we got along and to see what we might be interested in doing. "We all worked together a long time and have much in common, and what we have found is that we do like seeing each other," he continues. "We really are a cohort; we are a group. And this has been very gratifying to confirm. " Another objective the group's members have agreed upon, is that they would like to remain an informal entity. "One of our members was very wise and said we should go slowly and not be in a hurry to become overly organized and have officers and bylaws and such things," Gresham says. "He suggested that we just 'let it grow,' so that's what we're doing." Having reached a consensus that there is indeed a place for such a group, and that its organizational style should remain informal, the MEFG has set to work planning specific events and tasks. Last fall, they began hosting bimonthly roundtable lectures featuring distinguished speakers from the medical school who John R. Wright address topics put forth by the group. In November 2000, for example, Michael Bernardino, MD, MBA, vice president for Health Affairs at UB, spoke on "What Is the Relationship between the School and the Hospitals in Buffalo? " and in January 2001, Dean Wright spoke on "Where Is the School Now and Where Is It Headed?" The roundtable format has proved conducive to discussions between the speaker and members of the group, according to Gresham. In addition to the roundtable luncheons, the MEFG has formed a sub-set of interest groups that draw upon the special expertise of its members. "There's a lot of interest in medical education among our members, particularly with regard to mentoring and tutoring, " says Gresham. "We are a group that has enormous experience in these areas and many still feel they have much to contribute." To date, two such interest groups have been formed: One, headed by jacob Steinhart, MD, an emeritus professor of pediatrics, is aimed at working with physicians-in-training to hone their interactions with patients and to cultivate "clinical wisdom"; and a second group, headed by john Robinson, MD, an emeritus professor of psychiatry, is aimed at providing support to medical students interested in learning more about post-traumatic stress disorder. In the long run, Gresham foresees a number of other interest groups forming to establish a "bank of expertise" that's available to anyone who wishes to draw upon it. "Depending on who comes forward, I anticipate a variety of interest groups that capitalize on the strengths of our members," he says. Another specific task the MEFG has set its sights on is the completion of the emeritus faculty questionnaire, which they hope will help them to better define the group's goals and potential contributions for the future. They also hope to obtain office space for headquarters that would provide them with a place for small CONT I NUE D ON PA GE 26 S prin g 2 001 11111 11 Pbys i c i11 25 �---- M E D ----- - C A L SCHOOL E W S "In the past, when medical faculty members retired but wanted to stay involved with the school, they worked out informal arrangements with their former departments, but there wasn't a uniform approach to this transition," Gresham explains. KNOWLEDGE, CONTINUED FROM PAGE 25 meetings, a phone, fax and computer. "We envision the office being staffed by volunteers who can give of their time to help us accomplish another of our goals, which is to keep a master schedule for all the fascinating medical and scientific lectures at the school and Charles Paganelli, PhD, an emeritus professor of physiology and biophysics who is also a member of the MEFG steering committee, says "It's been a pleasure to see people you've known for years and to work with them in this capacity. This is a group of senior faculty, now retired, whose members have lots of experience around the school and there's no reason why their throughout Buffalo," explains Gresham. "Right now, accumulated knowledge can't be used by the school to these events are spread all over the place and nobody keeps a master calendar that could be made available to our members and whoever else would like to avail themselves of this information." some good purpose." Gresham and his fellow members of the MEFG's steering committee know that to effectively accomplish the goals they have outlined, they must integrate the group's presence into the fabric ofUB's School ofMedi- therefore, view themselves as a resource that not only can be tapped into by others but that can reach out to the school and community. "We've had wonderful careers and we're proud to be emeritus faculty at UB," says Gresham. "Many of us are very busy with volunteer work and some of us continue to practice. So, it's not that people aren't doing things; it's just that we haven't been doing anything as a group with the school. And the response we're getting from the school is very affirming of our goal to interact in this way." "The organization of an active, informed and dedicated emeritus faculty group is good news indeed for the School ofMedicine and Biomedical Sciences and for the university community," says Dean Wright. "Many of the current emeritus faculty have been leaders within the school and have a rich sense of history due to their long tenure here. They will be respected and effective ambassadors for the school." Harold Brody, PhD, MD, emeritus professor of anatomy and cell biology, and member of the MEFG's steering committee, concurs with Wright and Gresham. "A gap has existed because there hasn't been a group like [the MEFG] in the past. Potentially, it could be a very important group because it's made up of people who care very much about the school and understand how it works," he says. 26 lalfal1 Physiciaa Spring 2001 cine and Biomedical Sciences so that when faculty members retire, they see the potential for involvement with the MEFG as just another step in a continuum of interaction with the school. Toward this end, therefore, the MEFG would like to initiate a new stage in the process whereby a faculty member retires from the school. "We now have a faculty meeting where people who are retiring receive a 'diploma' that states he or she has been promoted to the rank of professor emeritus with all its rights and privileges," says Gresham. "In addition, we'd like someone from the MEFG to immediately approach those who have retired to say, 'welcome to the Medical Emeritus Faculty Group.' "In other words, we'd like to make it a seamless and positive transition for those faculty who are interested in continuing their involvement with the school." For more information on the Medical Faculty Emeritus Group, call Mary Glenn at (716) 829-2773; or e-mail her at glenn@acsu.buffalo.edu. �..James E. Allen, assistant professor of surgery Blake Reeves, professor of physiology Sprirrg 2001 l 11fale Hysicin 27 �.... G.> ..... = ....... - ~ -= ... 2. 1111111 Pkysitill Spring 2001 ��Hormones, I n s u I n a n d B r e a s t '> she has been looking at how the blood levels of estrogens and androgens are associated with the risk of developing breast cancer. More recentlywith the support of a two-year, $238,000 grant from the United States Army Medical Research and Materiel Command-she has turned her attention to conducting the first major study of the relationship between breast-cancer risk and levels of insulin in the blood. The Influence of Diet and Exercise When breast-cancer researchers set out to explore questions such as those Muti is pondering, they begin with the recognition that breast-cancer incidence rates are about 25 percent higher in Western countries than in Africa or Asia. "Although both genetic and environmental factors may contribute to explaining this large geographic variation in incidence rates, studies on migrants who moved from countries characterized by low incidence, such as Japan, to countries at higher risk, such as the United States, have shown a significant increase in breast-cancer incidence in individuals that migrate in comparison with their peers who remain in the countries of origin," Muti explains. This evidence has led researchers to surmise that environmental factors, such as diet and lifestyle, play a dominant role in breastcancer incidence, according to Muti. "In countries with high breast-cancer incidence rates, these environmental factors are characterized by an energy-dense diet rich in total and saturated fat and refined carbohydrates, and by low physical activity," she says. In terms of what role genetics plays as a risk factor in the incidence of the disease, Muti reports that "there are connections, but, in absolute terms, genetic predisposition as it has been studied up to now accounts for only 5 percent ofbreast cancer cases. "However, it is possible that the way in which we metabolize components of the environment-metabolize diet or pollutants-may give us a different risk in comparison with people who metabolize in a different way," she adds. 3 0 I u fl a I a Physician Spring 200 1 Cancer Given that genes appear to play a lesser role in the development of the majority of breast-cancer cases, Muti emphasizes that "at this historical moment in research on this cancer, it is very important that we identify the environmental factors that are placing women in our country at such high risk in comparison to women in low-risk populations. Clearly, there are environmental factors, but we really don't understand how they work." One potential explanation of the role environmental factors play in the etiology of breast cancer is that diets rich in total and saturated fat and refined carbohydrates often lead to the development of insulin resistance and hyperinsulimia. Like hormones, insulin is an endogenous substance; in other words, it originates within the body, as opposed to exogenous factors, which arise externally. These endogenous substances, Muti says, are "big mediators between the environment and ourselves." Muti's goal in her current study, therefore, is to test the hypothesis of the linkage between serum insulin and breast cancer. "We know that insulin itself is an important mutagenic factor because it is able to induce proliferation and growth of a cell," she explains. "The mechanistic model we are working with now leads us to hypothesize that because insulin can also increase production of androgens from the ovaries, and because androgens are the precursors of estrogen, insulin is then able to produce both androgens and estrogens, which are important factors for breast-cancer etiology." F"nding Markers of Metabolic Risk To conduct her study on the role of insulin in breast cancer, Muti is building on a series of related studies she has completed over the past decade. The studies are based on data she gathered on almost 11,000 healthy women in Italy between 1987 and 1992 for an initial prospective study on breast cancer, called the HORmones and Diet in the ETiology of Breast Cancer (ORDET) study. Five and a half years after the women were recruited to this original study, 144 were found to have developed breast cancer. In the early 1990s, Muti and her colleagues went back and looked at samples of blood from the women who developed cancer and compared them with samples from women who didn't develop the disease. It was this important study, later replicated all over the world, that first provided scientists with data indicating a definitive link between the presence of high levels of estrogens and androgens in a woman's blood and the subsequent development of breast cancer. In 1998, again relying on analysis of data collected on women who took part in the ORDET study, Muti and her colleagues conducted a study in which they sought to discover whether there was a way they could determine a woman's hormonal (androgen) and insulin levels other than by analyzing her blood-in essence, to �lstrogen Metabolism linked to Breast Cancer Risk and collaborators have Researchers analyzed the found that premenopausal women show a 40 percent lower urine samples from both breast risk of developing breast cancer if their predominant path- cancer cases and controls from way of estrogen metabolism produces by-products with little the ORDET study to determine the biologic activity, rather than by-products that are highly predominant estrogen-metabolism reactive. The research is based on data from 10,786 women pathway. Results showed that the who took part in a prospective study of breast cancer in Italy premenopausal women who devel- called the Hormones and Diet in the Etiology of Breast Cancer oped breast cancer had a higher (ORDETI study (see also article, opposite). Once estrogen has performed its essential hormonal duties, it must be eliminated from the body by undergoing a process called hydroxylation. "Estrogen hydroxylation takes place at two primary sites on the estrogen molecule, designated as the C-2 position and the C-16 percentage of the highly active byproducts of estrogen metabolism (produced by the C-16 pathway), than by-products from the C-2 pathway. Women with predominately C-2 pathway by-products-those with low activity-were 40 position," Muti says. "Earlier research has shown that hydroxyla- percent less likely to have developed breast cancer during those tion at the C-2 position produces metabolites with little or no five years. estrogenic activity and thus might be associated with decreased "The way to change from one pathway to the other is through breast-cancer risk. Conversely, hydroxylation at the C-16 position changes in lifestyle. Physical activity and eating a diet low in fat produces metabolites with high estrogenic activity, and might be and high in cruciferous vegetables can shift estrogen metabolism associated with increased breast-cancer risk. We set out to deter- from high-risk to low-risk," says Muti. mine if there was an association between later development of For more information on this study, refer to the paper published invasive breast cancer and the ratio of C-2 to C-16 by-products in on it in the November 2000 issue of Epidemiology. women before cancer developed." - LOIS BAKER discover whether biological markers exist for these substances other than in the blood . To accomplish this, they assessed the women's sebum production (the output of the skin's oil-andwax-producing sebaceous glands), their body-fat distribution and amount of body hair. (The relation of excess androgen in the blood with sebum production and symptoms of excess body hair, or "hirsutism," has been recognized by researchers for many years, Muti points out. In more recent years, clinical studies on women with established non-insulin-dependent diabetes mellitus and consequent elevated insulin concentration have shown that they have higher abdominal fat.) W hat M uti found in her study was that hair and sebum production were predictors of breast cancer in older, postmenopausal women. Furthermore, the body-fat distribution that fit a more male (pear-shaped) pattern, as opposed to the female (apple-shaped) pattern, was a predictorofbreastcanceronly in premenopausal women, in particular in women who were thinner. "One of the things this told us is that the hypothetical model we have for describing the mechanism of how insulin is able to induce increased production of androgens and estrogens as <!;) precursors to breast cancer is not so simple; it's more complex than we had thought. There are factors that make insulin a relevant risk factor in younger women and there are factors that make androgen and estrogen important risk factors in older women," says Muti. "In my present study on insulin, therefore, what I am looking at is the potential determinant of why insulin is so important in young women, and why androgen and estrogen, and not insulin, is so important in postmenopausal women." To date, the results from Muti's current insulin study are "telling us that insulin and IGF-1 [insulin-like growth factor- I), when measured in the blood, are more important in premenopausal than in postmenopausal women." These findings are leading Muti and her colleagues to hypothesize "that the insulin-resistance theory is stronger, is more valid, for younger women," she reports. "In particular, what we're finding is that glucose in the blood-glycemia-is a risk factor for breast cancer in these women," she notes. Based on these findings, she says, "we are very close at this point in our research to finding markers of metabolic risk that will tell us a little bit more about the potential markers of these environmental factors for breast cancer." Spring 200/ l a fla l a Pbys i c i u 31 �E RESEARCH W S Cocaine Use and Heart Attacks One- uarter of nonfa a heart attacks among persons under the age of 45 in the United I . ..• < States can be attributed to regular cocaine use, scientists at the University at Buffalo's Toshiba Stroke Research Center have reported in a study published in the January 2001 issue of Circulation. Lead author Ad nan I. Qureshi, to Qureshi. "What we do know is that cocaine use increases the levels of the neurotransmitters norepinephrine and dopamine at nerve terminals, which in turn increases heart rate, ventricular contraction and the heart's demand for oxygen. "Cocaine may also constrict blood vessels and increase platelet aggregation. In addition, it has MD, UB assistant professor of been shown to accelerate arter- neurosurgery, and colleagues found an association between frequent cocaine use and heart attacks in this age group, but not between cocaine use and strokes. "These findings "Cocaine may ndicate that changalso constrict blood ng behavior sur- iosclerosis in young patients. Since regular, but not infrequent, use of cocaine was associated with an increased risk in our study, our results seem to support vessels and increase platelet aggregation. In addition, it has been shown to accelerate arteriosclerosis in young patients. Since regular, but not infrequent, use of cocaine was associated with an increased risk in our study, our results seem to support this rounding cocaine use-due to public awareness and education-may reduce the incidence of cardiovascular disease n younger persons," Qureshi says. Previous researchers had reported cases of heart attack and stroke in persons who had sed cocaine within latter mechanism." the previous hour. Given the increase in cocaine use among young adults in the United States, the UB researchers undertook an extensive investigation of the possible relationship. this latter mechanism," he says. In their analysis the researchers used data from the most recent National Health and Nutrition Examination Survey (NHANES 1111, which was conducted between 1988 and 1994 by the Centers for Disease Control to estimate the prevalence of chronic disease in the United States population and identify factors that put people at risk of developing chronic health problems. It involved 40,000 persons two months of age or older. For the first time since these national surveys began, participants ages 18 to 59 were asked about life· time cocaine use. For their analysis of the association with heart attack and luffalo Physician Spring stroke risk, the UB researchers limited their study population to the 18 to 45 age group, which captured all but 25 cocaine users and resulted in a study base of 10,085. The study group was divided into three user groups: never, in· frequent, and frequent. This included anyone reporting using the drug from 10 to more than 100 times. The survey also contained data on prevalence of nonfatal stroke or heart attack. Analysis showed that about one in 20 subjects, 67 percent of whom were males, reported using cocaine regularly. To estimate the impact of the drug on nonfatal heart attack or stroke, the researchers calculated the percent of populationattributable risk-the portion of disease that would be eliminated if the exposure lin this case, use of cocaine) were removed. In general, regular users of cocaine were at nearly seven times the risk of having a nonfatal heart attack than non-users, results showed. The populationattributable risk was 25 percent, indicating that in this age group, one in four nonfatal heart attacks would not have occurred if there had been no cocaine use in the group. There was no relationship between cocaine use and nonfatal stroke. Additional researchers on the study included M. Fareed K. Suri, MD; Lee R. Guterman, PhD, MD; and L. Nelson Hopkins, MD, chair of the UB Department of Neurosurgery and director of the Toshiba Stroke Research Center. lOISBAK R searc Researchers aren't sure how cocaine might increase the chances of having a nonfatal heart attack or stroke, according 32 Adnan 1. Qureshi, MD 2001 �" THESF RESULTS SUGGEST THAT NATURALE DOCA .• ABL OID-SIG"'JALI G REGl.JlArF<; SPER\1 FU CfiONS IN HUMANS, Fl. 'DI. GS WITH :\1EDI< AL IMPLICATIONS FOR HUMAN REPRODUCTIO.' AND DRUG ABUSE," SCHUEL SA Y::i . Marijuana Abuse and Fertility For about the past 40 years, re- concentrations were inhibitory, stance called anandamide was which suggests that localized "In addition, the increased differences in anandamide levels load of cannabinoids in people may regulate sperm swimming who abuse marijuana could flood found to be that chemical. searchers have hypothesized that Regulatory mechanisms that marijuana smoke may affect sperm fertility. A recent study prepare sperm to fertilize eggs in human reproductive tracts remain poorly understood. Human THC inhibit structural altera- adversely impact fertil- scientists provides compelling sperm are bathed in male repro- tions, which are required for ity," he says. "This may "Defects in evidence in support of this ductive tract secretions when they physiological acrosome reactions, explain why men who endocannabinoidsignaling may be responsible for certain headed by University at Buffalo In VIVO. Secondly, both AM-356 and natural endocannabinoid-signal systems in reproductive organs and theory by discovering that a are ejaculated into the female's over the acrosomal cap during smoke the drug have cellular-signaling system that responds to THC (the active sub- vagina, and are not immediately capable of fertilizing eggs. How- capacitation. Thirdly, AM-356 inhibited lower sperm counts than nonsmokers." stance in marijuana), as well as to ever, once removed from the tight binding of sperm to the Collaborating on anandamide (a cannabinoid-like seminal plasma and exposed for egg's zona. "Failure of sperm to the research were Drs. unexplained molecule, or endocannabinoid, several hours to secretions with- bind tightly to zonae is predic- Robert Picone and types of normally produced in the body) in the female reproductive tract, tive of fertilization failure for in Alexandros Makri- may regulate sperm functions re- sperm become "capacitated" quired for fertilization in humans. and can fertilize eggs in vivo, or vitro fertilization," says Burkman. "Defects in endocannabinoid- yannis of the University of Connecticut; The study, led by Herbert by incubation in appropriate culture media in vitro. signaling may be responsible for Jack Lippes of UB; Mary C. Schue!, PhD, professor in pathol- certain currently unexplained Mahony of Eastern Virginia ogy and anatomical sciences, and "We know that sperm capa- Medical School; and Andrea Lani Burkman PhD, assistant professor of gynecology-obstet- citation and fertilizing potential are tightly regulated within types of infertility," Schue! says. "Conversely, endocannabinoidsignaling in reproductive tracts Giuffrida and Daniele Piomelli of the University of California rics, presents the first evidence female reproductive tracts, " that anandamide exists in Burkman says. "We also know may provide potential targets for future development of novel -LO IS BAKER human seminal plasma, mid- that the cannabinoid receptor cycle oviductal fluid and follicu- found in the human brain is ex- lar fluid. Sperm are normally exposed to these fluids as they pressed in the human testis, and that anandamide is produced in travel from the vagina to the site mammalian testes and uteri." of fertilization in the oviduct. Capacitated sperm exhibit a The study also shows that human sperm contain cannabinoid re- characteristic pattern of vigorous swimming called hyperactivated ceptors, and that anandamide motility. After binding to a specific protein in the egg's surface and THC regulate the sperm's "These results suggest that coat (zona pellucida), capacitated sperm undergo the acrosome re- natural endocannabinoid signal- action, a secretory event in sperm ability to fertilize eggs in vitro. ,.' drugs for reproductive medicine. activate these receptors. A sub- ing regulates sperm functions in humans-findings with implications for human reproduction and drug abuse," Schue! says. In 1991, a cannabinoid receptor gene was cloned from a currently infertility," Schuel says. at Irvine. that releases enzymes that enable sperm to penetrate zonae during fertilization. The current study found that an anandamide analog (AM-356) and THC affect the following processes in humans. : i ..• .... First, a low concentration of human brain, which suggested that the body must produce its AM-356 stimulated hyperacti- own chemical version ofTHC to vated motility while slightly higher lani Burkman PhD, and Herbert Schuel, PhD. Spring 2 001 Bu ffalo Physici an 33 �DEVELOPMENT N E w s (ve~ G"ft Vi ato School's future By Li nda J . Co rde r. PhD. CFRE and Biomedical Sciences received $10.8 million in gifts and grants. About two-thirds of the total represented grants awarded competitively by foundations, corporations and nonprofit organizations to outstanding faculty researchers. Members of the James Platt White Society account for the vast majority of the remainder, approximately $3.7 million. This figure represents current gifts, contributions to endowments, bequests and other estate gifts. When I see the tremendous difference that these gifts make to the quality of life for those who study, teach, conduct research and see patients, saying "Thank you" seems hardly enough ... I wish you could walk the halls of our school, our affiliated hospitals, our laboratories and student study areas with me. You would recognize many signs of your philanthropy at work. "Scholarships" is the designation for many gifts. We made proTHIS FUND SUPPLE· gress this year, but increasing both MENTS SCHOLARSHIP the size and number of scholarAWARDS, PAYS ships remain a high priority. CurTRANSPORTATION rently our medical students gradCOSTS FOR STU· uate owing, on average, about DENTS TO PRESENT $80,000 in education loans. For RESEARCH RESULTS the school to enroll its most AND UNDERWRITES promising applicants, it simply RECEPTIONS FOR needs more scholarship funds. DISTINGUISHED Members of the Society underALUMNI WHO RE· wrote several lectures this year. TURN TO TALK WITH The Department of Pathology STUDENTS ABOUT launched a lecture in memory of THEIR CAREERS. Dr. Kornel Terplan. Students heard inspiring lectures dealing with the "art of medicine" during their first- and second-year orientation sessions. Surgery residents participated in the 11 th annual Winfield Butsch Lectureship with an internationally renowned surgeon. The medical student Professionalism Committee finalized the Code of Conduct. It was overwhelmingly approved by students, the Faculty Council and Dean's Executive Committee. A member of this Society underwrote costs for it to be printed on attractive stock, worthy of the content, and distributed without cost to students. The first recipient of the Frawley Resident Research Award received laboratory support for his research in cardiac pathology, cardiac cell biology and integrative physiology. He worked under the guidance of Dr. John Canty, holder of the Rekate Chair in Cardiovascular Disease, an endowed position supported by the Rekate and Boardman Endowments. Many Society members gave to the school's general fund. These contributions provide flexibility to Dean Wright to respond to opportunities that arise serendipitously. This fund supplements scholarship awards, pays transportation costs for students to present research results and underwrites receptions for distinguished alumni who return to talk with students about their careers. Faculty recruitment costs, often not fully covered by budgeted funds, may be supplemented by this fund. A small proportion of overall philanthropy, the general fund remains an important component of the budget. Please help us spread the word regarding the importance of private support. Although state-assisted, the school receives only about 12.5 percent of its budget directly from New York State. Thus, every bit of gift money is vital to our school's future. Development staff members, working in conjunction with alumni, faculty and department chairs, some emeritus faculty members, most importantly, the dean and campaign volunteers who believe in this work, are responsible for encouraging private philanthropy. We want you to know that gifts are used precisely as " DE V EL O PME NT" l 1ffala Pbysician Spring 2001 CON TI NUE D ON P AG E 4 4 �}ANUARY the 1 , 2 0 0 0 - D E c E J\1 B E R 3 1 , 2 0 0 0 Society When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the ]ames Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis oflifetime membership. Names of Founders' Circle members are repeated in the annual category in any year that they make a new gift to the school. Founders' Circle UB's fo unders-pri maril y physicians and attorneysenvisio ned a school to trai n studen ts for service to the commun ity. The Society's Founders help to actual ize that vision by providi ng a genero us base of support fo r programs and activities that enri ch th e academi c enviro nment and enhance medical training. Dr. Willard H. Boardman '44 & Mrs. Jean E. Boardman '48 Winter Park, FL Dr. William M. Chardack Buffalo, NY Mrs. June M. Alker James Platt White, MD, (1811-18811 was instrumental in founding UB's medical school in 1846. W illiamsville, NY Charles D. Bauer MD '46 & Mrs. Mary Bauer Williamsville, NY Dr. Ralph T. Behling '43 San Mateo, CA Dr. Willard H. Bernhoft '35 & Mrs. Clarice L. Bernhoft Snyder, NY Dr. Thomas F. Frawley '44 & Mrs. Marigrace Frawley Gulfstream, FL Chesterfield, MO Dr. Joseph A. Chazan '60 & Mrs. Helen Chazan Mrs. Christine Gretschel Genner Providence, Rf Potomac, MD Mr. DuVal Cravens (deceased! & Mrs. Annette Cravens Mr. John H. Goodwin Jr. Buffalo, NY Dr. Kenneth M. Alford '37 & Mrs. Joan W. Alford Dr. Richard J. Nagel '53 & Mrs. Florence T. Nagel Mrs. Catherine Fix Martinsburg, WV Mr. Donald L. Davis & Mrs. Esther P. Davis Clarence, N Y Dr. Pasquale A. Greco '41 & Mrs. Lois J. Greco Buffa lo, NY Williamsville, NY Dr. Max Doubrava Jr. W illiamsville, NY Mrs. Marjorie B. Eckhert Dr. Thomas J. '61 and Mrs. Barbara L. Guttuso Buffalo, NY East A m herst, NY Ms. Rose M. Ellerbrock Dr. Eugene J. Hanavan Jr. '41 Willia msville, NY Buffa lo, NY Dr. George M. Ellis Jr. '45 & Mrs. Kelly Ellis Mrs. Morris Lamer Connersville, TN Mrs. Grant T. Fisher Palm Beach, FL East Aurora, NY Dr. Albert C. Rekate '40 & Mrs. Linda H. Rekate '71 William sville, NY Dr. Elizabeth P. Olmsted Ross '39 Buffa lo, NY Ms. Thelma Sanes Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Las Vegas, NV Orchard Park, NY Dr. Richard B. Narins '63 & Mrs. Ellen B. Narins Williamsville, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 O rchard Park, NY Dr. Janet H. Sung & Mr. John J. Sung Clarence, NY Dr. Philip B. Wels '41 & Mrs. Elayne G. Wels Williamsville, NY New York, NY Dr. Eugene R. Mindell & Mrs. June A. Mindell fOUNDERS' C IR CLE, CONT'D Buffa lo, NY Spring 200 1 Buffalo Physiciaa 35 �DEVELOPMENT just as a department chair leads a program, donors of leadership gifts in the range of $10,000 to $24,999 are given special recognition. Mrs. Mollie Holtzman Bergman Hollywood, FL Dr. & Mrs. Ernest Beutner Eggertville, NY Dr. Carl V. Granger Buffalo, NY Philip D. Morey M.D. '62 & Mrs. Colleen Morey Williamsville, NY Dr. Edward Shanbrom '51 & Mrs. Helen Shanbrom Santa Ana, CA The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Mr. Donald L. Davis & Mrs. Esther P. Davis Williamsville, NY Dr. Max Doubrava Jr. '59 Las Vegas, NV Dr. Lawrence Golden '46 & Mrs. Nancy Golden '48 Eggertsville, NY Dr. Albert C. Rekate '40 & Mrs. linda H. Rekate '71 Williamsville, NY Dr. Eugene J. Zygaj '50 Lancaster, NY A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporters whose annual gifts range from $5,000 to $9,999. Mrs. June M. Alker Williamsville, NY Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Joseph G. Cardamone '65 & Mrs. Susan G. Cardamone Eden, NY Dr. Morton A. Stenchever '56 Mercer lsland, WA Drs. Michael and Laura Garrick Getzville, NY Dr. Martin C. Terplan '55 San Francisco, CA Dr. Waun Ki Hong Houston, TX Mr. Fred K. Kurata & Mrs. Lynn W. Kurata Santa Monica, CA 36 I u II a I o Pb ys i c i a n E w Dr. Gordon R. Lang '62 Chicago, IL PLATT SOCIETY, CONT'O Annual donors of $1,000* or more are granted membership in the james Platt White Society. Annual memberships in the appropriate circle within the james Platt White Society are granted for one year, beginning january I (for gifts received the prior calendar year). The roster of the fames Platt White Society "Class of 2000" follows. N Spring 2 0 0 1 Dr. Shedrick H. Moore '55 Costa Mesa, CA Dr. John C. Newman Lewiston, NY Dr. Charles S. Tirone '63 & Mrs. Anne R. Tirone '94 Williamsville, NY Dr. James J. White Jr. '69 Buffalo, NY Scholars· Circle One strength of outstanding institutions is the caliber of those who study there. Scholars within the james Platt White Society have made gifts to the school totaling $1,000 to $2,499 during the past year. Those marked with an asterisk (*) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. '"'·c e Fellows within the school are recognized for added depth they bring to postgraduate study. Fellows are honored for gifts that total $2,500 to $4,999. Dr. & Mrs. Charles A. Bauda '42 Boynton Beach, FL Dr. C. John Abeyounis Williamsville, NY Dr. Kenneth M. Alford '37 & Mrs. Joan W. Alford Buffalo, NY Dr. Kenneth Z. Altshuler '52 & Mrs. Ruth Altshuler Dallas, TX Dr. Willard H. Boardman '44 & Mrs. Jean Boardman '48 Winter Park, FL Dr. Lawrence B. Bone '73 Orchard Park, NY Dr. Dennis L. Bordan '70 Port Washington, NY Dr. Suzanne F. Bradley '81 Whitmore Lake, Ml Dr. Martin '72 & Geri Brecher Amherst, NY Dr. Robert A. Brenner '59 Moravia, NY Dr. Harold Brody '61 Getzville, NY Dr. James B. Bronk '81 & Mrs. Suzanne Bronk Napa, CA Dr. August A. Bruno Sr. '51 Buffalo, NY Dr. David P. Buchanan '48 Hillsborough, CA Dr. Hossein Amani Ontario, Canada Dr. William M. Burleigh '67 Rancho Mirage, CA Dr. Melvin M. Brothman '58 Snyder, NY Dr. WilliamS. Andaloro '45 Caledonia, NY Dr. Washington Burns Ill '61 Berkeley, CA Dr. Jennifer L. Cadiz '87 Lemoyne, PA Dr. Mark Anders Buffalo, NY Dr. Charoen & Dr. Charlearmsee Chotigavanich Thailand Dr. Douglas Armstrong Buffalo, NY Dr. Evan Calkins & Dr. Virginia Calkins Hamburg, NY Dr. Robert Gillespie '74 & Mrs. Kathleen Gillespie Buffalo, NY Dr. Hak J. Ko Buffalo, NY Dr. Robert L. Malatesta '60 Warren, N] Dr. Susan V. McLeer Buffalo, NY Dr. Nancy H. Nielsen '76 Orchard Park, NY Dr. Thomas P. O'Connor '67 & Mrs. Sandra S. O'Connor East Amherst, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Orchard Park, NY Dr. J. Bradley Aust Jr. '49 San Antonio, TX Dr. George Bancroft '81 & Mrs. Susan K. Bancroft '79 Hamburg, NY Dr. Elizabeth P. Barlog '82 & Dr. Kevin Barlog '82 Amherst, NY Dr. Jared C. Barlow Sr. '66 & Mrs. Barabara Barlow Grand Island, NY Dr. Paul D. Barry '71 Arlington, VA Dr. Richard A. Berkson '72 & Mrs. Andrea Berkson Rancho Palos Verdes, CA Mr. Sheldon M. Berlow Buffalo, NY Dr. David T. Carboy '63 & Mrs. Jacqueline G. Carboy Lincroft, Nj Dr. Nicholas C. Carosella '54 Appleton, NY Dr. Yung C. Chan '73 Draper, VA Dr. Norman Chassin '45 & Mrs. Charlotte S. Chassin Williamsville, NY Dr. Charles Kwok·Chi Chow & Mrs. Patricia Chow Hong Kong Dr. Bernice S. Comfort·Tyran '58 Los Altos, CA Dr. Donald P. Copley '70 & Mrs. Andrea Copley Amherst, NY Dr. Linda J. Corder Buffalo, NY Dr. Irving Sterman '64 & Mrs. Gail K. Sterman jacksonville, FL Dr. Michael E. Bernardino & Mrs. Joan Bernardino Buffalo, NY Mr. Haskell Stovroff Buffalo, NY Dr. Beverly P. Bishop '58 Snyder, NY Dr. Julia Cullen '49 Buffalo, NY Mr. James I. Stovroff Buffalo, NY Dr. Theodore S. Bistany '60 Buffalo, NY Dr. Daniel E. Curtin '47 & Mrs. Elaine Curtin Orchard Park, NY Dr. J. Steven Cramer East Amherst, NY �E VE R Y LEADE R DEPE DS 0 HELP BR I NG T H E ORGA A SMALL CIRCLE OF ASSOC I ATES W H O I ZAT I ON ' S V I SIO I NTO R EALITY . Dr. David R. Dantzker '67 & Mrs. Sherrye Dantzker Dr. William A. Fleming '64 & Dr. Beth D. Fleming '67 Dr. John H. Hedger '75 & Mrs. Sandra Hedger Dr. Paul B. Karas '87 & Mrs. Donna Karas Dr. Mark J. Lema '76 & Mrs. Suzanne Lema Roslyn, NY Buffalo, NY Salisbury, MD Buffalo, NY East Amherst, NY Dr. Roger S. Dayer '60 & Dr. Roberta A. Dayer '72 Dr. Andrew J. Francis '84 Dr. Reid R. Heffner Jr. & Mrs. Elenora M. Heffner Dr. Julian R. Karelitz '68 & Dr. Mayenne A. Karelitz Dr. Harold J. Levy '46 & Mrs. Arlyne Levy Buffalo, NY Carson City, NV Amherst, NY Dr. William J. Hewett '61 Dr. Mahito Kawashima West Hartford, CT Japan Dr. David C. Lew & Mrs. June K. Lew Dr. Fredric M. Hirsh '73 & Mrs. Donna A. Hirsh Dr. John H. Kent '55 Buffalo, NY Coram, NY Dr. Neal W. Fuhr '52 Dr. Gerard J. Diesfeld '60 Arcade, NY Williamsville, NY Dr. Penny A. Gardner '69 Ronald I. Dozoretz M.D. '62 Falls Church, VA Dr. Robert Einhorn '72 North Brunswick, N] Dr. lillian M. EngasserRowan'45 Chatsworth, CA Dr. Domonic F. Falsetti '58 Lewiston, NY Dr. Leon E. Farhi & Mrs. Haya Farhi Eggertsville, NY Mr. Kevin Feor '80 & Mrs. Elizabeth A. Feor '78 Webster, NY *Dr. Amy E. Ferry '94 Bethlehem, PA Dr. Helen Marie Findlay '78 & Dr. Albert Schlissennan '77 Eggertsville, NY Dr. Marc S. Fineberg Williamsville, NY Dr. Susan Fischbeck '82 & Dr. Patrick T. Hurley '82 East Concord, NY Dr. Jack Fisher '62 La jolla, CA Los Altos, CA Dr. Ronald F. Garvey '53 Tyler, TX Kenneth L. Gayles, M.D. Amherst, NY Dr. Carmen D. Gelormini '50 Syrawse, NY Dr. Michael Goldhamer '64 San Diego, CA Dr. Peter H. Greenman '80 Fairfax Station, VA Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Williamsville, NY Dr. Robert T. Guelcher '60 & Mrs. Elizabeth Guelcher Erie, PA Dr. Thomas J. Guttuso Sr. '60 & Mrs. Barabara Guttuso East Amherst, NY Dr. Robert Joseph Hall '48 & Mrs. Dorothy N. Hall Houston, TX Dr. Christopher Hamill '89 Buffalo, NY Dr. Donald A. Hammel '60 Ravena, OH Dr. Thomas D. Flanagan '65 & Mrs. Grace Flanagan '70 Williamsville, NY n This society honors Genera l Edmund Hayes, an in ternat io na lly reno wn ed d es igner of bridges who bequea thed nea rly $390,000 to UB in 1923. Over the years, a growing number o f friends a nd alumni o f UB's School of Medicine and Bio medical Sciences have joined the Ed m und H ayes Society by including the school in their estate plan. If you are interested in becomin g a m e m ber of th e Dr. Seymour J. Liberman '61 Buffalo, NY Dr. John M. Hodson '56 Dr. Kenneth K. Kim '65 & Mrs. Susan W. Kim Williamsville, NY Clinton, NY Mr. Paul F. Hohenschuh & Dr. Marjorie E. Winkler Dr. Francis J. Klocke '60 Burlingame, CA Dr. Hilton R. Jacobson '45 Shaker Heights, OH Dr. Marshall A. Lichtman '60 & Mrs. Alice Jo M. Lichtman Rochester, NY Chicago, IL Dr. Hing-Har Lo '74 Dr. Robert A. Klocke '62 & Mrs. Barbara Klocke Dr. Alice Challen Lo Grasso '37 Blacksburg, VA Lakewood, NY Williamsville, NY Alameda, CA Robert M. Jaeger, M.D. '47 Mr. Tetsuri Kondo Allentown, PA Japar1 Dr. Gerald L. Logue & Mrs. Joelle Logue Dr. Herbert E. Joyce '45 & Mrs. Ruth Marie Joyce Dr. Joseph M. Kowalski '93 Lockport, NY Mr. Arthur H. Judelsohn Buffalo, NY Mr. Chan Y. lung & Mrs. Sooja Y. lung East Amherst, NY Dr. Wendy A. Kaiser '85 & Dr. Roger E. Kaiser Jr. '79 Clarence, NY Dr. James R. Kanski '60 & Dr. Genevieve W. Kanski '84 Eggertsville, NY Dr. Robert E. Kaplan '81 Buffalo, NY Williamsville, NY Dr. Thomas A. Lombardo Jr. '73 & Mrs. Donna M. Lombardo East Aurora, NY Amherst, NY Dr. Kenneth Krackow Williamsville, NY Dr. Jacob S. Kriteman '67 Danvers, MA Dr. Robert B. Kroopnick '72 Pikesville, MD *Dr. David R. Ludwig '90 Williamsvillie, NY Dr. Frank A. Luzi '88 & Dr. Lori Luzi '88 Clarence, NY Dr. Ivan W. Kuhl '45 Dr. James R. Markello '61 Wimberley, TX Eden, NY Dr. Marie Leyden Kunz '58 & Dr. Joseph L. Kunz ' 56 Lockport, NY Dr. Weerachai Ladakom '91 Bangkok Dr. Andre D. Lascari '60 Poestenkill, NY Williamsville, NY T Okahumpka, FL Dr. John M. Marzo '86 Buffalo, NY Dr. Conrad May '81 Kensington, MD Dr. Brian McGrath Buffalo, NY Dr. Ronald F. Garvey Dr. Karl L. Manders Dr. John T. Cangelosi Mr. John H. Goodwin, Jr. Dr. Benjamin E. Obletz Dr. Stanley B. Clark Dr. Adele M. Gottschalk Dr. Elizabeth P. Olmsted Ross H ayes Society, you m ay con tact the Planned Giving Office at 716-645-33 12. O r, if you have made similar plans and do not see yo ur na m e o n thi s lis t, please call Mary Glenn in the UB O ffi ce o f Develo pm ent, toll -free, at 1-877826-3246 so that we may in cl ud e yo u in sp ec ia l events d uring the year and honor you in futu re recogn itio n lists. Dr. Charles A. Bauda Dr. Frances R. Abel Mrs. Grant T. Fisher Dr. linda J. Corder Dr. Pasquale A. Greco Dr. Julia Cullen Dr. Glen E. Gresham Dr. Thomas G. Cummiskey Dr. Eugene J. Hanavan, Jr. Dr. Richard A. Rahner Dr. Albert C. Rekate Dr. Myron G. Rosenbaum Mr. Edward L. Curvish, Jr. Dr. David M. Holden Dr. Leonard S. Danzig Dr. Hilliard Jason & Dr. Jane Westberg Dr. Daniel S. P. Schubert Dr. Richard F. Kaine Dr. Albert Somit Dr. J. Walter Knapp Dr. Eugene M. Teich Dr. Melvin B. Oyster Ms. Rose M. Ellerbrock Dr. George M. Ellis, Jr. Dr. Kenneth M. Alford Dr. Jack C. Fisher Mrs. June M. Alker Dr. Lance Fogan Miss Thelma Sanes Dr. Harold J. Levy Dr. Pierce Weinstein Dr. Sanford H. Levy Dr. John R. Wright Dr. Milford & Dione Maloney Dr. Wende W. Young Spring 2001 lulf alo Physiciaa 37 �DEVELOPMENT E w Dr. Margaret W. Paroski '80 Dr. David S. Schreiber '69 Dr. James C. Tibbetts '64 Buffalo, NY Westwood, MA Sturgeon Bay, WI Dr. Harry L. Metcalf '60 & Dr. Kaaren Metcalf '78 Dr. Robert J. Patterson '50 & Mrs. Patricia M. Patterson Dr. Joseph I. Schultz '57 & Mrs. Yolanda Schultz Dr. Bradley T. Truax ' 74 Williamsville, NY Snyder, NY San Pedro, CA Dr. Merrill L. Miller '71 Dr. Norman L. Paul '48 Dr. Fred S. Schwarz '46 Hamilton, NY Lexington, MA Buffalo, NY Dr. David P. Mindell & Mrs. Margaret H. Mindell Dr. John H. Peterson '55 East Aurora, NY Dr. Roy E. Seibel Sr. '39 & Mrs. Ruth Seibel SCHOLARS' CIRCLE, CONT'D Ann Arbor, MI Eggertsville, NY Lewiston, NY Dr. John A. Tuyn '60 Williamsville, NY Dr. Hugh D. VanLiew & Dr. Judith B. Van Liew Dr. Alvin Volkman '51 North Hills, NY Dr. Molly R. Seidenberg '53 Georgetown, DE Buffalo, NY Rochester, NY Dr. Arthur M. Morris '65 Dr. Matthew Phillips '91 Dr. Arthur M. Seigel ' 70 Dr. Richard D. Wasson '58 & Mrs. Janet Wasson River Forest, IL Buffalo, NY Guilford, CT Holiday, FL Dr. John A. Moscato '68 & Dr. Beth A. Moscato '96 Mr. Edwin Polokoff Dr. Elizabeth G. Serrage '64 Dr. Arnold Wax ' 76 Boca Raton, FL Cape Elizabeth, ME Hendersor1, NV Dr. Anthony V. Postoloff '39 Mr. Eugene M. Setel Williamsville, NY Buffalo, NY Dr. Charlotte C. Weiss '52 & Dr. Hyman Weiss Manhasset, NY Dr. Arthur W. Mruczek Sr. '73 Dr. Kenneth John Raczka & Mrs. Rita Raczka Medina, NY Amherst, NY Dr. Richard L. Munk '71 Ms. Katharine B. Rahn Sylvania, OH Arlington, MA Dr. Masao Nakandakari '55 Dr. John Y. Ranchoff '52 Dr. John B. Sheffer '47 Williamsville, NY Dr. Peter E. Shields '79 Tonawanda, NY Dr. Timothy S. Sievenpiper '68 & Mrs. Karen S. Sievenpiper Greenville, NC Highland Park, NJ Carlsbad, CA East Aurora, NY John B. Neeld, M.D.P.C. Dr. Bert W. Rappole '66 & Mrs. Mary Helen Rappole Dr. & Mrs. Edward H. SiiMIOIIS Williamsville, NY Dr. Richard G. Williams '80 jamestown, NY Dr. Frederic D. Regan '45 Dr. Ralph M. Obler '52 & Mrs. June M. Obler '49 Los Angeles, CA Dr. Yasuyo Ohta Japan Dr. Kathleen O'Leary '88 & Mr. Michael J. Collins '90 Buffalo, NY Dr. Albert J. Olszowka '58 & Dr. Janice S. Olszowka Boca Raton, FL Dr. Frank T. Riforgiato '39 & Mrs. Mary Cecina Riforgiato Buffalo, NY Dr. John G. Robinson '45 & Mrs. Pauline H. Robinson '67 Williamsville, NY Dr. Bernhard J. Rohrbacher '83 Getzville, NY Dr. Richard R. Romanowski '58 Buffalo, NY Dr. James M. Orr '53 Dr. Jeffrey S. Ross ' 70 Gallipolis, OH Lebanon Springs, NY Nanuet, NY Dr. Albert Somit Encinitas, CA Dr. John J. Squadrito '39 Albany, NY Dr. Philip M. Stegemann '82 Orchard Park, NY Dr. William C. Sternfeld '71 Sylvania, OH Mrs. Gloria Stulberg Orchard Park, NY Dr. John R. Wright & Mrs. Deanna P. Wright Williamsville, NY *Dr. Shih-Ping Yang '93 Dr. Edwin A. Salsitz '72 Maitland, FL New York, NY Mr. Chun-Sik Park & Mrs. Younghae K. Park Dr. Arthur Schaefer (deceased) Dr. Sylvia W. Sussman '60 Allentown, PA Hideo Suzuki Holland, NY Dr. Wende W. Young '61 Dr. Meyer lllwchun 'XI and Mrs. Ann S. Rlwchun Malden, MA Dr. Warren M. Zapol Boston, MA Dr. Franklin Zeplowitz '58 & Mrs. Piera Zeplowitz Buffalo, NY & Mrs. Elizabeth Ann Schaefer Snyder, NY Dr. Wayne C. Templer '45 Dr. Adolphe J. Schoepflin '45 Mr. Fritz Terplan Ada, OK San Francisco, CA Walnut Creek, CA Dr. Israel Ziv Williamsville, NY Ph ysici an Spring 2001 Mr.WafterMazal *Ms. Sanda Yu '95 Dr. David C. Ziegler '64 & Mrs. Susan D. Ziegler Latrobe, PA Dr. Clan A. March '07 Canandaigua, NY japan Corning, NY Ms. V'll'linia A. lames Mrs. Grace S. Mabie Carmel, IN Tonawanda, NY The following individuals left generous bequests or made arrangements for the school to receive gifts from testamentary trusts. Gifts from the individuals listed below were received during 2000. Miss Ruth v. Hewlett '30 Dr. Michael A. Sullivan '53 Williamsville, NY Williamsville, NY Taiwan Buffalo, NY Williamsville, NY Dr. Marvin Z. Kurian '64 & Mrs. Eleanor Kurian Dr. Gregory E. Young '77 & Mrs. Diane Young Buffalo, NY Dr. Paul A. Palma '73 lul f a le Lewiston, ME Dr. Robert G. Smith '49 Clearfield, PA Mr. Ralph C. Wilson Jr. Dr. Heun Y. Yune & Mrs. Kay K. Yune Dr. Albert G. Rowe '46 Dr. John S. Parker '57 & Mrs. Dorris M. Parker Dr. Richard A. Smith Orlando, FL Mr. James J. Rosso '76 & Mrs. Cheryl Rosso Dr. Charles V. Paganelli Jr. & Mrs. Barbara Paganelli Seoul, Korea Orchard Park, NY Savannah, GA Amherst, NY Dr. Marvin G. Osofsky '59 Dr. James A. Smith ' 74 Dr. John L. Butsch Buffalo, NY Dr. Gary J. Wilcox '73 Fairview Park, OH Dr. Tomoe Nishimaki Ms. Janet F. Butsch Aurora, CO Buffalo, NY Honolulu, HI Japan Dr. David W. Butsch Montpelier, VT Dr. Paul H. Wierzbieniec '74 & Ms. Ellen Wierzbieniec Dr. Charles E. Wiles '45 Atlanta, GA A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. Dr. Robert Bernot '60 & Mrs. Carol Bernot Dr. James F. Phillips '47 & Mrs. Marcella Phillips Orchard Park, NY Special Members Barnstable, MA Dr. Maynard H. Mires Jr. '46 Dr. John D. Mountain '33 38 N Mrs. TModosia H. SlicllneJ '28 Mrs. Ethel Wlmbelty We have made every effort to ensure accuracy in these lists. If you have any questions or corrections, call Mary Glenn tollfree or or e-mail her at glenn@acsu.butfalo.edu. �Dear Fellow Alumni, was held the last weekend in April and 1 Q was a tremendous success, with over 300 University at Buffalo School of Medicine and Biomedical Sciences' alumni attending with their families. Be sure to look for a full report on the weekend's events in the summer issue of Buffalo Physician, which, among other things, will feature the four alumni chosen by the Medical Alumni Association Board to receive this year's achievement awards: Marcella F. Fierro, MD '66, Wendy W. Logan-Young, MD '61, Nancy H. ielsen, MD '76, and Morton A. Stenchever, MD '56. As my year of serving as president of the Medical Alumni Association comes to a close, I can tell you that it has been both a privilege and an honor to serve in this capacity and to have had the opportunity to meet so many interesting and outstanding members of our UB Alumni Association. At this time, I would like to thank a few people who help make this organization run as smoothly and effectively as it does. Bertram Portin, MD '53, our assistant dean for Alumni Affairs, is a tremendous source of support and information, as is Dr. Jack Richert, former associate dean for Alumni Affairs, who has served on the board this year at my request. Jack has also helped with his tremendous knowledge of the history of the organization and the medical school. Mrs. ancy Druar, who serves as our administrative assistant, is certainly the glue that holds this organization together and without Nancy's help, we wouldn't have any of the successful programs that we have today. I also would like to thank some of our fellow Alumni Association board members: Richard Collins, MD '83, who has served as past president, Patricia Duffner, MD '72, who served this year as vice-president, Colleen Mattimore, MD '91, who will be the next vice president, and Stephen Pollack, MD '82, who will be the next treasurer and secretary. I would be remiss if I did not mention one more time that we are still looking for many more lifetime members, and we hope that you, as alumni, will find it in your hearts to support our school in this manner. Once again, I thank you for allowing me to serve as your president. II , MD President, Medical Alumni Association jOHN j . BODKIN Spring 2001 luffal1 Physician 39 �CLASSNOTES 1940s William Herman Bloom, MD '48, has been elected to Who's Who in Medicine and Healthcare, as well as Who's Who in Science and Engineering and Who's Who in the World. He recently published After All, It's Only Brain Surgery (available in bookstores ISB l56167-573-3; publisher, Noble House). Michael Genco, MD '58, writes: "Ann and I are enjoying retirement. We have moved to a condo at 600 Main Street in downtown Buffalo, NY, 14202." E-mail address is: mgencobuf@aol.com. 1960s Dick Eggleston, MD '62, writes, "Hi, I retired from Ford Motors at the end of2000. We just completed a home in Hamilton, MT. I will be hiking, learning to fly fish and using my camera. In addition, I have accepted a parttime position at Marcus Daly Hospital in Hamilton." 1970s Howard R. Goldstein, MD '74, writes: "Judy and I are still living in Cherry Hill, NJ. I'm in an eightman urology practice and am very happy. Our children: Lee is a firstyear surgery resident at the Hospital of University of Pennsylvania (MD, Yale Medical School); Lauren is a the next four years. These included tours of duty in surgery, thanks to a surgi- In 1974, I was in· '46, FPCS, writes from cal residency while in the ducted as a Fellow in the Santa Barbara, CA: Philadelphia, Washington, Navy. Because of being in a Philippine College of Sur- Greetings from - of the members of the DC, the USNAS in the Phil- "goiter belt," I seemed to geons. As the years went ippines, and An- by, my role gradually short-term help to sister class of '46. In lieu of napolis before shifted to that of men· mission hospitals in tiYe Uncoln D. Nelson, MD a healthy body) but lose his soul?' Since retirement we haYe continued to glye my being able to attend discharge from tor for young Filipino foreign countries: the reunion In April, I actiYe duty in doctors. When we re- Bangladesh, Amazonas will write this note about '51. Six months tired from full-time Brazil, Togo, the Gambia our life's work. I say thereafter we duty with our Mission in West Africa and a clinic in the Ukraine. We 'our' since my life's were back in the lthe Association of partner, Lenore Butts PhHipplnes under Baptists for Wortd plan to continue doing Nelson, RN, became my a HeaYenly Com- EYangelism, Inc.) we so as long as the Lord bride in '44 and has re- mander In Chief. malned my closest friend For the next left three of these keeps us in good health. hospitals In the We are grateful for the and colleague in our 35 years, God capable hands of an training years at UB and medical missionary work enabled us to all-Filipino staff thank our mentors there. eYer since our training years In Buffalo. establish three rural major in thryoidectomies continuing the care of the We hnen't piled up mission hospitals and as- and deYeloped a technique total patient: body, soul much of this wortd's and spirit. goods, but the remu- sist in a fourth. These each of doing them under In a ciYIIIan hospital in became general hospitals regional block anesthesia. Hackensack, NJ, in '46- in which we had no choice When I last stopped count- 47, the Navy took charge but to be 'general special- of our appointments for ists,' with a major in After my Internship 4D grandfather, Tom Beahan, an Adirondack Larry Beahan, MD '55, has logger in the early 1900s. published a book, titled, "Larry describes life in a My Grampa's Woods, lumber camp in the the Adirondacks. Beahan, Adirondack woods of a physician active in 1900 in an honest and conservation efforts, intimate way," writes a has assembled a collecreviewer for Amazon. tion of colorful stories com, "so that you hear spanning the 20th centhe noise of the loggers tury. These tales of talking at breakfast, taste tragedy and death, the hot cakes covered humor and family lore with maple syrup, and stem from his family's smell the horses as they encounters in the sweat and strain at Adirondack Mountains pulling the logs across in northeast New York the snow-covered State, beginning with his forest floor." 1950s luffal 1 Phys i c i an Spring 2001 The theme plaque OYer neration is "out of this the door reads, 'For what wortd." We wouldn't ing, we had done OYer does it profit a man to gain switch jobs with any- 1,200 of them. the whole world !including body. �assnotes tion. I enjoy traveling with my wife, Carol, and our three wonderful children." E-mail is Dforster @pol.net. Michael Nancollas, MD, '85, senior at Columbia University and Daniel is a freshman at the University of Pennsylvania, where he is playing catcher for their Division 1 baseball team." E-mail is hrgmd1@home.com. Marguerite Dynski, MD '75, Rochester, Y, general surgery/breast disease, writes: ''I'm a site director of third-year students from the University of Rochester and am on faculty at RIT." E-mail address is marguerite.dynski@ viahealth.org. Claudette Robbins, MD '78, writes: ''I'm no longer at HDH, but am now a full-time radiologist at Olive View Medical Center in Sylmar, CA. E-mails are welcome: claudettemd@yahoo.com." Cavia L. Stanley, MD '78. MDiv, is listed in the 2000 (millennium) edition of Who 's Who in Medicine and Healthcare. He is the district health director of Waccamaw Public H ealth District in South Carolina. The district includes Horry Country (Myrtle Beach), Georgetown and Williamsburg counties. Stanley is a gynecologist in the U.S. Airforce reserves and a lieutenant colonel. 1980s Ellen M. Tedaldi, MD ·so. Philadelphia, PA, internal medicine, is director of the HIV Program at Temple Hospital. E-mail address is etedaldi@ unix.temple.edu. RPCI, where he is also director of the institute's Head and eck Surgical Oncology Fellowship Program. His research interests focus on respiratory epithelial injury-repair and differentiation, and his laboratory is doing novel work in bioengineering large conducting airway devices. David Forster. MD '85, Oak Hill, VA, ophthalmology, writes: ''I'm a clinical associate professor of ophthalmology at Georgetown University. I'm also vice president of the orthern Virginia Academy of Ophthalmology and president of Georgetown Ophthalmology Alumni Associa- Fayetteville, NY, hand surgery/orthopaedic surgery, writes: "I started a clinic for performing artists, so I get to practice a different type of 'sports medicine,' treating musicians in the Central ewYorkarea." E-mail address is hand.doctor@pobox.com. CO N T I NUED ON P AGE 4 2 Wigand's "Secrets through the Smoke" Wesley L. Hicks Jr. DDS, MD '84, associate profes- sor of otolaryngology/ head and neck surgery at the University at Buffalo School of Medicine md Biomedical Sciences, and attending surgeon in the Division of Head and Neck Surgery at Roswell Park Cancer Institute (RPCI ), has been invited by the American Board of Otolaryngology to serve as alternative guest exam iner for its 2001 oral examination and guest examiner for its 2002 oral examination. In 1991, Hicks joined Spri 11 g 200 1 laffala Physician 41 �CLASSNOTES CONTINUED FROM PAGE 41 Roseann Russo, MD '85, Manhasset, Y, pulmonary, critical care medicine, writes: ''I'm medical director of the respiratory care unit at orth Shore University Hospital in Manhasset. Am also the medical director of pulmonary rehabilitation for NSUH/LIJ." Lynda Stidham, MD '85, Glenwood, NY, pediatrics, writes, "Two years ago I returned to Christ the King Seminary where I am studying pastoral ministry, which is enriching my personal and professional life immensely. I'm practicing in a suburban pediatric group." 199 s Gale R. Burstein, MD '9D, Decatur, GA, pediatrics and adolescent medicine, is working as medical epidemiologist at the Centers for Disease Control and Prevention. E-mail address is gib5@cdc.gov. Pamela A. Clark, MD '90, Prospect, KY, pediatric endocrinology, writes: "I am currently chief of the Division of Endocrinology at the University of Louisville." E-mail address is paclark@pol.net. 42 l ulfal1 Pb ysiciaa Mark A. Flanzenbaum, MD Douglas P. Prevost, MD '90, '90, Glen Allen, VA, San Antonio, TX, orthopaedic surgery, writes: "I am an army staff orthopaedic surgeon, chief of joint service." E-mail address is dprevost@ gateway. net. emergency medicine and pediatric emergency medicine, writes: "I am a faculty member at the Medical College of Virginia." E-mail address is mflanz@worldnet.att.net. Eileen Schwartz Saltarelli, Robert J. Leon, MD '90, MD '90, Canton, OH, psy- ew York, NY, writes: "I live on the upper east side of Manhattan. My practice is located in NJ. I enjoy the culture of NYC and solo cardiology practice." E-mail address is rleonmd944@aol.com. chiatry, writes: "I work for a community mental health agency and consult in 12 nursing homes." E-mail address is msaltdoc@aol.com. Laura Nicholson, MD '90, Palo Alto, CA medicine, writes: "I joined Stanford University in 1997 as director of the Medical Consultation Service. I also serve as medical director of Inpatient General Medicine and associate program director of Internal Medicine Residency. On weekends, I enjoy the great outdoors of northern CA and great indoors of San Francisco." E-mail address is lnicho@leland. stanford.edu. Timur Sarac, MD '90, Orange Village, OH, vascular surgery, writes: "I have spent nine years in postgraduate education. Finally it's paying off, as I am working with my residency mentor at the Cleveland Clinic." E-mail address is saract@ccf.org. Valerie Vullo, MD '90, Clarence, NY, physical medicine and rehabilitation. "I am part of the Department of Rehabilitation Medicine at UB and a clinical assistant professor at UB's School of Medicine." Spring 200 1 surgery at the University of California at Davis in Sacramento, CA." E-mail address is rudolph.schrot@ ucdmc. ucdavis.ed u. Cynthia Leberman Jenson, MD '92, writes: ''I'm in Kenneth A. Levey, MD '97, private practice in Bangor, ME, (anesthesiology). My husband, Mark, is a stay-at-home dad with our two daughters, Alexandra, age six, and Erica, three." E-mail address is mcaejenson@ adelphia. net. writes: "I am completing both my residency in OB/GYN and my master's degree in public health this spring at the George Washington University. I will be starting this summer as assistant professor of OB/GYN at the New E-mai Jon Kemp, MD '93, writes: "Meri and I are in Portland, Oregon, and very happy. We have two little girls, Laurel and Sophie. I am practicing ophthalmology and not taking too much call." E-mail address is jkemp899@aol.com. Tara (Sosa) Paolini, MD '95, Lisa M. Nocera, MD '90, Greenville, NC, anesthesiology-pain management. I recently married, moved and started a new job! I'm as happy as I've ever been!" E-mail address is lmnocera@ hotmail.com. cal care at UPMC Passavant in Pittsburgh, PA. I look forward to retiring in 2035." York University School of Medicine." Mark L. Capener, MD '99, writes: "My practice is going very well here in Elko, NV. I also work in Ely, NV, and in Winnamucca on alternative weeks. Who woulda thought? Hello to all the gang in Buffalo!" E-mail is: capeners@elko.net. Steven P. Harris, MD '91, and Raymond V. Paolini, writes: "We are pleased to announce the birth of our third child, Elaina Anne-Marie. She is welcomed by brothers Donovan, age 4, and Steven, age 5. I am currently in private practice in pulmonary and criti- MD '90, write: "We are Thomas A. Cumbo, MD '99, happy to announce the birth of our daughter, Dora Rae, on August 14, 2000." E-mail address is tsosa@ yahoo.com. writes: "I completed my second research expedition to the epa! Himalayas last summer as a PGY-2 resident at The Johns Hopkins Rudolph Schrot, MD '96, writes: "I am currently PGY-3 in neuro - CONTINUED ON PAGE 44 �Erica (Heit) Remer pens amedical thriller Aplan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anything you need to keep enjoying life . Call686-8077. THE CENTER FOR H'lSPICE& PAlllATNE CARE wwtll. hospicebtiffalo. com Spr i ng 200 1 luffalo Physiciaa 43 �C L A CON TI NU ED FR O M P AC E 4 2 University/Sinai Hospital Program in Internal Medicine. I led an eightman team from the Himalayan Rescue Association into the Langtang region of the peaks (just below Tibet) where we gathered data to test a hypothesis regarding the pathogenesis of altitude illness. We studied a Hindu pilgrim population at a sacred high altitude lake at approximately 4,500 meters. The pilgrimage is an annual event in honor of the Vedic Diety Shiva and is performed by approximately 4,000-5,000 individuals. In addition In emo N 0 T E tO COllecting data, We were in charge of providing medical care for the masses in a Third-World environment. It was an exciting mix of basic science, field research, ThirdWorld culture, backcountry medical care and religion. I plan a biannual trek to further refine our numbers and test novel hypotheses. P.S. I have a letter to the editor published about high altitude medicine in the January 2001 issue of Emergency Medicine on page 6. " each donor specifies. The UB Foundation acts as the school's banker and investment manager, charges minimal fees (much less than profitmaking financial institutions) and makes disbursements in accordance with donors' stipulations. It is the Dean, however, who leads the development program. He articulates the vision and the dreams of the school. Our office does assist with details , but it is the donors and volunteer leaders who respond that make the dreams come true. With appreciation to all of those who make philanthropy a high priority, and on behalf of the ultimate beneficiaries , I thank our increasing number of committed james Platt White Society members. You make such a crucial difference to our school. CD mda f. (h 11 Cordu may he reached, toll-j•H at 1-877-826-3246 or mad at ljCOJ derCrobuffalo.edu. CD West Virginia; and Ronald of Buffalo in 1945. A diplo- in White Sulphur Springs, Burbank, California. mate of the National board of trustees for Board of Medical Examin- Aiken County Rescue West Virginia. Morhous was Squad and chair of the Board of Internal Medicine, George Alex Poda, MD '45, died on December ers and the American Eugene J. Morhous, MD '45, died Septem- Board of Preventive Medi- South Carolina Regional was a fellow of the Ameri- 22, 2000, at Aiken Re- cine, he was the author of Blood Bank. Poda orga- gional Medical Center in numerous papers and nized the Sabin Polio certified by the American 44 tal, was a member of the staff at the Greenbrier Hotel ber 11, 2000, at his can College of Physicians home in White Sulphur and served as a member of South Carolina. He was 79. books on nuclear medi- vaccine program in Aiken Springs, West Virginia. the National Board of Medi- A native of Jamestown, NY, cine. He served as an County and Richmond A native of Palmyra, cal Examiners. He was a Poda served as a captain associate professor in the County, GA, and champi- New York, Morhous past president of the Green- in the U.S. Army Medical Department of Community oned the formation of the received his under- brier Valley Medical Society Corps, both on active Medicine at the Medical associate degree nursing graduate degree from and was a member of the duty and reserve status, College of Georgia and program at USC Aiken. St. Lawrence University. West Virginia State Medical from 1941 to 1952, and was a visiting lecturer on He is survived by his wife, Following graduation Society and the American later in the U.S. Navy occupational medicine at Anna Michele Poda; son, from the University of Medical Association. Medical Corps. the Medical University of Steven Michael Poda, Poda was a graduate of Buffalo School of Medi- Morhous, who was pre- South Carolina (USC). He Aiken, South Carolina; cine in 1945, he prac· ceded in death by his wife, Alfred University and Mount served as chair of the and daughter, Deborah ticed medicine for 35 Betty Jane, is survived by Union College and com· board of trustees of Aiken Ann Poda Lyles, Spar· years as a member of two sons: Lawrence, and his pleted his medical degree at Country Hospital and later tanburg, South Carolina. the Greenbrier Clinic wife, Carolyn, of Bluefield, the University of Aiken Community Hospi· I UII aID Ph ySiC iII Spri11g 2001 CD b~ �- Based on F/MsM Data ffTheywere drJl sergeantsand cheerleaders~' - Frank Ste/arski, stroke rehab patien~ Harris Hill H.C.F Why do our patients have better rehab results compared to the national average? Maybe it's our staff ''They knew exactly how far to push me,'' says Frank Stelarski. ''But they also encouraged me every little step of the way. When you've been through what I have, that really means a THE lot:' To leam more about the nationally recognized McGuire Rehabilitation ~~cy}Jf1fl(91'{ CENTE~ Centers, call 1-888-POSTACUTE or visrt www.mcguire-group.com. Recognized for excellence in quabty care. AUTUMN VIEW • GARDEN GATE • HARRIS H*****" HILL • Spring 2001 NORTH GATE Bu f falo Pbysicin 45 �The State University of New York A R A UB's HISTORY OF MEDICINE COLLECTION PRESENTS reproduced prints from a pharmacopoeia by Otto Karl Berg (r8rs-r866) were on display last fall in University at Buffalo's Health Sciences Library (HSL), South Campus. The botanical show was developed by the HSL and the university's iMedia staff and is the first in a series of "Art in the Library" exhibits intended to promote the His tory of Medicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume, published in Leipzig in I863. Pictured is Papaver somniferum. BP 0004 01 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n04-2001-Spring Table Of Contents A list of subunits of the resource. Medicine Goes Molecular McKinley's Assassination Pathways Medical School Alumni Research Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. 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Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/a8125407dc7b423205f6a95c526ca3db.pdf d2631d990ed32d2649e035f8361406c4 PDF Text Text �l1fhh ••ysicial LIB_R_AR_Y_ _ L - -_ _ j ASSOCIATE VICE PRESIDENT FOR UN I VERSITY COMMUN I CAT I ONS Dr. C arole S nrit/1 Petro D I RECTOR OF P ER I OD I CALS Sue Wu e tcher New Dean Named EDITOR S t ephani e A . U n ge r ART DIRECTOR/DESIGNER A lan f . Kegle r N JUNE 28,2001, University at Buffalo Provost Elizabeth D. Capaldi, PhD, announced that CONTR I BUTING W R ITER the positions of vice president for health affairs and dean of medicine would be recombined, Lois Bake r and she named Michael Bernardino, MD, MBA, to the role, effective immediately. Bernardino has been serving as vice president for health affairs at UB since the spring of PRODUCT I ON COORD I NATOR Cy nthia Todd-Flick 1998. As the new dean of the School ofMedicine and Biomedical Sciences, he succeeds John R. Wright, MD, who has served in that capacity since 1998 and as interim dean since 1997. UN I VERS I TY AT B UFFALO ScHOOL OF MED I CINE AND Before assuming that role, Wright was chair ofUB's Department of Pathology for 23 years. In citing reasons for the consolidation, Capaldi explained that "given the current period of rapid change in the field of medicine, the university has decided that leadership for the school can most effectively be provided by one individual who is responsible for its overall educational and research mission, its financial affairs and its relationship with its affiliated teaching hospitals." Capaldi also announced that Wright will continue to serve as professor of pathology in the School of Medicine and Biomedical Sciences. "We all appreciate Dr. Wright's leadership in developing the school's new curriculum and in building a support base for the school with the alumni, students and other constituencies," she said. "These contributions form a strong basis for continued excellence." Prior to coming to UB, Bernardino served as director ()f managed care with the Emory University System of Health Care, in Atlanta, and was a professor of radiology in the Emory University School of Medicine. As vice president for health affairs at UB, he has been responsible for overseeing the clinical and collaborative activities of the university's five health sciences schools: medicine and biomedical sciences, dental medicine, health related professions, nursing and pharmacy and pharmaceutical sciences. He has also been responsible for spearheading the university's relations with its affiliated teaching hospitals and for leading the healthcscience deans in planning and executing joint and cooperative B I OMED I CAL SCIENCES Dr. Mi chael Bernardino, Dcatl EDITOR I AL BOARD Dr. john Bodkin Dr. Martin Brech e r Dr. Harold Brody Dr. Linda f . C orde r Jason Hoffman, C la ss of 2004 Dr. fame s Kan ski Dr. Elizabeth Olm st ed Dr. fames R . Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEACH I NG H OSPITALS Erie Co unty M edi cal Ce11t er Ros well Park Ca11 ce r In stitut e Ve tera11 s Affairs W es tenr New York Health ca re Sys t em K ALEIDA H EAITII: T he Buffalo Ge11 eral Ho spital Th e CIIildre11 's Ho sp i tal of Buffa lo Mill ard Fillmo re Ga tes Hosp i tal Mi llard Fillm ore S ubu rban H ospit al CA TIIOLI(. H EALTH s )'S1"EM : M ercy Health Sys t em Sis ters of Clwrity Hospit al programs of teaching and research. Earlier this spring, it was announced that Bruce Holm, PhD, senior associate dean for research in the School of Medicine and Biomedical Sciences, has been given the additional N iagara Fa lls M emoria l M edi cal Ce 11t er title of senior associate vice president for health affairs, reporting to Bernardino. @ John Hay, PhD, Grant T. Fisher Chair of Microbiology at UB, has assumed Holm's former administrative responsibilities related to the school's graduate programs in biomedical education. Also, the position of assistant dean for alumni affairs-formerly filled by Bertram Partin, MD '53-has been discontinued, with plans under way to restructure administrative roles in the Medical Alumni Office. UNIYEISIIY l!IUIIILO. THE STilE UNIYEISITY 01 NEW YORK Letters to the Editor Bllffalo Pl1ysician is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Ongoing developments at the School of Medicine and Biomedical Sciences will be addressed in messages by Dr. Bernardino in upcoming issues of Buffalo Physician, as well as in feature articles and news updates. - S . A. UNGER Letters to the Editor are welcome and can be sent c/o Buffalo Physiciall, 330 Crofts Hall, University at Buffalo, Buffa lo, NY 14260; or via e-mail to bp-notes@buffalo.cdu. The staff reserves the right to ed it a ll submissions for length and clarity. T...:.:... University at B-~~';, 1York ~ The State University OJ �VOLUME 36, NUMBER 0 p H y s c A N Features 2 'A Little Fire in the Belly' Donald Finkel, MD '51, . . p10neenng cancer researcher and founder of the Women, Infants and Children Program BY 10 S. A. UNGER Good Ways to Deliver Bad News New course teaches students how to deliver bad news in a caring, effective way BY M.D. This year'scommencement-held on May 18, 2001-marked the 155th at the University at Buffalo School of Medicine and Biomedical Sciences. Pictured above is new graduate Timothy 8. Curry, MO/PhO. KINNAMON Cov 15 Departments Merge 16 Match Day 20 CAT and NYSTAR programs announced 23 Buffalo-Niagara Medical Campus group formed 24 Graduation 26 Margaret Paroski new director of admissions 27 Beutner and Jordon receive Discovery Award 29 Robert Galpin, MD, heads pediatric orthopaedic surgery 30 Role of statins in heart disease topic of 200 l Stockton Kimball lecture by Antonio Gotto, dean of Weill Medical College, Cornell 31 Medical Alumni Achievement Awards IMAGE BY PAM f-RAN 34 Michael Baron reflects on his medical career after 30 years 35 Class reunion photographs s 38 Gifts of art beautify the school, inspire students jim Dine prints presented to school by AAMC now on display (see back cover) 40 News from your UB classmates and other alumni 43 In MemoriamClassmates remembered and their accomplishments honored �by S. A. Unger Donald Pinkel, MD '51. pioneering cancer researcher and founder ofWIC Program bout the time his Career began tO hit itS peak in the late 1960s, Donald Pinkel, MD '51, found himself at the center of two controversies, the resolution of which would help redefine standards for pediatric care during the latter half of the 20th century. The first of these controversies revolved around the fact that Pinkel insisted on the feasibility of curing childhood leukemia with agents that were then available, a stance that went in direct opposition to prominent pediatricians and hematologists at the time who felt any use of the word "cure" in this context would give false hope to parents whose children had leukemia. By the early 1970s, however, Pinkel and his colleagues had succeeded in silencing these critics by developing the first curative drug treatment for acute lymphocytic leukemia (ALL) in children. The second controversy, which grew out of the first, involved Pinkel's attempt to address the fact that many of the pediatric hematology/oncology patients he and his colleagues were treating also suffered from chronic malnutrition directly related to their socioeconomic status. As a result of this observation, Pinkel led a politically unpopular effort to develop and prove the efficacy of a public-health initiative that later came to be called "Everybody was getting the Special Supplemental Food Program for Women, Infants and Children. upset with us because we Known to health-care professionals today as WIC, this were talking about curing program has since been adopted at the federal level by the Food leukemia and they said, and utrition Service of the United States Department of 'You can't do that,' and Agriculture (USDA), which in its own literature refers to it as "one of the nation's most successful and cost-effective nutrition some people got pretty intervention programs." defensive and angry about How did this native Buffalonian and graduate of the thenthat in the early days," he University of Buffalo School of Medicine find himself on the says. "We were trying to front line of these key battles in oncologic research and publichealth policy? Pinkel-who returned to UB last September to be modest, but still alot of be honored as the 2000 Distinguished Medical Alumnusjournal editors and explains that, in retrospect, his career was stimulated in its course referees didn't like that not so much by clear direction as by disturbing voids in health kind of talk." care for children. 2 laffal1 Physiciaa S umm e r 2 001 ��inkel traces his interest in pediatric hematology/oncologyback to 1949, when, as a second-year medical student, he had the "good fortune" to take an elective in hematology with the renowned clinician David K. Miller, MD, who was head of medicine at E.). Meyer Memorial Hospital (now Erie County Medical Center). "I saw my first child leukemia patient while making rounds with Dr. Miller, and at that point I became very interested in these children. So, by the time I graduated from medical school I was, as you might say, 'into' hematology," he explains. This interest was reinforced during the first few months of Pinkel's internship at Children's Hospital of Buffalo (CHOB). "One of my first patients was a newly admitted child with all the symptoms and signs of leukemia, which I was pretty familiar with by then," he recalls, "so I made the diagnosis and was in the position of having to inform the parents that their child was going to die, because this diagnosis was like a death warrant then. "This was a very disturbing experience for a young person right out of medical school-so disturbing, in fact, that I felt l couldn't run away from it, which might be one's first impulse," he adds. Despite his strong interest in pediatric hematology/oncology, Pinkel had few role models he could look to at that time because the fields of hematology and oncology were still in their infancy, too new to recognize or support individuals with subspecialty interests. In fact, during the time he was a resident at CHOB, the hospital employed only one part-time pediatric hematologist, George Selkirk, MD, whom Pinkel remembers as being very encouraging and supportive. While serving as chief resident during his third year of training, Pinkel received a welcome boost to his aspirations when Selkirk took him aside and asked if he would like to take on a project to develop a tumor clinic at the hospital. "Dr. Selkirk had received funding from the American Cancer Society for a tumor board at Children's, so with those fundsand with the approval of Dr. Mitchell Rubin, chairman of pediatrics-he set me up with an office and a part-time secretary, and I began to review all the patients at Children's who had ever been diagnosed with cancer," he explains. Gradually, because there was no full-time hematologist/oncologist on staff at the hospital, Pinkel began to be called in to see all the children diagnosed with leukemia and other forms of cancer. "You have to understand, no one was doing much then with children who had cancer. Attitudes were negative everywhere," he emphasizes. "It was a very sad situation, so somebody had to get in there and start it." Over the course of his residency, therefore, Pinkel became that "somebody" who stepped in to fill the void. "By the time I finished my residency, I had become the [hospital's] unofficial pediatric oncologist because of my special interest in children with cancer," he says. "I also sensed that much more could be done, at least in terms of pain relief and comfort for the children and their families." lallala Phys iciaa S umm e r 2 001 "Real" Postgra~uate Training in Me~icine Having had the opportunity to see that he could, in fact, "get in there and start it," Pinkel was eager to seek greater exposure to his newly chosen field. Prior to completing his residency in June 1954, therefore, he applied for a fellowship at Memorial Sloan-Kettering Cancer Center in New York City and was accepted. Soon thereafter, however, his plans changed dramatically when he received notification that he had been activated out of his reserve unit at UB, the 338th General Hospital, which he had joined as a commissioned officer following graduation from medical school. In a twist of fate that would change his life in ways he never could have foreseen, Pinkel was assigned as head of pediatrics at the station hospital at Fort Devens, Massachusetts. There, not long after his arrival, he contracted poliomyelitis and became severely disabled, requiring hospitalization for six months at nearby Murphy Army Hospital in Waltham, Massachusetts. "I was extremely ill with it for a while, but after about six weeks I could start raising my head, and after about three or four months, I was able to ambulate some with long leg braces and crutches," Pinkel recalls. Upon discharge from Murphy Army Hospital, the 28year-old Pinkel was retired from the army on full, permanent disability. Still on long leg braces and crutches, �''Th.IS was the first curative treatment of any kind for leukemia and the first time that cancer had been cured primarily with drugs;' he notes. "It was also the first time that people who had generalized cancer were cured, so it was important in three different ways:' ------- he was transferred to a Veteran's Administration hospital outside Boston, where his rehabilitation continued for another year. Referring to this time as his "real postgraduate training in medicine," Pinkel recounts how after a year at the VA, most of which was spent in half-day outpatient physical therapy sessions, he progressed to where he was free of the wheelchair and could rely solely on short leg braces and a cane to walk. "So, after a while, I was able to move along and was very fortunate," he says. As part of his rehabilitation, Pinkel was encouraged to resume working, so the very first day he received his driver's license after relearning how to drive, he headed to Boston Children's Hospital preceded by a letter of introduction from Dr. Rubin at CHOB. The letter was addressed to Dr. Charles Janeway, who referred him to Dr. Sydney Farber, a fellow native Buffalonian and oncologist whose contributions to his field eventually led to Harvard University naming its Dana Farber Cancer Institute in his honor. "When I saw Dr. Farber, he hired me on the spot as a half-time fellow, and I began to work in the Jimmy Fund Clinic at Boston Children's Hospital. In this way I resumed my interest and my activity in hematology and cancer, especially leukemia," explains Pinkel. Back to Buffalo, and Beyond Toward the end of his first year as a fellow with Farber, Pinkel was contacted by Rubin and George Moore, MD, the new director at Roswell Park Cancer Institute (RPCI), who asked him if he would consider returning to Buffalo to establish a pediatric service at RPCI, as well as join the faculty at UB and the staff at CHOB. The answer was yes, and by April 1956, following discharge from the VA hospital, he was on his way back to Buffalo. In the five and a half years of whirlwind activity that followed, Pinkel set about organizing the new pediatric inpatient unit, clinic, laboratory and research programs at Roswell Park, while concurrently conducting his own research, teaching and seeing patients. Then, in 1961, Pinkel was asked to become the first director of St. Jude Children's Research Hospital, which was under construction in Memphis, Tennessee. As envisioned by its founder, entertainer Danny Thomas, the hospital would become the first institution in the United States devoted solely to basic and clinical pediatric research and the first racially integrated institution in that region. Pinkel accepted the offer and began preparing for his move to Memphis in October 1961. As it turned out, however, he didn't leave Buffalo without what would later prove to be a providential encounter in the airport with a former UB medical school professor, John Talbott, MD, who was also on his way out of town, having resigned as head of medicine at Buffalo General Hospital to accept the editorship of the Journal of the American Medical Association (lAMA). While in the airport, the two physicians had an opportunity to talk about their work and Talbott, sensing a future in the drug-intervention studies Pinkel was describing for pediatric malignancies, encouraged him to submit papers on S ummer 200/ l ulfale Physician 5 �his work to ]AMA. In the years ahead, both men recognized this meeting as a catalyst to Talbott's support of Pinkel's innovative studies at a time when other leaders in the medical community were skeptical. ne Controversial Cure Before Pinkel could begin building a world-class research program at St. Jude Hospital, he first had to attend to a few practical details upon his arrival at the hospital, which was still a work in progress. "I was the first person in the building," he recalls with a laugh. "I had a card table and a chair, and we strung a wire out to the telephone pole and another wire out to the electrical pole for my plugged-in heater, and I was in business!" Indeed Pinkel was in business, and over the course of the next few years, he oversaw the hiring of staff, the organization of basic and clinical research programs and the building of inpatient and outpatient clinics, while at the same time he worked to raise money needed to complete construction of the hospital in March 1962. "Shortly after we opened, it occurred to me that we actually ought to be trying to cure ALL, rather than just palliate it," Pinkel recalls. "But no one was talking about trying to cure it at that point because all attempts had been unsuccessful. Scientifically, the pessimism was justifiable because we did not know its cause or mechanism. However, a key feature of St. Jude was the integration of basic and clinical research. And the basic scientists at the hospital were adamant that there was an excellent theoretical basis for curative treatment of ALL with drug combinations." In contrast to the mute resignation that was prevalent at that time, Pinkel and his group moved into action, devising a new plan they called "total therapy," which remains the standard for treatment today. "The idea was that we would use drug combinations: one set for induction of remission, another set for intensive chemotherapy, and another set for continuation," he explains. "Then we used specific therapy aimed at the CNS [central nervous system] based on the observation that children on therapy with normal-appearing bone marrow were coming down with first relapse in the CNS because our drugs weren't getting into the cerebrospinal fluid." For the next five years, the St. Jude researchers conducted pilot studies that, while promising, were very difficult. "We encountered lots of new problems that we had not seen before because of the immunosuppression we were inducing in the children," 6 lu ffale Ph ysicin S11mmer 2001 Pinkel explains. By the time a fifth pilot study had been completed in 1968, however, Pinkel and his colleagues could see that they had something. "As it turned out later, we had reached a point where we were able to cure half the children . This was the first curative treatment of any kind for leukemia and the first time that cancer had been cured primarily with drugs," he notes. "It was also the first time that people who had generalized cancer were cured, so it was important in three different ways." Despite these milestones, Pinkel at first could not win support for the studies from some of his peers and was even "thrown out of' two leading oncology groups whose leadership disagreed with the protocols he was developing and felt strongly that the St. Jude team should not be focusing on trying to cure ALL. "Everybody was getting upset with us because we were talking about curing leukemia and they said, 'You can't do that,' and some people got pretty defensive and angry about that in the early days,'' he says. "We were trying to be modest, but still a lot of journal editors and referees didn't like that kind of talk." Talbott, who had followed Pinkel's work closely over the intervening years since their meeting in the Buffalo Airport, did like that kind of talk, and in 1971 he helped change the field of oncology forever by lending his support to publishing a paper in lAMA on Pinkel's five-year follow-up study. In fact, so confident was Talbott in the merit of the paper, he selected a special cover to highlight it and wrote an accompanying editorial to extol the work being done at St. Jude Children's Research Hospital. In recounting this historic show of support by Talbott, Pinkel says, "That was the first time the phrase 'five-year cure rate' was applied to leukemia in a medical journal. I'm not sure any other journal would have allowed that statement then." A year later, Pinkel won the Albert Lasker Award for Medical Research . Often called "America's Nobel's,'' Lasker Awards are our nation's most distinguished honor for outstanding contributions to basic and clinical medical research. rood as aPrescri~tion While Pinkel and his group could not help but savor seeing children cured of ALL, a problem that had come to light as they were conducting their studies on cancer had thrown a long shadow over their accomplishments. "We found that we were seeing children in that area [Memphis] with leukemia and other forms of cancer who in fact had two diseases: not only cancer, but malnutrition, as well," Pinkel says. "This made it very difficult to treat their �"Actually, we got into a lot of trouble for this [program];' he continues. "You have to remember this was the time of the civil rights movement and most of the youngsters we were seeing were from very poor black families, so people thought WIC was another form of civil rights agitation." cancers because they had such a low tolerance for the chemotherapy due to their poor nutrition." Realizing that the problem of malnutrition was rampant, especially among low-income African-American children in South Memphis, Pinkel began to recognize the need to address this threat to children's health at a community-wide level, not just in terms of how it was impacting those with cancer. In a move that put him well ahead of his time, Pinkel had recruited a full-time MD/PhD nutritionist, Paul Zee, when St. Jude first opened. Together they identified people in the community willing to work with them to establish clinics and a "nutrition warehouse" where food was collected for strategic dissemination to needy women and children. "In this way, we were able to tie in well-child care and prenatal care with the active-feeding program," says Pinkel. "The idea was food as treatment-food as a prescription-and that really hit home and was highly effective. "The food program the St. Jude team carried out was different from other food programs," he adds, "because we conducted a scientific study to test the effectiveness of combining food prescriptions with prenatal and preventive infant and child care. The results of the study documented not only the health-effectiveness, but also the cost-effectiveness of this combined approach to maternal and child health at a community level." As word about the success of the program spread, a local television station became interested and produced a documentary about it that ignited a political firestorm when it first aired. "Many people in Memphis didn't like it at all," Pinkel explains, referring to his nutrition program. So unpopular was it that the city's mayor felt compelled to call Pinkel and assert that he was giving the city a bad image. "When he told me this, I said, 'Wait, maybe you should look at it differently; maybe you should look at it as giving the city a good image because you are recognizing the problem and doing something about it, which is better than what other cities are doing,"' Pinkel explains. "But that didn't go over very well. "Actually, we got into a lot of trouble for this [program]," he continues. "You have to remember this was the time of the civil rights movement and most of the youngsters we were seeing were from very poor black families, so people thought WIC was another form of civil rights agitation. As a matter of fact, some of our St. Jude donors said they wouldn't contribute to the hospital anymore, which got our fund -raisers pretty upset with me." In the meantime, the television station that produced the controversial documentary had been unable to find a sponsor. As a result, they sold it to a national network called DuMont Televi- SLi mm er 200 1 Buffalo Pbysiciaa 7 �"The Ion er that I've been out of school and have taught at other medical schools, the more I appreciate the fact that the medical education we received at UB was really superb:' sion, which ran it as a late-night filler-"You know, one of those shows for insomniacs," says Pinkel. As the story goes, one such insomniac who just happened to tune into the documentary was Senator Hubert Humphrey from Minnesota. Galvanized by what he saw, Humphrey immediately became interested in the St. Jude Nutrition and Health Program and held hearings on Capitol Hill to investigate the problem of malnutrition in the country. "One of our people went to Washington and testified at the hearings," recalls Pinkel. "Senator Humphrey became very involved in this project and was responsible for getting Women, Infants and Children (WIC) legislation passed in the Congress. Before he died, he said he considered this to be his greatest achievement, and the Senate voted unanimous approval of increased funding in his honor." Pinkel, too, considers the WIC program St. Jude' s most noteworthy achievement, surpassing even the curative drug therapy for ALL. "Leukemia is a relatively rare disease, but malnutrition is the most prevalent, fatal and disabling childhood illness worldwide," he says. However, because ofthe tenor of the times and the study's revelation of widespread malnutrition in a high proportion of AfricanAmerican children in a wealthy American city, the St. Jude team was concerned that no journal would accept the study for publication, according to Pinkel. "I suggested to the senior author, Dr. Zee, that it be sent to lAMA because of Dr. Talbott's enlightened attitude and the fact that a student on our team had received an AMA Goldberger scholarship in nutrition," explains Pinkel. "Although peer review was favorable, I am convinced that, again, Dr. Talbott influenced its publication and the subsequent wide dissemination of our results. "It was this publication, plus a follow-up study in the AMA Journal of Diseases of Children, that documented remarkable im8 l uffal1 Pbysiciaa S u m m er 200 1 provement in nutrition and health from our program, convincing even the most conservative [individuals) to support WIC." Building on aProven Track Record In 1974, Pinkelleft St. Jude Hospital and embarked on a stage in his career that involved being recruited to fill a series ofleadership positions at institutions eager to capitalize on his proven track record as a researcher, administrator and teacher. The first stop was in Wisconsin, where he was professor and chair of the Department of Pediatrics at The Medical College of Wisconsin and pediatrician-in-chief at the Milwaukee Children's Hospital, and where he established the Midwest Children's Cancer Center. Fours years later, he accepted a position as chair of the Department of Pediatrics at City of Hope ational Medical Center in Duarte, California, just outside Los Angeles. There, he established pediatric inpatient and outpatient units and research laboratories in the Familian Children's Hospital. In 1982, he again pulled up stakes and moved to Philadelphia, where he assumed the chair of pediatrics at Temple University Medical School and the medical directorship of St. Christopher's Hospital for Children. "!was in Philadelphia long enough to get accomplished what I had wanted to do there, which was to make certain that a new hospital was built in the inner city rather than in a distant suburb," says Pinkel. "Then, I decided it was time to return to my research, so in 1985 I took a position at the University of Texas M. D. Anderson Cancer Center in Houston in an endowed chair in pediatric leukemia research, from which I retired in 1993." Currently, Pinkel continues to work part-time, at Driscoll Children's Hospital in Corpus Christi as a professor of pediatrics at Texas A&M College of Medicine. He also teaches, consults and chairs the Institutional Review Board [at the hospital) and is especially concerned about biomedical ethics. Challenges for the future After devoting more than 50 years of his life to helping define the frontiers of pediatric oncology, Pinkel is crystal clear when asked what he feels the major challenges are for the field today. "First," he says, "we need to find out what causes these cancers and eliminate these causes, because that's the only way to handle any pediatric disease, just as was the case with polio, diphtheria, rickets, scurvyall those terrible diseases." �them. They were also very aware of the 'art' of medicine-of looking at the whole patient, looking straight in the patient's eyes and listening. That's something many of the students today aren't learning." Pausing, he adds: "And I do think medicine is an art, and in order to be successful, it not only takes scientific discipline and integrity and devotion, but it also takes imagination, intuition and passion. You have to have a little fire in your belly." CD He also contends that researchers need to find much simpler ways of treating pediatric malignancies because the therapies being used today are too complex and expensive. "By that I mean, there can be a treatment that's 100 percent effective, but if only 20 percent of the children in need have access to it, then it's only 20 percent effective. "The treatment needs to be simple enough for a 'barefoot doctor' with an eighth-grade education to use," he continues. "One of the big problems we've had in the last 20 years is that we've been moving toward more and more sophisticated treatments that are complex and expensive-like megatherapy and stem cell transplantation. These have been a disaster as far as I'm concerned because they've moved us away from making therapy available to everyone and have separated even more the 'haves' and 'have-nots' in this world." The most promising future for pediatric oncology, Pinkel asserts, is in molecular genetics, "where we can develop therapies that work to block the expression of disease-causing genes or gene products. This is where we need to be putting our energies." Mr. Danny Thomas Paramount TV 5451 Marathon Street Hollywood, CaiHornia 90028 Carrying on the UBlradition When working with students throughout his career-whether in the laboratory, the clinic or the classroom-Pinkel says he has tried to carry on the tradition of teaching from which he benefited while a student at UB's School of Medicine. "I feel sorry for all the medical students I teach who can't go to UB," he says. "The longer that I've been out of school and have taught at other medical schools, the more I appreciate the fact that the medical education we received at UB was really superb. We had very good clinical faculty who were inspiring; they made you want to be a doctor, and they made you want to be good doctors like * Talbott was professor of medicine at the then-University of Buffalo and chief of medicine at Buffalo General Hospital from 1946 to 1959. In 1959 he left UB to assume the editorship of the Journal of the American Medical Association, a position he held unti/1971. Entertainer Danny Thomas founded St. Jude Research Hospital in 1962. 5 II Ill Ill C r 200 I luffala Pbysician 9 �ILLUSTRATION BY RANDY LYHUS �BY M.D. KINNAMON New course helps students learn essential communication skill ........... ..Haw to Bnak Bad module within the school's two· year-lang Clinical Practice of Medicine caursa Summer 2001 �'' ow TO BREAK BAD NEws," a new module within the school's two-year-long Clinical Practice of Medicine course, evolved in part from informal teaching interactions the medical school had with a local Chemotherapy Coach Program. As director of the program, Hillary Ruchlin often gave presentations to UB medical students about how best to communicate with seriously ill patients. To enhance the immediacy of her message, Ruchlin, who is now executive director of the Cancer Wellness Center in Buffalo, always brought along volunteers-«chemo coaches"who were cancer survivors. Her idea to introduce doctors- in-training to the feelings and experiences of cancer patients in a more structured environment evolved from seeing students questioning volunteers after the sessions. "I thought [the new module] would be a wonderful way to of the Standardized Patient Program, who organizes and in- help students understand just what is at stake the moment patients are told they have cancer," says Ruchlin. "It is a life- structs the patients in their real-to-life role-playing scenarios altering moment." Ruchlin approached Alan Baer, MD, UB associate professor of medicine, and they collaborated on the development of the curricular module, now referred to as the "Bad and in how to give feedback to students on the Bad News Checklist (see page 14); Diana R. Anderson, EdM, who assists with the administration of the Standardized Patient Program; and Deborah Waldrop, PhD, assistant professor in UB's School of Social Work. News Project." Their aim was to teach students how to give bad news to patients and to reinforce appropriate methods [motionally Charged Communication Issues by using a format that involves the participation of actual Dennis Nadler, MD, associate dean for academic and cur- cancer patients. ricular affairs in the Office of Medical Education, thinks To develop the curriculum, Baer looked to Dr. Robert "How to Break Bad News" is an idea whose time has come. Buckman's pioneering work on the subject as described in "This is a critical aspect of medical education, one that has his book How to Break Bad News: A Guide for Health Care Professionals (Johns Hopkins University Press, 1992). been left to on-the-job training for much too long," he says. "Actual cancer survivors Buckman, an oncologist at the Toronto-Bayview Regional are uniquely positioned to Cancer Centre (Ontario, Canada) and professor of medicine help young physicians at the University of Toronto, developed a method that learn how to do it right." with, and for me, the stresses the need for physicians to assess the patient's level of Baer thinks students encounter felt abso- understanding of the possible diagnosis. His methodology need help with these emo- lutely real because I also emphasizes the importance of using unambiguous lan- tionally charged communi- could see in their faces guage, presenting information honestly, identifying sources cation issues. "Historical- of emotional support and presenting a clear plan for therapy. ly, physicians have been In addition to Ruchlin, Baer worked to develop the mod- blamed for not doing this well," he explains. "Many ule with UB medical school faculty and staff, including Jack Freer, MD, associate professor of clinical medicine and social and preventive medicine, who teaches the first session of the class and oversees the school's palliative care elective; Karen H. Zinnerstrom, PhD, coordinator for training and evaluation 12 "For the patients I dealt I I f f a I I Pb y s i t i a I Summer 2001 they had gone through this before. One patient told me that it's almost patients have stories of how they first learned like reliving the whole about diagnoses of cancer, and often it's not very tions were authentic." experience. Her emo· �flattering to the medical profession. So now there's a protocol, a step-wise method for teaching students these skills." First taught in January 2000, the four-week-long module begins with two weeks of introductory material that includes lessons on the protocol for how to break bad news; a presentation of Buckman's video, "How to Break Bad News"; and a discussion with a panel of former cancer patients. The panelists describe their experiences, including how they were given their diagnoses, how they handled the information, how they would have preferred to have been told (if it was a bad experience), what they felt upon learning the news, and how they survived their illnesses. In the third and fourth weeks, role-playing begins. During these videotaped sessions, which take place in examination rooms of the Standardized Patient Testing Suite, students present the cancer diagnosis to "patients" using fictional case histories they've learned ahead of time. The patients, who are actual cancer survivors, are then able to give feedback on how effectively their "doctors" communicated the news. Patients complete a written evaluation checklist on the student's performance, and students are given pre- and post-tests to assess their approach to the task before and after their classroom and role-play experiences. Authentic [motions, Authentic Results In its first year the module was conducted as a research project, with Deborah Waldrop from the School of Social Work helping to design the research methodology. In October 2000, Baer presented an abstract on the project's findings at the Association of American Medical Colleges' annual meeting in Chicago. Titled "Breaking Bad News: Use of Cancer Survivors in Role-Play Teaching," the abstract described significant differences in students' approaches to breaking bad news based on the pre- and post-test results. After completing the module, Baer reported students used impersonal and technically specific language less frequently and instead adopted more personal, empathetic and reassuring phrasing. W hile many medical schools use standardized patients (scripted actors) in teaching, the use of actual cancer survivors is what makes UB's program unique. "It feels more real when you're dealing with a person who has been through it," notes Baer. "Students gain confidence and walk away feeling like what they've heard is valid and meaningful." To student Jennifer Payne, role-playing was the most valuable part of the sessions. "It made the biggest impact on all of us," she says. "For the patients I dealt with, and for me, the encounter felt absolutely real because I could see in their faces they had gone through this before. One patient told me that it's almost like reliving the whole experience. Her emotions were authentic." In order for all 140 second-year students to participate in the role-playing, each of the 12 volunteer "patients" had to hear the bad news up to six times a day in a two-hour period. Though these dedicated volunteers were eager to work with the students, it was difficult for them to relive the trauma they experienced upon learning they had cancer. Cancer survivor Ann O'Neil-Merritt, who is fully recovered from a rare cancer she was diagnosed with six years ago, says, "Participating [in the module] this year was a lot easier than last year. I'm one more year removed from the day I found out, but it's very difficult because you're trying to react honestly by putting yourself in the situation you were in and reacting like you did." Ruchlin adds, "We had volunteers 17 years removed from their [cancer diagnosis] who were still having a difficult time." Ultimately, "How to Break Bad News" is about communication and human connection. "The class helped all of us realize that you have to establish a rapport with your patient," Payne reflects. �e s" Chec list for Student reed back On Their Team to Help Them through It The experience was trying for the students as well, although in a different way. Payne explains that her confidence going into the role-playing was shaky, as was that of her peers. "All of us were exceptionally nervous. It was the most difficult thing we've had to do yet in terms of actual patient interaction," she says. "But it made me realize that this is as much a skill as is listening to a heart." Former patient O'Neil-Merritt got involved with the project "to awaken these soon-to-be doctors to the fact that we' re more than bodies. We're a whole organism, not just a set of cells." She also wanted to impart to the students the importance of paying attention. "Listen, watch and pick up clues from your patient and then react to them. Change your agenda and your protocol to meet the patient's needs because every patient will react differently. You have to be aware of what their emotions and body language are telling you," she says. 1. The student introduced him/herself. 2. The student addressed me by my proper name (i.e., did not call me by my first name). 3. The student began our conversation with a question as to my current well-being, health or state of mind. 4. The student asked me what I understood so far; about the symptoms I have been having; about my illness, or the reason for the diagnostic tests that had been performed. 5. The student asked me if I knew the results of the diagnostic tests that were performed. 6. The student asked me how much I would like to know about my illness. 7. The student checked with me several times during his/her explanation to make sure that I understood what was being said. 8. The student told me that the biopsy results were those of "cancer" (and not simply a "tumor" or "growth"). 9. The student described the possible forms of treatment that I might need. 10. The student identified sources of support for me (e.g., family, friends, community, professional). 11. The student outlined a clear plan for the future. A ccording to Baer, the medical education community is becoming increasingly interested in ways to develop the skill of communicating bad news, especially since many experienced doctors did not have this kind of training as students. "We'd love to present this program to physicians as a reminder," says Ruchlin. Associate Dean Nadler agrees, "Every health-care professional should be given this sensitivity training. This is 12. The student ended the interview with an appropriate, polite closure. Standardized patients are asked whether they "agree strongly," "agree," "do not agree or disagree," "disagree," or "disagree strongly" with the following: training that house officers and many faculty could benefit * The student appeared comfortable in his/her communication with me. * The student maintained appropriate eye contact with me throughout from, as well, not just medical students." Ultimately, "How to Break Bad News" is about communication * The student explained the results of the diagnostic test and/or my ill and human connection. "The class helped all of us realize that you have to establish a rapport with your patient," Payne reflects. "! assumed that doctors provided the information to patients and then let them go off and determine how they're going to deal with it from then on. But Dr. Buckman's protocol emphasizes that a physician should take a more active role and should be on their team to help them through it." CD the interview. ness in a language that I could easily understand. * The student facilitated the expression of my concerns and fears (e.g., possibility of impotence, need for mastectomy, fear of pain and death). * The student behaved warmly, but professionally, throughout our encounter. * The student acknowledged and responded em pathetically to my ex pressed fears, crying, tears, or other signs of emotion. * The student guided our dialogue along in a manner which made me feel comfortable. * Overall Rating: The student did an excellent job in presenting me with bad news. According to [Dr. Alan] Baer, the medical education community is becoming increas· ingly interested in ways to develop the skill of communicating bad news, especially since many experienced doctors did not have this kind of training as students. �B v S A. UNGER Department of Pathology and Anatomical Sciences formed N FOLLOW-UP TO A PLAN that was first proposed over four years ago, the Departments of Pathology to give anatomy, which is a pure basic science, a clinical base by linking it with pathology, which is both a and of Anatomy and Cell Biology in the University at clinical and a basic science," accord- Buffalo School of Medicine and Biomedical Sciences ing to Heffner. Heffner explains that yet another officially merged in March 2001 to form the Depart- factor leading to the merger was that ment of Pathology and Anatomical Sciences. The department is chaired by Reid Heffner, MD, formerly both departments had become smaller chair of the Department of Pathology. together a "critical mass" of talent to At the time of the merger, the Department of Anatomy in recent years, and the combining of faculty was viewed as a means to bring foster new research initiatives, especially in the neurosciences. ations, according to Heffner, including the fact that The proposal to merge the two departments was extensively reviewed by the Faculty Council, which established an ad hoc committee chaired by Distinguished Teaching Professor of Physiology and Biophysics Perry basic science departments, in general, are increasingly Hogan, PhD, to study its merits. After meeting with and Cell Biology, which had been without a chair since 1992, was being led by interim chair Frank Mendel, PhD. The merger was prompted by a number of consider- focused on overlapping areas of research, a trend that is particularly accentuated in the anatomical sciences and "THERE'S BEEN A MERGING OF BASIC SCIENCES IN A pathology because both disciplines are historically rooted in morphology. "There's been a merging of basic sciences in a sense that they all are now directly involved in such questions SE SE THAT THEY ALL ARE NOW DIRECTLY INVOLVED I SUCH QUESTIONS AS 'How DO GENES REGULATE CELLS? as 'How do genes regulate cells? How do they manufac- How DO THEY MANUFACTURE PROTEINS, AND HOW DO ture proteins, and how do they regulate growth?'" says Heffner. "Even though [anatomical sciences and pathol- THEY REGULATE GROWTH?'" SAYS HEFFNER. ogy] have morphology in common, we are also like a lot of the other basic science departments in that we are faculty from both departments, the committee wrote a investigating disease and cell and tissue function using report supporting the merger and making several recom - the same techniques, whether it's physiology, pharma- mendations, including that new bylaws and policies and cology, anatomy or pathology. So there's a lot ofblurring between departments; we're not as compartmentalized procedures be written for the department and that addi tional faculty be recruited. Committee members also as we used to be." A related reason for the merger is the planned imple- endorsed formation of a Division of Anatomy within the department, a step that has been taken, according to mentation in fall 200l of a new curriculum in the School Heffner. After two-thirds of the members of the Faculty of Medicine and Biomedical Sciences that will place an Council voted to approve the merger in October 2000, emphasis on the integration of all basic sciences and in the process for consideration of the proposed merger making those sciences clinically relevant to students. was reviewed and approved by the Faculty Senate, con- "One of the goals with this merger, therefore, was cluding two years of faculty input on the decision. <!:) S umm er 200 1 lufl alo Pbysiciaa 15 �MEDICAL SCHOOL N E w S Stacey Blyth, left, will stay in Buffalo and train in family practice, while friend Amy Woolever is headed for Einstein/Montefiore to train in pediatrics. ;; .. ..• L lbdelrazeq, Sonya z SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Obstetrics-GYJlecology Adams, Christopher Orthopaedic Surgery HIS YEAR's NATIONAL RESIDENCY MATCHING PROGRAM (NRMP) results Eve Sisser with her husband, ToddSullivan,andtheirsnen· week·old daughter Leeba, celebrate Eve's placement in psychiatryatLonglsland Jewish Hospital. were announced on March 22 by Dennis Nadler, MD, associate dean in University at Buffalo's School of Medicine and Bio· medical Sciences. Of UB's graduating medical students 80 percent of the students received their first, sec~nd or third . . choice of placements. Thirty percent will stay m Buffal~ to tram m the Graduate Medicai·Dental Education Consortium, while 45 percent will go out of state. "Competition for desirable residency positions continues to be intense," says Nadler. "We are very pleased that our students consistently match to some of the best programs in the country." Nationally, match results this year reflected a shift away from trends of recent years where new physicians showed greater interest in family practice programs and less interest for certain specialties, according to the NRMP. This year, the number of individuals entering family practice residency programs decreased by 4.9 percent. Conversely, specialties such as anesthesiology and pathology showed increases of 5.8 and 8.1 percent respectively. Despite the decline in family practice, 51 percent of graduating U.S. medical school seniors matched to a first·year residency position in one of the generalist positions. Among the UB students, 26 were placed in internal medicine, 22 in pediat· rics, 12 in family medicine, 4in medicine-pediatrics and 3in obstetrics-gynecology. Overall, 23,981 individuals participated in the match this year, a decrease from the 25,056 who participated in 2000. Of the total active applicants, 76.5 percent were matched to afirst·year position, a3.1 increase over last year. -S. A. UNGER Mayo Graduate School of Medicine ROCHESTER, MN Adamson, Jennifer Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Amoako, Patricia Medicine-Primary North Shore University MANHASSET, NY bosso, Daniel Emergency Medicine orth Shore University MANHASSET, NY Bax·Debiaso, Sarina Ge11eral Surgery SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Bellows, Jason Medicine-Preliminary George Washington University WASHINGTON, DC Emergency Medicine George Washington University WASHINGTON, DC Benedicto, IIberto Surgery-Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY 16 l 1llalo Physician S u 111 111 er 2 0 0 1 �Damian and Kristen Compa will train at the University Hospitals of Cleveland; he will pursue internal medicine and she, pediatrics. Azin Shahryarinejad, class of 2002. right, congratulates Eileen Lau, who is pleased to be going to the University of Southern California to train in pediatrics. Terry Thompson, who received his first choice, celebrates with his wife, Melissa, and their 14·month·old daughter, Makayla. Colletti. Richard Bergfeld, Deborah Bravin, Marina Chan. Keith Physical and Rehabilitation Medicine McGaw Medical CenterNorthwestern University CHICAGO, JL Medicine-Primary Columbia Bassett COOPERSTOWN, y Radiology-Diagnostic Bridgeport Hospital BRIDGEPORT, CT Bui. Hieu Chan, Mew Medicir1e-Preliminary Franklin Square Hospital BALTIMORE, MD Pediatrics Baystate Medical Center SPRINGFIELD, MA l11temal Medicine University Hospitals of Cleveland CLEVELAND, OH Buscaglia, Jonathan Cheung, Barbara Compa, Kristen Internal Medicine Einstein/Montefiore BRONX, y Internal Medicine St. Vincent's Hospital NEW YORK, Y Black. Thomas Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Blyth, Stacey Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Psychiatry Lama Linda University LOMA LINDA, CA Compa, Damian Pediatrics University Hospitals of Clevela nd CLEVELAND, OH Conboy, Thomas Butsch, Winfield Chou, Richard Internal Medicine SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY lntemal Medicine Ohio State University Medical Center COLUMBUS, OI-l Campbell. Katrin Chow, Selwyn Transitional Akron General Hospital AKRON, OH Medicine-Preliminary Brown University PROVIDENCE, Rl Botta, Thomas Cancilla. Laura Cicero, Mark Internal Medicine New York Presbyterian Hospital NEw YoRK, Y Internal Medicine University of Rochester/Strong Memorial Hospital ROCHESTER, NY Pediatrics Eastern Virginia Medical School NoRFOLK, VA Borgoy, John Medicine- Preliminary Lankenau Hospital WYNNEWOOD, PA Emory University School of Medicine ATLANTA, GA Bourne, Ryan Internal Medicine SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Bowman, Daniel Orthopaedic Surgery Albany Medical Center ALBANY, Y Braun, Amy Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Clark, Kristin Carrero, Albert Anesthesiology SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Chan, Audrey Medicine- Preliminary Pennsylvania Hospital PH ILADELPHIA, PA Ophthalmology University of Maryland BALTIMORE, MD Medici 11e-Preli m ina ry SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Radiology- Diagnostic SUNY/Buffa lo Graduate MedicalDental Education Consortium BUFFALO, NY Clementi, Jennifer Pediatrics Long Island jewish Hospital NEW HYDE PARK, NY Psychiatry Duke University Medical Center DUR II AM, c Curry, Timothy Medicine- Prelimi11ary SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Anesthesiology Mayo Graduate School of Medical ROCHESTER, MN Dalewitz, Jessica Medici11e- Preliminary Beth Israel Medical Center EW YORK, NY Neurology Albert Einstein College of Medicine BRONX, NY Den Haese, Ryan Neurological Surgery University of Maryland BALTIMORE, MD Diamantis, Pamela Pediatrics University of Texas Medical School HousTON, TX Summer 200/ l ulf1ID Physiciu 17 �M E D C A L SCHOOL N w Doran, James Figueroa, Jeanette Kallen, Dianne Family Practice Mercy Hospital PITTSBURGH, PA Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Family Practice St. Vincent Health Center ERIE, PA Dull, Michael Dwyer, Cheri Family Practice Atlanta Medical Center ATLANTA, GA Flood, Jeremy lntemal Medicine Thomas jefferson University PHILADELPHIA, PA Kling, Christopher Pediatrics SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Medicine-Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Derma to logy St Louis University School of Medicine STLOUIS, MO Psychiatry Harvard Longwood BosTON, MA Emerge11cy Medici11e SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Obstetrics-Gyr1ecology SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Galas, James Gilmore. Sasha Dwyer, James Kundu, Renita Gould, Milena /ntemal Medicine New England l'vledical Center BosToN, MA Ehrig, Debra Emergency Medicine Yale-New Haven Hospital NEw HAVEN, CT Kurtz, Stacey Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Greenberg, Barbra Psychiatry ew York University School of Medicine EW YoRK, NY Elliott, Frederick Pediatrics New York University School of Medicine EW YORK, y Gross, Kara Erway, Kimberly Guyer, Aaron Psychiatry University Health Center PITTSBURGH, PA Orthopaedic Surgery University of Michigan Hospitals ANN ARBOR, Ml Evanchuk, Darren Hannahoe, Brigid illtemal Medicine McGaw Medical CenterNorthwestern University CHICAGO, IL Pathology Cleveland Clinic Foundation CLEVELAND, OH Pediatrics Einstein/Montefiore BRONX, NY Facer, Jeffery Internal Medicine SU ¥/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Falvo, Mark General Surgery SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Fantuzzo, Joseph Surgery-Prelimirwry SUNY /Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY luffalo Phys i cian Kevin Mullen and his wife, Rachel, celebrate his placement in general surgery at the University of Pittsburgh's University Health Center. Kennedy, Suzette Medici11e Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Radiatior1-0ncology University of Minnesota Medical School MINNEAPOLIS, MN 18 E Pediatrics Georgetown University Hospital WASHINGTON, DC Laprairie, Danielle Obstetrics-Gynecology University of Connecticut FARMINGTON, CT Lau, Eileen Pediatrics University of Southern California Los ANGELES, CA Lesh, Charles Lim Sabina Psychiatry Yale-New Haven Hospital NEW HAVEN, CT Maness is, Anastasios Medici11e-Pediatrics St. Vincent's Hospital NEw YoRK, NY Mazzeo, Ramona Psychiatry University of Massachusetts Medical School WoRCESTER, MA McConn, Kara Psychiatry California Pacific Medical Center SAN FRANCISCO, CA lntemal Medicine SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Hughes, Jeffrey Medicine Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Radiology-Diagnostic Hospital of St. Raphael NEw HAVEN, CT Family Practice St. joseph's Hospital SYRACUSE, NY Lewin, Sami General Surgery University of Chicago Hospital CHICAGO, IL Pediatrics SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Medici11e-Prelimi11ary Winthrop-University Hospital MINEOLA, NY Radiology-Diagnostic Mt. Sinai Hospital NEW YORK, NY Jobes. Gregory Lezama, Jennifer lntemal Medicine SU ¥/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Psychiatry SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Jobes, Annmarie Summer 2001 McDonald, Amy Mezhir, James Millstein, Leah Medici11e-Pediatrics University Hospitals of Cleveland CLEVELAND, OH Miralog1u, Didem Medici 11e-Preli 111 ina ry Mary Imogene Bassett CooPERSTOwN, Y Physical and Rehabilitive Medicine Eastern Virginia Medical School NORFOLK, VA �Ndegwa Njuguna is headed for the University of Illinois College of Medicine. Ouilikon, Neva lr1temal Medici11e johns Hopkins/Sinai BALTIMORE, MD Paa, Kimberly Mallen, Kevin Gweral Surgery University Health Center PITTSBURGH, PA Morris, Eleazar TrallSitiorwl ew York Hospital/Medical Center Queens FLUSHING, Y A11esthesiology Mt. Sinai Hospital NEW YORK, NY Naik. Dhruti Pediatrics SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Njuguna, Ndegwa l11temal Medici11e University of Illinois College of Medicine CHICAGO, IL O'Brien, Kristen Family Practice Stonybrook Teaching Hospitals STONY BROOK, NY O'Connor, Thomas Medici11e-Primary University of Rochester/Strong Memorial Hospital RocHESTER, NY Odell, Barbara Medicine-Pediatrics Penn State HERSHEY, PA Ogie. Debra l11temal Medicine University of Illinois College of Medicine CHICAGO , I L Orr.Jeremy Family Practice University of Colorado School of Medicine DENVER, CO A11esthesiology SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Park, James lrttemal Medicine New York University School of Medicine EW YORK, NY Pasamba, Bernadette Medici11e-Prelimirwry Einstein/Montefiore BRONX, y Anesthesiology ew York Presbyterian Hospital EW YORK, NY Peters, Elyssa Medicine- Prclimirwry Abington Memorial Hospital ABINGTON, PA Ophthalmology Temple University PHILADELPHIA, PA Pfalzer, Aaron Plumpton, Jessica Swiencicki, James Pediatrics Wright Patterson, AFB DAYTON, OH Medicine-Primary Metrohealth Medical Center CLEVELAND, OH Rakhlin, Aleksandr Syed, Sufia Gweral Surgery Westchester Medical Center VALHALLA, NY l11temal Medici11e George Washington Universtiy WASHINGTON, DC Reynolds, Deborah Thompson, Terry l11temal Medici11e Mt. Sinai Hospital NEw YORK, Y Family Practice Lynchburg Family Practice Center LYNCHBURG, VA Salerno, Kilian Trapp, Kathleen Emergwcy Medici11e SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Family Practice SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Samanich, John Trebb, David Psychiatry Beth Israel Medical Center NEw YoRK, NY Pediatrics Brooke Army Medical Center FoRT SAM HousTON, TX Sarpel, Umut Trojan, Christopher General Surgery Mt. Sinai Hospital NEw YoRK, Y Radiology-Diagrzostic William Beaumont Hospital ROYAL OAK, Ml Medici 11e-Preli111 i 11ary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Radiology-Diag11ostic SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Setlik, Robert Yakani, Rajesh 1111emal Medici11e Brooke Army Medical Center FoRT SAM HousToN, TX Medici ne-Pedia 1rics Albany Medical Center ALBANY, NY Seelagan, Davindra Emerge11cy Medici11e SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, Y Shaposhnikov, Rimma Werth, Christopher l11temal Medici11e University of Southern California Los ANGELES, CA Surgery-Prelimi11ary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFfALO, NY Philip, Joey Sharma, Mudit Medici11e-Prclimirwry SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Surgery-Prclimirwry Georgetown University Hospital WASHINGTON, DC Neurological Surgery Georgetown University Hospital WASHINGTON, DC Pickhardt, Donald Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Pietryga, Michelle Psychiatry Harbor UCLA Medical Center TORRANCE, CA Pigos, Kevin Family Practice Williamsport Hospital WILLIAMSPORT, PA Sisser. Eve Psychiatry Long Island jewish Hospital NEW HYDE PARK, NY Steiding, Karena Pediatrics Yale- New Haven Hospital NEW HAVFN, CT Woolever, Amy Pediatrics Einstein/Montefiore BRONX, NY Wychowski, Adam Medici11e-Pediatrics Baystate Medical Center SPRINGFIELD, MA Yates, Robin Pediatrics New York University School of Medicine NEw YoRK, NY Zalar, Mona PEDIATRICS New England Medical Center BosTON, MA Summer 2 001 Bu ff 1 I o Physic i 1 n 19 �==, I CAT Program Returns to Buffalo Focus on biomedical and bioengineering technologies f lt.R 1\lF \RIY A DH. A.DF without a New York State Center for programs available to partners of such centers, Advanced Technology (CAT) program that supports industryuniversity collaborations to drive job creation and economic growth, Buffalo is once again home to a CAT, this time a joint venture between the University at Buffalo and Roswell Park explains Holm, adding, "that's why it was so important to get this formal designation." Cancer Institute (RPCI). At a press conference held on April 30, 2001, at RPCI, Governor George E. Pataki announced the new Center for Advanced Technology in Biomedical and Bioengineering Technologies along with $1 million in funding for the center. There are 14 other such centers around the state, each of which receives $1 million in funding annually. Noting that the elimination of Buffalo's CAT in the early 1990s "sent the wrong message" about UB and Western New York, Pataki said that the redesignation of the CAT program will have a tremendous impact on the people of Western New York by fostering the creation of new biotechnology start-up companies and by helping existing biomedical businesses to expand through new or im- v G The Center for Advanced Technology in Biomedical and Bioengineering Technologies will focus on developing new products and creating new jobs in Western New York from biomedical and bioengineering research conducted at UB, RPCI and Western New York companies. Robert]. Genco, DDS, PhD, SUNY Distinguished Professor and chair of the Department of Oral Biology in the School of Dental Medicine, was named director of the center. Genco explains that the Center for Advanced Technology in Biomedical and Bioengineering Technologies will fund projects that are close to the commercialization stage. Particular emphasis will be placed on two areas in which Buffalo researchers have traditionally excelled: the development of biopharmaceuticals, such as the PSA test for prostate cancer, lung-surfactant therapy-for premature infants, photodynamic-cancer therapy and interferon treatment for UB and RPCI by several years, explains Bruce Holm, PhD, senior for multiple sclerosis; and biomedical devices, such as the implantable pacemaker and the platinum coil for inoperable cranial aneurysms. According to Genco, the center will take advances like these and help ensure that they not only are developed in Western New York, but also associate vice president for health affairs. "We assumed we'd have to wait until 2004 to apply formally when the next round of com- produced and manufactured here once they are commercialized. In addition, he says that the Center for Advanced Technology in petition for a CAT becomes available," he says. "The governor's Biomedical and Bioengineering Technologies will function as the science-transfer and accelerator arm of other new centers that are fund- proved product lines. The governor's announcement shortened the formal CAT process announcement shortens the timeline by three years." The announcement also makes UB eligible for any and all state 2 0 B ELLEN 0 L 0 8 Au M 1111111 Pbysiciaa S um me r 2 0 0 1 ed in Western New York, such as the new NYSTAR center (see article, �State companies may compete for two different types of awards, Research Milestone which will be in the range of $100,000 to $200,000 per project. NYSTAR Program announced by governor opposite) and the proposed Center of Excellence in Bioinformatics. Researchers at UB and RPCI, in collaboration with ew York Discovery Awards are made for innovative projects that use a bioinformatics-type approach that allows researchers Particular emphasis will be placed on two areas in which Buffalo researchers have traditionally excelled: to "leapfrog" from a basic-science level to a develop- ~ MA'r 3,200l, GovernorGeorge Bv ment stage. Science Transfer Awards are for research E. Pataki came to the University at ELLEN that is nearly ready for commercialization. Buffalo School of Medicine and Bio- GOLDBAUM "The Discovery Awards typically will fund re- medical Sciences to announce that UB and its research search that uses a genomic or bioinformatics ap- partners have received three peer-reviewed grants total- proach," explains Genco. "Say a researcher has an idea ing $25 million from the New York State Office of Sci- for a diagnostic test or a treatment target. By asking ence, Technology and Academic Research (NYSTAR). a very practical question, and by doing very rapid Calling the funding one of the largest high- the development of throughput screening and analysis with the DNA technology/biotechnology-related investments ever biopharmaceuticals. microarray or on the computer, the scientist can very made by the state in the Buffalo area, Pataki said the quickly come up with some good candidate com- amount constituted one-fourth of the total funding awarded throughout the state under the NYSTAR program . "This new STAR center in Buffalo represents a major milestone and biomedical devices. pounds for drug targets or diagnostic tests." Science Transfer Awards will be made to research- ers who have something in late-stage development that requires additional testing. "This type of award has been the missing link for our researchers," Genco notes. "Government agencies won't fund such projects because they're not true 'discovery research' and often companies want this kind of 'proof-of-concept' work to have already been completed. The Science Transfer Award will facilitate the next step, which could be either solicitation from venture-capital companies or major funding from industry. We're particularly excited because the CAT fills that niche." in our efforts to foster the growth of high-tech and biotechnology research and economic development throughout New York State," Pataki said. "This new center-when combined with our $1 billion Centers of Excellence plan-will generate significant new research funding and spur the establishment of spin-off enterprises, bringing new jobs and economic opportunities to Western New York." The most substantial of the three competitive awards granted was $15.3 million allocated for the establishment of the new Strategically Targeted Academic Research (STAR) Center for Disease For more information on the Center for Advanced Technology Modeling and Therapy Discovery. The center is a partnership between UB, Roswell Park Cancer Institute, Hauptman-Woodward m Biomedical and Bioengineering Technologies, contact Dr. Med ical Research Institute and Ka leida Health. The corporate Genco at (716) 829-2854; or at rjgenco@buffalo.edu. CD . 0 partner is IBM Life Sciences Division, and Bruce Holm, PhD, Summer 2001 l af falt Pbys i c i aa 2 1 �senior associate vice president for health affairs at UB, is principal investigator for the award. The Center for Disease Modeling and Therapy Discovery is designed to make Western New York a world-class player in a broad range of new scientific fields made possible by the sequencing of the ew York." The strategy involves developing an academic-industry colocator facility in the vacant 50,000-square-foot Westwood Squibb Pharmaceutical building at 100 Forest Avenue in Buffalo. The co-locator will facilitate prototyping of new products and human genome. Its ultimate purpose is to discover and develop new drugs and clinical therapies using the tools made possible by the commercialization of research by providing laboratory and busi- genomics revolution and to bring them to the marketplace. An additional $8 million in NYSTAR funding was awarded to from academic and industry, as well as UB Business Alliance staff. UB's Institute for Lasers, Photonics and Biophotonics, under the direction of Paras Prasad, PhD, SUNY Distinguished Professor in locally, but throughout the state- through establishment of a "virtual collaboratory" with the IBM Life Sciences Computational the Department of Chemistry, as part of a $14 million information Biology Division. The virtual collaboratory developed and proto- technology research center awarded to Rochester Institute of typed by UB faculty members is an innovative informatics concept Technology. University at Buffalo researchers led by Robert E. Baier, that makes possible ubiquitous telecommunications between all PhD, professor of oral diagnostic sciences and director of the Industry/University Center on Biosurfaces, and George Lopos, PhD, dean of Millard Fillmore College, also received funding participating institutions. An additional economic engine for Western New York, this concept already has resulted in the forma - totaling $1.5 million as part of the New York Environmental Quality Systems Center established at Syracuse University. ness-incubation space to a multidisciplinary group of scientists The center will forge numerous links with partners-not just tion of a spin-off company, Visual Design Systems. The virtual collaboratory concept means that for the first time "It's a win-win situation for UB, its partners and the entire in Western New York, different institutions will be linked through Internet 2, the high-bandwidth portion of the Internet Western New York community, which will benefit greatly from new job creation in the biomedical field," said }aylan Turkkan, UB reserved for computationally intensive research. Already functioning on and between UB's North and South campuses, vice president for research. "Through our plans for virtual collabora- Internet 2 communications require the installation of so-called tories and academic-industry co-location, our researchers will be "dark fiber" connections, funding for which will be provided by the NYST AR award. integrated with industry in a way they never have been before." Holm noted that the awarding of the grant speaks highly of the quality of science being conducted by UB and its partners. "The fact that this gran t was awarded based on a peer-review process demon- "This will connect not only institutions in Western New York, but all across the state," said Holm. "And our experience in the past six months has been that even strates that the quality of science already being done in Western New just the possibility of having this type of connection has clearly York meets a particularly good standard," he noted. "We are opti- turned heads. To connect not only to faculty in the region, but to mistic that with this funding and with the plan that actually formu- have access to the intellectual capital all across the state has been a very strong draw." 4D lated the funded proposal, we will be able to accelerate both the 22 academic science and the corporate science in Western I u II a I o P b JS i cia n S " 111 111 er 2 0 0 I �Buffalo-Niagara Medical Campus New group formed to coordinate projects HE MAJOR PL \\ ERS IN ~1EDJCAL CARE, research, educa- Bv fruition. "In my 20 years as a volunteer in health care tion and biotechnical innovation concentrated in what has been L 0 Is around the High Street area, this is the best I have ever BAKER seen the institutions communicate and work with one termed the "High Street medical corridor" in Buffalo have formed an entity called the Buffalo-Niagara Medical Campus (B MC) to another," Beecher says. "It is encouraging to see the 'silo mentality' coordinate projects that will serve and enhance the group as a whole. disappear, which in the past has isolated individuals and groups Thomas R. Beecher, chair of the group's board of directors, announced the formation of the BNMC at a press conference held on April 30, 2001, at Roswell Park Cancer Institute (RPCI). from one another, thus making partnerships more difficult." The BNMC has adopted three goals that will drive its work in the future: Create a world-class medical campus that enhances the The members are the University at Buffalo, RPCI, Kaleida Health, already existing clinical, research and teaching excellence of the Hauptman-Woodward Medical Research Institute (HWJ) and the Buffalo Medical Group Foundation. The City ofBuffalo, Erie Coun- member institutions; create economic-development opportunities; and improve and expand the infrastructure of the current campus. ty and the adjoining neighborhoods of Allentown and the Fruit Belt The work is being funded by contributions from the Oshei Founda- are partners in the effort. The entity is governed by a 14-member tion and the five member institutions. Active since December 2000, board of directors composed of representatives from the institutions the group has a project director, Matthew K. Enstice, and has accomplished a number of tasks, including contracting with UB's Center for Computational Research to create a virtual medical campus for use in research collaborations, economic development and faculty recruitment. and partners. UB is represented by President William R. Greiner and Michael E. Bernardino, MD, MBA, vice president for health affairs and dean of the School of Medicine and Biomedical Sciences. Each institution retains its independent governance while collaborating on campus activities. They are being supported in their efforts by a loosely organized Trustee Council composed of corpora- While UB doesn't own land or structures on the medical campus, tions, businesses, government agencies and nonprofit organizations it has a major presence there through its faculty and research. UB's new Department of Structural Biology is located within HWJ, and that are asked to provide volunteer help and consultation as needed. The purpose of the B MC, according to Beecher, is to support the HWI scientists are on the department's faculty. The university and RPCI are joint operators of the DNA microarray facility, many needs of the member institutions as they work to form a world-class RPCI faculty have UB appointments, and UB's cancer research and medical campus that supports centers of excellence in research, teaching is carried out there. Moreover, Kaleida Health is UB's education and clinical care. He praised the synergy and cooperative largest medical-care teaching affiliate, and many members of the spirit of the BNMC members in bringing the collaboration to Buffalo Medical Group serve as UB clinical faculty members. Summer 200 1 . 0 CD Buffalo Physician 23 �MEDI C AL S C H 0 0 L N E w s Commencement 2001 Commencement for the University at Buffalo School of Medicine and Biomedical Sciences was held on May 18, 2001. This year, the school conferred 125 MD degrees, 2 MD/PhD degrees, one MD/MBA degree, 33 PhDs and 42 master's degrees. Pictured (1) Honored Speaker Ronald Dozoretz, MD '62 (2) Kathleen Trapp with children Will, Anne and Joseph (3) Dean John R. Wright, MD (4) Kristen A. O'Brien (5) Jeanette Figueroa and third·year student Pamela Livingston (6) Patricia lmoako (7) Timothy B. Curry, MD, PhD (B) left to right, Mark Cicero, Ndegwa Njuguna and Jennifer Lezama. The following excerpts are from the commencement speech given by this year'shonored speaker Ronald I. Dozoretz, MD '62, chief executive officer, chair and founder of FHC Health Systems. "Set your sights high-be braced and sure-footed on your journey. The possibilities before you in this remarkable time are infinite. With new technologies and understanding from initiatives like the Human Genome Project, you have the capability to make breakthroughs I could only dream of when I was in school." "And I challenge you not only to be bold and take chances in the field of medical science, but in the social sciences as well. Do not leave this very important responsibility to someone else . ... I am sure you are aware of the billions of dollars given to teaching institutions and research projects each year by local, state and especially the federal government. Be involved so you can help influence their decisions." "Few people will ever have such a magnificent opportunity to help society. You have an obligation to do so-seize it. There are many challenges that we face collectively: one in six children live in poverty in this country. There are 44 million Americans without health insurance. Public schools in most cities are in poor repair, and students have no books. AIDS in Africa threatens the future of the entire continent. "We as a nation and as a people must address these challenges. And with your expertise, society will look to you for leadership." "As you embark on your journeys in the world of medicine, research and teaching, please follow your dreams and don't be afraid to fail. Take chances. Be bold. Be passionate. Give back to your community But most important: Never give up. Never give up. Never give up." Summer 2001 ��PATHWAYS N Ews ABOUT UB' s ScHOOL oF M E DICINE AND BIOM EDICAL S c i EN CES AND I TS ALU MNI, F AC U LT Y, S T UD ENTS AND STAFF M Paroski Named Director of Admissions Margaret W. Paroski, MD '80, has been named director of admissions for University at Buffalo's School of Medicine and Biomedical Sciences. She succeeds Thomas Guttuso, MD '60, who served in this capacity at UB for 19 years. Paroski is professor of clinical neurology at UB and medical director for A RGA RE T P A R os KI Erie County Medical Center, a position she will continue to hold. She served as president of UB's Medical Alumni Association in 1996 and is president-elect of the UB Alumni Association. Currently, Paroski is a member of the Dean 's Advisory Council for the School of Medicine and Biomedical Sciences. Guttuso joined the Admissions Committee in 1977 and was named director of admissions in 1982. He has also served as acting chair of the school 's Department of Ophthalmology. - S.A . UNG ER Bojovic Selected for Medical Mission Branko Bojovic, Class of 2002, has been selected as a medical student participant on an international medical mission sponsored by Operation Smile. Medical students are chosen via a competitive application process, and Branko is the first University at Buffalo student ever selected for this prestigious opportunity. Approximately 20 medical missions are sponsored by "Op Smile" each year to over 20 countries, where free facial reconstruc- tive surgery repairs are provided to the medically needy, most of whom are children. - D E BR A STAMM Miller to Head Division of Child and Adolescent Psychiatry Following a national search, Bruce Miller, MD, associate professor of psychiatry and pediatrics in University at Buffalo 's School of Medicine and Biomedical Sciences, has been named director of the Division of Child and Adolescent Psychiatry at UB. He succeeds Gary Cohen, MD, associate professor of clinical psychiatry, who founded the division in 1978 and CA RY CO H EN has served as its director for the past 23 years. Miller, who joined UB 's faculty six years ago, is a national authority on emotional factors impacting on childhood asthma. He received his medical degree from the College of Medicine and Dentistry of New Jersey. He served as an intern in medicine at B RUC E MILLER Long Island Jewish/Hillside Medical Center in New Hyde Park, New York, and completed his residency tra ining in general psychiatry and child and adolescent psychiatry prior to completing a postdoctoral research fellowship in developmental psychobiology at the University of Colorado Health Sciences Center. Miller served MILLER, A NATIONAL AUTHORITY ON EMOTIONAL FACTORS IMPACTING ON CHILDHOOD ASTHMA, SUCCEEDS GARY COHEN, MD, ASSOCIATE PROFESSOR OF CLINICAL PSYCHIATRY, WHO FOUNDED THE DIVISION IN 26 I u If a I a Phy si c i an S umm er 1978 2 001 AND HAS SERVED AS ITS DIRECTOR FOR THE PAST 23 YEARS . �on the faculty of the University of Colorado for nine years before being named director of the Division of Child and Adolescent Psychiatry at the University of Rochester. Prior to his accepting the position of director ofUB's Division of Child and Adolescent Psychiatry, he served as the director of pediatric psychiatry at Children's Hospital of Buffalo, a position he will continue to hold. Since coming to Buffalo, Miller and his research team have been awarded over $2 million in federal grant support for government payers and patients will routinely use to make health-care decisions. "To see ECMC listed as a Top 100 Benchmark Hospital in two out of four specialized areas included in this national study is a proud achievement for our hospital," says Sheila K. Kee, chief executive officer at ECMC. "T his recognition serves as yet another confirmation of the outstanding quality care that is offered by the Western ew York region's medical center." -S.A. UNGER their research. -S.A. UNGER ECMC's Cardiovascular and ICU Services Top 100 Modern Healthcare magazine has cited the Erie County Medical Center (ECMC)-a major teaching facility for University at Buffalo-as one of the 100 top hospitals for cardiovascular and intensive care services in the United States, according to an independent study conducted by Solucient (formerly HCIA-Sachs Institute) healthcare information company. The magazine's February26, 2001, issue features Solucient's 100Top Hospitals program that examines clinical, financial and operational data from hospitals to establish benchmarks for excellence. Clark Bell, editor of Modern Healthcare, noted that the study has evolved into a legitimate tool that employers, CraigVenter Delivers 2001 Cori Lecture J. Craig Venter, PhD, president and chief scientific officer for Cetera Genomics delivered a talk on "Sequencing the Human Genome" at the 24th annual Cori Lecture at Roswell Park Cancer lnstitute (RPCI) held on May 23, 2001. Venter, who was on the faculty at the University at Buffalo School of Medicine and Biomedical Sciences and RPCl from 1982 to 1984, has been widely recognized as the scientist who led the team at Celera Genomics in sequencing the human genome. He has published more than 160 research articles and is one of the most cited scientists in biology and medicine. He has received a number of honorary degrees for his pioneering work and was selected as Man of the Year by the Financial Times. The Cori lecture honors Drs. Carl and Gerty Cori, who served on RPCl's faculty from J. CRAIG VENTER 1922 until 1933. During this time, they initiated work on the chemis- try of the glycogen-glucose cycle, research that earned them the 1947 Nobel Prize in Physiology and Medicine. With this honor, Gerty Cori became the first American woman and the third woman in the world to be awarded the Nobel Prize. -DEBORAH PETTIBONE Ceorge M. Ellis .Jr., MD '45, Receives Samuel P. Capen Award George M. Ellis Jr., MD '45, received the Samuel P. Capen Award-University at Buffalo Alumni Association's most prestigious prize-at a dinner held on April 20, 2001, in the Center for Tomorrow on the north campus. Ellis, a generous and devoted alumnus of the School of Medicine and Biomedical Sciences for half a century was presented the honor for his notable and meritorious contributions to the university and its family. Prior to his retirement, Ellis worked as a physician and surgeon in a small, semi-rural Indiana community. He established the George M. Ellis Jr., S 11 111 111 MD, Endowment Fund for Medicine at UB, and also donated a rare, first edition of De conceptu et generatione homin11s-written by Jacob Rueff and published in Zurich in 1554-to mark the university library's acquisition of its three-millionth volume. Since his graduation from medical school, Ellis has devoted countless hours to organizing annual reunions for the class of 1945 as well as to keeping his classGEORGE M. mates updated and informed about each other. Last year, at the class's 55th reunion, he compiled a book that featured a biographical sketch of each class member. "The book is a treasured piece of memorabilia for each of his classmates and the families of those no longer with us," says Mary Glenn, director of community relations for the School of Medicine and Biomedical Sciences. -S.A . ELLIS UNGER Beutner and .Jordon Honored for Research Ernst Beutner, PhD, professor emeritus of microbiology and dermatology at the University at Buffalo School of Medicine and Biomedical Sciences, and Robert E. Jordon, MD '65, chair e r 200 I ERNST H. BEuTNER Buffalo Physician 27 �PATHWAYS "THE WORK OF DRS. [ERNST H.] BEUTNER AND [ROBERT E .] JORDON ESSENTIALLY BEGAN THE MODERN ERA OF DERMATO-IMMUNOLOGY," SAYS DERMATOLOGY fOUNDATION PRESIDENT JouNI J. UITTO, MD, PHD, IN PRESENTING THE SCIENTISTS WITH THE DISCOVERY AWARD. of the Department of Dermatology at the University of Texas Medical School at Houston, were chosen as corecipients of the Dermatology Foundation's 2000 Discovery Award at the annual meeting of the foundation on March 3, 2001, in Washington. D.C. The Discovery Award was created by the Foundation's Trustees in 1991 as the specialty's highest tribute to those colleagues who embody the essence of scientific and intellectual curiosity that the foundation strives to nurture through its research awards program. Drs. Beutner and Jordon were honored for their seminal recognition of the role of autoantibodies in the pathogenesis of pemphigus vulgaris (PV). Together, they found that PV autoantibodies bind to the surface of keratinocytes in precisely the same suprabasilar location that PV bullae form, suggesting a direct pathogenic role for antibodies. "The work of Drs. Beutner and Jordon essentially began the modern era of DermatoImmunology," says Dermatology Foundation President Jouni J. Uitto, MD, PhD. "The clarity of the relationship between bullous disease manifestations and laboratory findings, first established by [them] has not only permitted important aspects of pemphigus pathogenesis to be deciphered but has helped frame the next set of research challenges." Beutner joined UB's faculty in 1956 and taught microbiology to students of medicine and dentistry until his retirement in 1994. In 1992, he became director of Beutner Laboratories in Buffalo. The UB School of Medicine and Biomedical Sciences is proud that a faculty member and alumnus are corecipients of this prestigious award. -S. A. UNGER Lema Leads State Anesthesiology Society Mark J. Lema, MD, PhD, professor and interim chair of the Department of Anesthesiology at University at Buffalo's School of Medicine and Biomedical Sciences, has been installed as president of the New York State Society of Anesthesiologists (NYSSA), a chapter of the Society of Anesthesi- ologists. Lema is also chair of the Department of Anesthesiology and Pain Management at Roswell Park Cancer Institute (RPCI) and associate research professor in the Experimental Pathology Program at RPCI. As head of NYSSA, Lema leads a community of approximately 3,000 New York State anesthesiologists and works closely with the national organization, which boasts a membership of more that 37,000 anesthesiologists. In addition to his new role with NYSSA, Lema is editor of the journal Regional Anesthesia and Pain Medicine, the American Society ofAnesthesiology Newsletter, special editor of SPHERE and associate editor of the Clinical journal of Pain. He is a member of the Cancer Pain and End -of-Life Care panels of the NationalComprehensive Cancer Network, a MARK J. LEMA member of the Cancer Pain Guidelines Panel of the American Pain Society, and serves on the New York State Commissioner of Health' s Preoperative Policy Panel. - DEB OR AH PETTIB ON E 28 lu lfal a Pb ysicin S umm er 2 001 Bakshi Named Associate Professor Rohit Bakshi, MD, has been named associate professor of neurology with tenure in the clinical-scholar track in the University at Buffalo's School of Medicine and Bio medical Sciences. A native of Buffalo, Bakshi received his medical degree from UB in 1991. As RoHIT BAK SHI an Alpha Omega Alpha scholar, he completed a neuroscience research fellowship with Alan Faden, MD, at the University of California at San Francisco, where he studied neuropharmacology and stroke. Following medical school, he served a one-year internship at the Massachusetts General Hospital and a neurology residency at the University of California at Los Angeles. He then completed a one-year MRI/CT neuro imaging fellowsh ip at the Dent Neurologic Institute in Buffalo, followed by additional training in functional imaging. Bakshi, a staff neurologist and neuroimager with Kaleida Health System, is board certified in neurology and is a diplomat of the American Society ofNeuroimaging. His research �and clinical interests include neuroimaging as it relates to neurologic diseases, especially multiple sclerosis (MS). Recently, he was awarded a threeyear $350,000, research grant from the National Institute of Neurological Disorders and Stroke to study iron deposits and atrophy in the brains of patients with MS using computer analysis of magnetic resonance imaging scans. The project is being conducted at the Buffalo euroimaging Analysis Center, part of the Jacobs Neurological Institute at Buffalo General Hospital and the UB Department of Neurology. Bakshi's previous work suggests that iron deposition is common in MS brains and that the level of iron is related to impairments in physical disability and brain atrophy. Since increased iron levels are known to cause brain injury in other diseases, his work raises the possibility of a new treatment for MS. -S. A. UNGER Robert A. Bermel Receives the C. Milton Shy Award Robert A. Bermel, a secondyear student at the University at Buffalo School of Medicine and Biomedical Sciences, has received the G. ROBERT A. BERMEL Milton Shy Galpin Heads Pediatric Orthopaedic Surgery at Kaleida OBERT D. GALPIN, MD, has been named chief of the Division of Pediatric Orthopaedic Surgery at Kaleida HeaHh System's Children's Hospital of Buffalo, and associate professor in University at Buffalo's Department of Orthopaedic Surgery. Galpin earned his medical degree from the University of Western Ontario, London, Ontario, Canada, where he also completed his orthopaedic surgery residency. Galpin brings with him over 13 years of experience in pediatric orthopaedic surgery. Prior to joining Kaleida HeaHh System and UB, he was clinical assistant professor of orthopaedic surgery and pediatrics at the University of ROBERT D. GALPIN Western Ontario. His clinical interests include the treatment of spinal deformities, limb lengthening, pediatric trauma, sports medicine and hip and foot conditions. Galpin is a diplomat of both the American Board of Orthopaedic Surgery and the National Board of Medical Examiners. He is also a member of Alpha Omega Alpha Honor Medical Society and the Pediatric Orthopaedic Society of North America. Award from the American Academy of eurology. The award, which recognizes the best essay in clinical neurology, was presented to Bermel on May 8, 2001, at the academy's annual meeting in Philadelphia, Pennsylvania. "I am honored to receive this award from the academy and am grateful to my mentors, Rohit Bakshi, MD, and Lawrence Jacobs, MD, for their guidance in my pursuit of a career in academic medicine," said Bermel. "This award is just one recognition of the world-class research which continues to go on in Buffalo in the battle against multiple sclerosis." Bermel is continuing his research on neuroimaging in MS this summer with Bakshi at the Buffalo Neuroimaging Analysis Center in Buffalo General Hospital. His work will be funded by student grants from Alpha Omega Alpha Medical Honor Society and the UB Research Foundation. -S. A. Varma Selected to Participate in Mead'-'ohnson Seminar Chelikani Varma, MD, clinical associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, and an attending at Kaleida Health's Children's Hospital of Buffalo, was nationally selected to participate in the MeadJohnson Clinical Seminar in April2001 in Tucson, Arizona. -S.A. UNGER (I) UNGER Slimmer 200/ 1 111211 Hysiciu 29 �the 64th An (xamination of "The Healthy Heart" Diagnoses and treatment of cardiovascular disease NIVERSITY AT BUFFALO School of BY S Medicine and Biomedical Sciences' 64th A. US G E R Annual Spring Clinical Day was held April 28, 2001, at the Buffalo-Niagara Marriott. The program, sponsored by UB's Medical Alumni Association, focused on "The Healthy Heart" and featured expert speakers who presented state-of-the-art information on the diagnoses and treatment of cardiovascular disease. The program opened with a talk on "Exploring the Power of Cardiac PET in Mainstream Clinical Practice," by Michael E. Merhige, MD, UB clinical associate professor of nuclear medicine and director of the Nuclear Cardiology Fellowship Program in the Department of Nuclear Medicine. "Interventional Cardiology in the Year 2001" was the title of the next talk, delivered by John C. Corbelli, MD '79, FACC, FACP. Corbelli is the Lipid Clinic and Research Director with Buffalo Cardiology and Pulmonary Associates, P .C., and clinical instructor at UB. 30 lalfalo Pbysiciaa S 11mm er 20 0/ Following Corbelli, Paul C. Kerr, DO, FACS, UB clinical instructor in the Department of Cardiothoracic Surgery, spoke on the subject of "Minimally Invasive Heart Surgery." After a brief break, the Stockton Kimball Lecture was delivered by Antonio M. Gotto Jr., MD, DPhil, the Stephen and Suzanne Weiss Dean and Professor of Medicine at Weill Medical College of Cornell University in New York City and provost for medical affairs at Cornell University. Gotto, who is also past president of the American Heart Association, spoke on "Perspective on the Role of Statins in Health and Disease." Prior to becoming dean of the medical college at Cornell, Gotto spent over twenty years at Baylor College of Medicine in Houston, Texas, where he was professor and chair of the Department of Medicine and chief of the Internal Medicine Service �at the Methodist Hospital in Houston . During that time, he was also]. S. Abercrombie Professor Chair for Athero sclerosis and Lipoprotein Research and was the scientific director of the DeBakey Heart Center at Baylor. Gotto and his associates were the first to achieve complete synthesis of a plasma apolipoprotein (apo C-1) and also determined the complete eDNA and amino acid sequence of apo B-100, one of the largest proteins ever sequenced and a key to atherosclerosis and coronary heart disease (CHD). In addition to his research interests, which have brought him worldwide repute as a leading expert on statins, Gotto brought to his lecture his clinical expertise on the pathology of atherosclerosis and CHD. He began his talk with a historical overview of the role of statins in reducing the risk ofCHD, explaining how the drugs were subject to a "backlash" controversy following their approval by the U.S. Food and Drug Administration in 1987. As an example of this backlash, he described a cover story published in the September 1989 issue of the Atlantic Monthly in which it was contended that the prescribing of statins amounted to a "conspiracy theory." Following this introduction, Gotto described the statins currently approved for use in the United States. In addition to explaining their mechanism of action, he outlined data currently available from five major clinical trials on the effect of statin therapy on CHD, which, he said, "show a relative risk reduction over the course of the trials." Results from these trials, he added, are remarkably consistent and provide "overwhelming evidence that statins stabilize plaque," reduce levels of LDL and reduce cardiac events. Gotto also described potential new targets for statin therapy, including diabetes, osteoporosis, stroke and dementia. While the drugs' efficacy in reducing risk for these conditions has not been demonstrated in clinical trials, studies are beginning, he explained. In concluding, Gotto said that, given statins proven effectiveness in reducing risk for CHD, he believes there is a "great underuse" of the drugs. Currently, 10 million Americans take statins, he noted, adding that, in his opinion, "some 25 to 30 million would benefit from them." At the close of Gotto's lecture, the audience had an opportunity to ask questions of a panel made up of all the morning's speakers, after which attendees gathered for a luncheon, where Gotto was presented the Stockton Kimball Award by John ]. Bodkin II, MD '76, president of the UB Medical Alumni Association. Me~ical Alumni Ac~ievement Awar~s Following presentation of the Stockton Kimball Award, Bodkin introduced the four recipients of this year's Medical Alumni Achievement Awards, who were honored for "work Gotto also above and beyond the general described potential practice of medicine, whether new targets for it be teaching, research or statin therapy. national service." including diabetes, Morton A. Stenchever, osteoporosis, stroke MD '56, was professor and and dementia. While chair of the Department of the drugs' efficacy in Obstetrics and Gynecology at the University of Washing- reducing risk for ton's School of Medicine these conditions from 1977 to 1996. Prior to has not been that, he held the same position at the University of Utah demonstrated in from 1970 to 1977. clinical trials, In announcing the award, studies are Bodkin briefly reviewed Stenbeginning, he chever's career, explaining that, after graduating from explained. UB's School of Medicine, he completed his internship and residency training at the Columbia- Presbyterian Medical Center in New York City. In 1962, following two years in the United States Airforce, he joined the faculty of Case Western Reserve University where over the next eight years he served in a S umm e r 2 001 l1f12ID Pbpiciu 31 �ALUMNI number of roles prior to moving to the University of Utah. Stenchever was unable to receive his award in person due to an obligation he was fulfilling in his current capacity as professor emeritus at the University of Washington. Wende W. LoganYoung, MD '61, a Buffalo native, is the founder and director of the Elizabeth Wende Breast Clinic in Rochester, New York, and a clinical professor of diagnostic radiology at the University of Rochester. When it was established in 1976, the Elizabeth Wen de Breast Clinic was the nation's first freestanding mammography and breastimaging facility devoted to breast-disease detection. Today, it is ranked WI just want to say as one of the nation's leading breast-care centers and has that when I opened my clinic 25 years ago, I been given a grant by Blue Cross/Blue Shield to define a was almost laughed Center of Excellence. out of town. For the "Many women from the Buffalo area-patients first five years, we of mine and many doctors didn't make any here-have traveled to money, but then the Rochester to see Dr. Loganpractice took off, and Young because she would tell them right away whether we did very well. And I their mammogram was norattribute that to the mal or not; she has really fact that people born helped to bring mammography to where it is today," and raised in Buffalo said Bodkin. don't know how to Logan-Young is also a take no for an past recipient of The American Cancer Society's (ACS) answer." 3 2 lllfale Hysiciu S umm e r 2001 Hope Award and The Distinguished Alumni Award from the University at Buffalo. She is currently a member of the Medical Advisory Committee for the ACS. Following presentation of the award, Logan-Young commented: "I just want to say that when I opened myelinic 25 years ago, I was almost laughed out of town. For the first five years, we didn't make any money, but then the practice took off, and we did very well. And I attribute that to the fact that people born and raised in Buffalo don't know how to take no for an answer." Currently, she also serves as the speaker of the House of Delegates of the Medical Society of the State of New York. She has served as a trustee of the State University of New York and chief medical officer for the New York State Department of Health's Western Region. Upon receipt of the Medical Alumni Achievement Award, Nielsen stated: "I wore two pins today. One is the UB pin and the other is the emblem they gave me that I'm to wear every time I represent the AMA. I wear that for you because if UB had not given me a chance to come to medical school, I would have been who knows where, and I want to thank all of you who came before me and on whose shoulders I stand. I think of you always and every time I wear this, I honor you." Marcello Fierro, MD '66, is the chief Nancy H. Nielsen, medical examiner for the Commonwealth MD '76, PhD, assis- of Virginia and professor and chair of the tant dean for student affairs at UB's Department of Legal Medicine at the School of Medicine and Biomedical Sci- Medical College of Virginia. Only the ences and clinical associate professor of ninth woman to have been certified by the medicine, has been very American Board of active in the politics of Pathology in forenNielson. PhD. MD '7& medicine throughout her sic pathology, Fierro career, Bodkin explained. today is a Fellow of In 2000, she was elected the American Acadvice speaker of the Ameriemy of Forensic Scican Medical Association's ences and serves as policy-making House of a consultant to the Delegates, which, if tradiFederal Bureau of tion holds, places her in Investigation at the line for the presidency of National Crime Inthe AMA. An internist in vestigation Center. private practice in Buffalo, In addition, she is Nielsen has twice been chair of the Forensic elected to the AMA's Pathology CommitCouncil on Scientific Aftee for the College of fairs and sits on its execuAmerican Patholotive committee and Strategists and serves on gic Planning Task Force. the board of editors Nancy �Marcello Fierro. MD '66 of the American Journal of Forensic Medicine and Pathology. Fierro has also gained renown for inspiring the creation of mystery novelist Patricia Cornwell's protagonist, Dr. Kay Scarpetta. Cornwell has based the character of Scarpetta (the fictional chief medical examiner for Virginia)on her mentor Fierro, whom she first met in the 1980s while working as a technical writer in the Medical Examiner's Office. Cornwell has said of Fierro, "I consider her the best forensic pathologist in the world, and she has been a tremendous inspiration to me." In accepting the Medical Alumni Achievement Award, Fierro said, "Thank you all very much for this award. It's hard to accept an award for work that you love and that you are driven to do." Pausing, she quipped, "And I have one other piece of information to pass along to you: Patricia Cornwell's character is five feet tall, blonde, blue eyed and lOS pounds!" 4D Olmsted Ross Receives lucien Howe Medal Iizabeth Olmsted Ross, MD '39, has received the prestigious the award in recognition of her lifetime accomplishments in Lucien Howe Medal for outstanding achievement in ophthal- teaching, research and community service. mology. The award, presented jointly by the University at Olmsted Ross has been in private practice in Buffalo since Buffalo School of Medicine and Biomedical Sciences and 1944. She began teaching clinical ophthalmology at UB's school the Buffalo Ophthalmologic Society, is named in honor of of medicine in 1955, and in 1974 was named clinical assistant Lucien Howe, MD, who began prac- professor, a position she still holds. She tice in Buffalo in 1874 and founded received a commendation for 50 years of the Buffalo Eye and Ear Infirmary in service at Millard Fillmore Hospital and a 1876. In addition to his private prac- citation for service at Deaconess Hospi- tice, Howe served as professor of tal, where, in 1968, she was named chief ophthalmology at the then-Univer- of the Department of Ophthalmology and sity of Buffalo from 1878-1909. The chair of the residency program. Howe medal, first presented in 1928, Recently, Olmsted Ross was honored was one of a number of awards he by the Buffalo Blind Society, which established to recognize contribu- named their newly renovated area the tions in ophthalmology. Elizabeth Pierce Olmsted Educational Center, and by the Western New York "Past awardees of the Lucien Howe Medal reads like a list of who's Blind Association, which changed its who in ophthalmology," says James name to the Elizabeth Pierce Olmsted, Reynolds, MD, chair of UB's Depart- MD, Center for the Visually Impaired. A ment of Ophthalmology. Olmsted reception in honor of her receipt of the Ross, who is the 23rd recipient of Elizabeth Olmsted Ross, MD, ritflt, and James Lucien Howe Medal was held at the the medal, was selected to receive Reynolds, MD, chair of ophthalmology at UB. center on May 3, 2001. S 11 m 111 e r 2 0 0 I Buffale Physicin 33 �ALUMNI Reflections on aMedical Career Trying to practice the type of medicine UB taught me 30 years ago For all of us, it was very S I SA \1 Ot.- R Spring BY special indeed to see Clinical Day dinner and \1 CHAEI BARO'< him again. listened to my classmates \1 D ' 1 FCCP Our 30th reunion summarize their memories allowed us to rekindle old friendships as of UB and their careers, I felt proud to be their colleague. What well as get to know some of our classhigher praise can I give them mates for the first time. Medical school, except to say that I would entrust residencies and practice have been a blur my life and care (and my family's) at times. It is a treat to have occasions like these to reflect. anyone in that room. It is wonderful to practice It was an honor to be accepted to UB's School of Medicine. We were all medicine. We have the priviyoung and eager then, and with each day lege of seeing miracles unfold that passed-and with every course-the in front of our eyes. In addition enormity of our task became evident. A to witnessing people who have lifelong commitment to study, work and healed and lived when we excellence was what we pledged. By the thought they would die, sadly time we reached our clinical years, the we have seen those who should awesome responsibility of our profession have lived, pass away. MICHAEL had became clear to us. I recount daily the words of The faculty at UB were excellent and, wisdom from the internal medicine director for our class, Dr. M. S. Megahed was the during my residency. He said, "Ladies and best of the best. While he combined his gentlemen, you can't expect your patients vast knowledge of neurology, neuro- to be as concerned about their health as anatomy and internal medicine to teach you are. That's why you are the doctors." us, he taught us far more than facts and I suppose it is human nature, but I still figures with his humanity, deep religious don't understand it. I struggle every day to and family convictions, and friendship. mitigate my patients' suffering and give • was elected to sene a sec:ond tenn as president of the Medical Alu111nl Association on April 28, 2001, at Spring Clnical Day. Bodkin, a 1976 graduate of UB, Is a clinical associate professor of famiiJ medicine and president of the Hllhgate Medical Group In Wllllanmille, New YortL. • class of 1991, becomes Yice president of the Medical Alumni Association. Mattlmore Is a UB clinical Instructor of pediatrics and Is on staff at Kalelda Health's Children's Hospital and Men:, Hospital of Buffalo. 3 4 l llflil Physicin St~mmer 2001 them my best counsel. If medicine has taught me anything, it has been to keep an open mind. As knowledge expands, changes, or goes full circle, we must adapt neither too quickly nor too late. It is my hope that during my career or lifetime I can begin to see and understand the rudiments of the mindbody connection. Whether the keys will be found in biochemistry, physiology, neuroanatomy, or other fields is inconsequential. It will be our ability to harness that great life force for wellness first, and healing second. At the reunion, I sought out Philip Wels, MD '41, who initially interviewed me for a position in the School of Medicine, and I BARON thanked him for the faith he showed in me by accepting me in 1967. I have tried to repay that faith by practicing the type of medicine that UB taught me so 4D many years ago. Michael Baron is a pulmonary and critical care physician who practices with Blue Ridge Medical Specialists in Bristol, Tennessee. • class of 1982, Is the new treasurer for the association. Polack Is a UB clinical assistant professor of ophthalmolou who Is In private practice In WIUianmille, New YortL. �FIRST Row, DOKALD L. BAROI'OE, LUDWIG R. KOUKAL, ELI ENGEL.jONATHAK P. LEOPOLD, BERNARD SMOLENS, MARVII'Oj. PLESKOW, LESTER E. WOLCOTT; SECOSD ROWe AL\'1:-.1 VOLKMAN, LEO!';ARD S. DAI'OZIG, AUGUST A. BRUNO, MARK E. HEERDT, ROBERT E. PLOSS; THIRD ROW, ANTHOSY C. BAROI'OE. WILS0:-.1 W. SHAW. FRA!';Kj. BOLGAS, GERARD E. SCHULTZ; FOURTH ROW, Or> STAIRS, EDWARD :VI. ZEHL.ER.jAY B. BELSKY, EUGE.'E V. LESLIE. CARL R. CO!';RAD, AL.LEK fiRST ROW: ROBERT\\". ED,fONDS.jOSEPH T. L. GOLDFARB. AQUILI. A, :\I.~RY H BOTSFORD. GEORGE ECKH ERT; SECOS D ROW, PASQUALE A. GRECO. PHILIP B. WELS. GEORGE GENT!';ER; THIRD ROW, EUGENE.). HANAVAN. DANIEL.}. MCCUE, BRADLEY HULL. fiRST ROW : IRA \fiLLER, ROBERT E . REISMA:-.i,jOSEPH j . DARLAK, ROBERT B. CORRETORE. HERMA:-.1 R. SCHOEr>E, CARL N. SCHUELER; SECO;-."D ROW, PAUL C. RONCA,JosEPH!.. Ku:-;z.jEAN C. HAAR, ERICK REEBER, HUGH F. Oi:-.:EILL, DEK:-IIS P. IIEIMBACK, HELENE BUERGER. ED,fO:-.ID.). GICEWICZ,jORDAr> S. POPPER, GEORGE H. CHRIST, BERNARD II. SKLAR. FIRST ROW, SEATED : RICHARD \\i. MuNSCHAUER, WILLIAM P. WALSH. HAROLD.). LEVY, As;-."ABEL iRO;-."S, CHARLES D. BAUER; SECO:-.ID RO\L EDWARD F. GuDGEL, LAwRDICE H. GoLDE:-.!, FRED S. ScHWARz. CHARLES A. jOY. HARRY E. PETZI:-.IG, MAY:-.IARD H. MIRES. STANLEY j. CYRAN. CARLj. ]M PELLITIER . jOSEPH R. NAPLES, HERBERT S. PIRSON, EuGENE :\1. \1ARKS . \ummrr 2001 l1ffal1 Hysici11 35 �LEFT TO RIGHT: HAROLD f. GRUNERT. jEFFREY L. KAHLER, jAMES COUGHLIN, CARY A. PRESANT, KENNETH V. KLEMENTOWSKI, VIRGINIA RuBINSTEIN,jOHN RuBINSTEIN.jARED C. BARLOW, THOMAS W. BRADLEY, CHARLES H. MICHALKO, DAVID L. BUCHIN, MARCELLA f. FIERRO, ROGER W. SEIBEL, LOUISj. ANTONUCCI fiRST ROW· TODD A. JACOBSON, THO~IAS LANE, TI!'.IOTHY P. COOLEY, BETTY E. :--,1 EREDITH HARRIS, ROBERTA SzCZUREK; SECO'< D ROW: L. BUKOWSKI. ROBERT E. KAPLA'< \'v.ELLS, STANLEY PATRICK \\1. DIESFELD, GEORGE BANCROFT. DIASA DA.'IELA. CASTELLANI. Ross S. E. ELLIS, SIL\ERSTEIN. fiRST ROW: lLJAj. WEINRIEB, RICHARD A. MANCH, MOHA!'.IED MEGAHED,jOEL H. PAULL, ROY M. 0SWAKS, HARVEY GREENBERG. DONALD H. MARCUS: SECOND ROW: SANFORD S. DAVIDSON, MARTIN N. "JANGO, SCOTT D. KIRSCH, ASKOLD D. MOSIJCZUK. ALLEN BERLINER, NICHOLASj. CAPUA:-iA, MICHAEL B. BARON. jERALD A. BOVINO, jONATHAN S. LEVY. jEFFREY D. fLEIGEL, LEFT ROW BOTTO\! TO TOP· ROSYLN R. RO~IANOWSKI, PAUL C. HOLMWOOD. LANCE A. BESNER. SANFORD H. THOMAS G. DISESSA. l FVY, RIC HARD WILKS: RIGHT ROW THERESA TARTARONE URCIUOLI. STEPHEN URCIUOLI. ANDREW P. GIACOBBE, LEO'<ARD ). PORTOCARRERO, DA!'>iiEL ANDERSON, Wll.LIA!'.I 3& Summer 2001 fl. STEPHAN. E. �FIRST ROW SEATED. LEFT TO RIGHT: t\ILEDi D. CHANG. ROSAI.IND ~OI.AN SuL~I:>.tAN, EussA \1. BoOKNER. JENNIFER). MoM£:>~. \II CHELLE SKRET. ·y SUSCO, KATHYLYNN PIETAK SOUTHARD, LINDA LOR£l>OZANI; SECOND ROW: KATHLEEN£. BETH IN, ADRIANA OROZCO KELLERMEIER, LEliA KIRDANI RYAN, YVETTE M . .JOCKIN , jENSIFER HENKIND FERRARO, MuKESH K.jAtN, Rou.:-~o RODRIGUEZ, PRA!>.IOD K. SHARMA. jOSEPH S. VASILE. \IARY E. BONAFEDE. COLLEEN A. MATTIMORE; THIRD ROW: ERIC SCHUBERT, GREGORY\\' . BRANCH, DwiGHT D. LEWIS, EDWARD PIORTOWSKI, fiRST ROW, LEFT TO RIGHT: THOMAS K. CIESlA, WENDE W. YOU:-iG, SYLVIA R. KENNEDY, j. ANTHONY BROWN; SECOND ROW : KEr-;1\ETH E. BELL, HAROLD BRODY, RICHARD C. HATCH, RONALD H. \IATTHEWj. PHILUPS , ASTHONYR. RICOTTONE , PHlUPj. RADOS, jOHN P.jOHN. MARKj. :\1ANCUSO,jOSEPH P. BONAFEDE. USIAK, EuGENE A. CI~IINO, :'viiCHAEL MADIANOS, ROBERT \1. \10RA!';, GERALD v. ScHWARTZ, ALFRED \lEssoR E. HE. ·RY F. GoLLER, MICHAEL E. COHE .. , HOWARD C. WI LINSKY. FREDERICKS. CIESlAK. SEY~!OURj. LIBERMAN. THE REUNION PHOTOGRAPH FOR THE Cuss OF 1996 WILL BE PUBLISHED IS THE AUTUMK ISSUE OF BUFFALO PH}'S/CHS. Gifts committed to the School by those celebrating reunions this spring totaled over $170,000, the largest class fund drive ever. On behalf of the UB School of Medicine and Biomedical Sciences, I extend a very sincere thank you to the class chairs and their classmates who responded. We are fortunate to have your support and greatly appreciate your generosity. -Lyn Corder, Director of Development FIRST ROW. LEFT TO RIGHT: SUSAN H. BARDE, LINDA \1. WILD, KARE. ·A. Gu.scow, KATHLEEN C. ACKERMA!';: SECOND ROW: STEPHAN LE\ ITT, Do. 'ALD GEORGE, SHINY. l.IONG, MICHAELA. SMITH, CHRISTOPHER). BARDE. DANIEL R. WILD, jOHN.). BOOK!.', PATRICK R. HAYES. CHRISTOPHER F. BRA.'DY, GREGG BROfFMA.', ANDREW \1. GAGE, PAUL P. ScHWACH. LAZLO TOMASCHEK. GRANT GOLDEN. Summrr 2001 llffall nysicial 37 �0 E V E L 0 P M E N T E W S Gifts of Anwork Beautif Our School By Li nda J . Cor de r , Ph0, CFRE we tend to focus on the larger monetary ones of stocks, bonds, charitable unitrusts and estate plans because they have the power to transform the school. As vital as these larger gifts are, however, we also deeply value other contributions; for example, the many volunteers who give of their time. Think about the Dean's Advisory Council, Campaign Steering Committee and National Advisory Group, or the Medical Alumni Association Board, Medical Student Parents' Council and newly formed Medical Faculty Emeritus Group, all of which add to the richness of the fabric that comprises our UB Family. Then, there are the class reunion chairs, alumni who return to talk with students about their specialties, alumni lecturers and the volunteer faculty, a most important group throughout the institution's history. This past year, a group of students became interested in AT PRESENT, WE ARE COMPILING beautifying their school and put A LIST OF ALUMNI ARTISTS AND out a call to alumni for gifts of FRIENDS OF THE SCHOOL WHO artwork that could be displayed in WOULD LIKE TO MOUNT EXHIBITS classrooms, study areas and the OF THEIR WORK OR CONTRIBUTE standardized patient offices, to TO THE SCHOOL'S PERMANENT name a few venues. COLLECTION. PLEASE LET US KNOW As a result, the school is IF YOU WOULD LIKE TO BE ADDED now beautified with works of art TO THIS LIST. such as those presented by one of our alumni who works for the 38 laffal1 Physiciaa Summer 2001 Journal of the American Medical Association and who sent two prints from a show of the journal's cover art. Also, in May of this year, with the help of one of our volunteers, students hung an exhibition of photographs taken by an alumnus. Another alumnus donated a dozen prints on the history of medicine that formerly hung in his office, all of which will be exhibited in a location where they may inspire students. Many others have contributed posters and prints, including Evolution (see below) and the Herd of Buffalo, as well as depictions of plants and flowers. In addition to gifts from alumni, the school has received from the Association of American Medical Colleges a set of five signed prints by Jim Dine (see back cover) . We also have a study of ]ames Scott, Himalayan Survivor signed by both Dr. Scott and the artist, Martin Howard Boscott, a gift from philanthropists in Melbourne, Australia. At present, we are compiling a list of alumni artists and friends of the school who would like to mount exhibits of their work or contribute to the school's permanent collection. Please let us know if you would like to be added to this list. 4D Linda (Lyn) Corder is associate dean and director of development. She may be reached by phone, toll free, at 1-877-826-3246, or by e-mail, at ljcorder@buffalo. edu. �Dear Fellow Alumni, Sl' .. ;S; 0 ·~in; ~"p11e11ed tc •ne on my way to a recent alumni board meeting. Patricia Duffner, MD '72, told me she was not going to be able to serve as incoming president for our Medical Alumni Association. She had a couple of unexpected situations come up that were going to require a great deal of her time. After discussing this with Bertram Partin, MD, '53, former assistant dean for alumni affairs, I decided to offer my services to the board as president for another year. As you all know, I felt very privileged to have served in this role for the past year. I feel I already "know the ropes" and so will be able to help the school even more in my second term in office. As president of our alumni association, I will work alongside Colleen Mattimore, MD '91, and Stephen Pollack, MD '82, who were elected vice president and treasurer, respectively, for the coming year. In the months ahead, I will keep you apprised of changes in the Medical Alumni Office in follow-up to the restructuring plans recently announced for the office, as discussed on the inside front cover. Since these changes were announced as this issue of Buffalo Physician was going to press, I'm unable to provide further details at this time. However, I will do my best to give you as complete an update as possible in the fall issue of the magazine. In other news, a major change in the bylaws of the Medical Alumni Association was approved at the annual meeting held during this past April's Spring Clinical Day and Reunion Weekend. We voted to expand our membership to include emeritus professors, fellows and residents of our graduate medical education programs. These changes will enable us to continue on our course of motivating more people to become interested and involved in "giving back" to our school. Anyone who feels that they might fit into one of these groups and would like information about joining our association, is invited to contact ancy Druar in the Medical Alumni Office, at (7 16 ) 829-2778. Finally, I would be personally remiss if I did not mention our continuing effort to expand the number of alumni who hold lifetime memberships in our association. So, again, please consider supporting our school by becoming a lifetime member of the UB Medical Alumni Association. Thank you for the opportunity to serve another year. jOHN J. BODKIN II , MD President, Medical Alumni Association St~mmer 2001 Buffalo Physician 3 9 �CLASSNOTES Charles J McAllister, MD, '73, writes: "Since July 2000, I have been in the position of chief medical officer of DaVita, the second-largest dialysis company in the world. We have over 430 dialysis units in 34 states. I finally ended clinical practice last year. Very good news is that Diane and I are to be first- time grandparents this year. I maintain offices in Los Angeles, CA, and in New Port Richey, FL." E-mail address is: HKidneydoc@cs.com. Richard J. Goldberg, MD '74, writes: "I am currently professor of psychiatry and medicine at Brown University and psychiatrist-in-chief at Rhode Island Hospital and The Miriam Hospital in Providence. I graduated from the Harvard School of Public Health with a masters of science in Health Care Administration in June 2001." 1980s Michele J. Armenia, MD '86, Barrington, IL, gynecology, writes: "My husband, Robert Aki, MD, and I have three children: Maria, age three, Matthew, age two, and Laura, eight months." 4 0 I u If a I a Amherst, NY, writes: "I completed a lung transplant fellowship in Pittsburgh, PA, in 1991 and currently work in pulmonary and critical care medicine. I am married to James Houck, MD." E-mail address is: lcampbell@kaleidahealth.org. as anyone and writes about them with passion and compassion. This fine, wrenching novel chronicles the addiction of a physician with sensitivity and fearlessness. Dr. Joseph Molea has crafted a wellwritten, important, intensely engaging novel." Karin E. Choy, MD '86, Sean T. O'Brien, MD '86, writes: "Turning 40 has been anything but uneventful! I've finally returned to New York from Connecticut and have taken the position of medical director for Clinical Associates for Rehabilitation and Evaluations, Inc. I also found time to get remarried (to a non-medical UB alum) in April, and we're dividing our time between homes in the city and Long Island. Can't wait to see what's next!" E-mail address is: kcmd@worldnet.att.net. Alpharetta, GA, interventional radiology, writes: "My wife, Sandy, and I have two children: Kasey, age seven, and Jake, age four." E-mail address: styob@aol.com. Lucy A. Campbell, MD '86, 1970s Katrina Guest, MD '86, Waukee, IA, pulmonary medicine, writes: "My husband, Andrew, and I have two children: Adam, ten, and Nathan six." E-mail address is: kaguest@home.com. Joseph Molea, MD '86, will publish his first novel, Duck Blood Soup, this summer. Molea trained as Physic i a a Summer a general surgeon, has a subspecialty in addiction medicine and practices administrative medicine as the executive director of Health Care Connection of Tampa, Inc., a chemical-dependency rehabilitation facility specializing in the treatment of impaired professionals. He lives in St. Petersburg, FL, with his wife, Heidi, a school teacher, and their twin 16month-old daughters, Sophia and Abbegail, whom they adopted from Cen tral Asia last year. Heidi is expecting their third child due this fall. Duck Blood Soup is the first-person account of one physician's struggle to become a surgeon while losing his grip on reality through Demerol 2 0 0 1 addiction. Senior surgical resident Rocky Van Slyke is young, single, living in Philadelphia, at the brink of a brilliant professional career. He should be happy. He's not. Molea skillfully dovetails Rocky's memories into the present-day odyssey of the young physician's own substance abuse, and, through the character of Vincent G. Buddy, the hospital attorney, demonstrates, with alarming accuracy, how the culture of abuse is passed from one generation of physicians to the next. Acclaimed author, Dr. Michael Palmer wrote of this work: "Duck Blood Soup is a powerful, haunting story. Joseph Molea knows the inner workings of addiction as well Deborah Richter, MD '86, Montpe- Sandy and Sean O'Brien lier, VT, family practice, writes: "My husband, Terry Doran, and I have two children: Justin, age 12, and Patrick, age 11. My favorite memory of medical school were the parties at Wally Straus' house." Roslyn R. Romanowski, MD '86, E. Amherst, NY, hematology/oncology, writes; "My husband, Robert Campo, and I have one son, Richard, age three." E-mail address is: rromanow @alum.mit.edu. Alan M. Stein, MD '86, Hooksett, NH, family practice, writes: "My wife, Susan Kunkel, and �I have three children: Sarah, age 15, Kevin, age 13, and Jimmy, age 10. Theresa Tartarone, MD '86, and Stephen Urciuoli, MD'86, Westport, CT, internal medicine, write: "We have three children: Stephanie, Carmine and Anna." Valerie E. Whiteman, MD '86, Hockessin, DE, obstetrics/gynecology, completed a MFM Fellowship at the University of lllinois at Chicago in 1990-1992. E-mail address is: drvwhite @home.com. Kathleen Grisanti Lillis, MD '87, has received the 2001 Catherine McAuley Distinguished Alumna Award from the Alumnae Association of Mount Mercy Academy in Buffalo, NY. The award is presented to an alumna of the academy "who has distinguished herself as a woman of faith, knowledge, integrity and compassion; a woman whose accomplishments in all areas of her life-her family, her community, her career-reflect the legacy and mission of Catherine McAuley, the foundress of the Sisters of Mercy. Lillis is chief of the Division of Emergency Medicine and medical director of the Emergency Department at Children's Hospital of Buffalo. According to Mount Mercy Academy, she has "dedicated her life to enriching the health, safety and well being of infants and children. 1n addition to managing an emergency department that is one of the best pediatric facilities in the country, Kathleen is also the volunteer director of Mercy Flight. She is on call for the helicopter team 24 hours a day, fielding calls and directing care, all for the welfare of children. As a distinguished alumna, Dr. Lillis's life models that of Catherine McAuley in her persistence to improve the quality of life for children, in leading by example and in believing that one life can make a difference." Vasile Chief of Psychiatry at faleahh Care 1990s RohitBakshi, MD '91, neurology and neuroimaging, writes: " My wife, Lori, and I are thrilled to announce the arrival of our first child, Adam. He has added much excitement and joy to our lives. He has been welcomed enthusiastically and lovingly by his four beaming grandparents who also live in the Buf- falo area, including Dr. George Baeumler, MD '59, and Dr. Suraj Bakshi, associate professor of nuclear medicine at UB." ite medical school memories include friends, Dermatones, yearbook staff." E-mail address is: gwmbranch @aol.com. Kathleen 8ethin, MD '91, St. Louis, MO, pediatrics, writes: "I am currently working at St. Louis Hospital in Missouri. E-mail address is: beth in_k@kids. wustl.ed u. Paul A. Brill, MD '91, Anderson, SC, neurology, writes: "My wife, Sandy, and I have a son, Andrew, age nine." E-mail address is: pabrill@viafamily.com. Gregory Branch, MD '91, Baltimore, MD, internal medicine, "I have a son, Byron, age 11. My favor- assnotes Sllmme r 200 1 Aileen Chang, MD '91, Stony Brook, Y, gastroenterology, internal medicine, writes: "My favorite memories of medical school include orientation week." E-mail address is: achang@pol.net. Buff a l o Phy sic i a a 4 1 �CLASSNOTES Robert C. Dukarm, MD '91, neonatology, Buffalo, NY, writes: "My wife, Carolyn Dukarm '89, and I have two sons: Ryan, age four, and Matthew, age two." have three children: Steven, Donovan and Elaina. My favorite memory of medical school was playing pool at Chevy's Bar and Grill." John Gelinas, Jr, MD '91, Ingrid C. Helmer, MD '91, Redding, CT, child and adolescent psychiatry, writes: "My wife, Carole, and I have three children: Andrew, jackson and Emuly. My favorite memories of medical school are times with my friends. UB was a great experience!" E-mail address is: jgjrchbg @gateway. net. Lunenburg, MA, pediatrics, writes: "My husband and I have two children: Natalie and Katherine." Toby D. Goldsmith, MD '91, Gainesville, FL, psychiatry, writes: "We have a new little boy, Reid Mitchell Shapira, born in September of2000." E-mail address is: goldsmith@pol.net. Ronald Hale, MD '91, Victor, Y, public health and general preventive medicine, writes; "My wife, Cynthia, and I have two children: Madeline and Benjamin. Among many other things, I am still under active duty with the Air Force." E-mail address is: erhale@sajx.rr.com. Steven P. Harris, MD '91, Gibsonia, PA, pulmonary, critical care, writes: "My wife, jane, and I 4 2 I u If a I o La jolla, CA, ophthalmology, writes: "We have a son, Erik Willem. My favorite memory of medical school was the Follies." E-mail address is: yvette@jockin.com. Tualatin, OR, anesthesiology, writes: "My favorite memories of medical school include studying in the study hall with my friends and then wandering around campus to find different places to study when it got too crazy in the study hall-and Buffalo wings!" E-mail address is: kubota@teleport.com. Physician Summer Bethesda, MD, pediatric endocrinology, writes: "My husband, Eric Feyer, and I have a daughter, Elyssa, and a new one due in August of 2001." E-mail address is: dmerke@nih.gov. Stephen Lipsky, MD '91, Susan Y. Kubota, MD '91, Amherst, NY, internal medicine, "My wife, Erica, and I have four children, Danitra, Diandrea, Delmarie and Dwight. My favorite memory: 'Rubbish,' or brownies." E-mail address is: dlera@aol.com. Deborah Merke, MD '91, '91, Westford, MA, physical medicine and rehabilitation, writes: "My wife, Kathleen, and I have two children: Marc and Elena. My favorite memories of medical school: friendships, colleagues pulling together to help each other through difficult times; first time on the wards; acceptance and graduation." E-mail address is: pliguori@pol.net. Yvette Jockin, MD '91, Dwight Lewis, MD '91 , Paul Anthony Liguori, MD Dunwoody, GA, pediatric ophthalmology, writes: "I completed a pediatric ophthalmology fellowship in 1996 at Indiana University. My wife, Karen, and I have two children: Harrison and Alexandra." E-mail address is: thelipskys @media.one.net. '91, Loganville, GA, psychiatry, writes: "I work for a community mentalhealth organization at a crisis stabilization inpatient unit." E-mail address is: cbmorgan @medscape.com RichardS. Musialowski Jr., MD '91, Rock Hill, SC, 2 0 0 I rics, writes: "My wife, Kathleen, and I have two children: Connor james and Ryan Elizabeth. I am currently on the hospital staff at Children's Hospital of Philadelphia." E-mai Forest Hills, NY, obstetrics/gynecology, writes: "My favorite memories are brownies, anatomy lab (our group was very funny) and finishing!" E-mail address is: jabram5453@aol.com. Keene, NH, pediatrics, writes: "My husband, Dean, and I have three children: Anna, Maxwell and jonathan." E-mail address is: janmcgonagle@hitchcock.org. Kevin C. Osterhoudt, MD '91, Radnor, PA, pediat- Carol Bradley Morgan, MD Susan J. Littler, MD '91, Jan McGonagle, MD '91, help me out when I had troubles with my classes-that they stuck with me. That support meant much for me." E-mail address is: atn0623@aol.com. cardiology, writes: "My favorite memory of medical school was Friday afternoon anatomy lab that continued on to become chicken wings and darts at a local establishment." E-mail address is: musialor @rjsonline. net. Anthony T. Ng, MD '91, Brooklyn, NY, psychiatry, writes: "My favorite memory of medical school includes having really good friends to Terrence S. Peppy, MD '91, Orlando, FL, obstetrics/ gynecology, writes: "My wife, Renee, and I have three children: Christopher, Stephen and Nicholas. My favorite medical school memories include classmates and rotations." Edward S. Piotrowski, MD '91, Orchard Park, NY, general surgery/trauma/ burns/laparoscopy, writes: "I am a member of the American Burn Association. My wife, judith, and I have two children: Elizabeth and Derek. My favorite CONTINUED ON PAGE 44 �Lloyd A. Clarke, MD'38 Clinical associate professor emeritus in psychiatry Abraham%. Freudenhelm, MD'38 Paul Kendrick McKissock, MD 'SG Renowned plastic surgeon .Jerome.J. Maurlz:l, MD 'S2 Founder of Occupational Health Services Summer 2 0 0 I lllfal• nrsicia• 43 �CLASSNOTES I wife, Donna, and I have two children: Joey and Christopher. My favorite medical school memory: Thursday night Simpsons and get togethers." E-mail address is: joewmd@hotmail.com. CONTINUED FROM PACE 42 Cook at Strong Memorial medical school memories include: ( l) The 'P' dissection group in gross anatomy; and (2) When my partner in secondyear clinical asked an elderly patient, "Do you have a history of subacute bacterial endocarditis?" Residents Arif R. Alam, MD, has been Phil Rados, MD '91, Buffalo, NY, writes: "My wife, Genevieve, and I have a son, Francis ( Frano ), born on january 31, 2001." E-mail address is: amalavinica@hotmail.com. Stephanie Han, MD '96, Susan, and I have two children: )yoti and Ravi." E-mail address is: pramodksharma@aol.com. New York, NY, radiation oncology, writes: "I will join the faculty practice at ew York University Medical Center in July." E-mail address is: stephanie.han@yale.edu. Michelle (Skretny) Susco, MD '91, Clifton, VA, pedi- Eileen Reilly, MD '91, Buffalo, NY, family practice, writes: "I am married to Ray Gomez. My favorite medical school memories include finishing the first year and planning a trip Ray Gomez and across the coutry." Eileen Reilly Vicki L. Seidenberg, MD '91, New York, Y, physical medicine and rehabilitation, writes: "My husband, Mark, and I have two children: early Brooke and Leah Nicole. My favorite memorygraduating!" Pramod K. Sharma, MD '91, Ann Arbor, MI, otolaryngology/head and neck surgery, writes: "I am currently on staff at the University of Michigan. My wife, 4 4 la lf al t atrics, writes: "Among other things, I recently finished a program for 'Physicians Leading Change' at Georgetown University Medical Center." E-mail address is: jmcsusco@erols.com. Rudolph Joseph Schrot, MD '96, Sacramento, CA, Beth MacDonald, MD '96, Portland, OR, internal medicine, writes: "One of my favorite memories of medical school is Karin Selva's cabin party." E-mail address is: sqrmf@aol.com. Joseph A. Zarzour, MD '91, Wichita Falls, TX, pediatric ophthalmology. "My favorite medical school memory: The feeling of relief after a block of exams!" Paul S. Matz, MD '96, Pawtucket, RI, writes: "My primary specialty is general academic pediatrics." E-mail address is: psm9@cornell.edu. Cindy (Repicci) Romanowski, MD '94, and Marcus John S. Pulvino, MD '96, Romanowski, MD '93, Old Orchard Beach, ME, obstetrics/gynecology. E-mail address is: jpulvino@mmicservices.com. write: "We welcomed our second child, Rachel, on April13, 2001. She joins Marcus Jr, age three." Phy si c i aa children: Katherine, Michelle and Rachel. My favorite memorygraduation!" E-mail address is: kmrobillard @aol.com. Kristen Schenk Robillard, neurosurgery, writes: "I remember drawing inspiration from my colleagues during Intro to Clinical MedicineClara K., Eileen K., Brad D.-for their enthusiasm and discipline." E-mail address is: rudolph.schrot @ucdmc.ucdavis.edu. Karen Sneii-Garus, MD '96, Williamsville, NY, obstetrics/gynecology, writes: "My husband and I have two children: Mitchell, age four, and Kyle, almost two. My favorite memories: anatomy, snow, late nights in the CT room at ECMC, the Law library." MD '96, Orchard Park, NY, family medicine, writes: "My husband, Paul, and I have three Summer 2 0 0 I Joseph C. Wittmann, Jr., MD '96, Amherst, NY, pediatrics, writes: "My appointed to the Division of Blood and Marrow Transplantation in the Department of Medicine at Roswell Park Cancer Institute (RPCI). He has also been named an assistant professor of medicine at University at Buffalo's School of Medicine and Biomedical Sciences. Alam joints RPCI and UB from City of Hope National Medical Center in Duarte, California, where he completed a clinical fellowship in bone marrow transplantation. He earned his medical degree from Dow Medical College, Karachi, Pakistan, in 1991, and completed residency training in medicine at UB in 1996. A nutnber flf Clasnotes antYednwewereplag tD press wlllt IIIII Iaue "' ..,.l'llpk#MJ. Plene Witch far them In the autumn 20011aue. �- Based on F/MsM Data ttTheywere ddl sergeantsand cheerleaders~' - Frank Ste/ars/<.j, stroke rehab patient, Harris Hill H.C.F. Why do our patients have better rehab resutts compared to the national average? Maybe it's our staff ''They knew exactly how far to push me:' says Frank Stelarski.' 'But they also encouraged me every little step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire Rehabilitation 11IE ~cfNn~Il9!{ CENTE~ Centers, call 1-888-POSTACUTE or visit www.mcguire-group.com. Recognized for excellence in quality care. AUTUMN VIEW • GARDEN GATE • HARRIS "*****" HILL • NORTH GATE �y H E A R T ARTIST jiM DINE's PRINTS ON DISPLAY Heart is one of five prints by Jim Dine , a well - known modern artist. Astra USA commissioned the prints and made an initial gift of several sets to the Associ ation of American Medical Colleges (AAMC) for dis tribution to its nonproft member institutions. In 1997 , the AAMC gave set 81 / 400 to the University at Buffalo 's School of Medicine and Biomedical Sciences. The prints hang on the second floor of the Biomedical Education Building on UB ' s South Campus. Recently , Heart graced the cover of the brochure for the school's Spring Clinical Day , the theme of which was "The Healthy Heart. " liP 0001 02 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n01-2001-Summer Table Of Contents A list of subunits of the resource. A Little Fire in the Belly' Good Ways to Deliver Bad News Medical School Pathways Spring clinical Day Alumni Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n01 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/69082f9aaa4291d81f3417ec6bf7ea4e.pdf a9e3771f9dabbf968482bef859318bc9 PDF Text Text �AssOCIATE \ ICE PRESIDE"T FOR UN I\ ERSITY Co~n! UNICATIONS Dr. C arole Smit/1 Pe tro DIRECTOR OF PERIODICALS S u e Wu e tcl1 e r EDITOR Dear Alumni and Friends, S t ephanie A. U nge r ART DIRECTOR & OESIG" A lan j. Keg le r OVEMBER, I ATTENDED THE AN UAL MEETING of the Association of American DESIGNER Da v id f. Riley Medical Colleges (AAMC) in Washington, DC, along with other individuals representing our school. An important reason for attending meetings such as this is that they provide a 0ESIG'I ASSISTANT Ka re n Lie/m e r national perspective on challenges faced by medical schools. This, in turn, enables us to understand that many of the day-to-day issues we deal with at UB are not unique but are instead part of larger trends and patterns. For example, we learned that, like UB, most medical schools are having difficulty placing their third- and four-year students in clinical teaching sites because faculty are increasingly situated in outpatient environments. In these environments it is difficult for faculty to take time to teach because of their patient load and paperwork. We also learned that about one-third of all medical schools are experiencing financial difficulties due in large part to the debt being incurred by their hospitals. While we do not have a university hospital and our school is not in debt, we do have pressing issues related to the dispersed nature of our school and its affiliated clinical sites. If we are to address these issues, it is important that we communicate with one another in an open and consistent way. This fall, therefore, the school's senior associate deans and l began hosting a series of Town Hall meetings at our affiliated hospitals and on campus. These meetings, attended by faculty, students, residents and staff, have spurred productive discussions about a wide range of issues. In order to share the content of these discussions with as many people as possible, we have prepared notes from each meeting and distributed them on a listserve. If you would like to be included on this listserve-which distributes other schoolrelated announcements, as well-please send your e-mail address to Mary Glenn, director of constituency relations in the Office of Alumni Affairs, at glenn@acsu.buffalo.edu. Another challenge schools are facing is the introduction of new curricula. At the AAMC CONTRIBUTING WRITER Lo is Ba k e r PRODUCTION CooRDINATOR Cy nthia T o dd - Fli ck UN I\ ERSITY AT BuFFALO SCHOOL OF \1EDICINE AI'D BIOMED ICAL SCIENCES Dr. Mi chael B e rnard i n o , D~oll EDITORIAL BOARD Dr. f o /w Bodk i n Dr. M artin Brech e r Dr. Har old Brody Dr. Linda j. C orde r 04 ja son H offmann , C lass of 20 Dr. jam es Kan ski Dr. Eli z ab e th Olm s t ed Dr. j a m es R . Ol so n Dr. S t eph e n Spauldin g Dr. Bradley T . T ruax Dr. Franklin Z eplowit z TEACHING HOSPITALS Erie Co unty M ed ica l Ce nt er Ros well Pa rk Ca ncer In st itut e \'et eran s Affairs Wes tem New }'~r k Hea lth care Sys tem K :\ll:ID," H t:-\IIH: T il e B uffa lo Ge nera l H ospital . 1 Tir e Clril d ren 's Hospit al of Buffll 0 M ill ard Fillm ore Ga t es Hospital . 1 Millard Fillm o re S ubu rban Hosprta meeting we learned that our peer institutions are finding that it takes anywhere from four to eleven years from the inception of a new curriculum to the time it is solidly in place and well adapted to the school's needs and educational goals. As you know, we introduced a new curriculum at our school this past fall. One thing I assure everyone when talking about this milestone achievement is that the new curriculum is a "work in progress" and one that will be evaluated and improved with as much input as possible from everyone involved. Finally, I would like to announce that according to numbers provided by the AAMC, our CArttotn H f.-tt1H S1srr\f: M ercy Healtlr Sys tem S isters of Clra rit y Hospital N iaga ra Falls Me m orial M edi cal Ce nt er ® UNIYEISITY IT IUFFILI. THE STATE UNIYEISITY If lEW Till school 's basic science faculty produce above the 90 percentile in revenues, per individual, when compared with other medical schools in the United States (specifically, $300,000/ faculty). What this tells us is these faculty are bringing in large amounts of grant dollars in an exceedingly competitive environment and that their work is of the highest quality. This is something I think we should all be very proud of, and it is a strength we will do our best to maintain and build upon in the future. J. R, (LA~; .... -c) ~~- BERNARDINO , MD. MBA Letters to the Editor Buffalo Plly;rcum "published quarterlY h)' the Um,·ersitv at Buffalo School nf ~1cdicine and Biomedical S(ICO(CS Ill cooperation with the Office of (.ommunicatiOns. Letter> to the Editor arc wckoille .md can be sent c/o IJ11(jalo Plr)'srcu"'· 330 Crofts Hall, Univ~r"t' at Bufl,,to, Buffalo, NY t 4260; or vi,J e-nMil to bp-notcs~• bufti1lo.edu. . ·dit ,Jll The >taft re>en·c; the nght to< submissions for length and darity. Dean, School of Medicine and Biomedical Sciences Vice Presiden t for H ea l t l1 Affairs University at Bu ffalo }vrk The State Uui~'Ct'Sity ofNeW �V 0 L U M E 36, Features 2 10 18 Healing in the Aftermath A report on three UB psychiatrists' work at Ground Zero and environs BY S. A. UNGER First Impressions, Lasting Memories Buffalo Physician readers write about September 11, 2001 One Woman's Global Concern Bess Miller, MD '77, a leader in efforts to prevent and treat AIDS and TB worldwide BY BETSY SAWYER COVER Convocation 26 Christiane Northrup, MD, delivers the inaugural Lawrence and a ncy Golden Lectu re EdwardS. Cheslow, MD '81, above, contributes to "First Impressions, Lasting Memories" about September 11, 2001. starting on page 10. Litchman, Class of 1960, ho nored as Distinguished Medical Alumnus 41 Messages from this year's reun ion chairs alumn i 31 Lawrence jacobs, MD, and Gloria Roblin, PhD, remem bered grant to fund study of lin k between periodo ntal d isease and hea rt d isease 34 Program project gra nt to develop vaccine fo r ear and respiratory tract in fections PHOTO OF ANTHONY tori um to the Hospitalthe Third-Year Experience, by Svetlana Bli tshteyn, Class of 2002 No BY 00UC LEVERE other alumni 46 Past Forward, a unique perspective on the Class of 1976 �BY S.A. Areport on three UB psychiatrists' work at Ground Zero and its environs u GER N THE LONG HOURS FOLLOWING THE ATTACK on the World Trade Center on September 11, 2001, many healthcare professionals trained to respond to disasters found themselves in limbo as they awaited a tidal wave of patients that instead arrived at their doors as a wayward trickle. As the days passed and even the trickle dissipated, it became clear that the definition of a worst-case cenario was being reconstructed in this environment of limited activity. Instead of physicians equipped to deal with the most devastating of physical traumas, what was needed were physicians equipped to treat psychic trauma on a scale previously unimaginable in our country. One physician well prepared to galvanize a response to this hastily redefined disaster wasAnthonyT. g, MD '91, who at the time of the attack was treasurer and vice president of operations for Disaster Psychiatry Outreach (DPO), an organization for which he is now medical director. Headquartered in ew York City, DPO comprises volunteer psychiatrists committed to providing on-site disaster mental health services, as well as to producing educational programs, research data and policy statements in support of this mission. �••••••••• ,. c •• �e p The photographs in this a.::» article that depict me- ... morials erected on the E5 e 1 I streets of New York City after the September 11 attack on the World Trade Center were taken by Bruce Jackson, SUNY Distinguished Professor and Samuel P. Capen Professor of American Culture at the University at Buffalo. Sixty of Jackson's photographs-documenting the commemorative candles, photos, flyers, notes, toys and flowers left in New York City's Union Square and Sheridan Square, at St. Vincent's Hospital and on the streets of lower Manhattan-were exhibited October 16--22, 2001, in UB's Center for the Arts. Jackson notes that many of the items displayed originally posed questions as to the whereabouts of thousands of individuals lost in the attack. By September 22, when he took the photographs, however, they had become memorials. "Every place you go in lower Manhattan," he says, "you see sheets of paper taped to walls, fences, kiosks and lampposts. They're all about people who are missing. "Most of the city's firehouses and parks have shrines-things people made or left to try and say something that could not be sail! in words." Buffalo Physician would like to thank Professor Jackson for his generosity in allowing us to include his photographs in this article. We would also like to thank Patricia Donovan, senior editor in UB's News Services, for providing the above information about Jackson's exhibit. -S. A. UNGER AST SUMMER, NG HAD CALLED his former teacher Cynthia Pristach, MD '83, associate professor of clinical psychiatry in the University at Buffalo's School of Medicine and Biomedical Sciences, and asked if she would be interested in not only joining DPO, but also in expanding its membership in Western ew York. Pristach joined the organization and recruited a number of her UB colleagues, including Linda Pessar, MD, associate professor of clinical psychiatry, and Helen Aronoff, MD '92, assistant professor of clinical psychiatry in the Division of Child and Adolescent Psychiatry. Two weeks after the attack on the World Trade Center, g was again on the phone to Pristach, asking if she and other members of DPO in Buffalo would be willing to come to ew York City to work at two sites: the Family Assistance Center and Ground Zero. g said he contacted Pristach because he was confident his former medical school professors would be up to the task. ''I'm biased because I know both Cindy [Pristach] and Linda [Pessar]," Ng admits, "but I also knew they would be very helpful for two reasons: First, they are very experienced, and second, there were a lot of Buffalo folks down here that week, both with the ational Guard and as firefighters, and I thought their having that connection would help us. Too, I knew Linda had previous experience working with firefighters, and that was a nice addition because they are a very tough group to get close to." On September 27, 2001, two days after she had the courage she would need. They assuaged many of these feelings by talking with one another and by confronting what Pessar calls "the imagined chaos of this time." The evening before they departed, which was the eve of Yom Kippur, Pessar and Aronoff went to services together. "We each would have done this anyway," says Pessar, "but I felt like we were preparing to enter another psychic space, and when we ended our final shift in ew York City that following Saturday, we accompanied Cindy to mass at St. Patrick's Cathedral. "So, it occurred to me that, in this time of crisis, we were mobilizing around the values of the important institutions in our lives-that we were bounded by religious, patriotic and vocational values," adds Pessar. Upon their arrival at La Guardia Airport, Pessar and Aronoff, both New York City natives, immediately noticed a dramatic change in the city. "Everything was spooky," says Pessar. "The airport was empty when we arrived, and the taxi dispatcher in Manhattan thanked us for coming! Everything was sort of tumbled about." That same evening, Pristach accompanied g to Ground Zero, where he taught her the protocol for intervention so that she could in turn teach it to Pessar and Aronoff in the days that followed. Pessar and Aronoff did not go directly to Ground Zero, but instead began a 4 p.m. to midnight shift at the Family Assistance Center, located in the cavernous Pier 94 on the Hudson River, which housed a wide array of centralized services for families and survivors. g called, Pristach, Pessar and Aronoff boarded a plane to New York City. In recalling their decision to help, all three psychiatrists say that while they were not ambivalent about going, each did experience some anxiety prior to departing and even questioned whether THE FACES OF TRAGEDY At the Family Assistance Center, Pessar and Aronoff began work at a booth next to another sponsored by the ew York City Department of Mental Health. Thousands of people milled about, �availing themselves of services provided by such almost like what you would see in a painting." Some people needed counseling and referral, organizations as the Red Cross, Salvation Army, Social Security Administration, and Department of while others needed simple advice or an opportuVeterans Affairs, as well as the mayor's office and nity to vent anger, frustration, grief and fear. the city's police and fire departments. Also on site Counseling sessions took place anywhere the psywere groups prepared to provide assistance with chiatrists encountered need, and the need they housing and financial needs, as well as representa- encountered was as diverse as the population. tives from companies formerly located in the World Trade Center. Food was available in cafeterias, and AN FOLD! G OF STORIES places were allotted for children to play and for families to rest. "There were also two long rows of Ten minutes after arriving at the pier, Pessar talked attorneys whose job it was to take data and fill out with a woman referred by a Red Cross worker. The death certificates," recounts Pessar. "Later, we woman lived in an apartment several blocks from learned that the Department of Mental Health had the World Trade Center and, in the aftermath of organized support groups for these lawyers because the attack, was extremely agitated. "She kept repeating, 'I'm not crazy.' She had they had heard some 3,000 stories." At the pier, as well as at Ground Zero, a number of terrible post-traumatic stress disorder," says Pessar. shrines had been spontaneously constructed. Pessar "What we did was talk about the events that had so recalls that along one wall at the pier was a massive upended her life, and what it was she was dwelling collage of photographs of the missing-people of on and worrying about. I reassured her that she every ethnicity, age and appearance. The area was had a well-known and predictable syndrome and roped off, and under the pictures were hundreds of that she would get 'all better' with quick linkage and Teddy Bears sent from families in Oklahoma City. ongoing psychotherapy at a clinic." Helping people identify and name what they "People walked by and looked at this makeshift were experiencing was key to the psychiatrists' shrine, and it was very moving for everyone," says Pessar. "Again, 1 think this was an attempt to use work. "I think the most important advice we gave ritual as a way of containing people's grief and fear." people was that their enormous emotional upUnder the aegis of Disaster Psychiatry Out- heaval was proper and that they didn't need to be reach, the psychiatrists were asked to perform two afraid of their own responses," Pessar notes. If neckinds of services. One was to respond to requests for essary, in addition to talking with people, she and formal evaluation made by the various agencies at the other six or seven psychiatrists working at the the site on behalf of individuals they were assisting, pier also gave medications, but provided only a few and the second was to walk around the pier and talk days' supply so that people wouldn't become comwith people who appeared distressed, with the goal placent about seeking further help. Another encounter at the pier took place in the of providing them with a quick linkage to longladies room, where Pessar and Aronoff struck up a term mental health services. conversation with an African-American woman "What I remember most about the pier are the who appeared outwardly composed. "This wonderfaces, the faces of tragedy," says Pessar. "You knew whom to walk up to, and it was like nothing I had fully dignified woman in her mid-50s talked to us ever seen. The grief had drained and etched them; about her faith, explaining that she was very relithe detail of suffering in their faces was exquisite, gious," says Pessar. u "\VIzat I remember most about the pier are the faces, the faces of tragedy," says Pessar. "You knew whom to walk up to, and it was like nothing I had n•er seen. The grief had drained and etched them; the deta if of suffering in their faces was exquisite, almost like what you would see in a painting." �HE WOMAN ALSO TOLD THEM HER STORY, "There were also two long rows of tJttorneys whose job it was to take data and fill out death certificates," recounts Pessar. "Later, we leamed that the Department of Mental Health lznd organized support groups for these lawyers because they had heard some 3,000 stories." explaining that she was a receptionist for one of the administrators at the World Trade Center and that she had been in the 1993 bombing and had escaped without incident. On September 11, one of the planes hit the tower very close to the floor on which she worked. The ceiling fell in, but she was unscathed. "When she didn't get anything on her from the ceiling, she thought that was a sign from God, that God had created a shield around her to protect her, and that calmed her," recounts Pessar. "One of the secretaries on her floor was not so fortunate and was consumed by a fireball." The woman further explained that when the plane hit, the building's sprinkler system was activated and all the doors in her office automatically locked. She knew of a door that had been kept ajar so people could go down to the level below and smoke. She headed for this exit and proceeded to walk down 73 flights of stairs. "She described water pouring down on these slippery steps and how she just tried to go step by step while the firemen were rushing up," Pessar relates. "And she did escape. But, after telling us her story, she said, 'I'm a religious woman, and my faith is very important to me, but I've been through two bombings, and I need counseling.' So before we parted, Helen provided her with referral information." While working at the pier, Aronoff also recalls going into a television lounge and finding an Ecuadorian woman curled up tightly on a couch, accompanied by her four-year-old son and her sister. Aronoff sat on the floor and talked with them for about half an hour, relying on her limited proficiency in Spanish and the sister's equally limited English to piece together their story. She learned that the mother had recently left behind three other children in her homeland to come to the United States with her husband, who was in the World Trade Center and was missing. When Aronoff asked how the boy was doing, she discovered that the mother was very concerned about him. "She told me he was 'acting like a baby again,"' says Aronoff. "He wanted to sleep in her bed, was clinging to her, was enuretic and was having temper tantrums if he didn't get what he wanted. And she didn ' t know what to do about it because she was barely able to function day to day herself. So I focussed on giving her support, and I think that was very helpful to her. " No E D To THE NEED As intense and draining as these patient encounters were, Aronoff and Pessar found that their work didn ' t end when they left the pier. Each night when their shift was over, they boarded one of the buses provided by the city that stopped at subway stations and other locations in order to facilitate transportation for people traveling to and from the pier to receive services. As it turned out, these bus rides also proved fertile ground for counseling sessions. On one occasion they met a woman on the bus whose fiance worked at the World Trade Center as a carpenters' supervisor. He was called in to work that day and had died in the attack. "The woman told me they had planned to marry and that they had custody of his two small children," recalls Pessar. "She was accompanied by the man's sister, who herself had recently been widowed and had no living relative except her brother. So these sad women had come to the pier only to discover that because the woman was not legally married to the carpenter, she was not entitled to any benefits. "And this was quite common in terms of what we found," continues Pessar. "The pier was populated by people who represented all kinds of domestic catastrophes. These were the families of the janitors, the secretaries, and the cafeteria workers in the World Trade Center. Most had scanty resources to �begin with, and many saw all those resources disappear. They needed to be advised about psychological services and given practical advice." On another bus ride, Aronoff remembers meeting and talking with a husband and wife who had come from south New Jersey because the woman's brother had been killed in the attack. "They were planning a memorial service," says Aronoff, "and they wanted to get as close to Ground Zero as possible just to get a cupful of dirt so they would have something to remember him by." GROU D THAT DEFIES DESCRIPTION On Friday, the second day they were in ew York City, Aronoff worked at Ground Zero in the morning, while Pessar and Pristach worked there in the evening. All three women relate that it is difficult to put into words their first impression of Ground Zero, saying simply that it defies description. Each says she was initially struck by the vastness of the space, approximately 70 acres of dirt and gray mountains of rubble. "On the periphery are cinder-stained buildings with windows blown out and sections of the World Trade Center imbedded in them; and this is Manhattan! " recalls Pessar. Adding to the disorienting effect produced by the obliteration of streets and other directional cues was the fact that at night the site was artificially lighted, which gave it a garish, foggy atmosphere made all the more lurid by the smells that hung in smoke-filled air. Dotting the site, as at the pier, were a number of shrines, where exhausted and dispirited workers stopped to pray. "Everywhere you looked, there was this eerie contrast of the sacred and the profane," says Pessar. "Among the workers, there was a sense of enormous grief, but enormous purpose and patriotism, too. This was a sacred site, sacred to all of us because of the death and because we were Americans and felt we needed to protect it; but then it was a hellish place, too." Along with the grim mood and somber respect evoked by destruction and death, there was a strange, almost carnival-like atmosphere that developed at the site, as well. "Amidst the ruins, there were rows of tents with free food of every kind," says Pessar, "and booths full of new clothes, boots and socks, all free for the taking; heaps of stuffed animals for your children; and places where you could make free calls home. It made me think of Pleasure Island in the Pinocchio movie. And then there was this pile of rubble with 3,000 human remains." MEMORIES OF THE U IMAGINABLE At Ground Zero, the psychiatrists' first task was to meet with the disaster medical assistance teams (DMAT), which are teams of health professionals mobilized by the federal government during emergencies. There were five DMAT teams on the perimeter of the site, and it was their job to respond to any medical emergency, whether it be a cut finger or more serious situations. As was the case at the pier, in addition to responding to formal requests for evaluation, the psychiatrists were expected to approach people at the site-construction workers, firefighters, police, and members of the National Guard-and to provide counseling if needed. A crucial aspect to work at Ground Zero was helping the workers validate their experience, according to Pristach. "Although nobody was saying it officially, during the four days we were there, work at the site was transitioning from rescue to recovery. The workers digging through the rubble needed help validating that they were living through the experience and that what they had been doing was in some way helpful," she says. In one instance, Pristach and Pessar had a lengthy conversation with a high-ranking firefighter who The woman further explained that when the plane hit, the building's sprinkler system was activnted and all the doors in her office automnticnlly locked. She knew of a door that had been kept ajar so people could go down to the level below and smoke. She headed for this exit and proceeded to walk down 73 flights of stairs. �On another occasion, Pristach says she was approached by a firefighter who was concerned about a coworker who had fallen five stories in one of the towers and had survived, but was not coping well in the aftermath. "He told me that his friend was shaking like a leaf at home and that nobody knew what to do for him," she recounts. they said "just needed to vent." He explained how the younger firefighters looked to him for support and guidance but that, as a leader, he had few people to turn to for comfort. He was exhausted by the continuous 12-hour shifts he had been required to work and was concerned about new manpower shortages the fire department was experiencing as a result of the disaster. He explained that, in addition to the many deaths among his ranks, SO new recruits had decided to rethink their career paths, putting pressure on older firefighters not to retire as they had planned. "He was not only grieving the loss of his coworkers and time away from his family, but the fact that everything in his life had been displaced," says Pristach. "And the worst thing was he felt he couldn ' t complain because so many had died." On another occasion, Pristach says she was approached by a firefighter who was concerned about a coworker who had fallen five stories in one of the towers and had survived, but was not coping well in the aftermath. "He told me that his friend was shaking like a leaf at home and that nobody knew what to do for him," she recounts. The firefighter gave Pristach the man's phone number, which she then passed on to a local outreach center for appropriate intervention. Pessar says she found people at Ground Zero more reluctant to talk than at the pier, but that the older firefighters, in general, were more open about their feelings than their younger colleagues. "They had nothing to prove," she says. While working at the site, she recalls being pulled aside by one such older firefighter who said, "Can I speak with you, Doc?" He then began telling her how he had been off duty when he heard the reports of the attack on the radio and had come to the World Trade Center to help. He was in the second tower when it collapsed and was saved by being thrown under a metal table that protected his head. He was rescued from the rubble, given last rites and hospitalized for ten days. '' from the hospital he became preoccupied by the fact that his injuries were not on his face," says Pessar. "He didn't have any legitimate markings of his involvement, and he thought that there were rumors in his neighborhood that he was lying about his experience." Again, Pessar found it important to help the man name what he was experiencing and to be assured that it was normal. "So we talked extensively about survivor guilt, and I tried to help him understand what he was feeling," she says. "We must have talked 4S minutes; it was really a psychotherapy session, and as we finished I asked him to link up with services offered through the fire department and he promised me he would." For Aronoff, one of the most lasting memories of Ground Zero pertains to seeing families of the victims who were brought to the site by Red Cross workers to say their final good-byes. "The first day I was at Ground Zero, the Red Cross began escorting family members by ferry boat from the Family Assistance Center over to Ground Zero in groups of about SO at a time," she explains. FTER HE WAS DISCHARGED "When the first boatload of families came, it was a very moving experience because we were literally standing at the site of the twin towers and all of a sudden from one of the side streets came a group of people who were clearly not rescue workers. They were holding on to each other, holding Teddy Bears, holding flowers, and were absolutely silent as they walked past the towers. Spontaneously, every one of us working at the site took off our hard hats and held them to our hearts," she says. " It was incredibly painful, and it happened three or four times while I was there." �TIME To Go HoME After four days, the remarkable ordeal of these three psychiatrists came to a close and it was time to return to Buffalo and their families, practices and students. In attempting to sum up the enormity of their emotions surrounding this experience, they expect it will take months, perhaps years, to fully absorb what they encountered. All agree that the experience is one they never would have forfeited, and they relate wholeheartedly to Aronoff when she says, "I felt like it was an honor to go, to be called to help. You never really know how much individual help you provided, but I think none of us feels our time was wasted. For me, at least, I was glad to have a chance to be able to give something back." Echoing Aronoffs sentiment, Pessar adds, "I think all three of us-Cindy, Helen and I-are fairly idealistic. And I know that when I went to medical school, I was taught that medicine is a calling. "During the time we were in the city, there was a sense of responding to one's calling. I think this is something all three of us felt; and it was a privilege to respond." CD Drs. Pristach, Pessar and Aronoff would like to thank Dr. Susan McLeer, chair of University at Buffalo's Department of Psychiatry, and other administrators in the School of Medicine and Biomedical Sciences for allowing them to take time away from their normal schedules to travel to New York City to work with Disaster Psychiatry Outreach. .- hllall ,.rslclu I �--- -- Buffalo Physician readers write about September 11 [~itor'snote: J allowing the tcrrorists'attacks zn" 'cw York, \\ ashington, DC, Waiting for Few Patients and Pcnnsylmnia on September 11,2001, "\litlwel Bcmard111o, AID, dean Bv ALEXANDER VoLFSON. CLASS O F 2002 of the Unn·ersity tlt Buffalo School of Medicine and Bio111CdJml Sciences, conl'eycd in 11 letter to alllllllll, flu ulty and students the deep sorrow and disbelief our UB COIII/Illllllt)' felt in the ajtermath oj tillS tragi( day. Dean Bernardino also expressed concern f(Jl· the saJcty of our school's alumni, explaining that some 1,550 lil'c and \\'Orkin the New York Cit)' area, and anaddit1onal600 or more within a 45-minute dnve of\\'ashington, DC At the cl(N o( Ius letter, he inntcd ltllhl'Jduals to contact Buffalo Ph) sician should they lun•e stories they "1shcd to tell about e1 cnts surrounding eptC1nl1cr 11th. Here arc so11zc of tilt' responses \\'e receJ\'cd. n September 11th I was in the fourth week of an anesthesiology elective at ew York Presbyterian Hospital/Weill Cornell Medical Center and spent most of the day in the emergency room. Once I rea lized the scope of what had happened, I felt shocked and scared, but definitely proud to be in a position to help. When the hospital went into emergency mode, there was no panic; everyone just came together and worked calmly. Physicians from all specialties were divided into teams, each assigned to an ER station. There were nurses, students and other staff there as well. Volunteers passed out food and drinks, and we had shifts so that no one would get tired. Unfortunately there weren't too many patients to treat. Cornell has a big burn center, and many patients were directed straight there, bypassing the emergency room. We took care of a few firefighters and police who suffered minor inhalational injuries. Several buses took doctors to the Chelsea Piers, where a triage area was set up. At one point, the discovery of the bodies of two EMT workers brought to tears many of the people in the ER who knew them. But everyone remained calm and continued to work. At the end of the day, a couple of us went to get some pizza at a nearby pizza shop. As we walked in, the customers there began to applaud us. It was a great feeling knowing that you were part of a special group of people who know how and a re ready and willing to help others. CD �SORE SPASMODIC SO ET U SU G VESALIUS EXFOLIA T SUBJECT DESCE DI FREE OF GALILEO A G D EWTON BOTH AT 0 E POI T, THE DISCOVERY OF THE BODIES OF TWO EMT WORKERS BROUGHT TO TEARS MA Y OF THE PEOPLE I WHO K EVERYO A THE ER EW THEM. BUT E REMAINED CALM D CO TI UED TO WORK. �Grey Sonnet Following the Cloud Solace and Inspiration BY EDWARDS. CHESLOW, MD '81 Cataclysmic Convulsions Imploding Laden in grieving horror of chagrin As the initial Witnesses all too complicit in expedient libel begin numbing phase Substitutive Echo of the Enigmatic Hate began to wane, Unpardonable Occurrence action we mistake the psychiatric repercussions of this trauma began to surface. \\'e saw immigmnts with post-trcwnwt1c stress Immediate nearly complete in lethality aftermath unrest Incalculable misery seed to vitiate our unsoiled mighty granite nest Sore spasmodic sonnet unsung Vesalius' exfoliant subject descending disorderfrom war- Free of Galileo and Newton both tom countries who Terminal velocity of neither feather nor weight were rc-tmumatized; Applied accelerant to both Human body and symbol in at least one case I either hope nor solution this encountered, this led Innumerable Particulate to psychotic dcc0111pcnsation requiring Or Clzeslow" a, Ticholas Ra11go Fellow i11 HI\' ,\fedu i11c at the 4IDS Institute, \lowlt Si•m1 S( fwol of A!ed!Wie, m, 1cw York City hospitaliza tio 11. CATHY BUDMAN BY CATHY BuDMAN, MD '84 am an academic psychiatrist on staff at the orth Shore-Long Island Jewish Health System, approximately 20 miles from Manhattan. While our staff remained on alert, anxiously awaiting for what we expected to be the many injured, we could see the smoke from the burning towers from our hospital. To our horror, the patients never arrived. The devastating reality for health-care workers throughout the ew York metropolitan area on September 11 was that there were no large numbers of civilians to be saved. Many, many people perished without tangible remains. Forty to 60 people are missing from my hometown, Manhasset, on Long Island. Some families are missing two siblings, or both parents. In the majority of cases, there are no whole bodies to retrieve, only body parts that were gruesomely dispersed throughout the rubble. The human loss is overwhelming. On a personal level, this catastrophe impacted directly on my sister and her family. They became homeless, the children's elementary school was destroyed, and my sister's office in the American Express building was used as a morgue. And my sister-in-law, who survived the 1993 tower bombing, managed to safely evacuate from the ninth floor of Building 7, which later collapsed. Both witnessed the carnage: the terrifying crashes of both planes into the towers, the desperate people jumping from the upper floors, those killed by falling debris on the streets, and the tidal waves of dust and debris that followed the collapse of the towers. Of course, they have lost neighbors and colleagues. We feel blessed that our immediate family members are alive. For the first few days after the disaster, my office at the hospital was unnaturally quiet. We spent some time counseling emergency medical service personnel from Long Island, many of whom were at Ground Zero but unable to find survivors to help. Many had lost colleagues and friends from the various fire or police departments. �September 11,2001 BY LARRY BEAHA ' .MD '55 t's like On the Beach. What would you like to do As the initial numbing phase began to wane, the ' on the last day of your life?" my wife, Lyn, said. psychiatric repercussions of this trauma began to We were launching our tandem canoe into the surface. We saw immigrants with post-traumatic Erie Barge Canal on our way for apple strudel stress disorder from war-torn countries who were at Omi's Deli across the water. A battered Stars re-traumatized; in at least one case I encountered, this led to psychotic decompensation requiring and Stripes dangled at two-thirds mast as brilliant sun turned a cotton-spattered sky unreal baby blue. hospitalization. "If this is the last day, it will do," I said. We saw families reeling from the unimaginable loss of loved ones, in many cases involving young That morning as I was at work on my computer, people with young children. We saw elderly who Lyn came in breathless: "They just crashed a jet into had survived America's wars overseas and who the World Trade Center." We rushed to the televiwere now heartbroken to experience it on our soil. sion as another plane exploded the second tower in We saw paranoid-schizophrenic patients who were orange flame. It was unbelievable. Like watching delusionally convinced that they had actually King Kong climb the Empire State Building. It lookcaused this disaster. We saw Moslem patients who ed like a trick. The audio portion was Orson Wells were afraid to leave their homes lest they be threat- and his "War of the Worlds" over again but there ened and beaten. We saw angry, depressed adoles- were no disclaimers. cent boys filled with fantasies of rage and retaliOur son, Teck, called from work. "Did you hear ation, as well as many patients with anxiety disor- what happened?" he said. ders and depression who were experiencing severe Yes, we did, and we recalled a pilot with a Kenworsening of symptoms. Many children were pre- more connection who was killed when his B-25 senting with somatization and conversion disor- crashed into the Empire State Building in fog, and ders. We expect the need for psychiatric services will Kennedy's death. Curiously, I remembered the only increase as time goes on. bowl of oyster crackers I ate in a Deco restaurant Being a doctor has provided me with great solace when the Pearl Harbor news came over the radio and inspiration during this crisis. I appreciate more that day my dad had taken us Christmas shopping. than ever the gift of being able to help others. Each Our out-of-town son, Nick, got through on the day brings new challenges and opportunities to phone. "We haven't heard how Pat and Mike are," exert one's humanity, and for this I am so very I said. Our niece and her husband have a tiny rentthankful. 4D controlled apartment they inherited in lower Manhattan. He works in the Financial District. "Thank God you aren't flying today," Lyn said. Nick said, "Isn't Patty's baby just about due?" I remembered the Bay of Pigs. I was in the Air Force on temporary duty in the U.S. Lyn and our kids were on a troop ship sailing from our home base in Japan to meet me in Hawaii. While we were there, Teck and I watched from Waikiki as a hydrogen bomb, tested 600 miles from us, ignited the en tire Pacific sky. As New York rocked in the aftershocks of the World Trade towers, we watched and watched the death and destruction on television. Reports of the Pentagon crash and of another jetliner in Pennsylvania came in. A friend e-mailed, "What if that jet went into the nuclear reactor at Three-Mile Island?" \\'e recalled a pilot with a Kenmore Connection who \\'{IS killed when his B-25 crashed into the Empire State Building in fog, and Kennedy's death. Curiously, I remembered the bowl of oyster crackers I ate in a Deco restaurant when the Pearl Harbor news came over the radio that day my dad had taken us Ch ristmns shopping. -LARRY BEAHAN �That afternoon in the canal and at Omi's, it might fum.' been the last day of our ln·es, so Lyn and I rclJShed the sun, the \Vlltcr and a great blue heron's flight. \\'c paddled our canoe doH 11 the canal and across to the do(k at Omi's little dclzcatesscn. - I f 1• LARRY BEAHAN ~ I 1 f f a f 1 P ys i ei a1 That evening I had two meetings I was planning to attend. Both were cancelled. I argued with one chairman who felt we must mourn rather than meet. I believe it would have been better for our groups to meet and talk and plan joint action, maybe a carpool to the Red Cross to donate blood or to pray. Staying home glued to the one-way communication of the television screen does little for me. That afternoon in the canal and at Omi's, it might have been the last day of our lives, so Lyn and I relished the sun, the water and a great blue heron's flight. We paddled our canoe down the canal and across to the dock at Omi's little delicatessen. Omi, the transplanted German grandmother with her big smile, her bad hip and her full-length apron of pale roses, was flustered. " o, I didn't forget your soup. Who would believe it, how could it happen in this country?" I accepted the hot chocolate she brought instead of the chocolate milk I ordered. "Everything is discombobulated this morning, "she said. An elderly couple arrived by bicycle and took their tea and brownies outside in the sunshine. "I'll pay, you paid last time at Mississippi Mudds," she said. Apparently it was their second date. Omi called, "How do you want your strudel, hot from the oven or cold? "Hot, I love it hot," I called back. Two young women talked, one in a bright red dress with a watermelon-size bulge in front, the other in similar red top and white pants but carrying her newborn in a car seat. "I like to make a big pile of spaghetti with a red meat sauce," one said as the other picked up with her ideas on how to make pickles. Omi, between serving her Transylvanian horseradish soup and delicious flaky, tart-sweet strudel, talked of war: "You tell me how that was possible, in this country. In Germany the airports have soldiers with machine guns. Here we pay inspectors minimum wage. When she interviewed me, Janice Okun loved this soup. I got one granddaughter, lives twenty miles from the Pentagon." One of the mothers peeked at the baby in the basket. "He's nodding. They do that, you know," she said: then, "I just sat and watched an airplane fly into the World Trade Tower. You know how sometimes you can't grasp what you're looking at. IV , , r ,. r 1 oo2 I couldn't believe it. Jt was like something in the Third World." I went to the counter to pay Omi. She was working on a sandwich as she talked on a cell phone tucked under her tilted chin. "Bye, bye Shatzi. I love you too. Goodbye," she said; then to me, "All my kids are calling. I charged you for the lunch special since you had the sandwich and your wife the soup. Was everything okay?" "That strudel, just hot out of the oven, was wonderful." "I know, but some people only like it cold. You have to ask." I tried to tell her about Lyn's On the Beach question- "How would you like to spend your last day?" I don't think I got it through Omi's "discombobulation" that, if this had to be our last day, then a paddle on the canal with Lyn and strudel at Omi's would do fine for me. That evening my sister e-mailed me, "Mike got home covered with dust. He helped rescue workers till there was nothing more he could do. Pat and the baby are okay." CD Dr. Bcaha11 ;, a rcttrcd p:-rclzl<ltn~t mui c111thor o(Mv C.randp.1\ \\'oods, th~ Admmd,1cb. 1-h lives 11ot far from where the Fnc Hargt Canal pa:scs througlz 'orth f'otull\'<lllda, 'ew York. 1-lt• wrote thi.< story 011 the Cl't'lllllg o('\eptl'll!bcr II, 2001. ADay in Downtown Manhattan BY HAROLD BRODY , MD '61, PHD hile on a visit to ew York City to see my cousin on October4, 2001, I took the opportunity to travel into downtown Manhattan to visit the area around what was formerly the World Trade Center. Since my cousin lives on Broadway and West I 1 I th Street, I rode the subway downtown to two station stops before Canal Street and walked the remainder of the way to the site. Leaving the subway, I was immediately struck by how few people were on Broadway. Uptown, there had been about 100 persons per city block, while downtown there were only two to four people per block. �"IT's LIKE ON THE BEACH. WHAT WOULD YOU LIKE TO DO 0 THE LAST DAY OF YOlJR LIFE?" MY WIFE, LY , SAID. WE WERE LAUNCH! DEM CA G OUR TA ERIE BARGE CA AL 0 OE INTO THE OUR WAY FOR APPLE STRUDEL AT 0MI'S DELI ACROSS THE WATER. A BATTER~D STARS A D STRIPES DANGLED AT TWO-THIRDS MAST AS BRILLIANT SUN TUR SPATTERE SKY U ED A COTTO - REAL BABY BLUE. MY ONLY HOPE IS THAT WHAT ALSO LINGERS IS THE RESPECT AND REGARD THAT PEOPLE SHOWED EACH OTHER AT THE SITE. IT SEEMS A PITY THAT WE MUST GO THROUGH AN EXPERIE CE LIKE THIS TO DEVELOP A ATTITUDE OF REGARD AND RESPECT FOR EACH OTHER. BUT PERHAPS THIS PAl FUL LESSO WITH US. WILL REMAI �I went into a hardware store to speak with the owner, who said that the streets had been desolate since the World Trade Center was destroyed and he could not see how he and his family could remain there for very long, given the drop-off in customers to his store. Restaurants were empty, hardly a car passed by, and I saw few police patrolling the area. In short, there was a feeling that everyone had forgotten the existence of this part of the city, where even 24 days after the attack, a cloud of smoke hung in the air. As I neared Canal Street I noticed that store fronts and apartment houses were covered with thick deposits of ash. There was an increase in the number of pedestrians and police, although automobiles, including taxicabs, were virtually absent. Pedestrians were restricted to walkways that had been built on the sidewalks. We could venture as far as one street from the periphery of the damaged area, but no closer. The number of police in this area was very great and they were clearly in charge. Looking toward Ground Zero, the amount of damage I observed was incredible. o buildings were standing in the area; everything had been destroyed. Occasionally, people walking by would wipe tears from their eyes. As we stood observing the work at the site, no one smiled or laughed. There were few young adults in the area, and I saw no children. The area around Wall Street, assau Street, Fulton Street and the former World Trade Center is normally very noisy. Yet while I was there, I was struck by how quiet it was. When people spoke, they kept their voices low. o one shouted, everyone was patient, and there was a total regard for the next person, as well as a gentleness toward complete strangers. In talking with people I encountered, l often sensed confusion in their minds about how to respond to what had happened. While they wanted some form of retribution for those who had created this hell and killed so many thousands without regard, at the same time they were very sad, and several remarked that they wanted to cry as they looked at the broken buildings and debris. Many talked about struggling with the realization that life must go on. You have to leave this area before you can overcome the feeling of dread that envelopes you while you are there. And the feeling does not disappear completely once you've left, but haunts you for hours and days after. My only hope is that what also lingers is the respect and regard that people showed each other at the site. It seems a pity that we must go through an experience like this to develop an attitude of regard and respect for each other. But perhaps this painful lesson will remain with us. 4D Dr. Harold Brody 1sa lh<tmguishcd fcaclung Projl·ssor l;mcntus of anatomical sciences in the Ulllvcrsit)' at Bu{fi1lo School of.\lcdicillc a111f Biomedical Scic11ccs. lhttp://www.sciam.coml attacks are most at risk fo~ post-traumatic stress disorder feel much more vulnerable. Author Sarah Graham discusses wliat events in this article on the Scientific American web site. An internet study lhttp://coping.stanford.edu/J launched on September 22nd attempts to assess responses to the attacks on America. The article also offers a set of do's and don'ts for coping with anxiety and links to other relevant topics. mental heaHh services to those who have survived disasters such also available in print, free of charge, from the Center for Mental �ALUMNI Oistin~ished Medical Alumnus Named Marshall A. Lichtman, MD '60 arshall A. Lichtman, MD '60, received the University at Buffalo's Distinguished Medical Alumnus Award from the Medical Alumni Association at a dinner held on September 20, 2001, at the Buffalo Club. Lichtman is former dean of the University of Rochester School of Medicine and Dentistry and former executive vice president for research and medical affairs for the Leukemia and Lymphoma Society of America. After graduating from Buffalo's Lafayette High School, Lichtman attended Cornell University, where he earned a bachelor of arts degree in zoology. He then entered the thenUniversity ofBuffalo School of Medicine, graduating in 1960. Lichtman spent his entire academic career at the University of Rochester. He completed his residency in internal medicine there in 1963, after which he served in the Public Health Service until1965. He then returned to the University of Rochester to serve as chief resident in medicine. After completing his residency training in 1966, he pursued a strong interest in hematology and was awarded a Special Postdoctoral Research Fellowship from the National Institutes of Health from 1967 to 1969 to conduct studies on the biochemistry and physiology of blood cells and their abnormalities in leukemia. In 1969, he was named a Scholar of the Leukemia Society of America, an honor that was complemented by research support from the National Cancer Institute. In 1968 Lichtman was appointed assistant professor of medicine at the University of Rochester School of Medicine and Dentistry and in 1970, assistant professor ofbiophysics. In 1974, he was appointed professor of medicine and of biophysics, and in 1975 he was named chief of the Hematology Unit. From 1979 to 1989 he served as dean for academic affairs and research at the university, in addition to his responsibilities as a professor, scientist and hematologist. From 1990 to 1995, Lichtman served as dean of the University of Rochester School of Medicine and Dentistry. In 1996, he was named executive vice president for research and medical affairs of the Leukemia Society of America, now the Leukemia and Lymphoma Society. He also retained his appointment as professor of medicine and of biochemistry and biophysics at the University of Rochester. Lichtman has served on the editorial board of five scientific journals and as the editor-in-chief of Blood Cells, Molecules, and Diseases. He has been the editor of two monographs and four textbooks of hematology, one of which is in its sixth edition, and has authored more than 230 scientific articles and book chapters on the physiology, biochemistry and disorders of blood cells. Left to right: John Bodkin II, MD '76, president of the University at Buffalo's Medical Alumni Association, Marshall A. Litchman, MD '60, and his wife, Mary Jo. A Master of the American College of Physicians, Lichtman has been a visiting professor at over 40 medical centers in the United States and Canada. He has served on the Hematology Study Section of the National Institutes of Health and as chair of the U.S. Navy's peer review group of the Division of Biological and Medical Research. He is a past president of the American Society of Hematology and has been chair of the society's advisory board. Lichtman also served on the Council for Graduate Medical Education of the State of New York and on the board of governors of the American Red Cross. CD -S. A. UNGER \V i 11 t er 2002 lulfale Physiciaa 11 ��"There are about eight million new cases of TB worldwide each year, 95 percent of which occur in the developing world," Miller says. "Unless we act aggressively to control and eliminate this treatable and preventable disease, it will continue to take an enormous toll." The World Health Organization (WHO) estimates that without dramatically strengthening public health control and elimination efforts, one billion people will become infected with TB within the next 20 years, 200 million people will become sick and 35 million people will die from TB. Moreover, there are approximately 36 million people living with HIV infection-some 5.3 million of whom became newly infected in 2000 alone. To date, nearly 22 million people worldwide have died from AIDS, and the number of individuals who have been co-infected with this disease and TB-estimated to be about 11 million people-is expected to dramatically increase in the next 10 years. Persons infected with both HIV and TB are 50 to 100 times as likely to develop active TB as those who are not HIV infected. As a result, rates of TB in subSaharan Africa, formerly 10 to 20 times higher than rates of TB in the U.S., have doubled and tripled in the past 10 years. "To prevent HIV infection is to prevent TB, and to treat TB is to treat AIDS," Miller observes. "These two pandemics are intimately linked, and the tactics to control them must be synchronized." 1.1.1 a: TO MAKE A DIFFERENCE u; Born in 1947 in Racine, Wisconsin, and raised in Gary, = 1.1.1 Indiana, Miller was encouraged to pursue her academic interests by her mother, and equally imbued with a strong sense of community and a desire to make a difference in the world by her father, who is a rabbi. A career in public health seemed the logical choice, Miller explains, because of its scientific rigor and its potential to improve conditions for large numbers of people. With this in mind, Miller studied public health nutrition at Harvard University, earning a master's degree in that field in 1970. Three years as a public health nutritionist whetted her appetite for medical knowledge and prompted her to enroll in medical school at the University at Buffalo. C "I loved Buffalo from the beginning," she says. "The \Vi11ter 2002 luffalo Physiciaa 19 �approach there was, and continues to be, very practical and very patient oriented." At UB, she adds, she found further inspiration to work in the area of public health under the tutelage of such mentors as Harry Metcalf, MD, UB associate clinical professor of family medicine, and Robert Dickman, MD '68, then a UB professor of medicine in the Department of Social and Preventive Medicine, who is currently chair of family medicine at Tufts University. Both professors, she says, conveyed a strong concern for and awareness of community-oriented medicine. Her interest in public health was further reinforced when she and a fellow medical student, Benjamin Gitterman, MD '76, established a community board to work with the administration of Buffalo General Hospital to enhance the hospital's responsiveness to the needs of the local community. C PANDEMIC AND OTHER ..... INTERNATIONAL Miller's interest in international health was sparked by another unusual opportunity that came her way during her two-year training with the Epidemic Intelligence Service. This time it was the chance to track down the cause of an illness affecting more than 900 Palestinian schoolgirls on the West Bank of Israel. The illness was characterized by headache, dizziness, abdominal pain and leg weakness, and many of the girls were hospitalized. "I was asked to participate in this outbreak investigation because I had previously worked in the Middle East and because I was a woman," Miller notes. "We visited five hospitals where the girls were receiving care in wards accommodating up to 40 patients, generally two to a bed. Some clearly appeared in distress, but most were full of the bubbling enthusiasm and curiosity of teenage girls. While all were wearing abbayahs and appeared appropriately modest, further examination re- c::t CROSSCURRENTS en After completing her internship and residency in internal e medicine at Washington Hospital Center in Washington, .... DC, Miller moved to Atlanta to join the staff at the CDC as a member of the Epidemic Intelligence Service, a practical training program in public health, emphasizing field work. The year was 1981, a momentous time in public health, as a puzzling affliction (a generalized lymphadenopathy syndrome) had recently emerged among gay men and appeared to be associated with the growing numbers of cases of Kaposi's sarcoma and Pneumocystis carinii pneumonia in the same population. Miller spent months in ew York City investigating the condition. She and her CDC colleagues produced the most complete description of the syndrome, which is now known to be an early manifestation of HJV disease. "The experience was life changing because we were seeing so many vibrant young men in the prime of their lives with an unknown illnes ,"she says. "We conducted extensive interviews, drew blood specimens for the virologists in Atlanta, and reviewed thousands of pathology records to look for a pattern. We found one: There was an increase in generalized lymphadenopathy in ew York C ity among homosexual and bisexual young men between 1977 and 1981. This syndrome appeared to be linked to the illnesses affecting gay men. In a few years, nearly all of the men we had interviewed would be dead." en 20 laffale PhysiciaA \Vi11ter 2002 ..... a: 1111 ..... a: ..... ...:z: w w : �asks, 'What are the major health issues for this community and nation? What causes the greatest burden of disease and loss of productive life? What is the cost to the community and nation in terms of economic development and quality of life? '" a:1!5 BEFORE THE STORM vealed that most were wearing blue jeans and tee shirts beneath their traditional dress. I was filled with feelings of tenderness. "Thankfully, we were able to rule out organic disease and toxic exposures and to rapidly identify possible trigger factors for what turned out to be an epidemic of mass psychogenic illness. Despite the political tensions of the region, the CDC's structured, epidemiologic approach helped calm the situation, and we were able to put a community's concerns over this immediate worry to rest. " Although she found such detective work fascinating, Miller left the CDC in 1983 in favor of a clinical practice as an internist. As much as she enjoyed working with patients, however, she found that she missed the breadth and scope of public health work. After two years, she returned to the CDC, this time taking a position with the Division of TB Elimination, where she could combine her interests in clinical medicine Miller's first years with the Division of TB Elimination in the mid-1980s were .... fairly quiet, she recalls. Because the pub:Z:: lie was not yet aware that the Pandora's .... box of tuberculosis had been reopened, federal funding was sparse. Miller primarily worked in the U.S., consulting with state and local TB control professionals on public health practice. The link between TB and HIV infection was just becoming apparent in the U.S. , and much of Miller's writing and consultation were focused on this connection. As this assignment involved less travel, it gave Miller and her husband, Steve Solomon, an infectious disease specialist who works on patient safety and health-care quality at the CDC, an opportunity to settle in and concentrate on raising their two sons, David and Matthew, now ages 17 and 14. "I like the fieldwork. It's energizing and allows me to learn about the concerns of health-care workers and the people in the community involved," Miller says. "However, when the boys were younger, I felt strongly about not being away from home too much. Now, they beg me to leave!" she jokes. On a more sombre note, she adds that following the September 11 attack on New York City, CDC staff continue to travel and work abroad. However, they closely monitor all State Department warnings regard- and public health. Part of the balance she strives to achieve between practicing clinical medicine and public health comes from her work at a weekly TB clinic in Dekalb County, Georgia, where she has seen patients for the past 12 years. "I like the mixture of the political, analytic and medical features of public health," she says. "At the same time, my clinical work keeps me grounded. " Miller emphasizes, however, that a supervening challenge for everyone working in public health is getting public and private sectors to communicate. "The world of private medicine is geared toward the individual patient, primarily toward illness and cure, although it is becoming more prevention oriented," she says. "The focus of public health, on the other hand, is the entire community. The public health practitioner ing specific destinations. Despite the increasing incidence ofTB, control of the disease remained a low priority throughout most of the 1980s. Late in the decade, however, reports of the spread of multidrug-resistant TB jolted the U.S. public out of complacency. The mounting HIV/ AIDS crisis prompted further concern as epidemics ofTB among AIDS patients were reported in hospitals, prisons and other institutional settings where persons infected with HIV lived or received care. As a result, numerous public and private foundations entered the fray against the disease at both the national and international levels, and Miller soon found herself at the forefront of well-financed efforts to bring TB under control. U ll'i11ter 2002 luflalo Physiciaa .....,;.. E - ·= ........ ...... ........ ..=..._ ... ...... ...... -E -= = co ... co • b.O ·S ... -~ ~ = ... _.,.= -:;; ... ...- I'=co ...... "'... .....: • "' ... ·!:E . ... =-= co ~ ..... >I ... _ ... = ...... =-s_ ·... !J: ·-... .s..... IIIIII :z: 1- z .... > c:; w w 21 �• GLOBAL HEALTH PRIORITY .... So alarming is the modern TB pandemic that WHO declared it a global emergency in 1993. In 1998 the organization C launched the STOP TB Initiative, a global partnership to increase resources and move worldwide TB control higher up on the international public health agenda. Since then, numerous partners have joined this initiative, including United ations agencies, private donors, universities, professional societies and nongovernmental agencies. Miller has represented the CDC on this initiative and strives to promote collaboration between the Global AIDS Program and the efforts of STOP TB. TB control is particularly challenging in developing countries in Africa, Asia and Latin America, where TB and HIV/AIDS are prevalent and health-care infrastructures may be weak. In an effort to improve control in all settings, WHO promotes the Directly Observed Therapy Strategy (DOTS) for TB. "This strategy requires political commitment on the part of the government of each country, a stable supply of anti-TB drugs, direct observation of each patient's therapy for six to nine months, a network of laboratories to perform microscopic examination of sputum, and a recording and reporting system," says Miller. "Political commitment is the key, however, because TB control efforts require perseverance." :Z A major hurdle in the battle against TB is the tendency for patients to discontinue treatment prematurely. "TB is a very slow-growing organism, and it takes six to eight months to treat it," Miller explains. "Because it's time consuming and labor intensive for patients to complete the regimen, it's not surprising that many drop out of treatment after the symptoms go away, even though they still have the disease. " The result may be an increase in drug-resistant disease in the community, Miller notes. When people fail to complete standard treatment regimens, or are given the wrong treatment regimen, the persisting bacilli may include organisms that are res istant to one or more of the anti-TB drugs. These individuals may then transmit these drug-resistant organisms to the people they infect. Multidrug-resistant TB requires up to two years of more toxic, less effective chemotherapy and may be up to 100 times more expensive to treat than drug-susceptible disease. "All of these activities require a strong primary health-care infrastructure, which is critical for the improvement of the health sector in developing countries," Miller explains. "However, these activities are significant challenges for countries where the per capita health expenditure may be less than five dollars a year." There is a great need for new drugs, a shorter treatment regimen, an improved and more effective vaccine than BCG, and "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One John James Audubon Parkway Amherst, New York 14228 716.636.7600 22 lull a lu Ph ysi cian IV i 11 I c r 2 0 0 2 H oGAN & W ILLIG, PLLC ------ Attorn e ~· s at Law----- - hoganandwillig.com �...... = ... "i ~ ·= -....... = ... :§ .=CI. -... ... ~ e new tools to make the diagnosis of TB quicker and easier in the field, Miller stresses. "It takes years of research to develop effective new drugs, and large financial commitments to fund that research. Given that TB is a 'poor person's disease'-afflicting homeless people, prison inmates, refugees and people with HIVthe market for TB drugs isn 't very lucrative. This tends to inhibit research in this area," she says. -= ..."' ........ ....:.~e"' =-... -=..,_ ~ -·- .... .,:;c -=~ . e ...... = ...... .,...,. ..."'= ·c::; ...... ...... ,. Cl,. ~a; ... > cn FORHOPE 1::::1 Despite these challenges, Miller is optimistic that c: .... !!§ > "' ,. -=... ...= TB can be brought under control, even in areas c:::» where HIV infection is prevalent. "Though TB is "'-~ :E 1:::1::: --... by far the most common opportunistic infection associated with HIV infection, it is treatable and preventable, provided that treatment is begun early and carried through to completion," she says. The growing collaboration among international agencies, governments and private donors seeking solutions to TB and other health concerns greatly encourages her. In 1998, for example, WHO launched a massive effort toward elimination of "diseases of poverty, " including malaria, HIV/AIDS and TB . ·;:; e .... ::I ... ---== c.::l ... = ... ...... .... ~ :E ·- = z ~ ... .... ... u .... -:'... ~ j 'II 'II Recently, the CDC has also substantially expanded and formalized its efforts in the international arena, a direction that has been supported by Congress. "This past year, as part of the STOP TB initiative, a Global Alliance for Drug Development, spearheaded by the Rockefeller Foundation, has been created to promote new drug development for TB, which is really quite thrilling," Miller points out. Scientific progress offers additional hope. "The genome of the TB bacillus has been sequenced. That's a huge breakthrough that will have a great impact on treatment and vaccine development. All of this makes me optimistic. The TB bacillus is a very complex and tenacious organism, but we have finally moved into the 21st century and are poised to eliminate it." Miller encourages medical students to consider a career in public health as an opportunity to make a difference for entire populations. "When I was in medical school, I don't think many of us looked to public health practitioners as role models. But since then, I've been impressed by the creative, inspiring professionals contributing to this field of medicine. In the arena of TB, with the enormous burden of disease it imposes on world health, the challenge to public health practitioners is tremendous and thoroughly motivating. I feel privileged to be among those responding to that challenge." <TI> Take the Life Care Plunge ... Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, w hile addressing your needs and desires for a w orry-free future . Call today for your personal tour. Westem New York 's first Life Care Commtmity. ~nterbury UJoods ('5) Cal/ 716/929-5817 for your personal tour .. . 705 Renaissance Drive Williamsville, New York 1422 1 ~=·~ \V i 11 t er 2 0 02 luflalo Physician 23 �M E C D A E SCHOOL L W S Honors Convocation Reco nizes first· an Second-Year Achievements ur A \ Hr) rw<; Co ' ·oc \flO recognizing academic excellence among first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held in Butler in general and systemic pathology. Dr. john Sheffer practiced pathology in Buffalo for over 35 years and was acting chair of the Department of Pathology from 1972 to 1974. Auditorium October 6, 2001. The following is a list of award recipients and a description of the Elizabetb laurke, '03, received The Department of Pathology' s awards received. Departmental Awards CARl- . level in the laboratory portion of the courses the second-year student achieving the highest grade in the microbiology and immunol- American Society of Clinical Pathologists Award for Aca- The departments of the School of Medicine mzd Biomedical Sciences have established awards to recognize meritorious performance in their courses as well as outsta11di11g achievemerzt i11 other curriculum-related activities. Iarin Llrb•anee,'13, outstanding performance in the received the Department pathology laboratory. Carea Cellia, '14, received the Department ofMicrobiology' s Marek of Anatomy and Cell Biology's Gibson -A twell - jones Award, Zaleski Award, which is prese nted to the student ment of Pharmacology and which recognizes the student with the highest combined average in the anatomical sciences courses of gross anatomy, histology, neuroanatomy and embryology. The award is named in honor who best combines high Toxicology's Edward A. Carr Jr. Clinical Pharmacology Award and the DouglasS. Riggs Award. GtLLIN ogy course. Dr. Witebsky was the founding chair of the Department of Microbiology. demic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and ELIZABETH BOURKE ~iaa Lia, '13, received the Depart- standards of academic achievement with outDARius LoGHMANEE standing service to the community. The second-year class chooses The award is given to the student achieving the highest the recipient average in the Fundamentals of of past chairs of the department }IAN LIN Pharmacology course. Drs. Carr Drs. james A. Gibson, Wayne ). Atwell and Laura Ciaski, '13, received and Riggs were chairs of the Department of Oliver P. jones. the Department of Pa- Pharmacology and Toxicology. thology's Kornel Terplan Natalie Sbaw, '14, received the Award, presented to the Department of Biochemistry's student with the highest Lisa Esler, '13, larn Cbaa, '13, an~ IISs Iieber, '13, received the AstraZeneka Car- Edward L Curvish Award, which combined average in the diovascular Drug Monograph Awards, recognizes the student with the two second-year pathology courses. Dr. Terplan which are presented to second-year students highest average in the two first- LHRA C1NSK I year biochemistry courses. was a past chair of the department by the Department of Pharmacology and Toxicology. They are based on the quality of a mono- Timatby Par~ee, '13, NATAUF SHA\\ graph written '13, ceived the Department in the form received the Department of Pathology's john B. of a package Sheffer Award, which is insert Darat~y Hn~ricks, ofMicrobiology's Ernest Witebsky Award for given to the second-year student who has per- Proficiency in Microbiology, which is given to formed at the highest DoROTHY 24 re- laflale Phpician H rNDRICKS \Vi11ter 2002 TIMOTHY PAROFF LISA ESLER Ross RICHER �Je1aifer NIWibilski, '14, received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to the student with the highest combined average in the l \ two physiology courses in the first year. Dr. Rennie was a former vice president for research at UB and chair of the Department of Physiology AL F R E D FRo NTE RA SARA KAPROVE LYNDS AY ESME FINLAY WILLMOTT-BARTOS Discipline Honorary Societies: Narab Jaaasy, '13, received the and Biophysics. The Association of Pathology Chairs Honor Society awardees were Laara Ciaski, Alfred .leaaifer Naw1bilski, '14, aad Natalie Sbaw, '84, re- and Esllle Fialay, all in the Class of 2003 ( Cinski Evan Calkins Primary Care Achievement Award, which is given to one outstanding student in the Primary Care Summer Externship Program. Dr. Calkins is a former chair of the Fr11tera. Lyadsay Willmatt·lanas, Saralapme. ceived the McGraw-Hill Book Awards, which are given to the two highestranking students in the first -year curriculum. is pictured on page 24.) Department of Medicine. CD NoRAH JANosv NATALI E SHAW Dean's Letters of Commendation Dean's Letters of Commendation recognize exceptional coursework. In years one and two, they are a earn honors grades in 75 percent of required courses or achieve 75 percent of available honors pom three, students who earn at least four honors and two high satisfactory grades are honored. Letters in Yea NICOLE MANN DANIEL BAER )EFFREY MARTI DOROTHY HENDRICKS CHRISTOPHER Ross1 Tooo )ANICKI ELENA SALKOVSKY FORESTO CHRISTINE KERR MEGAN MooRE ADAM COHEN NoRAH )ANOSY ERIC SCHAEFER DAVID KRAKOWSKI CHRISTOPHER SYED MusTAFA DANIEL COTTER SARA KAPROVE DAviD ScHLESINGER BRIAN MALM KIMBERLY CARNEY jENNIFER NELSON KAMALJOT DHINGRA jENNIFER KoRZEN LARISSA STABINSKI ANTHONY MATO jENNIFER DANIELLE DoRSANEO THERESA Kouo jENNIFER TRASK CHRISTOPHER MUTTY LISA DosSANTos KIMBERLEY LEONARD STEPHEN TURKOVICH KATHLEEN REBECCA DWYER )IAN LIN )ULIE VOGEL LISA ESLER )AMES LIN BoBBI WAx ANDREW SWAN LYNDSAY WILLMOTT- ANDREW SYMONS OWOBILSKI ORA CHAN GREGORY Co NOLLY THOMAS DuQUIN SARA GAUGHAN CAREN GELLIN BRIAN GIORDANO DIANA PRATT ATALIE SHAW GARRON SoLOMON ESME FINLAY MARA LINSCOTT STEPHEN VARA DAVID FINTAK NATASHA MANES MICHAEL MELANIE FIORELLA VALERIE MARCHI ZAIR FISHKIN CYNTHIA MARTINEZ- CARMINE "ALEX" l KIT CHENG LAURA CINSKI )AMES BoYLE BRENNAN I EZ WEINGARTEN DAVID FLI T GRIECO )ASON GUTMAN CHRISTINA HAVERSTOCK Lett .arll APRIL BAKER SUNIL BANSAL CAPOLINO BARTOS )OYCE ZMUDA MICHAEL WHITESIDE HEATHER MORGANTI SUZIE ARIYARATANA ALFRED FRONTERA RICHARD LILY BELFI BRYAN GARGA 0 AARON OLDEN LINDA CUOMO jENNIFER DEFAZIO KEELY DWYER- SHERU KANSAL ELIZABETH BouRKE )ULIE GAVIN BRIAN PAGE ERIC Ko )AMES BOYLE LISA GELMAN TIMOTHY PARDEE SANDY KOTIAH BRANDY BRYDEN DAVID GRAY BRENT RISCILI CRISTINA LAM PURl ALBERT CHA G HoWARD HAo KERRYN ROCK )ULIANE THURLOW KAREN WEISS Le ters in ear Ill ANDREW FREEMAN EWELL O'DoNNELL MATZKY CHRISTOPHER Wint e r 20 0 2 l lflall nysieiu 25 �M E D C A L SCHOOL E W S • Bv 10 Engender Health I COLE PERADOTTO Christiane Northrup, MD, delivers inaugural Lawrence and Nancy Golden Lecture hen Christiane orthrup, MD, When it came time to decide began stressing the importance of who would kick off the lectureship, holistic health during the 1980s, it Northrup was an easy choice for the seemed like she was a lone voice in Goldens. A dynamic speaker who the wilderness. The obstetriciangynecologist remembers shutting has hosted four popular specials on PBS, the Ellicottville, ew York, her office door while discussing native, who now lives and practices nutrition with a patient, for fear in Maine, has received international a colleague would hear her dispen- acclaim for advocating that women sing such unconventional advice. tune in to their bodies, take charge of their health and take it easy on What a difference 20 years can make. Today, mainstream news pro- While addressing UB medical stories about healing foods. Ameri- students, she similarly encouraged cans are pending billions of dollars them to listen to their inner wis- in alternative medicine and thera- dom and know their limits. "We all pies. At health clubs, yoga and Pilates have this intuitive ability to know are all the rage. For her part, Northrup doesn't what's the right thing to do for our patients," Northrup said. "What need to whisper behind doors anymore. In fact, so many you need to learn is how to be good surgeons, good people want to hear what she has to say about wellness plumbers. You have to tie the knots right; you have to know this body of work. But that also means that you cannot treat every patient in an ideal way because it and health that her first book, Women's Bodies, Women's Wisdom, sold more than 1.2 million copies. Last year's follow-up, The Wisdom ofMenopause, leaped to first place takes too long. So choose one patient a week with whom among advice books on the New York Times best-seller list you'll interact fully, on whom you'll take a full history. a week after it was released. "You can be St. Francis of Assisi and pretend that "It's really gratifying to see how things have changed," patient is someone you're administering to. Be a physi- Northrup said during a September 24, 2001, lecture at the cian in that way for one person a week who somehow University at Buffalo School of Medicine and Biomedical grabs your soul." Sciences. "As far as I'm concerned, it's a miracle." orthrup warned the group that physicians who orthrup was the featured speaker for the inaugural blame themselves for every patient death simply can't Lawrence and Nancy Golden lecture on mind-body perform effectively in the medical profession. "The medicine. Founded in 2001, the annual lectureship aims reason doctors get burned out is that they begin to think, to teach medical students how the mind and body inter- and you're taught-at least, I was-that if someone dies, act to promote or endanger good health. A clinical professor of medicine at UB, Lawrence Golden, MD '46, was faster than [thinking like] that." chief of medicine and cardiology at the Millard Fillmore Hospital, where he founded the first cardiac rehabilitation program with his \vife, ancy, a family therapist at Child and Family Services for more than 30 years. 26 themselves. grams and magazines abound with lufl a l e Pb Jsician IVi11tcr 2002 it's your fault. othing will take the wind out of your sails When treating patients, orthrup told the physicians- in-training, it's wise to consider factors outside the traditional medical model of cells and genes-factors such as the health of a patient's marriage, her job satisfaction or �\, even incidents of physical abuse lingering in her past. She acknowledged that she makes it a habit to ask patients, one simple question: "What's going on in your life?" From the answers, she's often able to glean important information about situations that may be compromising her patients' health. Although she doesn't minimize the role of molecular biology, orthrup argues that it can't always explain the complex roots of illness and disease. She worries that physicians too often opt for a pill's quick fiX, yet fail to address the circumstances in a patient's environment that may be aggravating the condition. To make matters worse, the so-called magic bullet may even result in a new complication-addiction. As she spoke, orthrup reinforced her points with a slide presentation of advertisements Jeffrey Ross, MD '70, Delivers Terplan Lecture The second annual Kornell. Terplan Memorial Lecture was held October 17, 2001, in Farber Hall at the University at Buffalo School of Medicine and Biomedical Sciences. The lecturer was Jeffrey Ross, MD '70, chair and Cyrus Strong Merrill Professor in the Department of Pathology and Laboratory Medicine at Albany Medical College. He is also vice president for molecular pathology at Millennium Pharmaceuticals of Cambridge, Massachusetts, where he served as a Scientific Fellow during 2000. Ross's lecture was titled "From Gene to Patient: The Emergence of Targeted Therapy and Personalized Medicine in Oncology." The event was made possible by the generlished an endowment to fund the lecture. Terplan's son, Martin Terplan, MD '55, assum- for psychotropic drugs. An ad for Valium showed a woman jogging ed a major role in creating the endowment and down the street, her face a portrait of bliss. A Xanax ad claimed to have unraveled the mystery of depression, pinpointing its origins at a was in Buffalo to attend the lecture and host a particular synaptic site in the brain. "Depression and anxiety in the brain are highly overlapping and r-------..1.....-- osity of the Terplan family, which has estab- reception following it. Kornel Terplan, MD, was professor and chair of UB's Department of Pathology from 1933 to they intercept," she said. "You might have some professors who think 1960 and served for many years as a pathologist that if you get the absolute correct dose of Xanax or Prozac you will cure your patient's life. I wish it were that easy." orthrup added that she's not against prescribing such drugs, if circumstances warrant it. "They all help some people. But what about all the women who are battered in their marriage? We can't get a at Children's Hospital of Buffalo and Buffalo General Hospital. biochemical solution for that." He was internationally recognized for his work in childhood tuberculosis and brain pathology associated with chromosome anomalies of children. "Not only was Dr. Terplan an eminent scholar and one ofthe leading figures at the medical school, he was also a man with great energy and enthusiasm who was known for his personal S umming up her concerns, she read a quote from Max Lerner's warmth," recalls Reid Heffner, MD, chair of UB's Department 1959 book The Unfinished Country: "What. is dangerous about tranquilizers is that whatever peace of mmd they bnng ts a of Pathology and Anatomical Sciences. packaged peace of mind. When you buy a pill and buy peace of mind, you get conditioned to cheap solutions instead of deep ones." Since she began preaching the merits of a mind-body approach to medicine, orthrup has contended that a woman's health is tied to the culture she lives in. She's a harsh critic of the messages that society sends women-destructive messages that make them feel insignificant When the endowment to support this lecture was established by the Terplan family, the long-term goal was for UB to work to expand it by asking former students and colleagues, as well as those who enjoy the lectures, to join in expanding the endowment, according to Heffner. "We would like to be able to fully underwrite one lecturer each year, with a visit lasting for at least one day in order to and self-conscious. Casting an accusing glance at a lingerie ad featuring provide an opportunity for all current medical and graduate a gorgeous woman preparing breakfast while clad only in a bra and students to interact with the guest lecturer," he says. "These panties, she quipped: 'Tm sure that most women make eggs like this- types of visits enhance the curriculum and provide students, you know, before you go into the clinic and get going for the day." When women- and for that matter, men- are made to believe about exciting innovations in pathology research." residents and practicing physicians with an opportunity to hear that they should do it all, they're bound to think they've come up short For information on contributing to the endowment in at the end of the day. The cover of the health magazine Northrup support of the annual Kornel Terplan Memorial Lecture, used to illustrate her point read: "Be loved, think positive, eat right, please contact Lyn Corder, associate dean for alumni affairs stay fit, enrich your life, save the world." "This is the new American dream," she sighed. "It makes you crazy, and development. She may be reached by phone, toll free, at and very stressed out." 1-877·826-3246; or by e-mail at ljcorder@buffalo.edu. CD W in t er 2 00 2 1111111 Pbysiciaa 27 �PATHWAYS NEws ABOUT UB's ScHooL oF MEDICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF ((I HAD THE OPPORTU- NITY TO MEET SOME OF MY FELLOW TORCHBEARERS AT A TRAINING EVENT [IN EARLY NOVEMBER], AND I WAS TRULY HUMBLED." TURKOVICH 28 l1flal• Physician \I' i 11 t r r Turkovich Selected as Olympic Torchbearer Steve Turkovich, a third-year student in University at Buffalo's School of Medicine and Biomedical Sciences, was selected to be an Olympic Torchbearer for the 2002 Winter Games in Salt Lake City, Utah. A native of West Seneca, ew York, Turkovich attended Orchard Park High School before coming to UB to complete a major in anthropology. He was nominated for the honor by a relative who, among other things, highlighted his past involvement in the Tar Wars Program, which educates elementary students about the dangers of tobacco use, as well as his work with Hospice's Life Transitions Center, which provides support to children whose parents have a terminal illness. Turkovich was notified of his selection on September 12, 2001, at which time he was 2 0 0 2 told he would be running Because Turkovich will be in two-tenths of a mile at a yet- his medicine clerkship in to-be determined location in February, his near-future plans unfortunately do not include Western New York on December 31 or January 1. attending the Olympics. "This is an unbelievable For more information on honor," says Turkovich about the Olympic Torch relay and his selection. "I had the optorchbearers, visit the 2002 portunity to meet some of Winter Olympics' website at my fellow torchbearers at a www.saltlake2002.com and training event [in early ov- click on Game Programs. ember 2001], and I was truly -S. A. UNCER humbled. Trevisan Named "Many of them have overInterim Dean of HRP come much adversity in their Maurizio Trevisan, MD, prolives and are very inspira- fessor and chair of the Departtional. It's a privilege to carry ment of Social and Preventhe torch with them. tive Medicine in the "Too, this is the University at Buflast time the Olymfalo School ofMedipics will be held on icine and Biomedical American soil for at Sciences, has been least the next ten named interim dean years," he says. of UB's School of "And given the Health Related Proevents of September fessions (HRP). TREVISAN 11, I am especially Trevisan succeeds proud to represent the United Mark Krista!, PhD, professor States in an event that stands of psychology, who has refor peace and unity." turned to the faculty after When asked what he hopes serving as interim dean of his future as a physician will HRP for 18 months. A search hold, Turkovich says, "''d like for a permanent dean has been to pursue a career in either under way since the death of general pediatrics or child Frank Brady in November psychiatry, and perhaps also 1999, just a month after he teach clinical medicine." assumed the dean's position. �l In addition to serving as chair of the Department of Social and Preventive Medicine, Trevisan is diEDGE rector of the Center for Preventive Medicine, part of the Women's Health Initiative. A UB faculty member since 1985, Trevisan's current research is focused on cardiovascular disease epidemiology. He earned a medical degree from the University of aples Medical School in Naples, Italy, and a master's degree in epidemiology from UB. L EV I N E Edge and Levine Named Best Breast Cancer Doctors Two Roswell Park Cancer Institute (RPCI) physicians and University at Buffalo professors were named among the top breast cancer doctors in America in the October 2001 issue of Redbook magazine. Stephen B. Edge, MD, chief of breast surgery at RPCI and an associate professor of surgery at UB, and Ellis Levine, MD, chief of the medical divisions of breast and genitourinary on cology at RPCI and associate professor of medicine at UB, were among the 355 physicians cited by the magazine's "Exclusive List: The Breast Cancer Specialists Rated the Best by Their Peers." "The faculty and staff of Roswell Park congratulate these two outstanding physicians for the recognition given to them by their peers through Redbook magazine," CIAN C IO says David C. Hohn, MD, president and chief executive officer of RPCI. "Drs. Edge and Levine lead a team of caring and compassionate cancer specialists who are dedicated to giving breast cancer patients the best possible care, as well as improving outcomes for the disease." Ciancio Receives Cold Medal from AAP Sebastian G. Ciancio, DDS, SU Y Distinguished Service Professor and chair of the Department of Periodontology, has received the Gold Medal Award from the American Academy of Periodontology (AAP). Ciancio received the award- the AAP ' s highest honor-at the group's 87th annual meeting, held this past fall in Philadelphia. The Gold Medal Award is given annually in recognition of outstanding contributions to the field of periodontology and the diagnosis and treatment of periodontal diseases. A member of the AAP for 35 years, Ciancio is a past president of the association, as well as of the American Academy of Periodontology Foundation. He is a consultant for the Journal of Periodontology and an editor for Biological Therapies in Dentistry and Periodontal Insights. Ciancio received the AAP's Clinical Research Award in 1996, a Special Citation in 1994 and the William]. Gies Award in 1988. A prolific researcher, he has authored more than I 00 scholarly papers. Cinsberg's Earigator Device on the Market The Earigator, an ear-wax removal device invented by Irwin Ginsberg, MD '44, adjunct clinical professor in University at Buffalo's Department of Otolaryngology, is currently being marketed by SURYA Technologies of Amherst, ew York. Ginsberg says he identified the need for an improved method of removing ear wax after observing the discomfort that many patients endured while undergoing the procedure, which traditionally involves irrigating with a syringe that injects water into the external auditory canal. In addition to requiring two-people to complete, the procedure is time-consuming and messy, he explains. The Earigator, on the other hand, delivers a large quantity of irrigating water maintained at 3 7 degrees Celsius and is controlled by a pistol-grip tip equipped with an optically programmed trigger. A large deflector disc uses fiberoptics to illuminate the gently pulsating stream of water and the ear canal. The proce- GINSBERG dure can be done in one-third the time of the syringe method and can be performed by a trained medical professional other than a physician. Currently SURYA Technologies is featuring the device at trade shows and arranging onsite demonstrations for audiologists, otolaryngologists, pediatricians and hearing aid dispensaries. "The response to the product has been very good, and we are quite encouraged," reports "THE RESPONSE TO THE [£ARIGATOR] HAS BEEN VERY GOOD, AND WE ARE QUITE ENCOURAGED," REPORTS RAJ BANSAL OF SURYA TECHNOLOGIES. "WE HAD BEEN FOCUSING ON WESTERN NEW YORK BUT NOW ARE TAKING IT NATIONWIDE." ll' i 11 ter 2002 luffalo Physician 29 �PATHWAYS GET C oNNECTED. • • the exclusive right to all PDT compounds and technologies discovered during the next five years of collaboration between Light Sciences Corporation and the PDT Center of RPCI. This agreement also provides - S . A. UN G ER Light Sciences Corporation with a license to certain novel Global Licensing PDT compounds previously Agreement for discovered at RPCI. In return, Photodynamic Therapy RPCI will receive research Roswell Park Cancer Institute funds, licensing fees and cer(RPCI) and Light Sciences tain milestone payments, in Corporation have entered into addition to royalties on coman exclusive global licensing mercialized products. and research agreement for "Light Sciences brings a the development of future unique perspective to PDT Photodynamic Therapy (PDT) that may well extend its use products. both in cancer and Photodynamic other diseases," exTherapy, pioneered plains Dougherty, at RPCI by Thomas director of the PDT J. Dougherty, PhD, Center at RPCI. "Combined with and colleagues, is a several highly effectwo-step treatment tive new photosenthat uses a light sitizers developed at sensitive drug, called DOUGHERTY RPCI over the past a photosensitizer, and visible light to destroy few years that are activated at cancer cells in solid tumors. deep-tissue penetrating wavePDT using Photofrin, a photo- lengths, this collaboration sensitizer developed in the promises to advance the field PDT Center at RPCI, has been of PDT and, most importantly, approved by the U .S. Food benefit patients," he adds. and Drug Administration Projects to be developed (USFDA) and regulatory under this agreement include agencies worldwide for the preclinical and clinical retreatment of certain types of search on several unique comcancers, including lung and pounds aimed at approval by esophageal cancers. health agencies worldwide, The agreement secures for including the USFDA. CD Light Sciences Corporation - CATHERINE D O NNELLY Raj Bansal of SURYA Technologies. "We had been focusing on Western ew York but now are taking it nationwide." Eventually, the product is expected to make its way into the worldwide market. CARITAS MEDICAL ARTS BUILDING 2625 HARLEM RoAD , CHEEKTOWAGA, NY ADJACENT To S r. JosEPH HosPITAL MARIAN PROFESSIONAL CENTER 515 ABBOTT RoAD , BuFFALO, NY ADJACENT ro MERCY HosPITAL SETON PROFESSIONAL CENTER 2121 MAIN STREET, BUFFALO, NY ADJACENT TO S tsTERS H osPITAL 3 PRIME LOCATIONS (ALL CONNECTED TO AREA HOSPITALS VIA ENCLOSED WALKWAYS) 0 SuiTES N ow AvAILABLE 1000-5000 SQUARE FEET 0 FoR MoRE INFORMATION 716.631.8000 ~ CIMINELLI ' 30 luflall Physician \\' i nt er 2 00 2 • Development Company, Inc. �Lawrence D. Jacobs, MD, world-renowned researcher in the an honorary doctorate from D'Youville College. He also received treatment of multiple sclerosis who was professor and chair of a Dean's Award from the College of Arts and Sciences at Niagara the Department of Neurology in the University at Buffalo School University and the Alumni Merit Award from St. Louis University. of Medicine and Biomedical Sciences, died November 2, 2001, Jacobs served on the board of the International Federation of in Memorial Sloan-Kettering Cancer Center in New Multiple Sclerosis Societies, was past president of the American York City. He was 63. Society of Neuroimaging anti was a founding member and former Jacobs' ground-breaking research, geared toward developing better treatment for relapsing multiple sclerosis, led to the development of the drug Avonex officer of the American Academy of Neurology Education and Research Foundation. Jacobs is survived by his wife, the former Pamela Ryan, a (interferon beta·lal the most widely prescribed drug member of the State University of New York Board of Trustees; used to treat this debilitating form of multiple three sons, Christopher L., Luke T. and Lawrence D. Jr., all of sclerosis. As early as 1981, Jacobs' research showed that early treatment of multiple sclerosis with interferon beta·la, a genetically engineered form of beta inter· feron, significantly reduced the rate of progression and impact Buffalo; two daughters, Jessica H. Enstice of Snyder, NY, and Elizabeth R. of Buffalo; two brothers, Max of Captiva Island, FL, and Jeremy M. of East Aurora, NY, who is chair of the UB Council; two sisters, Michelle of Laguna Beach, CA, and Jennifer of Phoenix; and a granddaughter. of the disease, which often includes brain and nerve damage. Jacobs funded his initial work privately, eventually attracting multi-million dollar grants from the National Institutes for Health. In 2000, the New England Journal of Medicine published the results of a large-scale study, led by Jacobs, of the benefits of beta·la interferon in treating multiple sclerosis, which led to the Harvard Health Letter naming his research as one of the 10 leading health advances for 2000. After earning his medical degree from St. Louis University and completing his residency at Mount Sinai Hospital and School of Medicine in New York City, Jacobs returned to his native Buf· falo, where he began his career in medicine as an attending physician at Millard Fillmore Hospital. He served as chief of research at the Dent Neurological Institute from 1985 to 1989. In 1987, he became director of the William C. Baird Multiple Sclerosis Research Center at Buffalo General Hospital, which was devoted to developing better treatments for the disease and excel· lence in patient education, clinical programs and support services. The Jacobs Neurological Institute, which he also directed, was dedicated in memory of his parents, Genevieve and Louis. Jacobs held the Irvin and Rosemary Smith Chair in Neurology in the School of Medicine and Biomedical Sciences, established in 1998 with a 51.5 million endowment from Biogen, manufac· turer of Avonex. He authored more than 200 publications on neurology and served on numerous medical journal editorial boards. He was the recipient of many awards, including the Stockton Kimball Award from the UB School of Medicine and Biomedical Sciences, the Gloria L. Roblin, PhD, the first non-physician to become a full clinical professor at the University at Buffalo School of Medicine and Biomedical Scie ces, died April25, 2001, in Millard Fillmore Hospital. She was 76. Born Gloria Landsman in New York City, Roblin graduated from Barnard College at age 20 and within two years earned a master's degree and joined the Columbia University faculty. She moved to Buffalo and put her career on hold · after marrying local industrialist and civic leader Daniel A. Roblin Jr., who died in 1986. Once her children completed elementary school, however, Roblin returned to UB and earned a doctorate in psychology in two years, finishing the coursework ROBLIN with distinction. During her years as a clinical professor at UB, she pioneered the medical study of both human sexuality and clinical hypnosis. In particular, she was credited with engendering understanding of sexual orientation. An animated and entertaining speaker, her lectures and speeches drew standing-room-only audiences. In 1980, the medical school's yearbook was dedicated to her. Surviving are her husband, Bennett Friedman of Bradford, PA. her son, Daniel A. Ill of Buffalo, and her daughter, Diane Finlayson of Toronto. Stephen B. Kelley Award from the National Multiple Sclerosis Society of Western New York and Northwest Pennsylvania, and r\ 1 tJ t t~ ... llffaft Hysitill 31 �RESEARCH E W S $7.3 Million Crant to Study the Effects of Periodontal Treatment on Heart Disease he University at Buffalo has received a $7.3 million grant from the National Institute of Dental and Craniofacial Research to plan and conduct a pilot study for a clinical trial of the impact of periodontal disease treatment on prevention of second heart attacks. The three-year effort, involving five centers, will set the stage for a definitive clinical trial on a larger scale of the relationship between periodontal infection, which affects 75 percent of Americans, and cardiovascular disease. Robert }. Genco, DDS, PhD, chair of the Department of Oral Biology in the School of Dental Medicine and a SUNY Distinguished Professor, is principal investigator on the grant. UB is leading the study, which also involves the University of North Carolina, Boston University, Kaiser Permanente/ Oregon Health and Science University and the University of Maryland. DDS, PhD, SUNY Distinguished Professor and chair of the Department of Oral Biology in the University at Buffalo School of Dental Medicine. Recently, Genco A Potential New Weapon Against Heart Disease Genco says the grant "provides an opportunity to bring the basic research we have been doing at UB on periodontal infection and its potential effect on the risk of heart disease and stroke into the real world of the clinic. "If we find through this pilot study that keeping gum disease in check appears to lessen the chances of a second cardiovascular incident," Genco continues, "we will be justified in proposing a large-scale clinical trial that should provide definitive answers on the relationship between these two chronic conditions. If the study is positive, it will give us one more weapon in the battle against heart 32 I u f f II 0 p by sic i I D \1 ' i 11 t er 2 0 0 2 was named a vice provost at UB and appointed head of its new Office of Science and Technology Transfer and Outreach, which replaces the UB Business Alliance. The new office will strengthen the university's existing business partnerships and foster creation of new businesses and commercialization of the university's intellectual property. disease; however, we are a long way from having the data necessary to suggest that treatment of gum disease or any infection will reduce heart disease. " The grant will allow Genco and coinvestigators to assemble a team of cardiologists, periodontists, epidemiologists, infectious-disease specialists, biostatisticians, research nurses in periodontics and cardiology, and data managers necessary to carry out a full-blown periodontal intervention trial. The Question to Be Answered The planning period and pilot study are intended to form the foundation for a definitive trial to answer the question "If periodontal infection is suppressed by an anti-infective intervention , will this result in decreased risk of heart disease?" "It is important to answer this question in a clear and definitive fashion before any clinical decisions are to be made to treat periodontal disease for general health reasons," Genco says. �The pilot clinical trial will begin after a nine-month planning and development period. It will include three groups of subjects: one that will receive antibiotic therapy directed to suppressing the local gum infection; a second that will receive local therapy plus treatment with the systemic antibiotic azithromycin; and a third that will receive standard care. The investigators will assess a risk factor for heart disease, the C-reactive protein, which also may be related to periodontal infection. A total of 900 persons who have periodontal disease and have had one heart attack or are otherwise at high risk for a cardiovascular event will be recruited for the trial by the five centers. The pilot trial will be used to refine the infrastructure and to select or refine an intervention protocol for the definitive trial, Genco says. Growin g Evidence of a Link Epidemiological studies conducted at VB and elsewhere have shown an association between various measures of poor dental health and coronary disease, even after accounting for other risk factors. A 1999 study using data collected nationwide through the Third ational Health and Nutrition Examination Survey, for example, found that people with the most severe periodontal disease were nearly four times more likely to have had a heart attack than people with no periodontal disease. Genco's research team at VB, in one of several studies, assessed the presence of specific oral bacteria in heart-attack patients compared to healthy controls. The researchers found that two periodontal bacteria (Porphyromonas gingiva/is and Bacteroides forsythus) were associated with a 2.5 and 3.0 increase in risk, respectively, of heart attack. Periodontal disease is common in the United States. Seventy-five percent of the population suffers mild forms, while 20-30 percent has more severe forms, according to the most recent statistics from the national health survey. "There is growing evidence of a relationship between infection and atherosclerosis, as well as a specific link between periodontal infection and heart disease," Genco says. "Previous studies have established possible effective treatments of periodontal disease, and it is possible these treatments may lead to fewer subsequent myocardial events in people at high risk for cardiovascular disease. Our study is designed to select the periodontal treatment with the best chance of reducing the risk for heart disease." Co-investigators-all from UB-are Maurizio Trevisan, MD, professor and chair of the Department of Social and Preventive Medicine and interim dean of the School of Health Related Professions; Susan Graham, MD, associate professor of medicine; Sara Grossi, DDS, clinical assistant professor of oral biology; Joseph J. Zambon, DDS, PhD, professor of periodontics and endodontics; and Paola Muti, MD, PhD, associate professor of social and preventive medicine. - Lots BAKER \mce /911 Experience the quality of life our Buffalo Niagara region offers by contacting the AWARD WINNING Hunt Real Estate Relocation Team. HUNT Relocation Center There is so much to think about when considering a transfer. We want you to know what our city offers including housing, cultural attractions, education, entertainment and the truth about our climate. If you have a different destination in mind or moving locally let us know and we'll do the rest. CD We don't just move people... We help people move. Call for a free relocation portfolio regarding your Medical Student Research Training Grant Faculty in the University at Buffalo's School of Medicine and Biomedical Sciences have received a five-year, $231,000 training grant from the National Institutes of Health to support summer research fellowships for medical students. The grant will fund stipends for eight first- and second-year medical students to spend 10 weeks during their summer sessions performing a mentored research project that focuses on infectious destination city. Call l -800-888-1170 or go on-line and visit our web site at huntrealestate.com Hunt Relocation Center 5570 Main Street Williamsville. NY 14221-5410 Email: huntrelocation@huntrealestate.com Wint e r 2 00 2 1111111 nysicill 33 �RESEAR C H E W S earc it funds. Murphy has had a long-standing interest in ear and respiratory tract infections. He holds several patents in volving vaccines, in- - $2 Million Crant · Targets Ear and Lung Infections u Scientists at the University at Buffalo, the Veterans Affairs (VA ) Medical Center in Buffalo and Roswell Park Cancer Institute ( RPCI) have received a 2 million program project grant from the ational Institutes of Health to conduct research aimed at developing vaccines to prevent ear infections in children and respiratory tract infections in adu lts with chronic lung disease. Timothy Murphy, MD , professor of medicine and microbiology and chief of infectious diseases at UB and the VA medical center, is principal investigator for the four-year grant, as well as leader of one of the three research projects 34 luflale Phys ician ll'tll ter cluding one for the P6 protein, which he discovered and has been studying for 15 years. This protein is a promising vaccine candidate for the prevention of recurrent ear and lung infections caused by nonencapsulated strains of the bacterium Haemophilus influenzae, and it is currently being tested in early clinical trials in humans. collection of samples obtained from the long-running VA COPD study, in which 110 veterans have been followed. Yasmin Thanava la, PhD, cancer research scientist at RPCI, and Anthony Campagnari, UB associate professor of microbiology, each will direct one of the remaining projects. Thanavala, an immunologist who has performed innovative research in the develop- Ge11tzke & Associates. Inc. Registered Investment Advisor All three projects include studies of clinical samples emanating from a chronic ob- Prinrte Portfolio/ \\' ca It h \ lanagrmcnt structive pulmonary disease (COPD) study clinic that has been conducted continuously since 1994 at the VA hospital by Murphy and Sanjay Sethi, MD, UB associate professor of medicine. The project Murphy is leading will involve experiments to determine the human antibody response to th e bacterium Moraxella catarrhalis, which is a common cause of ear infections in children and of lung infections in adults with COPD. To accomplish this, he and his team will test a 2002 ment of vaccines for hepatitis, wi ll study the human immune response to specific regions of the P6 molecule. She will introduce human lymphocytes into mice that lack immune systems, creating an animal model with a human immune system. The mice will be immunized with P6 and the researchers will study the antibody response. This is the "next best thing" to immunizing people, according to Murphy, because the mice make human antibodies. As another part the project, researchers will collect lymphocytes from healthy donors and Comprrhrn:,i,·r Planning Financial. C~tale. l?etin'lltenl. Tax Tru:,t Sc 1Yice::, Pre<odent and cro Gleon Gefltzke and Oloef Investment StrategiSt Chris King Concierge ScrYicr::, l UB Commons 520 Lee Entrance Suite 205 Amherst, NY 14228 Tel: (716) 639·0475 Holland Office 10661 Crump Road Holland, NY 14080 Tel: (716) 537·2269 www.gentzke.com ri\\-C.HI.I· \<hi-,or 1'1\\ orl ( .t'rl ifit·< I (JuidJJooks Proft•-,-,ionnl \< h i-,or-, �from adults with COPD and study the response of these cells to P6. Campagnari is a widely recognized authority in studies of the mechanisms of infection and the immune response to the bacterium M. catarrhalis. His project involves studies of an important molecule on the surface of the bacterium called lipooligosaccharide, or LOS. This molecule is critical to the bacterium 's ability to attach to the human mucous membranes and to cause the inflammation seen in the ears of children and the airwa ys of adults with COPD during infection. "Understanding the speci fie mechanisms whereby the LOS molecule does this is the first step in designing novel strategies to prevent these deleterious effects of infection, " notes Murphy. " Dr. Campagnari will clone the genes that are responsible for making LOS and make mutant bacteria with altered LOS molecules. This will allow him to elucidate the role of LOS in infections. " In addition, samples from the COPD study clinic will be used to study the human immune response to the LOS molecule. Campagnari also will collaborate with Howard Faden , MD, UB professor of pediatrics at Children 's Hospital of Buffalo , to study samples obtained from children with ear infections. <Ii) - L O IS B A K ER diseases, microbiology or immunology. Twenty UB faculty members with active, extramurall y funded research programs will serve as a pool of mentors for the students. Principal investigator on the grant is Timothy F. Mur- phy, MD, director of the Division of Infectious Diseases at UB's School of Medicine and Biomedical Sciences and chief of infectious diseases at the Department of Veterans Affairs Medical Center. Coprin cipal investigators are Stanley Schwartz, MD, PhD, director of UB's Division of Allergy/ Immunology and professor of medicine, pediatrics and microbiology; and Charles M . Severin, MD, PhD, assistant dean for years l and 2, and associate professor of pathology and anatomical sciences. <Ii) - S. A. UNGE R C'l 2002 Porsche Cars North Amenca, Inc. Porsche recommends seat belt usage and observance of all traff1c laws at all t1mes. Performance specd 1cat 1ons for companson purposes only. a You dream about it. You decide to get it. Then you enter kindergarten. The more kids you have, the more practical it becomes. Maybe it was the shape. Or the sound. Maybe it was so long ago you can't remember what made you determined to someday drive one. Meanwhile, we put the years to good use, making the 320 horsepower 911 Carrera our best yet. A top that glides elegantly back in seconds. A new, more powerful 2.7 mid-engined flat six that pumps out 217 hp. And exactly two seats. The Boxster. If this isn't a perfectly engineered means of escape, what is? ® CULLIGAN F=ICJ~SC:HE: 8135 Main Street, Williamsville • 716-633-5200 • www.CulliganPorsche.com 1Vi11ter 2002 l •ffale Hysicia1 35 �RESEARCH N E w s average amounts, but who drink together and in their own home, tend to be very satisfied with their marriages. We also have found that couples in which the husband and wife have dramatically different drinking patterns are often the least satisfied with their Impact of Alcohol on Marriage Studied The impact of alcohol on marriage-for better or for worse-is the focus of a study being conducted by a scientist at the University at Buffalo's Research Institute on Addictions (RIA) under a new 1.5 million grant from the ational Institute on Alcohol Abuse and Alcoholism. Kenneth E. Leonard, PhD, a clinical psychologist at RIA who also is a research professor Children's Health and Polluted Fish The Toxicology Research Center at the University at Buffalo School of Medicine and Biomedical Sciences will receive $1.3 million over the next five years as a par- "This study will ment of Psychia- ticipant in a new six-member examine how try in the School of Medicine and Biomedical Sciences, is studying alcohol, the transition to mar- children's environmental health change and adapt their drinking patterns to each other over the early riage, and spouse and peer influ ence on the use of alcohol. "While it seem common sense that drinking problems can cause divorce, there also is evidence that some couples can incorporate heavy drinking into the marriage," Leon- years of marriage." ard says. "Our previous research has found that couples who drink frequently and drink above l alfalt Hysician Wt11ter pal roles in the project are James Olson, PhD, professor of pharma- Researchers will look at the effect cology and toxicology, and Rich- of eating fish from these contami- ard Fitzpatrick, laboratory direc- nated sources on the motor, sen- tor of the Toxicology Research sory and mental development of Center. The University of Illinois at Chi- the refugees' children. The project also will involve educating the cago, Michigan State communities on safe fishing University, the New York sites, safe types of fish and pre- State Department paration methods that reduce the of Health and the risk of contamination. The Toxicology Research Cen- University of Texas Health l--\.1~-::::::;;;:~:;;;:::=:~ "(f ter will serve as the core analytical ScienceCen- toxicology facility for the study. ter also are Paul Kostyniak, PhD, director of membersofthe the center, will head the analytical new consortium. core project. Also playing princi- - CD LOIS BAKER -KATHLEEN WEAVER in the Depart- husbands and wives 36 marriage. "This study," he adds, "will examine how husbands and wives change and adapt their drinking patterns to each other over the early years of marriage, and which couple-drinking patterns can have a deleterious effect on marriage." CD important part of the diet of the two refugee groups being studied. research center formed to study the effects on Laotian and Hmong refugees of eating large quantities of contaminated Great Lakes fish. "I've retired my snow shovel!" A5 a semor, l enJoy my mdependence. That:S why the Amberleigh lifestyle IS appealing. Without mowing the lmm, rakmg the leaYe or shm·eling the snow, I have ume to spend on thincr that I enJoy' My monthly rental lee includes three meals a day m a grac1ous dining room, weekly housekeepmg, scheduled courtCS) transportation, plus a \\ide range of socwl and recreational acmiues. If )'l) 1 think Amberielgh IS what you've been lookmg for, why not call today for a personaltour7 Call 689-4555 ... you'll be glad you did' The project, called the Fox River Environmental and Diet Study, or FRIENDS, is centered at the University of Illinois at Urbana-Champaign. The Fox River, which cuts through Green Bay, fv\onthly rent inc udes. we -oppr m•• d ore and twc.bedrocm oporlm •nl • th _ "leo s served dody • w ,kJy h ,, p1ng and mo•n enonce serv• • 24-hour stoffng • emergency resp< n "' •Y''' m • sc~edu ed tronspo • exercise room • pet w1ng • guest apartments is one of the most heavily PCB· contaminated sites in the Great Retirement living... the way you always dreamed it would be. Lakes Basin and the single largest source of PCBs entering Lake Michigan. Fish from the Fox River and Lake Michigan make up an 2002 -~~~!,. 2330 Maple Road, \\'illiamSYllle For a Jtcc brochure or personal row~ Call (716) 689-4555 �DEVELOPMENT N E w s any Rainbows Yet to find By Li nda J . Cor de r , PhD. CFRE the rainbow ended at Farber Hall. There had been a run of gray days, literally and figuratively, so the ephemeral colors leading right to our school seemed to be a good sign, and I spent the remainder of the semester looking for rainbows. New York was hit hard by the tragedies in September, especially those families who were directly affected by terrorists' actions. Budgets, already tight, became more tentative as legislators struggled to decide among competing priorities, and donors dealt with myriad requests under the shadow of a volatile stock market. Within the school, course coordinators, administrators and students met in different types of ad hoc groups to adjust to change and devise plans for finding resources that make our respective responsibilities possible. You are likely aware of some of our efforts. The first full alumni annual appeal was mailed. We are stili receiving responses from graduates of the school's many programs. Class chairs for spring medical reunions are working to increase class gifts. The Pathology and Anatomical Sciences Department held the second annual Terplan Lecture and added several thousand dollars to that endowment. A bequest, "on the books" for more than twenty years, came in, half designated for scholarships, the remainder for a radiology lecture fund and seed money for radiation research. The school also received proceeds from a charitable trust, again designated for scholarships. As a community, we celebrated the life of, and grieved for, Dr. Lawrence Jacobs, chair of neurology, who died "too soon," yet who accomplished much through his research on multiple sclerosis. A dedicated faculty and staff group began plans to augment the Clinical Skills Development Fund, an extremely important account for those teaching students how best to communicate with patients. Family Medicine, the first department to form an advisory board and hire a development officer, launched a drive to increase their departmental endowment, with an initial goal of $250,000. Members of the Medical Emeritus Faculty Group met regularly throughout the year, and the Medical Alumni Association has extended its membership to them. Dean Bernardino and administrative staff joined those in comparable positions for the Asand sllllnts .et illlffmlt sociation of American Medical ~ Colleges' fall meeting in Washington D.C. These gatherings llljlst t1cllaiCIIIIIIIInisl provide a perspective on where the school is now, relative to peer institutions and to its own progress compared with a year, or res,.sillilities jiiSSillle. several years, before. My personal benchmark is the beginning of the campaign, summer of 1996, essentially the same time I returned to UB. That year, Buffalo Physician had an interim editor. This year, the magazine received highest honors from AAMC's Group on Institutional Advancement. In 1996, we had 169 members in the James Platt White Society and raised slightly over a million dollars from alumni and friends. Today, we have commitments for 85 percent of the school's campaign goal of $50 million. We have several new endowed lectures, many more scholarships, nearly 300 White Society members, a few endowed chairs and many planned gifts in the pipeline. We have an active Dean's Advisory Council extending the network of volunteers and donors-which is fortunate because, in one sense, we have barely begun. Those meetings come around with startling frequency and there are many rainbows yet to find. 4D ....,... Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at 1-877-826-3246, or via e-mail at ljcorder@buffalo.edu. ll'111ter 2002 II If a II Pb J sic i a I 37 �STUDENT C L U M Wisdom Shared and Gained B v SvETLANA Moving from Butler Auditorium to the hospital-the third·year experience BLITSHTEY CLASS 0 or NEVER KNEW what "CCIII" meant until a year ago, when as a third-year medical student I left the safe familiarity of Butler Auditorium and entered the unfamiliar surroundings of the hospital. Suddenly, an intricate and exciting world of clinical practice unfolded before me in a way that had been impossible to anticipate in the sheltered environment of a classroom. It was in the hospital, hidden in the white coat, blue scrubs and progress notes, that I found the meaning of CCIII"clinical clerk of the third year"and came to the realization that I occupied the lowest rank in the hierarchy of hospital titles. After two years of basic science, many students welcomed the third year, while others feared the unknown. Regardless of how anyone felt, we all knew that what lay ahead was printed on a schedule: family medicine, obstetrics/gynecology, medicine, psychiatry, pediatrics and surgery. Looking back, I wonder who could have predicted that becoming a CCIII would turn out to be one of the most memorable and fulfilling experiences in medical education? 38 luffall Physician 1\' i 11 t e r 2 0 0 2 Fam· · edicine: Deep Re elation I opened the door to the room where a patient was waiting anxiously for the doctor. She had been coughing, running a fever and feeling so fatigued that washing dishes had become an ordeal in endurance. She was expecting the doctor to uncover the mystery of her bothersome symptoms and make her feel "all better." This expectation changed abruptly when she noticed a short white coat and the phrase "medical student" in the formal introduction. "How much do you know?" she asked suspiciously. "Certainly not enough to feel confident," I thought to myself. With her permission, I dared to continue asking numerous questions and to complete a physical exam. After analyzing her history and physical findings, I suddenly realized that I was about to embark on a crucial milestone in my medical student career: my first diagnosis, a case of pneumonia. At last, the two years of basic sciences and what had, at the time, seemed like useless memorization of details were merging into a whole. The knowledge of anatomy, physiology and pathology of the respiratory system and the knowledge of microbiology and pharmacology related to pathogenesis and treatment of pneumonia were now necessary to help this patient. And so !left the room with a sense of deep revelation: I was ready. Obs et ics and Gynecolor'" Wha• oTextbook Can Teach T he evenly scheduled outpatient appointments of the family medicine practice were followed by the fast pace of obstetrics and gynecology. For the first time, I was spending more than 24 consecutive hours working in the hospital, realizing that in obstetrics and gynecology, night no longer signified a time for relaxation and sleep. The distinction between day and night was forever lost on the floors oflabor and delivery. It was there, however, that I first witnessed something beautiful, something no textbook was capable of teaching me: the birth of a child. I will never forget �standing anxiously by a woman whom I had known only since the beginning of my shift, surrounded by her family, and by nurses and residents. I, the CClll, was allowed, under the watchful eyes of the residents, to deliver a baby into this world. As I tried to hold on desperately to the small slippery body of the newborn taking its first breath, I thought to myself what a privilege it was to take part in the sanctity of this Medicine: An Introduction to the End of Life I have wondered relentlessly what it takes to become a good physician. If I memorize the names of every muscle and every nerve, if I understand the pathology of every disease, if I learn every pathogen and every medication, will I then have acquired sufficient knowledge to become a physician? While my medicine clerkship taught me the basic skills of reading EKGs, interpreting laboratory tests and recognizing emergency states, working with patients taught me the meaning of the phrase "my patient." For the first time, I felt a tremendous sense of responsibility, obligation and loyalty to those chosen among many on the ward as "the best teaching cases." I knew their every complaint, abnormal physical finding and lab value, their daily vitals and pending diagnostic procedures. I was introduced to their family members, was made aware of their occupation and hobbies, and was contacted by their numerous care providers about the status of their condition. One of my patients, a 50-year-old woman with stage IV adenocarcinoma of the lungs, was planning to undergo an experimental treatment at Roswell Park Cancer Institute. Every day she would tell me "''m a little better today," even though her condition was obviously deteriorating. Then one day during grand rounds, she could no longer contain her emotions and began crying. She knew as well as we did that she would not live to undergo the experimental therapy. Struggling to carry on a conversation, she described her feelings of desperation, hopelessness and fear of impending death. She was already grieving for herself, for her children and for her seven-year-old granddaughter, whose get-well picture posted by the bed served as a subtle reminder of a future stripped of watching her grow. I ;\lE;\lORIZE 1 HI.:. I With her permis· patient is gone." sion.l dared to continue asking Psychiatry. Compassion and Complex Ques ions ompassion in medicine is viewed not as a trait of character; it is emphasized as an essential element that defines the physician as a healer. Compassion is naturally felt toward a patient battling cancer or a severe physical disease. However, to feel this emotion for those suffering from a mental illness requires a willingness to look past the disease, as well as an encounter that may influence how one views mental illness. For me, this encounter occurred when I was asked to evaluate a 50-year-old man with chronic schizophrenia who was accompanied by his sister. Her concern was that "he just wasn' t himself lately": He acted confused and lethargic and appeared physically ill. Although his presentation was less than typical, he exhibited several signs and symptoms suggestive of acute exacerbation of schizophrenia. As a result, he was admitted to the psychiatric unit and placed temporarily in the isolation room. While I tried to convince myself that my limited experience in psychiatry precluded disagreements with the higher authorities, 1felt perplexed. There were certain aspects in the history and presentation of this patient that were inconsistent with a diagnosis of schizophrenia. Could it be that the etiology of his symptoms were rooted in a different disease? I wondered. The answer came with the results of the routine laboratory tests taken upon admission, which, fortunately, I decided to check before leaving the hospital. Printed in bold on the computer screen with the letter "C'' attached for "critical'' was a blood sugar value ten times higher than normal. Instantly, the diagnosis changed from acute exacerbation of schizophrenia to a life- threatening complication from undiagnosed and untreated diabetes mellitus. While the patient was being transported to the intensive care unit for treatment, a psychiatrist on the ward approached me. H e thanked me for A;\lES oF J:\ ER\ J\IuSCLF A. o I-.VER\ • ~::RVE, Ir PATHOLOGY OF EVERY DISEASF, IF \\'ILL her family. The next morning I was approached by one of the nurses, and for the first time I heard the words "Your C family's happiest occasion! IF I later witnessed the final hours of her life as she gasped for air, trying to maintain her strength for I I u. · o~::Rs rA numerous questions and to complete a physical exam. After analyzing her history and physical findings. I suddenly realized that I was about to embark on acrucial milestone in my medical student career: my first diagnosis. acase of pneumonia. n 1 HE lEAR.' bYFRY PATHOGL' A. 'D EVERY ;\1EDICAriO, , THE.' HAVE ACQUIRED SUFFICIE. ' T K. ' 0\\'LFDGE TO BEC0:\1£ A PHYSIUA. •? \\' irrter 2002 luffalt Pbysiciaa 39 �STUDENT COLUMN calling attention to the problem, mentioning that "the patient's life was saved" because I checked his lab results. Although I felt honored by his words, I did not feel proud. If this man had lost his life to diabetic coma, would it be because he also had a mental illness? Who would be to blame for his death? The psychiatrist whose diagnosis was confounded by the past psychiatric history? The primary care physician who never addressed the problem of hyperglycemia, IF YOU ARE A STUDENT although it had been demonstrated several OR RESIDENT INTERESTED times in the past? Or was it the patient's fault IN CONTRIBUTI G TO for being noncompliant with keeping appointTHIS COLUMN , E - MAIL BP - NOTES@BUFFALO. EDU ments and taking medications, for being unTO SUGGEST A TOPIC. able to express or comprehend the nature of his physical symptoms, for being apathetic to his health because he suffered from a mental illness? As I looked at the patients through the window of the locked doors on the psychiatric ward, I thought of others who, by the very nature of their illnesses, are incapable of being actively involved in their healthcare. All they can do is trust the people in white coats and hope that they can find the right treatment and have some compassion for their souls. Your Turn? Pediatrics: No Need for aStethoscope A s we walked through the long hospital corridors during morning rounds, I glanced at a nearby bed where a 15-year-old girl had just received a diagnosis of insulin-dependent diabetes mellitus. She sat alone in her room crying. As the team of residents and students proceeded to discuss her case- presented with an admirable degree of accuracy by a pediatric intern- the verdict was confirmed: a classic manifestation of diabetes. The treatment plan was simple and concise: administer insulin, check blood glucose and urine ketones, enroll in the diabetes teaching program and begin her on a diabetic diet. " othing exciting," the senior resident said, "just a typical case of new-onset diabetes." The team then moved to the next room where another case was waiting to be discussed. At the end of the official rounds, I decided to visit the girl. She had stopped crying and was looking out of the window, perplexed. She told me she dreamt of becoming a dancer and had been taking dance lessons since she was five. "What will my life be like?" she wondered aloud, expecting a reply. "Will I ever become a dancer, now that I have this disease?" 40 IDIIIII rhysiciaa II' 1 11 re r 2 0 0 2 As I thought of my response, I began to realize the complexity of my situation. This girl needed comfort, support and guidance. She was not interested in hearing the pathophysiology of diabetes, or the plan of treatment outlined in her chart. or was she interested in the statistics of long-term complications, or the benefits of tight glucose control. She just wanted to hear from me that she will be all right; that despite the daily insulin injections and glucose checks, despite multiple visits to doctors, emergency rooms, and even intensive care units, she will be able to reach for her dreams and lead the life she desired to have. I sat down next to her, listened to her and reassured her, and for that I did not need a stethoscope. Surgery: AFascinating and Intimidating Close here is something mysterious about the way lights shine on the operating table and the way people ' dressed in blue gowns and masks work diligently in an atmosphere of precision governed by concrete commands. The profession of surgery- and the demands imposed on those who dare to join itboth fascinates and intimidates. Surgery is the clerkship concluding the yearlong journey as CCIII. Its completion brings us to the finish line of the third year and grants us the higher status of CCIV. Six clerkships ago, the third year of medical school seemed as unattainable as a mountain that I had to climb before reaching the next destination. Looking back at the accomplishment, the height of the mountain was merely a product of heightened anticipation. Living it day by day, week by week, clerkship by clerkship was nevertheless difficult and, at times, overwhelming, but a small price to pay given the rewards. ow another class of students joins the ranks of CCI lis, wondering whether the third year will be a positive experience. Like all of us, they will be immersed in the details of rotations, hospitals, grading and exams, while becoming oblivious to the insignificance of each in shaping an overall experience. As I am nearing the completion of the year I realize, in retrospect, that the experience was about more than an education in the clinical practice of medicine and how to function in it. It was also about lessons learned from the lives of the patients, wisdom shared by those who care for them every day, and knowledge gained as a medical student and, above all, as a person. CD �Mark your calendars Sherman Waldman. MD '57 Saturday, April 27. Fo~ more information, call the Medical We're all still here! Carpe diem! We should all enjoy each other while we can. Please consider a glorious 45th reunion. Alumni Association at (7161 829-2778. The reunion classes are 1947, Sebastian S. Fasanello. Sr. MD'&2 1972, 1977, 1982, God bless America. We must maintain our traditions. I'm looking forward to seeing you in April. James F. Phillips. MD ·.n Dear Classmate, I am chairing this year's 55th reunion for our class. Please attend. The dinner will be held at the best restaurant in town: my house at 106 Depew AYenue, with Western New Yoril's best chef, my wife, Marcella. Thomas P. O'Connor. MD '&7 Congregate and celebrate 35 years of the finest profession on earth. Donald (. Miller. MD '&7 The face of medicine has changed drastically since 1967. Has yours? Let's get together and share war stories. Robert I. Baumler. MD "52 There haYe been a lot of changes in medicine during the past half century. Come to our 50-year reunion and let us fill each other In on what has been going on with us and medicine during those years. Linda I. lam. MD "72 Thirty years! Let's get together to celebrate, reminisce and renew friendships. Ileal W. Fuhr. MD '52 Start making your plans now to join those of us who remain for our sr medical school reunion. So much has happened to all of us since graduation. Come and bring us up to date oa your life in and out of medicine! Gregory (. Young. MD '77 Try to make every effort to join us as we celebrate the 'Silver AnniYersary' of our grad· uation from medical school. Come back and see how UB has changed! H • n t e r 2002 I 1 I I I I I P' 1 1 i C i 1 I 41 �Which can you afford to waste? FEATURES BENEFITS • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Practice management with • Gain peace of mind from professionally trained staff and knowing that your finances are experienced C.P.A.'s being managed optimally Thomas A. Maher, C.P.A. President 50 Alcona Avenue MEDICAL B ILLING S PECIALISTS Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com �Dear Fellow Alumni, ~e winds of change continue to blow through our medical school. I see these changes as signs of positive growth, and not just change for the sake of change. Following the membership vote on Spring Clinical Day, the Medical Alumni Association (MAA ) is now welcoming as members emeritus faculty, PhD graduates, residents of our affiliated teaching hospitals and postdoctoral fellows. These additions will both broaden and strengthen the interests of the association. Dean Bernardino decided that the informal working relationship between the school's offices of Alumni Affairs and Development should be formalized. Thus, late in the semester, we welcomed Mary Glenn to her first MAA board meeting in her new official role as director of constituency relations. In this capacity, Mary will serve as the school's liaison with our association. Another significant change in our association is the departure of ancy Druar on December 31, 2001. As most of you know, Nancy was secretary in the MAA's office for the past 21 years and was responsible for coordinating its day-to-day operations. In addition, she was instrumental in planning the school 's annual Spring Clinical Day and Reunion Weekend. ancy's presence and singular competence will be missed, and we wish her all the best. As we incorporate these and other changes, our association will stay true to its goal of initiating and supporting social and educational projects related to the school. These projects will no doubt be enhanced by the increased involvement of Lyn Corder, whom Dean Bernardino has named associate dean for development and alumni affairs. We welcome Lyn's interaction with all alumni and know that the merger of these two offices within our school be a "work in progress" throughout this next year. In September, the past presidents of the MAA gathered to toast our newest Distinguished Alumnus, Marshall Lichtman, MD '60. We congratulate Dr. Lichtman on receipt of this award and invite you to read more about his remarkable career and accomplishments on page 17 of this issue of Buffalo Physician. Also this past fall, the Reunion Class Chairs met for dinner to continue the planning for reunions that will be held in conjunction with Spring Clinical Day, April27, 2002. The program will take on a historical flavor this year, with the theme "Presidential Assassinations in the 20th Century." jack Fisher, MD '62, will deliver the Stockton Kimball Address. Finally, I continue to ask for your support of our alma mater through your interest, time, jOH N j. BODKIN!! , MD '7 6 President, Medical Al11mni Association �C L A 1940s Maynard Mires. MD ·46, Georgetown, DE, Preventive Medicine, writes: "! am now retired. I have N 0 T E Herbert Pirson. MD '46. Orchard Park, NY, Diagnostic Radiology, writes: "I am retired. My favorite memory was graduation." E-mail address is hsp-ecp@ worldnet. att.net. Daniel A. Phillips. MD '51. 1950s Carl R. Conrad. MD '51, Clarence, NY, Internal Medicine, writes:"! will never forget my first day with Dr. 0. P. jones." E-mail address is carldocc@cs.com. , Gen- Williamsville, Y, Radiology, writes: "My wife, having fun with special Leslie, and I have five grown children. Who fond memories of the old Medical School at 24 with Harold Levy and Ross lmburgio in the old High Street, where the worn steps, the antiquated amphitheater on High Street." fixtures and the memorials on the walls reminded me that we are all part of an ancient and honorable could forget Doc Leonard's messages to the graduates?" Alvin Volkman, MD '51, Me Cutcheon. Greenville, NC, Pathology, writes:"! have so many favorite memories MD'56. of medical school. Physical diagnosis provided our first clinical experience, but my group was not satisfying our instruc- tor Dr. john Boylan. He demanded more than we seemed capable of doing. Finally, we got it all to- am retired from a pri- McCuTCHEON vate practice in Michi- 1960s ting pretty smart.' We were on our way to being Long Beach, CA, OBI G , writes:"! am chief doctors." E-mail address is alphavic@earthlink.net. of staff at Kaiser Permanente Medical Center in Anaheim, CA. Mark A. Dentinger, MD '56, Carmichael, CA, writes: "!am retired. When I My favorite memory of medical school was carrying anatomic specimens think of medical school, I think fondly of the from Buffalo General Hospital to the medical original school on High Street." school in the trunk of my car in metal pails. I always feared I would Daphne, AL, Otolaryngology, writes:"! and kidneys thrown across the roadway." am on the GACEK 2002 Kenneth E. Bell. MD '61. be in an accident with multiple livers MD'56, IV1111er gan. Friends can e-mail me at wrenwood@ webtv.net." gether, and Dr. Boylan said in his slow stutter, 'You gentlemen are get- Richard Gacek. l uflale Physician Pittsboro, C, Internal Medicine, writes:" I assnotes tradition. My wife, Ruth, and I are pictured here with our family." 44 ries of medical school include the old building on High Street and "Doc" Leonard. Sue A. Eugene Leslie, MD '51, eral Surgery, writes: "My favorite memories include friends, and shooting dice Danny Cordova and Bob Burke." E-mail address is hospital staff at the University of South Alabama. My wife, Elaine, and I have four grown children. My favorite memo- madap@prodigy.net. Fred Schwarz. MD' 46, Williamsville, Reno, , Orthopaedic Surgery, writes: "I am retired. My favorite memories include my marriage to Mary Ann in 1949, the good friends like the late �Harold Brody. MD '61, PhD. Wayne P. Fricke. MD '66, Brody's late wife, Anne, was recently honored as one of 100 outstanding women in the history of Western ew York. A stone was placed on the Women's Walkway- Olcott, Y, Orthopedic Surgery, writes: "I am retired and enjoying life." E-mail address is frickes@attglobal.net. located at the HSBC Arena and the Waterfront-to recognize her work in helping to establish the International Committee of the Women 's Club of the State University of ew York at Buffalo. This committee has helped students, faculty, and families to adjust to living in the United States. Anne Brody also pioneered in establishing the Adult Day Care Program at the Amherst Center for Senior Services. Marino, CA, Hematology/Oncology, writes: "! am on the faculty of the University of Southern James R. Markello, MD '61, Greenville, C, Pediatrics, writes: "I am retired. One of my favorite memories is the evaluation session at the home of Mitchell Rubin, MD, professor and chair of pediatrics." E-mail address is munmark@ earthlink.net. Thomas W. Bradley, MD '66, Tonawanda, Y, Family Practice, writes: "Retired August 1, 1999." E-mail address is tomjan1936@ aol.com. Cary Presant. MD '66, San California School of Medicine as professor of Clinical Medicine and Oncology. One of my most vivid memories was being tested by 0. P jones in gross anatomy on Saturday morning, and I did not have many parties on Friday nights during that course." 1970s Jerald A. Bovino. MD '71, Aspen, CO, Ophthalmology, writes: "!remember Saturday morning anatomy questions from 0. P. jones; Dr. Megahed's kindness and teaching generosity; my good fortune in having wonderful classmates; our great parties to music of the Beatles (Sergeant Pepper's Lonely Hearts Club Ba11d)." Scott A. Kirsch, MD '71, the people in my class, but most of all the UB campus, which is where I met my wife." Richard A. Manch. MD '71. Phoenix, AZ, Internal Medicine, writes: "I am on the staff at the University of Arizona College of Medicine and the Good Samaritan Regional Medical Center. Fondest memories are gross anatomy lab with Robby Kaufman, Henry Milgrom, Mike Armani." 1980s Shirley A. Anain, MD '85, has been elected president of the medical staff at Sisters of Charity Hospital, part of the Catholic Health System, in Buffalo, NY. Anain has been a member of the hospital's medical Young B. Huh, MD '89, staff since 1992. She com- writes: "! completed a pleted her residency in general surgery and plastic surgery at the Cleveland Clinic Foundation and a fellowship in plastic gastroenterology and hepatology fellowship in 1996 at the University of Pittsburgh Medical Cen- surgery at the Hospital for Sick Children in Toronto, Canada. She will serve a one-year term. Mitch lublin. MD '88, and Mary Davitt, MD '88. re- cently moved back to Pittsburgh, PA. Mitch is chief of ultrasound at University of Pittsburgh Medical Center in the Department of Radiology. Mary plans to return to practicing general pediatrics soon. E-mail address is: tublindavitt@msn.com. ter. I have just joined Gastroenterology Associates, P.C., in Quad Cities, !A. My wife, Veronica, and I have two children: Christopher and Hannah." E-mail is kimhuh@aol.com. 1990s Deb (Delozier) D'Souza and John DeSouza. MD '94, write: "We recently celebrated the birth of our second child, john joseph, on june 12, 2001. His older sister, Irene, is four. We also recently moved to Toledo, OH, where john is practicing neuroradiology, and I plan to practice OBI Commack, Y, Family Practice, writes: "My favorite memories include GYN. Chris Wood, MD '94. writes: "! recently married julie Marz, an architect. We're living in a suburb of Chicago and I'm practicing ophthalmology." E-mail address is fenny90@hotmail.com. E-mai CD RICHARD MAN CH AND fAMILY. Wi11ter 2002 l ulfall Physician 45 �A t last year's Spring Clinical Day and Reunion Weekend, we decided to have a little fun with the Class of 1976, which was celebrating its 25th reunion. In addition to asking class member to provide us with an update on their families and careers, we also requested that they have their pictures taken. Little did they know that we also had managed to lay our hands on a 1976 issue of Iris, as evidenced below! \I ~ R Y G L E .• S D I R l C T 0 R 0 F C 0 " ST I C Y R E L A I 0 S S 0 F I C E 0 F \I E D I C A L 6, Dayton, Ohio. Chris is certified in internal 18a top medicine and gastroenterology and is chief of medicine at Dayton VA Medical Center. Susan is a consultant in allergy and respiratory medicine. They have two children, Christian and Andrew. Ch John Bodkin, MD '76, Williamsville, NY, family medicine. Bodkin is the president of Highgate Medical Group and president of the UB Medical Alumni Association. He and his wife, Maria, have four boys, Jack, Michael, Ryan and Andrew. athl n (Can ell) c er an D '76, Bethesda, MD, child psychiatry. Ackerman and her husband, Ronald, have two children, Elizabeth and Jeffrey. Kathleen writes: "My favorite memory of UB is graduating and seeing my father-an MD who graduated from UB's School of Medicine-just beaming." E-mail address is drwireman@aol.com. Christopher Brandy, MD '76, Morristown, Y, general surgery. Brandy and his wife, Linda, have three children, John, Brian and Kathryn. Friends can e-mail him at curtieb@giseo.net. GreggB o man, MD 76, Glenwood, NY, medical management, pediatrics. Broffman is a member of the governing board of the Medical Alumni Association. He and his wife, Denise, have three children, Lauren, Andi and Jake. Gregg writes: "One of my favorite memories of UB is time spent with friends at Don George's family cabin in North Java." E-mail address is lbroffman@aol.com. Paul B. Cotter Jr.. MD '76, Cohasser, MA, ophthalmology, writes: "Who can forget Dan Wild's bachelor party." Paul and his wife, Margaret, have three children, Paul. E-mail address is pbcotter@hotmail.com. lndr w artin Gage, MD. '76, Williamsville, athaniel, John and Y, general and vascular surgeon. Gage is director of the Noninvasive Diagnostic Vascular Lab in Williamsville, NY. He is married to Mary M. Burke. •6 l1ffal• Pbysici11 \V I II t e r 2 0 0 2 A L U ~~ �(married to Patrick Hayes), Dublin, OH, internal medicine, writes: "My favorite memories include study dates with Pat, lunches with special friends at the 'Tiffin Room,' and movie parties at Grant Golden's." E-mail address is karen.glasgow@ mailcity.com. Kare Patrick R. Hayes MD '76 Dublin, OH, emergency medicine, writes: "One of my favorite memories is meeting my future wife in gross anatomy!" Patrick and Karen have a son, Gavin. E-mail address is pathayes@mailcity.com. r S Buffalo, NY, diagnostic radiology. Golden is married to Deborah Goldman, and they have three children, Holly, Geoffrey, and Margaret Curtis. Golden is on the hospital staff St. Joseph's. E-mail address is old-chestnut@hotmail.com. Donald Geor e. MD '76 Jacksonville, FL, pediatrics. George is chief pediatric/nutrition at Nemours Children's Clinic. He and his wife, Linda, have four children, Sarah, Katherine, Christopher, Elizabeth. E-mail address is dgeorge@mediaone.net. n M.levitt, MD' Nashua, H, dermatology. Levitt and his wife, Deborah, have been very busy with their five children, Michelle, David, Tammy, Stephen and Scott. He is in private practice in New Hampshire. Step ShinY liongMD 76. Anaheim Hills, CA, internal medicine. Liong works in Rancho Cucamonga as a clinical physiatrist. Pa · 6. Olean, NY, surgery. Schwach and his wife, Barb, have three children, Davis, Rebecca and Catherine. E-mail address is docschwach@yahoo.com. Michael Smith. MD, '76. Reidsville, NC, family practice. Smith works in a a val Hospital in Camp LeJeune in Jacksonville. Laszlo lomas he , D' 6, Cleveland, OH, ophthalmology. Tomaschek works in Parma, OH, with his wife, Susanne. Linda Wild MD 76. Buffalo, Y, pathology. Linda Wild is an associate professor of clinical pathology at UB's School of Medicine and Biomedical Sciences. E-mail address is wil@buffalo.edu. Linda's husband, Dan Wild, MD '76, is an orthopaedic surgeon in private practice in Buffalo. They have two children, both of whom are in college, Katherine (Katey) and Michael. 4D Wi11ter 2002 l uff1le Physiciu 47 �WINTER Kenneth M. Alford, MD '37 Kenneth Alford, MD '37, a prominent member of the Buffalo medical community and a decorated Army veteran, died October 26, 2001, in his Buffalo home after a long illness. He was 89. A Buffalo native, Alford attended Lafayette High School, where he was an AllHigh basketball playerfor two years. Following graduation, he attended Colgate University, where he also played basketball. After college, he returned to Buffalo to study medicine at the University of Buffalo, graduating in 1937. Alford interned at Buffalo General Hospital and the Hospital for Sick Children in Toronto, where, from 1939to 1940, he was chief resident in to 1982 and a fellow in adolescent medicine at Harvard Medical School and Boston Children's Hospital in 1971 and 1972. He served as trustee of CHOB from 1979 to 1993 and as a director of the Cummings Foundation from 1975 to 1997. Alford is survived by his wife of 61 years, the former Joan Wendt; a son, David H. of Durango, CO; a daughter, Anne Surdam of Buffalo; four grandchildren; and a greatgrandchild. FrankT. Riforgiato, MD'39 Fran T. Rifor& ato, MD '39, died unexpectedly October 26, pediatrics. During that time he was also an instructor in pediatrics at the University of 2001, in Sisters Hospital. He Toronto Medical School. A World War II Army veteran, Alford served five years medicine on Buffalo's West Side for 46 years, was born In Buffalo in 1913 and attended elementary schools in the city. He attended Canisius High School, graduating in 1931, and then went on to Canisius College, earning a bachelor's degree in 1935. Following graduation from the then-University of Buffalo Medical School in 1939, Riforgiato interned at Sisters Hospital and com- in the 4th Medical Battalion. On D-Day, he was part of the landing force on Utah Beach and served as commanding officer at the clearing station hospital, caring for and evacuating the wounded soldiers. For his efforts, he was awarded the Bronze Star. Following the war, Alford joined the pediatric medical staff at Children's Hospital of Buffalo (CHOBI, where he was attending pediatrician from 1977 to 1982. He also was a member of the pediatric staff at Millard Fillmore and Buffalo General hospitals. At Buffalo General, he served as chief pediatrician from 1950 to 1977. 48 Alford was clinical professor of pediatrics at the University at Buffalo from 1973 lllllll Pbysicill was 87. Riforgiato, who practiced pleted his medical residency at the former E.J. Meyer Memorial Hospital in 1941. During World War II, Riforgiato served in the Army, rising to the rank of captain. He was stationed in Surinam, South America, from 1941 to 1943, and also was based at Camp Butner in North Carolina and hospitals and clinics \\ ' 1 11 t e r 2 0 0 2 in Kansas, including the Menninger Clinic. After returning to Buffalo, Riforgiato practiced general family medicine for 46 years on the lower West Side of the city, retiring just a few years ago. "He probably delivered about half the babies in Buffalo during the baby boom," says his son Francis. Besides his wife of 60 years, the former Mary Cecina Gallo, survivors include two daughters, Margaret Mary Rumunno of Conway, NH, and Mary Frances Nagel of Gilmanton, NH; three sons, Leonard of Miami, Philip of Eggertsville and Francis of the Town of Tonawanda; a brother, John of Amherst; and six grandchildren. PaulA. Cline MD'43 Paul A. Cline, MD '43, a retired Kaiser Permanente surgeon, died in Parma, OH, on June 26, 2000, at age 80. A resident of Strongsville, OH, since 1972, Cline began his ten-year tenure as chief of surgery for Kaiser Perrnanente Hospital in Parma a few months after joining the staff in 1973. He retired as a surgeon in 1989, but continued working as a consultant at Kaiser's Musculoskeletal Clinic for a few years. Born in Budapest, Hungary, Cline came to the United States at a young age. Following graduation from US's school of medicine in 1943, he interned at Massachusetts Memorial Hospital in Boston. After a three-year stint in the Army, he served residencies at former E. J. Meyer Memorial Hospital in Buffalo, NY, 2002 and at the Veterans Administration hospitals in Buffalo and Batavia, NY. For 20 years, Cline had a general surgery practice in Buffalo and was also clinical assistant professor at UB and an attending surgeon at Kenmore Mercy Hospital. He is survived by his wife of 28 years, Harriett "Hattie"; daughters, Sandra Schlerf of Columbia, SC, and Barbara Warren of Lawrenceville, GA; son, Clifford of Dallas, TX; stepdaughter, Holly MacMurray of Orchard Park, NY; stepson, Daniel Lewin of Los Altos, CA; two grandchildren; three great-grandchildren; and a brother. Earl K. Cantwell, MD'4S Earl K. Cantwell, MD '45, a former Erie County medical examiner who practiced obstetrics and gynecology for many years, died on April4, 2001, in Kenmore Mercy Hospital, Town of Tonawanda, NY, after a lengthy illness. He was 80. Born in Buffalo, NY, Cantwell graduated from Amherst Central High School in 1938 and completed his undergraduate and medical studies at the then-University of Buffalo, where he received his medical degree in 1945. After interning at the former E. J. Meyer Memorial Hospital, he joined the Army Air Forces, and in 1948 graduated from the School of Aviation Medicine. He was aviation medical examiner at Griffis Air Force Base in Rome, NY, before leaving the service with the rank of captain. After returning to Buffalo, he met Rita J. Roll, whom he married in 1950. Cantwell worked at Deaconess Hospital and maintained a general practice until 1956, when he decided to become an obstetrician-gynecologist and moved his family to Indianapolis to serve a residency at St. Vincent Hospital. After working at the Sault Ste. Marie Clinic in Michigan, Cantwell returned to Buffalo in 1963. He was county medical examiner for 15 years and Amherst town physician for five, as well as a school doctor for the Buffalo Public Schools. He also was a civilian Armed Forces examining officer for 21 years and chief medical officer at the Armed Forces entry station in Buffalo for 10 years. Cantwell maintained an OBI GYN practice in his Amherst, NY, home before retiring in 1984. "By temperament and spirit, he was a physician, and that calling defined his life," says his son, Kevin, of Amherst. "His passion for medicine inspired two of his children to become doctors as well." In addition to his wife and son, Kevin, he is survived by two daughters, Dr. K.C. Ackerman of Bethesda, MD, and Mary Beth of Buffalo, NY; two other sons, Earl K. II of Buffalo, and Dr. Michael of San Francisco, CA; and seven grandchildren. Ansel Robert Martin, MD '48 Ansel Robert Martin, MD '48, who studied dermatology under Dr. Earl Osborne, died on July 17, 2001. <Ii) �Early nineteenth century Italian tourniquet with a brass key and iron-cogged-wheel tightening mechanism. The brass frame is stamped "Giannattasi In Napoli." The tourniquet has many brass and iron decorative flourishes, including the fluting to the screw heads and the iron loop of the catch. In the ear1y 18th century, Jean Louis Petit, a French surgeon, invented the screw tourniquet to control bleeding. The device made thigh amputations possible and reduced risks associated with amputations below the knee. Tourniquets similar to the one pictured here were still in use during the American Civil War. The instrument is part of the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences library, Abbott Hall, on the University at Buffalo's South Campus. �CM I SC CATHY GEAqy HE~LTH p H A ] SCIE CE LI~R RY SOUTH C MPU 130 ASEOTT H ll CAr-PUS "'1 IL A UB's HISTORY OF MEDICINE COLLECTION PRESENTS PHARMACOPOEIA. Digitally reproduced prints from a pharma copoeia by Otto Karl Berg (1815 - 1866) were on display last fall in University at Buffalo's Health Sciences Library (HSL), outh Campus. The botanical show was developed by the HSL and the university' s iMedia staff and is the first in a series of "Art in the Library"' exhibits intended to promote the History of Medicine Collection through the display and sale of reproductions of selected works. F1·ed Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume, pub lished in Leipzig in 1863. Pictured is Colchicum Autumnale (Autumn Crocus). HP 0001 02 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n03-2002-Winter Table Of Contents A list of subunits of the resource. Healing in the Aftermath First Impressions, Lasting Memories One Woman's Global Concern medical School Alumni Pathways Research Student column Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n03 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b3def877e14766f5a9307dce69790cf0.pdf aea8e1a006e8e9754fc81f41174dba71 PDF Text Text �hffale P~ysician ASSO CIATE VICE PRESIDENT FOR UNIVERSI TY COMMUNICATIO NS Dr. Carole Smith Petro DIRECTOR OF PERIODI CALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stepl1a11ie A. U11ger ART DIRE CT OR & DESIG N Alan f. Kegler AST SPRI ·c, YOL READ ABOVI the pride and excitement we felt when Governor George Pataki p roposed in his "State of the State" address that Buffalo be designated the site for a world-class Center of Excellence in Bioinformatics-a collaborative effort involving the state, industry partners and area academic institutions. In january 2002, this proposa l moved one step closer to rea lity, when Governor Pataki visited Buffalo to announce $200 mi ll ion in state and private-sector funding for the center (see article on page 14 for details on this announcement). The Center of Excellence in Bioinformatics-combined with the establishment of the Strategically Targeted Academic Research (STAR) Center for Disease Modeling and Therapy Discovery in Buffalo-will have a sign ificant influence on the types of basic research we will be conducting at our school in the decades ahead. It will also affect the growth and development of our school's faculty because we will be hiring individuals to fi ll positions that will mesh with the center's goals. Working synerg istically, these two ce n ters-with the aid of supercomputers-will place our school in an excellent position to take a lead role in research that will help provide a better understanding of interactions between molecules and proteins, and disease states and genetics. Ultimately, such studies hold great promise for the timely development of novel drugs, as well as the discovery of new, more viable ways to manage and treat disease. DE SIGNER David f. Riley DESI GN A SS ISTANT Kare11 Lichner Co NTRIB UT ING WRITERS Lois Baker and Elle11 Goldbaum PR ODUCT I ON COO RDI NATO R Cynthia Todd-Flick UNIVERSITY AT BUFFALO S CHOO L OF MEDI CINE AND BIOM EDI CA L S CIE NC ES Dr. Michael Bemardino, D ea 11 E DIT ORIAL BOARD Dr. john Bodkin Dr. Marti11 Brecher Dr. Harold Brody Dr. Linda f. Corder jason Hoffman II, Class of 2004 Dr. james Ka11ski Dr. Eliz abet/1 Olmsted Dr. james R. Olson Dr. Steph e n Spaulding Dr. Bradley T. Truax Dr. Frat1k/in Zeplowitz The establishment of the Buffalo Center of Excellence in Bioinformatics is extremely important to our school, and we will continue to update you on the progress of this exciting venture in the months and years ahead. I am also p leased to announce that Suzanne Laychock, PhD, professor and associate chair of the Department of Pharmacology and Toxicology at UB, has agreed to serve as the T EAC HI NG H OSPITALS Erie County Medical Center Roswell Park Cancer In stitute Veterans Affairs West ern N ew York Healthcnre Syst em K ALE I DA H EAl T JI : significant role in determining what research will be conducted at our school in the future . Th e Buffalo General Hospital Til e Cl1ildren 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital She will also help deter mine how resources will be allocated for th is research and will C A TH O II C new senior associate dean for research at our school, replacing Bruce Holm, PhD, who has been named a senior vice provost at UB. In her new position Dr. Laychock wi ll have a oversee the recruitment and hiring of new research facu lty. Recent data provided by the Association of American Medical Colleges (AAMC) indicates that our school's performance in basic and clinical research is very good and, as a result, UB has moved up in AAMC rankings in this area. Certainly this improvementalong with the recent steps made toward establishing a center in bioinformatics-gives us H EAcr u S rsrE M: Mercy Health System Siste rs of Clwrity Hospital Niagara Falls Memorial Medical Center @ UNIYEISITY lT IUFFlLO. THE STATE UNIYEISITY II NEW Ylll a positive context within which to work as we strive to conduct research that will help reshape the fie ld of medicine as it enters the new era of proteomics and genomics. Finally, I would like to announce that in the coming year we are planning to recruit new faculty in surgery, pediatrics, neurology and medicine. Currently, we are conducting national searches for chairs of surgery, neurology and rehabilitation medicine, and !look forward to updating you on these once completed. MI C HAEL E. BERNARDINO . MD , MBA Dean, Sclwol of Medicine a n d Biomedica l Sciences Vice President for Hea lt h Affairs Letters to the Editor Buffalo Physician is published quarterly by the University at Buffalo School of Med icine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; o r via e-mail to bp-notes@buffalo.edu. The staff reserves the right to edit all submissions for length and clarity. T~ ~ University at Buffalo T11e State University ofNew York �V 0 L U M E N U M B E R 36, 0 Features 2 Minimal Access Surgery for Kids Buffalo's pediatric surgeons are leaders in performing and teaching laparoscopic surgery BY 16 24 S. A. UNGER APlace for Business in Medicine A student's perspective on UB's new MD/MBA Program BY Jennifer Wiler, Class of 2003 Imaging and Imagination A look back at a decade of research: Pet Center marks its tenth anniversary The Buffalo Center of Excellence in Bioinformatics receives $200 million in state, federal and private-sector support. Article begins on page 14. BY ALAN LOCKWOOD, MD COVER PHOTOGRAPH, CLOCKWISE, FRONT RIGHT, PEDIATRIC SURGEONS PHILIP GLICK, MARC LEVITT , M I CHAEL CATY , AND GuY BRISSEAU 15 ational Science Foundation grant bolsters computer storage capacity 21 Sung and White scho larship recipients Alpha Omega Alpha scholars inducted 22 Orvan Hess, Class of 1931, a pioneer in fetal-heart monitoring 30 Suzanne Laychock, PhD, named senior assoc iate dean for research 31 Maxine Hayes, 36 Message from MD '73, honored by theAMA 37 james Platt 33 ew faculty at Society Roswell Park 42 News from your UB classmates and other alumni the directorthe cost of medical education then and now White Society 40 Edmund Hayes ~- \ I\ JUN ' 5 ���NE OF THE THINGS THAT IS DIFFERENT ABOUT OUR PROGRAM in Buffalo compared to others around the country is that our entire faculty has embraced the goal of converting over to minimally invasive surgery as a way to think about every operation;' says Glick, who also serves as interim chair of surgery at the University at Buffalo and professor of surgery and pediatrics. "Five years ago, each faculty member made a commitment to this and said, 'I'm on board.' We decided we were going to learn together, sharing both our successes and our mistakes," he adds. ''Although the learning curve was just as steep, I believe we got to the flat part of the curve much quicker than we would have otherwise." At the time they began the transition, the surgeons at CHOB were applying minimally invasive surgical techniques to about 5 percent of their cases; currently, they are up to about 50 percent, and their goal is to eventually reach 100 percent. Convinced that these proven techniques provide a host of benefits to patients and their families, as well as savings in healthcare costs, they now want to do for other pediatric surgery training programs in the country what they've done for their own. "There are some programs out there that are still at 5 percent, so the children in those cities are not benefiting from these great techniques," says Glick. "We'd like to help change that." An Operating Room with a View The new MASC includes two state-of-the-art operating rooms custom-designed for the performance of multidisciplinary, minimally invasive surgery, including laparoscopy, thoracoscopy, endoscopy, arthroscopy and cystoscopy. All equipment in each room is suspended from ceiling booms and is totally automated by a voiceactivated computer controlled by a headset worn by the surgeon. Simply by talking into this headset, he or she can direct all the equipment located on the booms, in cluding flat-screen televisions used to view procedures in real time as transmitted from cameras embedded in the tips of the endoscopes. [n addition, cameras built into the lights above the operating table capture on-screen a bird's-eye view of what the surgeon is seeing with his or her own eyes. Situated unobtrusively in the corner of each room is a "communication control center" that allows images captured by these cameras to be telecast to any location in the world equipped for teleconferencing, which provides the MASC with expansive telesurgery and "telemen to ring" capabilities. I u f fa I o Physician Spri11g 2002 On October 10, 2001, the first live operation from the MASC was broadcast to a meeting of the American College of Surgeons in New Orleans. On March 15, 2002, a second surgery was broadcast from the MASC to a meeting of the Society of American Gastrointestinal Endoscopic Surgeons in New York City. Also located within the MASC are state-of-the-art conference room facilities and an observation room, where medical students or other visitors can view surgical procedures being performed and telecast on a highresolution screen mounted in the room. Surrounding this minimalistic surgical environment are walls and ceilings painted with soft blue clouds and floating teddy bears. Children can select a cartoon movie from a collection of 20 videos donated by Warner Brothers and watch it on the four television screens in the operating room while anesthesia is administered. Or they can choose to play Xbox games donated by Microsoft. "So the kids go off to sleep watching the cartoon or playing the games," says Glick. A New Way to Teach and Train Students I eveloped in tandem with the MASC is the Miniature Access Teaching, Training and Research (MASTTAR) Center, housed in the Biomedical Research Building on the campus of the University at Buffalo School of Medicine and Biomedical Sciences, located five miles from CHOB. This $900,000 center-linked fiberoptically to the MASC- is a component of the Buffalo Center of Excellence in Bioinformatics (see related article on page 14) and is supported by the university for the purpose of teaching medical students, residents, fellows, nurses and technicians about minimally invasive surgery. The idea to make the MASTTAR Center a component of �l the Center ofExceUence in Bioinformatics was championed by Bruce Holm, PhD, former senior associate vice president for health affairs at UB, who was recently named a senior vice provost at the university. "Bruce Holm's efforts have been an essential component of the MASTTAR," explains Marc Levitt, MD, UB assistant professor of surgery and pediatrics and medical director for both the MASC and the MASTTAR Center. "Several years ago, he foresaw how it could be a part of the bioinformatics center, and because of his involvement from the start, the university has been extremely supportive of the MASTTAR Center by providing a significant amount of funding, as well as by encouraging multidisciplinary collaborations with engineers, computer scientists and others on campus." he MASTTAR Center includes an eight-station laboratory that is used to conduct basic-science projects and minimally invasive surgery training courses. Located adjacent to a fully-equipped surgery suite that is used in conjunction with this training, the MASTTAR Center also houses cutting-edge computer facilities, fiberoptic connections and office space available for personal computing needs, including data storage and reduction, statistical analysis and graphic presentation. Also located in the center is an $850,000 Zeus surgical robot donated by Computer Motion. This highly sophisticated robot is an earlier model of one that is located in Buffalo General Hospital's (BGH)* Center for Less Invasive Cardiac Surgery and Robotic Heart Surgery, which is directed by Hratch Karamanoukian, MD, a UB assistant clinical professor of surgery (see page 9 for details on a robotic heart surgery trial currently under way at this center). "Dr. Karamanoukian is one of the premier cardiac surgeons in the country, and he routinely performs coronary anastomoses with the Zeus robot," says Levitt, who adds that Karamanoukian collaborates on a number of projects at the MASTTAR Center. "Basically, Dr. Glick worked out a deal with Computer Motion, where they gave Dr. Karamanoukian a newer model of the robot, and the MASTTAR received the older one he had been using." In the future, surgeons fully expect that robots will merge with minimally invasive surgery to provide surgical applications that could only have been imagined a few years ago. For example, NASA and the military are interested in this technology, which, theoretically, could allow an operation to be performed on an astronaut in space by a surgeon on Earth, or on a soldier on a battlefield by a surgeon located miles away at a secure site, according to Levitt. These scenarios recently took one step closer to becoming a reality when Michel Gagner, MD, a surgeon at Mount Sinai Hospital under whom Levitt trained, performed a Spri11g 2002 Bu If a I o Ph ysi cian 5 �(bottom right) (bottom left) The stmulator was donated to the MASTTAR by Computer Motion. �laparoscopic gallbladder operation on a woman in France from his office in New York City. " In addition to these applications, the reason we're interested in robots is because they can do repetitive motions in very small places, very accurately, and eliminate any tremor a surgeon might have, so you can be incredibly precise," explains Levitt. In pediatric surgery, this instrumentation would be particularly advantageous for such procedures as esophageal repairs on newborns, according to Glick. It would also be a valuable tool for ligating extra blood vessels between the heart and lungs in a procedure called patent ductus arteriosus ligation, and may have some applications to biliary atresia, where surgeons sew extremely small pieces of the intestine to the liver and bile ducts. A t the MASTTAR Center, Glick and his colleagues also are working to develop and test a wide variety of new equipment and technologies related to minimally invasive surgery. Currently, for example, they are collaborating with a multidisciplinary Surgical Simulator Team to develop a next-generation laparoscopic virtual-reality surgery simulator in partnership with two companies: Mentice Corporation, of San Diego; and Silicon Graphics, of Mountain View, California. Members of this team include Christina Bloebaum, PhD, UB Professor for Competitive Product and Process Design and director of the ew York State Center for Engineering Design and Industrial Innovation (NYSCEDII) on UB's orth Campus; and Eliot Winer, PhD, UB research assistant professor of engineering and applied sciences and the associate director ofNYSCEDII; Thenkurussi Kesavadas, PhD, UB assistant professor of mechanical and aerospace engineering and director of the UB Virtual Reality Laboratory; Russ Miller, PhD, UB professor of computer science and engineering and director of the university's Center for Computational Research (CCR); and Thomas Furlani, PhD, associate director of CCR and UB research associate professor of chemistry. Each of the three entities that makes up the Surgical Simulator Team provides specialized expertise that makes this project possible, according to Glick and Levitt. CCR primarily provides the computing power and knowledge; YSCEDII provides advanced virtual-reality technology; and the VR Laboratory is contributing groundbreaking work on hap tics. "Haptics involves, for example, a surgeon using virtual-reality technology to pick up an instrument on the computer screen and being able to feel its weight and consistency with his hand," explains Levitt. The surgical simulator under development at the MASTTAR Center will have two specific applications. The first is preoperative planning, where radiographic images, such as CAT scans or MRis, are burned onto a CD and loaded in a computer, where the images are reconstructed in three dimensions. "If you have a patient with a tumor in his liver, which has a lot of blood vessels around it, you could reconstruct the liver in three dimensions and then remove certain components of the anatomy to see how close the tumor is to the main blood vessels," says Michael Caty, MD, a CHOB pediatric surgeon and UB associate professor of surgery. "This is work we have already done, and it can help the surgeon avoid potential problems and discover safer approaches to take." The second application being developed is one that will enable an individual to simulate an operation on the computer for training purposes. "If you had a surgical resident learning to remove a gallbladder," says Levitt, "she could perform the whole operation before she met her first patient. It's just like the flight simulators used by the airlines, and in both cases it really enhances safety." In addition to these and other research and development projects, Glick has established a clinical laboratory at the MASTTAR Center that focuses exclusively on minimally invasive surgery. He explains that surgeons working with adults have recently begun to examine how minimally invasive surgery affects the physiology of their patients; however, few such studies have been conducted in the pediatric population . "Our goal, therefore, is to explore how this type of surgery impacts on the physiology of children," says Glick. "For example, when you insufflate the abdomen of a fivepound infant with carbon dioxide [in order to create a hollow space so you can perform a minimally invasive Spring 2002 Buffalo Physician 7 �surgical procedure], what exactly is going on in that little baby? This is the type of question we are asking in our research." Stitching in the Curriculum Piece Glick is tremendously enthused about ways in which these research projects and the technologies made available through the MASTTAR Center will affect the training of medical students and surgical residents at UB. He also feels the center can play a role in reversing trends in medical education over the past decade that have resulted in fewer students choosing surgery as a career. "Over the past 10 or more years, because there has been such an emphasis on primary care, students have lost valuable contact time with surgeons and other specialists and, as a result, some of the best students have been turned on to things other than surgery," explains Glick. 0 etermined to do his part to counter this trend, Glick has embarked on an effort to build what he calls "a farm team for the Department of Surgery." To accomplish this, he has begun a surgical interest group (the "SIG") at UB for first- and second-year students, and he is working with administrators to introduce changes in the curriculum that, among other things, will expose students to stimulating new laboratory experiences. Guy Brisseau, MD, CHOB pediatric surgeon and UB assistant professor of surgery and pediatrics, is collaborating with Glick on the details of this new secondyear elective. There are inducements for third-year students, as well. On the first day of their surgery rotation, the students are brought to the MASTTAR Center, where they begin learning basic hands-on skills, such as suturing, the placement of chest tubes and endotracheal intubation. Also, students can test their hand-eye coordination by attempting to take balls from one beaker and place them in another using the laparoscopic virtual reality-surgery simulator/trainer (the same simulator for which the MASTT AR Center researchers are working to develop a next-generation model). "The student's proficiency on this trainer is really amazing," notes Levitt. "If you took a senior surgeon and put him next to a third- or fourth-year medical student on the virtual-reality simulator, the student would do better because they have grown up playing video games and so 8 Bu ff a l o Physicia n Spring 2002 are used to looking at a TV screen while working with their hands. People 50 years and older never did this as children. The computer can record how quickly the students learn these skills, and they are very adept right away." Glick is also developing an entirely new curriculum and training for pediatric surgical residents, a goal he says the MASTTAR Center is "totally suited to support." Recently, he created a teaching program in miniature access surgery for third-year residents aimed at helping them to acquire a clearly defined set of surgical skills prior to being allowed to work in an operating room. "In England, they're very into this kind of'programmed learning,"' notes Glick. "Basically, you have to be credentialed in certain skills before you can operate on humans. In this country, a lot of teaching has been done in the OR, but we're going back to the basics now and our residents are going to have to be credentialed in certain skills before they can progress to the operating room." Alan Posner, MD, UB assistant professor of clinical surgery and chief of laparoendoscopic surgery at Erie County Medical Center (ECMC) and Buffalo General Hospital, will collaborate with Glick and others to help train the residents in acquiring these skills. In addition, ECMC has been fiberoptically linked to the MASTTAR Center, and in February 2002 Posner taught a course on nephrectomy for urologists. For the course, a nephrectomy was performed at ECMC and broadcast live to a conference room on UB's campus. In addition to medical students and residents, practicing surgeons-many of whom attended medical school before minimally invasive surgery was taught-now are being retrained in these techniques utilizing teleconferencing and "telementoring" capabilities at the MASC. In reference to this latter mode of training, Glick explains that there are a number of new operations he and his colleagues have developed and want to teach to others, but they don't have time to travel to locations to be present with surgeons who are performing the operation for the first time on their own. Instead, the surgeons can come to Buffalo to train and when they return home to a facility whose operating rooms are equipped with teleconferenc- �ing capabilities, they can then perform the new procedure while being closely monitored by a CHOB surgeon situated in the MASC conference room. A key to taking the center's teleconferencing capabilities to such an advanced stage is an ongoing collaboration between MASC faculty and Lisa Stephens, associate director for Distance Learning Operations at UB. Due in large part to the technical assistance provided by Stephens and her group, the MASC this year is offering six postgraduate teleconferencing courses, not only to physicians, but to nurses and technicians, as well. The first course, held on January 26, 2002, was attended by 80 operating room nurses and technicians representing 30 hospitals in five different cities in Western New York. f or the past five years, a course has been taught at Miami Children 's Hospital to train pediatric surgery fellows in pediatric laparoscopy. This year, the course moved to Buffalo, where it was taught by the CHOB pediatric team of Glick, Levitt, Caty and Brisseau. Joining this team as v1s1tmg professors were four other leading pediatric surgeons from around the country, including Raleigh Thompson, MD, Steve Rothenberg, MD, Keith Georgeson , MD, and Thorn Lobe, MD. Held in April 2002, the course was attended by more than 20 pediatric surgery fellows from across orth America. In addition, a pediatric laparoscopic fellow, funded by Ethicon Corporation, currently is being trained at CHOB in minimally invasive surgery. The fellow, )oselito Tantoco, MD, is from the Philippines; after two years he will return to his homeland, where he will be the only pediatric surgeon trained in these skills. Another exciting development is the completion of a fiberoptic connection between the MASC and Butler Auditorium in UB's School of Medicine and Biomedical Sciences, which equips that venue with telesurgery capabilities. The new telecommunications system was unveiled on March 19, 2002, for a class on minimally invasive surgery sponsored by UB's Mini Medical School , which seeks to educate the community about science and medicine. More than 300 people attended the class, which was taught by Glick while Levitt simultaneously performed an operation at CHOB, key portions of which were telecast live in Butler Auditorium throughout the lecture. "Our multifaceted approach is the thing that sold our program to our corporate sponsors," Glick says, explaining that the MASC and the MASTTAR Center are supported by grants from the Stryker Corporation; Ethicon Endo-Surgery, a subsidiary of johnson and Johnson; Berchtold Corporation; and Steris Corporation. The MASC has also been supported by the Children's Hospital of Buffalo Foundation, and the MASTT AR, by funds from UB. "There are many people knocking on the doors of corporations, saying they want to be a center of excellence," adds Glick. "But what made us unique is that we were the first pediatric group to approach these sponsors and offer them the clinical excellence, as well as teaching, training and research, in one program. " CD *Children 's Hospital of Buffalo and Buffalo General Hospital are part of the Kale ida Health System. Sp r i11g 2002 luflalo Physician 9 ��inimally invasive surgery is the antithesis of the traditional "open access" approach to surgery in which an operation is performed through an incision in the body large enough to accommodate a surgeon's hands wielding a scalpel, suction tubes or other instruments. Alarge, open wound brings with it collateral tissue damage, risk of infection, pain and alengthy recovery, not to mention permanent, often prominent, scarring. The ability to perform surgery through small "ports," or keyhole incisions, became possible with the invention of the endoscope, a rigid or flexible tube a few centimeters in diameter equipped with a light and camera at one end. By introducing the endoscope and other tiny instruments into small, strategically located incisions via conduits called "trocars," surgeons can complete almost any task. Gynecologists have been performing laparoscopic procedures for several decades; in many ways, they pioneered the field of minimally invasive surgery as we know it today. The first laparoscopic cholecystectomy (gallbladder excision) was performed in 1987, and since then laparoscopy has been applied to many surgical problems, leading some to predict that minimally invasive surgery will make up greater than two-thirds of operating room cases in the near future. Despite its success in adults, however, this form of surgery was rarely used in infants and children until recently. "There was a lot of resistance to minimally invasive surgery in pediatrics, and some was for bad reasons that have taken us a decade to get past," says Philip Glick, MD, surgeon-in-chief at Children's Hospital of Buffalo (CHOB)*, executive director of its new Miniature Access Surgery Center (MASC) and UB professor of surgery and pediatrics and interim chair of the Department of Surgery (see previous article). These reasons include the fact that postoperative pain in children was not well understood and was underestimated, so the need for a more minimal approach was not deemed necessary. Also, because pediatric surgeons prided themselves on making small incisions to begin with, the advantages of Spring 2002 I u If a I o Phy s i ci an 11 �even smaller incisions were not at first recognized, but instead dismissed by early critics of laparoscopy in pediatrics as merely "cosmetic." Other major stumbling blocks were the steep learning curve for minimally invasive surgical techniques and the fact that the equipment was costly and time consuming to set up. Finally, the unavailability of instruments that were small enough in size for infants and children served to effectively stymie those few pediatric surgeons amenable to exploring these innovative surgical procedures. Over the past five years, Glick and his colleagues at CHOB have played a leading role in surmounting many of these barriers, as well as in pioneering new minimally invasive surgery techniques for use in children that, ironically, now are being adapted by surgeons working with adults. A Quest to Move the Field Forward 8 ecause there are 35,000 general surgeons in the United States and only 400 pediatric surgeons, the manufacturers of medical instrumentation were not interested in downsizing their tools for use in pediatrics, claiming that the market was not big enough. "It took a few companies to believe in what we were doing to realize that we were going to push the envelope on this technology, and then they started miniaturizing the equipment for us about five years ago," says Glick. So, instead of 10- to 12-millimeter telescopes-about the size of a chunky pen-pediatric surgeons now can use three- to five-millimeter tools that also have been shortened in length. The new instruments have proven so effective that general surgeons have started using them, especially in adults for whom scarring is a concern. With the new instruments on board, other barriers began tumbling, and minimally invasive surgery in children has taken off at a brisk pace, especially given the obvious benefits to patients and the bottom line for hospitals. "The benefits of minimally invasive surgery for children are significant," says Marc Levitt, MD, UB assistant professor of surgery and pediatrics and medical director for the MASC and the Miniature Access Teaching, Training and Research (MASTTAR) Center at UB. " It leaves little or no scarring, and the risk of pul monary problems is greatly reduced. Also, the chil dren have shorter hospital stays, and once they are discharged they can return to school and normal activities. Essentially, after most of these operations 12 I u If I II P h J s i e i a n S p ri 11 g 2 00 2 there are no restrictions on their activities." Levitt says that evidence is now pointing to a correlation between a decrease in pain due to the smaller incisions and the decrease in pulmonary complications. "Because they have less postoperative pain, they are better able to cough and breathe deeply," he notes. In addition to improved patient care, the equipment and instruments that have been developed are resulting in reductions in healthcare costs. The state-of-the-art operating rooms in the MASC can be readied for surgery with the flip of a switch, in comparison to the lengthy and labor-intensive set-up procedures required for minimally invasive surgery in years past. "We basically have a 'preflight' checklist, where the nurses walk into the OR and in five minutes it's ready to go; all they have to do is set up the sterile equipment," says Levitt. In addition, recent studies have shown that the dollars saved in turnaround time for these operating rooms-where six to eight cases can be done in a day instead of just four- will pay for them in a short time. Leaving No Procedure Unturned By having all the latest equipment and instrumentation at their fingertips, the pediatric surgeons at CHOB have become innovators in their field, challenging themselves and their peers to take a fresh look at all procedures, leaving none overlooked. What they are finding is that many surgeries not only can benefit from the adaptation of minimally invasive techniques, but in some cases can be converted over to these new techniques exclusively. An example of such a surgical procedure involves the treatment of Hirschsprung's disease, a congenital disorder in which the bowel malfunctions, resulting in severe constipation. This condition once required three separate operations during a baby's first six months of life, with each surgery involving a five- to seven-day hospital stay. Using a laparoscopic approach, surgeons at CHOB now perform one three-hour operation that requires no incision. The procedure is done during the first month of life, and the baby can go home in one or two days. "We've done 20 of these operations using telescopes. This gives us a lot better visualization and mobilization from above, which makes the operation safer," says Michael Caty, MD, who, along with Levitt, performed this procedure at the MASC while it was being broadcast live to a group of several hundred surgeons watching it on a screen at the annual meeting of the American College of Surgeons in ew Orleans in October 2001. Caty and Guy Brisseau, MD, along with Glick and Levitt, �make up the pediatric surgery team at CHOB and are the only pediatric surgeons in Western New York. Building on this work, these surgeons have begun using trocar-less surgery in exceptionally small babies in need of minor operations. "Instead of using a trocar, we introduce the surgical instruments directly into the abdominal wall through a three-millimeter incision," says Glick. "This greatly reduces scarring, and it allows you the flexibility of putting the instru- to eight hours to complete. ow, with the assistance of the pediatric surgeons at CHOB, the orthopedists are using thoracoscopic techniques to complete this phase of the surgery, reducing it to a two- to three-hour process and avoiding a large incision. The pediatric surgeons' role is to insert all the trocars and camera instruments for the orthopedic surgeon. Once this is done, they can either go down the hall to the MASC conference room, where they can observe the procedure via telesurgery, or they can go next door to perform their own surgery while still being available to communicate with the orthopedic surgeons should the need arise. ments tn anywhere you want. In the past, we were very rigid about where we placed our trocars, but now we understand that this can be cus- As they eagerly look to the future to explore how other minimally invasive techniques can be incorporated into surgical procedures, the pediatric surgeons at CHOB take pride in the fact that they consider no operation outside the bounds of their scopes. "When we started doing minimally invasive surgery here five years ago, it involved about 60 of the 2,000 cases we complete each year. ow we're up to about 1,000 cases," says Glick. "And the ones we're not doing, we're still asking ourselves, ' Can we do it?' Right now, the answer is, 'We can't,' but we keep asking ourselves that question every day, and as the equipment gets better and we gain more experience, we'll be approaching 100 percent. It's just a matter of time." CD tomized for each operation." The CHOB surgeons also are collaborating with specialists in other fields to develop innovative alterations to surgical procedures that significantly affect quality of life and outcomes for patients. A dramatic example of this is the work they've been doing with orthopedic surgeons to correct spinal deformities resulting from congenital scoliosis. In this procedure, the orthopedic surgeons at CHOB-Robert Galpin, MD, and Douglas Armstrong, MD-must first release the ligaments on the child's anterior spine, after which the patient is turned over and the corrective hardware inserted. In the past, using the traditional open-surgery approach, the surgeon had to make a large incision across the chest or the abdomen to access the spine and release the ligaments, a process that took six *Children's Hospital of Buffalo is part of the Kaleida Health System. Lois Baker, senior editor in News Services at the University at Buffalo, contributed to this story. Sp r i 11 g 2002 l ullala Physician 13 �RESEARCH E W S Bioinformatics Center Receives 8200 Million Bv ELLEN GOLDBAUM -Merging of high·end technologies to foster advances inhealthcare and science n December 6, 2001, ew York State Governor George E. Pataki announced $50 million in state funding and more than $150 million in private-sector funding for the Buffalo Center of Excellence in Bioinformatics, a collaborative effort involving ew York State, industry partners and academic institutions. Building on the emerging discipline of bioinformatics, which uses the power of supercomputers to interpret data in the biological sciences at the molecular level, the new center will merge high-end technology, such as supercomputing and visualization, with expertise in genomics, proteomics and bioimaging to foster advances in healthcare and science. First proposed in January 200 l by Pataki, the Buffalo Center of Excellence in Bioinformatics is an integral part of the governor's plan to develop centers of excellence across the state to harness the strengths of universities and the private sector to create strategically targeted hightechnology centers of innovation, all aimed at spurring economic development and creating jobs. Since that initial announcement, the Buffalo Center of Excellence in Bioinformatics has attracted funding from major national corporations. In December, Pataki acknowledged that efforts to garner such funding were bearing fruit and that the center "will go forward. " In addition to an "initial installment" of $50 million from New York State, he announced the following commitments in software, hardware, venture capital, cash and equipment from the industry partners 14 I u I I a II Physic i a a S prir~ g 2 00 2 to date: Veridian will contribute $62.5 million; Compaq, $42.6 million; Informax, $20.8 million; and a group ofWestern New York businesses is investing 15 million. Stryker Communications is providing $7.2 million to create a communications network for the center (see related article on page 2), and Dell Computer Corporation and Sun Microsystems Inc. together are providing more than $1 million. Other partners include Invitrogen Corporation, Q-Chem, SGI, Amersham Pharmacia Biotech, AT&T, Wyeth Led erie, Human Genome Sciences, Inc. and the Alfred P. Sloan Foundation. The level of the commitment of New York State and the industry and academic partners, Pataki said, will assure that the center will be "the state-of-the-art facility, not just in the United States, but in the world"; and he also predicted that the center "will transform Western ew York into a 21st-century economy." On behalf of the University at Buffalo, which is taking the lead among the center's academic partners, UB president William R. Greiner thanked Pataki for his vision, leadership and continuing commitment to Buffalo- iagara. "It is much appreciated in this region," Greiner said, "and we will work to make you proud." In addition to support from the state, the Buffalo Center of Excellence in Bioinformatics will receive funding from the federal government. On December 7, Representative Thomas Reynolds an nounced that $3 million had been earmarked for the center in the House version of the defense appropriations bill. Senator Hillary Rodham Clinton worked hard to supplement this allocation in the Senate, and on December 21 she and Representative Reynolds announced $3.1 million in funds from two separate Congressional appropriations, providing important start-up costs for the initiative. The Buffalo Center of Excellence in Bioinformatics will be headquartered in a 150,000-square-foot facility to be built on the Buffalo-Niagara Medical Campus (formerly known as the "High Street medical corridor") and will house drug-design and research laboratories, high-performance computational facilities, 3-D visualization capabilities, product commercialization space and workforce training facilities. The center is a natural progression of the pioneering work that the center's major research partners-the University at Buffalo, Roswell Park Cancer Institute and the Hauptman-Woodward Medical Research Institute- have been doing for years in the areas of high-performance computing and visualization, structural biology, genomics, proteomics, pharmaceutical science and �generation of custom gene "chips" through the generation of DNA microarrays. Global link for Bioinformatics Center In a related development, the University at Buffalo has entered into a new hightechnology partnership with Biopharma Ireland, Ireland's new national institute focused on biopharmaceutical research and development, giving the Buffalo Center of Excellence in Bioinformatics an important international connection. UB and Columbia University were named as Biopharma Ireland's first U.S. partners in an announcement made on March 27, 2002, by U.S. Senator Hillary Rodham Clinton. Biopharma Ireland was established by Dublin City University and Athlone Institute of Technology to promote research leading to the discovery of new pharmaceuticals and to the creation of new companies and investments based on that research in Ireland and ew York State. "As a true Center of Excellence we need not only national, but international, connections and recognition," says UB Provost Elizabeth D. Capaldi, PhD. "Ireland has strong computer and pharmaceutical industries and is an ideal partner for our bioinformatics effort. We are pleased to be able to have Biopharma Ireland as a partner." Bruce Holm, PhD, UB senior vice provost and the university's representative at the announcement, notes, "It only makes sense that as a center of excellence, Buffalo's bioinformatics center should be linked with other centers of excellence. "In particular, Ireland has made substantially more of an investment in pharmaceutical research than most other places in the European community," he says. "With our partners in Ireland, as well as with Columbia, this is a natural, complementary partnership for UB." The pharmaceutical companies Elan, Wyeth (a subsidiary of American Home Products) and Schering-Plough recently have made major investments in Ireland. Biopharma Ireland also is putting resources into developing spin-off biotech companies that will benefit both Ireland and New York State. UB's partnership with Biopharma Ireland has its roots in previous research collaborations with Irish institutions facilitated initially by the Atlantic Corridor USA, a Buffalo-based, non-profit alliance created to link the NAFTA and European Union markets. Last semester, UB's Institute for Lasers, Photonics and Biophotonics and the Hauptman-Woodward Medical Research Institute hosted visiting researchers from the University of Galway and the Athlone Institute of Technology. UB has been partnering with Columbia University on the Northeast Structural Genomics Consortium, a $25 million project involving nine institutions to study structural genomics, a new field dedicated to determining gene function by defining the protein structure encoded in a gene's D A sequence. UB's Center for Computational Research, one of the world's leading academic high-performance computing sites, serves as the computational backbone for the ational Institutes of Health-funded project. ( D Sp r i 11 g 20 0 2 Buffalo Physician 15 �16 lallala Hysiciaa Spri11g 2002 �Sprtng 2002 1111111 .. JSICIII 17 �hile the general public may not fully understand how business skills can help today's physicians function more effectively in our complex health care economy, medical students do-and increasingly they are seeking ways to obtain these skills. In response to this growing demand. UB'sSchool of Medicine and Biomedical Sciences teamed up with the School of Management in 1997 to design an innovative program aimed at providing business skills to medical students. This collaboration has since resulted in the formal establishment of an MD/MBA program at UB, which last spring matriculated its first graduate. The new program, one of MBA student Michael Chilungu, Class of neurship, which may help them to open 17 MD/MBA programs in the 2003. " I see a need for physicians who are their own practices, participate in hospital country, was designed to allow medical students to obtain a dual degree in medicine conversant in the business aspects of medi cine to serve as an antidote to this problem. administration, serve as managers in health maintenance organizations, or simply and management in five years, instead of the l t is they who can best reconcile the need for improve their understanding of personal six it would take if the degrees were earned sound financial management with quality finance. independently. Students enrolled in the pro- patient care." gram spend years one and two completing gram is that students are required to complete traditional preclinical medical school also Class of2003, had no previous business a semester of internship training, which helps coursework. They then spend the following experience before entering the MD/MBA ground coursework in the realities of the year as full-time MBA students, after which program. Instead, she credits her clinical market economy. To date, UB students have they return to medical school to complete experience in medical school and intern- completed internships that have involved their third-year medical clerkships and the ships at Independent Health as her primary performing quality assessment research in required fourth-year medical rotations. They conclude the five-year dual-degree motivation to better understand the business of medicine. Erie County Medical Center's Emergency Department; developing and facilitating a "I became interested in the program after course in medical ethics; working as an ac- The reasons students cite for entering the I began working with physicians during my countant; and assisting in product develop- program are as eclectic as the choice of a outpatient experiences as a first-year stu- ment and strategic planning at Cognigen medical specialty. Some report having felt intimidated by financial jargon, others say they have been unsure of what will be dent," says Perez. "I realized that most phy- Corporation, a local firm that performs sta- sicians were overworked, pressured for time and very frustrated with the effect managed care is having on them and their practices. tistical analysis and consulting services for global pharmaceutical organizations. program with a semester of MBA classes. required of them to run a private practice, while still others are drawn to an opportunity to explore a subject other than medicine. Diverse as these motives are, however, one "I feel that the way around this obstacle is to get physicians involved in the decisionmaking processes of HMOs," she adds. l hadeus Grasela, PhD, PharmD, chief executive officer and president of Cognigen, says his company recruits students from the program because their education and training provide them with a students are seeking ways to provide the "In general, I believe that the business aspect of medicine should be understood highest quality of care for their future patients. by all physicians in order to help them de- assets to his organization. theme is echoed by all: Ultimately, these "I have been hearing so much about the changes that are going on in the medical profession with regard to cost-cutting and managed care, and it concerns me that this 18 A notable feature ofUB's MD/MBA pro- Like manyofhercolleagues, Brenda Perez, liver optimal care to their patients." unique skills set-and perspective- that are "The students have a background and Medical students who earn their MBA interest in both science and business, so they have an opportunity to gain exposure to bring a new vision of the future to the table," says Grasela. " In order for Cognigen to be increased emphasis on the business aspect of numerous subjects that are essential to a practicing physician, such as finance, medicine will lead to a disregard for the well - accounting, information technology, man - knowledge for decision making, we must being of the patient, particularly when top agement development and negotiations. also develop paradigms for the use of management consists of individuals with little or no clinical experience," says MD/ Students can also receive training in health - knowledge in strategic planning. luffala Hysiciu Spri11g 2002 care consulting, marketing, and entrepre- successful, we must not only develop new "Society desperately needs individuals �trained in science and the use of knowledge for decision making," he continues. "The obtain a dual degree. "The year of business training between the second and third year directors looked upon his degree favorably when he interviewed. "They were uniformly lack of these individuals will become more of medicine is well-timed," observes Michelle Clark, Class of2003. "Without interrupting impressed and encouraging," he says. apparent as we move into the next phase of increasing productivity based on the efficient use of technology. "The [MD/MBA] students bring an enthusiasm and interest in global affairs that is refreshing and stimulating. It is a pleasure to rotations, we gain business knowledge after having been introduced to medicine. This Some MD/MBA students, however, have received feedback about their participation in the program that reflects deeply felt allows us to begin applying our business experience during our clinical years." schisms in our society regarding the rela- or the most part, students report that Third-year student Perez, for example, has f tionship between medicine and business. responses to their dual degree aspira- been asked questions such as, "Why are you tions have been positive. Daniel Avosso, getting a business degree, only to go work for For students, the opportunity to fluently MD/MBA '01-the UB program 's first an HMO?" And, "If you are interested in transition between two well- integrated professional training environments is viewed graduate-is currently working as an emergency medicine resident at Long Island's as both an efficient and pragmatic way to North Shore Hospital. He says residency business, why not just go to business school? You are taking the spot of someone who is truly interested in practicing medicine." work with such motivated-and motivating-individuals," Grasela adds. I see aneed for physicians who are conversant in the business aspects of medicine to serve as an antidote to this problem. It is they who can best reconcile the need for sound financial management with quality patient care. �The students have abackground and interest in both science and business, so they bring anew vision of the future to the table. In order for Cognigen to be successful, we must not only develop new knowledge for decision making, we must also develop paradigms for the use of knowledge in strategic planning. About the author Jennifer Wiler is a Colorado native who has lived in NewYorkStateforthe past 10 years. After completing her undergraduate education at Colgate University in Hamilton, New York, she worked at Memorial Sloan-Kettering's Harlem Women's Clinic Some have even suggested to her that she is adds. "By now, I feel it has become abun- betraying the profession of medicine, ex- dantly clear that medicine is not practiced in pressing the opinion that "there is no place a vacuum-it must be understood within the context of its environment, part of in medicine for business." Fortunately, many physicians and students which includes our market economy." and then on Wall Street as an assistant securities do appreciate the critical role that business Students in UB's new MD/MBA program analyst. She has now plays in medicine, and they recognize the are delighted with the training they have been an active need for physicians who are both clinicians received thus far and, as a group, we are member of the and managers. "Regardless of whether I later anxious to see where our degrees will lead decide to go into private practice, hospital us. As we look to the future, we have no administration or medical consulting, there- doubts that throughout our careers as medical school community and served as president of the alities of business have a daily and profound physicians, we will strive to increase the medical student body for 1999-2000. Upon impact on how medicine is practiced in any of quality of care delivered to our patients, completion of her MD/MBA degree in 2003, these settings," says MD/MBA student while simultaneously acting as informed she hopes to practice emergency medicine Charlton Byun, Class of2003. patient and physician advocates when busi- "Understanding the basic concepts un- ness issues enter the equation. This is not a derlying the business world will likely be formula for us to "make a lot of money," but very helpful, if not essential, in any attempt to deliver high-quality patient care," he perhaps it is a way to enrich the healthcare experience for our patients. <t) 1501 Ferry Road , Grand Island , NY 14072 773-7063 z0 in New York City l1ffale Pbys i c i u S priu g 200 2 and design programs for victims of domestic violence and sexual assauH. <t) �Alpha Omega Alpha Honor Medical Society White Family Memorial Fund Recipient B Alpha Omega Alpha is a national organization dedicated to supporting academic rittany Lee Morse, Class of 2004, participated in a six-week rural family practice excellence and perpetuating excellence externship in Perry, ew York, with support provided by the White Family in the medical profession. It is the only A native of LeRoy, New York, Morse currently resides in Corfu, New York, a world; students are selected on the basis Memorial Fund. national medical honor society in the rural town in Genesee County. Prior to entering the University at Buffalo's School of Medicine and Biomedical Sciences, she attended SU Y College at Geneseo, where she of scholarship and integrity. Newly nominated Alpha Omega Alpha earned a bachelor of science degree in biology. Lee's goal is to members of the University at Buffalo's practice medicine in an underserved rural community and, to Epsilon Chapter from the Class of 2002 date, she has pursued a strong interest in family medicine. inducted this spring are: The White Family Memorial Fund was established in 2000 to memorialize Deborah A. White, MD '87, and her husband, Christopher, and son, Adam, who died in a car accident in 1999. It supports a summer internship for a firstor second-year student who is interested in pursuing a career Garrick A. Applebee Suzie Ariyaratana Lily M. Belfi linda J. Cuomo Keely E. Dwyer-Matzky in rural medicine. "It was an honor to take part in achieving the goals set forth by the White family, and I look forward to furthering this effort in my career," says Morse. <li) Christopher M. Foresta Anthony R. Mato Christopher E. MuHy Kathleen T. O'Donnell -S. A. UNGER Aimee l. Stanislawski Andrew B. Symons Cra:z:iade Receives Sung Scholarship Juliane M. Thurlow Matthew S. Traugott llison Graziade, Class of2005, is the first recipient of the john J. and janet H. Sung A Karen M. Weiss Scholarship. Graziade, a native ofL1ttle Falls, New York, attended Umon College m Schenectady, New York, where she majored in biology, with a minor in psychology. "!am honored to receive the Sung Scholarship and be chosen out of the first- Students from the Class of 20021nducted Last Spring: year class to be the first recipient," says Graziade. "The Sungs are outstanding people, Shaleen l. Belani and I appreciate that they have provided a scholarship to recognize medical students. Jennifer l. DeFazio "In addition to the honor of receiving this award, the monetary gift is extremely helpful considering the burden of financing a medical education." The Sung Scholarship is funded by a $1 million gift to the University at Buffalo School of Medicine and Biomedical Sciences by John and Janet Sung, who came to the United States from Korea in 1972 with only $200 to complete their education. At the time, they had two dreams: to financially assist other deserving students to attain their educational goals and to establish a renowned clinic in radiology, both of which have <li) been realized. David M. Krakowski Brian J. Maim Caryn E. Orr Andrew P. Swan Students from the Class of 20031nducted This Spring: Esme E. Finlay Alfred T. Frontera Julie A. Gavin Stephen D. Hess Sara I. Kaprove Natasha S. Manes Richard G. Newell �A L U M N BY S.A. UNGER ATribute to Orvan Hess A pioneer in fetal·heart monitoring opment that made it possible to keep a continuous, accurate check on the unborn University at Buffalo School of Medicine and Biomedical Sciences-and certainly one of the most baby's heartbeat even when medical peraccomplished. Over the course of his career, which spanned more than 50 years at Yale-New Haven sonnel were unable to be in the room. Hospital, Hess helped pioneer fetal-heart monitoring, was an early advocate for the return of natural "The fetal cardiac electrical signals childbirth methods and was instrumental in the first use of penicillin. could then be monitored and transmitted While not able to travel from his home in Connecticut to join us for last year's Spring Clinical by radio signal to a distant receiver," Day and his 70th class reunion, Dr. Hess, age 95, was nonetheless with us in spirit. explains Hess. The following article is published as a tribute to Dr. Hess, whose many scientific accomplish· While these early fetal-heart monitors ments not only have earned him world renown in his field, but also a place of pride among his fellow were crude by today's standards and medical school alumni. - John J. Bodkin II, MD '76 Preside11t, Mediml Alumni Association would eventually be replaced by ultrasound, their development by Hess and his colleagues marked the beginning of the field of fetal cardiology. In large part due to his work in this field, Hess received the Scientific AchieveOLLOWI G GRADUATIO from faint and difficult to isolate from the the then-University of Buffalo mother's. As a result, physicians were forc- ment Award from the American Medical School of Medicine in 1931 , ed to employ what he calls the "watch-and- Association in 1979. Contributing to his receipt of this prestiOrvan Hess completed his in- wait-and-pray" method. ternship and residency training Watching and waiting, however, was gious award was the work he did following at the New Haven Hospital in not Hess's style. Upon his return to Yale, World War II to usher in the renaissance of natural childbirth, as well as New Haven, Connecticut. In therefore, he teamed up \VHI LE THESE EARLY pioneering studies he led in 1936, he began a research fel- with Dr. Edward Hon, a FETA L· H EA RT MO l'<I TORS wound healing of the uterlowship at Yale University postdoctoral fellow, to WERE C R t; DE BY TODAY'S us after a Cesarean section. School of Medicine, where he address this problem. In STANDARDS AN D WOULD was named clinical instructor 1957, the two researchers Hess's clinical judgEVENTUA LLY BE REment also proved presm 1937. Five years later, he left the uni- became the first in the PLACED BY uLTRASOuND, cient in 1942, when he versity to serve as a surgeon during World world to monitor fetal THE I R BY was a catalyst for the first War II as part of the evacuation hospital heart activity by continHESS AND H I S COLsuccessful clinical use of attached to General George Patton's 2nd uously detecting and reLEAGUES MARKED THE penicillin. He recalled the cording electrical cardiac Armored Division during the invasions BEG INNING OF THE FIELD circumstances leading to signals indicating the of North Africa, Sicily and ormandy. OF FETAL CARDIOLOGY. this milestone in a 1999 In 1949, Hess returned to Yale Univer- condition of the unborn. interview. "My associate, sity as assistant clinical professor and re- The machine they develsumed work he had begun as a resident on oped was six-and-a-half feet tall and two Dr. A. Nowell Creadick, asked me to go a way to electronically monitor fetal-heart feet wide, far from being portable or com- see Mrs. Anne Miller in the isolation unit of New Haven Hospital. She was one of activity before and during delivery. One of pact in a crowded delivery room. Working in collaboration with Wasil our obstetrical patients, pregnant with her the problems obstetricians faced at that time was the inability to diagnose fetal Litvenko, chief of Yale Medical School's fourth child, when she contracted scarlet distress during the critical period oflabor electronics laboratory in the 1960s, Hess fever from her youngest son and suffered a and delivery. devised a system of telemetering the fetal miscarriage, subsequently developing an "The stethoscope just could not do the electrocardiogram and intrauterine pres- overwhelming bloodstream streptococcus job," says Hess. The fetal heartbeat was sure during pregnancy and labor, a devel- infection. Doctors had done everything Obstetrician/gynecologist and surgeon Orvan Hess, MD '31, is one of the oldest living alumni of the DEVELOP~IEl'<T 22 B u II a I o Physician Spri11g 2002 �possible, both surgically and medically. I went to see her and knew she was dying. " From the hospital I went to the Graduate Club to see her internist, Dr. John Bumstead. I discovered he was upstairs in the library, where he had fallen asleep reading a newspaper. While I was waiting for him to wake up, I sat and read the latest Reader's Digest, in which there was an article called " Germ Killers from Earth, " about the use of a soil bacteria to kill streptococcal infection in animals. "When I spoke to Dr. Bumstead, I asked if anything more could be done for Mrs. Miller, and I said, 'Wouldn't it be wonderful if we had something like this gramicidin mentioned in the Reader's Digest?' This suggestion prompted Dr. Bumstead to talk with his neighbor, John Fulton, a professor of physiology at the Drvan Hess, MD '31, says he is still fascinated with technology and the excitement of medical progress. Yale School of Medicine, who had worked in England with Howard Florey, who was studying penicillin. Dr. Bumstead asked Fulton if he could contact Florey and possibly obtain some of the scarce penicillin. Fulton agreed and Anne Miller received her first injection on March 14, 1942. By the next day, her fever had broken. " Today, Hess says: "I am more convinced than ever that technology can be applied to medical practice without sacrificing humanism or our sacred patientphysician relationship. " (Ji) . 0 ... .,E "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law HoGAN & WILLIG, PLLC - - - - -- Atto n1 eys ut L nw - - -- - - hoganandwillig.com Proud Sponsor of The Tour de Cure • June 1, 2002 Fundraisirrg event {or tire A m erican Diabetes Association One john james Audubon Parkway • Amherst, New York 14228 • 716.636.7600 Spring 2002 lu ff a l o Phy sici lD 23 �IMAGINATION PET CENTER MARKS TENTH ANNIVERSARY BvALAN H. I LOCKWOOD. MD n November 2001, the University at Buffalo-Veterans Affairs' Positron Emission Tomography (PET) Center celebrated its 1Oth anniversary. In recognition of this milestone-and the notable accomplishments emanating from this center since its inception-we asked Alan Lockwood, MD, director of operations, to write an article highlighting work that has taken place at the facility over the past decade and to preview the direction in which he sees this research moving in the years ahead. Lockwood, a UB professor of neurology, nuclear medicine, and communicative disorders and sciences, has won international acclaim for PET studies he has led in recent years on the origins of tinnitus. These studies-conducted in collaboration with Richard Salvi, PhD, UB professor of communicative disorders and sciences and clinical professor of otolaryngology and neurology, and Robert Burkard, PhD, also a UB professor of communicative disorders and sciences-were the first to show that tinnitus sounds originate in the brain, not in the cochlea, as scientists previously thought. Following the announcement of these findings in January 1998, Lockwood received a steady stream of calls from news reporters around the world. The study was featured on NBC's Today Show and reported on in the New York Times, the Los Angeles Times and Time magazine, among other publications. As Lockwood reports here, a number of other studies conducted at the UB- VA PET Center over the past ten years have uncovered intriguing findings that demonstrate what can be accomplished when talented researchers from a broad range of disciplines combine the science of imaging with the power of imagination. S. A. lJ~GER EDITOR 2 .. Ia f fa I o Physic i aa Spri 11 g 2 00 2 �hat do tinnitus , heart attacks, cancer and the past tense of English verbs all have in common? These seemingly disparate topics have all been the focus of research studies performed in the UB-VA Positron Emission Tomography Center. To mark its first ten years of operation, center investigators described their accomplishments in an Anniversary Symposium held last ovember. Positron emission tomography, better known as PET, is a technique that captures basic life processes in a pictorial format. The PET image is, in essence, a snapshot of how the body functions from a biochemical or physiological perspective. By contrast, X-rays, computerized tomography (CT) scans and magnetic resonance images (MRI) typically portray anatomical information. This ability of PET images to photograph life processes has led to important advances in research and patient care. PET imaging begins with knowledge of how a critical body system works. For example, the brain uses glucose, a sugar, as its only source of energy. Since the brain can't store glucose, it depends on the rest of the body to deliver this vital compound on a second-to-second basis via the bloodstream. In a very real sense, the brain is like the engine of a car-it does lots of work, but it depends on the constant delivery of fuel to be able to function. By measuring how much glucose the brain is using or how much blood is flowing to the brain, it is possible to deduce how hard the brain is working. In other words, measurements of glucose use and blood flow yield impor- ALA" LOCKWOOD, ~D largest medical cyclotrons in the United subject or a patient undergoing a PET scan, inject a tracer (isotope) and take pictures. Behind this fa<yade, however, there is a large team of technicians. Since the isotopes used in PET all have very short half-lives (the time it takes for the activity to fall by 50 percent ), all the tracers the process is deceptively simple. All they are synthesized just before they are used. need do is to lie down with their head in the This step takes place on UB's South Cam- The most commonly used PET tracers camera while members of the PET team pus, in Parker Hall, home of one of the are fluorodeoxyglucose (FDG ) and water. tant information about how normal or healthy a part of the brain might be or how hard it is working. From the perspective of a research States. After the tracer is synthesized, it is whisked over to Buffalo's VA medical center, some 3,000 feet away, via an underground pneumatic transport system. At the VA, images are produced and then analyzed using sophisticated computer software. S pri ng 2002 lullalo Physicin 25 �I111aging and I MAG CONTINUED I NAT I FROM PAGE o N 25 The metabolism of FDG is very similar to glucose metabolism, with one important exception: One of the key enzymes for glucose metabolism can't act on FDG, so the metabolic process stops at this step. This traps the tracer, which allows the PET camera to image its distribution in the body. The amount of trapped FDG is proportional to the amount of glucose that is being metabolized. High amounts of the tracer are an indication of a high glucose metabolic rate, and vice versa. Blood flow is measured in studies that use labeled water as a tracer. These studies are complicated by the fact that the halflife of the water used is only 123 seconds, SO every tWO minutes the amount of jAMES fALLAVOLLITA , MD, left, AND jOHN CANTY, MD tracer is reduced by half. As a result, these studies require close cooperation be- parts of the brain become active or inac- energy to bring this complex projecL tween the cyclotron operators and chem- tive. Thus, a typical brain mapping study to fruition. After securing critical support ists who make the labeled oxygen and includes scans done at rest and scans done from the community in the form of a convert it into water and the technolo- as a subject performs a series of increasingly substantial grant from the James H. Cummings Foundation, Prezio and his associates convinced UB and the VA that the center would become a vital element "THE STUDIES IN THE UB-VA PET in their quest for excellence. Several years CENTER SERVE AS A MODEL FOR INTERDISCIPLINARY COLLABORATION. THE OPPORTUNITY TO WORK WITH COLLEAGUES WITH VASTLY DIFFERENT BACKGROUNDS of planning, construction and recruitment of staff led to the first PET scan in October 1991. Since then, thousands of patients have been scanned and more than HAS BEEN ONE OF THE MOST REWARDING ASPECTS OF MY JOB AS DIRECTOR OF PET OPERATIONS." - ALAN LOCKWOOD, MD $4 million has been awarded to support research in the center. The Anniversary Symposium was planned to highlight major research accomplishments. gists and investigators who use the labeled complex tasks. By subtracting the resting- water in a PET study. state scan from the scan done while the Although blood-flow studies using labeled water are complex, they have been the key to some of the most important work done in the UB- VA PET Center. By comparing the pattern of blood 26 brain is at work, it is possible to identify the parts of the brain that mediate the task. Using this basic strategy, center investigators have made important discoveries that have identified the brain regions that flow at rest with the pattern during the mediate tinnitus and those that we use performance of a specific task, it is pos- when we form the past tense of a verb. sible to identify the regions of the brain The Anniversary Symposium began that perform the task. This strategy works with a brief history of the UB-VA PET because the brain can' t store energy. It Center, which reviewed how joseph Prezio, depends on instantaneous changes in the MD, the then-chair of the UB Department delivery of glucose and oxygen as various of Nuclear Medicine, had the vision and l1ffalo Physician Spri11 g 2 00 2 BETTER CARE FOR HEART DISEASE Heart disease is a major cause of death and disability among Americans and is a particularly serious problem in Western ew York. John Canty, MD, and James Fallavollita, MD, from the UB Department of Medicine, have used FDG PET to define and study "hibernation" in the heart muscle. Hibernating muscle is still alive but does not function properly, causing the heart to pump inefficiently. A better understanding of this process will lead to improved care for patients with coronary artery disease. �Since PET cameras are thesizes that some of these new connec- nearly noiseless, unlike tions are responsible for this false sense of magnetic resonance scan- ringing in the ears. ners, PET is the ideal tool These studies are complemented by for studies of hearing dis- studies of the normal auditory systems orders. A research team performed by the tinnitus team and inves- consisting of myself, Robert tigations of other aspects of the normal Burkard, PhD, and Richard auditory system spearheaded by Ann Salvi, PhD, from the UB Eddins, PhD, associate professor in the UB Departments of Communi- Department of Communicative Disorders cative Disorders and Sci- and Sciences. ences, Neurology and Nuclear Medicine, have identi- L ANG UAG E AND GENDER fied and mapped the brain regions that mediate tinnitus, the false perception of a sound in the absence of an environmental source. This problem plagues millions and is almost always associated with hearing loss. By studying a group of patients who are able to modulate the loudness of their tinnitus, this investigative team was able to pinpoint the auditory cortex as the site ROBERT BURKARD. PHD. front. A~D RICHARD SALVI. PHD DI FFE RENTIATING LESIONS Every year, doctors must tell some of their patients that a routine chest X-ray reveals where tinnitus originates. In related studies, these researchers have found that hearing loss leads to a reorganization of the auditory jeri jaeger, PhD, from the UB Department of Linguistics, directed studies that show how the brain forms the past tense of English verbs. By mapping brain regions activated by forming the past tense of regular verbs (e.g., walk/walked), irregular verbs (run/ran) and clusters of letters that look like words (brep/brepped), jaeger and her colleagues concluded that the brain minimizes word storage needs by using rules to form the regular past tense and a dictionary look-up strategy for irregular verbs. In addition, the brains of men and women perform these tasks differently: Women use both brain hemispheres to form a past tense, whereas men use the left hemisphere. pathways in the brain. The team hypo- a spot or nodule in the lung. Not all of these nodules are cancerous, but that is always the main concern. Since cancerous cells use large amounts of glucose, FDG PET scans can help differentiate the cancers from benign lesions, without the need to perform invasive surgical procedures. Syed Husain, MD, a nuclear medicine physician at the VA, is the Buffalo site investigator in a nationwide cooperative study designed to better characterize the ability of PET to differentiate malignant nodules in the lung from those that are benign. B RA I N R EGIONS AN D T I NN ITUS Studies of the auditory system, particularly investigations of tinnitus, have been a major focus of research in the center. JERI jAEGER. PHD Spring 2002 8 u If a I o Ph JS i ci a n 27 �Jmagin,~ and I M A G I N AT I 0 N anatomy relationships revealed by MRI scans, and brain physiology revealed by PET. CusTOMIZING CANCER CARE Hani Abdel-Nabi, MD, PhD, chair of UB' s Department of uclear Medicine, and his associates from otolaryngology and surgery have made important contributions to the emerging field of PET oncology. In patients with cancer PET often yields information about the extent of a patient's disease with images that are more sensitive and specific than images obtained with other methods. PET scans allow a cancer patient' s physicians to plan treatments RALPH BE!';EDICT, MD THE IMPACT OF MULTIPLE SCLEROSIS ON AUDITORY ATTENTION Attention is a term psychologists use to describe the process of focusing brain resources on a given task. The neural systems that mediate visual attention have been studied extensively in other centers. Ralph Benedict, MD, and his colleagues from the UB Department of Neurology have developed a task that tests auditory attention. Not surprisingly, some of the same regions of the brain are used by both the auditory and the visual systems. In a recent extension of those studies, Benedict and his colleagues have studied attention in patients with multiple sclerosis, They have found that there are changes in the auditory attention pathways that appear to be the consequence of the disease, and they have begun to show how the brains of these patients are reorganized in an attempt to compensate for the lesions in their brains. This team is also collaborating with Rohit Bakshi, MD, from the UB Department of eurology, to study brain that are the most effective while avoiding high-morbidity surgical procedures that would be ineffective. This is a win-win situation that helps the patient, the physician and the healthcare system by reducing costs. Left to right, laflalo Physician S prin g 20 0 2 D THE AUDITORY SYSTEM Salvi and Burkard and I have teamed up with investigators from the University of Rochester to study aging in the auditory system. Studies by this group have shown that aging has an effect on the central auditory system that is independent of the hearing loss common among the elderly. MIGRAI E PHYsiOLOGY AND TREATMENT Headache is one of the most common problems faced by Americans and is a frequent cause of lost time from work. Edward Bednarczyk, PharmD, of the UB Departments of Nuclear Medicine and Pharmacy Practice, and his associates have tackled this problem in a series of studies of spontaneous migraine headaches. They augmented these investigations by using a model of migraine in which tiny amounts of nitroglycerine are given to migraine patients as they are scanned. To complement these studies, the team is evaluating drugs designed to prevent headaches. PET AND EUROPSYCHOLOGY The symposium was rounded out by showing how PET imaging can be integrated with psychological testing. In separate studies that have probed the effects of head injury and the effects of liver failure on brain HA:-11 ABDEL-N'ABI, MD, PHD. EDWARD BEDNARCZYK. PHARMD, AND SYED SAJID HUSAIN. MD 28 AGING A �function, my colleagues and I have shown that specific brain regions are associated with the performance of some of the most common tests used by psychologists. IN ANOTHER STUDY ON THE HORIZON, CENTER INVESTIGATORS WILL BEGIN COLLABORATION WITH COLLEAGUES UB RESEARCH PROJECTS ON THE HORIZON FROM THE DEPARTMENTS OF NEUROLOGY AND The studies in the UB-VA PET Center serve NEUROSURGERY IN A NATIONWIDE EFFORT TO IDENTIFY as a model for interdisciplinary collaboration. The opportunity to work with col- STROKE PATIENTS WHO WOULD BENEFIT FROM SURGERY leagues with vastly different backgrounds DESIGNED TO BYPASS BLOCKED ARTERIES TO THE BRAIN. has been one of the most rewarding aspects of my job as director of PET Operations. Clearly, none of the research conductstudy of multiple sclerosis, where inves- ed in the center would have been possible without grants from sources that are as a nationwide effort to identify stroke patients who would benefit from surgery tigators from the Jacobs diverse as the expertise of the center' s sci- designed to bypass blocked arteries to Institute are studying genetic markers in entists. These include several branches of the brain. these patients. eurological ational Institutes of Health, the Also, Canty and Michael Haka, the For these reasons and more, I believe Department of Veterans Affairs, the De- center's chief radiochemist, have recently that the next decade will be even more partment of Education , the American Heart Association, a number of pharma- teamed up to study the nerve supply to the exciting than the first for the UB- VA heart using a novel PET Center. ceutical companies, Siemens Medical tracer, hydroxy- the Systems, and a variety of foundations, ephedrine. Canty most notably the James H . Cummings suspects that an Foundation of Buffalo. In looking toward the next decade, I abnormal nerve PET Center. Several new initiatives are supply to the heart may be an important factor in sud- under way that will expand its research den cardiac death. program . In a new half- million-dollar grant from I also anticipate that the ini- feel the best is yet to come for the UB-VA the VA Merit Review program, Burkard tiatives growing and I, along with other collaborators, will out of the Buffalo study the effects of background noise on Center of Excel- the auditory system. Merging recordings lence in Bioinfor- of brainwave activity with PET is a cen- matics (see related tral aspect of this research. It takes about a minute for a PET camera to image brain article on page 14) will enable PET activity. This is an eternity, in terms of neural activity, where communications expand their stud- investigators to between nerve cells occur in thousandths of ies and enhance a second. By combining PET images that show where something happens with the value of their PET data by creating links with in- electrophysiological recordings that show 4D when something happens, we hope to improve our ability to probe brain function. In another study on th e hori zon, center vestigators study- investigators will begin collaboration liminary steps in with colleagues from the UB Departments of eurology and Neurosurgery in been taken in the ing genomics and proteomics. Prethis direction have Spri11g 2002 Bu ffalo Physician 29 �PATHWAYS NEws ABOUT UB's ScHooL oF MEDICINE AND BIOMEDICAL SciENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF IN THIS CAPACITY [LAYCHOCK] WILL PLAY A LEAD ROLE IN DETERMINING WHAT RESEARCH WILL BE CONDUCTED AT UB's SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND HOW RESOURCES WILL BE ALLOCATED FOR THIS RESEARCH. 30 I u I I a I o Physician logy from Brooklyn College, Laychock to Lead Research Efforts City University of New York, Suzanne G. Laychock, PhD, and a doctorate in pharmacolprofessor and associate chair ogy from the Medical College of the Department of Pharm- of Virginia. In 1990, she was acology and Toxicology in the selected as the outstanding University at Buffalo STAR alumnus at School of Medicine the Medical College and Biomedical Sciof Virginia. ences, has been apLaychock serves pointed senior associas associate editor ate dean for research of Lipids and was and biomedical eduassociate editor of cation at the school. Endocrine Research In this capacity, LAY C HO C K from 1992 to 200 l. she will play a lead She has also served role in determining what re- as field editor for the Journal search will be conducted at of Pharmacology and ExperiUB's School of Medicine and mental Therapeutics, and on Biomedical Sciences and how the editorial board of the resources will be allocated for journal Diabetes. this research. She will also Laychock's research into oversee the recruitment and endocrine pharmacology with hiring of new research faculty. an emphasis on the cellular Laychock, a member of the mechanisms regulating insuUB faculty since 1989, is an lin secretion has been funded accomplished researcher with since 1979. more than 80 publications. In She is a member of several addition to serving as associ- professional societies, includate chair of her department ing the American Diabetes since 1995, she was codirector Association, the American of its Institute for Research Society for Pharmacology and and Education on Women and Experimental Therapeutics Gender. She holds bachelor's and the Endocrine Society. and master's degrees in bio- - LOIS BA K ER S p ri n g 2 00 2 Holm Named Senior Vice Provost Bruce A. Holm, PhD, has been named a senior vice provost at the University at Buffalo, where he will serve as the point person on many of the university's high-technology/ biotechnology projects. In this role, Holm, who formerly served as UB's senior associate vice president for health affairs, will represent Provost Elizabeth D. Capaldi in a variety of capacities. He will be the chief administrator in the provost's office for the Buffalo Center of Excellence in Bioinformatics (see related article on page 14), the Strategically Targeted Academic Research (STAR) Center for Disease Modeling and Therapy Discovery, and the Center for Advanced Biomedical and Bioengineering Tech nologies (CAT). He also will participate in the development of an institute in biomedical engineering at UB and collaborate with administrators in the Office of Science, Technology and Economic Outreach. "Dr. Holm will work closely with our academic partners- �Roswell Park Cancer Institute and the Hauptman-Woodward Medical Research Institute-and with our corporate HOLM partners, the local business community and faculty and deans as these projects move forward," says Capaldi. "He also will work to develop further external relations and scientific and corporate partnerships." Holm holds faculty positions as professor of pediatrics, pharmacology and toxicology, and gynecology-obstetrics, and also serves as associate senior vice president for scientific affairs at Roswell Park. He is principal investigator of the STAR center, as well as several other large awards, including those from the Markey Trust and the Howard Hughes Medical Institute. In addition, he maintains an active research program that has attracted millions of dollars in grant awards to VB. - S U E WUETC HER Mihalko to Direct CAT William M. Mihalko, MD, has been named executive director of the University at Buffalo's Center for Advanced Technology (CAT) by Provost Elizabeth D. Capaldi. Mihalko is an associate professor in the Department of Orthopaedics in UB's School of Medicine and Biomedical Sciences and research director in the Department of Orthopaedic Surgery. Holding both medical and biomechanicalengineering degrees, he serves as the head of arthroplasty at the Erie County Medical Center and is on the medical staffs of Kaleida Health's Millard Fillmore hospitals, Buffalo General Hospital and Children's Hospital of Buffalo. "We are delighted to have someone of Dr. Mihalko's caliber to direct the CAT," Capaldi said in making the announcement. "He is a bioengineer with an active research and clinical program who will provide superb leadership in evaluating and developing biodevices for commercialization in Western New York." Mihalko ' s appointment comes at a time when the CAT- barely three-quarters into its first official year-is already making strides in its main mission: to provide funding to innovations in biopharmaceuticals and in biomedical devices that are close to commercialization. ew York State Governor George E. Pataki announced creation of the CAT and $1 million in funding for its first year of operation last May. "Dr. Mihalko's expertise bioengineering represents an area in which we' re very strong," says Robert Genco, DDS, PhD, a vice provost and head of UB's Office MIHALKO 111 Hayes Honored by the AMA Maxine Hayes, MD '73, assistant secretary of Community and Family Health for the Washington State Department of Health and the recipient of UB's 2000 Stockton Kimball Award, has received the American Medical Association's 2002 Nathan Davis Award in the category of Career Public Servant at the State Level. She was nominated for the award by Mary Selecky, Secretary of Health, Washington State Department of Health. In announcing the award, the AMA stated: "The awards, presented to local, state and federal career and elected government officials, were established by the AMA in 1989 and are truly one of the most prestigious forms of recognition for outstanding public service in the advancement of public health .... The caliber of our nominees [this year) was truly inspiring, and your selection from such an impressive group certainly speaks volumes in recognizing the dedication and diligence of your public service." Hayes, who also holds a master's degree in public health from Harvard University, is a nationally known HAYES pediatrician who, among other things, has strongly advocated for universal health and dental care for children and the elimination of tobacco use among our youth. The award was presented to Hayes on January 29, 2002, at a dinner in Washington, D.C., that was attended by officers of the AMA, as well as by members of Congress and administration officials. <t) -S. A. UNGER Spri11g 20 0 2 I u If a I o Physician 31 �PATHWAYS MIHALKO's APPOINTMENT COMES AT A TIME WHEN THE CAT ... IS ALREADY MAKING STRIDES IN ITS MAIN MISSION: TO PROVIDE FUNDING TO INNOVATIONS IN BIOPHARMACEUTICALS AND IN BIOMEDICAL DEVICES THAT ARE CLOSE TO COMMERCIALIZATION. of Science, Technology and Economic Outreach. Previously director of the CAT, Genco is a SU Y Distinguished Professor and chair of the Department of Oral Biology in the School of Dental Medicine. After completing his residency at the UB Department of Orthopaedic Surgery, Mihalko completed an Adult Reconstructive Surgery Fellowship at the Missouri Bone and Joint Center. He earned his medical degree, as well as a doctorate in biomechanical engineering, from the Medical College of Virginia. He is the recipient of an award from the Buffalo Orthopaedic Research and Education Foundation for Outstanding Orthopaedic Research during Residency, and the American Medical Association's Physician Recognition Award and, with colleagues, the Knee Society's Ranawat Award for research on knee-joint stability. - ELLE N GOLDBAUM Baker and Coldbaum Win Writing Awards Lois Baker and Ellen Goldbaum, senior editors in the University at Buffalo's News Services unit and regular contributors to Buffalo Physician received a Gold Medal in the research, medicine and science writing category in the 200 l Council for the Advancement and Support of Education (CASE) District II Accolades competition. The silver medal in this category was awarded to the University of Toronto and the bronze to Princeton University. Baker ' s submissions included a series of articles on research being conducted by Frederick Sachs, PhD, UB professor of physiology and biophysics, in which he has shown how a protein isolated from the venom of a Chilean tarantula holds promise as the basis for new GOLDB A UM drugs for preventing atrial fibrillation. Also judged to be excellent were articles she wrote on research conducted by Herbert Schue!, PhD, UB professor of pathology and anatomical sciences, that elucidates an internal cannabinoid-signaling system that regulates human sperm fertilization potential; and a study by Ad nan Qureshi, MD, UB assistant professor of neurosurgery, which found a lack of preventive efforts to avert second heart attacks. Goldbaum was singled out for her article on work being conducted at UB by Thenkurussi Kesavadas, PhD, assistant professor of mechanical and BAKER aerospace engineering, who is collaborating with researchers in UB ' s School of Medicine and Biomedical Sciences to develop a virtual palpation glove. Baker and Goldbaum's medical-science reporting also won Bronze Medals in the national 200 l and 2002 CASE Circle of Excellence Awards competitions. -S. A . Rokitka Named to Editorial Post Mary Anne Rokitka, PhD, clinical associate professor of physiology, assistant dean, and director of undergraduate studies in the University at Buffalo's School of Medicine and Biomedical Sciences, has been named an associate editor for Advances in Physiology Education. The peer-reviewed journal, a publication of the American Physiological Society, is dedicated to the improvement of teaching and learning physiology and to the advancement of physiology as a teaching profession. 4D - S. A. 3 2 luttale Physician Spring 2002 UNG ER U NGE R �Roswell Park Cancer Institute IRPCII was founded in 1898 and is the nation's first cancer research, treatment and education center and the only National Cancer Institute-designated comprehensive cancer center in Western New York. The cancer center is a teaching and research affiliate of the UB School of Medicine and Biomedical Sciences, and many faculty at RPCI hold joint appointments at UB. Over the past two years, RPCI has developed and implemented a strategic plan to aggressively recruit new clinical and scientific talent to the cancer center. In January 2002 RPCI president and CEO David Hohn, MD, held a press conference to summarize the successful results of this effort. He also took the opportunity to announce the recent recruitment of two national leaders in the field of oncology, Donald L. Trump, MD, and Candace S. Johnson, PhD. Below are brief profiles of Trump, Johnson and other faculty who have joined RPCI and UB's School of Medicine and Biomedical Sciences in leadership positions since 2000. Donald L. Trump, MD Senwr V>ce President for Clinical Researrh Chazr, Department of Medicim Copnncipnl Jnvestzgator, Cancer Center Support Grant Roswell Pnrk Cancer Institute Donald L. Trump, MD, joined the faculty of RPCI in February 2002 as senior vice president for clinical research, chair of the Department of Medicine, and coprincipal investigator of the Cancer Center Support Grant. Trump earned his medical degree from The Johns Hopkins University School of Medicine, Baltimore, in 1970 . From 1970 to 1975 he completed an internship and resiTR U MP dency training in medicine at The Johns Hopkins Hospital, along with a fellowship in oncology at The Johns Hopkins Oncology Center. Most recently, Trump served as deputy director of clinical investigations at the University of Pittsburgh Cancer Institute (UPCI), where he had primary responsibility for directing the clinical and translational research activities, and as chief of the Division of Hematology and Oncology in the Department of Medicine and professor of medicine and urology at the University of Pittsburgh Medical Center. Trump is a Diplomate of the American Board of Internal Medicine, with subspecialty boards in medical oncology, and a Fellow of the American College of Physicians. His research interests include innovative clinical trials and chemoprevention studies in prostate cancer; antitumor mechanisms and therapeutic effects of vitamin D; and feasibility studies on retinoid treatment in emphysema. He is a member of the Eastern Cooperative Oncology Group and a principal investigator or coprincipal investigator on several National Cancer Institute-funded trials. Trump is the recipient of numerous awards and honors including the 2001 Pittsburgh Science, which recognizes those individuals who dedicate their services to making Pittsburgh a better place to live; multiple citations in Best Doctors in America; and, yearly since 1998, awards from the Association for the Cure of Cancer of the Prostate (CaP CURE) for his research on the role of vitamin D in the treatment of prostate cancer. Trump serves as secretary/ treasurer of the American Society of Clinical Oncology and is a member of many professional societies. He is also reviewer and/or member of the editorial board of several prestigious journals, such as the New England foumal of Medicine, and the Journal ofthe National Cancer Institute. Gentzke & sociates, Inc. Registered Investment Advisor Priva te Po rtfo lio .\ la n age mcnt T a, Co n ~:> uhin g Es tate PI a nn iJ1g President and CEO Glenn Gentzke and Chief Investment Strategist Chris King Fcc- Based 1\ ssrt .\la nagcm cnt UB Commons 520 Lee Entrance Tll\A-C RE F Ackisor Suite 205 ~e t\\·o rk Amherst. NY 14228 Tel: (716) 639-G475 Certified Qflicf.JJooks Profrss iona l Ackiso rs www.gentzke.com Vectors Person of the Year in Sp rin g 2 0 0 2 l alfal1 Physiein 33 �PATHWAYS Candace S . .lohnson, PhD Senior ~'icc Pres1dwt {or Translational Research Semor Member, Department of Pharmacology and Therapeutics Roswell Park Cancer Institute Candace S. Johnson, PhD, joined the faculty of RPCI in February 2002 as senior vice president for translational research and senior faculty member of the Department of Pharmacology and Therapeutics. Johnson earned her doctoral degree in immunology from Ohio State University in 1977. From 1977 to 1981 she completed research and postdoctoral fellowships in immunology/cell biology at the Michigan Cancer Foundation in Detroit. Most recently, Johnson jOHNSON served as deputy director of basic research at the University of Pittsburgh Cancer Institute and as professor of pharmacology and medicine at the University of Pittsburgh School of Medicine. Johnson's research interests include translational research to facilitate the efficient application of promising laboratory findings in clinical studies; preclinical design and development of more effective therapeutic approaches to cancer using highly characterized tumor models; and mechanisms of vitamin D-mediated antiproliferativeeffects either alone or in combination with other cytotoxic agents. 34 luflal1 Pbysiciaa Johnson is a member of the National Institutes of Health Reviewers Reserve and the National Cancer Institute Review Group Subcommittee A-Cancer Center (Parent Committee). She is also a member the editorial board of Oncology Reports, Molecular Cancer Therapeutics, and Molecular PIUlrmacology. Michael C. Brattain, PhD Chair, Department of Phannacology and Therapeutics Basic Science Director, Cancer Center Support Grant Roswell Park Cancer Institute Michael Brattain, PhD, joined RPCI in 2001 as chair of the Department of Pharmacology and Therapeutics and basicscience director of the Cancer Center Support Grant. Brattain, who earned his doctoral degree in biochemistry from Rutgers University in 1974, carne to RPCI from the San Antonio Cancer Institute, a National Cancer Institutedesignated comprehensive cancer center, where he was associate director for basic research. At the same time, he served as professor of surgery at the University of Texas Health Science Center in San Antonio. Over the years, Brattain has held several research, administrative and academic positions, including professor of biochemistry and molecular biology at the Medical College of Ohio; director of the BristolBaylor Laboratory Division, Baylor College of Medicine; and director of molecular and Spring 2002 cellular biology, anticancer research, at BristolM y e r s Squibb, Inc. He serves on BRATTAIN the editorial board of Cancer Research, International Journal of Oncology, and Oncology Research. Brattain is a member of the American Association for Cancer Research, the American Association of Pathologists, and the Metabolic Pathology Study Section of the National Institutes of Health. His research in signal transduction pathways in breast and colon cancer has attracted major funding from the National Cancer Institute, and he has created a broad national network of scientific collaborations. .lohn K. Cowell, PhD, DSC Chmr, Department of Cancer Genetics Roswell Park Cancer Institute Professor, Cellular and Molecular Biology Program Roswell Park Graduate Dll'lsion, University at Buffalo John K. Cowell, PhD, DSc, joined the staff of RPCI in 2000 as chair of the Department of Cancer Genetics. He also is professor of the Cellular and Molecular Biology Program in the Roswell Park Graduate Division, University at Buffalo. Cowell earned his doctoral degree in genetics from Sheffield University (UK) in 1978 and completed research fellowship training in the Department of Cellular Pathology at the Imperial Cancer Research Fund (London, UK) in 1981. He was honored with a doctor of science degree from Sheffield University in 1993. Cowell came to RPCI from the Cleveland Clinic Foundation (CCF), Lerner Research Institute, where he had served as direc- CowELL tor of the Center for Molecular Genetics since 1995. He also had a joint appointment at the CCF Cancer Center and was a CCF professor of clinical chemistry at Cleveland State University. Cowell's research interests include molecular genetics of cancer and cancer predisposition, molecular analysis of neuroblastoma, molecular genetic changes in leukemia, and genetic analysis of brain tumors and breast cancer. Soldano Ferrone, MD, PhD Cha1r, Department of Immunology Roswell Park Cmzcer Institute Professor, Aficrolnology University at BujJalo Soldano Ferrone, MD, PhD, joined the staff of RPCI in 1999 as chair of the Department of Immunology. He also is professor of microbiology at the University at Buffalo. Ferrone earned his medical �degree at the Medical School, University of Milan (Italy) in 1964, and his doctorate in hematology at the University of Milan in 1971. He was a member of the faculty of the Department of Medicine at the University of Milan from 1964 to 1965; the Department of Experimental Pathology at Scripps Clinic and Research Foundation (La Jolla, California) from 1971 to 1981; the Department of Pathology at Columbia University from 1981 to 1983; and chair of the Department of Microbiology and Immuno- logy at New York Medical College (Valhalla, New York) from 1983 to 1999. Ferrone's laboratory research program focuses on developing approaches to counter the multiple mechanisms used by human melanoma cells to escape immune recognition and destruction, and on designing a strategy to target humoral and cellular immunity to malignant lesions in patients with melanoma. Ferrone is a member of the American Association of Immunologists, the American Association for Cancer Re- search, and the Transplantation Society. Currently, he is a member of the Biological Resources Branch Oversight Committee and of Subcommittee F (Manpower and Training) of the National Cancer Institute Initial Review Group. Ferrone has been issued patents on "Anti-idiotypic Monoclonal Antibodies MK223MelanomaAntibody763.74" and on "Anti-idiotypic Monoclonal Antibodies for Treatment of Melanoma." He was honored with the Alexander Von Humboldt Award, Senior Distinguished U.S. Scientist Award, Germany, in 1997. Ferrone has authored or coauthored more FERRONE than 700 journal publications, book chapters and abstracts. He serves on the editorial board of the International Journal of Oncology, Journal of Im111unology, Journal of l111munothernpy, Tissue Antigens, and Vaccine Research. GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" rvoJraireJ Daniel Schneider, AuD Jennifer Schneider, MA Spring Jerri Kaplan Joyce, MA 2002 lulfal1 Physician 35 �DEVELOPMENT N E w s Scholarships for Our Students By Li nd a J . Cor d e r , PhD, CFRE OR YEARS, THERE'S BEEN DISCUSSION about the importance of scholarships- "We're losing some of our best 'acceptances' due to higher scholarships elsewhere ... ";or, "If we had even one full scholarship, we might be more competitive ... " Recently, I decided to look into tuition, average student debt and scholarship assistance at UB. What I found begs for additional research and analysis, including correlation of tuition with the number of paid full-time faculty, when medical class size changed and when the school added basic science programs. In the interim, I found that UB's tuition has always been relatively low. Initially, this was due to the short course of study ( 15 weeks) by people who were already, in effect, apprentices to volunteer faculty members who organized the first curriculum. The Class of 1847 paid $80. This included their graduation fee. This situation scarcely changed for 70 years. Although the course of study lengthened, the cost per year remained stable. In 1916, tuition had risen to only $125 a year. In 1928, a mere 12 years later, medical education had in1:-\CREASL 'G creased fourfold to $500 annually. ENDOWMENTS FOR Another period of stability lasted SCHOLARSHIPS WILL through WWII. Then, from 1948 CO, 'TINUE TO BE A to 1955, costs rose from $600 a \IA)OR FOCUS FOR year to $850. During the late 1950s, THF RE,\!AINDER OF tuition decreased and fees increasTHE CA\!PAIG::-.. FOR ed, with the net cost steady. In UB AND BEYO:\'D. 1959, tuition climbed to $1080, but fees declined. Five years later, in 1964, two years after UB's merger with the State University, tuition dropped slightly to $800 for New York residents, remaining at $1,000 for all others, plus a UB fee of $81. This remained constant through the 1970s, increasing somewhat towards the end of the decade. By 1982, residents paid $4,300 a year, when the national average for public medical schools 36 luffalo Physician Spring 2002 was only $2,1 00! By the early 1990s, tuition was $5,600 for New Yorkers, nearly $9,000 for others, with fees still at about $300 a year. We seem to be in another growth mode. Last year was slightly under $12,000. This year we're at $12,840 in-state and $22,940 out-of-state. There is a projected annual increase of $2,000 for the next three years. The above figures might dispel a few myths. Tuition was incredibly low while UB was private. The clinical faculty, high in experience, volunteered their time to teach, which kept costs to students artificially low. The "drop" in tuition and fees when the school merged with SUNY was minor. The largest increases have taken place recently. UB is still a relative bargain, but the fact is that medical and biomedical education and research now cost significantly more than they did for the majority of our graduates. Our students are graduating with an average debt in excess of$80,000. With current scholarship endowments, we were able to award only about $288,000 this academic year m scholarships. The school's Alumni Scholars Endowment got a big boost this year with a generous bequest from AI Dobrak, MD, Class of '39. His gift, in excess of $200,000, increased this endowment by 53 percent, bringing it to about $580,000. Last year, Janet Sung, MD, a Western New York radiologist, and her husband, John, established a scholarship fund with a million-dollar gift. Several alumni have set up smaller named scholarship endowments. Every one of these gifts helps, but the fact is we have a long way to go. Increasing endowments for scholarships will continue to be a major focus for the remainder of the Campaign for UB and beyond. Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at I -877-826-3246, or via e-mail at ljcorder@buffalo.edu. �Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the fames Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis of lifetime membership. Names of Founders' Circle members are repeated in an annual category in any year that they make a new gift to the school. UB' s Founders-primarily physicians and attorneysenvisioned a school to train students for service to the community. The Society's Founders help to actualize that vision by providing a generous base of support for programs and activities that enrich the academic environment and enhance medical training. Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley '44 Chesterfield, MO Mrs. Christine Gretschel Genner Potomoac, MD Dr. Lawrence Golden '46 & Mrs. Nancy Golden '48 Mrs. Joan W. Alford Mrs. Annette Cravens Buffalo, NY Buffalo, NY Mrs. June M. Alker Mr. Donald l. Davis & Mrs. Esther P. Davis Williamsville, NY Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Ralph T. Behling '43 Williamsville, NY Dr. S. Max Doubrava Jr. & Mrs. Joan Doubrava Las Vegas, NV Eggertsville, NY Dr. Pasquale A. Greco '41 & Mrs. Lois J. Greco Buffalo, NY Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '8S Williamsville, NY Dr. Thomas Jr. '60 & Mrs. Barbara l. Guttuso San Mateo, CA Mrs. Marjorie B. Eckhert Dr. Willard H. Boardman '44 & Mrs. Jean E. Boardman '48 Buffalo, NY East Amherst, NY Ms. Rose M. Ellerbrock Dr. Eugene J. Hanavan Jr. '41 Winter Park, FL Williamsville, NY Buffalo, NY Dr. William M. Chardack Dr. George M. Ellis Jr. '4S & Mrs. Kelly Ellis Mrs. Morris Lamer Gulfstream, FL Connersville, IN New York, NY Dr. Joseph A. Chazan '60 & Mrs. Helen Chazan Mrs. Grant T. Fisher Dr. Eugene R. Minden & Mrs. June A. Mindell Providence, RI Palm Beach, FL Buffalo, NY Dr. Phil Morey '62 & Mrs. Colleen Morey Dr. Philip B. Wels '41 & Mrs. Elayne G. Wels Williamsville, NY Williamsville, NY Dr. Richard J. Nagel '53 & Mrs. Florence T. Nagel Dr. John & Mrs. Deanna Wright Orchard Park, NY Williamsville, NY Dr. Richard B. Narins '63 & Mrs. Ellen B. Narins East Aurora, NY Dr. Albert C. Rekate '40 & Mrs. linda H. Rekate '71 Williamsville, NY Dr. Elizabeth P. Olmsted Ross '39 Buffalo, NY Mrs. Mary Cecina Riforgiato Buffalo, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Orchard Park, NY Dr. Albert Somit Carlsbad, CA Dr. Janet H. Sung & Mr. John J. Sung Clarence, NY Spri11g 2002 Annual Memberships All annual donors of $1,000 or more are granted membership in the]ames Platt White Society. Annual membership in the appropriate circle within the society are granted for one year, beginn ing January 1, for the gifts received the prior calendar year. The roster of the fames Platt White Society "Class of 2001" follows. lullalo Phy sic ian 37 �DEVELOPMENT I jAMES PLArr\VHITE. cosT. Dean's Circle The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Professors' Circle A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporters whose annual gifts range from $5,000 to $9,999. Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Melvin B. Oyster '52 Niagara Falls, NY Mrs. Lidia Hreshchyshyn Williamsville, NY Mr. Donald l. Davis & Mrs. Esther P. Davis Williamsville, NY Dr. Max Doubrava Jr. '59 & Mrs. Joan Doubrava Las Vegas, NV Dr. Janet Sung and Mr. John Sung Clarence, NY Dr. Gordon R. lang '62 Chicago, IL Dr. John C. Newman Lewiston, NY Mr. James I. Stovroff Buffalo, NY Dr. Charles S. Tirone '63 & Mrs. Anne R. Tirone '94 Williamsville, NY Chairs' Circle Fellows' Circle Just as a department chair leads a program, donors of leadership gifts In the range of $10,000 to $24,999 are given special recognition. Fellows within the school are recognized for added depth they bring to postgraduate study. Fellows are honored for gifts that total $2,500 to $4,999. Dr. and Mrs. Ernest Beutner Dr. Willard H. Boardman'44 & Mrs. Jean Boardman '48 N E w Dr. Douglas Sinensky Dr. Jay Belsky' 51 Dr. Roman Cham Williamsville, NY San Pedro, CA La Mesa, CA Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Dr. Richard A. Berkson '72 & Mrs. Andrea Berkson Draper, VA Orchard Park, NY Rancho Palos Verdes, CA Dr. Irving Sterman '64 & Mrs. Gail K. Sterman Mr. Sheldon M. Berlow Dr. Isidore S. Edelman New York, NY Dr. lawrence Golden '46 & Mrs. Nancy Golden '48 Eggertsville, NY Philip D. Morey M.D. '62 & Mrs. Colleen Morey Williamsville, NY Dr. John R. Wright & Mrs. Deanna P. Wright Williamsville, NY Winter Park, FL Dr. Melvin M. Brothman '58 Snyder, NY Buffalo, NY Williamsville, NY Dr. Yong Baek Chi Dr. Martin C. Terplan '55 San Francisco, CA Buffalo, NY Dr. Theodore S. Bistany '60 Scholars' Circle One strength of an outstanding institution is the caliber of those who study there. Scholars within the fames Platt White Society have made gifts to the school totaling $1000 to $2,499 during the past year. Those marked with an asterisk (*) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. Mrs. Joan W. Alford Buffalo, NY Dr. Kenneth Z. Altshuler '52 & Mrs. Ruth Altshuler I uI I a I o n ys i c i a n West Seneca, NY Dr. lawrence B. Bone '73 Dr. Charles Kwok-Chi Chow & Mrs. Patricia Chow Orchard Park, NY Hong Kong Dr. Jerald Bovino '71 Dr. George H. Christ '56 Aspen, CO Largo, FL Dr. Suzanne F. Bradley '81 Dr. Eugene Cisek Whitmore Lake, MI Buffalo, NY Dr. Martin Brecher '72 & Geri Brecher Dr. Mark Comaratta '85 Amherst, NY East Amherst, NY Dr. Harold Brody '61 Dr. Bernice S. ComfortTyran '58 Getzville, NY Los Altos, CA Dr. James B. Bronk '81 & Mrs. Suzanne Bronk Buffalo, NY Napa, CA Dr. August A. Bruno Sr. '51 Buffalo, NY Dr. linda J. Corder Dr. J. Steven Cramer East Amherst, NY Dr. Julia Cullen '49 Buffalo, NY La jolla, CA Dr. Daniel E. Curtin '47 & Mrs. Elaine Curtin Dr. Stanley Bukowski '81 Orchard Park, NY Buffalo, NY Dr. Stanley J. Cyran Jr. '46 Prospect, KY Dr. William S. Andaloro '45 Chapel Hill, NC Dr. David R. Dantzker '67 & Mrs. Sherrye Dantzker Dr. James P. Burdick '75 Roslyn, NY Caledonia, NY Dr. Mark Anders Dr. Douglas Armstrong Buffalo, NY Dr. J. Bradley Aust Jr. '49 San Antonio, TX Lemoyne, PA Hamburg, NY Dr. Charoen & Dr. Charlearmsee Chotigavanich Dr. Jared C. Barlow Sr. '66 & Mrs. Barbara Barlow Thailand Grand fsland, NY East Amherst, NY Dr. William M. Burleigh '67 Rar1cho Mirage, CA Mrs. John Buyers Little Silver, NY Dr. Roger S. Dayer '60 & Dr. Roberta A. Dayer '72 Williamsville, NY Buffalo, NY Dr. Gerard J. Diesfeld '60 Hamburg, NY Dr. David T. Carboy '63 & Mrs. Jacqueline G. Carboy Lincroft, N] Dr. Nancy H. Nielsen '76 Mrs. Agnes T. Baron Orchard Park, NY Snyder, NY Eden, NY Dr. Thomas P. O'Connor '67 Dr. Michael B. Baron '71 Dr. Nicholas C. Carosella '54 & Mrs. Sandra S. O'Connor Blountville, TN Appleton, NY Dr. Paul D. Barry '71 Dr. leonard S. Danzig '51 Dr. Evan Calkins & Dr. Virginia Calkins Dr. Joseph G. Cardamone '65 & Mrs. Susan G. Cardamone 2002 Dr. Prem Chopra Dr. Timothy Bukowski '87 & Dr. Naomi J. Kagetsu '86 Dr. George Bancroft '81 & Mrs. Susan K. Bancroft '79 Spring Lockport, NY Dallas, TX Arlington, VA 38 Buffalo, NY Dr. Helene E. BuergerPeck'56 Dr. Jennifer l. Cadiz '87 East Amherst, NY Dr. Norman Chassin '45 & Mrs. Charlotte S. Chassin Dr. Michael E. Bernardino & Mrs. Joan Bernardino jacksonville, FL Buffalo, NY Eggertville, NY Dr. Yung C. Chan '73 Arcade, NY Mr. James B. Docherty Orchard Park, NY Ronald I. Dozoretz M.D. '62 Falls Church, VA Dr. Robert Einhorn '72 North Brunswick, Nj Dr. Domonic F. Falsetti '58 & Mrs. Margaret Falsetti Lewiston, NY �Dr. Leon E. Farhi & Mrs. Haya Farhi Eggertsville, NY Dr. Carl V. Granger Buffalo, NY Dr. Bernard J. Feldman '66 Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Palos Park, IL Williamsville, NY Mr. Kevin Feor '80 & Mrs. Elizabeth A. Feor '78 Dr. Robert T. Guelcher '60 & Mrs. Elizabeth Guelcher Webster, NY Erie, PA Dr. James R. Kanski '60 & Dr. Genevieve W. Kanski '84 Dr. Gerald L. Logue & Mrs. Joelle Logue Eggertsville, NY Williamsville, NY Latrobe, PA Dr. Steven R. Kassman '87 & Mrs. Jeannine Kassman Dr. Thomas A. Lombardo Jr. '73 & Mrs. Donna M. Lombardo Dr. Margaret W. Paroski '80 Glendale, AZ Dr. Kenneth K. Kim '65 & Mrs. Susan W. Kim Clinton, NY East Aurora, NY Dr. Frank A. Luzi '88 & Dr. Lori Luzi '88 Bethlehem, PA Dr. Robert Joseph Hall '48 & Mrs. Dorothy N. Hall Dr. Francis J. Klocke '60 Dr. Helen Marie Findlay '78 Dr. Albert Schlisserman '77 Houston, TX Chicago, JL Dr. Christopher Hamill '89 Dr. Robert A. Klocke '62 & Mrs. Barbara Klocke Dr. Brian McGrath *Dr. Amy E. Ferry '94 Clarence, NY Dr. John M. Marzo '86 Buffalo, NY Eggertsville, NY Buffalo, NY Dr. Donald Hauler '57 and Mrs. Barbara Hauler Williamsville, NY Buffalo, NY Dr. Ludwig R. Koukal '51 Dr. Susan V. McLeer Pensacola, FL Tucson, AZ Buffalo, NY Dr. Mark Heerdt '51 & Mrs. Lois Heerdt Dr. Joseph M. Kowalski '93 Dr. Harry L. Metcalf '60 & Dr. Kaaren Metcalf '78 Dr. Susan Fischbeck '82 & Dr. Patrick T. Hurley '82 East Concord, NY Dr. Jack Fisher '62 La jolla, CA Dr. John Fisher Buffalo, NY Dr. Thomas D. Flanagan '65 & Mrs. Grace Flanagan '70 Williamsville, NY Dr. William A. Fleming '64 & Dr. Beth D. Fleming '67 Greer, SC Dr. Reid R. Heffner Jr. & Mrs. Elenora M. Heffner Buffalo, NY Amherst, NY Dr. Daniel Kozera '59 Lackawanna, NY Dr. Kenneth Krackow Williamsville, NY Dr. Fredric M. Hirsh '73 & Mrs. Donna A. Hirsh Dr. Jacob S. Kriteman '67 Williamsville, NY Danvers, MA Dr. John M. Hodson '56 Dr. Harold Krueger '51 Williamsville, NY Rockford, IL Buffalo, NY Mr. Paul F. Hohenschuh & Dr. Marjorie E. Winkler Dr. Ivan W. Kuhl '45 Dr. Neal W. Fuhr '52 Burlingame, CA Dr. Marie Leyden Kunz '58 & Dr. Joseph L. Kunz '56 Williamsville, NY Ms. Peggy Hong Dr. Robert Galpin Milwaukee, WI Buffalo, NY Wimberley, TX Lockport, NY Dr. Andre D. Lascari '60 Dr. Penny A. Gardner '69 Dr. Waun Ki Hong & Mrs. Mihwa Hong Los Altos, CA Houston, TX Drs. Laura & Michael Garrick Dr. Bradley Hull '41 Brooklyn, NY Getsville, NY Rocky River, OH Dr. Mark J. Lema '76 & Mrs. Suzanne Lema Dr. Ronald F. Garvey '53 Dr. Hilton R. Jacobson '45 Tyler, TX Lakewood, NY Mr. Warren Gelman '70 Robert M. Jaeger, M.D. '47 Buffalo, NY Allentown, PA Dr. George A. Gentner '41 Dr. Charles Alexander Joy '46 Poestenkill, NY Dr. Sanford E. Left '68 East Amherst, NY Dr. Dolores C. Leonard '87 & Mr. Martin Leonard East Amherst, NY Dr. Eugene Leslie '51 & Mrs. Faith Leslie Buffalo, NY Dr. Robert J. Patterson '50 & Mrs. Patricia M. Patterson Snyder, NY Dr. Norman L. Paul '48 Lexington, MA Dr. Marc S. Fineberg Williamsville, NY Dr. John S. Parker '57 & Mrs. Dorris M. Parker Dr. Joel H. Paull '71 &Mrs. Linda Paull Eggertsville, NY Dr. John H. Peterson '55 East Aurora, NY Dr. Harry E. Petzing '46 Hamburg, NY Williamsville, NY Dr. Daniel Phillips '51 & Mrs. Mary Ann Phillips Dr. Merrill L. Miller '71 Reno, NV Hamilton, NY Dr. James F. Phillips '47 & Mrs. Marcella Phillips Ms. Sounghae Min Korea Buffalo, NY Dr. David P. Mindell & Mrs. Margaret H. Mindell Dr. Matthew Phillips '91 Ann Arbor, M I Buffalo, NY Dr. Anthony V. Postoloff '39 Dr. Maynard H. Mires Jr. '46 Georgetown, DE Williamsville, NY Dr. Richard A. Rahner '58 Dr. John A. Moscato '68 & Dr. Beth A. Moscato '96 Orchard Park, NY Erie, PA Dr. John Y. Ranchoff '52 Fairview Park, OH Dr. John D. Mountain '33 Manhasset, NY Dr. Arthur W. Mruczek Sr. '73 Medina, NY Dr. Bert W. Rappole '66 & Mrs. Mary Helen Rappole jamestown, NY Dr. Frederic D. Regan '45 Boca Rator1, FL Dr. Richard L. Munk '71 Sylvania, OH Dr. Robert E. Reisman '56 & Mrs. Rena Reisman Dr. Masao Nakandakari '55 Williamsville, NY Honolulu, HI Dr. Bernhard Rohrbacher '83 Dr. Richard Narins '63 & Mrs. Ellen Narins Getzville, NY Dr. Richard Romanowski '58 Phoenix, AZ Fairview, PA Dr. Allen L. Goldfarb '51 Buffalo, NY Dr. Herbert E. Joyce '45 & Mrs. Ruth Marie Joyce Dr. Elizabeth P. Olmsted Ross '39 Dr. Michael Gold hamer '64 Dr. Harold J. Levy '46 & Mrs. Arlyne Levy Depew, NY Lockport, NY Dr. Tomoe Nishimaki Buffalo, NY San Diego, CA Mr. Arthur H. Judelsohn Amherst, NY japan Ms. Barbara Mcalpine Gong'90 Buffalo, NY Dr. Seymour J. Liberman '61 Dr. Ralph M. Obler '52 & Mrs. June M. Obler '49 Williamsville, NY Dr. Myron Gordon '48 Dr. Jeffrey Kahler '66 Chapel Hill, NC Albany, NY Dr. Wendy A. Kaiser '85 & Dr. Roger E. Kaiser Jr. '79 Dr. Walter Grand Clarwce, NY Williamsville, NY Williamsville, NY Slwker Heights, OH Dr. Hing·Har Lo '74 Blacksburg, VA Dr. Alice Challen LoGrasso '37 Alameda, CA East Aurora, NY Buffalo, NY Dr. John Naughton Dr. Jeffrey S. Ross '70 Los Angeles, CA Lebanon Springs, NY Dr. Albert G. Rowe '46 Tonawanda, NY Dr. Rudolph Oehm '66 Walnut Creek, CA Dr. Joseph F. Ruh '53 Orchard Park, NY Dr. Kathleen O'Leary '88 & Mr. Michael J. Collins '90 Buffalo, NY Spring 2002 B u If a I o P h y s i c i a n 39 �~ -~ -- ---~ - --- DEVELOPMENT I jA\f ES PLATT W HITE CO"\T. Dr. Edwin A. Salsitz ' 72 New York, NY Dr. Iqbal A. Samad & Mrs. Vicar Samad Williamsville, NY Mrs. Elizabeth Ann Schaefer Snyder, NY Dr. David S. Schreiber '69 Westwood, MA Dr. Fred S. Schwarz ' 46 Buffalo, NY Dr. Molly R. Seidenberg '53 Rochester, NY Dr. Elizabeth G. Serrage '64 Cape Elizabeth, ME Mr. Eugene M. Setel Buffalo, NY Dr. Timothy S. Sievenpiper ' 68 & Mrs. Karen S. Sievenpiper 40 Dr. Daniel J. Tutas Washington Grove, MD Dr. Gregory E. Young '77 & Mrs. Diane Young Dr. John J. Squadrito ' 39 Dr. Salvador M. Udagawa & Mrs. Aurora Udagawa Dr. Wende W. Young '61 Lake View, NY Cmw11daigua, NY Dr. Alvin Volkman ' 51 *Ms. Sandra Yu ' 95 Greenville, NC Malden, MA Dr. Coolidge S. Wakai '53 Dr. Franklin Zeplowitz ' 58 & Mrs. Piera Zeplowitz Albany, NY Dr. Philip M. Stegemann '82 Orchard Park, NY Dr. Morton A. Stenchever '56 Mercer Island, WA Dr. William C. Sternfeld '71 Sylvania, OH Mr. Franz T. Stone Clarence, NY Mrs. Gloria Stulberg Buffalo, NY Dr. Michael A. Sullivan '53 Williamsville, NY Dr. Joseph Tannenhaus '45 Homosassa, FL Dr. Michael Taxier '75 Columbus, OH Dr. Wayne C. Templer '45 Dr. Howard C. Smith '53 Mr. Fritz Terplan Huron, OH San Francisco, CA Dr. James A. Smith ' 74 Dr. James C. Tibbetts '64 Orchard Park, NY Sturgeon Bay, W I Dr. Robert G. Smith '49 Dr. Bradley T. Truax '74 Savannah, GA Lewiston, NY internationally renowned designer of bridges who in 1923 bequeathed nearly $390,000 to UB. Through the years, many generous individuals have been inspired by the same conviction and have elected to build on Hayes' foundation of support. Through their commitment to the university, and through their investment in University at Buffalo, benefactors have taken part in shaping the future of UB and securing its legacy into the next century. I u II a I a n ysic ian S Encinitas, CA Corning, NY This society is named after General Edmund Hayes, an W Dr. Albert Somit East Aurora, NY The Edmund Hayes Society E Several of the Medical School's friends and alumni have joined the Edmund Hayes Society, demonstrating their support of our school by including the UB School of Medicine and Biomedical Sciences in their estate plan. If you are interested in becoming a member of the Hayes Society, you can contact our planned giving department at (7 16) 645-3312. Dr. Frances R. Abel Mrs. June M. Alker Dr. Charles A. Bauda Dr. John T. Cangelosi Spri11 g 200 2 Honolulu, HI Dr. Richard D. Wasson '58 & Mrs. Janet Wasson Holland, NY Buffalo, NY Holiday, FL Dr. David C. Ziegler '64 & Mrs. Susan D. Ziegler Dr. Arnold Wax '76 Walnut Creek, CA Henderson, NV Dr. Charlotte C. Weiss '52 & Dr. Hyman Weiss Highland Park, N] Dr. Paul H. Wierzbieniec '74 & Ms. Ellen Wierzbieniec Buffalo, NY Dr. Gary J. Wilcox '73 Carlsbad, CA Special Members A few individuals and couples were gra nted multi-year memberships based on generous gifts made between 1989 and 1993. Dr. Myron E. Williams Jr. ' 46 Batavia, NY Dr. Richard G. Williams '80 Clearfield, PA Mr. Ralph C. Wilson Jr. Orchard Park, NY Dr. Robert Bernot '60 & Mrs. Carol Bernot North Hills, NY Dr. Marvin Z. Kurian '64 & Mrs. Eleanor Kurian Williamsville, NY Dr. Stanley B. Clark Dr. Richard F. Kaine Mrs. Edith Corcelius Dr. J. Walter Knapp Dr. Linda J. Corder Dr. Harold J. levy Dr. Julia Cullen Dr. Sanford H. levy Dr. Thomas G. Cummiskey Dr. Milford C. Maloney & Mrs. Dione E. Maloney Mr. Edward l. Curvish Jr. Dr. leonard S. Danzig Dr. Melvin Oyster Ms. Rose M. Ellerbrock Dr. George M. Ellis, Jr. Mrs. Grant T. Fisher Dr. Jack C. Fisher Dr. lance Fogan Dr. Ronald F. Garvey Dr. Pasquale A. Greco Dr. Glen E. Gresham Dr. Eugene J. Hanavan Jr. Dr. David M. Holden Dr. Hilliard Jason & Dr. Jane Westberg Dr. Kart l. Manders Dr. Benjamin E. Obletz Dr. Richard A. Rahner Dr. Albert C. Rekate Dr. Myron G. Rosenbaum Dr. Elizabeth P. Olmsted Ross Dr. Daniel S. P. Schubert Dr. Albert Somit Dr. Eugene M. Teich Dr. Pierce Weinstein Dr. John R. Wright & Mrs. Deanna Wright Dr. Wende W. Young �Dear Fellow Alumni, nother Spring Clinical Day and Reunion Weekend has comeai1d gone, the success of which will be reported on in detail in the summer issue of Buffalo Physician. As I close out my two-year term as president of the Medical Alumni Association (MAA ), l feel I would be remiss not to thank some of the people who have made my job very easy, including Nancy Druar, our longtime secretary, and Mary Glenn, director of constituency relations and the school's liaison with our association, both of whom have greatly assisted me. I also want to thank all the current and past MAA board members and my fellow officers-Colleen Matti more, MD '91, and Stephen Pollack, MD '82-for the help they have lent toward making the different activities we had throughout the year very successful. I appreciate everything you have done for the association and for the school. In my final message as president, l would like to remind you of the three major awards the MAA bestows on our fellow alumni throughout the year. I think that these awards are very special and that more of our alumni need to know the criteria for nominating individuals to receive them. The Distinguished Alumn us Award, our most prestigious award, is presented each September at the dinner for past presidents. The qualifications for the award are an alumnus who has distinguished himself or herself nationally or internationally among peers and who has made an outstanding contribution to medicine or to the arts and humanities. The Med ical Alumn i Ac hievement Awa rds and the Robert S. Berkso n Memorial Award are the other two awards, which are presented during Spring Clinical Day in April each year. The achievement awards are presented to alumni who have shown conspicuous and outstanding achievement in one of the following areas of medical endeavors: teaching, research, innovation, practice, service, and medical administration. Traditionally, these awards are given to alumni celebrating their reunions that year so that their classmates and friends can join with them in celebrating their success. The RobertS. Berkson Award has been presented since 1988 in memory of Dr. Berkson, a wellknown internist in the Western New York community. It honors a physician who has performed his or her teaching responsibilities in an outstanding manner during five or more years on the volunteer teaching faculty and who combines scholarship and compassion in a way that elevates medicine, in its best sense, from a science to an art. Because I am sure there are many deserving alumni who have not yet been recognized by our association, I encourage you to write to the MAA office to nominate a peer for one of these awards. If you prefer to send your nominations via e-mail, they can be forwarded to Mary Glenn at glenn@acsu.buffalo.edu. In closing, I would also just like to put one more plug in for all eligible candidates-medical school alumni, faculty, PhD graduates and emeritus professors-to join our association and, if you are able, to become a lifetime member. Again, thank you for the honor of allowing me to serve as your alumni association president. 4d14eft4·? BooL,~:~ JoHN J. ' 76 President, Medical Alumni Association S prin g 20 0 2 Buffalo Physician 4 1 �~~- ------- C L A SNOTES 1940s Raymond Bondi, MD '44, writes: "Enjoying salubrious and warm South Florida. I even exercise daily, with a knife and fork." 1950s Joseph F. Ruh, MD '53, writes: "I retired from the office in 1996, but am working at the hospital one day a week doing GI endoscopy." E-mail address is joe@ruh.net. Over the years, Bell has been nationally recognized for his extensive work in promoting women's health issues, particularly familycentered OB care. In 1980, he pioneered the certified nurse mid- University of California, Irvine. Michael I. Weintraub, MD '66, FACP, FAAN, writes: "I am in full-time private practice of neurology and pain medicine. Currently, I am performing clinical research with dia- Medical Center in Anaheim, CA. At that time, betic peripheral neuropathy and carpal tunnel syndrome with alternative modes of therapy; i.e., magnetic therapy and laser therapy. I have over 190 publications, James Youker, MD '54, it was the first such pro- and recently I edited a writes: ''I'm still working gram within the Kaiser book, titled Alternative and chair of radiology at the Medical College of Wisconsin. In March 2002, I finish my two- system and one of the first in the nation. and Complementary Treatment in Neurologic Illness (Churchill Livingstone, 2002). Presently, I am clinical professor of neurology and medicine at New York Medical College and ad- wifery program at Kaiser Jacob (Jack) Lemann Jr., MD '54, New Orleans, LA. E-mail address is dr.jack@lemann.net. year term as president of the American Board of Medical Specialties." E-mail address is: jyouker@mcw.edu. 1960s Kenneth Bell, MD '61. After 33 years as a Kaiser Permanente obstetrician and gynecologist, including the last 14 years as area medical director for the organization in Orange County, CA, Bell retired from the Southern California Permanente Medical Group on December 31, 2001. 42 assnotes luff al a Ph ysici an Pemlallel1te In 1997, he was honored with the prestigious Mentor in Medicine Award from the March of Dimes for his commitment to and leadership in the community and the healthcare industry. While Bell is retiring from Kaiser Permanente, he is not giving up his work as a medical administrator. On January 2, 2002, he stepped into his new role as CalOptima's chief medical officer (Cal-Optima is Orange County's Medi-Cal managed care program). He also serves as clinical professor at the Spri11g 2002 junct clinical professor of neurology at Mount Sinai School of Medicine in ew York City." from 1987 to 1990." E-mail address is andyandcarole@netzero.net. E-mail address is: miwneuro@pol.net. Barry Schultz, MD '&B. John R. Anderson, MD '67, Wyomissing, PA, writes: "After a year at sea, I spent the next year doing Depew, NY, writes: "In 1998, I retired nothing but vasectomies 16/day, 5/day week. Then from Brothers of Mercy Hospital, where I was I went into urology at the University of Connecticut with classmate Bruce Stoesser. I am now chief medical director. From 1999 to 2001, I taught anatomy and physiology and medical terminology at Bryant & Stratton. Currently, I work as a program physician two days a week at UB's Research Institute on Addictions. I had two teaching degrees before earning my medical degree, and would love to teach in the medical school again, as I did of urology at the Reading Hospital and Medical Center in my hometown. I am past president of the Urological Association of Pennsylvania. I may slow down a bit after I get new knees." John Fisk, MD '69, profes- sor of surgery at Southern Illinois University School of Medicine, was �HUNT Since 1911 elected in january 2002 to a two-year term as chair of the board for the U.S. members of the International Society for Prosthetics and Orthotics. Hunt Relocation Center 1970s Donald H. Marcus, MD '71. Northridge, CA, writes: "! have just been reelected to the board of directors of the Southern California Permanente Medical Group for my seventh three-year term. My daughter Elizabeth is in her second year at the University of Southern California School of Medicine." Diane L. Matuszak, MD '74, MPH, was appointed director of Community Health Administration in the Maryland Department of Health and Mental Hygiene, effective December 26, 2001. This administration oversees all local health departments and statewide programs for Epidemiology and Disease Control (including bioterrorism), Food Protection and Consumer Health Services, Environmental Health and Health Planning. E-mail address is dmatuszak@home.com. Greg Antoine, MD '76, writes: "! am the new chairman of plastic surgery at Boston University School of Medicine. I am board certified in plastic surgery and otolaryngology. I specialize in congenital and posttraumatic facial reconstruction. I retired as a colonel from the Army and was formerly on the faculty at Case Western Reserve University School of Medicine. My son Elliott's high school football team won the Ohio State Division I championship. My daughter, Tai, graduated from Dartmouth, and my son Greg got a master's degree from the University of Miami, both in june. I am sad to hear that UB lost its otolaryngology residency program. Jane (King) Dorval. MD '76, was recently elected chair of the Rehabilitation Accreditation Commission's (CARF) board of trustees for the 2002 term. CARF is a private, nonprofit organization that promotes quality rehabilitation services by establishing standards of quality for national and international organizations to use as guidelines in developing and offering their programs or services to consumers. CARF standards are developed with input from consumers, rehabilitation professionals, state and national organizations and those funding the process. There are more than 26,000 medical, behavioral, employment/ community services, adult day services and assistedliving CARF-accredited programs in the U.S., Canada and Europe. As a board-certified physiatrist, Dorval is currently senior vice president of medical affairs and quality oversight at Good Shepherd Rehabilitation Hospital in Allentown, PA. She is also a division chief of rehabilitation medicine at Lehigh Valley Hospital, also in Allentown, and a clinical associate professor on the faculty of Pennsylvania State University School of Medicine in Hershey, PA. Totally customized service portfolio including • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour · A complete cost of living analysis • A list of all school systems and administrators throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured We don't just move people... We help people move. Call for a free relocation portfolio regarding your destination city. Call 1-800-888-1170 or go on-line and visit our web site at huntrealestate.com Ira Salom, MD '77, has been appointed to the ew York State Board of Medicine, in the Office of the Professions, State Education Department, to serve on license restoration and moral fitness hearing panels. Mary Croglio Corporate Relations Officer Hunt Relocation Center 5570 Main Street Williamsville, NY 14221 -5410 Email: huntrelocation@huntrealestate.com S p r in g 2002 8 u f fa I o Physician 43 �CLASSNOTES Fred H. Geisler, MD '78, publ ished three papers on the natural evolution and treatment of spinal cord injury in the December 200 I issue of the journal Spine. He works in the Chicago Institute of Neurosurgery and Neuroresearch, specializing in spinal instrumentation. E-mail address is: fgeis ler@co ncen tric. net. Leigh Lachman, MD '78, writes: "I live in New Jersey and practice in Manhattan . I am boarded in both otolaryngology and ,;._..;. genera l plastic surgery. I'm married and have three children: two girls, ages 10 and 17, and a boy, age 13. I truly miss those days and parties in medical school. I'd be happy to hear from my friends, who can e-mail me at devilsrul9@aol.com. " Roger E. Kaiser, Jr, MD '79, has been appointed medica l di rector of the Erie County Medical Center (ECMC) Hea lthcare Network. The network encompasses a base of off-campus health centers, an advanced academic medical center with 500 inpatient beds and 156 skilled nursing home beds, and the Erie County Home, a 638-bed skilled nursing facility. Kaiser, who has served as clinical director of the Department of Anesthesia!ogy (1989-present) and as attend ing anesthesio logist ( 1983-present) at ECMC, will continue to It is never less than 94% efficient at trapping particles as small as 0.35 micron. No other whole-house air cleaner can reach more that 70% efficiency on these t 7/EA~lNG BILLS TOO HIGH? Plan ahead and consider updating your heating equipment with a natural gas furnace Just because you have allergies doesn't mean you have to suffer. The Ap rilaire® High Efficiency Air Cleaner is up to 99% efficient at removing allergy-causing sym ptoms from the air in your home. So not only does it relieve your allergies, it also removes airELECTRONIC AIR CLEANERS borne dust and dirt, making your Nobody Makes Clean Air Easier" home Cleaner. e® H & Q HEATING & AIR CONDITIONING " Where Quality Means Quality " • INSTALL HEATING & AIR CONDITIONING SYSTEMS • SERVICE & REPAIR • AIR CLEANERS & HUMIDIFIERS 830 1575 • FREEESTIMATES • FULLYINSURED • • CARBON MONOXIDE TESTING Call George Hoage - References Upon Request NATURAL GAS YOUR BEST ENERGY VALUE 44 Buffalo Phys i cian Spring 2002 practice in these capacities. He also concurrently serves as medical director at the Western New York Center for Ambulatory Surgery (2001present) and is associate professor of clinical anesthesiology (1993present) for the University at Buffalo's School of Medicine and Biomedical Sciences. Kaiser is a member of the American College of Physician Executives, Society of Critical Care Medicine, American Society of Anesthesiologists, and In- ternal Anesthesia Research Society. 1980s Frank W. Sanchez, MD '8D, writes: "I am in my sixteen th year of practice in interventional radiology. l am president of the medical staff at Memorial Hospital in Jacksonville, FL. I had a great time at the 20th reunion in spring 2000." John Claude Krusz, PhD, MD '83, Dallas, TX, was elected vice president of �~-~~--~ the American Board of Electroencephalography and Neurophysiology (ABE ), which administers board certification exams in EEG. Krusz recently cofounded the ational Deaf People's Institute, a nonprofit organization dedicated to providing clinical services to the deaf and hard of hearing. E-mail address is nodynia@ swbell.net. Joseph Carrese, MD '84, MPH, Ellicott City, MD, writes: "I was recently ~- ----- promoted to associate professor of medicine at The johns Hopkins University School of Medicine (November 2001), and am a core faculty member of The johns Hopkins University Bioethics Institute. " E-mail address is: jcarrese@jhmi.edu. - physician assistant. We also expanded our office. John R. Fudyma, MD '85, l continue to enjoy the full spectrum of family ciate medical director of the Erie County Medical care, including obstetrics. My spare time goes into maintenance of home, yard and kids. Rachel ( 16) is hoping to drive soon. jacob (12) is work- work. Fudyma is currently associate professor of clinical medicine in internal medicine ( 1998- Benson Zoghlin, MD '84, ing on preparing for his bar mitzvah. Mindy, my wife, is practicing law Hilton, Y, writes: "Our family practice group expanded again and working on her second-degree belt in lsshin Ryu Karate." E-mail last year to five full-time docs, one part-time (my semi- retired dad) and a address is: drben862 @aol.com. has been appointed asso- Center Healthcare Net- present) and associate ties, including assistant program director of the Internal Medicine Residency Program A ( 1996present) through the University at Buffalo's program director (19951996), assistant clinical professor ( 1991-1998), clinical instructor ( 1989-1991 ) and clinical School of Medicine and Biomedical Sciences. He assistant instructor (1985- 1989). The ECMC has also served in other university faculty capaci- Healthcare Network encompasses a base of Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, while addressing your needs and desires for a worry-free future. Call today for your personal tour. Western New York's first Life Care Community. ~nterbury 1JJoods @l ~~-::.~ Call716/929-5817 for your personal tour.. . 705 Renaissance Drive Williamsville, New York 14221 S prin g 2 0 02 Bu f f a I a Phys i cia n 45 �CLASSNOTE off-campus health centers, an advanced academic medical center with 500 inpatient beds and 156 skilled nursing home beds, and the Erie County Home, a skilled nursing facility. Kathleen O'Leary, MD '88, has been appointed director of the Operating Room at Roswell Park Cancer l nsti tu te (RPCI ). In her new position, O'Leary coordinates the scheduling, staffing and day-today adm I IllStration of the seven operating rooms at RPCI, in which 3,500 procedures are performed annually. O'Leary joined the faculty of the Department of Anesthesiology and Pain Medicine at RPCI in 1992. She has served as medical director of the PostAnesthesia Care Unit (1993-1995); medical director of the Respiratory Therapy Department (1993-1995); director of resident education in the Department of Anesthesiology ( 1994--1997); chief of surgical anesthesia (I 997); and vice chair of the Department of Anesthesia (2000.) Howard Chang, MD '89: Dawn and Howard are pleased to announce the birth of Katherine Mei Chang on December 17, 2001. She weighed in at 5 pounds, 13 ounces, and was 17.5 inches long. Baby Kate is blessed with lots of beautiful, silky black hair and has features similar to that of her sisters, jenny and Marisa, who are thrilled with their new baby sister. town Seattle. Our three girls keep us very busy and sleepless ... (in Seattle!) ." E-mail address is longomc@aol.com. IIana Feinerman, MD '93, writes: "My husband , Cary, and I have settled in Dartmouth, MA. I have just become a partner in my practice. We have a son, jeremy, who is a green belt in tae kwon do. Our daughter, Emily, is two, and our 1990s third baby is on the way. " Marie Christine Longo, MD Lisa F. Keicher, MD '93, '92, writes: "Mike and I are happily transplanted in the Pacific Northwest-great outdoors-and we both have great jobs in down- writes: " Last summer my husband, Steve, and I experienced the greatest and most rewarding adventure of our lives! We In Men1orian1 SPRING 46 traveled halfway around the world to Kazakhs tan, where we adopted our beautiful son, Eli Sergei! He is now a healthy, thriving one year old who is the love of our lives! We continue to live in Verona, NY, where I practice general pediatrics, and my hubby, veterinary medicine. " E-mail address is scneth@dreamscape.com. CONTINUED ON PACE 48 2002 Marvin L. Amdur, MD'36 Buffalo, NY, from early tions. He frequently deliv· two sisters, Adele "Ettie" childhood. Following gradua- ered expert testimony on Brock and Genevieve ing Long Island University, Marvin L. Amdur, MD '36, tion from the then-University and wrote about toxic expo- "Shaney" Cohen of Helfert achieved distinction emeritus professor of Social of Buffalo School of Medi- sure to substances, includ- Rochester, NY, six grand· by graduating from the and Preventive Medicine in cine, he practiced occupa- ing lead and asbestos. In children and two great- then-University of Buffalo the University at Buffalo tiona! medicine and was the mid-1980s, a lifelong grandchildren. Dental School in 1934 and , School of Medicine and Bio- director of the Buffalo interest in art led Amdur medical Sciences, died on Industrial Medical Center back to UB, where he stud- sors, from UB's Medical JanuarY 18, 2000, in San at 755 Tonawanda Street, a ied with the artist Harvey Irving Helfert, DDS,MD'36 Diego, CA. Amdur, 86, was private group practice (with Breverman. In later years he a pioneer in occupational Drs. Robert A. Caputi, also developed his skills on medicine and an expert on Harold L. Graff and John N. the organ and piano. In ad- toxic exposure in the work· Strachan) for 50 years be- dition to his wife, Myra, place who, in his 70s, re· fore retiring. Amdur served Amdur is survived by a turned to college to earn a as a consultant to industrY, daughter, Susan Hayman of degree in fine arts. A native federal and state govern- San Diego, CA; a son, Dr. of Erie, PA, Amdur lived in ment and private organiza- Mark Amdur of Chicago, IL; la ff al1 Physician Spring 2002 Hall High School and attend· by invitation of the profes- Irving Helfert, DDS, MD '36, died on December 10, 2001, at age 90. Born and raised in Brooklyn, NY, Helfert was the son of a well-known New York tailor of fine men's clothing. After graduating with honors from Erasmus School in 1936. Helfert was chief resident in urology at Columbia University and assisted in the advanced development of the well-known Gomco Clamp circumcision tool. He was board certified in urology, a Fellow of the Ameri- �I CONTINUED FROM PAGE 46 can College of Surgeons and a Fellow of the International College of Surgeons. grandson Dylan B. from Niagara Falls High 1930s and later the railway surgeon from 1956 to 1981, Swerdlow; sisters Gertrude School in 1942. He attended mail service. During World with offices in the San Tarnower and Rena Rifkin, the then-University of Buf- War II, he served in the Fernando Valley, CA. He is and former wife Sylvia falo for premedical and Army Corps. Upon discharge survived by his wife, Helen. medical school studies, from the military, Erickson Dinhofer Helfert. Helfert moved to Day· ton, OH, in 1943 and served as chief of staff and chief of Amo John Piccoli, MD'46 surgery at St. Elizabeth and Amo John Piccoli, MD '46, Good Samaritan Hospitals. died February 19, 2000, in Shortly after World War II, Fort Myers, FL. He was 77. at the request of the U.S. Piccoli, originally from Roch- Government, he was one of ester, NY, received his the first doctors to adminis· bachelor's degree from ter penicillin to civilians. If a Cornell University and his patient could not afford life· medical degree from the saving surgery, Helfert was then-University of Buffalo. known to accept homemade He completed his training pies in lieu of payment and and residency at the Roches- was remembered as a ere· ter General Hospital and ative, caring and beloved served as a major in the U.S. doctor who found tremen· Army during World War II. dous satisfaction in helping Piccoli practiced internal people from all walks of life. medicine at Rochester Gen- In 1971, he moved to eral Hospital until retiring in los Angeles, CA, and joined 1990, when he moved to the Sherwood Trimble Medi· Fort Myers. cal Group with the intention He was a member of the of practicing urological Monroe County Medical So- medicine with his son, Cap· ciety, New York State Medi- tain Bruce Stephen Helfert, cal Society, New York State MD, who died in 1972. Society of Internal Medicine, While in practice in Califor· the American College of nia, Helfert trained young Physicians and the Roches- doctors in Mexico and Cen· ter Academy of Medicine. tral America for City of Hope Piccoli is survived by his and donated time to the La· wife, Bess (Gioia), and a guna Beach Free Clinic. In daughter, Julie Margaux 1976, he retired and moved Kelleher. to Laguna Hills, CA, with his second wife, Gertrude Kolbert Helfert, who passed away in 1995. Helfert is survived by his children, Jay Helfert and Carole Helfert Aragon and son-in-law, Audie Aragon; grandchildren Heather Helfert Swerdlow and her husband Aaron Swerdlow and Breanna Helfert; great- graduating in 1948. He entered UB's medical served a general surgery school, after which he in- residency at the former E. J. terned in San Mateo, CA. Meyer Memorial Hospital in Buffalo and completed his training, he opened a gen- training at Veterans Hospital eral practice in Hemet, CA. in Omaha, NE. Graff In 1954, he left his practice enlisted in the Air Force in to work for the Dade County 1952 and was stationed at Public Health Department in Mitchell Air Force Base on Miami, where he remained long Island, where he was untill961. During that chief of surgery. There, he time, Erickson worked in the met Mary Ellen White, a field trials of a then-new registered nurse, and the oral vaccine against polio· couple were married in myelitis and earned an MPH 1955. They returned to degree from Tulane Univer- Buffalo, where he practiced sity. In 1961, he moved to general surgery at Kenmore Crescent City, Fl, where he Mercy Hospital and occupa- practiced for a year before tional medicine at Buffalo moving to De land, where Industrial Medical Center he practiced until his retire· until he retired in 1997. ment in 1977. Erickson is Besides his wife, he is survived by a son, Jonathan, of Madison, WI; a brother, Deborah, of San Clemente, Charles G. Erickson, of CA; and three brothers, Williamsville, NY; and a Sanford and Harry, both of sister, Marie T. Erickson, Amherst, NY, and Herman of of De land, FL. George Erickson, MD'49 died June 12, 2001, of complications related to Alzheimer's disease. He was 70. According to his oncology colleagues at the Uni· versity of Nebraska (UN) Medical Center, Foley strove to provide the best care possible to his patients and to keep up with research; but it was in helping to train future oncologists that he took the most pride. A native of Buffalo, NY, Foley was first in his graduating class at the then-University of Buffalo in 1955. He later earned a doctorate from the University of Minnesota School of Medicine. He joined the UN Medi· cal Center as an assistant professor of internal medicine in 1963 and was named a full professor in 1968. He Hospice Program from 1977 Gertrude Waite DeLaney, MD '50 to 1990. In 1994, he was Gertrude Waite Delaney, among 29 Nebraska physi· George MD '50, died in Tampa, Fl, cians selected for the book Erickson, on April 18, 2001. Best Doctors in America. WilliamS. Glassman, MD '51 wife, Janet; three sons, Harold L. Graff, MD '48, a gust 8, retired general surgeon, 2001, in Foley is survived by his MD '49, died unexpectedly on August De land, Fl, where he lived 27, 2000, at his summer since 1962. He was 90. A home in Rose Hill, Ontario. graduate of South Park High He was 75. in Buffalo and Canisius Col· NY, Graff grew up on Memo· John F. Foley, MD '55, also served the University Niagara Falls. died Au· rial Parkway and graduated survived by a son, Matthew George Erickson, MD, PhD, of Amherst, NY; a daughter, Harold L. Graff, MD'48 Born in Niagara Falls, Upon completion of his John F. Foley, MD'55 lege, Erickson worked in the Bethlehem Steel Works in lackawanna, NY, in the William S. Glassman, MD '51, died November 8, 2001, in las Vegas, NV. Glass- Peter of los Altos Hills, CA, David of Fairview Heights, ll, and James of Petaluma, CA; and three daughters, Sharon of Milwaukee, Judy of Schaumburg, ll, and Susan of los Angeles. man was a general Spri11g 2002 I u f I a I o Phy si ci a n �Which can you afford to waste? BENEFITS FEATURES E-mai I CONTINUED FROM PAGE 46 C. White, MD. DDS '93, writes: "! am practicing emer- gency medicine in Ravenna, OH. I am a partner in PES, Inc. and have been practicing at Robinson Memorial Hospital since 1997." E-mail address is CRW36@aol.com. • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts are delighted to announce the birth of our daughter, Naomi Hahna Kissel, on April12, 2001. We make Madison, WI, our home and would welcome visitors." E-mail address is: jsbae22@hotmail.com. • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master Pamela (Crowell) Grover, MD '98, writes: "Last year I • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Gain peace of mind from • Practice management with knowing that your finances are professionally trained staff and being managed optimally experienced C.P.A.'s Thomas A Maher, C.P.A. President MEDICAL BILLING SPECIALISTS 50 Alcona Avenue Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com Gregg Kissel, MD '97, and Jean 8ae, MD '97, write: "We graduated from the University of South Florida/ Morton Plant Mease Family Practice Residency Program and was the recipient of the Outstanding Family Practice Resident Award. I am currently a junior faculty member for the program and will be completing my fellowship in Faculty Development at the Michigan State University Primary Care Faculty Development Fellowship in june, 2002. I am also medical director for the Turley Family Health Center-the outpatient site for our residency program. On May 27,2001, my husband, Will, and I were married at Letchworth State Park, NY." E-mail address is pgrover@tampabay.rr.com. Hannah loon, MD '98, writes: " ! was married to Steven lsserman on November 17, 2001. After a brief honeymoon in Hawaii, I've resumed my duties as chief resident in anesthesia at Massachusetts General Hospital. I am anticipating starting an ICU fellowship at MGH in August 2002." E-mail address is: HToon@massmed.org. 2000s Steve Ambrusko, MD 'DO, writes: "My wife, Amy, and I are doing well and are very excited about our baby on the way, due in June 2002. Otherwise the pediatric residency is going very well." E-mail address is sj_ambrusko@hotmail.com. CD 48 luffalo Physician Spring 2002 �Nineteenth-century shagreen leather lancet case with four tortoise-shell handled blades. Knives such as these were used to bleed patients. After applying a tourniquet, the physician would cut a vessel, usually a vein, with the lancet, which he carried in a case. (Shagreen is a dyed, untanned leather or sharkskin.) The instrument is part of the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences Library, Abbott Hall, on the University at Buffalo's South Campus. �~-----------' p H A c. r~rsc CA HY GEAR Y 1E LTH 1 30 ~a )JU T ~ ~==~--~=====- C SCIE~Ct OTT H LL L I~R RY I A C A~PJS PUS M~I L UB's HISTORY Of MEDICINE COLLECTION PRESENTS PHARMACOPOEIA Th is illustration was digita ll y reproduced from offizinellen Gewachse , a four - volume edition of pharmaceutical plants a and their medicinal uses , published in German in I 863. The pharmacopoeia by Otto -Karl Berg (I815 () c ~~afl~ .. ~ I866) is part of the Rob ert L. Brown History of Medicine Collection , located in the Abbott Hall ~ Health Sciences Library. Pi ctured is the Cherry Blossom , one of a series of botanical images digi tally r estored as part of an initiative to preserve a nd highlight unique re sources from the library' s coll ection. R e production s are avail a bl e for purchase through the library , and ca n b e viewed onlin e at iMedia. buffalo. edu/ art/ . Image restoration was performed by iMedia , the instructional media ser vices department of Computing and I nforma tion Techno logy, Univer sity at Buffalo . c BP o no 2- 0 2 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n04-2002-Spring Table Of Contents A list of subunits of the resource. Minimal Access Surgery for Kids A Place for Business in Medicine Imaging and Imagination Research Medical School Alumni Pathways Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1f9f80a7249cf0b628331132b008c118.pdf 9268fd1e42601b3a68ca00d9a0a7516d PDF Text Text �l1ffal1 P~ysicial ASSOCIATE VICE PRESIDENT FOR UNIVERSITY CoMMUNICATIONS Dr. Carole Smith Petro DIRECTOR OF PERIODI C ALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stephat~ie A. Ut~ger ART DIRE C TOR & DESIGN Ala"]. Kegler School of Medicine and Biomedical Sciences graduated its ! 56th class, m arking yet another chapter in the histo ry of one of the oldest institutions of m edi cal edu cation in o ur coun tr y. Anyone familiar with o ur school's histo ry knows that its lo ngevi ty is d ue to both an adherence to trad ition and an adaptability to change. While the graduation ceremony fo r the Class of 2002 paid tribute to trad it io n, this year's incoming class paid tribute to change by bei ng the first group of students to complete a year of study in our new curriculum. Th is new curriculum , which is essen tia l to our rem ai ning at th e cutting edge of med ical educatio n, is a change that the students, for the most part, took in str ide, giving DESIGN ASSISTANT Karen Liclwer CONTRIBUTING WRITERS Lois Baker and Ellen Goldbaum PRODUCTION COORDINATOR Cynthia Todd-Flick U NIVER S ITY AT BUFFALO S C HOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean us reason to believe that we have gotten off to a good start in what we EDITORIAL BOARD know will be an o ngo ing process of refi nement. While it is imperative that we immerse our students in the most modern and effective curricul um possible, it is equally important for us to turn our attention to other ways we can support their medical school experience. This support can be demo nstrated in a num ber of different ways, including financia l, ca reer and psychosocial counseling, to name a few. The bottom line is that, as educators, we must establish a relationshi p with our students that assures them we are as interested in their success as they are. Programs that support our students require a financial investment, as well as a moral commitment. In looking to the future, 1 anticipate that our school, like most state-assisted schools, will not receive significantly more money from the state than what it is already receiving, which is about 13 percent annuall y. Therefore, if we are to provide a "value- Dr. john Bodki11 Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder 5 Elizabeth Volz, Class of 200 Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. ]ames R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zep/owitz TEA C HIN G HOSPITALS Erie Cout~ty Medical Center Roswell Park Cat~cer lt~stitute Veteratls Affairs Wester" tetll New York Healthcare Sys . I The Buffalo General Hosplta lo The Children 's Hospital of B4f~ Millard Fillmore Gates Hosplta "tal Millard Fillmore Suburban Hospl KAI.EIOA Ht .\ LT H: added" education to ou r students it is clea r that a major issue we must devote our energy to in the years ahead is development and ph ilanthropy. Currently, our school receives about $200,000 a year from its alumni. I would like to see that fig ure rise to $3 to $5 mill ion. It is important that these funds be used to enhance research efforts, to recruit and retain fac ulty, and to bolster a discretionary fund that supports special projects that arise each year. However, I feel it is equally important that we be in a position to use these fu nds to support programs and services that make our students feel that they are having a positive and worthwh ile experience. Also, because the cost of a medical education is only go ing to increase, it is crucial that we be able to provide scholarships to high-quality students who don't have the wherewithal to attend med ical school without financia l assistance. Sr sTE-"' Mercy Health System Sisters of Charity Hospital CA1Hou c H EAI.TII Niagara Falls Memorial Medical Center @ ONIYEISITY AT IUFFllO. TIE STliE UNIYEISITY OF NEW YOlK If we can do these things, then today's students will be motivated to support tomorrow's students, further ensuring the integrity of a med ical school experience that has Letters to the Editor meant so m uch to so many people over the past century and a half. Buffa lo Physician is published quarterly by the University at Buffalo School o f Medicine and Bio medical Sciences In cooperation wi th the Office of Communications. Letters to the Editor a re welcome and can be sent c/o Buffa lo Physician. 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; o r via e-mail to bp-no tes@buffalo.edu. Telepho ne: (7 16) 645-5000, ext. 1387. . The staff reserves the right to edit all submissions for clarity and length. As we look to the future, therefore, I hope that you will join me and others at ou r school to not only help define both short- and long-term goals for how we can enhance o ur students' experiences, but to also provide the resources and support needed to see these plans through to fruition. ) _ R.. ~~£4 ./l_;_ y .i) M I CHAEL E . BERNARDINO. MD . MBA Dean, School of Medici ne at~ d Biomedical Sciet~ces Vice Presidetlt for Hea lt h Affairs T...:.:.... University at auffal~rk ~ TI1e State University ofNeW �VOLUME 37, NUMBER t l p H y c s A N Features Sound Science UB scientists advance our understanding of how we hear and what happens when we don't BY LOIS BAKER AChild Abused, but Not Forgotten Stephen Lazoritz, MD '76, brings the lessons of history home to the present by M .K. Kinnamon David Hojnacki, MD '02, pauses to savor the long-awaited moment on stage at this year's commencement, held on May U . For more on the day'scelebration, turn to page 22. COVER 1& Medicine Taken to Heart-John Canty, MD '79, Albert and Elizabeth Rekate Chair in Cardiovascular Disease 18 Match Day Listing 22 Graduation Day, 2002! 24 jeffrey Sko ln ick amed Director of the Buffalo Center of Excellence in Bioinformatics I LLUSTRATION 30 Presidential Assassinatio ns of the 20th Centuryup Close and Medical Honored for Lifetime Achievement SANDRA 35 Find Your Class and All the Familiar Faces from Your Medical School Days OtONISI 42 News from Your UB Classmates and Other Alumni 49 Spring Clinical Day- a Collage 31 Medical Alumni 2& Carl Granger BY Achievement Awards �B I ILLUSTRATIONS SA ND R A D PHOTOGRAPHY KC 2 BY I 0 N IS I BY KRATT laffafo Physicin y L 0 I I s B A K E R �n this multidisciplinary laboratory, specialists in anatomy, audiology, biophysics, engineering, otolaryngology, pediatrics, neurology, physiology, pharmacology and psychology are conducting studies in hair-cell regeneration, drug therapy and ototoxic drugs, noise-induced hearing loss, middle-ear disease, infant hearing loss, central-auditory system plasticity, mechanical transduction (the fundamental process of transferring sound energy to electrical energy), age-related hearing loss, hormonal influence on hearing loss, and central-auditory processing in the brain. Center scientists have generated more than $12 million in research funding, including a highly competitive $5.7 million multidisciplinary program project grant from the National Institutes of Health awarded in 1999, which focuses specifically on the mechanisms underlying acquired hearing loss. Why is a large segment of the population becoming "hard of hearing?" S umm er 2 00 2 luffal1 Pbysician 3 �BOUT 10 MILLION CAN ATTRIBUTE THEIR LOSS OF HEARING TO NOISE EXPOSURE. Listening to music through stereo headphones at top volume, for example, is as damaging to the auditory system as the thunder of a diesel locomotive. Thirty million people in the U.S. are exposed to similarly dangerous noise levels each day. Infections and some cancer chemotherapy drugs also can cause deafness, but the maJor culprit is Father Time. The National Institute on Deafness and Other Communicative Disorders estimates that 30 to 35 percent of people between the ages of 65 and 75 have a hearing loss. The percentage climbs to nearly 50 percent among those over 75. For much of the 20th century, technology to improve hearing had advanced little beyond the ear trumpet, a large cone-shaped megaphone-in-reverse that was intended to amplify sound. That was state-of-the-art for our hard-of-hearing great-grandparents. Salvi, professor of communicative disorders and sciences, neurology and otolaryngology and director of the UB Center for Hearing and Deafness, says that until the past five to eight years, people looked at hearing loss from a descriptive point of view. "They measured loss-how poorly people detected speech and other sounds, and how well they could hear in a background of noise," he says. "That's been the situation for about the last 100 years." Only within the past two decades have hearing researchers begun to understand that hearing depends primarily on the ability of tiny cilia on hair cells of the inner ear to transform sound-wave energy into electrical energy, and on how accurately the brain receives and translates the resulting nerve impulses. "The big change came with advances in biology and our ability to study how inner-ear hair cells develop, live and die," Salvi says. "A huge amount of work is now being done in that area, and our lab was one of the first to get involved. Hearing research has moved from the cellular to the molecular to the genetic level." Tracing the Path of Cell Death Most cases of hearing loss occur when inner-ear hair cells in the cochlea are damaged or killed. Hair cells transfer their neural activity to the auditory nerve, which carries the nerve impulses to the brain's central auditory system. Considerable research in recent years has been devoted to finding compounds that might protect against hearing loss by preventing hair-cell death or by rescuing and repairing damaged cells. Center researchers, collaborating with colleagues at Roswell Park Cancer Institute, were among the first to study the process of hair cell death-specifically programmed cell death called apoptosis- in inner-ear hair cells. Salvi and fellow center scientists are attempting to determine what triggers the cell-death switch of apoptosis by subjecting cultured inner-ear sensory cells and sensory neurons to known ototoxic drugs- the antibiotic gentamicin and cancer therapy drugs cisplatin or carboplatinand tracking the biochemical pathways involved in cell death. 4 luflal1 Pbysici11 S umm e r 2 00 2 Armed with these findings, the researchers now are using certain drugs to try to block these pathways. The primary candidates are a protease inhibitor called leupeptin and an inhibitor of the tumor suppressor gene p53, which acts a "cell executioner" of sorts. "Gentamicin is used in the U.S. to treat infections that arise in persons with muscular dystrophy and cystic fibrosis and is prescribed extensively in other parts of the �world to treat a wide range of bacterial infections," Salvi says. "Unfortunately, gentamicin causes severe deafness, so there is tremendous interest in finding drugs that block hair-cell death. "We have found that leupeptin does a tremendous job of rescuing cells exposed to gentamicin. In inner-ear cultures, we see 70 percent loss of hair cells without it, but with it we can rescue most of those cells. We've also shown that using a p53 inhibitor, we can block cisplatin toxicity in the inner ear." RI HASHINO, PHD, a center research assistant professor and specialist in neuroscience, is studying the cellular mechanism thought to be responsible for the uptake of gentamicin into the hair cells. Her studies suggest that gentamicin is captured and sequestered in lysosomes (cell components that take up external material in the body) for a period of time before it kills hair cells. This finding suggests that lysosomes may be an important factor in the cell-death process and could be targeted for intervention. Hair-cell death due to noise exposure is the primary focus of the work of Donald Henderson, PhD, professor of communicative disorders and sciences and otolaryngology at UB. He and colleagues are conducting investigations into compounds that may protect the auditory system from too much noise. They have identified and are concentrating on a family of enzymes, some of which trigger the death process and some that execute it. "Now we are trying to trace the pathway of these enzymes to following three to six hours of moderate-level noise exposure. Initial studies indicate that even moderate noise exposure stimulates the repair and replacement of proteins in the inner ear, suggesting that if this repair process can be started early enough, it may be possible to condition the ear against hearing loss. Taggart also is investigating the potential of inherited variation in DNA sequences of the inner ear to influence an individual's susceptibility to noise-induced hearing loss. These studies, which involve U.S. Navy personnel who work in high-noise jobs, are assessing the possible role of genetic variation within the specific inner-ear proteins that maintain cellular homeostasis of the inner ear during and after noise exposure. Taggart is targeting a group of functionally related proteins called connexins that maintain normal functioning within the inner ear and are thought to be linked to noise-induced hearing loss. Hearing loss due to aging, responsible for the largest cohort of the hearing impaired, also may have a genetic component, an avenue Robert Burkard, PhD, professor of communicative disorders and sciences and otolaryngology, is pursuing. "Many hearing losses are genetically programmed to show up later in life," says Burkard. "There is quite a bit of evidence to indicate that age-related hearing loss may be a result of a genetic inability to cleanup free radicals. If we know that the gene turns on at, say, 60, we can be poised to do something ''The big change their starting point," says Henderson. "If we can do this, we can rescue, and perhaps prevent, hearing loss due to noise damage." One enzyme being studied as a possible protectant is gluthathione peroxidase, a compound important for maintaining antioxidant activity, which in turn is essential for combating cell damage from free radicals. "We know noise can increase formation of free radicals in the cochlea," Henderson says. "We are investigating how this enzyme would work as a treatment in humans, and how and when to give the drug." The Genetics of Hearing Loss Center researchers led by Tom Taggart, PhD, associate professor of communicative disorders and sciences, are taking center stage in a new avenue of auditory research: the genetics of hearing loss. UB's center is one of the first to conduct gene-expression studies identifying genes within the inner ear that are up-regulated in response to intense sound stimulation. So far they have identified about 100 genes that increase their expression substantially about it. Once we have ideas concerning the causes, we are in a better position to approach a treatment or cure." Tinnitus from the Brain's Perspective UB researchers have done groundbreaking research into tinnitus, the debilitating phantom sounds known as "ringing in the ears" that plague millions of persons, some to the point of disability. Alan Lockwood, PhD, professor of neurology, nuclear medicine and communicative disorders and sciences, a member of the center faculty and director of operations for DBVeteran Affairs' PET Imaging Center, was the first to identify certain sites in the brain where tinnitus originates. Lockwood, Salvi and Burkard now are studying volunteers who can change their tinnitus with certain eye or jaw movements to define further the brain regions that are involved. They also are investigating the effects of the painkiller lidocaine on tinnitus, as the drug is said to reduce the symptoms by up to 30 percent in some sufferers. S u m 111 e r 2 0 0 2 luff al o Ph pici an 5 �"We are trying to determine what is causing tinnitus from the brain's perspective," says Burkard. "Why is the sound being modified? Do different parts of the brain light up? We're looking for areas less and more active that could be helping turn off tinnitus." Burkard, Salvi and Lockwood also are working with an experimental device that can interrupt or mask tinnitus in some subjects through the use of ultrasonic bone conduction. In a related project, center researchers are capitalizing on PET's ability to track brain responses to stimuli to determine if different brain regions are activated during noise and quiet. The Mysterious, Pliable Brain For other center researchers, studies in the field of brain plasticity have more immediate clinical applications. It is known that the neuronal network responsible for hearing reorganizes itself after damage to inner-ear hair cells-in a system may be important for hearing during noisy situations." McFadden also is investigating the potential role of estrogen as a protectant against hearing loss. Hers is the first study to look at the hormone in this context. Working with chinchillas, she found that noise exposure caused less damage in animals receiving estrogen than in those that didn't. These results suggest that estrogen, like gluthathione peroxidase, may act as an antioxidant. "Men get more noise-induced hearing loss than women, and they experience age-induced hearing loss earlier and more severely than women," McFadden says. "In part, this may be because men are exposed to more noise throughout life. But we are seeing some very similar sex differences in chinchillas." In experiments conducted before and after administering estrogen, she found that the females were less susceptible to noise damage at baseline, and that animals receiving estrogen were less likely to develop hearing loss due to noise. She is now measuring natural estrogen levels in the animals and testing their susceptibility to noise. "Now we are trying to trace sense, changing the channel to get better reception. Burkard says one explanation for this phenomenon may be that somewhere in the brain, the inhibition mechanism that protects the central auditory system from too much stimulus develops a lower threshold when less sound reaches the system. The brain's penchant for reorganizing itself may then explain why people who receive hearing aids or implants often have trouble adjusting to the devices. "When people first try a hearing aid, they frequently don't like it," Burkard says. "We think this is because the brain has already compensated for less stimulus, and when the signal is turned up with a hearing aid, it's bothersome; it helps to explain people's distress. This is why it is really important for people to stay with their devices until the brain once again adjusts to the new stimuli." Sandra McFadden, PhD, research assistant professor at the center at UB, and Henderson have found that a poorly understood segment of the auditory organs called the efferent system may play a role in permanent hearing loss. "The efferent system is the appendix of the auditory system," McFadden says. "We don't really know what it does." natomically, the efferent system is a large bundle of fibers running from the brain to the cochlea that functions as a feedback mechanism. "We' re one of the first laboratories to show that if you cut the efferent fibers in one ear, those ears show more damage from noise," McFadden says. "It appears the efferent 6 luffalo Pbysicin S umm e r 2 0 02 Knowledge is power in nearly every endeavor, and this is particularly true in basic scientific research. Understanding how hearing is lost and how hearing loss can be recovered or prevented will make possible the development of new devices and therapies that will brighten the lives of millions of people. The future for understanding and treating hearing loss and other hearing disabilities looks bright, Salvi says. "Drawing from brain imaging, genetics, neuroscience, molecular biology and biochemistry," he says, "we now have a whole arsenal of weapons at our disposal, ranging from those that allow us to look at acquired hearing loss at the molecular level to those that let us look at the whole brain at once." Great-grandmother, with her ear trumpet, would no doubt be a mazed. CD Additional UB scientists who have contributed to the studies described above include Dalian Ding, Wei Sun, Xiangyang Zheng, MD, and Bo-Hua Hu, MD, all of whom are research assistant professors. For more infonnation on the studies described in this article or other major research advances made at the UB Center for Hearing and Deafness, visit the center's web site at http://wings.buffalo.edulfaculty/research/chdl �SENSORY PHYS I CS AND THE SUBSPECIALTY OF Most hearing research and treatment to date has concentrated on the transmitting of auditory signals to the brain-the How Sound, Taste, PSYCHOACOUSTICS "sending" end. It is possible, however, for people to have trouble hearing even when the sending mechanism is in fine shape. One new and promising field of hearing research focuses on how One of the theories she is following is that during hearing loss, these and where the brain receives and deciphers certain signals from the cells may lose their sensitivity due to lack of stimulation. "This leads us auditory nerve. to address a number of questions," she notes. "How plastic is the David Eddins, PhD, and Ann Clock Eddins, PhD, both associate professors in Communicative Disorders and Sciences By Lois Baker (and also husband and wife), are conducting frontline research in this area within University at Buffalo's Center for Hearing and Deafness. brain? Are the cells in the brain being damaged? If we can provide some other type of stimulation, can they recover? Can we stimulate them in a way that will help them respond better?" In another approach to studying the temporal quality of sound, Eddins is conducting PET studies on human volunteers to observe which parts of the brain are active when exposed to auditory signals and what features of sound prompt the brain to shift focus from one part to another. "We are trying to understand why hearing comes easily when listening to certain aspects of sound, while other aspects are more difficuH," she says. "We've found that processing shifts from one side of the brain to the other, depending on whether you are listening globally, such as to general conversation, or locally, such as to a teacher's instructions." This work may help to explain why a problem student "can't hear" even though a hearing test finds no deficit-there may be a glitch in the central processing. David Eddins, PhD, trained in clinical audiology and experimental psychology, studies how the intensity of a sound varies across different frequencies, a concept called spectral processing. "The ability of the ear to identify peaks and valleys of sound is very important in identifying the characteristics of sound," he says. "Every sound has a characteristic spectral pattern, which helps in identifying They work in the field of sensory physics, which is the study of how the source of the sound and in telling the difference between sounds, sound, taste, smell, touch and vision are perceived, and within this but we don't know how the brain processes this information." larger field, in the subspecialty of psychoacoustics. Eddins bases his research on the earlier work of vision researchers. Ann Eddins, a specialist in auditory physiology, studies the brain's These scientists had shown that the brain breaks down an image into temporal processing of sound, or how sound varies over milliseconds of many different parts, then assigns the parts to specific places in the time. "There is a lot we don't know about how the auditory system codes brain's visual center, where specialized cells tuned to certain spatial time," she says. "Most people are able to process temporal variations in frequencies become excited and create a neural representation of sound, but in hearing loss we think people lose some of this proces- the image. sing abilitY." "This discovery brought a revolution in visual science," Eddins says. This results in sounds being smeared together, especially if the "We think there may be a general mechanism for processing features person is listening in an environment with background noise, Eddins of all stimuli. Are cells in the brain tuned to certain spatial frequencies says, which probably contributes to poor understanding of speech in for hearing? We have found strong evidence of "tuning," and we think the hearing impaired. tuning can be explained by the presence of channels-groups of cells Eddins is studying the question of how the temporal aspects of sound devoted to different spatial frequencies of sound. This provides us with are processed in the brain using several approaches, working with an a basic understanding of how sound is interpreted in the brain and how animal model. On a "global" level, she measures the electrical action this tuning changes with hearing loss. created by groups of cells in the brain, called evoked potentials, during "We suspect that the evidence we and others find in this research sound. This identifies the parts of the brain that are activated. She then will completely change the way we think about how the central-auditory measures responses of single neurons in the regions activated to deter- system works." mine which cells respond to sound duration, or to high or low frequency. Summer 2002 l u ffa l1 Pb ysici a a 7 ��BUT NOT FORGOTTE THE WORK OF STEPHEN LAZORITZ, MD '76, PEDIATRICIAN, CHILD ADVOCATE AND AUTHOR WHEN STEPHEN LAZORITZ, MD '76, FIRST "MET" MARY ELLEN WILSON, IT WAS THE LATE 1960s AND HE WAS A UNIVERSITY AT BUFFALO As UNDERGRADUATE. A STUDENT IN SOCIAL WORK 101 HE LEARNED ABOUT THE 10-YEAR- OLD GIRL, A NEW YORK CITY ORPHAN, WHO HAD SUFFERED HORRIFIC ABUSE AT THE HANDS OF HER FOSTER MOTHER FOR ALMOST EIGHT YEARS. S 11 111 m ,. r 2 0 0 2 llflal• nysicia• 9 �Not FORGOTTEN Mary Ellen was not a modern-day child, however. Born in 1864, she was a child from another century, a time when laws accommodated the rescue of abused animals yet made no provision for rescuing abused children. In 1874, her tragic young life became the subject of one of the most celebrated and important legal cases of its time, a case that led to the establishment of the first child protection agency in the United States: the New York Society for the Prevention of Cruelty to Children (NYSPCC). Lazoritz never forgot the little girl whose suffering resulted in a landmark child protection case. Years later, as a pediatrician with expertise in child abuse, he picked up the thread of Mary Ellen's story and embarked on a 15-year quest to find out more. In 1988, his perseverance and a few serendipitous occurrences yielded a book titled Out of the Darkness: The Story ofMary Ellen Wilson, now in its second printing. A Simple Twist of Fate window, along with books and files, and the crowd chanting 'off Today, as vice president for medical affairs at Children's Hospital ROTC.' Eventually, this and other action by vocal students and in Omaha, Nebraska, Lazoritz can look back on a career in which he faculty led to the program being discontinued." has dedicated more than 20 years to abused and neglected children. As a result, Lazoritz, who had been accepted into the Air Force's Despite this remarkably long tenure in a field noted for its quick pilot training program with high honors, had to decide whether burnout, Lazoritz did not enter college at the University at Buffalo in he would transfer to a ROTC program at another university, or 1968 with a driving desire to become a physician. As an undergrad- stay at UB and declare a new major. Eventually, he decided to stay at UB and pursue studies in sociology and pre-medicine. To catch uate in Air Force ROTC at UB, he had pretty much decided on a career as a pilot. However, his experience as a hospital volunteer up with his coursework in these areas, he attended summer while in high school had also sparked an interest in healthcare, school for two years, an effort that paid off when he was admitted which prompted him to take classes in social work. to UB's School of Medicine in 1972. In his third year of medical school, Lazoritz completed his "UB's social work department back then was radical. And there I was, a politically conservative sophomore in my ROTC uniform," Lazoritz recalls. "So, needless to say, I didn't really fit into social work at that time." pediatric rotation at Mercy Hospital in Buffalo, where he met faculty who inspired him to make a lifelong commitment to working with children. "! had some really great preceptors who had a big influence on my life," says Lazoritz. In particular, he remembers UB clinical professors of pediatrics Although he didn't know it in 1987, t return to Buffalo ing more of the Mary Ellen mystory. Upon learning that the child was ventually placed with a family who lived near Rochester, ew York. he made several trips there to investigate. joseph Mattimore, MD, and Chelikani V. Varma, MD. "These physicians and the staff at Mercy showed me that working with kids was a fun thing to do," he recalls. On-the-Job Training Upon graduation in 1976, Lazoritz began a 10-year stint in the United States military, during which time he served in both the Navy and Army. After completing his residency in pediatrics at the Naval Regional Medical Center in Portsmouth, Virginia, in 1979, 10 Ultimately, anti-Vietnam sentiments on campus culminated in events that forced Lazoritz to make a tough decision about his career plans, a decision that put him on a path to becoming a physician. he began his pediatric career at the Naval Regional Medical Center in Orlando, Florida. "One afternoon a crowd looted the ROTC office in Clarke Gym," he recalls. "! remember a Xerox machine flying out the abused children. A turning point in his exposure to these cases laffala Pbysiciaa S umm e r 2 00 2 As a pediatrician, it was inevitable that Lazoritz would encounter came one day while he was working with a group of psychiatrists �and overlooked documents. During his tenure as assistant professor of pediatrics at the Uniformed Services University in Bethesda, Maryland, from 1981 to 1987, he used his free time to search the Library of Congress for information on her case. Finding newspaper articles from 1874 that documented the court trial was easy, he says, but what he really wanted to discover was who her descendants were and how her life later unfolded. On a trip to the National Archives he met a man who gave him a crash course on how to conduct genealogical research, which led to a major breakthrough. performing evaluations of abused kids in Orlando. "On my first day, I got paged to the emergency room to see a child abuse case, and my boss said, 'Oh, by the way, you're also on the child abuse team,"' recalls Lazoritz. "I found out that Mary Ellen had gotten married, and !learned what her husband's name was," recalls Lazoritz. "Then I started looking through years of obituaries to find out when he died so I could get a list of their descendants." In 1987, Lazoritz, his wife, Mary, and their growing family (which "When I saw that first patient, which was a sexual abuse case, I realized that I didn't know what I was doing, and I knew I had to eventually numbered six children, including a daughter named learn," he continues. "Until the late 1970s and early 1980s, we didn't Mary Ellen) returned to Buffalo, where he joined the UB School of know much about sexual abuse. Those of us working in the field at Medicine and Biomedical Sciences as an assistant professor of the time had to teach ourselves and learn in an informal way from pediatrics, a position he held until 1992. During this time, he also other people who knew what they were talking about." Lazoritz soon discovered that the "other people" who knew what they were talking about often were the allied healthcare professionals involved in the abuse cases. "One of the things that intrigued me most about working in the area of child abuse is that you were a member of a team that could include social workers, psychologists, law enforcement officers, lawyers, or prosecutors. And we all had to share information; this is one of the tenets for this field. For example, early in my career I didn't know as much about child abuse as the social workers, nor did I know about the social work aspects of interven- served as director of pediatrics at Erie County Medical Center, where he established the hospital's first child sexual abuse clinic ing in child abuse cases. I had to learn all this in order to be on common ground with them." (sec related article on page 15). Although he didn't know it in 1987, his return to Buffalo moved To this day, teamwork has remained an integral part of Lazoritz' work ethic. Lazoritz literally closer to solving more of the Mary Ellen mystery. History in the Making In 1980, Lazoritz began giving presentations in Orlando to educate the public about child abuse. One day in 1983 while researching a Upon learning that the child was eventually placed with a family who lived near Rochester, New York, he made several trips there to investigate. Not only did he find Mary Ellen's grave, but he also found a school that was named after one of her daughters, florence Brasser, a renowned teacher in the area. lecture, he again encountered the scant, but extremely moving, In talking with the school's principal, Lazoritz was elated to Jearn details of the Mary Ellen Wilson story. "Right then I decided that I had to know as much as I could about that Florence Brasser was still alive and living in a nearby nursing this girl. It became an obsession," recalls Lazoritz. "I kept thinking information that eventually gave him access to the original files from of her as a child, the way she was in 1874, and I believed there were the Mary Ellen case that were stored in a box in the basement of the NYSPCC in Manhattan. real insights and lessons that could be learned from her story." Lazoritz credits "serendipity and divine providence" for helping him painstakingly reconstruct :V1ary Ellen's history from scattered home. He visited the 86-year-old Brasser and was able to gain "My meeting with Florence Brasser basically unlocked all kinds of clues and information," says Lazoritz. S11mmer 2002 lulfa l l npicill 11 �'ot FORGOTTEN 1 A Chance to Finally Tell Her Story In September 1989, eager to share his latest findings on the case, Lazoritz published "Whatever Happened to Mary Ellen?" in the journal Child Abuse and Neglect. A subsequent article about her in American Heritage magazine, which mentioned Lazoritz's research, caught the attention of Eric Shelman, a playwright and fiction writer who lived in Southern California. Shelman had earlier become interested in Mary Ellen's story after reading about her case in a book of little-known facts. In 1991, Shelman contacted Lazoritz via e-mail and the two men began communicating by phone and computer. Eventually they decided to combine their talents to finally tell Mary Ellen's story. "I did most of the research and some of the writing; Eric did the majority of the writing," says Lazoritz. "We were equal partners: I couldn't have done it without him, and he couldn't have done it without me." "Until the late 1970s and early 1980s, didn't know orking in the Milwaukee, where, in 1997, he was appointed associate professor. In 1998, seven years into their collaboration, Lazoritz and Shelman finally met, a year before Out of the Darkness was published. Unique Opportunity to Advocate for Children In the late 1990s, after more than two decades of working on the "front lines" with cases of child abuse, Lazoritz began to feel that his job's high stress level was exacting a toll. "Some people can take a daily dose of the worst that our world has to offer without getting bitter, disillusioned or burned out," he says. "However, I found myself getting bitter, hostile and angrylosing my objectivity and becoming part of the problem. "I like the term 'compassion fatigue,"' he adds. In 2000 Lazoritz left Wisconsin for his current position as vice president for medical affairs at Children's Hospital in Omaha, where he also serves as clinical professor in Creighton University School of Medicine's Department of Pediatrics and as adjunct professor in the University of Nebraska Medical Center's Department of Pediatrics. In his leadership role at Children's Hospital, he feels he has a unique opportunity to advocate for children. "My job is to be a field at the time had to teach ourselves and learn in an facilitator, to provide the medical staff with the tools they need to do informal way from other people who knew what they their work, and to look at the medical needs of the community to see how we can better serve them," he says. were talking about." Collaborating by e-mail, phone and fax, the two created a work of "historical fiction" that is firmly grounded in facts. Initially, Lazoritz was reluctant to include even an iota of fiction; however, Shelman convinced him that a strict reading of court transcripts, dates, and data would not do justice to the story. Having the complete original court transcript of the case was crucial to retelling the story, as it supplied the authors with dialogue in a realistic context. Still, Shelman's storytelling expertise was needed to recreate the settings and thoughts of the characters, as was the assistance of a historian whom the writers employed to review the book for accuracy. For his part, Lazoritz walked the streets of New York and gathered factual information about the neighborhood settings described in the book. In 1992, when his collaboration with Shelman was just beginning to gain momentum, Lazoritz left Buffalo for a position as assistant professor of pediatrics at the Medical College of Wisconsin in "As an administrator at a children's hospital," he continues, "I get a dose of the best that our world has to offer: a team of dedicated professionals working tirelessly to save lives or make children's lives better." While awareness and activism against child abuse has grown tremendously in the past 30 years, the fight to protect children is far from over, says Lazoritz, who points out that an average of three children die from abuse and neglect in the United States every day. One Person Helping One Child During his career Lazoritz has been a keen observer of how the medical profession reacts to child abuse cases, and he hasn't always liked what he's seen. "The issue is not identifying child abuse," he stresses. "For 10 years, every physician licensed in New York State has had to take a course in identifying and reporting child abuse. Unless they were sleeping, they have had the facts. The real issue is taking a stand." Physicians, he says, deny child abuse or don't report it for a number of reasons: "For example, they don't want to get involved, don't want to go to court, don't believe that a family they are well acquainted with I 12 l1ffala Ph ysician Summer 2002 CONTINUED ON PACE 14 �children, Wheeler and Bergh rescued Mary Ellen by relying on laws written to protect animals from inhumane treatment. As a result of the Mary Ellen case, Bergh later went on to found the New York Society for the Prevention of Cruelty to Children INYSPCC). Before the creation of the NYSPCC, child abuse and neglect was considered a family matter; challenging parents or Ellen7 intervening on behaH of a child was unheard of. The land- • mark case of Mary Ellen Wilson forced society to accept a moral responsibility to protect children, even from their parents, and many states followed New York in making child abuse illegal. The Story of Mary Ellen Wilson by In April 1874, Mary Ellen's foster mother, Mary Connolly, was convicted of felonious assault and sentenced to a year in the first child in America to be legally removed from an abusive the penitentiary at hard labor. home. Born in 1864 in the New York City tenements of Hell's In June 1875, Mary Ellen Kitchen, Mary Ellen was only two months old when her father was placed in the care of Etta was killed in the Civil War, leaving her mother destitute. Wheeler's sister, Elizabeth, Unable to care for her daughter, Fanny Wilson was forced and grew up in the country to find others who could. When Fanny later died of consump- outside of Rochester, New tion, Mary Ellen was placed in a home where she was horribly York. She eventually married abused by her adoptive parents. She was beaten with a rawhide and had two daughters who whip almost daily, forced to sleep on a piece of carpet on the are remembered as educated, floor of a closet, burned with an iron, cut with sewing scissors, successful and compassion- and sexually abused by her foster father. Clothed only in a ate women. Mary Ellen Wilson tattered and tom dress she wore in all seasons, she was finally died in 1956 at the age of 92. rescued at age 10. Out of the Darkness, The The two extraordinary people who came to Mary Ellen's Story of Mary Ellen Wilson, is rescue were Etta Wheeler, a social worker who served victims available at online booksell- of poverty in the tenements, and Henry Bergh, who in 1866 ers; or it can be purchased founded the American Society for the Prevention of Cruelty to directly from its publisher, Animals IASPCA). Because there were no laws in 1874 to protect abused Dolphin Moon Publishing, at dolphinmoon.com. Summer 2002 1111111 Pbysicin 13 �FORGOTTEN CONTINUED FROM PACE 12 could be abusive, or they don't want to cause trouble for the family." Lazoritz's hero, C. Henry Kempe, a researcher, teacher, pediatrician and pioneer in the field of child abuse and neglect, was outspoken in what he believed a physician's role should be. "Since 1961, when Kempe said 'physicians have a duty and a responsibility to identify abuse and prevent its likely recurrence,' the medical profession has had this responsibility," says Lazoritz. Child Abuse Resources The Child Abuse Resources page The American Professional Society on the Abuse of Children (APSAC) Another factor that affects the issue of effective intervention is the differing ways a culture views child abuse over time. "Child abuse is defined by society. Some of the things that we now call child abuse would not have been labeled this 100 years ago, or even 20 years ago,'' explains Lazoritz. "As societies advance and become more sophisticated, they identify things as child abuse that other cultures wouldn't. Too, we're identifying abuse more often because we're looking for it." In addition to a rise in child abuse cases due to more strenuous reporting, the incidence of abuse is increasing due to societal changes. The biggest change, Lazoritz feels, is in the increased numbers of single-parent families and teenage pregnancies. "An MARv ELLEN AT AGE 16 art icle titled 'Infanticide' in the October 22, 1998, issue of the New The International Society for Prevention of Child Abuse and Neglect (IPSCANI England journal ofMedicine stated that the highest risk factors for an infant being killed in his or her first year oflife are a maternal age of less than 19 and less than 12 years of education," he explains. "The number of single teenage mothers has gone up, and therefore I think that's why serious child abuse has gone up." Another disturbing risk factor in abuse cases-and the subject of an abstract Lazoritz coauthored-is a boyfriend or husband who is The National Clearinghouse on Child Abuse and Neglect Information not the child's biological father. In the abstract, Lazoritz cites a 1998 study showing that the rate for child physical abuse committed by mothe rs' boyfriends lies somewhere between 16 and 25 percent. Another form of abuse is the subject of Lazoritz's latest book, Shaken Baby Syndrome: A Multidisciplinary Approach, which he coedited with Vincent). Palusci (Haworth Press, November 2001). "! can't say there's a direct cause-and-effect relationship between early childbearing age and infant homicide, but there certainly is a strong correlation,'' he says. "We can tell people never Prevent Child Abuse America to shake a baby, but if we can get teenagers not to have babies, that would be more effective." Ultimately, Lazoritz hopes his work reflects and inspires a passion for helping children. "We are at a point now where each physician who deals with children should ask: 'What more can I do Compiled by Pamela M. Rose, MLS, Health Sciences Library, University at Buffalo, 3435 Main St., Buffalo, NY 14214. (716) 829-3900 x129; pmrose@acsu.buffalo.edu. to prevent abuse? How can I advocate more for this child who has been abused? How can I do more to help this abused child heal?"' Again, he recalls a quote from Kempe: "It is just not possible to worry about all of the needs of all of the children all of the time. There lies frustration and total inaction as well. " What should be learned from the Mary Ellen story? "Each one of us must have our own 'Mary Ellen,"' says Lazoritz. "One person helping one child at a time can make a difference." 1 1 1f al1 Hysicin S u m m er 2002 CD �~Uo.;'JW'"""'tl when a child living in Buffalo or the surrounding area was discovered to be sexually or physically abused, he or she was referred to ·nOur Own ackyar the only physician in town who was providing medical care for these emergent Coyne is paid by Kaleida Health System's Children's Hospital of Buffalo to treat patients through CATS. FURTHERING THE WORK OF STEPHEN LAZORITZ Niagara tor of pediatrics at Erie Country Medical Center and a University at Buffalo assistant professor of pediatrics. "Steve not only would see the children medically, he also would very In addition, he treats children at the CAC of cases: Stephen Lazoritz, MD, then direc- pital; the former is more of a justice model, where children needed to do," says Jack Coyne, MD '85, clinical associate professor of are primarily advocated for through the court system. pediatrics at UB, and medical director of the Child Advocacy Centers of Each week, Coyne treats 10 to 12 children at the Child Advocacy Center of Erie County, or about 600 a year. In 1992 Lazoritz left Buffalo for a position with the Medical College "That's medically speaking," he emphasizes. "From of Wisconsin in Milwaukee (see article opposite), and Coyne stepped there, the children are seen therapeutically, and CATS in to fill the vacancy he left. advocates on behalf of the children for a wide variety of On several occasions in the early 1990s, Coyne traveled to Milwaukee reasons." to train with Lazoritz in how to medically treat children who had been In addition to the efforts of Lee Anthone, Coyne sexually or physically abused, and since then the two physicians have says, "Our community wouldn't be where it is today in maintained a close friendship. this process if it hadn't been for the work Steve Lazoritz "Steve taught me the process for physically examining the children, did while in Buffalo. By educating the community about as well as how to talk to them and how to document what I saw," says the medical exam we can provide for sexually abused Coyne. In addition to treating abused children, Coyne also picked up children-and what we can do with these exams- where Lazoritz left off in attempting to better organize how the chil- Steve showed how we can really help the children." dren's cases were responded to in Buffalo by a multidisciplinary team of Prior to Lazoritz's educational efforts, instead of professionals that included child protective services, police and district abused children being allowed to begin healing after attorneys. At the time, disputes over areas of responsibility were result- intervention, they were often subjected to a series of ing in less than optimal intervention strategies for the children. court-ordered physical exams-sometimes four or five "For two years, we met as a group in an attempt to discover common ground so that the process of evaluating these children and advocating by different individuals and as late as nine months after the initial intake exam. for them wouldn't be one that was detrimental to their well-being," says "Now we have colposcopy and we can document Coyne. "In order to do that, we had to get on the same page and give up with video and still photography for the medical record," things that we in our separate disciplines were doing, and that's exactly says Coyne. "So if a defense attorney contests evidence what happened." that's being presented and wants another opinion, he In 1994, as a result of these meetings, the Child Advocacy Center (CACI of Erie County was established in Buffalo on Delaware Avenue; can get it by having a physician look at the film and not by traumatizing the child with another exam." three years ago, it moved to its current location at 556 Franklin. Since Despite such progress, there is still much work to be that time, more than 300 such centers have been established in the done in the area of child abuse in our region, Coyne United States, including 14 in New York State. stresses. "Right now, the only entity that 'owns' this According to Coyne, much credit for this effort goes to the late Lee whole process is CATS; in many cases, our healthcare Anthone, the wife of Sidney Anthone, MD '50, a Buffalo general surgeon. system is just doing what it needs to do and no more. "Lee Anthone took this work upon herself as a citizen in an effort to Getting the community involved with ownership-that's try and make something happen. She helped facilitate the whole process," says Coyne. The Child Advocacy Center of Erie County is part of the Child and Adolescent Treatment Services (CATS), a local nonprofit social and and according to Coyne, and is affiliated with Niagara Falls Memorial Hos- effectively advocate for them by going to court or doing whatever he Erie, Niagara and Genesee counties. County the CAC of Genesee County. The latter operates along a hospital model, the most important thing now," he says. For more information on the Child Advocacy Center of ~ Erie County, contact Edward Suk, CSW, director, at (716) 886-5437, or e-mail him at sukedward@aol.com. therapeutic agency. Summer 211112 laffale Hysician 15 �ALUMNl MEDICINE, ibernating myocardium i. a condition causec1 by the progressiv£ narrowing of th£ heart arteries, re· suiting in chronic reduction of blood flow tc t-ho hPtJrt M. CANTY MD '79, ALBERT JoHN While contraction of the heart is depressed, the heart tissue remains viable. Since function can improve if blood flow is restored, it is a reversible cause of heart failure. At the University at Buffalo School of Medicine and Biomedical Sciences, John M. Canty Jr., MD '79, and colleagues in the Center for Research in Cardiovascular Medicine are investigating ways in which the heart adapts to chronic reductions in blood flow. Their goal is to discover techniques by which this condition can be diagnosed and to devise new therapies to improve heart function. Canty, a professor in UB's departments of medicine and in physiology and biophysics, recently received a four-year, $700,000 grant from the Department of Veterans Affairs to support a study in which he is using gene transfer by injecting the heart with experimental viruses that contain vascular growth factors in order to try and stimulate development of new or existing blood vessels in the hibernating porcine model. "Over the last several years, there has been intense interest in developing angio- JR., A~D ELIZABETH KATE CHAIR IN .ARDIOVASCULAR DISEASE 16 laffalo Phpiciaa S umm e r H111,r!P 2 00 2 genic gene transfer therapies to stimulate the development of the coronary collateral circulation as an alternate approach to care for patients with inoperable coronary artery diseases," says Canty. "This investigation will identify the ability of different therapeutic strategies to improve collateral perfusion and reverse chronic ischemic left ventricular dysfunction." This study is just one of a number of funded investigations currently being conducted by Canty, who is internationally known for his work in the area of chronic adaptations of the heart to ischemia, according to Robert Klocke, MD, chair of the Department of Medicine in UB's School of Medicine and Biomedical Sciences. In addition to the VA grant, Canty's support includes two grants from the National Heart, Lung and Blood Institute (NHLBI) that total $3.2 million. "At the present time, we have very few options other than cardiac surgery or interventional cardiac catheterization to improve blood supply to compromised cardiac muscle," explains Klocke. "Dr. Canty's work has the promise of providing alternate means of improving cardiac blood flow in all patients with heart disease, not just those who are well enough to tolerate invasive procedures." In recognition of his ongoing contributions to research in cardiovascular medicine, Canty was appointed as the Albert and Elizabeth Rekate Chair in Cardiovascular Disease in UB's School of Medicine and Biomedical Sciences in January 2001 (see article, opposite). "It is a tremendous honor to have been appointed the Rekate Chair," says Canty. �"Since its inception nearly 20 years ago, the Rekate endowment has been instrumental in facilitating a steady expansion of the cardiovascular research programs at UB. It has allowed us to support a number of talented physician/scientists pursuing basic research in cardiovascular medicine in Buffalo." A native of Buffalo, Canty received his bachelor's degree in biomedical engineering from Rensselaer Polytechnic Institute in 1975 and his medical degree from UB in 1979. After training in internal medicine at the University of Rochester, hereturned to UB as a cardiology fellow and joined the full-time faculty in 1983. In 1995 he was named professor of medicine at UB and in 1996, professor of physiology and biophysics. Currently, he also serves as associate chief of the Division of Cardiology and is director of the Cardiac Care Unit at Erie County Medical Center. Canty has received numerous academic awards, including membership in Alpha Omega Alpha, the James A. Gibson Anatomical Society and the Tau Beta Pi Engineering Honorary Society. In 1982 he received the John C. Sable Memorial Fund Award and in 1983 was named a Sinsheimer Scholar. He was also the recipient of a Clinical Investigator Award from the National Institutes of Health's HLBI. In addition, Canty has held numerous memberships on national committees of the American Heart Association and has received consecutive four-year appointments to the Cardiovascular-Renal Study Section of the NHLBI. He has also served on the editorial boards of the American journal of Physiology, Circulation Research and the journal of Cardiovascular Pharmacology and currently reviews manuscripts for numerous other journals, including the New England journal ofMedicine. He is a Fellow of the American College of Cardiology, the American College of Physicians and the American Heart Association. An active teacher and speaker, Canty has mentored over 20 undergraduate students and postdoctoral trainees and has accepted many invitations to speak at recognized centers of cardiovascular excellence worldwide and to chair national and international meetings. 4D 1 he Albert and Elizabeth Rekate was established in 1982 to support and strengthen the educational and research activities of the Division of Cardiology in the University at Buffalo School of Medicine and Biomedical Sciences. Albert C. Rekate, MD '40, has served UB in a number of capacities, including professor of medicine, director and acting chair of the Department of Rehabilitation Medicine, acting dean of the School of Health Related Professions, and associate dean. Since 1995, he has also served as a member of the Dean's Advisory Council for the School of Medicine and Biomedical Sciences. In 1999, the Albert and Elizabeth Rekate Chair in Cardiovascular Disease was augmented by the Willard H. Boardman, M.D., and Jean Boardman Endowment. William Boardman, a retired cardiologist, earned a medical degree from UB in 1944; his wife, Jean, earned a B.A. degree in biological sciences from UB in 1948. 4D CRoss-DisCIPLINARY CoLLABORATIONS m the cent r is their poten estern New c app 1c for Research in Cardiovascular Medicine has a tion to the development of new diagnostics and York Healthcare System. Fallavolhta has re broad interest in integrative cardiovascular bi- therapies for patients w1th chronic coronary ar- ceived a three-year, $390,000 grant from t ology. By combining investigatiOnal stud1es di- tery disease, accordmg to Canty. "In this regard, Department of Veterans Affairs to support a rected at understanding pathophysiological we collaborate closely w1th the UB-VA Center for study he 1 conductmg to determme wh1ch mechanisms m the intact heart with stud1es Positron Em1ss1on Tomography, as well as w1th cardiac tests are most useful in pred1ctmg aimed at tter understandmg the basic bio- bas1c scientists in the School of Med1cine and those patients w th coronary heart d1s ase chemical mechamsms at the molecular level, who w1ll benefit most from surgery. the program emphasizes research that can Biomed1cal Sciences," h says. "The translational nature of the research translated from the laboratory to the beds1de. giVes us the opportunity to test the concepts we the heart improve clmically when blood flow "The central theme of our research is fo- know to be mechanistically involved based on 1s restored by cardiac bypass surgery, accord- cused on understandmg chronic adaptive re- pnor laboratory work with patients who have car- mg to Fallavolhta. "However, m patients w1th sponses of the heart to repetitive ischem1a diovascular d1sease," adds Canty. "Many of the coronary artery d1sease, chromcally dysfunc- ar to that occurring m chronic coronary expenmental approaches that we use are iden- tional myocardium artery d1seases," says John M. Canty Jr., MD, tical to those used m the care of patients w1th coronary revascul rlzation can improve left Albert and Elizabeth Rekate Chair in Cardio- chronic cardiovascular d sease." ventricular function, symptoms and mortal- si vascular D1sease at UB and director of the university's card logy research programs. A key feature of all research projects with- At present, Canty is collaboratmg on myocar- Not all patients wsth poor blood flow to IS frequently v1 le and ity. Therefore, the abihty to identify th1s via· dial hibernation studies with James Fallavolhta, bility m patients, prospectively, is of great MD, assoc1ate professor of medicme at UB, who 1s chnical importance," he says Su mm er 2002 lulfalo Hysiciu 11 �MEDICAL ScHOOL N E w s a This yea National Residency Matching Program (NRMP) results were announced on March 21.2002. Thirty percent of University at Buffalo's graduating medical students will stay in Buffalo to train in the Graduate Medical-Dental Education Consortium, while 46 percent will go out of state. "For the first time, the NRMP has not provided data on choices," says Nancy Nielsen, MD, assistant dean for Student Affairs in DB's Office of Medical Education. "However, polling our students reveals oustanding results, with over 60 percent receiving their first choice and over 90 percent matching in their top three choices." Nationally, match results indicate adecrease in residency positions filled in six primary care specialties: family practice, internal medicine, pediatrics, medicine/pediatrics, internal medicine primary and pediatrics primary. There were 373 fewer U.S. seniors filling these generalist residency positions, with 2051ess positions filled overall. Some specialty areas experienced an increase in match rates compar· ed to last year, including anesthesiology, which had afill rate of 95.1 percent-a 7percent increase over last year; and physical medicine and rehabilitation, for which the fill rate increased from 77.3 percent to 90.4 percent. Diagnostic radiology filled an additional44 PGY-2 positions this year, while there was aslight decrease in U.S. medical school seniors matching to general surgery positions. Overall, 23,459 individuals partici· pated in the match this year. Active U.S. medical school senior applicants enjoyed the highest percentage of matches to first·year residency positions. with a94.1 percent match rate. Nazaneeo Grant learns she is gaing to Geargetown to train 11 surgery. Amodeo, Victoria Blitshteyn, SYetlana U ROCHESTER/STRONG MEM-NY UN i v BuFFALO GRAD MED-N Y Applebee, Garrick UVM/FLETCHER ALLEN-V T Ariyaratana, Suzie lulfal1 Pbysiciaa Summer2002 LOYOLA UN I VERS ITY MEDICAL CTR- I L UN I V NoRTH CAROLINA HosP Brennen, Dnid Auerbach, Marc SAUS H EC/ B ROOKE ARMY NYU SCHOOL OF MED ICINE MED CTR-TX Azodo, Uchendu Brooks, Victoria M OREHOUSE SCHOOL OF MED IC I NE-GA UN I V BUFFALO GRAD MED-NY Beaman, Antoinette Brunetti, Vito r BETH I SRAEL MED CTR- y MERCY H OSP- P ITTSBURGH-PA Beaman, Shawn UN I V H EALTH CTR OF PITTSBURGH- P A UN I V H EALTH CTR OF P I TTSBURGH-PA ALBERT E I NSTE I N COM-NY Bullaro, France sa UN I V H EALTH CTR OF P I TTSBURGH-PA Burke, Mark Beatty, Matthew UNIV BUFFALO GRAD MED-NY UN I V BuFFALO GRAD MED-NY Carlin, Matthew Belani, Shaleen SUN Y H SC-SYRACUSE-NY W I LLS EYE H OSP I TAL-PA Belli, Lily Chang, Jerry LONG I SLAND ) EWISH-NY Choe, Hana LENOX H I LL H OSP ITAL-NY W I NTHROP-UN I V H OSP-NY Binder, DaYid U SouT H ERN CA LI FORN I A Chopra, Liza UN i v BuFFALO GRAD MED-NY CAMBRIDGE H osP/C H A-MA NEW ENGLAND MEDICAL CTR-MA 18 MAYO CLIN IC- ) ACKSONV I LLE BojoYic, Branko �Asuccessful couple'smatch takes Jay Mepani and Rachel Kozower to Case Western University's Metrohealth Medical Center. Francesca Bullaro and friends celebrate news that she will train in pediatrics;Margo McKenna, leh, was aresearch scholar at the NIH last year. Hennon, Mark Chu, Alvina ALLEGHENY GEN H osP-PA UN1v OF CHICAGO HosP- I L DeiBroccolo, Jennifer Fleming, Emily Hinchey, Paul Chung, Jeffrey y STONY BRooK TEAC H H asP- Y Foresta, Christopher Hineman, Ashley NYP HOSP-COLUM PRESBY-NY WAYNE STATE UNIV-M I W I NTHROP-UNIV H osP- Den Haese, Diane Collure, Don UNIV BuFFALO GRAD MED-NY P HOENIX C HI LD/MAR ICOPA-AZ UN I V MARYLAND MED CTR MART I N L K I NG ) R/DREW-CA Dischner, Kurt Conklin, Jeffrey METROHEALTH MED CTR-0H MEM SLOAN- K ETTER I NG-N Y YU SCHOOL OF M ED ICINE Gordon, Kelly THOMAS ) EFFERSON UN I V-PA Domaracki, Beth Connery, Cristine NYU Sc H OOL oF MED I C I NE H ARTFORD H os PI TAL-CT OHIO STATE UN I V MED CTR-O H Grant, Gavin Courtright·Orr, Caryn EMORY UN I V SOM-GA Dwyer·Matzky, Keely UN I V BUFFALO GRAD MED- y UN I V BUFFALO GRAD MED-N Y Horn, Scott B ETH I SRAEL MED CTR-NY NYU SCHOOL OF MED IC I NE U CoLORADO SOM-DENVER Hrycelak, Michael Grant, Nazaneen Cuomo, Linda NYP HosP- CooK CouNTY H oSP ITAL- I L Dufort, Elizabeth UN I V BuFFALO GRAD MED-NY Holder,Amy MARY I MOGENE BASSETT-NY CooK CouNTY H oSPITAL- IL Corvino, Timothy Hoghooghi, Alexander Hojnacki, David Gore, Robert UNIV BuFFALO GRAD MED-NY Hines, Ryan Gittleman, Alicia ST. V I NCENT MERCY MED-O H y Y YU SC H OOL OF MED IC I NE DeSantis, Melissa Cone, Jesse COLUMBIA BASSETT- UN I V BUFFALO GRAD MED- UN1v NoRTH CAROLINA H osP WILSON MEM REG/UHS-NY UN IV H OSPS CLEVELAND-O H U ROC H ESTER/STRONG M EM-NY Y CoRNELL- Y Dayrit, Marivic N SHORE U-MANHASSET-NY De Jolla, Daniel GEORGETOWN UNIV H osP-DC Elliott. Darianne GEORGETOWN UN I V H OSP-DC N S H ORE U-MAN H ASSET-NY Gregory, Charmaine Figueroa, George UN I V BUFFALO GRAD MED- Filipink. Robyn y UNIV BuFFALO GRAD MED-NY STONY BROOK TEACH HosPs-NY UN I V H EALTH CTR OF PITTSBURGH- P A Filsinger, Daren CEDARS-S I NA l MED CTR-CA UN 1v BuFFALO GRAD MED-NY Janis, Gregory DUKE UN I V MED CTR-NC Gupta, Anjeli E1 NSTE I N/MONTEF IORE-NY Kader, Michael UN1v BuFFALO GRAD MED-NY Defazio, Jennifer Huebschmann, John CLEVELAND CL I N IC FOUNDATIONO H U ROCHESTER/STRONG MEM- Y Kam,Steven Hebrank, Jessica £1 NSTE I N/M ONTEF IORE-NY W I LSON MEM R EG/U H S-NY UC SAN FRANCISCO-CA Summer 2002 l 1 f f af • H ys ic iaa 19 �M E C D A L N SCHOOL E w Ab1g sm le for Hana Ch e, who IS on ber way to the Umversity of Southern California to train in general surgery. S Katona, Kyle Lee, Angela Lundgren, Janell N SHORE U-MANHASSET-NY U UNIV HosP CINCINNATI-OH Kenjarski, Brian Lee, Mitchell Pr UNIV BuFFALO GRAD MED-NY IV BuFFALO GRAD MED-NY FLUSHING Maceda, Aimee HOSPITAL MEDICAL U MD-MERCY MED CTR CTR-NY Kerr, Christine U FLORIDA PRoG-SHANDS HosP YU SCHOOL OF MEDICINE Mak, John BROWN U INT MED REs- RI Lerner, Alexander Kim, David ST . LuKE's-RoosEVELT-NY WILSON MEM REG/UHS- Y BARNES-)EWISH HOSP-M0 B I DEACONESS MED CTR-MA EINSTEIN/JACOBI-NY Kozower, Rachel Maim, Brian METROHEALTH MED CTR-OH Lesser, Adam METROHEALTH MED CTR-OH NYP HosP-NY CoRNELL- I WINTHROP-UNIV HosP-NY Krakowski, David Y Mato, Anthony IV Hosr-NY HosP oF THE UNIV oF PA Lin, Peter MT. SINAI HOSPITAL- Mclean, Erika y Lang, Christopher Logue, Christopher Miller, Rebecca UN1v BuFFALO GRAD MED-NY MT. SINAI HOSPITAL-NY WINTHROP-U Mepani,Jay Morcos, Morcos ST. FRANCIS MED CTR-PA UNIV BuFFALO GRAD MED-NY MAIMONIDES MED CTR- NY RIVERSIDE METHODIST- 0H U HLTH Svs E CAROLINA - C ''We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One John James Audubon Parkway Amherst, New York 14228 716.636.7600 20 laflal1 Hysiciu S umm e r 2 002 HOGAN & WILLIG, PLLC .\ ttorneys at Law - - - - - - hoganandwillig.com �Robert Gore ispleased to be going to Cook County Hospital to train in emergency medicine. Mutty, Christopher Rosella, Peter Sorci, Jonathan UNIV BuFFALO GRAD MED-NY U UNIV BUFFALO GRAD MED-NY UNJV BUFFALO GRAD MED- Weiss, Karen Stanbro, Peter MT AuBURN HosP ITAL- MA y Nguyen, Doan u LA MEDI C AL CENTER-CA Russell, Teresa BOSTON U MED CTR-MA UNIV H EALTH CTR OF Stanislawski, Aimee BosToN U MED CTR-MA I LLINOIS COM-CH ICAGO Weitzman, Steven PITTSBURGH-PA O'Donnell, Kathleen UNIV MAss MED ScHOOL Samson, Gregory LONG I SLAND ) EWISH- Swan, Andrew EMORY UNIV SOM-GA UNIV NoRTH CAROLI Oh, Richard y Whiteside, Michael A HosP H osP OF ST. RAPHAEL- CT Schapiro, Ann MARY I MOGENE BASSETT- NY YALE UN I VERSITY-CT UNIV BuFFALO GRAD MEDMAIMON I DES MED CTR- Y y Osman, Magda UN I V BuFFALO GRAD MED- NY Ostrow, Gregory H ARTFORD H OSP I TAL-CT HLTH PART/REG IONs HosP-M Symons, Andrew Schindler, Kim Wisnoski, Jennifer r UN I V BuFFALO GRAD MED- NY UN I V BUFFALO GRAD MED- y UN I V BuFFALO GRAD MED- NY Tenney, Emily Wolpiuk, Anne CLEVELAND CLINI C FouNDATIONOH UN I V BuFFALO GRAD MED- NY Schwartz, Lainie Teper, Irene UNIV BUFFALO GRAD MED- NY ST . MARY's MED ICAL CTR-CA Seereiter, Phillip Thurlow, Juliane UN I V BUFFALO GRAD MED-NY UN I V B UFFALO GRAD MED- UNIV BuFFALO GRAD MED-NY UNIV BuFFALO GRAD MED-NY Packianathan, Nalini UNIV BuFFALO GRAD MED- NY y ) OHNS HOPKINS H osP- MD Selip, Debra Traugott, Matthew E1 NSTE I N/J ACOB I-NY L ONG I SLAND )EW I S H-NY Selkirk, Stephen Vannelli, Patrick Woo, Junda BAYLOR CoLL MED- H ousTON - TX Yoon, Daniel YU SOM UN I V BuFFALO GRAD MED- Perez, Brenda Y ATLANTI C HEALTH SYs- N J Shahryarinejad, Azin Puchalski, Rebecca BETH I SRAEL MED CTR-NY UN I V BuFFALO GRAD MED- NY Singh, Sandesh Ramsdell, Robert THOMAS ) EFFERSON UNIV - PA UN I V BuFFALO GRAD MED- NY lf'd Yolfson, Alexander CASE WESTERN RESERVE- OH ST. }osEPH ' s-SvRACUSE-NY y UNIV HosP C I NC I NNAT I- OH Pasol, Joshua YU DowNTOWN HosP-NY Wong, Robert UN I V BuFFALO GRAD MED- UN I V BUFFALO GRAD MED- y Siuta, Jonathan Ridgeley, Jamison U NEBRASKA AFFIL HosP NYP H osP-NY CORNELL-NY Zwerling, Brian Walcott, Roger NY H osP/MED CTR QuEENS ST. ELIZABETH ' s MED CTR- MA LONG I S LAND }EWISH MED CTR- NY Weinstein, Jody NAVAL HOSPITAL PENSA C OLA-FL PROGRAM - U H LTH Svs E CAROL I NA- N C UNIV BuFFALO GRAD MED-NY u "' m e r 2 0 0 2 la ffalo Hys i c ian 21 �THE 156TH COMMENCEMENT FOR THE SCHOOL OF MEDICINE AND BIOMEDICAL SciENCES wAs HELD ON MAY 24, 2002, AT THE CENTER FOR THE ARTS ON THE NoRTH CAMPus. THIS YEAR, THE SCHOOL CONFERRED 136 MD DEGREES, 2 MD/PHD DEGREES, 7 MD/MBA DEGREES, 22 PHD DEGREES, 2 MPH DEGREES, AND 27 MASTER'S DEGREES. THE HONORED SPEAKER WAS NEW YORK STATE HEALTH COMMISSIONER DR. ANTONIA NovELLO. CLASS SPEAKER WAS ANTHONY 22 l1ffala Pbysicin MATO. ��PATHWAYS N E ws ABOUT UB' s ScHooL oF M E DICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAF F SUMMER Skolnick t 2002 ad Jeffrey Skolnick, PhD, a worldrenowned scientist in the fields of computational biology and bioinformatics, has been named director of the Buffalo Center of Exce ll ence in Bioinformatics and UB Disting u ished professor of structural biology at the University at Buffalo, the lead research SKOLNI C K partner in the center. Skolnick has served as director of computational and "THIS C OMBI Fl structura l genomics at the Danforth Plant Center in St. Sl PPORT MADE I I Louis, Missouri, since 1999 POSSIBI E FOR US TC' and as an adjunct professor of biochemistry at Washington GO AFIER HIE BfSl University in St. Louis, where ) OF THE. BFST. he has been a member of the faculty since 1982. He has developed algorithms for the prediction of protein structure and folding pathways from protein sequence and has pioneered the use of lattice-based approaches to protein tertiary structure prediction, as well as the simulation of membranes 24 l a lfal e Phy si c iu S t~ m m e r 20 0 2 and membrane peptides. He has also developed structurebased approaches to predict protein function from amino acid sequence, protein-protein interactions and pathways that can be applied to entire genomes. He holds nearly $700,000 in grant support from various agencies, including the National Institutes of Health. Sko lnick earned a bachelor's degree in chemistry from Washington University in St. Louis and master's and doctoral degrees in chemistry from Ya le University. He was a postdoctoral research fellow at Bell Laboratories from 19781979 and an Alfred P. Sloan Foundation Research Fellow from 1983-1987. He is chair of the Scientific Advisory Board on Geneformatics and a member of the Scientific Advisory Board of the Proteome Society and the NIH's Molecular and Cellular Biophysics Study Section. Skolnick is a member of the editorial boards of Biopolymers and Applied Genomics and Proteomics, and also has served on the editorial boards of Proteins, Biophysical Journal and Journal of Chemical Physics. He serves as a referee for professional journals that in cl ude Nature, International Journal of Biological Macromolecules, Journal of Molecular Evolution, Journal of the American Chemical Society and Science. Two accomplished researchers at the Danforth Plant Science Center, Andrzej A. Kolinski, PhD, and Marcos R. Betancourt, PhD, will be joining Skolnick at the Buffalo Center of Excellence in Bioinformatics. Kolinski is a professor at the plant center and heads the biopolymers laboratory at the University of Warsaw 1n Poland. He has won numerous grants and earned several honors, inc! uding the Swietoslawski Award in 1994 and an International Scholar's Award from the Howard H ughes Medical Institute in 1995. Kolinski earned his doctorate in chemistry from the University of Warsaw in 1979, and has taught there and at Washington University in St. 1 I �1 1 Louis, in addition to having worked at the Scripps Research Institute in La Jolla, California. Betancourt has worked in the computational genomics laboratory at the plant center. Prior to that, he held positions at the University of Maryland and at the University of California at San Diego, where he earned his doctorate in physics in 1995. His honors include the Enrico Fermi Award in 1986, a National Defense Science and Engineering Fellowship in 1989 and a National Science Foundation Fellowship in 1996 and 1998. The John R. Oishei Foundation has awarded UB a threeyear, $1,542,000 grant to help support the salaries of Skolnick, Kolinski and Betancourt. "Thanks to the generosity of the John R. Oishei Foundation, in addition to Governor George E. Pataki's strong and visionary financial commitment to this initiative and, at the federal level, the efforts of Congressman Tom Reynolds and Senator Hillary Rodham Clinton, we're delighted to have secured the talents of Jeffrey Skolnick and the world-class team he has assembled for our Buffalo Center of Excellence in Bioinformatics," said President William Greiner at the time of the announcement. " This combined support made it possible for us to go after the best of the best." achsNamed UB Di tinguished Frederick Sachs, PhD, professor of physiology and biophysics was one of 13 University at Buffalo faculty members named in May2002 to the first class of UB Distinguished SA c Hs Professors. The UB Distinguished Professor designation is open to faculty members who have achieved national or international prominence and a distinguished reputation within their field through significant contributions to the research/ scholarly literature or through artistic performance or achievement in the fine arts. Sachs is an authority on cell mechanics and director ofUB's Center for Single Molecule Biophysics. He is also a member of the university's Center for Advanced Molecular Biology and Immunology and its Center for Neurobiology and Vision. His research attempts to understand the electrical processes in cells. Of particular interest are the mechanisms of mechanoreception and the role of ion channels. - SU E W U ET C HER Norton edaiConferred on Jacobs The late Lawrence D. Jacobs, MD, who was professor and chair of the Department of Neurology and a wortd·renowned researcher in the treatment of multiple sclerosis IMSJ, was chosen to receive posthumously University at Buffalo's highest award, the Chancellor Charles P. Norton Medal. The Norton Medal is given annually at the uniYenlty's general commencement ceremony to recocnize someone who has, in Norton's words, "performed some great thing which is identified with Buffalo . · . a civic or political act, a great book, a great work of art, a great scientific achievement, or any other thing which, in itseH, is truly great and enabling and which dignifies the performer and Buffalo in the eyes of the world." "Larry Jacobs was one of our most distinguished faculty mem· ben, and a great Buffalonian-a scholar, researcher and teacher whose groundbreaking research discoveries were exceeclecl only by his compassion and his desire to serve our university, our region and all of humanity," said Presl· dent William R. Greiner. "Throughout his career, Larry brought national and international acclaim to our Depart- ment of Neurology and the UB medical school, as well as to Buffalo-Niagara." Jacobs, who also held the Irvin and Rosemary Smith Chair in Neurology at UB and served as director of the Jacobs Neurological Institute and the William C. Baird Multiple Sclerosis Research Center at Buffalo General Hospital, died of cancer last November at the age of 63. His innovative research, geared toward developing better treatment for relapsing multiple sclerosis-a form of MS that affects 350,000 people in the United States-led to the development of Avonex, which today is the most widely prescribed drug to treat this debilitating form of MS. -SUZASNE CHAMBERLAIN - A RTH U R PA GE Su mm e r 2002 Ia If a I a n y sic ian 25 �PATHWAYS Cranger Pr nted ;t=.n ... i"F..,e Achi vemen Carl Granger, MD, an internationally recognized authority in the field of rehabilitation medicine and professor and chairemeritus of the Department of Physical Medicine and Rehabilitation at the University at Buffalo, received the Lifetime Achievement Award at the third Annual Health Care Heroes Breakfast on April 18, 2002, sponsored by Business First. Granger was honored for his role in developing the Functional Independ e n c e Measure, or FIM™ an easy-to-use rehabilitation assessGRANGER Patrick J Kelly, MD '66, FACS, the Joseph P. Ransohoff Professor and Chainnan of Neurosurgery at New York University (NYU) School of Medicine, received the Olivacrona Award from Karolinska Institute in Stockholm in December 2001 in conjunction with the Nobel ceremonies. Kelly has pioneered computer-assisted stereotactic neurosurgery and minimally invasive surgical techniques for the removal of brain tumors-techniques he is credited with introducing to NYU Medical Center. While a faculty member in the Department of Neurosurgery at UB in the early 1980s-before moving to the Mayo Clinic in 1984-Kelly conducted innovative work in image.guided neurosurgery. To date, he has operated on more than 6,000 patients with brain tumors and is internationally known not only as a brain tumor surgeon but also as an expert in the surgical treatment of movement disorders. In April 2002, Kelly became the only neurosurgeon in history to deliver the William P. Schneider honorary lecture at the American Association of Neurological Surgeons (AANSJ for a second time, having also delivered it in 1996. In this year's lecture he talked about his experiences as a surgeon in Vietnam in 1968-1969. In 1997, Kelly was awarded the Scoville Achievement Award ment tool that allows trained personnel to assign a numerical value-the FIM rating-to a patient's ability to function, based on performance of 18 physical and mental tasks that represent a basic daily routine of personal-care activities. The federal Centers for Medicare and Medicaid Services (CMS), formerly called the Health Care Financing Administration, recently selected the FIM™ as the assessment instrument to be used by rehabilitation hospitals to document requests for prospective payment for rehabilitation treatment. The FIMTM now is used by 1,400 facilities in 50 states and the District of Columbia and has been translated into several languages. In conjunction with the FIM™, Granger established a nonprofit business, the Uniform Data System for Medical Rehabilitation, or UDSMR, to provide reports and store the data for their FIM™ users. That database now holds information on more than 4 million patients, comprising the largest database of medical rehabilitation treatment outcomes in the world. UDSMR is a part of UB Foundation Activities, Inc. -LOIS BAKER art- from the World Federation of Neurological Surgical Societies, marking only the second time in the organization's history that this award has been given. He is also the recipient of The Sir Peter Freyer Medal (Ireland, September 2001), and the Obrador Medal from the Spanish Neurological Association (1996). -S. A. 26 UNGER luffalo Hysician Summer 2002 Ashwani Raj put, MD, has been appointed attending surgeon at Roswell Park Cancer Institute (RPCI) and assistant professor of surgery in the University at Buffalo School of Medicine and Biomedical Sciences. Rajput earned his medical degree (1993) and completed a research fellowship in the DepartmentofSurgery (1997) RAJPUT and residency training in general surgery (2000) at Case Western Reserve University School of Medicine in Cleveland, Ohio. He also completed a fellowship in clinical oncology at RPCI (2002). Rajput's research interests include the molecular genetics of colon cancer and other gastrointestinal malignancies. He is a member of the American College of Surgeons, the Association for Academic Surgery and Society of Surgical Oncology. -DEBORAH PETTIBONE nv tors Recogniz: d School of Medicine and Biomedical Sciences faculty named on United States patents issued to The Research Foundation of the State of New York in 2001 were among those honored by the University at Buffalo at a reception held on May 2, 2002. Among those recognized were Wesley H icks Jr ., DDS, MD '84, associate professor of otolaryngology, who invented the first model of a tracheal lumen that combines epithelial �'V\ R PROl.DTHA A I> IT I M r Y lB W PTTHE<; AWI\RD<;.l8's~CIE CEA D R't Hl( H PRIORIIY I-OR THE l cHI v ME ..,I and mesenchymal elements in a manner that mimics the tracheal lumen surface. Hicks was also honored for his role in developing a method for providing novel surface modified biodegradable polyester polymers that allow small amounts of surface modifiers to be situated on the surface. The research goal for both technologies is the development of wound-healing membranes. Paul }. Kostyniak, PhD, professor of pharmacology and toxicology; Rossman F. Giese Jr. and Joseph A. Syracuse, PhD, co-director of the Toxicology Research Center, were recognized for developing an antimicrobial composition that can impart antimicrobial properties both in, and on, the surface of various household, industrial and medical products. Donald D. Hickey, MD, research assistant professor of physiology and biophysics and clinical assistant professor of neurosurgery, was honored for inventing a device and method to provide a noninvasive estimate of cardiac performance parameters by inserting a catheter and balloon into the esophagus, adjacent to the aortic arch, to sense aortic pressure (part of the previously paten ted Hickey Cardiac Monitoring System). I\ R'\IIY CH UlOGYI<.OF rH 0 ( OMME R( lAllZF fH <;I THLH HI AR AARI rRLLYI tPRESSI\LA I>WI APPR CIAr Stephen Rudin, PhD, professor of radiology and codirector of Radiation Physics Laboratory and Toshiba Stroke Research Center, and Daniel R. Bednarek, PhD, professor of radiology, were recognized for their role in developing a radiographic image apparatus and method for vascular interventions for acquiring veryhigh-resolution radiographic digital images over a small region of interest using a digital solid-state x-ray image detector for the medical imaging application of angiography. Faculty Who Received e Anthony Auerbach, PhD, Physiology and Biophysics; Anthony Campagnari, PhD, Microbiology; Leonard Epstein, PhD, Pediatrics/ Social and Preventive Medicine; Jo Freudenheim, PhD, Social and Preventive Medicine; Paul Knight III, MD, PhD, Anesthesiology/ Microbiology; Mulchand Patel, PhD, Biochemistry; Stanley Schwartz, MD, Medicine; Suzanne Laychock, PhD, Pharmacology and Toxicology. Inventors affiliated with the University at Buffalo were also recognized by the State University of New York as being among the outstanding inventors within the SUNY system at a ceremony held in Albany on May 20, 2002. The UB inventors represented more than one third of the 64 SUNY faculty and staff members from campuses across the system who received awards for their achievements from SUNY Chancellor Robert L. King. Noting this UB Provost Elizabeth D. Capaldi says, "We are proud that UB swept these awards. UB's science and technology is of the highest quality and it is a very high priority for the university to commercialize this intellectual property. Our faculty's achievements in this area are truly impressive and we appreciate SUNY's recognition." The SUNY inventors were honored in four categories: "outstanding inventor," "entrepreneur," "first-time patent" and "first-time invention disclosure." Faculty members were honored as "outstanding inventors," either because they have received multiple patents, their invention has brought in considerable licensing income or their invention is seen as significant in other ways. Faculty in the UB School of Medicine and Biomedical S umm er SG HCH '>TQlALirY. l Al PROPI RTY. YsR coc Ot R 0 • Sciences recognized in this category were: Claes Lundgren, MD, PhD, professor of physiology and director of UB's Center for Research and Education in Special Environments. He has been awarded (with coinventors) more than 120 patents pertaining to, among other areas, human engineering (breathing gear for divers) and the pharmaceutical fields (Nicorette® for smoking withdrawal). Since joining the UB faculty in 1974, Lundgren has submitted six new technology disclosures and has been awarded three patents, two of which are licensed to Sonus Pharmaceuticals and one to a Swiss company, Idiag AG (equipment for respiratory muscle training). Timothy F. Murphy, MD, professor of medicine and microbiology. During his distinguished career at UB, Murphy, who conducts research in the area of vaccine development, has submitted 11 disclosures. Nineteen U.S. and foreign patents have been issued and many more are pending. He is working on a vaccine that targets a bacteria that is the second most common cause ofear infections in children and a leading cause of recurrent infection in patients with chronic obstructive pulmonary disease. 2002 laffale Pbysiciu 27 �PATHWAYS Frederick Sachs, PhD, UB Distinguished Professor of Physiology and Biophysics. Sachs has submitted more than 35 invention disclosures. In a recent study published in Nature, he reported that a protein isolated from the venom of a Chilean tarantula shows promise as a drug to prevent and treat atrial fibrillation, a chaotic beating of the heart that affects 25 million Americans. Several companies are considering the technology for licensing. Those honored as "entrepreneurs" have demonstrated entrepreneurial spirit that enabled them to move their inventions from the research laboratory into wide-scale use. Faculty in the UB School of Medicine and Biomedical Sciences recognized in this category were: EdmundA. Egan, MD, professor of pediatrics and physiology, and Bruce A. Holm, PhD, senior vice provost and professor of pediatrics, pharmacology and toxicology, and gynecology-obstetrics. Egan and Holm developed the commercial surfactant-replacement therapy, INFASURF neonatal, which received new drug approval from the Food and Drug Administration in 1997 as a lifesaving drug that has been demonstrated to reduce the morbidity and mortality of premature newborn infants. INFASURF adult is now in phase II clinical trials. INFASURF drugs are manufactured by ONY, Inc., located in the UB Technology Incubator, part of the university's Office of Science, Technology Transfer and Economic Outreach. Faculty in the UB School of Medicine and Biomedical Sciences recognized for receiving their first patents in 2001 were: Wesley L. Hicks Jr., DDS, MD, associate professor of otolaryngology and attending head and neck surgeon at Roswell Park Cancer Institute, and Frederick Sachs, PhD, UB Distinguished Professor of Physiology and Biophysics. 4D - LORRAINE WAPPMAN AND SUE WUETCHER Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, while addressing your needs and desires for a worry-free future. Call today for your personal tour. Western New York's first Life Care Community. ~nterbury UJoods 1}5) 28 Call7161929-5817 for your personal tour ... laffal1 Physician S umm e r 2 00 2 705 Renaissance Drive Williamsville, New York 14221 �and physiological feedback systems led to the publication of two books on the subject. Dougtas S. Riggs, fonner chair of the Department of Phann· Riggs and his wife of 60 years, Robin Palmer Riggs, acology in University at Buffalo's School of Medicine and shared an uncompromising belief in pacifism. With her help Biomedical Sciences, died on December 22, 2001, at his Riggs was a conscientious objector in World War 11, took in home in Halifax, Canada. He was 87. Hungarian refugees after the 1956 revolution and worked Born in Harpoot, Turkey, of missionary parents, Riggs was educated at Rollins College and at Yale University, where he earned BS and MD degrees. Prior to coming to UB as chair of the Department of Pharmacology in 1954, he pursued an with Physicians for Social Responsibility in the Nuclear Freeze Movement. Riggs is survived by his three children: Timothy A. Riggs of Durham, NC, Virginia P. Riggs, MD (Wendy Lyons) academic career in pharmacology, with teaching positions at of Suffield, CT, and Robin Elizabeth Sagurna of Taufkirchen, Yale and Harvard universities. Gennany; three grandchildren; and a brother, Lorrin A. Riggs was a respected researcher, a gifted teacher and Riggs of Hanover, NH. an enthusiastic mentor. His fascination with mathematics Keyser Cadillac History of Orthopaedic surgery at UB Eugene R. Mindell, MD, chair of the Department of Orthopaedic Surgery at the University at Buffalo School of Medicine and Biomedical Science from 1964 to 1988, has written a history of the department, which is now available for purchase. The book includes an over· view of trends in orthpaedics, both locally and nationally, that impacted on the development of this department, starting in about 1860 and continuing to the present. Complementing this overview are infonnative descriptions of universityhospital affiliations dating from 1848 to the present, and succinct profiles of faculty who contributed to ortho· paedic education at UB over the last 155 years. Also chronicled is Upstate New York's only exclusive Cadillac Dealer the evolution of medical student curriculum and residency training in orthopaedic surgery in Buffalo. Supplementing the 70-page text are 80 photographs, spanning the entire history of the department. The book, titled History of Orlhopaedic Surgery at the University at Buffalo, can be purchased for $25 by sending a check, made payable to the University at Buffalo Foundation, to Michael Quinn, Keyser Cadillac Orthopaedic Surgery Department, University at Buffalo, Hayes 4130Sheridan Drive· Williamsville. Y Annex A, 3435 Main Street, Buffalo, NY 14214. All copies of the 634-4100 key ercadillac.com book and sale proceeds have been donated to UB's School of Medicine and Biomedical Sciences by Dr. Mindell. Summer 2002 4D luffalo Pbysician 29 �BY S. A. UNGER PRESIDENTIAL AssASSINATIONS, Up osean I e c -REEXAMINING THE DEATHS OF KENNEDY AND McKINLEY chair of the Department of Legal Medicine Trauma, presented a talk titled "Trauma Care at Virginia Commonwealth University, Today." He described treatment McKinley Medical College of Virginia, and codirector received in 1901 after he had been shot in of the Virginia Institute of Forensic Science Buffalo and then contrasted this with the and Medicine. Fierro presented a fascinating care a president similarly wounded today look at both the Kennedy and McKinley au- would receive; he also outlined the detailed topsy reports from the perspective of a for- medical-contingency and security plans that ensic pathologist with decades of experience would be put in place wherever the chief executive travels worldwide. studying fatal gunshot wounds of all kinds. After a brief break, the Stockton Kimball In keeping with the lively public debate he University at Buffalo School of Lecture was delivered by Jack C. Fisher, MD, surrounding Kennedy's assassination over Medicine and Biomedical Sciences' emeritus professor of surgery and former the decades, Fierro peppered her talk with 65th Annual Spring Clinical Day was head of the Division of Plastic Surgery at the candid and thought-provoking rebuttals of held on April 27,2002, at the Buffalo/ of California at San Diego. Fisher, University a number of conclusions reached by Becker. Niagara Marriott. The program, sponsored who has authored a book on the McKinley Following Fierro, Roger Seibel, MD '66, by UB's Medical Alumni Association, focused on "Presidential Assassinations in the UB clinical professor of surgery and ortho- assassination titled Stolen Glory, recounted 20th Century." The opening talk was titled "A Surgeon pedics and medical director of the Regional Evaluation for Quality Improvement in how he had become interested in this subject while a medical student at UB. He then pre- Looks at the Assassination of John F. Kennedy" and was delivered by Donald R. Becker, MD, a UB emeritus clinical professor of surgery. Becker provided a riveting description of Kennedy's assassination-his wounds, emergency room treatment and autopsy (the latter of which he characterized as "chaotic"). He also reviewed the criminal investigation that followed, the findings of the Warren Commission and the myriad conspiracy theories that persist to this day. Becker was followed by Marcella Fierro, MD '66, chief medical examiner for the Commonwealth of Virginia, professor and 30 luffall nysician S ummer 2 002 I �sented a well-argued case for why the con- Sullivan, Sharon Murphy, Teresa Vietti and troversy surrounding McKinley's operative the late Brigid Leventhal. His prominence on and postoperative care in Buffalo should finally be laid to rest. At the close of the lectures, the audience the Hodgkin's and non-Hodgkin's lymphoma disease committees of the Pediatric Oncology Group, as well as his role as principal investi- had an opportunity to ask questions of a gator of seminal phase 3 studies of children editor in chief of Vaccine Bulletin. He also serves as a reviewer and editorial board member for many other publications, including Pediatrics. panel made up of the morning's speakers, with these disorders, have Jed to important ad- After leaving Buffalo in 1974, Dantzker after which attendees gathered for a lun- vances in treatment worldwide. In addition to cheon, where Fisher was presented with the Stockton Kimball award by Stephen his scientific and academic credentials, Brecher is known as a devoted, tireless and Pollack, MD '82, on behalf of the UB compassionate pediatrician who exemplifies served as an instructor in the Department of Internal Medicine at the University of California at San Medical Alumni Association. the best qualities of a caring physician. Diego for a year before joining the Each year at Spring Clinical Day, medical of pediatrics at the UniversityofCalifornia at faculty at the Universityof Michigan, where he contrib- alumni achievement awards are presented to Los Angeles and director of pediatric infec- uted greatly to the graduates of UB's School of Medicine and tious diseases and the Pediatric AIDS growth and reputa- Biomedical Sciences. Recipients are nominat- Program at the Cedars-Sinai Medical Center tion of the Depart- ed by their fellow alumni, with final selections made by the governing board of the in Los Angeles. Prior to that, he served for six years as professor and head of the Division ment of Internal Medicine's Pulmo- Medical Alumni Association. This year's re- of Infectious Diseases in the Department of nary Medicine Sec- Pediatrics at the University of Texas Health tion. In 1983, he moved to the University of Science Center at San Antonio, where from Texas Health Science Center in Houston, 1975 to 1981 he was professor and chair of where he served as professor and vice chair of the Department of Internal Medicine atrics at Roswell Park Cancer Institute, chief the Department of Pediatrics. Brunell was a member of the Advisory Committee on Im- of the Division of Pediatric Hematology/ munization Practices Oncology at Kaleida Health's Children's of the Centers for Dis- cine. In 1990, he was nam- Hospital of Buffalo and chief of pediatric ease Control (CDC) ed chair of the Depart- hematology/oncology in the Department of Pediatrics in the University at Buffalo's and the Consultative Group on Vaccine De- ment of Medicine at Long School of Medicine velopment, which is and Biomedical Sci- concerned mainly with medicine at Albert Ein- ences. He is recog- evaluating vaccines for stein College of Medicine nized as a national developing countries. in New York City. He is He has also served as a member and chair of currently a partner in a of childhood lym- the Committee on In- Wheatley Medtech Part- phomas and has fectious Diseases of the MEDICAL ALUMNI Since 1987, Brunell has served as a professor cipients are as follows: Brecher is chair of the Department ofPediat- and international authority in the area and Critical Care Medi- Island Jewish Medical Center and professor of biotechnology company, ners LP. Dantzker has Academy of Pediatrics (the Red Book Committee). In addition to disease and non- serving as a consultant to the World Health Organization, the CDC, the National Insti- textbook Cardiopulmonary Critical Care, Hodgkin's lym - tutes of Health and the Food and Drug Ad- which is the foremost text of its kind. He phoma in children ministration, Brunell has contributed to most of the standard textbooks of pediatrics, med- also established a major investigative jour- icine and infectious diseases in the area of his served on the editorial boards of numerous expertise. Currently, he is chief medical editor of Infectious Diseases in Children and other journals, including The American Review ofRespiratory Diseases. published more than stracts on Hodgkin's and adolescents. Brecher is first author on many papers, published in collaboration with such prominent pediatric oncologists as Margaret :~ 0 and director of the Division of Pulmonary authored more than 100 peer-reviewed papers and several text- 400 articles and ab- c a E books. He is best known for his remarkable nal, The Journal of Critical Care, and has S Limm e r 2002 luffale Physician 31 �A L U M N Spring Clinical Day B rkson M morial Award The RobertS. Berkson, MD, Memorial Award in the Art ofMedicine is presented annually to honor the values and ideals epitomized by Dr. Berkson, who was an esteemed family physician in Buffalo. Patient care was his forte; competence, compassion, patience and dedication to teaching were his virtues. His special expertise in "the art of medicine" is perpetuated in this award. This year, the award was presented to Lawrence Golden, Lawrence Golden a local cardiologist who has served in a number of leadership positions at Millard Fillmore Hospital, including chair of the Department of Medicine (1969-86), chief of cardiology (1967-87) and director of the Cardiology Fellowship Program (1980-92). Throughout his career, Golden has given freely of his time and expertise to a wide variety of services and programs, according to Margaret Paroski, MD, senior associate dean in the School of Medicine and Biomedical Sciences, who nominated him for this award. "In addition to dedicating his life to giving his patients the best care possible and teaching the students and residents how to appreciate the humanism of medicine, Dr. Golden and his wife, Nancy, recently endowed a lectureship series in mind-body medicine at our school," says Paroski. "This generous gift builds upon what his many years of voluntary service have exemplified to our studentsthat physicians who are well versed in mind-body medicine concepts will better provide humanistic care for their patients." D an's Community Service Award Melvin Oyster is the inaugural recipient of the Dean's Community Service award, which recognizes outstanding accomplishments that contribute to making our community a better place to live. "After 50 years in medicine, I can recall only five outstanding physicians, and Dr. Mel Oyster is one of them," says Francis Fote, MD '52, who introduced Oyster at Spring Clinical Day. Oyster is best known for having established the accred- Gentzke & Associates, Inc. Registered Investment Advisor ited Family Practice Residency Program in Niagara Falls, New York, which has graduated 90 residents since 1974. The program grew out of an internship he created in 1952 that was dedicated to preparing students for family practice. "He did this without having Private Portfolio Management President and CEO Glenn Gentzke and Ch1ef Investment Strateg1st Chns King Tax Consulting was one of the first to participate in the internship. "And he earned recognition for the program the hard way. Initially his request for help to support it was turned down by UB's medical school, so he looked Estate Planning instead to the University of Rochester School of Medicine." Fee-Based Asset Management UB Commons 520 Lee Entrance TIAA -CREF Advisor Suite 205 Network Amherst, NY 14228 Tel: (716) 639-0475 had any formal residency training himself," recalled Fote, who Certified QuickBooks Professjonal Advisors www.gentzke.com In addition to founding the residency program, Oyster continues to be "medical director of everything in Niagara Falls that concerns the poor and underprivileged," according to Fote. "He continues to work and teach with the enthusiasm of his youth, long after his contemporaries have retired, and he remains a favorite of the students." Thomas Rosenthal, MD '75, chair ofUB's Department of Family Medicine, says, "Dr. Oyster has been a mentor to me since I was in medical school, and he continues to offer insight into how I, as department chair, can best serve primary care physicians in Western New York. He is an outstanding physician, a leader with energy, an innovator with style, and an educator by example. Dr. Oyster defines community-based primary care." 32 luftal• Hysiciaa Summer 2002 4D �was elected president of · will se"e as treasurer. Kozera is the Medical Alumni Association on April27, 2002, at Spring Clin- the medical director for social services and assistant medical ical Day. Duffner is a UB professor of neurology and pediatrics and administrator for Erie County Health Department. a physician in the Department of Neurology at Kaleida Health's Children's Hospital of Buffalo. will se"e as the new vice president for the association. Pollack is a UB clinical assistant professor of ophthalmology who is in private practice in Williamsville. GENESEE HEARING SERVICES 61 Wehrle Drive (Near Harlem) Amherst 14225 THE AUDIOLOGY CENTER 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 712-2000 837-6213 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" rvouaireJ Jerri Kaplan Joyce, MA Summ e r 2 00 2 Buffalo Physicin 33 �DEVELOPMENT N E w s The Choice to leave ale ac By Li nda J . Cor de r , PhD. CFRE of my first child and became a member of the "older generation" quite recently, when my last parent, my mom, died. Neither transition was unexpected. We are schooled in this normal course of events from our earliest years. It is, however, our personal experience of these transitions that gives the concept, "Generation to Generation," substance. On this day of transition, we met, a small group of those closest to my mom, with several doctors and a hospital social worker. The lead doctor explained what had happened medically, since Mom's admission several days before. One or two others added some small detail. Altogether, we spent forty minutes discussing the physical aspects of her body's rapid deterioration, in both technical-and very down-to-earthterms. Each ofher children reaffirmed what we had accepted in our hearts the night before around her bed: If there was no hope, life support should be withdrawn. At the end of this discussion, one of Mom's ministers-a woman not many years younger than ! suggested we say the Twenty-third Psalm together, "one of Eva's favorites." Hand spontaneously joined hand around the circle, physicians and children, grandchildren and close friends. Familiar words both comforted and strengthened each of us for our respective roles in the final few minutes of her long, loving life, already irrevocably complete. I was participant and spectator at once. I was grateful for the education and experience of these doctors, that they handled this particular endof-life discussion with such compassion and caring. (I hoped that it was typical.) I was thankful that they were part of the circle that symbolized our contemplation of the mystery of life, and what it meant to walk in the shadow of death. 34 Ia f fa II P b J sic i a1 Summer 2002 This healing and profound transitiOn also made me proud to be a part of one of our nation's medical schools. It made me want to return home and make certain that UB's curriculum included practice in these crucial conversations. It made "The Oath," repeated by each new class of graduating medical doctors, more poignant and imminently real: " ... I will "It made crystal clear tread with care in matters of life that medicine is art as and death. If it be merely within my abilities to help ease suffering well as science, and that at the end of a life, may I face this we must provide our awesome responsibility with humility and awareness of my students with experi· own frailty." It made crystal clear ences along this entire that medicine is art as well as scicontinuum." ence, and that we must provide our students with experiences along this entire continuum. My sibs and I spent the rest of that day of transition making arrangements. Mom's service was a celebration, and memorials were designated for nonprofits in which she was involved for many years. Who can say where her impact will be the greatest? For those who knew my mom, memories, love, values, hope, even her genes, are her most direct legacy. For others, it will be the story of her courage to change and grow, her ideals and career as a teacher. It may also be the scholarship created in her memory that will provide an opportunity for a few more members of the next generation to earn a college degree. When it comes right down to it, such possibilities are why I work in this field, for UB and wholeheartedly through our current campaign-to assist those who, like my mom, choose to leave a legacy that will truly make a difference from "Generation to Generation." Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at 1-877826-3246, or via e-mail at ljcorder@buffalo.edu. CD �SUMMER 2002 1 - - - - - - - -l FI RST ROW, LEFT TO RIGHT' GUEST MARGARET PAROSKI (SENIOR ASSOCIATE DEAN), DANIEL CuRTIN.jOHN SHEFFER. HENRY GARDNER. SECON D ROW: WILLIAM EDGECOMB, PHILIP REITZ, DONALD C. NUWER, ROBERT jAEGER, ANTHONY PREZYNA. HANS f. KIPPING,jAMES STAGG, jAMES PHILLIPS. Summer 2002 l 1ffale Hysiein 35 �, FIRST Row, LEFT TO RIGHT· DONALD H. SPRECKER, 0LIVERj. STEINER, RALPH 0BLER, BERNIE DAVIS, EUGENE W. LOESERjR., ROBERT McDONOUGH WILSON, KURT j. WEGNER, AARON SIMPSON, PHOEBE E. SATUREN, jOSEPH f. CENEWICH, FRANCIS A. FOTE, DONALD F. DOHN, MILTON C. lAPP, ROBERTA. BAUMLER, MELVIN B. DYSTER, jOHN Y. RANCHOFF,jAMES F. ZELLER, DONALDj. KELLY, MELVIN KROHN, NEAL fUHR. , FIRST ROW, LEFT TO RIGHT· BEN CELNIKER, CERMANTE L. BONCALDO, ROBERT B. SuSSMAN, SHERMAN WOLD MAN, jAMES E. lASRY, j. DAVID SCHNATZ. SECOND ROW: fRANKj. CHAFEL, SOL MESSINGER , PHILIP ALFRED BRUNELL, BERNARD WAKEFIELD, jOHN PARKER, ARTHUR L. BECK, PAULL. ARCHAMBEAU. 36 llffall nysiciaa �FIRST Row, LEFT TO RIGHT: DAVID CARLSON, ALAN POHL, GEORGE R. TZETZO. SECOND ROW: RONALD I. DOZORETZ, PHILIP D. MOREY, ROBERTA. KLOCKE, jACK C. fiSHER, PAULj. LOREE, ANTHONY P. MARKELLO, M I CHAEL M . MADDEN, MELVIN j. STEINHART, SEBASTIAN S. fASANELLO. FIRST Row, LEFT TO RIGHT• ROBERT M. BENSON,jOHN RANDALL ANDERSON, RONALD P . jOSEPHSON, DAV I D R. DANTZKER. SECOND Row: jACOB KRITEMAN. T H OMAS P. O'CONNOR, ARTHUR C. SOSIS. GoiNG UP STAIRS ON THE LEFT, BOTTOM TO TOP· jAMES P. GIAMBRONE, THOMAS P. SHEEHAN, RICHARD G. jUDELSOHN, ANTHONY LO GALBO . LAST FOUR BOTTOM TO TOP: T H OMASAUGUSTI NEjR.,j. BRIAN SHEEDY, DONALD E. MILLER, Rocco C. VENUTO. Summer 2002 1111111 Phys ici n 37 �SUMMER FIRST Row, 2002 1 - - - - - - - - ' LEFT TO RIGHT: ROBERT EINHORN, LINDA A. KAM. SECOND Row: RICHARD SAVAGE, MARTIN BRECHER. I FIRST ROW, LEFT TO RIGHT: EuGENE A. PAUL, HOWARD LIPPES, IRA l. SALOM, LINDA SMITH, ALAN S. KURITZKY, RONALD A. VIDAL, CARLj. SCHMITT. SECOND ROW: MARK DE~ARIE,jOSEPH K. BYLEBYL, 0URET S. SMITH, KEVIN C. GREENIDGE, GREG YOUNG. 38 l1ffale Pkysiciae Summer 2002 �FIR.ST ROW, LEFT TO RfGHT: GERALD A. HARSTER, I VAN A. B AUMWELL, NA!'<CY j. PETERS, jESS ICA R OCKWELL, SUSAI'< fiSCHBECK, MARY A. KELLY, ELIZABETH P. BARLOC. SECOND ROW: TI~!OTHY j. CEERING,jO H N S. SANTELLI, ARLENE R. CURRY, DOUGLAS K . PLESKOW, RAND! C. PLESKOW. LINDA C. RABINOWITZ. ROBERT A. CIANFAGNA, jOSEPH P. LEBERER. THIR.D ROW: ANDREW R. HORDES. jOSEPH f. GIOIA, DAVID I. KURSS, jOSEPH WAYNE, RICHARD HEATH, STEPHEN POLLACK PATRICK HURLEY, 1\EIL KLUGER, KEV I N BARLOG, PHILLIP STEGEMAN, ROBERT STERN, jOSEPH CELORMINI. BOTTOM TO TOP: ADA\! K. ASHTON, TIMOTHY BUKOWSKI, DANIELA. BUR!'iS, PATRICKj. SHAUGHNESSY, YUOKO YERACARIS, CARLOS LOPEZ, CAETANO SCUDERI, KATHY LiLLIS. PATRICIA L. KAUFMANN, DOLORES C. LEONARD ]. KEVIN QUINLIVAN. IVAN HARANGOZO, MICHAEL B. WEINBERG. MICHAELS. WATSON. S11mmer ' 2002 llfflll nys i cial 39 �Flli.STROW, LEFT TO RIGHT: jOHN K. CUMMING, KATHARYNE SULLIVAN, DIANE SANFILIPPO,jUDINE C . DAVIS, SHERI BACZKOWSKI ILDIKO MIKOS, PATRICIA A. VORIES, MAUREEN E. DLUGOZIMA, SHARON R. MALLEN, PHILOMENA~. BEHAR, REBECCA HAVERLY, GAYLE FRAZZETTA, ROBERT HAVERLY, KEVIN jACOBSON, MARK IPPOLITO, BRIAN E. J. McGRATH. SECOND ROW: BOB l.AUDICO, MARK PIOTROWSKI, MICHAELA. COLUCCI, GERARD DILLON, EILEEN CRESPO , CYNTHIA JENSON, EvELYN CoGGINS, SUZANNE ROSENBERG, STEPHANIE fRETZ, CATHY YI, VINEET SINGH. FIRST ROW, LEFT TO RIGHT• jEANNIE KAO - KOENIG, SUCHITRA KONERU,jANICE M. LEE, CLAUDIAjARAMILLO LEE, ANDREA TORSONE. SECOND ROW: DAVID NOVAK, WILLIAM WIND, BENJAMIN KOENIG, fRANK M . LEE, RONIKA D. CHOUDHARY, CATHERINE COSTELLO. jARED C. BARLOW JR., PETER ERCOLINO . THIRD ROW: CHARLES SEVERIN, RAVI K. DESAI, M. ANGELA MCLELLAN,jOSEPH 40 11ffal1 Hysiciu L. CHOW, THOMAS R . ELMERjR., ALEXANDER MARCUS. Summer 2002 �Dear Fellow Alumni ' tis with great pleasure that I begin my year as president of the Medical Alumni Association (MAA ). John Bodkin, who served as president for the last two years, ran the organization smoothly and successfully, with insight, intelligence and good humor. I am pleased to announce that he has promised to continue to play an active role as past president. This year's Spring Clinical Day-a fascinating blend of medicine and history-was extremely successful, and I invite you to read about it, starting on page 30 of this issue. Over the past several months, 1 have had the opportunity to serve as a member of the Liaison Committee on Medical Education (LCME) Task Force, a self-study group that reviews all aspects of the medical school in preparation for the accreditation review in October. The last LCME visit was in 1994, and since then there have been a number of significant developments at our school. For example, lecture halls have been renovated and new classrooms and seminar rooms added-all of which are equipped with the latest educational technologies. A new curriculum has been developed for the first- and secondyear students that combines basic science and clinical teaching, with less emphasis on lectures and more on small-group and independent learning. Since 1994, recruitment in the basic sciences has been very successful, and faculty in these areas (including those at Roswell Park Cancer Institute and Hauptman-Woodward Medical Research Institute) have received grants equivalent to the 86th percentile of all medical schools in the country. The clinical faculty has also seen a sizeable increase in research dollars. Under Dr. Bernardino's leadership, an infrastructure for the medical school has been put in place, with clear-cut lines of authority. Direct communication between the medical school administration and faculty has been greatly enhanced by Town Hall meetings that are hosted by Dean Bernardino at each of the clinical sites. As is the case elsewhere in the country, the biggest challenge to medical education in Buffalo is the shortage of hospitalized inpatients for third- and fourth-year medical students. Additional outpatient teaching clinics in hospitals and private offices will be necessary in order to train medical students and residents in the future. As such, the school's administration and faculty are working hard to establish and enhance these venues throughout our community. Finally, following the tragedy of September II, the enormous financial pressures on New York State have directly impacted the medical school. Because our endowment is so limited, money for scholarships, minority student recruitment and funding of resident and medical student research projects is suboptimal. I hope that the medical alumni will take up the challenge to increase donations to the medical school to support these important projects. Medical students are our future and we need to do everything we can to get the brightest and most compassionate to come to Buffalo. In closing, I would like to say that it is a great honor to serve as president of the MAA. If you have concerns or questions that you feel I can address on behalf of the association, please feel free to contact me at any time by calling the MAA office at (7 16) 829-2778. I /_LA- PATRICIA K. DUFFNER, MD •72 President, Medical Alumni Association Summer 2002 luflalo Physiciaa 4 1 �C L A 1950s John W. Richards, MD '52, FACS, writes: "I retired from general surgery in Chicago 1992 and like living in the Ft. Lauderdale area very much. Enjoy opera, symphony and ballet here, plus great weather. " N 0 T E S the antique car hobby. We spend our summer months in Western New York, at our 150-year-old home in Franklinville, NY, and keep up contact with our Meyer Eye Department colleagues." E-mail address is: thelorees@hotmail.com. William Sperling, MD '66, Jacob (Jack) Lemann Jr., MD '54, New Orleans, LA. E-mail address is dr.jack@lemann.net. "In May 2001, I retired from Kaiser Permanente, where I practiced pulmonary and critical care with one office in suburban Williamsville, NY, and the other in midtown, Buffalo, close to the Children's Hospital of Buffalo and the school of medicine. The city office, especially, serves a highly diverse and often clinically challenging population of children and adolescents. Because of my interest in public health and epidemiology, I serve as the medical director of the spending two exciting years traveling nationwide and internationally. I have been a member of the New York State Immunization Advisory Council since its formation by the governor and legislature in I 995. With the rapidly expanding spectrum of vaccines that have been introduced in recent years, I have had a busy schedule teaching and consulting on the subject." care physician with Group Health Cooperative in Spokane, W A. The sun and snow were great, and it is hoped that there will be more trips in the future." E-mail address: schaffer@icehouse.net. Robert Z. Fialkow, MD '72, writes: "My wife, Mikie, and I live in beautiful Owensboro, Kentucky, where we are building a farmhouse on our 22acre farm. We have three Michael S. Bardo, MD '55, writes: "I retired from medical practice on December 31, 2001, because of my wife's illness. My last 11 years of medical practice were with the State of California at the California Correctional Center, where I served as the chief medical officer." 1960s Jack Fisher, MD '62, writes: "In June 2002-at the tender age of 64-I graduated with a master of arts degree in history from the University of California at San Diego as a member of the class of '02-40 years after '62!" E-mail address is: jfishermd@aol.com. medicine. My wife, Barbara, and I are traveling around the U.S. and Canada in our motorhome. We are also enjoying tandem bicycling and playing golf and tennis. " E-mail address is: billsperl@aol.com. James Giambrone, MD '67, is director of the Catholic Health System, Western New York Board of Directors; also chief operating officer for Associated Physicians ofWNY, P.C. Richard Judelsohn, MD '67, writes: "Sally and I are Florida residents (Ft. Lauderdale) and are enjoying retirement, traveling, grandchildren, and writes: "As a practicing pediatrician for over 25 years, I am the managing partner of Buffalo Pediatric Associates. The group has six physicians and two nurse practitioners, luffalo Hysiciaa S umm e r Paul J. Loree, MD '62, 42 assnotes 200 2 Erie Country Department of Health. My responsibilities there cover a broad range, including supervision of programs for school health, chi!dren with special needs, inner-city clinics, STD and TB clinics, outbreak investigation and control and immunizations. Vaccine-preventable diseases-and their eradication-have been of special interest to me since my pediatric training at Cornell Medical Center-New York Hospital (where I volunteered at city vaccination dinics ), followed by appointment to the Epidemic Intelligence Service at the Centers for Disease Control. At the latter, I was an immunization officer, E-mail address is: judelson@bflo.co.erie.ny.us. Donald P. Copley, MD '7D, a cardiologist with Buffalo Medical Group, P.C., was installed as the new president of the Medical Society of the County of Erie on May 7, 2002. Daniel J. Schaffer, MD '7D, and Alan Podosek, MD '7D, reunited this past january in Vail, CO, for a week of skiing. Alan has a private practice in Lynchburg, VA, and Dan is an urgent sons: Dr. Lawrence Fialkow, who lives in Charlottesville, VA; jared, who graduated from medical school in Philadelphia in May and who presented us with our first grandchild in January 2002; and Ethan, who is married to a gorgeous Japanese girl and is a first-year law student at the University of Louisville. I run four dialysis units with my two associates and contemplate retirement in the next few years to enjoy my hobbies of running, tennis, music and video poker. " E-mail address is fialkow@yahoo.com . ��CLASS NOTE Bruce R. Javors, MD '73, received the Award of Merit from the Rochester Academy of Medicine in 2001. A boardcertified surgeon who practices at Rochester General Hospital, as well as a fellow of the American College of Surgeons, Dynski holds numerous faculty positions and finds time to teach surgical, internal medicine and 08-GYN residents. She is also the liaison between the writes: "I was recently named chairman of radiology at St. Vincent's Catholic Medical Center in NY. I was elected to become a Fellow of the American College of Radiology, effective this September. Last year, I was appointed professor of clinical radiology at New York Medical College. I have just completed the manuscript for my second text, to be published this fall by Springer-Verlag. My wife, Susan, and daughter, Alii, continue to light up my life." E-mail address is: bjavors@ saintvincentsnyc.org. Department of 08-GYN and has served as director of the Breast Clinic at the Women's John Marra, MD '74, is a Center since 1992. cardiologist at Good Samaritan Hospital in Baltimore, MD. He is director of cardiac rehabilitation and assistant professor of medicine at johns Hopkins University. He and his wife, Maggie, live in Roland Park and have three children. Dynski, who is a sister of St. Joseph, is involved in numerous community programs and has been a Special Olympics volunteer since 1997. She is a member of a Congregational Committee to evaluate the future of geriatric needs and member of a committee on medical ethics advising the Catholic Diocese of Rochester through the Department of Social Justice and Social Ministries. "Perhaps most admirable and intriguing about Marge," writes her friend Jeanne Grove, DO, "is her courage and continuing accomplishments in spite of being paralyzed from the waist down" as a result of complicated back surgery in 1994. "Through intense rehabilitation and amazing perseverance, Marge has taught herself to walk without gaining sensation in her lower body. "A quote by Willa Cather, I feel, epitomizes Dr. Marguerite Dynski as follows: 'There are some things you learn best in calm and some in a storm."' Larry Altschul, MD '77, writes: "I can't believe it has been 25 years already. My wife, Mercedes, and I live in Dix Hills on Long Island. I am the 'senior' (I can't believe that word actually applies to me) partner in a large cardiology practice. Since April 2000, I have been director of cardiology at Good Samaritan Hospital 44 llffala nysicin Summer 2002 Medical Center. We have five children, ages 15, 17, 19, 21, and 22." E-mail address is: drlarryalt@ aol.com. Andrew S. Ross, MD 'BD, writes: "I have been in practice in Boca Raton, FL, since 1986. I completed my general surgical residency and colon and rectal surgical fellowship. I practice in the largest surgical group in South Florida ( 11 surgeons). I have a busy colorectal practice with a lot of laparoscopy. I remain happily married (26 years) and have three wonderful daughters: Dara, age 23, llana, age \9 and Jordana, 16." E-mail address is arossl7481@aol.com. Adolph Soto Jr. MD '83, writes: "! am still working for Saint Vincent's CMC of New York as a pyschiatrist-Harrison, NY. Adopted a baby, Lucas Enrique, born on january 18, 2001." E-mail address is asoto@ saintvincents.com. Herbert B. Newton, MD 'B4, writes: "My family continues to enjoy Columbus and Ohio State. Alex is into TaeKwonDo, swimming, soccer and riding his bike. Ashley is into ballet, gymnastics, swimming and piano lessons. Cheryl is still the clinical nurse specialist for the neurology/neurosurgery floor at OSU. Work remains busy as I continue my role as the director of neurooncology at OSU and the james Cancer Hospital. I was recently elected vice chairman and chairman elect of the NeuroOncology Section of the American Academy of Neurology. In addition, I am thrilled with the publication of an article entitled "Review of the Molecular Genetics and Chemotherapeutic Treatment of Adult and Pediatric Medulloblastoma" in the December 2001 issue of Expert Opinion on Investigational Drugs. Blackford Middleton, MD '85, writes: "I have re- turned to the world of academic medicine after leaving MedicaLogic/ Medscape (now owned byGE Medical Systems) in early 2001. I have joined the faculty in general medicine at the Brigham and Women's Hospital, Harvard Medical School, and I am director for clinical information systems research and development at Partners HealthCare System, Inc. I'm having fun with students and research, and still building clinical �information systems. Daughters Julia (9) and Lillian (5) are wondering, 'Where is the snow?' Wife Ursula King is making our new home and considering work ... eventually." Laura L. Post, MD '87, writes: "I have been living and working in Saipan, Commonwealth of the Northern Mariana Islands (U.S.) for five years now and am very much enjoying medical practice in a remote, underserved area. I am sorry that I was not able to come to the reunion, but the trip would cost over $2,000 and taken longer than 24 hours. Maybe I will be ble to make the 20th reunion. I spend my days as the correctional psychiatrist at the local prison and commute to the nearby Territory of Guam (U.S.) to serve at their Medication Clinic for seriously mentally ill adults. After hours, I see private clients and on weekends do competency and insanity evaluations for the court, disability and fitness-forduty evaluations in the private sector, and opinions in personal injury civil and sentencing mitigation in criminal matters. My partner, Judith E. Avery, RN, MS (SUNY at Buffalo '87), CNS and I live in a beautiful house overlooking the ocean with our small dog, Max; our medium-sized dog, Sasha, and our large dog, William Palmer Jr. MD. '90, Boris." E-mail address is drlaurapost@hotmail.com. the move again. Stephanie, Janee (12), Jilian (9) and Jayson (2) Pat Shaughnessy, MD '87, and I relocated to Winston-Salem, NC, in june 2002. I have joined another physician in pri- writes: ''I'm in a twoman rehabilitation medicine practice in rural Western Pennsylvania. (I see Dennis Moll ins at conventions.) I am president-elect of the Mercer County Medical Society. My wife, Maggie, and I have three daughters: Colleen, a freshman in high school, Maureen, 12, and Kathleen, 11. All are involved in music. I am cantor and accompany at church. Our "Farmette" is six acres, and we have llamas, sheep, chickens, etc. I'm in Disney World's 20012002 promotional video-biggest accomplishment to date!" Anthony J. Bufo, MD '89, writes: "I am a pediatric surgeon in West Palm Beach, FL." E-mail address is: ajbcrb@ netscape.net. Glen M. Ginsburg, MD '90, pediatric orthopaedic surgeon at the University of Nebraska Medical Center, has been promoted to associate professor. He has been on the staff there si nee 1996. E-mail address is: gi nsy4549@yahoo.com. writes: "We have been on vate practice to work at Whitaker Rehabilitation Center. I have also assumed the outpatient rehabilitation medical directorship. We left Indiana after eight years." Andrew Feinberg, MD '95, and Whitney (Orman) Whitney writes: "Andrew and I got married E-mail address is: wpalmerjr@aol.com. and have a two-year-old son, Ryan, and a Susan J. Littler, MD '91, ophthalmology in a private practice here in PhD, is an attending in Atlanta, and I am working part-time at a OB/GYN at Mt. Sinai Hospital. E-mail address is: suejlittler@aol.com. pediatric urgent care center." on November 2, 1996. We live in Atlanta baby due in June 2002. Andrew is practicing Atif Zafar, BA '89, MD '94, received the George W. Thorn Award from the University at Buffalo Alumni Association during its annual awards dinner held on April19, 2002. The award recognizes graduates under the age of 40 who have made outstanding national or international contributions to their career field or academic area. A medical computer scientist, Zafar is clinical assistant professor in the Department of Medicine at the In diana University (IU) School of Medicine and is on the staff of the Regenstrief Institute, a 25-year-old research foundation located on the IU medical school campus dedicated to the study and improvement of health and health care delivery. Gonzalo Bearman, MD '97, writes: "Regrettably, I was not able to attend the reunion this year. All is well. I am an infectious diseases and public health Fellow at Cornell University in New York City. I will finish the program in july 2003. Currently, I'm dedicating most of my time to clinical research and an MPH degree. Regards to all." Dayo (Wilson) Lanier, MD '97, wrote: ''I'm a pediatrician, living in Albany, NY, with my husband, Rob, and my nine-month old son. I took this past year off from practicing medicine to stay at home with my son, but started back to work parttime this june." Stephen Milback, MD '97, writes: "My wife, Cindi, and I now have three beautiful children ages 5, 3, and 16 months. We've enjoyed living in San Diego these past five years and look forward to a new adventure as we plan our move to Japan." E- mail address is: steve milback@hotmail.com. CONTIN U ED ON PAGE 4 8 Summ e r 20 0 2 luffale Physicia n 45 �• e .John Ambrusko, named in his honor in 1988. 2002 After military service he University of Buffalo School LTJG, he returned to Buffalo of Medicine. He was an All· in private practice. In his 80s, Ambrusko returned to Buffalo and re· John S. Ambrusko, a fonner took on the role of father to sumed his medical career, American basketball player Buffalo surgeon and Florida two grandsons, 4 and 6 serving as chief of the head and captain of the 1940 shaped the rest of Loeser's career occurred in 1953, The defining event that public health official died on years old, after their and neck service at Roswell Dartmouth team that won April 25, 2002. He was 88. mother, his daughter Sara Park Cancer Institute. He the Ivy League title. He when he fell victim to polio The youngest of nine Tokars, was murdered near also maintained a private served in the Anny during during the last major epi- children of Hungarian immi- Atlanta. Eventually her hus· surgical practice in the Buf- World War II, rising to the demic in the Buffalo area. grants, Ambrusko rose from band, Atlanta attorney falo area and served as a rank of captain. According to his brother, humble beginnings to be- Fredric Tokars, was convicted clinical professor in UB's come one of New York of arranging the murder. medical and dental schools. State's most recognized and respected surgeons. Ambrusko's wife, the Marchetta's colleagues After the war, Sullivan Eugene W. Loeser, MD '52, was on the staff of Kenmore he spent agonizing months Mercy Hospital in the Town in an iron lung, and only after further months in re- former Phyllis Eusterman, describe him as a dedicated of Tonawanda, served as died in 1998. He is survived humanitarian and skilled chief of staff and surgery at habilitation was he able to cal degree, Ambrusko be- by six daughters, Therese of surgeon whose career was Sheridan Park Hospital in ambulate sufficiently to After receiving his medicame a surgical fellow at San Francisco, CA; Gretchen marked by quiet service the Town of Tonawanda and work in the UB Respiratory the Mayo Clinic in Roches- Schaeffer of Newport Beach, to his patients. He has operated a private practice and Rehabilitation Center, ter, MN. When World War II CA; Mary Bennett of also been honored by the for many years on Kenmore where he later served as broke out, he enlisted in the Shrewsbury, NJ, Joni of many medical residents Avenue in the Town of medical director. Loeser's Navy, serving for several Bradenton, FL, Karen Wilcox he trained. Tonawanda. A sports enthu- personal experiences led years before returning to the of Buffalo, NY; and Krissy of siast, he was team physician him to introduce improve- Marchetta was a diplo- Mayo Clinic. In 1948, he Woodstock, GA; and 11 mate of the American Board for the Bisons baseball team ments in feeding and joined the surgical faculty at grandchildren. of Surgery, a fellow of the in the 1950s and for the breathing techniques to aid American College of Sur· Bills from 1960 to 1963. patients in weaning from the UB. He also opened a general surgery practice and in rank Marchetta, 1950 helped the Sisters of geons and a member and Survivors include his iron lung. In 1958 Loeser relo- past president of the wife, the fonner Mary Ferguson of Delray Beach cated to Youngstown, Ohio, Mercy found Kenmore Mercy Frank Marchetta, a re- International Head and Neck Surgical Society. Hospital, where he served as spected oncologic surgeon chief of surgery for 20 whose medical career Survivors include his years. From 1954 through spanned more than 50 1978, he was chief medical and Rose Hill, Ont.; a daugh- to become director of medi- ter, Elizabeth S. Bond of cal education for its hospital wife of 53 years, Jean; two Wellesley, MA; a son, Ken· association. During this pe- years, died unexpectedly daughters, Linda Marchetta neth F. of New York City; riod he introduced renal di- consultant to Niagara March 6, 2002, in his home Wild, MD '76, of Williams- and two grandchildren. alysis into the local hospital. Mohawk Power Corporation. on Sanibel Island, FL. He ville, NY, and Joanne was 81. Marchetta of San Francisco, After cataract surgery forced him to give up his Born in Utica, Marchetta Although he never re- 1am • Loeser: CA; a son, Dr. Charles of attended Cornell University East Aurora, NY; and five William D. Loeser, died on moved to Florida, where he prior to earning his med- grandchildren. February 11, 2002, at 79 passed the state's medical ical degree at the then- board exam and began a University of Buffalo Medical new career as public health School. After World War II, years of age. ames Sullivan, Loeser was a native of Buffalo and a graduate of he served James R. Sullivan, a former County Health Department in the U.S. in Bradenton. He also served Medical as an associate medical ex- Corps sity of Buffalo ('41). Follow- cally in his later years, but Buffalo Bills and Buffalo ing graduation from medical his good spirits and humor Bisons, died April 8, 2002, school, he trained in inter- never failed him. with the in Boynton Beach, FL, after nal medicine at Jewish a long illness. He was 85. Hospital of Brooklyn and forces of his career. Post-polio team physician for the occupation under General Douglas who became close friends and colleagues for the rest syndrome slowed him physi- aminer for the State of agency, Ambrusko was re- resume private practice and joined a group of internists Lafayette High and Univer- Florida from 1980 to 1995. As director of the Manatee gained full strength, Loeser felt the calling in 1964 to surgical career, Ambrusko director of the Manatee 46 SUMMER Sullivan graduated from Nichols School, Exeter and Loeser is survived by his wife of 55 years, Annette completed his residency Brown Loeser; a son, David, under John Talbott, MD, at of Needham Heights, MA; sponsible for building a new McArthur, attaining the rank Dartmouth College prior to Buffalo General. After a stint daughters Ellen of West health center, which was of captain. attending the then- as a naval medical officer, Roxbury, MA, and Cynthia luffale Hp i cian Summer 2002 �RELOCATION HU T REAL ESTAT E ERA Loeser Sandoval, of Daly was an Erie County medical where he practiced anesthe- City, CA; and his brother, examiner. He was also clini- siology for two decades. Eugene, of Jupiter, FL. cal instructor emeritus of rehabilitation medicine at UB. er ert S. Wolfe, Mrs. Herbert S. WoHe, RN, Survivors include his For the past 15 years, Potenza had been medical director of the health center wife of 45 years, the former at Geneseo State College. Kathryn "Katie" Siegfried; a He was also a past president writes: "After Dr. WoHe had daughter, Karen Vergo of of the Livingston County open heart surgery and he Kenmore, NY; a son, Robert Medical Society. feH better, we headed for of Santa Barbara, CA; a Texas. We located in Mission, TX, at the Bentsen cal care, often free, to indi- NY; and five grandchildren. gent patients. He received .James mr awards, and July 24, 1984, Grove Trailer Park. We en· joyed all the activities, and many community service the friends we made were was declared Lucien A. wonderful. Each year we James lmre Szabo, of stayed longer, and about Winter Garden, FL, died three years ago, we became Monday, March 18, 2002, permanent residents. "Doctor's heaHh started to fail, and each year he did Potenza provided medi- brother, Nicholas of Buffalo, at age 84. Szabo, a Buffalo native, moved to Central Florida in 1953. He was a less. He was hospitalized member of the American many times and then on Association of Physicians January 26, 2002, he went and Surgeons, American home to be with the Lord he Geriatrics Society, American Potenza Day in Buffalo. Survivors include his wife, the former Susan Baer; a daughter, Evelyn Frank of Lewiston, NY, Michael both of Amherst, NY, Andrew Bellman of loved and served all his life. Gerontologic Society. He is survived by his wife, Nancy; 59 years in June." daughters, Lisa A. Stone of and a sister, Carmello Oviedo, FL, and Nancy J., of .James N. "Bo" Menno of Cheektowaga . Gainesville, FL; son, lmre A., of Winter Garden, FL. former chief of rehabilita- Cheektowaga, NY, and Paul Bellman of Berkeley, CA; ary Miller, MD Lucien A. Gary Miller, died unexpect- Affairs Medical Center in Lucien A. Potenza, died heart attack while jogging. He was a professor of tion medicine at Veterans edly May 25, 2001, of a Batavia, NY, died March 26, April 1, 2002, in Strong 2002, in Town of Tona· Memorial Hospital, pathology and urology at wanda, NY, after a long ill- Rochester, after a brief the University of Colorado ness. He was 73. illness. He was 71. A native of Buffalo, Potenza was born in Buf· HeaHh Sciences Center in Denver, where he was also Schmitt attended Canisius falo and graduated from College and the then- Canisius High School. At the urologic University of Buffalo School University of Buffalo School cancer of Medicine he served as research. as a surgeon and lieutenant president of his class. He was commander in the Navy dur- Following the war, he • • • • • • • Nationally trained relocation experts Complete family needs analysis Global home sale assistance Special services for seniors Full community tour A complete cost of living analysis A list of all school systems throughout W NY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour o r less response time • Confidentiality assured known For over 30 years both na- Potenza maintained a gen· eral medical practice on Totally customized service portfolio including director of of Medicine prior to serving ing the Korean War. Call for a free relocation portfolio regarding your destination city. Call 1-800-688-1170 or go on-line and visit our web site at huntrealesta te .com Bellman and David Bellman We would have been married James N. "Bo" Schmitt, ...we help people move! Buffalo; six sons, Daniel of Warner, NH, Mark of tionally and internationally headed rehabilitation medi- Buffalo's west side. He was in the field of prostate can- cine at the veterans hospi- also a former president of cer research. tal, and until the mid-1970s Lafayette General Hospital, <D) Hunt ERA Relocation Center 5570 Main Street Williamsville, New York 14221-5410 Email : huntrelocation@huntrealestate.com S 11mmer 2 002 luffalo Pbysician 47 �CLASS I CONTINUED FROM PAGE 45 Kristen Andresen, MD '98, Milford, CT, writes: "After finishing my residency in internal medicine at the University of Rochester and marrying a fellow resident, I've moved to Connecticut, where my husband, Scott, is doing a fellowship at Yale. I'm presently working as a hospitalist and enjoying life with Scott and our two best friends: Shadow (black lab) and Sonner (golden NOTES retriever)!" E-mail is: skskibo@ comcast.net. Lisa E. Heichberger, MD '98, Tacoma, WA, writes: "I completed my family practice residency at Hamot Medical Center in Erie, PA, where I served as chief resident. This past year, I was granted a fellowship in Rural Family Medicine at Tacoma General Hospital in Tacoma, WA. My husband, Mark Peterson, and I presently reside in Tacoma." E-mail address is MPeter32@aol.com. Michael P. Melman, MD '99, Sue Miller, MD '99, writes: writes: "After graduation I spent a year at the NIH completing research in the field of pediatric hematology/oncology. Currently, I am a pediatric resident at Emory University in Atlanta and will be applying for a fellowship in pediatric emergency medicine. Hope all is well with my fellow alumni! E-mail address is: mpmcrew@ aol.com. "Larry and I are excited to be moving to Seattle, WA, in june. I finished my pediatrics residency at Children's Hospital of Buffalo and will be starting my fellowship in CELEBRATE THE SEASONS OF YOUR LIFE AT AMBERLEIGH 48 I u II a II Ph J sic i a 1 Summer 2002 neonatology at the University of Washington. Larry completed his MBA and is currently a consultant with Andersen. We hope everybody is doing well!" E-mail address is: smm4S@hotmail.com. E-mai �Held at the Buffalo/Niagara Marriott, THE 65TH ANNUAL SPRING CLINICAL DAY AND REUNION WEEKEND WAS A TIME FOR OLD FRIENDS AND CLASSMATES TO REUNITE AND REMINISCE ABOUT THEIR MEDICAL SCHOOL YEARS . Dean Michael Bernardino briefing the luncheon crowd on mam of the positive changes taking place at the school, as well as ongoing challenges. ..----- Stephen Pollack, MD '82, vice president for the \!edtcal Alumm Association, was ke} to makmg the day a success. �p H A R M A c 0 p 0 E .I A OF MEDICINE COLLECTION PRESENTS PHARMACOPOEIA This illustration was digitally reproduced from offizinellen Gewachse, a four - volume edition of pharmaceutical plants and their medicinal uses , published in German in 1863. The pharmacopoeia by Otto Karl Berg (18I5I866) is part of the Rob e rt L. Brown History of Medicine Collection , located in the Abbott Hall Health Sciences Library. Pi ctured is the Pomegranate, one of a series of botanical images digi tally restored as part of an initiative to preserve and highlight unique r e sources from the library's collection. Reproductions are available for purchase through the library, and can be viewed online at iMedia. buffalo .edu/ art/ . Image restoration was performed by iMedia , the instructional media se rvices department of Computing and Info rma tion T echnology, University at Buffalo. b, R P 000 3- 02 .E � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. 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Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1485f88b0d716aba78a368ac0f4b5d8f.pdf 90848b6cc9a03855aadebcfb1e95cdb4 PDF Text Text �l1ffale r•ysicial ASSOCIATE VICE PRES I DENT FOR UNIVERSITY COMMUNICATIONS Dr. Caro le Smith Petro DIRECTOR OF PERIODICALS Sue Wuetcher EDITOR Dear Alumni and Friends, Stephanie A. Unger ART DIRECTOR & DESIGN Alan f. Kegler David]. Ri ley N N OVEMBER, I ATTENDED T HE ANNUAL MEETING of the Association of American Medical Colleges (AAMC) in San Francisco. Because the meeting is a forum for discussing topics affecting academic medicine nationwide, it serves as a valuable bellwether for deans and other school leaders whose responsibility it is to prepare as best they can for foreseeable trends, as well as for sudden exigencies. DESIGN ASSISTANT Karen Lichner CONTRIBUTING WRITERS Lois Baker and Ellen Goldbaum PRODUCTION COORDINATOR The financial status of medical schools was a prominent theme at the meeting due to the fact that as many as 70 percent of all schools are having financial concerns. A number of deans l spoke with experienced cuts between 4 and 8 percent in their school's budgets last year and are expecting further cuts of about 4 to 6 percent for the coming year. Cynthia Todd-Flick UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean As a result of the current economic environment, many universities are postponing building projects; others that have built are not sure how they are going to pay for the buildings or maintain them. This reflects a notable difference in how our school operates because the state builds and maintains our buildings. Although we may have smaller cuts in our school's budget, these cuts are in some ways more painful because labor and union laws preclude us from exercising the flexibility that others schools have in implementing them. In general, however, I feel the financial status of our school is currently no worseand no better-than many of our peer institutions. TEACHING HOSPITALS An especially controversial topic at the meeting was physician shortages, which participants spent an entire day debating. As you are aware, the number of residents was capped in 1996 by the Balanced Budget Act, a move that was endorsed by the AAMC and a number of other groups. EDITORIAL BOARD Dr. John Bodkin Dr. Martin Brecher Dr. Harold Brody Dr. Linda f. Corder Elizabeth Volz, Class of 2005 Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. ]ames R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zep lowitz ow, for the first time, the wisdom of this move is being questioned due to the fact that, nationwide, there is a shortage of specialists in a growing number of fields. This is a debate that will directly impact our school, which ten years ago moved sharply toward training primary care physicians and away from training specialists, as did many other schools. l don't know when or how the pendulum is going to swing back to a point that better reflects the needs of our society, and l certainly don't advocate for reversing current trends by instituting equally sharp upward adjustments in specialist training. However, most leaders in our school's administration feel, as I do, that we currently have too many primary Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Westem New York Healtltcare System KALETD.~ HEALTH: Tlte Buffalo General Hospital Tile Cltildren's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital CATHOLIC HEALTH SYST£\1: Mercy Healtlr System Sisters of Cltarity Hospital Niagara Falls Memorial Medical Center @ IIIYEISITY AT IIFFALI , TIE SliT£ UIHISJTY If lEW Ylll care and internal medicine residents and that it makes increasingly good sense to gradually move some of them into specialties. Letters to the Editor Lastly, a topic that concerned many at the meeting is the amount of debt medical students are assuming upon graduation. (It was reported that the mean average debt for all medical graduates in 2002 was $103,855. When specialty training is factored in, the amount of course rises.) This is an issue that we as educators must address. We must find a way to decrease the significant debt burden of our students. J. R. 4-A .i.:. ,_A-<) ~.BERNARDINO , MD, MBA Dean, School of Medicine and Biomedical Sciences Vice President for Health Affairs Buffalo Pltysicratr is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent cfo Buffalo Pltysicimr. 330 Crofts Hall, Unrversity at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.edu. Telephone: (716) 645-5000, ext. 1387. The staff reserves the right to edit all submissions for clarity and length. T~ ~ University at Buffalo TheStateUniversityofNt:wYork �VOLU M E 37, NU M BER 0 p H y c s A N Features 2 Family Medicine, aGlobal Perspective Refugee Cultural Competency Training Program gives students an opportunity to work with patients from other cultures BY 12 S . A. UNGER ADegree of Latitude Popular biomedical education program helps young scientists make smart career choices May Shogan, left, translating coordinator atthe lnternationallnstitute, and Luis Zayas, PhD, right, a medical/cultural anthropologist and research instructor in the Department of Family Medicine, helptrain medical students and residents in University at Buffalo's new Refugee Cultural Competency TrainingProgram, developed by KimGriswold, MD'94. Turn to page 2 for more. BY NICOLE PERADOTTO 16 On Course A conversation with Margaret Paroski about medical education, curriculum and admissions COV ER PHOTO AB OUT THE 32 Update on Convocation 21 Alpha Omega Alpha Scholars 22 Sung and Medical Alumni Association scholarships Golden Mind and Body Lecture Lawley named Distinguished Medical Alumnus 41 Messages from reunion class chairs 43 Alumni President's column faculty, staff, students and alumni 30 Western ew York Pioneers of Science In Memoriamjohn Edwards work in UB's Center of Excellence in Bioinformatics 34 The Living Anatomy Program 36 Women's Health Initiative spins off new projects BY COVER , RHEA ANNA SEE PA C E 40 The Road Best TraveledKim Griswold's circuitious route tomedical school other alumni 11 ��Family Medi ine: aGlobal I I 1 I �~-~- - - - - - - - · ~-. Despite the presence of interpreters, attention to protocol and the neat stacks of paperwor , the participants were not convened to resolve border disputes, monitor free elections, intercede on behalf of warring parties or debate the merits of armed intervention. Instead they had gathered to welcome new arrivals to America-men, women and children forced to flee their homelands for safety-and to help these refugees learn how to navigate the labyrinthine health-care system that awaits them in their new country. Conspicuous among this group gathered at the Columbus Health Center were two young men and a woman in starched white coats, all first-year students in the University at Buffalo School of Medicine and Biomedical Sciences, who were participating in the meeting as part of an innovative educational program aimed at increasing their cultural competency while improving access to preventive and primary care services for refugees in Western ew York. An Immersion Experience The voluntary program, which is open to all students and primary care residents at UB, was developed by Kim Griswold, MD '94, MPH, an assistant professor of family medicine, who has garnered a three-year, $393,933 grant from the ew York State Department of Health to support its integration into UB's medical school curriculum. A joint sponsor of the program, along with UB's Department of Family Medicine and Kaleida Health's Columbus Health Center, is Jericho Road Family Practice (also located on Buffalo's West Side), which is operated by Myron Glick, MD '93 UB assistant professor of clinical family medicine. Assisting the two clinics with implementing the program are the International Institute of Buffalo and Journey's End Resettlement Services. "Our strategy is to offer a concentrated cultural-immersion l1ffale Hysiciaa W11!t e r 2 003 experience to students and residents at evening clinical sessions that serve only refugee patients," says Griswold. "The students work with people from Rwanda, Sudan, Somalia, Ethiopia, Congo, Kosovo, Bosnia, and Cuba, as well as from a number of Asian countries." All refugees seen in the program are legal immigrants who are being resettled through the federal government, according to Glick. "They receive Medicaid for a year, during which time they are expected to learn English, find a job and provide for their family," he explains. "Some people do incredibly well with that. There are a lot of success stories, but there definitely are those who struggle, and health care is a big part of that struggle because even when they do get jobs, they' re often low-paying and so don't provide health insurance." T he program, formally titled the Refugee Cultural Competency Training Program, builds on a pilot project developed over the past two years by Griswold, UB medical students and volunteers in which medical students conducted health screening of refugees during monthly "health nights" at one of the participating clinics. Clinics for the newly funded program take place from 5:00 to 10:00 p.m. and are dedicated to medically evaluating refugees who have recently entered the country. Prior to seeing patients, the students attend an orientation discussion presented by staff �Pictured, left to right, May Shogan, from one of the resettlement agencies, a cultural/medical anthropologist, a physician, and a case worker from either Journey's End or the International Institute who is informed about the medical, psychosocial, financial, cultural, gender and legal issues of the refugees to be seen. "The orientation focuses on helping the students know what to expect during the clinical session, " explains Griswold, who adds that each session is limited to a maximum of three students to assure that they receive as much one-on-one training as possible. "In particular, they are briefed on what type of psychosocial problems the refugees might present with; for example, traumatic stressors such as torture, mutilation, religious persecution, murder of family members, or loss of home and possessions. They also learn about the medical problems common to the refugees ' homeland, such as parasites and infectious diseases. " In the orientation session, the students also are instructed in how to address the problem of translation and how the translation will be handled during the upcoming session-whether through a telephone translator, physician or health-care translator. Finally, the program's medical/cultural anthropologist, Luis Zayas, PhD, research assistant professor in UB's Department of Family Medicine, teaches the students about basic principles of medical anthropology and introduces them to the concept of "culture," as well as to methods for "taking the role of the other. " In discussing this latter concept, Zayas and a staff member at the International Institute talk to the students about the importance of being open, interested, empathetic and tactful with the patients, attributes that will assist them not only in building trust, but also in gaining meaningful information about the patients' lives. Zayas, an experienced ethnographer who is fluent in Spanish and Portuguese, also briefs the students on the importance of note taking while performing a history, as well as the etiquette for doing this effectively, yet unobtrusively. The Preceptor and the Process After the orientation session, the students spend several hours in the clinic, where they are encouraged to practice their interviewing and listening skills in order to gather knowledge about a patient's life story, as well as facts about his or her health history. Giving the refugees an opportunity to tell their stories serves as a means to help validate the often bewildering and painful experience they have undergone as an immigrant, according to Winter 2003 l 1 fl al• Hysicin 5 �Griswold. "Too, a patient's life story can include important cultural, emotional, sociopolitical and economic events not captured in a standard medical history," she explains. Glick, who leads similar evening sessions at his Jericho Family Practice, recalls an encounter he had with a patient several years ago that reinforced for him the importance of knowing as much about a refugee's past as possible in order to deliver effective care. "I met a woman from Sudan who was especially sad," he says, "and when I heard her story-that she had lost her three older children in a war, and that, basically, they were killed right in front of her and her three younger children-this allowed me to understand her a lot differently than if I didn 't know that part of her story. "But we hear countless stories like this," he continues. "The refugees come with a lot of trauma in the past that can end up causing depression , post-traumatic stress disorder, marital conflict or domestic violence-a lot of psychiatric issues that are hard to put a finger on and are hard to treat, especially if you don't know their stories. " Despite the importance of gathering information about a refugee's life story, Griswold is quick to tell the students that they need to be patient in the interview process and that they don 't need to obtain everything in one visit. "Often the patients are not ready to divulge their histo ry, whatever it is," she says. "For example, torture is a huge issue, and we need to ask about it sensitively. On the first visit, you're not going to say, 'Okay, tell me about your torture.' You can't be that direct; you 6 laffala Hysiciu Winter 2003 have to establish the rapport, the trust. And it may take many visits before a person is comfortable talking about things like that." In addition to taking a medical history and listening to patients' life stories, students also conduct physical exams (depending on their level of training), or assist a resident or attending physician. Further data are collected on health behaviors such as smoking, drinking and the patient's understanding of health in general. 0 nee the exams are completed, the students are taught how to review the patient's story and objective findings, make an assessment and plan with the preceptor forthe patient's continuing medical and psychosocial care. Refugees in need of psychiatric care or mental health services are referred to Lakeshore Mental Health Counseling or to Child and Adolescent Treatment Services, as well as to other agencies and practices collaborating with the program. Attention also is paid to the refugees' oral health, as many have never seen a dentist in their lives and are in urgent need of such care, according to Glick, who is hoping to establish a similar referral network among area dentists. At the close of the clinic session, the students then re-group in the conference room for a half-hour debriefing session that is conducted in a focus-group format by Zayas and the supervising physician. "We ask the students to talk about all aspects of their clinical session with the refugee," says Griswold, "and we pay special �attention to their emotions, especially if they have had few or no experiences with a refugee population." In addition to monitoring the students' emotional responses to their patient encounters, the instructors ask the students to summarize what they learned as it pertains to cultural issues and to talk about hurdles they may have encountered related to translation. They also ask the students to suggest ways they feel the experience could be improved. As part of the program, the students--each of whom must commit to a minimum of two such sessions in order to participate-are asked to keep a diary in which they record all of their encounters with refugees, whether they be within the formal context of the program or in extracurricular activities they undertake on their own, and to complete a written evaluation of their experience in the program. They also are required to write a short paper linking the clinical experience to the lecture aspect of the program and to describe how they feel they benefited from participation in the program. The data obtained during the debriefing sessions are recorded and will be qualitatively analyzed by Zayas at the end of the program in order to assess its success, including how effectively it was integrated into the medical school's curriculum. Life Stories. LiYe The first-year students participating in the late October session at Columbus Health Center were Lynne Learned, Justin Spooner and Brian Eichner. Prior to the start of the session, they were told by Griswold to expect the arrival of two refugee families as the evening progressed: one from Vietnam and the other from Bosnia. They also were reminded that once the refugees and the other participants arrived, introductions would be made and the refugees would be invited to tell the group as much about themselves as they wished. After this discussion, Griswold, Learned and Spooner would escort the refugees down the hall to the clinic to begin the clinical exam sessions. Eichner, who, unlike his two classmates, had not yet attended an orientation session, would remain behind and be briefed by Zayas and a representative from the International Institute, later joining the others in the clinic. As it was the dinner hour, snacks and beverages were passed around the table, and an air of warmth and collegiality filled the small room as others trickled in and introductions were made. Among the first to arrive were the translators from the International Institute: Bong Vu, a Vietnamese man who has been in the United States for 30 years, and Vesna Demirovic, a Bosnian woman who came to the United States five years ago with her husband and 12-year-old daughter. They soon were joined by Barbara Burns, a social worker and a conPictured,leh to right, are sultant on the grant, and Sister Mary Judith, medical students Justin a case worker at the International Institute. May Shogan, an immigrant from Jordan who has been in the United States for 15 years, also arrived and sat with Zayas, with whom she partnered to present the orientation session for Eichner. Fluent in English, French and Arabic, she, too, is a consultant on the grant, with special expertise in cultural issues and refugee assimilation. Rounding out the group were Griswold and two staff members in UB's Department of Family Medicine who work closely with her to administer the day-to-day operations of the grant: Joan Kernan and Christine Wagner, a social worker. A fter about 15 minutes, the first refugee family arrived: a husband and wife and two teenage daughters from Vietnam . The parents were seated next to Vu at the head of the table, while the girls sat to the left of their mother. The girls immediately began interacting with the group, helping themselves to the food and drink that was offered and playfully trying to sound out how to pronounce words printed on the label of a pop bottle. The younger girl, clearly the most outgoing and spontaneous, stood up to offer to pour a cup of soda for the social worker seated across the table from her and engaged in a cheerful pantomime with Kernan, who admired the girl's blouse as she took off her winter coat and settled into her chair. Although Winter 2003 l affal1 Plysiciu 7 �little English was spoken by either girl, clearly they were relishing the encounter and eager to dive headlong into their new life. Their father sat quietly and appeared anxious and withdrawn, the skin on his face deeply creased and worn in contrast to the bright, fuchsia-colored sweatshirt that reached high on his neck, forming the middle layer of several shirts he wore on this chilly evening. The girls' mother also sat quietly, her reserve broken only when Vu drew her into conversation in low tones. Occasionally she cast a quick, guarded look around the room and seemed mildly amused with her daughters' chatter. H aving been informed that the Bosnian family was experiencing-delays in their transportation to the clinic, Griswold decided to move ahead and formally opened the session, asking those in the room to introduce themselves to the family. Once the introductions were completed, Spooner, upon request, briefed the family about what to expect during the clinical exam, after which he and Griswold addressed a few questions from the younger daughter. Zayas then gently encouraged the parents to tell about themselves, if they wished: Where were they from? What was life like in their village? The father, too shy to speak, deferred to his wife. After a brief pause, she began talking rapidly while holding out both hands and repeatedly flashing her fingers to show the numbers "two" and "five," as if convinced her words alone could not convey what she needed to explain. The younger daughter, hearing her mother's sudden outpouring of words, implored her to slow down for the interpreter, tugging on her mother's arm and making a pumping, brakelike motion with her hands. Her distraught mother appeared not to notice and proceeded with her story unabated. When she stopped after a few minutes, Vu paused to collect his thoughts, and then slowly turned to the group and spoke. He explained that she had described how she and her husband had met and married. She also said that they were from a rural province in South Vietnam, about 80 kilometers south of Saigon. When the communists took over, it was very hard because her husband worked for an American company. They gave them all kinds of problems, so it was very difficult to live under the new regime. They didn't think they could survive in Vietnam. Two of their children are here with them; five still are back in Vietnam. Griswold thanked the mother for sharing some of her story and then asked Vu to explain that she and two of the students were going to escort the family down the hall to begin the clinical session. ll•lrli1nlll.••·u. tl!b ...... ..uns .. i1lrtll( 1M R•flt• C•lt•r•P Ce•••t••cr Ti'IIIIIC Prep-. Ill&' • ._ ?lit II ....a; 111· ..............,••, 1111· ucn ... •ret.....IIYII ftnt·,...,ltllll ...lpllltl 1U flc1 tbt ..., II .tlll ..... ltltli. ............. lilllltJU..a.a .r-.m.a.,.llwYIIk.LIIIIil ......,. If w111t lrlinlll calli.., . . . ..... .........-111111 .... II . . - ,_. 111n ,.nJclptlllll ................ iiJIIiti•• !lilt .. . ......... .... ..... 11111 .... till •1 2I 2 I Ill till ...... CIPtlnl c Jl_,,...,.......... ..., ,... . . till..,... ... 8 lulfala PbysiciiR W1n t er Stltll II IIIZ. 2 II I h Cl8flllll . . . . . tUt c-. ,.,._ .................. . &!It .. 2ilfll-.t?ll ... ....... c. . ........... - •I ..... .....,... ...... , I .........., .................. _ . . . .......... ....,.... I ,... ............... , I liM "'IIIC................ ..,........ . . _.... 1 I .....,.. Mtlllil_...._...,._• ............... ......,......., .......................... lriinPII ..... till ....... ...,. ......... . , ............. AJI lilllliiiiMilwlllt . . . . ~tlll .............. ll ....... l?ltull. ...... WntiNIFiiii?J .... . . 2003 �A for now, they communicate by writing letters. fter they left, and before the orientation for Eichner began, The youngest of the two daughters with them attends a local Sister Mary Judith, the caseworker, made a few follow-up high school and the older takes English classes at the Internacomments about the Vietnamese family. She explained that in tional Institute. 1995, immigration policy in the United States changed and, as a They are happy to be in the United States, but the father worresult, children who are over age 18 or who are married cannot ries about finding a good job, although he currently does enough accompany their family. She surmised that the couple's five other piece work for the family to live without public assistance. children remained behind for that reason. Learned, who examined the mother and two daughters, exLater that evening, during the debriefing session, Learned and plained that she was impressed with their closeness. Spooner shared additional information that they had learned "They seemed very loving and concerned for each other," she about the family during the clinical session. said. "They freely discussed sensitive sexuality and gynecological They explained that the parents are in their late 50s and have five adult children in Vietnam. The family had been in the counquestions, even though neither girl is sexually active nor has a boyfriend, something they believe they are try about four months, and they hope that someday the far too young for because, in their culture, it older children also can come to the United States but, Betty Lim, Class of 2003 means marriage." On the whole, Learned concluded, "the entire family was quick to laugh and were very loving toward one another and seemed happy. I found them easy to talk with and was even invited to come to their home. It was sad leaving them in the end." Shortly after Eichner's orientation session with Zayas and Shogan ended, the Bosnian couple arrived and were seated with their interpreter, who introduced them to the others and then talked quietly with the couple for a few moments. B ,.................... ...... .., ...., ................... ............................., ................... .... ........................ ....... ,,,...... u. .............. _ ......,....... .,.....,. ......... _ . ... ........... ,,,6 ....,_ ..................... - .....a,.u. ............... _,.UIIL"'IIIII~)IItlfflrta ............................ ...., ................ ,., .................. ....,_,., a. ................. ....... .. ......_,..,_ t 3 1 oth appeared to be on the brink of exhaustion. The man's thin cheeks, stubbled with whiskers, were sunken in his face, and his eyes were red rimmed and bloodshot, as if he had not slept for days. His wife's pallor was gray and her brown eyes were faded to a lusterless amber. Sturdily built, she sat upright in her chair, tensely dangling her purse over the side of the armrest and staring vacantly around the room, her occasional words to the interpreter revealing broken and missing teeth, similar to her husband's. In a short while, Griswold reappeared to talk briefly with the interpreter and, because the hour was growing late, she and Eichner then escorted the couple to the exam area . Following the clinic sessions, the refugees returned home and the group reconvened in the conference room to debrief the students. In the debriefing session, Eichner, who had Win t er 2003 l tffala Hysieiaa 9 �- ....... ........, __ ............. ... ... ). ....... . . ......... a••• ...., ......., atllllltlll.,. ........... cltll• ............. .................. ..._._,., IJ•IIII•II lltlrlllttutiJ . . . . . . . .... . . - whll ......,., IIIII,_... ... ..., ..... u. ,,... ........., at lllllr.'l ...... lllhlr- IIC ¢1-Jlllillll ........ • ..............., flltll. ,....llltmll1mat••7• • ......... ..-llw -'lillll]lra.... 111111111 F-lllflfa. . . . . . . ........................... ........-. ...... .......................,..... _, .. ......,_ ..., ........... ......................... .. ................ .... lllfrla - - ' .. ........ ~ 1111 . . . . .111MI-'If(•ftnt ............., ....... Jllltlll ..... c•••,.... fir . . . . . . . ~•111 I1Mt.ll 1MI Clfllllr, .................... C111¢1 1111 tr11t111 ,...... w111 all fiiiiiiCIIIII. Tlnl,... .... ..._ ....... _ _ ._..... ........ 111111111 F-•--••~flrl ......................... .... ...... ,... ...... . . . ...................._....... .... ....... ........... ........... _..., ..........., ..., ........................... ... .............. ...,CIIIt. ............. ..... ....................... ................,......_ nni llultll .... .nr1tlll ]11'111'1& llllllrlntlllr,wllllllll . . . . . . . ..... 11111. . . . tllllllnllll 11illlllw111l-111171.tllll...., ....... ~~~u~ .............. -- .... Cllllll't- .... - tllllll I .............. llllllllallll • ..................... Ill E_..._.llftn.,PIIIIIIII IIYIII II lfrlcl lllllllr • ........ ..... \ ...... ,_..lllflr ...... .... ....... JIIIIIC_ ...... ...... . . . . -...... a~~ ... ...................... ,,, . earlier that the remains of her husband had been found in a mass grave in Srebrenica; she had then been asked to describe his personal effects over the phone. The Demographics of Doctoring While the experiences students gain through this intensive program may seem exotic to some, Glick and Griswold both point to the fact that, more than ever, such experiences are increasingly pertinent to the practice of medicine in the United States and will teach students important clinical skills no matter where they eventually practice or whom they choose to serve. In his Jericho Family Practice, Glick estimates that he sees patients from approxiParisima Mirzakazemi. MD mately 50 different countries around the interviewed the Bosnia woman, shared with the world, some 20 to 30 percent of whom are refugees. group more about the family's story. "More and more of our country is becoming increasingly He explained that the couple, in their early 40s, has three sons, diverse," he says. "And whether you end up practicing in rural the oldest of whom was shot in the head but survived. They had been in the United States for four months and speak very little Iowa or on the West Side of Buffalo, you're going to end up dealEnglish, so are taking classes at the International Institute. They ing with folks who are different from you and who come from are Muslim, from a small village in northeastern Bosnia, and the different places, so I think it's wise early on in your training to get husband is an environmental scientist. The wife lost her brothers exposure in a controlled setting such as this program affords." Too often, the first clinical encounters medical students have in the war, and her mother also died recently. She has several with people from other cultures take place in an emergency sisters in the country, one of whom had been notified two weeks 10 lulfalo Hysiciaa W ill t er 2003 �......................... ............................ ................... ,. ••a•am. _. ... ...., .............1. ., 11111111 .. filii ....,. whll .................... .....•••c, ...... ... __....,......,....... ....... _..... _. ...... ......... ......, .. ...... ., • troll I .,._ • fllln•• alii • • 'Y• .... _ .......__ naiL_ 1111 ..,. tllat ......... tllll( ..................... 1..... . . 1111 ....... ..._ tUt ....... c.'t ........... , ......... tnllla( . . ntaMI( 1111 ..... . . . . . . . . . . . .lllllllt- ...... , . . . ........ F-. ...................,.... .......................... ........................... ..................... .. ......................... 1'1111-............,... ..................... ..........._.............. ... ..,.,._.................... .... ............... . .......................... _.,.......................... .................... .., ..... .,......................... .......................... CllllalrJ .... ..., . . . ~ cld- -. Clltanl u ••• ..., ......... ............... naiL _,, ••• r-..t ......... -dllflntCIIIIalrJIIIat ....... ..., ..................... ............. ...., ..... u... llllcwll II "'alll,1 . .'tllana dlllriiiCIII.IIilllllllltwllll..,.. I:III'J................ ., ....,, til. . . . . . . . , - . : . . ,illtllilll'tllana...ay." room, according to Glick. Because of the hectic nature of this setting, the encounter often becomes a source of frustration for the student, instead of a potent learning experience, he feels. "One of the things that this grant does is it allows us to bring students in for an evening that is fairly slow paced," says Glick. "So they get a chance to just go in and talk with the patients, and that gives them a chance to give in a different way than if the visit were just about a medical problem. This is incredibly important because if you don't see people as people, if you don't see them for who they are and where they come from, then you're not going to give them the kind of care that you really should be giving." S pooner couldn't agree ~ore with G~ick's .assessment of the merits of the program. I feel workmg with the refugees IS the most rewarding activity I participate in," he says. "The refugee population needs our help to get acclimated to American culture and lifestyle," he adds. "Each person brings with them a history of family, beliefs and knowledge that varies greatly from my own, and I feel I can learn a great deal from listening to them. Also, interviewing people across a language and cultural barrier is challenging and educational. Prior to this, I really took language for granted!" First-year student Brian Eichner, who previously worked with migrant farm workers from Mexico, says he's interested in learning about the health-care needs of refugees because they are an underrepresented group that has few advocates, and by immersing himself in their lives, he hopes to learn about how to help them. This, he adds, "might also shed some light on aspects of my own family's immigration experience generations ago and so help me to understand my past on a new level." Having met and talked with the Bosnian couple in detail during their clinical visit, he says he was most impressed with their bravery. "The mother spoke to me as openly as she could about her struggles in Bosnia, even though it was clearly difficult for her to do, and she eventually changed the subject," he explains . "However, in that brief time, I felt that I made an emotional connection with her and gained her trust, if for nothing more than a minute; but that was truly a powerful feeling, especially when working with someone who has had to endure so much." Eichner feels it would be valuable for anyone working in health care to be exposed to the type of patient encounters he has experienced through his participation in the program. "It's very easy for us to get caught up in our own daily struggles and to lose sight of how lucky most of us are," he says. "Experiences like this remind me of why I am working so hard in medical school and of how blessed I am to have the opportunities and freedoms that I have in my life." CD Pictured on the cover is the Nzotungicympaye family from Burundi. Left to right. back row: Agnes Musoni , holding five·month·old Nelson Peary Nzo; and Protais Nzotungicympaye, holding Franklin Sijeniyo. age three. In front is She ilia lngabire, age 7. The family immigrated to Buffalo in January ZOOZ via Rwanda. ��Progran1 helps young scientists n1ake smart career choices 0 f-o ~< "' "' p.. "' ...J 0 u z �One of the great advantages of the program is that you get to explore different disciplines and choose the one that you prefer the most. "!thought, 'What a novel idea.' owl don't have to make an uninformed decision about what l want to do for the rest of my life," recalls the Minnesota native, currently a fifth-year IGPBS student in toxicology. "What sold me most on the program was the prospect that interdisciplinary training in biomedical research would open the most doors for my future." Apparently, quite a few students feel the same way. Since the program's inception in 1997, the number- and caliber-of applicants has exceeded the expectations of UB's staff and faculty. "As soon as we set it up, our enrollment increased," notes Suzanne G. Laychock, PhD, senior associate dean for research and biomedical education. "The students have responded extremely well." A ll involved with establishing the program agree that get- ting it off the ground was an incredible undertaking. From developing the curriculum and creating new classes to uniting faculty members and determining the best ways to recruit students, it required participation from dozens of different voices. "We were moving graduate education out of the medical curriculum, and that was revolutionary for us," says Lachock. "There was a lot of dissension on how things would go, and which courses would be given, but we had to get beyond that. The program went forward and now everyone's on board." The faculty's dedication to the program has paid off in more ways than one. With the IGPBS attracting so many applicants, the admissions committee can be more selective in the candidates it chooses. "In the past couple of years we have been competing very well with institutions such as Cornell, University of Rochester and St. Louis University," says Elizabeth Hayden, staff associate for Graduate Biomedical Education. "We have brought students in from as far away as Texas and Utah, and all over the East Coa t." And just what type of student is attracted to the interdisciplinary approach? According to Anthony Campagnari, PhD, former director of recruitment and admissions for the IGPBS and professor in the department of microbiology, the program is geared for students still looking for their research focus. "We attract those individuals interested in multiple disci- 14 laffall Hysician \V inter 2003 plines, and those who are not ready to commit to one single program," he says. "The students are very creative in terms of being able to think about things they would like to do," adds Laychock. "But many of them are unwilling to say they would like to do something specific because their undergraduate programs didn't provide them with the breadth of information to make that decision." Even students with predetermined interests often favor the IGPBS over a traditional departmental program because it provides them such a strong foundation in the sciences. Of those students, Laychock notes, roughly 80 percent are open to the possibility of changing fields. ~e program's first graduate can count himself among that .1_ group. In the summer of 1997 Mohamed R. Mohamed came to UB as part of a training program jointly sponsored by the U.S. Agency for International Development and the Egyptian Ministry of Health. Although he planned to apply to the microbiology department's PhD program, he was encouraged to instead apply to the IGPBS. In June of2001, Mohamed received his PhD-not in microbiology, but in biochemistry instead. "Of course, I would not have been able to change majors ifi wasn't in the IGPBS," says Mohamed, who is conducting postdoctoral research at UB. "One of the great advantages of the program is that you get to explore different disciplines and choose the one that you prefer the most." The program is also popular because it equips students with a knowledge of various fields, which is considered a desirable trait among potential employers, according to Richard Rabin, PhD, director of IGPBS and professor of pharmacology and toxicology. "Gone are the days when the scientists went to their labs by themselves and did their own thing," says Rabin, "That just doesn't happen anymore. There's a lot of interaction across fields. "Of course, students have to specialize; you can't be a jack-of-all-trades. But you have to have an appreciation for the other fields to know what their needs are. Students get a broad experience from the IGPBS rather than immersing themselves immediately in a field and getting myopic." The IGPBS's first-year curriculum includes mandatory lecture courses in cell biology and biochemistry as well as a course on the principles of lab techniques. In the spring semester, students are asked to critique and present papers in a seminar series designed to hone both their analytical and communicative skills. Elective-course options also help �students explore new fields of interest. During the first year, students are required to rotate through at least three labs-and they have the option of working in a fourth-allowing them an opportunity to narrow down their areas of interest and determine their PhD adviser. "These lab rotations are very meaningful experiences," Rabin says. "They're 12 to 20 hours per week and half a semester in length. The students are in there learning new techniques, getting involved to see how they like it and, from the investigator's mind-set, to see how they do. "They are really in the thick of things," he adds. In the spring of the first year, students are asked to rank, in order of preference, the three faculty members with whom they would most like to work. The match is made-with the vast majority of students receiving their first choice of labsonly after it's certain the professor has the funding and space to accommodate the student. In this way, the students differentiate into PhD programs in anatomical science, biochemistry, biological science, biophysical science, microbiology, neuroscience, oral biology, pathology, pharmacology, toxicology, physiology or structural biology. S cott Severance, currently in his fifth year of the program, works in the biochemistry lab of Daniel Kosman, PhD. For Severance, one of the most alluring aspects of the program is the fact that the courses are tailormade to his needs, not those of an aspiring physician. "Although we are associated with a medical school, we do not take medical school classes," says Severance. "Medical school classes are great if you are going to be a doctor, but the instruction, examinations and expectations are different in a graduate school class. "It would be much easier to have the IGPBS students fulfill their course requirements by taking medical school classes, as is the case at many other schools," he adds. "But the directors of the program have done just the opposite." Another bonus of the program comes from an administrative point of view: With the creation of the IGPBS, the recruitment process has been dramatically streamlined. "Previously, each department had to have its own recruitment brochures, and they had to support financially all the recruitment activities," Laychock says. "That was a very expensive and time-consuming undertaking, and we were not necessarily reaching the students we wanted to reach. " ow, with the interdisciplinary program, everything is consolidated, so all the expenses go toward attracting students to this centralized program. We have cut down on expenses and decreased duplicated efforts." "Recruitment involves far more personal contact and follow-up than before," adds Campagnari. "I attempt to contact students as soon as I receive any inquiries or GRE scores and encourage them to fill out an online application." And while the Internet has certainly helped prospective students find out about the program, it's interesting to note that the old-fashioned word of mouth still works wonders. "About three years ago, we did a mailing to PhD alumni informing them of what we were doing and how we were proceeding," Hayden says. "Many of those involved in academic programs have sent us some very qualified candidates. Our alumni are some of our best recruiters, and we welcome their recommendations." Winter 2 00 3 II If Ill rb J SiC iII 15 ��Recently, Paroski agreed to sit down and talk with Buffalo Physician as part of an ongoing series of conversations with leaders of UB's School of Medicine and Biomedical Sciences. (Part I of the interview is published on the pages that follow; Part II will appear in the spring 2003 issue of the magazine.) In addition to this conversation-and an earlier conversation with Dean Michael Bernardino-future issues of Buffalo Physician will publish interviews with Roseanne Berger, MD, senior associate dean for graduate medical education, and Suzanne Laychock, PhD, senior associate dean for research and biomedical education, each of whom will be asked about issues pertinent to her areas of responsibility. The goal in publishing these articles is to inform our readers about the complex economic, political, regulatory and historic considerations school leaders must weigh in making decisions and to provide a larger context within which to understand the many new developments taking place on campus. Comments and questions, as well as suggestions for future topics, are welcome and can be emailed to bp-notes@buffalo.edu or mailed to the address printed on the inside front cover of the magazine, below the heading "Letters to the Editor." -S. A. Unger, editor Q: What are the primary challenges you face in leading the three offices you oversee: medical education, curriculum and admissions? A: Let's start with admissions, since that is the office I started in when I first joined the medical school's administration full time. There, Dr. Bernardino has basically tasked me to do two things: to give the school a better class every year and to give it a class that looks more like the community. In terms of a better class every year, that can be a tough call because I don't think that the "best class" is necessarily the one with the highest grade point averages and MCAT scores. While being bright is certainly a prerequisite for being a doctor, there are many other characteristics that are important in defining what makes a good physician; for example, being personable and professional. So, in the Office of Admissions our primary challenge is to come up with a methodology for finding people who are capable of excelling in their coursework and who possess '' critical non-cognitive attributes. In terms of a class that looks more like the community, we have a great deal of diversity in Buffalo, Western ew York and throughout the state. For example, we have large African-American and Hispanic populations. Our current second-year class of 135 students, however, has only six under-represented minority students in it, which certainly does not reflect the demographics of our community. So, our challenge is to look for ways to recruit more students who will not only be competitive, but also make their class better reflect the community they are going to go out in and serve. In the Office of Medical Education [OME], our primary challenge is twofold: The first is to serve a registrar function-to track students and to produce all the paperwork that enables them to go where they need to go- and secondly, to provide a wide range of guidance and counseling services for our students. With regard to the counseling component, we find that every student who enters our school is truly unique. They all differ widely in the pressures they experience and how they respond to them, whether they be academic, financial or personal. Believe me, these are people who lead widely diverse and exciting lives, and trying to sort out reasonable solutions to their concerns or dilemmas takes up a lot of folks' time! In addition, the students need guidance counseling to help them to decide what area of medicine to choose. This can be a very tough decision. Some of the students have a family full of doctors and they've been exposed to everything, and choosing a career path is not a problem. For other students, they get to the end of their third year and they either love or hate everything and it is truly a crisis for them. ancy Nielsen, who is the dean for the third and fourth years, coaches them through this, and Chuck Severin, who is the dean for the first and second years, helps them through the early years. W int e r 2 003 l 1ffal1 Pbysicial 17 �Debbie Stamm, who is our assistant dean for student services in OME, spends a lot of time taking care of the details of daily life that may not be medicinesuch as financial aid, insurance, clubs, summer internships, special events, and so on-but these are the things that make the medical school experience tick. Some of our students are married and have children; there are just so many facets of life they need help integrating. Again, these may seem like little things, but taken together, they make the difference between a student having a good experience or a bad one. In the curriculum office, our challenge is, obviously, to give the students the education they need to be good practicing physicians, now and in the future. To accomplish this, the curriculum needs to be interesting and stimulating for both the students and the faculty and it needs to have something on the menu for all types of learners. Last year we implemented a new curriculum for the first and second years. In doing so, we switched from a discipline-based curriculum to an organ-based curriculum, where, for example, when you learn the gastrointestinal system, you learn GI physiology, pharmacology, anatomy, microbiology, and so on, because when you go out into the real world and begin practicing medicine, this is how you will need to put information together. When I went to medical school here in the '70s, we sat through lecture hour after lecture hour-a very efficient way for the teacher to stuff as much information into your head as possible, but arguably not the most effective way to learn. Adult learners like to see the relevance of what they are studying; they like to apply it, they like to be active learners. Therefore, in devising the new curriculum, the goals were to have fewer lecture hours and more interactive learning sessions and to teach the students how to go out and find their own information because, again, that's what you do once you get out and begin practicing medicine. Q: In recent years, as you have described, the Office of Medical Education has placed an increased emphasis on providing services to students, and in 1999 the position of director of student services was created. Was that a big change for OME? A: Yes, it sure was. Actually, when I went through school here, the staffing and services in OME were 18 I u II all Pb y sic i 11 Wi nt er 2003 fairly generous, but then they went through a period where they were pretty scant. I think that the staff in the office were very overextended and it was hard for them to be creative because they were running to stay in place with the basic mechanics of: Did the students have grades recorded? Have the dean's letters gone out? As a result, I think a lot of the quality-of-life issues got away from them. Every year the AAMC [Association of American Medical Colleges] has the fourth-year class fill out a graduation survey and they send the results back to the schools. Again and again, it was very clear to us at UB that the students felt they received a good basic education, but that a lot of the support services that made a difference to people weren't there. The school realized that these were not things that could be addressed by somebody as a sideline task ten minutes a day. This was a full-time job. In 1998, therefore, the position of director of student services was created, which was filled by Debbie Stamm. Debbie has done a fantastic job, and the position has assumed such importance that we recently changed the title to assistant dean for student services. Q: How is the success of the new curriculum going to be measured, and when might there begin to be results from these measurements? A: It's always hard to prove that the way you're doing something is better, particularly when the results are so far down the line. You know, who makes the best doctor is going to take time to sort out! However, in the short term, what we can measure is how they do on Step 1 of the national boards, the USMLE. Our first class in the new curriculum is coming through the second year now, so next summer we're going to know how they did on that. We have been told, however, that when schools put a new curriculum in place, they often see a dip in these scores before they see an improvement, so we are aware of that trend. For the type of curriculum we've put in place, where you tend to see the difference is when the students get into their clinical clerkships. Because this year's third-year class is the last class to go through the old pre-clinical curriculum, we're going to survey the clerkship directors to get a handle on how well prepared these students were when they walked in the door. We will be asking such questions as: Did they seem to be able to integrate the basicscience material? Were they able to think on their feet? How good were they at going and getting other resources and information and integrating it? And then we will do this for next year's thirdyear class, which will be the first through the new curriculum, to see if we have a difference. Feedback on the success of the new curriculum will be conveyed to the faculty through the appropriate committee structure-for example, the Curriculum Committee, which reports to the Faculty Council-and through Town Hall meetings. �Q: Are changes planned for the third and fourth years, as well? If so, what is the goal of these changes, and what is the timeline for their implementation? A: We do have changes planned for the curriculum in the third and fourth years, but they are not quite as sweeping. Our goal is to put some elective time into the third year for career exploration. For the students, choosing the direction they will take after graduation is a very pressured decision, and so we want to provide them with a bigger sampling of career options in their third year. Currently, the third-year students have seven-week clerkships in family medicine, psychiatry, OB-GYN and pediatrics and eight-week clerkships in internal medicine and surgery. We are proposing reorganizing the clerkships into four 12-week blocks. One 12-week block would have six weeks of OB-GYN and six weeks of pediatrics; another would have six weeks of family medicine and six weeks of psychiatry. The remaining blocks would be eight weeks of internal medicine or surgery, combined with four weeks of elective time. The four weeks during medicine could be used for any type of elective, and the four weeks during surgery will be used for the advanced-surgery elective previously required in the fourth year. This clerkship design will reduce the number of students per clerkship because, at any given time, approximately 25 students will be taking an elective. This will relieve some of the congestion on the inpatient services and in the clinics. We also plan to give all third-year students two weeks off at at the end of December and over New Year's, as students want to be home with their families during the holidays and the combination of cancelled clinics, few elective surgeries and a decreased inpatient census makes these two weeks a difficult time to teach. We are also proposing that the third year of medical school start earlier than we currently do- in early July rather than mid-August. One of the advantages of starting earlier is that it gives the students more time when they get to their senior year to either take additional electives in things they think they may want to do, or to get things out of the way to give them time to travel when they're on the interview circuit for residency positions. With regard to the timeline for these changes, we propose to partially implement them in 2003 and fully implement them in 2004. We need to phase in the earlier start date for third year to avoid overlap between the incoming and outgoing third-year class and to allow students adequate notice to adjust summer plans and financial aid. We also want to make sure we have faculty buy-in regarding the proposed changes. Q: What is the "continuity series" being developed for third- and fourth-year students, and what is its purpose? A: The continuity series-so called because it will span all 48 weeks of those clerkships we just discussed-is something we are putting in place for two reasons: The first is to keep the third- and fourth-year students connected to the school once they begin their rotations in the hospitals. We have a very decentralized clinical campus; one class can be placed in up to nine different hospitals. Given these logistics, they can lose touch with each other and the school's faculty. This is tough on the class and can be very alienating. It can also make it difficult to provide the students with the counseling they need. So, to that end, the continuity series will bring the students back on campus a couple of times a month in the evenings and will give us an opportunity to talk with them about all the housekeeping details that need to be covered and to keep them connected to one another and to the school. The second reason for starting the series is to provide a forum for introducing the students to topics that don't belong in any one place in the curriculum, but that belong everywhere. These 'orphan topics' can include ethics, professionalism, and some basic-science integration, as well as topics that are suddenly in vogue-for example, bioterrorism. Do you put that in obstetrics or pediatrics? Obviously, it doesn't really fit a particular clerkship. And yet, would you in this era graduate someone from medical school who hadn't been introduced to this topic? o, you wouldn't. So this is the continuity series, and we are piloting it in a limited fashion this year, from 6:00 to 8:00 in the CD evening on some Tuesdays. Editor's note: Part II of this conversation, which will be published in the spring 2003 issue of Buffalo Physician, will include in-depth discussion of admissions procedures and criteria, minority recruitment efforts and the role scholarships play in attracting quality students. Winter 2003 l11fal1 Hysiciu 19 �MEDICAL SCHOOL E W S Honors Convocation Recognizing medical students' achievements HE ANNUAL Ho ORS CoNVOCATION recognizing academic excellence among first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held in Butler Auditorium on September 21, 2002. The following is a list of award recipients and a description of the awards received. Departmental Awards The departments in the School of Medicine and Biomedical Sciences have established awards to recognize meritorious performance in their courses as well as outstandingachievement in other curriculum-related activities. Garron Solomon, '04, has received the Department of Microbiology's Ernest Witebsky Award for Proficiency in Microbiology, which is given to the secondyear student achieving the highest grade in the microGARRO'I SOLOMO" biology and immunology course. Dr. Witebsky was the founding chair of the Department of Microbiology. Primary Care Summer Externship Program. Dr. Calkins is a former chair of the Department of Medicine. Natalie Shaw, '04, received the Department of Patholo gy's Kornel Terplan Award, presented to the student with the highest combined average in the two second-year pathology courses. Dr. Terplan was a past chair of the department. Shaw also received an Association of Pathology Chairs Honor Society Award. Carmine Grieco, '04, David Block, '04, received the Department D A\' 1[) 20 of Microbiology's Marek Zaleski Award, which is presented to the student who best combines high standards of academic achievement with outstandingservice to the community. The second-year class chooses the recipient. Block also received the BLO< K Evan Calkins Primary Care Achievement Award, which is given to one outstanding student in the laffall nysiciaa W ir1t er 2003 received the Department of Pathology's John Sheffer Award, which is given to the second-year student who has performed at the highest level in CAR\11 "1E GR IECO the laboratory portion of the courses in general and systemic pathology. Dr. John Sheffer practiced pathology in Buffalo for over 35 years and was acting chair of the Department of Pathology from 1972 to 1974. Julie Baker, '04, received The Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, J u LIE B AKER which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the pathology laboratory. Jennifer Nelson '04, received the Department of Pharmacology and Toxicology's Edward A. Carr, Jr. Clinical Pharmacology Award and the Douglas S. Riggs Award. The former award is given to the student achieving the highest average in the Fundamentals of Pharmacology course. Drs. Carr and Riggs were chairs of the Department of Pharmacology and Toxicology. elson also received an Association of Pathology Chairs Honor Society Award. Other Awards Neeta Chaudhary, James Hereth, Jason Hoffman, Jennifer Maclaughlin, and Eric Ko, Class of 2004, received the AstraZeneka Cardiovascular Drug Monograph Award, which is presented to second-year students by the Department of Pharmacology and Toxicology. They are based on the quality of a monograph written in the form of a package insert. �)EFFREY FEI!'<ER MATTHEW fERNAAYS Jeffrey Feiner and Matthew Fernaays, Class of 2005, received the McGraw-HillLA GE Medical Student Award, which is given to the two highest-ranking students in the first-year curriculum. Discipline Honorary Societies The Association ofPathologyChairs Honor Society awardees were Carmine Grieco, Sandy Kotiah, Jennifer Nelson, Jennifer Nowobiliski, Natalie Shaw, Class of2004. ELIZABETH BOURKE LISA ESLER ]AMES W. BOYLE DAVID LAURA CINSKI DANIELLE DORSANEO Ft ToDD ]ANICKI LY:--<OSAY ]ENNIFER KORZEN WILLMOTT- MELANIE FIORELLA TIMOTHY PARDEE BARTOS BRYAN GARGANO ERIC SCHAEFER DOROTHY STEPHEN LISA ANN DOS TAK HENDRICKS JoYcE ZMt:DA TURKOVICH SANTOS CD Dean's Letters of Commendation Years 1, 2 and 3 Dean's Letters of Commendation recognize exceptional coursework. In years one and two, they are awarded to students who earn honors grades in 75 percent of required courses or achieve 75 percent of available honors points each year. In year three, students who earn at least four honors and two high satisfactory grades are honored. Year One GLENN MILLER MATTHEW ABOUDARA MICHAEL NAZARETH KRISTINE ALGOE RYAN Ross BAUER CHADD SARA BROOKSSIENKIEWICZ CHRISTOPHER BRENNAN SHERIN HUSSAIN KAVITA MICHAEL jORDAN TIMOTHY O'HERRON YALAKONDA LAURA Clt-<SKI MICHELLE CLARK A:-.' LORI BRODERICK MANAS! KADAM KIMBERLY CARNEY JosEPH ]AY PAHADE CATHERINE CASEY ERIC Ko DIANA PRATT EsME Ft:--<LAY KRISTOPHER PAOLINO LEE CHALUPKA SANDY D. KOTIAH MARAT REYZELMAN DAVID FI:-<TAK ALFRED FRO:-.JTERA ELSON ESBIT EETA CHACDHARY KtTA jESSICA PELOW LISA ]ASON PERICAK LtsA EsLER DOS SA:--<TOS ROBERT BUCELLI RoNALD PARSONS CRISTINA LAMPURI KARl SCANTLEBLRY MARK BuRKER BETH PETERSON REBECCA CHUSID MARY LEUNG ELIZABETH ScHNEIDER BRYAN GAR(,ANO SAMANTHA CHEN KEVIN SHILEY SHAWN CIECKO DEANNA LoVALLO CORINE SEBAST }ULIF G.>.\ IN } EFFREY FEINER KEITH SIKORA DAVID CIPOLLA }ENNIFER MATTHEW FERNAAYS DALJIT SINGH GREGORY CONNOLLY ALLISON GRAZIADEI jOANNE SMITH SARA CONNOLLY ICOLE MANN ATALIE SHAW MACLAUGHLIN ICHOLAS 51 LV ESTRI GARRON SoLOMON CHRIST"A GRACZYK DoROTHY HENDRicKs 5TEPHEK HESS THOMAS GRt-BER HoUMAN VosoGHI )EFFREY DAYTON TANIA MARIANI ERIK STEINIGER Tooo ]ANICKI CRAIG HENDLER DAVID WAGNER ANNE DELLES }EFFREY MARTINEZ KEVAN STERNBERG SARA KAPROVE }ACQUELINE }ULIUS STEVEN WATSON }F. 'NIFER KoRnN FAYE ]USTICIA-LINDE THOMAS DUQUIN MEGAN MOORE ]AMES SULZER ANDREW FABIANO BRITTANY MORSE }ILL THOMAN K1>1BERELY LEONARD CAREN GELLIN EvE MoscATO MEGAN TRACY MICHELE 0BROBINA MICHAEL WEII\GARTEN • STEPHEN TL'RKO\'ICH )OHN KARPIE Year Two SAFINA KoREISHI MEGHAN ANDREWS BRIAN GIORDANO )OLENE MusCAT AMANDA KOST CATHERINE ARTMAN CARMINE GRIECO SYED MusTAFA MICHAEL LADRIGAN DANIEL BAER )ASON GuTMAN }ENNIFER MONICA LEE )ASON BARKER CHRISTINA )AMES NITZKORSKI ELIZABETH BoL•RKE ANDREA LUCZKOWSKI )A,1ES R. BOYLE )ENNIFER LYNN )AMES W. BOYLE SAMUEL McCABE HAVERSTOCK ELSON }ENNIFER WILER Year Three Ln..:DSAY WILLMOTT BARTOS )OYCE Z.\1l DA OWOBILISKI W i 11t e r 2 00 3 1 111111 Hysici11 21 �MEDICAL SCHOOL E W S Sung Scholars Named M oLLY M ooRE H ANG K YU P ARK Molly Moore and Hang Kyu Park, Class of2006, are the recipients of this year's John J. and Janet H. Sung Scholarship. Moore, a native ofHamburg, ew York, earned a bachelor of arts degree in biomedical sciences from University at Buffalo. "I wish to express my sincere gratitude to Dr. Sung and Mr. Sung, and I'm honored to be a recipient of their generous gift," says Moore. Park, who was born in Korea and immigrated to the United States in 1994, earned a bachelor of science degree in chemistry from Queens College, CUNY. "I am fortunate to be accepted to UB's medical school," says Park. "Furthermore, I am very honored to be recognized as a Sung scholar. This scholarship enhances and enriches my educational experience at UB and encourages and assists me to be successful academically. I have had the chance to meet many helpful and wonderful people because of the Sung scholarship." The Sung Scholarship is funded by a $1 million gift to the University at Buffalo School of Medicine and Biomedical Sciences by John and Janet Sung, who came to the United States from Korea in 1972 with only $200 to complete their education. At the time, they had two dreams: to attain their educational goals and to establish a renowned clinic in radiology, both of which have been realized. Medical Alumni Association Scholarship Lori-Ann Oliver and Jodi-Ann Oliver, Class of 2006, are recipients of this year's Medical Alumni Association Scholarship. The scholarship is made possible by the generosity of the alumni through their reunion gifts designated to the Medical Association endowment fund. Recipients are selected by the admissions committee according to considerations of financial need and academic merit based on the incoming students' applications. The Olivers, twin sisters, were born in Jamaica and raised in Queens, ew York. They attended Cornell University and earned bachelor of arts degrees in English in 2001. 4D - S. A . UNGER 2 2 11flal1 Hysiciao Wr11ter 2003 �Thomas J. Lawley, MD, an internationally known expert in autoimmune skin disease and Dean and William P. Timmie Professor of Dermatology at Emory University School of Medicine, is the recipient ofthe University at Buffalo's 2002 Distinguished Medical Alumnus Award. Lawley was presented the award on September 19,2002, by Patricia Duffner, MD '72, president of the UB Medical Alumni Association, at a dinner held at the Buffalo Club. fter graduating with honors from UB's school of medicine in 1972, Lawley trained in dermatology at Yale University School of Medicine, UB and the National Institutes of Health (NIH). Following completion of his training, he stayed on at the NIH, where he rose to the rank of senior investigator in the Dermatology Branch of the National Cancer Institute(NCI). In 1988, Lawley left the CI/NIH to become chair of the Department of Dermatology at Emory University School of Medicine. Under his leadership, the faculty grew six-fold and the department went from having no NIH funding to becoming the third highest NIH-funded department in the country. Lawley, whose research interests include the cell biology of endothelial cells and the regulation of cell adhesion molecules and inflammation, has published more than 150 original articles and book chapters. In 1996, Lawley was appointed dean of the Emory University School of Medicine, having served the previous year as interim dean and executive associate dean. In this role, he has focused on creating and implementing two critical strategic plans. Under the research plan, he has recruited more than 80 new scientists and has fostered the establishment of several interdisciplinary centers. He has also established the Dean's Scholar Program, which protects the research time of clinician scientists and Distinguished Medical Alumnus Thomas J. Lawley, MD '72, left, being congratulated for his outstanding contributions to research and education by Patricia Duffner, MD '72, right, president of the Medical Alumni Association. fulfills all 25 goals outlined by his comprehensive plan. During Lawley's tenure as dean, the amount of research space in the Emory University School of Medicine has doubled and the amount of research funding increased by 150 percent. Under the teaching plan, Lawley has increased scholarships, created the Dean's Teaching Awards, expanded the MD/PhD Program and developed plans for a new Medical Education Building. In addition to spearheading these strategic initiatives, Lawley takes a proactive role in overseeing the clinical enterprise at Emory and its affiliated sites and has continued to see patients on a regular basis. As a result of these and other initiatives, the Emory School of Medicine has risen dramatically in rankings to become one of the outstanding medical schools in the nation since Lawley assumed the role of dean in 1996. Over the years, in addition to his academic responsibilities, Lawley has served on many national boards and committees, including NIH study sections and the National Advisory Allergy and Infectious Diseases Council for the National Institute of Allergy and Infectious Diseases of the NIH. He is president of the Emory Medical Care Foundation and chair of the board of directors of the Emory Children's Center. He also serves on the board of directors of the Emory Clinic, Emory Healthcare, and the Emory Children's CD Research Center. -S. A. UNGER Wi11ter 2003 llffal• Pkysicia1 23 �PATHWAYS NEws ABOUT UB's ScHOOL OF MEDICINE AND BIOMEDICAL SciENCEs AND ITS ALUMNI, fACULTY, STUDENTS AND STAFF Velazquez Named Interim Chair VELAZQUEZ 24 laffa le H ys ic i aa Mallory Institute of Pathology and Boston University Medical Center in Boston, Massachusetts. Velazquez is board certified in clinical pathology and is currently enrolled in the Master's in Health Care Administration and Policy Program at Harvard University. Francisco Velazquez, MD, has been named interim chai r of the Department of Pathology and Anatom ical Sciences in the University at Buffalo School of Medicine and Biomedical Sciences. Velazquez has held -S. A. UNGER the rank of clinical associate professor since August 2000 Robotic Surgery Specialist and has also served as pathologist-in-chief Celeste M. Hollands, MD, a at Kaleida Health. pioneer in pediatric robotic Recently, he was surgery, joined Children's appointed division Hospital of Buffalo in commissioner for Western September 2002 as clinical New York for the College director of the of American Pathologists' Miniature Access Laboratory Accreditation Surgery Center Program. (MASC) and Velazquez has held the Miniature academic appointments Access Teaching, at Boston University Training and School of Medicine and Robotic Research H OLLANDS Wayne State University Center (MASTin Michigan. He received TARR), located at the Unihis medical degree from versity at Buffalo School of Universidad Central del Medicine and Biomedical Caribe, Puerto Rico, and Sciences. Hollands, who has served his residency at the also been named associate Wznter 2003 professor of surgery and pediatrics at UB, debuted robotic surgery at the MASC on September 27, 2002, when she operated on two children using this new technology. The procedure was telecast live to UB's School of Medicine and Biomedical Sciences, where twenty-four pediatric surgeons-in-training from various institutions throughout orth America viewed it as part of a two-day advanced training course in pediatric surgery hosted by UB, CHOB, the MASC and the MASTT ARR. "We are very fortunate to have Dr. Hollands as a member of the Children's Hospital staff and the UB medical faculty," says Philip L. Glick, MD, surgeon-inchief at CHOB and professor and interim chair of surgery at UB. "She is one of the few pediatric surgeons in the world to work extensively with robotics. Her work is ground breaking." Hollands earned her medical degree at the �University of South Alabama researchers College of Medicine. She in science, completed her general medicine and surgery training at the engineering Graduate Hospital of the honored at a University of Pennsylvania special dinner and her pediatric surgery held last training at Miami Children's October in TREY! SAN Hospital. Her research Albany. interests include pediatric Trevisan is interim dean of trauma and surgical educathe School of Health Related tion in addition to miniature Professions and professor and access surgery, robotics and chair of the Department of new technologies as they Social and Preventive apply to these fields. Medicine (SPM) in the UB "The work we will be School of Medicine and doing here at Children's will Biomedical Sciences. A UB faculty member since 1985, be paving the way for other types of robotic surgeries," he is director of the Center for says Hollands. "Eventually, Preventive Medicine-part of we will find ways to use this the Women's Health Initiative-as well as SPM chair. technology to help very tiny He has served as interim dean infants and possibly even for of the School of Health surgery in the womb. I am very excited about the Related Professions since prospect of finding new and September 1, 2001, and in better ways to perform that capacity is spearheading surgery on infants." an effort to create a School of The two-day training Public Health and Health program was sponsored by Professions at UB. Ethicon Endo-Surgery, Inc., A prolific researcher, Stryker Corporation, ComTrevisan has authored or puter Motion, Inc., Berchtold, co-authored more than 110 B-K Medical Corporation, articles in scholarly publications and LSI Solutions. and delivered numerous - S. A. UNGER presentations at national and international meetings. A recipient of grants from such Trevisan Receives Chancellors' Award funding entities as the ational Institutes of Health, Maurizio Trevisan, MD, was the American Heart Associaone of three University at tion and the ational Cancer Buffalo faculty members Institute, his current work is selected to receive Chanfocused on cardiovascular cellor's Research Recognition disease epidemiology. Awards for 2002 and was among leading SU Y - SuE WuETCHER Kaiser Named Interim CEOatECMC The Erie County Medical Center (ECMC) Board of Managers has appointed Roger E. Kaiser Jr., MD '79, interim CEO of the ECMC Health care Network. Kaiser, who is an associate professor of clinical anesthesiology in UB's School of KAISER Medicine and Biomedical Sciences, currently serves as ECMC's medical director, as well as clinical director of its Department of Anesthesiology. Kaiser agreed to fill the pos1t1on in ovember 2002 while the ECMC Board of Managers completes its search for a permanent CEO to replace Sheila K. Kee, who stepped down from this role on October 31, 2002. -S. A. UNGER Book on Children's Mental Health David Kaye, MD, associate professor of clinical psychiatry, and Maureen Montgomery, MD, assistant professor of clinical pediatrics at the University at Buffalo, have authored KAYE a text titled W i nte r the Handbook of Child and Adolescent Mental Health, along with Stephen Munson, MD, associate professor of psychiatry and pediatrics at the University of Rochester. Published in October 2002 by Lippincott, Williams and Wilkins as part of its "Core Handbooks in Pediatrics" series, the book is intended to be a practical, handson guide for primary care physicians. Its authors took special care to integrate the perspectives of both mental health professionals and pediatricians, explains Kaye, who adds that the book fills a niche in an area of increasing importance in health care. "There are large numbers of children and adolescents with mental health problems presenting to primary care physicians, and yet there is no single source of treatment information available to guide the practitioner on the front lines," he says. "Pediatricians are increasingly asked to prescribe psychotropic medications, and we hope this book will help them make more informed decisions." In addition to addressing common mental health problems seen frequently in practice, the book explains the various systems involved 20 0 3 I I ffI II Pb J SiC iII 25 �PATHWAYS in children's mental health (i.e., school, social services, the legal system, the mental health system ). By blending the perspectives of child psychiatry and general pediatrics, "the authors present a pragmatic and current approach to issues of office evaluation, assessment, and treatment, including pediatric psychopharmacology," according to the publisher. - S. A . U N G ER .lames Waxmonsky .loins Psychiatry from Cornell University in 1992 and a medical degree, James G. Waxmonsky, MD, summa cum laude, from UB in joined the University 1996. He completed at Buffalo School of residency training in Medicine and adult psychiatry in the Biomedical Sciences UB Medical-Dental in September 2002 as Consortium in 1999. assistant professor of Following residency psychiatry. He is training, he comaffiliated with the pleted a fellowship in Children's Hospital WAXMONSKY child and adolescent of Buffalo, where he psychiatry at serves as the primary psychiaMassachusetts General trist in the Outpatient Hospital (MGH) and a Behavioral Health Unit. psychopharmacology research Waxmonsky earned a fellowship, led by Dr. Joseph bachelor of science degree Biederman, also at MGH. Waxmonsky's primary research interests include the pharmacological treatment of children with bipolar disorder and attention-deficithyperactivity disorder (ADHD) and treatment of adolescent addictions, as well as adults with ADHD. - S. A . UN G ER Ferrick .loins Orthopaedics Michael Ferrick, MD, has joined the pediatric orthopaedic surgery staff at the Children's Hospital of Buffalo and has been appointed When is a house more than a home? ... When it is a Patio Home at Canterbury Woods. Come and learn more about what makes our new Patio Home Community so unique. Informational Seminar Seating is Limited Call 929-5817 To Reserve your Date and Time Episcopal Church Home and /tffiliE.tes 26 l tffllt nysiciiD Winter 2003 $ 705 Renaissance Drive, Williamsville, NY 14221 �clinical assistant professor of orthopaedics at the University at Buffalo School of Medicine and Biomedical Sciences. FERRICK A Buffalo native, Ferrick graduated, summa cum laude, from the University of otre Dame in 1987. He earned a medical degree from the University of Michigan in 1992, after which he returned to Buffalo for residency training in orthopaedic surgery. From 1997 to 2001 Ferrick served as an active-duty orthopaedic surgeon in the United States Army, and in 2002 he completed a fellowship in pediatric orthopaedics and scoliosis at the Texas Scottish Rite Hospital for Children in Dallas, Texas. Ferrick's research and clinical interests include pediatric spinal deformity and childhood lower-extremity disorders. - S. A. UNG ER Stamm Named Assistant Dean Debra L. Stamm has been promoted to assistant dean for student services in the Office of Medical Education (OME) in University at Buffalo's School of Medicine and Biomedical Sciences. She previously served for three years as director of student services in OME. In her new position, Stamm STAMM continues to advocate for students and to act as a liaison between the student body and the school's administration. She also serves as a resource person for student clubs and organizations recognized by Polity, coordinates summer programs for students and assists with the implementation of MedCAREERS, a fouryear career planning program created by the Association of American Medical Colleges to help medical students select a specialty. Stamm earned a bachelor of arts degree in psychology at "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One john james Audubon Parkway Amherst, New York 14228 716.636.7600 H oGAN & W ILLIG, PLLC - - - - - Attorneys a t Law - - - - - hoganandwillig.com Winter 2003 l 1ffal1 Pbysicia1 2 7 �PATHWAYS the State University of ew York at Genesee in 1992 and a master of education degree in college counseling and student personnel administration at UB in 1995. Prior to joining the staff in OME in September 1999, she was admissions coordinator in the Offices of Admission and Financial Aid at Harvard Medical School in Boston, Massachusetts. -S. A. UNGER Chief of Thoracic Surgery at RPCI Todd Demmy, MD, has been named chief of the Thoracic Surgery Division at Roswell Park Cancer Institute (RPCI) and associate professor of surgery at the University at Buffalo School of Medicine and Biomedical DEMMY Sciences. Demmy comes to Buffalo from the University of Missouri Hospital and Clinics, Columbia, MO, where he served as chief of thoracic oncology, associate professor of surgery in the Division of Surgical Oncology and Cardiothoracic Surgery and co-director of the Cardiac Transplant Program. He earned his medical degree at Jefferson Medical College, Philadelphia, PA, in 1983, and completed residency training in general surgery 28 llffal1 Hysiciaa (1988) at Baylor College of Medicine, Houston, TX, and in cardiothoracic and cardiovascular surgery (1991) at Allegheny General Hospital, Pittsburgh, PA. Demmy is a Diplomate of the American Board of Thoracic Surgery and the American Board of Surgery. Although he has had laboratory and human research projects in both heart and lung surgery, he is joining RPCI to focus his efforts on thoracic oncology. His research interests include the minimally invasive management of tumors of the lung, esophagus and central portion of the chest. - DEBORAH PETTIBONE Kuvshinoff .Joins Surgery at RPCI Boris W. Kuvshinoffll, MD, has joined the Division of Gastrointestinal Surgery at Roswell Park Cancer Institute and has been named assistant professor of surgery at the University at Buffalo School of Medicine and Biomedical Sciences. Kuvshinoff comes to Buffalo from the Ellis Fischel Cancer Center, Columbia, MO, where he served as chief of the Section of Hepatobiliary and Pancreas Tumors, Division of Surgical KuvSHINOFf Wr11t er 2 00 3 Oncology, and interim chief in the Division of Surgical Oncology, Department of Surgery, at the University of Missouri HealthCare. He earned his medical degree from the University of Maryland (1986) and completed residency training in the Department of Surgery (1993) University of Cincinnati Hospital and a fellowship in Surgical Oncology (1995) at Memorial Sloan-Kettering Cancer Center. Kuvshinoff is boardcertified in general surgery (1995) by the American Board of Surgery. His research interests include radiofrequency ablation of primary and secondary liver tumors and neoadjuvant therapy with sphincter-sparing surgery for low-lying rectal cancers and the surgical treatment of hepatobiliary and pancreatic malignancies. - DEBORAH PETTIBONE Ciovino Receives Doii/Wynder Award Gary Giovino, PhD, a tobacco control specialist in the Department of Cancer Prevention, Epidemiology and Biostatistics at Roswell Park Cancer Institute and a research professor in University at Buffalo's Department of Social and Preventive Medicine, received the Doll/ Wynder Award during the 2002 annual meeting of the Society for Research on icotine and Tobacco (SRNT) in Savannah, Georgia. Giovino is only the second winner of this prestiGIOVINO gious award, which is presented every three years. The award honors scientists who have made ground breaking advances in public health, public policy or epidemiological research, focused on tobacco use and the consequences of smoking on populations of smokers. The award is named after Sir Richard Doll and Dr. Ernst Wynder, whose influential research in the 1950s clearly established the link between smoking and lung cancer. Giovino is recognized internationally for his contributions to the measurement of tobacco use. In April 2002, he received a four-year grant of approximately $3.5 million from the Robert Wood Johnson Foundation to conduct a comprehensive survey to assess youth smoking cessation needs and practices. - DEBORAH PET T IBONE O'Connor and Fakih .Join Medicine Two medical oncologists have received joint appointments to Roswell Park Cancer Institute (RPCI) and to the University at Buffalo School of Medicine and �Biomedical Sciences, where they have been named assistant professors of medicine. Tracey L. O'Conner, MD '97, will serve in the Breast Cancer Division at RPCI, and Marwan G. Fakih, MD, in the Gastrointestinal Cancer Division. After earning her medical degree from UB in O'CONNER 1997, O'Conner completed residency training in internal medicine at Strong ., """ ,.,, Memorial Hospital, University of Rochester Medical Center, in 2000 and a fellowship in medical oncology at RPCI in 2001. She is board certified in internal medicine by the American Board of Internal Medicine and is a member of the American Association of Cancer Research and Alpha Omega Alpha Honor Medical Society. Her research interests focus on novel treatments for breast cancer and supportive care therapies for patients with advanced disease. Fakih comes to Buffalo from the University of Pittsburgh School of Medicine, where he served as assistant professor of medicine. He earned his medical degree at the American University of Beirut, Lebanon, in 1992 and completed residency training in internal medicine at Wayne State University in 1995 and a fellowship in hematology and oncology at the University of FAKIH Pittsburgh in 2001. He is board certified in internal medicine and medical oncology by the American Board of Internal Medicine, and is a member of the American College of Physicians, the American Society of Hematology, the American Society of Clinical Oncology and the European Society of Medical Oncology. His research interests include the development of novel treatments for patients with gastrointestinal malignancies. - DEB O RAH PETTIB O NE GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60 day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" ( Voltai re) Daniel Schneider, AuD Jennifer Schneider, MA Win t er Jerri Kaplan Joyce, MA 2003 111111 1 Pbysicill 29 �PATHWAYS Western New York Pioneers of Science The inaugural Western ew York Pioneers of Science Educational Conference and Awards Banquet, sponsored by the Hauptman-Woodward Medical Research Institute, was held on October 30, 2002. The purpose of the awards is to focus public awareness on the many significant scientific advancements that have been developed in our region and to recognize those individuals who have achieved prominence through their discoveries. Among those honored at this event were the following members of University at Buffalo's medicalscientific community and affiliated institutions: T. MingChu, PhD, DSc, a research professor at Roswell Park Cancer Institute, developed the PSA (prostate specific antigen) test, which has revolutionized the detection of prostate cancer and become the world standard for early detection. Chu received postdoctoral training at Hauptman-Woodward Medical Research Institute, University at Buffalo and Buffalo General Hospital. Currently, he is engaged in research that focuses on the immunodiagnosis of pancreatic cancer. John A. Edwards, University at Buffalo professor emeritus of medicine and founder of the Alzheimer's Disease Assistance Center of Western New York, died October 28, 2002, in Sisters Hospital. He was 66. Edwards, who retired from UB in 2000, had been acting head of the Division of Geriatrics/ Gerontology in the School of Medicine and Biomedical Sciences. Dr. Wilson Greatbatch is known for inventing the implantable cardiac pacemaker and for introducing the long-life lithium iodine battery into medical usage. He has dedicated his life to studying interdisciplinary areas combining engineering with medical electronics, agricultural genetics and the electrochemistry of pacemaker batteries. He is currently adjunct professor of electrical engineering at the University at Buffalo. Herbert A. Hauptman, PhD, a world-renowned mathematician, received the obel Prize in Chemistry in 1985 for a mathematical formula known as direct methods. His work changed the field of chemistry and began a new era in molecular structure determination of crystallized materials. He is currently president of Hauptman-Woodward Medical Research Institute and a UB Distinguished Professor in the Department of Structural Biology. Anative of Hawarden, Wales, Edwards obtained medical degrees from the University of Liverpool in the United Kingdom in 1959 and trained in internal medicine in the U.K. He came to Buffalo in 1967 and completed atwo·year fellowship in medical genetics at the University at Buffalo School of Medicine and Biomedical Sciences. He joined the UB faculty as aresearch assistant professor of medicine in 1969. Edwards received aNational Institutes of Health Research Career Development Award and was a member of the American Posthumously Lawrence D. Jacobs, MD, was chair of University at Buffalo's Department of Society of Clinical Investigators, eurology and head of the Jacobs eurological Institute at Buffalo General Hospital, which is affiliated with UB. A dedicated physician-scientist, he was world renowned for groundbreaking research on multiple sclerosis and for the development of new treatments for this disease. the American Foundation for Clinical Research and the New York Academy of Sciences. He was medical director of the Episcopal Church Home Long Term Care Facilities and Adult Day Program, and was a member of the Episcopal Church Homes board. He also was president of the Amherst Senior Center advisory board. 30 l ufllil Pbpitill W i n ter 2003 �New Web Index to the Buffalo MedicalJourna1(1845-1919) The Buffalo Medical Journal, published from hospitals and discoveries, 1845 through 1919, contains original submis- • contain obituaries and biographies about Education Services, and linda Lohr, manager of Sharon Gray, former head of Reference and sions by Buffalo and Western New York physi- Western New York physicians and nurses the Robert L. Brown History of Medicine Col- cians, including case studies, editorials and • chronicle the UB medical school and regional lection in the Health Sciences library, Jed the articles, as well as reprints of articles published medical history. in other American and foreign medical journals of the time. project and established criteria for articles. Un- Also included are select editorials by Buffalo der the direction of Corinne Jorgensen, PhD, Medical Journal editors. (The first editor of the students in the UB Department of library and Because indexing for this publication was journal was Austin Flint, MD, a founding faculty Information Studies completed half of the in- inconsistent and sporadic, a comprehensive in- member of the then-University of Buffalo School dexing (nearly 1,200 articles). dex in a single, searchable site on the web has of Medicine. A professor of medicine as well as Funding for the project was provided by the recenUy been compiled, increasing access to the the medical school's first registrar and treasur- Friends of the Health Sciences library and the journal's unique information for those interested er, Flint edited the journal from 1845 to 1855.) Western New York library Resources Council. in the medical history of Western New York. The database includes articles that: The indexing project was a collaborative Mouse Calls is compiled by Pamela M. Rose, effort between the UB Health Sciences library, MLS, Health Sciences Library, University at Buf- • are written by Western New York physicians the UB Department of library and Information falo, 3435 Main St., Buffalo, NY 14214, (716} • describe Western New York heaHh issues, Studies, and the UB University libraries. 829-3900, ext 129; prose@acsu.buffalo.edu. ' · Chofce Employee Benefits G roup LLc THEN GET TO BUFFALO. Pressure at your current pos1t1on JUSt too much to handle? Is your pract1ce giVIng you way too many headaches? If so. then 1t ~ t1me to shuffle off to Buffalo' ? Worned about the snow? No sweat. Buffalo only averages about 25 days of snow a year Snowfalls that would bnng l1fe 1n some Cities to a gnnd1ng halt are no problem here' And our average summer temperature IS a perfect 79 degrees e Here's what we've got! Physicians Ufet1me Health IS a not-for-prof1t complete care prov1der featunng state of the art health centers. We are seeking BC/BE physiCians to JOin our prest1g1ous roster of health care professonals Find out how Ufet1me can f1t your 1fe by send1ng CV to: Physician RecrUitment. Lifetime Health. 205 Park Club Lane. Buffalo. NY 14221 PH 877-217-7465 FAX 310-917-5062 EMAIL: lscreeney@earthllnknet Lifetim e Health (716) 631-3614 • Toll Free: 877-552-1508 w wwfitsyo uri ife.com Equal Opportun1ty Empl ' JP.f m/f/d, e-mail: hs@choice4benefits.com web: www.choice4benefits.com 6633 Main Street • Williamsville, Winter 2003 ew York 14221 1111111 Pbysiciae 31 �era otential outcomes for the newly christened post- The Structure of Proteins genomic era have been widely prophesized and pub- At the UB Center of Excellence in Bioinformatics, one aspect of licized: The development of drugs targeted to an research focuses on predicting the structure of proteins of a individual's genetic profile. The elucidation of ways certain size-below a couple of hundred amino acids-and all biochemical processes interact in the human body. figuring out how they fit into the extremely complex biology of The creation of precise methods of diagnosing condi- both normal function and disease. tions and treating them with minimal side effects. "Ultimately, we' re trying to reduce the lead time for drug Key to translating these theoretical potentials into development, not for one molecule or a few, but for hundreds concrete results is the relatively young science of bio- or even thousands," Skolnick explains. informatics and the ability ofbioinformaticians to acWithout the power of the CCR's supercomputers, this recess and leverage the exponential power of supercomputers. search would not be capable of fulfilling its cutting-edge At the University at Buffalo's Center of Excellence in Biopotential. "Even if each simulation of each protein took informatics, director Jeffrey Skolnick, PhD, UB Distinfive days of computer time, and even if you're looking guished Professor, and his research team have access to BY at just 14,000 protein structures (the small proteins in ELLEN this indispensable computing power and are focusing all the human genome), then you're talking about 70,000 GOLDBAUM their efforts on leveraging it to its maximum capability. days to predict protein structure on a single computer In fact, when describing computing capability at UB processor," says Skolnick. these days, the word that often comes to mind is "staggering." "So if you don't have on the order of several thousand proThat's because in September 2002 a new Dell supercomputer cessors, you just can't reasonably do it. But if you have 4,000 cluster was installed in the university's Center for Computational processors, which we do, then, theoretically, it could take only Research (CCR). 18 days," he predicts. Weighing more than 80,000 pounds, the cluster has a capacity And that's only for one genome. Skolnick and his colleagues in to perform 5.8 trillion operations per second; it contains 4,120 the Department of Structural Biology in the UB School of Pentium processors, more than 2 trillion bytes of random access Medicine and Biomedical Sciences are studying numerous gememory and 160 terabytes of storage. nomes, including those of pathogens and organisms such as the Currently more than 50 scientists at UB are engaged in mouse, the basis for many models of important human diseases. bioinformatics research in the fields of genomics, proteomics, They also are studying less complex genomes, an understandbiophysics, biology, pharmaceutics, chemistry and computer ing of which will provide the basis for better approaches to the science. Many, like Skolnick, will use the supercomputers in the human genome. CCR for their research, which ranges from molecular-structure After important protein structures are determined-a huge determination and computational chemistry to materials sci- undertaking in itself that requires collaboration with experi- �mentalists-comes what Skolnick calls "the hard part," the analysis of each structure to determine its role in biochemical function and how it may both influence, and be influenced by, cellular processes involved in disease. "Ultimately, what we want to do is to relate genotype (what's happening genetically) to phenotype (what's happening clinically)," he says. "What we want to find is, What's the physiological manifestation of this protein structure in this cellular pathway? "The overall goal is to develop personalized medicine, which is based on understanding how a drug affects one person versus how it affects another, " he adds. the interacting proteins that will help scientists discover their role in biochemical pathways. "That's what our method aims to do," he continues. "Using our supercomputer, we can start to see how the path fits together, how this enzyme interacts with that small molecule, or functions in a cascade of cellular processes. "Ultimately, you want to know how the expression of these particular molecules relates to a particular phenotype; for example, whether a particular set of proteins causes a certain kind of cancer," he says. Appetite for Data Connecting the Dots kolnick and his team already are making headway in connecting those dots. In the November 15, 2002 issue of Proteins, the team published results developed while Skolnick was at the Danforth Plant Science Center in St. Louis that provide the first large-scale (genome-based) ability to predict protein-protein interactions. * "With that research, we are now moving toward an understanding of how the whole system works-what's known as systems biology, which is the key revolution in the post-genomic era," he explains. According to Skolnick, the Protein Data Bank, the international "public library" of solved protein structures from which scientists draw data, contains not just isolated molecules but in many instances solved compounds of two or more proteins interacting with each other. "Lots of cellular signals are mediated by these protein-protein interactions," he explains, "but it's a very crowded party, and we want to know exactly who's interacting with whom. Often, the function of one protein can be deduced by studying the proteins with which it interacts." Skolnick conjectures that perhaps there are hundreds of millions of these interactions, a seemingly intractable problem. However, he adds that the process is greatly accelerated if you have a computational method that helps pinpoint the sites on For bioinformaticians like Skolnick, these unprecedented challenges carry with them unprecedented opportunity, for these scientists are getting a first glimpse of the dazzling array of complex cascades of the biochemical activities that make up human life. "Right now, there are only about 500 proteins that are targets of existing drugs, and there are 35,000 genes," explains Skolnick. "The questions we are going to attempt to answer include exploring what makes a drug target a drug target? Can we predict interesting drug targets? Can we suggest cocktails of drug leads? "There is an immense and voracious appetite out there for the kind of data we are generating. " If the post-genomic era lives up to its promise, then experimentalists working in laboratories around the world will eagerly devour these fresh computational results and in the years ahead will translate them into findings that, step by step, will guide the development of medications whose power and precision can today only be imagined. 4D •For a detailed description of the article published in the November 15, 2002. issue of froteins by Skolnick and his team in which they describe a promising new algorithm they have developed that can predict interactions between proteins whose struc· tures are unsolved, visit the University at Buffalo's New Services Web site at http:// www.buffalo.edu/news and enter the keyword "Skolnick" in the search engine. �RESEARCH E W S Virtual Surgery, Virtual Organs Living Anatomy Program takes on a life of its own esearchers at the Uni- if I could learn how to do an versity at Buffalo are operation that poses a high combining 21st-century mortality risk-one I may materials and comput- never see until I'm called to erized sensors to create do it at 3 p.m. on a Tuesdaya simulator for surgical if I can find a way to allow training with "organs" that people to learn surgery techfeel, smell and respond like liv- niques quickly and efficiently, it could save lives."' ing tissue in the human body. That was in 1993. Today The work is being led by David Fineberg, MD, clinical Fineberg is working with UB assistant professor of surgery computer scientists, engineers, and oral and maxillofacial sculptors, materials experts, in the UB School of Medicine pharmaceutical firms, highand Biomedical Sciences, who school curriculum coordinawants to change the way sur- tors and a veterinary school to create a surgical version geons train. In fact, he of a simulator he has also wants to change BY named "The Living LOIS the way content is deBAKER Anatomy Program." livered across many In the process, he has industries and disciplines, including the teaching come to believe that the technology being developed for a of mathematics and science. Fineberg's idea took shape surgical simulator could have nearly 10 years ago when he applications far beyond that was a trauma surgery resident original goal. at Erie County Medical Center. ''I'm interested in creating a A young woman arrived at profound, in-depth immersion the hospital with internal in- into content through a technojuries sustained in an automo- logy platform based on interacbile accident the day before tive physical-virtual models," she was to be married. The im- says Fineberg. "Users will be pact had ripped her liver from able to enter, become immersed its tethering vessels, and her ab- in and manipulate computerdomen was filled with blood. generated content in a very The trauma team worked for natural way by using their three hours in a frantic but fu- hands-a development that tile attempt to save her life. represents a new step in the 'Til never forget that," says evolution of a human-systems Fineberg. "It really affected me. approach to interface developI thought, 'If! had had a model ment. This can be accomplishto practice that procedure on, ed with custom-made physical 34 ltffalo Physician Wi11ter 2003 objects that direct motion of related virtual models." In referring to "a humansystems approach," Fineberg explains that he is collectively describing a myriad of interrelated components that are customized to represent sensory systems of the human body in order to allow, for example, a surgeon-in-training to communicate more effectively with an artificially generated environment. In the case of the Living Anatomy Program, "the sensation of touch and its relationship with vision is the focal point," he explains. Fineberg sees a variety of potential applications, from teaching math and science to high school students, to using simulation to train workers to perform potentially risky tasks, such as operating industrial machinery, without actually putting them in harm's way while they're learning.'Tm looking to change the way content is delivered across all industries and disciplines," he says. The surgical simulator would showcase the technology's potential and function as a prototype for this human/virtual reality interface. Prospective surgeons, like all medical students, learn about the body from a cadaver, which is useful but far from optimal, says Fineberg. "A cadaver is cold, hard and preserved. It bears little resemblance to the living body. "With a surgical simulator, surgeons-in-training could learn, for example, how a ruptured spleen feels or how to locate a torn blood vessel in a blood-filled abdomen." �FINEBERG WILL USE 21ST-CE TURY MATERIALS AND ENDOW THE MODELS WITH COMPUTERIZED SE SORS TO CREATE PSEUDO-ORGANS THAT WILL FEEL, SMELL A D RESPO D LIKE LIVING TISSUE I Fineberg and Thenkurussi Kesavadas, PhD, UB associate professor of mechanical and aerospace engineering and director of UB's Virtual Reality Laboratory, have begun working toward that goal, one organ at a time, with $100,000 in development funds from the ew York State Office of Science Technology and Academic Research (NYSTAR). rgan models, per se, are nothing new, but Fineberg's organs will be unlike anything that exists currently. He will use 21stcentury materials and endow the models with computerized sensors to create pseudoorgans that will feel, smell and respond like living tissue in the body. "This has not been done before," says Fineberg. "You have to have someone who knows what human organs feel like committed to the project to make it work. o one even comes close to our technology of combining these organs with the computer interface." To date he has made molds of the liver and spleen using cadaveric organs as models . He is now working with Polytek, a materials company, to find polymers that feel like living tissue with which to fill the molds. The University of Ottawa Heart Institute's Medical Device Department has also offered engineering assistance and mentoring services on the project. THE BODY. Translating the tactile information into electronic data falls to Kesavadas. He is helping to capture the properties of human tissue using his virtualreality glove, a device that collects data on what the wearer is feeling through sensors located in the glove's fingertips. Kesavadas is creating a database of information that describes the biomechanical properties of soft tissue under various conditions. Just as flight simulation involves more than manipulating instruments on a panel, surgical simulation, to be truly representative of reality, must recreate the sense of urgency and controlled chaos of the surgical suite. "There is a complex atmosphere that exists in a surgical setting that must be reproduced for a realistic simulation," Fineberg says. "That includes sound, people walking around, and algorithms of activities that are occurring. A computer-generated environmentcan capture much of this." Before the project can reach this point, the model organs likely will have a first life as individual teaching tools . Fineberg plans to market them and the technology platform for a number of uses to generate funds to finish the surgical simulator prototype. A firm in Rochester, ew York, is interested in marketing a complete set of organs for teaching biology and anatomy. Veterinary schools also have shown interest in models of dog organs for use in training veterinary surgeons. (Washington State University's College of Veterinary Medicine is currently formalizing a relationship with Fineberg to install a lab to use his models as alternatives to live dogs in the training of veterinary surgeons.) The spleen model will be marketed to physicians who treat bloodrelated diseases. Kesavadas is working on a virtual-reality "overlay" of the spleen, which could make it appear to be injured, inflamed or of a particular age. Fineberg plans next to produce a "liver trainer," for use by anyone who needs to learn the liver's physiology; a pancreas model will follow. "What we are working toward doing is linking spatial position and motion of physical objects with related images in a computer-generated visual scene, so that we can selectively control objects in a virtual world," Fineberg says. "This will allow us to merge the physical with the virtual. We cannot do this without quite a bit of front-end development in both the physical and the virtual area, and that is what we are doing now." <P for every ring purchased a $10 donation will be made to the University at Buffalo alumni fund / February 12th·14th , 10am to 4:00pm place an order call 1.800 .424.1492 or visit www.jostens.com C 2002 Jostens Inc. Printed in U.S.A. 02·0920 Winter 2003 l11fale Pbysiciae 35 �RESEARCH E W S Rich Vein of Data Women's Health Initiative a catalyst for new studies hen researchers in the University at Buffalo School of Medicine and Biomedical Sciences began recruiting women to participate in the three-pronged Women's Health Initiative (WHI) in 1993, the relationship of gum disease to osteoporosis was not one of the questions they were seeking to answer. generation, all of which The goal ofWHI is to BY are direct spin-offs of gather essential clinical LOIS the original initiative. BAKER data on the major disToday, a decade after eases affecting women, the initiative was launched, hun- using women as subjects. With dreds of other spin-off projects that mission in mind, researchare under way at the WHI's 40 ers set out to determine, once clinical sites across the country, and for all, if a woman's risk of catalyzed in whole or in part by developing coronary heart disthe 12-year, $625 million initia- ease,breastandcoloncancer,and tive funded by the ational In- osteoporosis could be lowered stitutes of Health. The WHI is through three interventions: hormone replacement (estrogen alone or with progesterone); vitamin D and calcium supplementation; or a low-fat diet. Meanwhile, myriad ancillary studies have begun addressing questions that weren't even being asked in 1993. "This is one of the legacies of WHI," says Jean WactawskiWende, PhD, co-director with Maurizio Trevisan, MD, ofUB's WHI Vanguard Center. "With comprehensive health data on 162,000 women, we have an invaluable mine of information to use to advance public health. I think we'll be learning from it Jean Wactawski·Wende, PhD, co-director with Maurizio Trevisan, MD, of University for 50 years." at Buffalo's Women's Health Initiative Clinical Vanguard Center UB's interest in the link beIn the "one-thing-leads-to- the largest clinical trial ever un- tween oral health and osteoanother" nature of scientific dertaken in the U.S.; currently, porosis dates to the early 1990s. research, however, investiga- some 162,000 women are en- Researchers in the Department tors in UB's WHI Clinical rolled in it nationwide, includ- of Oral Biology in the School of Vanguard Center have sincere- ing 4,000 in Buffalo. Dental Medicine in 1995 received $3 million in funding to Historically, clinical trials ported results of a pilot study conduct a series of studies on have been conducted only on demonstrating that women with the link between the two condi- men. As a result, treatments increasing levels of periodontal tions. UB also is taking part in tested exclusively on men were disease showed corresponding trials examining the effect of prescribed for women without losses of bone mineral density. estrogen on memory, Alzhei- evidence that they would receive That study, supported in part by mer's disease and macular de- the same benefit. the U.S. Public Health Service, 36 l ulfalo HysicilD Wi11ter 2003 led to a $750,000 grant from the U.S. Army to investigate this link in UB participants enrolled in one arm of the WHI study. Based on those findings, which duplicated the pilot study results, UB received $2 million in the summer of 2001 from the ational Institute of Dental Research to follow the women for four more years and document any gum disease-osteoporosis link. Having a periodontal-disease clinic in place for this WHI spinoff study provided the opportunity for UB researchers to move forward quickly on another major investigation: the link between periodontal disease and heart disease. Trevisan and co-principal investigator Robert J. Genco, DDS, PhD, vice provost and SUNY Distinguished Professor in the Department of Oral Biology, received $7 million from the a tiona! Institute of Dental and Craniofacial Research in October 2001 to plan and conduct a pilot study to determine if treating periodontal disease in patients who have had one heart attack will prevent a second. Genco was one of the first scientists to show a connection between inflammation from periodontal disease and heart disease. He has been working for several years to further elucidate this connection and identify the particular oral pathogens involved in inflammation in the blood vessels. �Inflammation now is considered an important cause of heart disease, and research is progressing in this area on several fronts. Perhaps the richest WHI vein available to be mined is the data bank of blood samples taken from alll62,000 participants at the start ofthe initiative. As various conditions and diseases develop in participants, these blood samples can be scanned for disease "markers," that could form the basis for future screening tests designed to catch diseases in the very early stages. none study, Trevisan and another group of WHI investigators led by Paul Ridker of Harvard University Medical School are analyzing the sam- pies of WHI participants who develop cardiovascular disease, looking for such clues. This research will help detect blood markers that can be used to identify people who are at risk of having a heart attack before any symptoms develop. UB researchers and scientists at additional WHI clinical sites also are studying CA 125, a blood marker for ovarian cancer, using this large database. The collection of blood samples could lead to the discovery of currently unknown disease markers and new methods of early identification for a wide variety of conditions, according to Trevisan. "The fact that we can wait for a disease to show up and then look for clues in the specimens already collected and stored in the WHI blood sample bank will give us better and quicker ways to identify disease markers," he explains. The studies of estrogen replacement and its relationship to Alzheimer's disease and macular degeneration are being carried out at UB and several other WHI clinical centers in participants over the age of 65. Even though the estrogen/ progesterone arm of the trial has been halted, these women will continue to be followed to determine if hormone replacement was beneficial in preventing dementia or vision loss. Women in the estrogen- alone arm of that trial, which was not halted, will continue their participation as scheduled. Results of those trials will begin to be released when the WHI ends in 2005. As the end of the initial WHI trial approaches, UB and other WHI clinical centers will be applying for additional grants to follow participants into the future. "The idea is to keep a data stream going," notes Wactawski-Wende. "The intention is to keep the cohort together. I look at this as a lifespan study. "There'ssomuchdata,people will be analyzing it and learning from it for years." 4D Phillips, Lytle understands that health care providers face unique legal challenges. HIPAA, STARK, compliance issues, DOH regulations, reimbursement, the OPMC, and let's not forget about MFCU audits. These are all hot topics that we are prepared to help you with . Experience • • Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq., the health care practice group coordinator, at (716) 847-5478 or lmcdougall@phillipslytle.com. PHILLIPS. LYTLE. HITCHCOCK. A T T 0 BLAINE 8 HUBER LLP R N E Y S est.1834 3400 HSBC Center, Buffalo, NY 14203 (716) 847-8400 website: www.phillipslytle.com BUFFALO • FREDONIA • jAMESTOWN • NEW YORK • ROCHESTER W i nt e r 2 00 3 l1ffalu Pbysician 37 �G u E s T COLUMN MEDICAL B v an STEPHEN W E A p H R , 0 :LH,I C S CUlture ditor's Note: Last summer, Stephen Wear, PhD, associate professor in the Department of Medicine at the University at Buffalo School of Medicine and Biomedical Sciences, and co-director of the UB Center for Clinical Ethics, was invited to be a visiting professor at the Graduate Institute of Philosophy, National Central University, in Chung Li, Republic of China (Taiwan). Wear, who holds adjunct appointments in the gynecology/obstetrics and philosophy departments at UB, sits on various ethics committees in Buffalo, including those at the Veterans Affairs medical center (where the UB Center for Clinical Ethics is located), South Buffalo Mercy Hospital, Erie County Medical Center, Kaleida Health System and Millard Fillmore Hospital. He has published some 40 articles on a wide range of bioethics' topics and has authored a book titled Informed Consent: Patient Autonomy and Clinician Benef'icence within Health Care, which is now in its second edition and has been translated into Italian. At the invitation of Buffalo Physician, Wear has written the following article that encapsulates observations he made during his stay in Taiwan regarding that country's efforts to establish ethical guidelines for health care that incorporate both traditional and modem approaches to treatment. -5. A . Unger f rom July 3 to August 4, 2002, I had the privilege of being a visiting professor at the Graduate Institute of Philosophy at the ational Central University in Chung Li, in the Republic of China (Taiwan). During my month-long stay, I delivered a series oflectures and grand round presentations and participated in a number of case conferences at health-care facilities in the Chung Li and Taipei area. In addition, I collaborated on various research projects that focused on ethics committees and bedside ethics consultation, and consulted with staff at the institute, as well as with physician and nursing faculty at the Yang Ming School of Medicine in Taipei. Technologically, the Taiwanese seem to be about on par with the United States. For example, I was shown medical facilities that boast enormous 200-bed intensive care units, was briefed on very active research efforts in the teaching hospitals, and observed medical student/resident education models that are fairly similar to our own. One notable difference in the educational system, however, is that students begin medical 38 la lf ll t Pb ysicin Wi11ter 2003 school right out of high school and earn their medical degree after a seven-year course of study. As I met and became acquainted with faculty and attendings at various hospitals, I was surprised to discover that a large percentage had been trained in the West, particularly in the United States. Taiwan has what is probably the last large, concentrated population in which traditional Chinese culture abounds, as the communists have done everything they can to eradicate it on the mainland since they took over in 1949 (e.g., the Great Leap Forward, the Cultural Revolution, and the Red Guards). Given that the focus of this ancient tradition is on the family as the basic social unit-not on the individual, as in the West-this produces very different clinical approaches to patient care than what we have become accustomed to in our culture. For example, even when the patient is competent, families are the first to be approached with diagnoses and treatment recommendations by staff. Respect for patient confidentiality is thus not a major ethical principle in �Taiwan, and a family's demand that a patient not be told bad news is usually honored. It was also interesting for me to learn that informed consent for procedures may be obtained by law from either the patient or the family. While the technological level of health care in Taiwan seems in many ways to be as high as ours, the country is about 15 years behind the West in grappling with the issues of medical ethics that inevitably accompany such technology. They are just now beginning to deal with such issues as do-not-resuscitate orders, they have not yet made provision for advanced directives and withdrawal of life support rarely occurs. In this sense, they are behind us; however, their much higher respect for families as surrogates has allowed them to deal with many death and dying issues more comfortably than we have in the West. B efore I left for my visit, I was warned that, in general, Taiwanese health-care professionals are not interested in a rendition of Western individualistic, patient-centered medical ethics. The reason for this sensitivity, I was told, is that this approach would be perceived as just another form of Western imperialism, something the Chinese have certainly had quite enough of over the course of the past two centuries. Given the emphasis on diversity in our own culture, and out of respect for my host country's mores, I was of course prepared to avoid any affront in this regard. Interestingly, however, throughout my visit, my Chinese colleagues consistently wanted to know how a given issue or case would be dealt with in the West. On closer examination, it soon became apparent to me that they were in many ways wrestling with the same sorts of concerns we had wrestled with 25 years ago, when bioethics arose in reaction to the Western tradition of physician paternalism. In particular, they expressed concern that the well-known lack of confidentiality in their medical culture has resulted in a tendency for patients not to be candid when interviewed by physicians. They also report that, for the same reason, people with AIDS come in for treatment much too late. As to truth-telling and patient autonomy, anumber of the cases I was presented with involved patients with treatable malignancies whose families had forbidden the doctors to tell them their diagnosis and took them home for traditional Chinese medical therapy, only to have the patient return a few months later when their disease had metastasized and was untreatable. In response, I found myself wondering if we in the West are being too humble about our progress in medical ethics or too accepting of cultural diversity. In effect, I felt that my hosts were most concerned about the negative, harmful effects of a paternalistic medical ethic, just as we had been a few decades ago. This concern was demonstrated not just in their more general discussions, but over and over again in the cases they chose to present to me in their healthcare institutions. It's not that I feel that the Western individualistic approach to bioethics has the full answer for the Chinese, any more than it does for Western cultures. Often in the West our approach to patients commits the opposite evil of not involving their loved ones at all, an approach that the traditional Chinese practitioner would not allow. As my visit drew to a close, however, it became increasingly apparent to me that cultural diversity only goes so far, and that there may well be a bedrock of desires, expectations and needs common to all patients that any culture and medical establishment must somehow accommodate in order to be successful. Many clinicians in Taiwan are seeing traditional Chinese culture, on its own terms, as challenged by the new technologies and therapies of 21st-century medicine. As a result, I came to understand that they are curious not so much about how we in the West deal with such issues, as about how their own tradition can deal with them as they move forward. 4D Winter 2003 E loffal1 Pbysiciu 39 �DEVELOPMENT E W S The Road Best Traveled By Linda J. Corder, PhD, CFRE UR STUDE TS TRAVEL many paths to reach medical school. One of the most interesting journeys is that of Kim Griswold, MD '94, MPH, whose work with refugees is highlighted in this issue. Kim grew up in San Antonio but moved East to attend Bard College, where she majored in acting. She then took a job in summer stock in Virginia, later moving to Boston to work for the Boston Repertory Company and to be near her parents, who had relocated to Massachusetts. When her mother became ill with breast cancer, Kim moved home to help. Shortly after her mother's death, she spent several weeks in the hospital herself, recovering from injuries sustained in a horseback riding accident. With her acting career on indefinite I I hold, Kim spent many long hours in the hospital bed thinking about what she would like to do with her life. Her primary doctor provided a possible answer: "nursing." She enrolled in a two-year program at Syracuse University and after graduation went to work at Massachusetts General Hospital in neurology. After five years, a neurologist-mentor asked ifshe had ever considered medical school. She said she hadn't because she was sure she "couldn't do it"; but the question led Kim to realize she needed a new challenge. Eventually this same mentor suggested public health, and Kim entered the MPH program at Yale University. Her work at Yale brought to the fore an interest in displaced populations, and a fellowship resulted in her spending ten months at Oxford University, where she studied the delivery of health-care services. After she completed her MPH degree, Kim's father, who had remarried and moved to Buffalo, suggested that Kim consider moving to Buffalo, as well. She did, and took a job writing grant proposals for UB's School of Health Related Professions. Later she worked with the Department of Pediatrics, helping to obtain a grant to study developmental problems of children with severe disabilities. She then began to teach research methods in the Family Medicine Department and approached a 40 l ulf al1 Hysicin Wt11t e r 2 00 3 mentor-supervisor with a request for flexibility so she could pursue a PhD. He said no, but added that he would support her studies if instead she pursued a medical degree. This time she took the suggestion seriously and went back to school to complete prerequisite science courses. As the application deadline approached, her mentors wrote letters acknowledging her nontraditional path, but whole-heartedly endorsing her admission. Once admitted, it wasn't easy. The socialization process was " overwhelming," says Kim, who turned 39 the day of her first anatomy exam, which she failed. But she worked, I I she studied, she cried, and by the end of I her first semester, she had passed everyI thing. It was the turning point Kim needed, and from then on, she knew she would succeed. In deciding on an area of practice, Kim was conflicted until one day she finally "just knew family medicine was it." The field allows her to combine all the elements she encountered on her road to medical school, including public health and research. And, along the way, Buffalo had become home: Her family and friends are here, and she feels she is in her element in the city, whether it be practicing on the west side, teaching medical students or conducting research in the Family Medicine Research Institute. In addition to other ways that Kim gives back, she has initiated two endowments: a scholarship fund to honor Adelaide and Brendan Griswold, who encouraged her to "consider Buffalo"; and the Family Medicine Research Fund, which will eventually underwrite research combining many of the areas of interest reflected in Kim's circuitous journey to medical school. 4D Linda (Ly n) /. Corder is associate dean for alumni affairs and development. She can be contacted via e-mail at ljcorder@buffalo.edu; or by phone at 1-877-826-3246. �Spring Clinical Day and Reunion Weekend Class of' 58 / Mike Genco, MD, '58 and Mickey Stein, MD, '58 Mark your calendars It's not too early to plan for the 2003 Spring Clinical Day and Reunion Weekend. A cocktail reception will be held Friday, April 25, 2003. The 66th Spring Clinical Day and Reunion Dinners will be on Saturday, April 26. For more information, turn to Patty Duffner's message on page 43, or call the Medical Alumni Association office at (716) 829-2778. Our 45th reunion . • • Can you believe it? We have much to be thankful for much to look forward to. We'll see you in April! \Class of '63 Charlie Tyrone, MD, '63 The face of medicine has changed drastically since 1963. Has yours? Make plans now to attend our 40th reunion in Buffalo. Let's get reacquainted and reminisce about the Class of' 43 / good old days. Ralph Behling, MD, '43 Plans are still evolving! There are 37 "old timers" who are contemplating our 60th! I hope to be there and hope you will be there too. Class of' 68 / Tom Cumbo, MD, '68 and Bob Milch, MD, '68 Class of '48 / Dan Fahey, MD, '48 We are putting together a 35th reunion weekend that should prove enjoyable, and we sincerely hope you will make every effort to attend. Plans are well underway to celebrate the 55th anniversary of our graduation from med school. Wouldn't it be great if all 41 surviving alumni of our class could attend? / Class of '73 Arthur Mruczek Sr, MD, '73 and Michael A. Sansone, MD, '73 We have accomplished great things with our degree from '73! Our 30th reunion success depends on your participation ••. Come and share your triumphs with us and see how UB has changed! Class of'53 Bert Portin, MD '53 "Hey everyone, great 50th party planned. Look forward to seeing you!" Class of '78 / David Marchetti, MD, '78 Don't miss a chance to see old friends and get caught up on what they're up to after 25 years. W in ter 2003 l uff 1 l1 Hysici11 41 �D EVE L O PM EN T E W S Class of '83 / Ken Zimmerman, MD '83 1983 ••• 2003 -The more things change the more they stay the same. Come see for yourself. Which can you afford to waste? /Class of '88 Helen Cappuchino, MD, '88 and Andy Cappuchino, MD, '88 1988--We were listening to Michael Jackson sing "The Way You Make Me Feel" and Bobby McFerrin sing "Don't Worry Be Happy." Gorbachev withdrew troops from Afghanistan and the U.S. PeachKeeping Force won the Nobel Peach Prize. The World Series was between two teams from California. Andy still had hair and we had only one child! AND, we all graduated FEATURES BENEFITS • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction from UB med school! Join our classmates on April 26 to reminisce and have fun. We really hope to see you for this great weekend! Class of '93 / Ray Ogra, MD, '93 "Can you believe it's been over 10 years since Renier had his accident with bleach and transformed himself into "Carrot-Top" ? Or since yours truly asked the stupidest question ever (hint: cadaver and wax·injected vessels)? Do you remember the Follies? The H.O.P.E. clinic? The Dive of the Week? The Talent Show? We've all come so far and have so many great memories to share, so come join us this April for our loth year class reunion! • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Practice management with • Gain peace of mind from professionally trained staff and knowing that your finances are experienced C.P.A.'s being managed optimally /Class of'98 Thomas A. Maher, C.P.A. President Michael Zionts, MD, '98 Can you believe it's already been five years? Come back and see who is doing MEDICAL BILLING SPECIALISTS what, and where! 42 1111111 Pbysitill Wint e r 2 00 3 50 Alcona Avenue Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com �Dear Fellow Alumni, he highlight of the year thus far for the Medical Alumni Association (MAA ) was the Past President's Dinner, in which we honored our Distinguished Alumnus of 2002, Thomas Lawley, MD '72, dean of the Emory School of Medicine (see article on page 23 ). University at Buffalo has had many alumni who have made significant contributions to the field of medicine, but Tom is really special, and I was honored to be able to present him with this award! As I mentioned in my last message, Spring Clinical Days will be held April25-26, 2003. This year Marty Brecher, program chair, and I would like to highlight the UB Center of Excellence of Bioinformatics and the Buffalo/Niagara Medical Campus (see article on page 32 ). The welcome cocktail party will be held on April 25 (Friday night) at the Jacobs Executive Mansion (the old Butler Mansion ) on Delaware Avenue. The formal program on bioinformatics will be held Saturday morning, April 26, in Hillboe Auditorium at Roswell Park Cancer Institute, and the speakers will include Dr. Jeffrey Skolnick, who will deliver the Stockton Kimball Lecture, Dr. Bruce Holm, Dr. Robert Genco, and Dr. Rob Bakshi. An overview of present and future plans for the Buffalo/ Niagara Medical Campus will also be provided. Following the lectures, a luncheon will be held at the Buffalo Club. This should be an exciting conference, which I know both out-of-town and local alumni will enjoy. In another development regarding one of the MAA's most successful programs-the PhysicianStudent Mentoring Program-! would like to announce that Debra Stamm, assistant dean for student services in the Office of Medical Education (OME), has graciously agreed to assume administrative responsibility for the program, with support from our MAA Governing Board member Marty Mahoney. The program had previously been administered through the Office of Development and Alumni Affairs, which recently underwent staffing changes that limited its ability to continue management of the program. The staff in OME maintain close contacts with the medical students, and we feel they will do an excellent job of matching students with the appropriate mentor. Another important change in the MAA relates to our finances, including dues and expenses, which up until now had been managed by our administrative secretary, who retired last year. After much thought, the Governing Board has decided to enlist the services of the University at Buffalo Foundation (UBF) to collect dues and manage our accounts. UBF has experienced accountants with auditing oversight, and I personally believe these professionals will offer an increased level of financial security for our organization. Finally, the Medical Alumni Scholarship Endowment has grown significantly following a very generous gift from AI Dobrak, MD '39. Our goal is to raise the endowment to 1 million so that we can increase the number of scholarships we give each year (see page 22 for this year's recipients of the scholarship). Please donate generously to your class gift for the scholarship endowment! And please remember to put Spring Clinical Days on your calendar. We're very excited about the program, and know you will enjoy seeing the new campus and hearing about plans for its future. J,b~,:?.~ President, Medical Alumni Association Win t er 2003 llfllll Pbysician 43 �C L A S N 0 T E Cedric M. Smith, MD '52 (started with the Class of '52; graduated with the Class of '53, with an MD/MS degree.) Currently, Smith is a professor emeritus in the Department of Pharma· co logy and Toxicology at the University at Buffalo School of Medicine and Biomedical Sciences, and associate research scientist in UB's Research Institute on Addictions. He also teaches pharmacokinetics and sources of quality drug information to residents in psychiatry. He spends the majority of his time following up on publications he has authored. (Over the past ten years, he has authored 22 scientific/medical articles and edited two pharmacology textbooks and 25 abstracts and book reviews.) 1950s Phoebe Sat uren, MD '52, physical medicine and rehabilitation, lives in Nyack, Y. She writes: "The May 2002 50-year reunion of the Class of 1952 was spectacular, as was our class party and the clinical day. I spoke to the residents in rehab about the growth of pediatric rehabilitation over the years. Dr. Thomas Polisoto hopes to invite more alumni physiatrists to lecture. I also attended a Sunday brunch with some of the students who wanted to meet with alumni. I think this event should continue." E-mail address is: saturendoc@aol.com. He writes: win addition, I have some pet projects such as renewing antique family Ben Celniker, MD '57, ob- photographs, cultivating numerous medicinal stetrics-gynecology, lives in Phoenix, AZ, where he works in a group practice and is on staff at the Maryvale Hospital Medical Center. Favorite medical school memory: "Putting sugar in Harris Kanel's urine in biochemistry class." plants, and studying the yellow bird of the tropics-the Bananaquit and its appetite for sugar and alcoholic beverages. wl am also involved in an active medical/ legal consulting practice specializing in describing the time course of alcohol effects and blood levels and adverse reactions to psychoactive drugs. " My wife, Katerina Kobakof, and I are blessed with five children and nine interesting and active grandchildren. We are challenged to keep up with gardening around our house that over looks the Niagara River. During at least part of the winter you can find us walking/biking the beach of Jekyll Island, GA. Although we are beginners at golf, we fre· quently conclude, along with many others, that golf 'is a good walk ruined. '" E·mail address is: cms23@buffalo.edu. .... la f f al1 Hysici11 Winter 2003 1960s Richard H. Daffner, MD '67, is a di- agnostic radiologist affiliated with Allegheny General Hospital in Pittsburgh, PA. He and his wife, Alva, have two children: Marc, 33, and Scott, 29. Favorite medical school memory: "Summer radiology preceptorship with Dr. George Alker in 1966, which convinced me to become a radiologist." E-mail address is: rhda ffner@netsca pe. net. David Silverstein, MD '72, ophthalmology, lives and works in Saratoga, CA. Favorite medical school memory: "Saturday morning anatomy with 0. P. jones." E-mail address is: dsseyedoc@aol.com. Mark Zlotlow, MD '72, 1970s Sanford J. Holland, MD '72, anesthesiology, lives in Scranton, PA, and is on staff at Moses Taylor HospitaL Favorite medical school memories: "The 'Kent State' year (1970): Erie County K-9 cops on campus; tear gas in Norton Union; no sophomore final exams in pharacology, pathology or microbiology." E-mail address is: sanfordh@mth.org. Joanne Levitan, MD '72, is a diplomate of the American Board of Surgery, and the American Board of Plastic Surgery, with added qualifications in surgery of the hand. She lives and practices in St. Clair Shores, MI. She is in group practice and is affiliated with the Harper Hospital in Detroit and the Cottage Hospital and Bon Secours Hospital in Grosse Pointe. pediatrics, lives in Sacramento, CA, and is on staff at the Kaiser Foundation Hospital in Sacramento and Roseville. His favorite medical school memory: "Buffalo General HospitaL" E-mail address is: mark.zlotlow@kp.org. l ewis R. Groden, MD '77, ophthalmology, lives in Tampa, FL. He is director of the Ophthalmology Residency Program and director of the Cornea Service at the University of South Florida. He is also medical director of Lasikplus Vision Centers in Tampa. E-mail address is: doccornea@aolcom. 1980s Jill Brody, MD '82, internal medicine, lives in Providence, RI, with her husband, R. Nicholas Camp, and their two children, Michael, 16, and Sabrina, 14. Favorite medical school memories: "Biochemistry with Alexander Brownie; neuroanatomy with Harold Brody; medical sub-internship at ECMC; getting done with �Timothy P. Bukowski, MD Paul B. Karas, MD '87, lives '87, FlAP, FACS, has opened in Cheektowaga, NY, with his wife, Donna, and a new office (Pediatric Urology of North Carolina) in Raleigh, NC. Following graduation from UB, Bukowski completed his surgical/urology residency at Wayne State University. After a pediatric urology research fellowship at Cincinnati Children's Medical Center, he returned to Children's Hospital of Michigan to complete his accredited pediatric urology fellowship. From 1995-2001, Bukowski was director of pediatric urol- anatomy." E-mail address is: ralph.camp @verizon. net. Manuel Leonardo Saint Martin, MD '82, lives in Los Angeles, CA, where he has a solo practice in forensic psychiatry. Favorite medical school memory: "All of it. Working with Roberta Pentney, PhD." E-mail address is: cerberus 1113 @hotmail.com. Jessica Rockwell, MD '82, endocrinology, lives in Cooperstown, Y, with her husband, Peter Jederlinic, and their three children: Nicole, 17, their three children: Paul B. (Ben), Jr, 10, Andrew Jay (AJ), 8, and Catherine, 5. He is in a group practice and on staff at Sisters Hospital in Buffalo. Favorite medical school memory: "Getting accepted to the school as a transfer student." E-mail address is: bandofive @aol.com. Adam Ashton, MD '87, psy- chiatry, lives in East Amherst, NY. He and his wife, Cindy, have three children: Evan, 10, Leah, 8, and Alexis, 6. Favorite medical school memory: "Playing drums in the Follies Talent Show bands." E-mail address is: aashton@buffalo medicalgroup.com. ogy at the University of orth Carolina at Chapel Hill, where he received several teaching awards; and from 2001-2002, he was chief of pediatric urology at Children's Hospital of Michigan in Detroit. Bukowski is a Fellow of the American College of Surgeons, F;:i!cw of the Society of Pediatric Urology, and Fellow of the American Academy of Pediatrics, Section on Urology. He has an active interest in laparoscopy and fetal urologic intervention. He and his wife have four children. Sheri Baczkowski, MD '92, is an obstetrician/gynecologist and lives in Williamsville, NY. She Bonnie Orzech, MD '87, is a pediatrician and lives in Finksburg, MD. She and her husband, Bert Nixon, assnotes Alex, 15, and Eric, II. She is board certified in internal medicine and endocrinology and is on staff at Bassett Healthcare. Favorite medical school memory: "Biochemistry classes with Alexander Brownie." and their one-year old daugher Emma. She completed residency training in neurology at the Mayo Clinic in 1996 and is currently on staff at Fairview Southdale. E-mail address is: jald@ dnamail.com. have three children: Bryan, 7, Beth, 4, and Brooke, 2. Favorite medi- and her husband, Jerry Wild, have two-year-old twins, Jenna and Mia. Favorite medical school memories: "Dive of the week, studying in the Study Room, the holiday part and the formal." E-mail address is: wildplace@aol.com. Judine Davis, MD '92, cal school memories: "Friends, parties, snowdrifter!" E-mail address is: bfnbon@aol.com 1990s Janiece Aldinger, MO '92, lives in Edina, MN, with her husband, Tim Clavin, Winter 2003 obstetrics/gynecology, lives in Hamburg, Y, with her husband, Jeffery, and their twoyear-old son Liam Jeffrey Davis. She works in a group practice and is on staff at Sisters Hospital and Kaleida. Favorite medical school memory: "Transition from second to third year, after exams and boards-a really great celebration!" l uff a l• Pb ysiciaa 45 �CLASS Mark Ippolito, MD '92, lives in Davidson, NC, and is on staff at the Northeast Medical Center in Concord. He and his wife, Donna, have two chi!dren: Arielle and Ethan. He completed residency training in neurology at the ational Naval Medical Center in Bethesda, MD, in 1996 and a neurophysiology fellowship at Walter Reed Army Medical Center in Washington, DC, in 1999. He is board certified in neurology, clinical neurophysiology and electro- NOTES diagnostic medicine. E-mail address is: ippolitofour@yahoo.com. lldiko Mikos (Gyimesi), MD '92, plastic surgery, lives in Louisville, KY, with her husband, George, and their two children, Christopher, 4, and Anthony, 3. She completed residency training at UT Southwestern in Dallas, TX, in 1997, and a fellowship in breast reconstruction in Atlanta, GA, in 1997. She is on staff at the Baptist Hospital East. E-mail address is: lldikom@aol.com. Alphonse Daniel Osinski, MD '92, psychiatry, lives in Mount Kisco, Y. Residency training was split between Sheppard Pratt Hospital in Baltimore, MD, and Cornell Medical Center in New York City; completed a fellowship in child psychiatry at the Sheppard Pratt/University of Maryland )oint Program in 1998. "I am on the faculty of Mount Sinai School of Medicine and work at a satellite program at the Elmhurst Hospital of Queens, as a unit chief on an inpatient Keyser Cadillac Upstate NelNYorks only exclusive Cadillac Dealer Keyser Cadillac 4130 Sheridan Drive · Williamsville. 1\lY 634-4100 key ercadillac.com 46 laff al• Hysiciaa Wi11ter 2003 adolescent psychiatric unit. (And I love it!)." Favorite medical school memory: "In some ways I took it all far too seriously, although I remember, with thanks, support I received in various study groups-and some fun, too. Sorry I couldn't make it [to the reunion] E-ma this time guys, but I'll come to one in the future. My best wishes to everyone for success in all aspects of your lives." E-mail address is: alosinski@aol.com. Donna (Sinensky) Ferrero, MD '94, recently moved from Boston, MA, to • • Classnotes can also be submitted by e-mail to: bp-notes@buffalo.edu "Hi, I'm Susan Hunt. I invite you to come to see my Mom's new home ... the Amberleigh Retirement Community. You 'll smile too!" .AB~~nf~~nity 2330 Maple Road, Williamsville For a free brochure or personal tour, call 689-4555 �- ==----------- Rochester, Y, with her husband, Vincent, and their IS-month-old daughter, icole. She works as a physiatrist at Strong Memorial Hospital and is assistant professor in the Department of Orthopedics at the University of Rochester. E-mail address is: vferrero 17@aol.com. Jeffrey W. Kanski, MD '94, has joined the Radiation Oncology Department of the Massachusetts General Hospital and the faculty of the Harvard Medical School. Thomas Burnett, MD '94, and Carol Ann Killian, MD '94, are pleased to an- nounce the birth of their son, Matthew Killian Burnett. He was born March 14, 2002, and weighed 8 pounds, 2.5 ounces and was 21 inches long. Big sisters, Kristen (4 112) and Lauren (3), love their little brother and are enjoying preschool. Tom continues to practice internal medicine in a large multi-specialty group, and Carol Ann practices emergency medicine per diem at two local emergency departments." E-mail address is: tburn @cloud9.net. got married (September 28, 2002) to Todd Wilkerson, who works as a project manager for UPS corporate headquarters. E-mail address is: lesleywilke @aol.com. Lesley (Orman) Wilkerson, completed her residency in internal medicine at the University of Maryland in June 2001. She and her husband, Rajat Bannerji, PhD, MD, subsequently moved to the Seattle area, where she is in her second year of an Rachna Gupta, MD '98, MPH, MD '97, completed her residency in pediatrics at the Childrens' Hospital of the King's Daughters in Norfolk, VA, in 2000, and currently works for Children's Healthcare of Atlanta, GA. She recently infectious disease fellowship at the University of Washington. Her husband is a hematologist/ oncologist at Madigan Army Medical Center. They are also excited to announce the arrival of their daughter, Aradhana Bannerji, born June 16, 2002 (Father's Day). Rachna welcomes e-mails from friends from the classes of 1997 and 1998. E-mail address is: rachnag@u.washington.edu. «D SAVE TIME . •• Order your medical books online at efollett.com Mention this ad and get 5°/o off your next in-store purchase! T..:J... University at Buffalo ~ The State University ofNew 1Vrk UNIVERSITY BOOKSTORE Main Street • Phone:(716)833-7131 www.buffalo-medical.bkstr.com Winter 200 3 I u I I I I D Physic i I D 47 �In Memoriam Orvan Hess, MD '31 when he administered the Health for the State of Orvan Hess, antibiotic to a 33-year old Vermont. During his tenure, MD, '31, died mother who suffered from leopold developed one of on September scarlet fever and a blood the nation's first statewide 6, 2002, infection following a miscar- system of community-based after a brief riage. Her fever broke the mental health services. After illness. He next day and she lived to be a brief stint as an associate was 96. Hess, an obstetrician/ 90 years old. Hess also pioneered the gynecologist by training, was study of healing wounds fol- a medical pioneer who devel- lowing Cesarean sections. oped the first fetal heart "He was a leader in the professor at The Johns Health and Hygiene, he returned to direct patient care, serving in hospital medical community," says settings with the Veterans physician in the United Timothy Norbeck, executive Administration in New York, States to administer penicil- director of the Connecticut Florida and Virginia. lin to treat a life-threatening State Medical Society. "He illness. He spent his 50-year was also one of the friend- at Johns Hopkins, he served career in New Haven, deliver- liest people on earth-pro- as a part-time faculty at UB ing thousands of babies at fessionally and personally." emeritus of obstetrics and .Jonathan Porter A. Leopold, MD '51 gynecology at the Yale Uni- Jonathan Porter Aaron In 1937, while still a resident, Hess began working on a machine that could monitor the heartbeats of In addition to teaching (1957-1965), the University of Vermont (1965-19721 Yale-New Haven Hospital and versity School of Medicine. leopold, MD '51, died on and the University of South Florida at Tampa (19871990). leopold also served on numerous advisory grams at the Brookings huntrealesta te.com September 22, 2002, at his boards and participated in home in Richmond, VA. leadership development pro- leopold retired in 1996 after a distinguished career Institute and the National of more than 45 years as a Institutes of Health. World War II broke out, he physician, public official and leopold is survived by left research to join a U.S. educator. Following gradu- his wife of 21 years, Anita, Army medical team that fol- ation from UB medical and his children: Jonathan lowed General George S. school in 1951, leopold P. A. Jr of Burlington, VT; Patton's Second Armored completed residency train- James S., of West Danville, Division through North Af- ing in internal medicine at VT; Christopher B. of Walter Reed hospital in Shelburne, VT; and Elizabeth After the war he resumed Washington , DC, and A. leopold of Greensboro, his research, and in the served as a captain in the VT. He is also survived by mid-1950s he and another U.S. Army Medical Corps. In his former wife, Barbara, of physician developed a ma- 1954, he joined his father, Shelburne, VT: his brother chine that could pick up and Francis, in private practice David Francis leopold of of internal medicine. After a South Burlington, VT: and record electrical heart signals of a fetus during labor, launching the field of fetal cardiology. In the years that followed , Hess worked to refine the fetal monitor and reduce its size. In 1942, Hess participated in the first clinical use of penicillin in the world residency in psychiatry in his stepchildren Kenneth 1958, he began his public Callahan, Peter Callahan, career as a staff psychiatrist and Patrick Callahan. and, later, as director at we help people move. Call for a free relocation portfolio regarding your destination city. Calll-800-688-1170 or go on-line and visit our web site at unborn children. When rica, Sicily and Normandy. HU. 'T REAL ESTATE ERA Hopkins University of Public monitor, he was also the first becoming clinical professor RELOCATION Totally customized service p ortfolio in cludin g • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured In lieu of flowers, Niagara County Mental the family requests that Health Services. In 1964, contributions be made in Governor Philip Hoff ap- leopold's memory to the pointed leopold as the first UB School of Medicine and Commissioner of Mental Biomedical Sciences. Hunt ERA Relocation Center 5570 Marn Street Williamsville, NewYor1< 14221-5410 48 l a ff al1 Plysitill Wi11ter 2003 Email: huntrelocallon@huntrealestate.com �Three i11tercowzected buildi11gs \\Jll make up the Buffalo L1fe Soences Complex on the l3ut1alo- 1agara Medical Campus (l3NMC). 1()() acres bordered by Mam Street. orth Street. Michigan Avenue and Goodell Street. Pictured. abol'c /~ft, is the Umversity at But1alo Center of Excellence in Bioinformatics, and, abtwc r('(ht, Roswell Park Cancer Institute's Center for Genetics and Pharmacolot,'Y· A third building, headquarters for Hauptman-Woodward Medical Research Insntute, not pictured. will be constructed to the left of the Ul3 building. for more information on the BNMC. and \\·ork under way in l3iomformaucs, see article on page 32. ,lt the Ul3 Center of Excellence �p H A R M A c p 0 E I A 0 LB ' 'HISTORY Of 1EDICI ' E ( OLLEC.TIO PRESF TS PHARMA C OPOEIA This illustration was digitally reproduced from offizinellen Cewachse, a four - volume edition of pharmaceutical plants and their medicinal uses, published in German in r863. The pharmacopoeia by Otto Karl Berg (1815-1866) is part of the Robert L. Brown History of Medicme Collection, located in the Abbott Hall Health Sciences Library. Picture here is the Apple, Pyrus malus, one of a series of botanical F images digitally restored as part of an initiative to preserve and highlight X ~ I 0- 1/ / a 0 1' unique resources from a.(/ the library's collection. Reproductions c are available for purchase through the library, and can be viewed online at i Media. buffalo. ed u/art/. Image restoration was performed by iMedia. " the instructwnal media r services department of Computing and Infor mation Technology at the University at Buffalo. 8POOO Ol � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2003 Subject The topic of the resource State University of New York at Buffalo. 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Family Medicine, a Global Perspective A Degree of Latitude On Course Medical School Alumni Pathways Research Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v37n03 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. 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